Tag Archives: Medicine

Psychologists Want an Alternative to the DSM

In another life (or a different timeline, if you prefer) I didn’t change paths and continued on to become a clinical psychologist. In that life (or timeline), I, and many other psychologists are using something totally different than the DSM and the psychologists in this timeline are jealous. Confused?

Recent research published sought to see if the attitudes of psychologists, with regard to the DSM, have changed at all. It turns out, they haven’t:

The results are no different from what was found three decades ago, namely, that a significant number of psychologists are unhappy with the DSM, but almost all of them use it.

So, why do we continue to update the DSM instead of scrapping it and making something better? Well, that’s probably a can of worms for a different post, but it seems telling that in 30 years that psychologists still aren’t happy with what is supposed to be a very important source book for the profession. More than that, as 30 years have spanned, it’s fair to say that even the next generation of psychologists aren’t warming to the DSM.

In reading this study, the most troubling sentence comes from near the end of the article [Emphasis Added]:

They appreciate its help in making diagnoses and supplying reimbursable diagnostic codes, but continue to have scientific, professional, economic, and ethical concerns about it.

That’s troubling, indeed. Scientific, professional, and ethical!

It seems to me that a profession whose bedrock is based in morality and ethics should be motivated to rectify this concern. If they were to change things, what would they change it to? [Emphasis Added]

Even though they may not see the categories in the DSM as merely problems in living, psychologists are interested in alternatives not rooted in the medical model common to the DSM and ICD. Psychologists might be prepared to further develop and use psychologically focused diagnostic alternatives if conditions encouraging them to do so were in place.

That sounds congruent. I remember my time in as a doctoral candidate and many of my colleagues at the time were far more interested in modes of analysis that didn’t subscribe to medical models. There are a number of reasons for this, but for this kind of a wholesale change to occur, I think there needs to be a push from the APA. I suspect that other psychologists would agree with that, but there’s also the possibility that there’s some sort of grassroots “uprising” that starts with individual psychologists. The one hitch with that possibility that I see is that many psychologists work on their own. That is, instead of working alongside their colleagues, they have their own office space and work by themselves. I think if psychologists had something resembling a “union” like there are in some other professions, it would be far easier for them to organize and create the kind of change they’re looking for.

To be clear, I’m not advocating for or suggesting that psychologists should form something like a union, I’m merely saying that if there were this kind of infrastructure in place, I believe it might be easier for there to be a change to the way psychologists diagnose.

ResearchBlogging.orgRaskin, J., & Gayle, M. (2015). DSM-5: Do Psychologists Really Want an Alternative? Journal of Humanistic Psychology DOI: 10.1177/0022167815577897

What if There Were Live Music at the Doctor’s Office?

There was a really interesting study published earlier this year that had live music in a medical waiting room. The aim of the study was to learn more about the staff’s perceptions of this live music, but as you might expect, the live music had an effect on patients, too:

One of the unanticipated results of the music program was that patients often play the piano in the clinic waiting room. This code emerged frequently in the transcriptions and seemed to enhance staff abilities to initiate non-medical discussions with patients, potentially increasing rapport, trust, and therapeutic alliance.

That second sentence seems important. Allowing the patients to play the piano, it made for a more natural way for a staff member to initiate a conversation with them. I found the next sentence of particular interest:

Another unanticipated result of the music program was that patients often remained in the clinic after their appointments to enjoy the live music.

If someone asked you the probability that you’d voluntarily remain at the doctor’s office after your appointment, I bet almost 100% of people would say that there’s a 100% chance that they’re leaving ASAP.

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In thinking about this study, the one thing that I find *possibly* concerning is the novelty of the situation. That is, yes, having live music in the doctor’s office would be a new (and enjoyable) experience for many, but I wonder if patients (or staff) would habituate to there being a live musician in the waiting room. And as a result of this habituation, would the positive benefits ‘wear off?’ I suppose given how infrequently we go to the doctor’s office in a calendar year, instead of habituating to the experience, maybe it’s something we look forward to doing. Can you imagine your teenager saying to you, “Yes, I hurt my arm, we get to go to the doctor’s office!”

OK, that probably wouldn’t happen, but I really like this idea of having live musicians in the waiting room. The marriage between live music and waiting rooms seems obvious, especially given the healing qualities of live music. This could also be a great opportunity for younger musicians who have a hard time cracking the lineup at some venues. Instead of playing on street corners or in the subway, they could share their music within the medical community.

ResearchBlogging.orgSilverman, M., & Hallberg, J. (2015). Staff perceptions of live classical music in an urban medical clinic: A qualitative investigation Musicae Scientiae, 19 (2), 135-146 DOI: 10.1177/1029864915583375

Women and Words: Women Who Read Objectifying Words More Likely to Seek Cosmetic Surgery

I’ve tried to write about this article on a few occasions and had to stop because I simply felt terrible with the implications of the research. In short, as the headline of this post suggests, when women read words that are objectifying, they’re more likely to seek cosmetic surgery. I’ve written about the importance of words and how they can have an effect on us in the past, but this is one of the first times I’ve written about it with such awful implications. Here’s a bit more from the researchers:

Our results provide the first evidence that intentions to pursue cosmetic surgery stem (in part) from being in a state of self-objectification— a state where women are focused on how their bodies look in the eyes of others as opposed to what their bodies can do. Compared to the non-self-objectifying conditions, women primed to self-objectify reported more body shame and a greater intent to pursue cosmetic surgery.

You might consider this finding to be intuitive, but it’s really important when research like this is published and we can say with more conviction that the words we use can have a catastrophic effect on some people. In particular, impressionable young women. I should clarify that I don’t mean for that to come across as paternalistic. The study focused on women (and didn’t include look at whether this effect holds in men, too).

While the headline from the article is mostly “Bad News Bears,” there’s still a ray of hope to be found [Emphasis Added]:

In addition, we found that body shame was significantly lower among women primed with the non-self-objectifying physicality words compared to the neutral words. This finding suggests that exposure to text that emphasizes body functionality and competence without a focus on observable physical attributes may be protective against selfobjectification and body shame.

As the researchers suggested, this should be subjected to further investigation. Regardless, these findings are very important for all of us who write for consumption in any form, but probably more so for folks who write for consumption by young women. Before I end this post, I wanted to include a few more passages from the article that I think are important, with some commentary [Emphasis Added]:

Our research has a number of implications for practitioners. First, knowledge of this link between self-objectification (stemming from a sexually objectifying environment) and intentions to have cosmetic surgery should be useful to practitioners who work with girls and women. In particular, it is necessary to move beyond the understanding that sexual objectification makes women feel bad per se to identify the potentially harmful actions against themselves that women might take in response to such encounters.

For those who are in any kind of counselling profession or role, this seems very important. Understanding the actions that a client/patient may take as a result of their state can be key to offering the right kind of counsel.

Second, community members who wish to advocate for girls and women—including activists, educators, counselors, and policymakers—must raise awareness of the harms of self-objectification more consistently, including the pressure to undergo risky elective surgery.

Raise awareness. That’s why, despite my difficulty in trying to complete this post, I persevered. Persevere is probably too strong of a word, but I felt it important to write this, so that when you read this, you may consider changing your behaviour and hopefully, educate those around you in the hopes that they may change their behaviour, too.

Third, more emphasis should be placed on expanding the self and identity of girls and women to provide other domains in which they can glean social rewards and secure esteem beyond a sexualized appearance.

Please, please, please, rent/buy Miss Representation and tell your friends about it. It’s one of the most succinct (and recent) documentaries exploring the issues with how women are portrayed in the media.

Fourth, it is necessary to provide girls and women with specific actions that can be taken in the face of sexual objectification that do not require modification of one’s body in order to arm them with a greater sense of control over these largely uncontrolled and uncontrollable situations.

This goes back to that first point about those in the helping professions — it’s so important that one is able to offer a different avenue of action for one who is seeking out something like cosmetic surgery as a result of self-objectification.

Fifth, to the extent that self-objectification might be a risk factor for repeated surgery and low satisfaction with surgical outcomes, engagement with cosmetic surgery professionals to at least think about the implications of these patterns is worthwhile.

Almost as a “last resort” kind of thing, as the researchers suggested, it would be important for folk who work in cosmetic surgery offices to have knowledge of this issue of self-objectification (through the words they’ve read). While it may not be “good for business,” I would hope that for folks who work in this industry, counselling their potential clients on research like this would come first. I should clarify that I don’t mean to imply that anyone working in the cosmetic surgery industry is simply in it for the money, it’s as noble as any other medical field (consider those who work in plastic surgery, which is the umbrella that cosmetic surgery falls under, that seek to help burn victims).

Finally, it is critical that practitioners take up the challenge of changing the system of sexual objectification that perpetuates self-objectification and the concomitant consequences in the first place (Calogero & Tylka, in press). In light of the potential risks of undergoing any surgery and anesthesia, the pursuit of elective cosmetic surgery may represent another harmful micro-level consequence of selfobjectification for women, which will require our attention on many fronts.

ResearchBlogging.orgCalogero, R., Pina, A., & Sutton, R. (2013). Cutting Words: Priming Self-Objectification Increases Women’s Intention to Pursue Cosmetic Surgery Psychology of Women Quarterly, 38 (2), 197-207 DOI: 10.1177/0361684313506881

More Scientific Evidence That Beliefs Affect Biology

If you’ve been following me since I started writing on the internet a couple of years ago, you know that I have a certain soft spot for the power of belief (sampling: here, here, here, and here). I understand that many folks are still leery of that phrase, but when you couch it in the context of the “placebo effect,” it’s amazing how many people begin to accept it as a thing.

Depending upon your philosophical bent, you may believe that willpower is a depletable resource. You certainly wouldn’t be alone in that thought, as President Obama seems to subscribe to this point of view. There are also those who believe that willpower is not a limited resource. So, which one is it? A simple question without a simple answer. It’s important to remember that depending upon from which point we begin, we may be less inclined to believe the other side of the story (remember the confirmation bias?) As much as possible, it’s important to try to take in new information with an open mind. With that being said, (regardless of where you stand), try to examine the following study with an objective and critical eye.

…following a demanding task, only people who view willpower as limited and easily depleted (a limited resource theory) exhibited improved self-control after sugar consumption. In contrast, people who view willpower as plentiful (a nonlimited resource theory) showed no benefits from glucose—they exhibited high levels of self-control performance with or without sugar boosts. Additionally, creating beliefs about glucose ingestion (experiment 3) did not have the same effect as ingesting glucose for those with a limited resource theory.

When I read this, my first thought was, as the title suggests, more evidence that our beliefs can affect our biology (see: Biology of Belief). Of course, I understand if some folks have a hard time jumping on board with this, so, like I said, couching it in the language of the “placebo effect” seems to make it more palatable.

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After reading this, I’d encourage you to follow-through with application. That is, now that you have this knowledge, apply it to your own life. Test it out. See what works for you. Maybe you used to believe that willpower was a limited resource, but after reading this, think the opposite. It’s certainly worth taking a chance, right?

If Laughter is the Best Medicine, Why Don’t Doctors Specialize in It?

A couple of weeks ago, I heard the old adage that “laughter is the best medicine.” And then I thought to myself, if that’s true, then why aren’t there any doctors of laughter? Is there an degree-granting institution out there that issues doctorates in laughter? Shouldn’t there be?

I realize that idea is a bit off-the-wall, but bear with me for a moment. If laughter is the best medicine, shouldn’t we have comedians/comediennes in hospitals? Can you imagine that a doctor doing their rounds consisted of going to a number of patients and telling jokes? Wouldn’t that be fun(ny)! I wrote about medicine in the 22nd century a few days ago — maybe by then, we’ll have doctors who specialize in making their patients laugh. Probably not, but wouldn’t that be something?

So the whole idea of doctors who specialize in laughing may be a bit too far, so then I thought, wouldn’t it make a good bit? That is, wouldn’t it make for a good stand-up comedy bit. I’m certainly no expert in stand-up comedy and I’m sure that stand-up comedians often get their friends telling them (hey this might be funny) even though it’s not, but I think, with the right comedian, that bit could be really funny. To make it really work, I think the comedian would have to be really serious when telling the bit (but isn’t that true of most bits)?

Now that I think of it, I don’t know what I’d rather see more: an article that details a clinic in some remote village that has an LD (Laughing Doctor) or an article that details a comedian that’s a big hit because of the comedian’s bit about a doctorate in laughing.

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As an addendum to this, I saw a tweet this past week that makes the case that laughter isn’t just related to medicine!

 

What Will Medicine Look Like in the 22nd Century?

Every now and then, I like to watch some old episodes of Star Trek. I should clarify: I watch “The Next Generation.” I’m a little young for the original series. The Next Generation aired during my younger formative years (and how grateful I am for this). I often think that my strong sense of morals has a lot to do with the fact that I was often presented with ethical dilemmas through the vehicle of this show.

A few weeks ago, I happened to catch an episode from near the end of the final season: Thine Own Self. One of the two featured plot lines for this episode is Data‘s visit to a ‘primitive’ village. Data, suffering from amnesia, is taken in by this village. Maybe I should back-up and tell you how he got there. Data was sent on a mission to recover some radioactive material from a probe that crashed on the planet. Having suffered injuries during this recovery attempt, Data walks to this village (miles and miles away), carrying a box that says radioactive.

As I said, this village welcomes Data — at least for a little while, but I won’t get into all of that. The parts I want to focus on are those that occurred with the town’s healer. Because Data doesn’t know who he is, he is taken to see the town’s healer. Listening to her assessment of Data’s injuries and the like is a real treat. The way the healer reasons that this is causing that because of something unforeseen is just what you might expect from a pre-industrial society. That’s not meant to sound pejorative — societies do the best they can with what they’ve got.

I looked and looked for a clip of the healer diagnosing Data or of the healer diagnosing the members of the village (as some of them get radiation poisoning), but couldn’t find it. However, I was able to find a clip of the healer teaching some of the children about the elements.

Strange, eh?

After seeing this episode again, I had to think to myself, what are our assumptions in medicine today that will seem laughable in 100 years. What about in 300 years? What about in other fields? Will we laugh that we ever used to think that we weren’t able to communicate telepathically? What about seeing things at a distance? Will there still be poverty? Hunger?

Whenever we start to take ourselves and our assumptions too seriously, it’s important to remember the humble beginnings from which we come.

A Newfound Sense of Empathy: Taking Medicine for Dizziness or Headaches

When I got out of bed this morning, I wasn’t feeling very well. To be more specific, when I stood up, I felt a bit dizzy. The more I moved my head, the dizzier I felt. I laid down — dizzier, still. It wasn’t until I realized if I sat up, the dizzying feeling stopped. Now, this might not sound strange to a lot of you, but for me, being sick (or feeling unwell) is not something I’m familiar with.

I rarely — rarely — get sick. And when I do, it’s usually some kind of cold. The experience I had this morning was very humbling. There wasn’t a lot I could do to make myself feel better. I just sat there on the bathroom floor, trying not to think about … the things that usually happen when you’re sick. The best word I can think to describe it: humbling.

It’s important to rest when you’re sick, but when I wrote that piece, I didn’t consider the incapacitating feeling of being dizzy or having an “unusual” or abnormal feeling in your head. If your head’s not right, there really isn’t anything you can do.

I’m saying all of this because my experience this morning gave me a better understanding of why people take aspirin (or other kinds of pharmaceuticals). I suppose I’ve been rather lucky in life — I haven’t been very ill (or had many injuries). My one visit to the hospital was for taking a baseball to the face (maybe one day I’ll share that story on here). So, because I’ve had little need to take these kinds of drugs, I’ve always wondered why people appeared to be so dependent on them (I’m taking more about aspirin or things that help you when your sick, not other, more debilitating kinds of maladies/diseases). After my experience today, I have a newfound understanding for those who feel it necessary to take this kind of medicine.