Horizon - Living with autism

… and many more reviews, including the Beyond Seizures exhibition, burnout in sport, What the Thunder Said, and the Noba Project

A radio history of psychology

In Search of Ourselves:
A History of Psychology and the Mind
Falling Tree Productions
BBC Radio 4

In a new 25-part series on the history of psychology and psychiatry, and author and broadcaster Martin Sixsmith, who retrained as a psychologist, has turned his search for a better understanding of his own experiences of mental illness into an examination of the historical antecedents of psychology and psychiatry. My preview of the first five episodes suggests that this series will be an accessibly formulated survey of the ‘big-hitters’ of psychology and psychiatry peppered with fascinating historical clips from interviews with Freud, and others, musical soundbites, and commentary by eminent scholars. With reference to David Cameron’s ‘Happiness Index’ and the national implementation of the IAPT, Sixsmith asks how our culture has come to place such huge faith in psychology and psychotherapeutic techniques and whether the research tools of psychology can successfully be applied to such large-scale interventions in public and private life.

The series begins with the reformulated search for a modern ‘self’ as a product of Enlightenment ideas, which gave rise to a new application of scientific principles to mental disorder following the ‘death of God’ and the adoption of scientific inquiry into subjects previously reserved for religion. We hear about the pioneering techniques of German physician Franz Mesmer and French neurologist Jean-Martin Charcot, who opened up new ways of thinking about mental disturbance and the relationship between the physical and mental (see picture for example of his chronophotographic technique). We are shown how Freud’s exposure to Charcot’s successful use of hypnosis to cure physical ailments at Salpêtrière Hospital inspired him to develop new theories about unconscious thought which would join Marxism and feminism as key shapers of our modern society. Sixsmith’s narrative explains how through the development of a ‘talking cure’, with new emphases on early sexual experiences, Freud generated huge controversy in public and academic circles, which spurred a variety of competing schools of psychoanalysis.

From Freud and psychoanalysis Sixsmith moves on to the rise of behaviourism and the ultimate primacy of the scientific. Here the work of Pavlov, Thorndike, Watson and Skinner takes centre-stage as psychology became entrenched in the academic sphere and experimental research was favoured over the therapeutic relationship between analyst and patient. The series describes how these two opposing methods of explaining mental functioning and dysfunction were brought together by new work in the 1960s which, though still rejecting the psychoanalytic focus on the unconscious, returned to the milieu of the patient–therapist relationship and sought to integrate new behavioural research findings with patient descriptions of their conscious thoughts. Ellis’s rational emotive behavioural therapy, Fritz-Perl’s Gestalt therapy and Roger’s Person centred therapy are given as examples. The series continues on its historical tour with William James, Wundt, and coverage of psychiatric treatments before turning to the present-day branches of research. These episodes take in every facet of psychology from developmental to neuroscientific to problem-solving as well as Sixsmith’s stated aim of engaging with the influence of popular research trends and the ways that psychology is applied to societal issues such as Cameron’s Happiness Index.

Those familiar with the history of psychology will recognise the usual cast of well-known characters, and the predictable sampling of theories from around the globe. Though considerably enlivened with the addition of appropriate musical soundbites, and occasional references to concurrent cultural and philosophical developments, Sixsmith does not venture far from the standard names and places. However, the combination of historical content with modern research is novel, and Sixsmith’s promise to tackle the possibilities of applying psychology to modern life represents a relevant and important question in the face of government claims that ‘psychology will get us back to work’ and the underlying assumption that psychology can provide simple solutions to the exceedingly complex task of managing the vulnerable and unwieldily populations of the unemployed and unwell.

In Search of Ourselves promises to be a series of relevance to both experts and the wider public and perhaps even an opportunity for new talking points between psychologists.

- The series runs over five weeks Monday to Friday at 1.45pm from 21 April on Radio 4 or on iPlayer.

Reviewed by Nathalie L. Chernoff who is Associate Editor: History of Psychology

Clear and authoritative 

8 Keys to Building Your Best Relationships
Daniel A. Hughes

I’m always interested in anything new that Dan Hughes produces. In this case I think he has produced another fine book aimed at anybody who would wish to think or work on the quality of his or her relationships. This book, another in the series of emotional health self-help books all beginning ‘8 Keys to…’, is grounded in Hughes’s expert understanding of attachment theory and therapy. He was the creator of dyadic developmental psychotherapy to help fostered and adopted children bond with their carers.

He begins with a very clear description of the attachment processes helpfully illustrated with vignettes and explores areas such as early experience, brain function, emotional functioning and effective communication. This is a very readable book that will help readers understand themselves and their relationships better. Even as someone familiar with this area I found the clarity of his writing helpful. Many people are familiar with attachment theory but understanding exactly how it translates to social and emotional functioning can be difficult to grasp.

This book is a very helpful way in for many. I would have no hesitation in recommending it as a self-help book useful for not just for those who are having problems in their primary relationships but who would like a better understanding of themselves or an up-to-date account of the usefulness of attachment theory written in a clear and authoritative manner.

Norton; 2013; Pb £14.99
Reviewed by Dr Steve Killick who is with Cardiff & Vale University NHS Health Board 


Burnout in professional sport
Jonathan Trott: Burnout
Sky Sports 1

On 24 November Jonathan Trott left the England cricket team’s Ashes tour of Australia, one test into the five test series. England Team Director Andy Flower stated that he had left due to a ‘stress-related condition’. Many quarters of the media came to the conclusion that Trott was suffering from depression, as this was similar to the fate that had befallen former England internationals Marcus Trescothick and Michael Yardy during international tours. There was much sympathy and support for Trott at this time.

In an hour-long interview with former professional cricketer Ian Ward on Sky Sports, Trott revealed that he had in fact not been experiencing depression, but ‘burn-out’. He had become ‘physically and emotionally spent’, with perceived technical weaknesses in his game causing long-term stress for many weeks leading up to the tour. Trott reported being unable to concentrate on the ball as he batted, and experiencing severe headaches. He had been offered time off to rest, but instead insisted on playing in the home one-day series against Australia before the tour. His form merely dropped further, and he spent the remaining time before the tour practising intensely in the nets, giving himself just four days off.
All this begged the question: What is burn-out? There is no universally accepted definition, but it has been described by sports psychologist Dan Gould and colleagues as ‘a physical, emotional and social withdrawal from a formerly enjoyable sport activity’. More importantly, this withdrawal often occurs as a result of chronic stress, so it is fair to categorise burn-out  as a ‘stress-related condition’. Perfectionism has been found to be a factor, and this certainly rings true from Trott’s account: he responded to his poor form by toiling away for days practising in the nets trying to make improvements to his game, when he should have been resting.

However, an expert explanation of burn-out was unusually absent from this interview (despite the programme’s title). The hour-long programme focused on Trott’s account of his experiences and his efforts to return to the England team, which on the one hand is commendable. However, the interview led to Trott being criticised by some less-informed quarters of the media in the following days. Some journalists and ex-professionals claimed that the interview revealed that he had simply ‘cried off’ and ‘given up’, and that he hadn’t been suffering from a ‘stress-related condition’ because he said that he wasn’t experiencing depression. It appears that burn-out is a condition that isn’t recognised by the popular media. Furthermore, the interview failed to provide any sort of expert view on burn-out; perhaps a short interview with a sports psychologist would have given Trott’s account the added legitimacy it required.

Having consulted with psychologists since the tour, Trott now believes ‘balance’ and ‘perspective’ has been the key to his recovery from burn-out and his drive to return to the England team. However, this interview was arguably a missed opportunity in raising awareness of both burn-out and broader mental health issues in sport beyond depressive illness.

- Reviewed by Darren Britton who is a trainee sport and exercise psychologist

A positively skewed view 

Prostitution: What’s the Harm?
BBC Three 

This one-off documentary describes the ‘thriving’ world of UK prostitution: with garish results at times. It comes during an apparent glut of related programmes, including Strippers on Channel 4 and The Truth about Webcam Girls on BBC Three. Prostitution: What’s the Harm? apparently aims to be different in teasing out the benefits of prostitution to the women,  clients and businesses involved.

Presenter Billie JD Porter meets customers, an escort and a brothel owner: all keen to stress the joys of prostitution. Prostitution is described by two male friends as a cheaper and more reliable way of securing sex than the pub and club scene. Escort Charlotte boasts of earning thousands of pounds a month from prostitution and webcam jobs: the presenter is left agog. All this prompts a young, carefree, fast-paced lifestyle – in typical BBC Three fashion.

The darker side of prostitution is also thankfully considered, although for a briefer period. 140 sex worker murders have been reported in Britain since 1990. The site of one such killing is visited with words heard from an anonymous sex worker about the violence and emotional damage she experienced. Brothel owner Becky Adams declares a need for brothel legalisation to protect the safety of working women, an opinion that has been echoed elsewhere. However, this is largely overshadowed by her role in organising a mock-up brothel so modern and pristine that I fear only adds to the picture painted here of today’s prostitution scene.

Instead of making a thought-provoking piece about the actual harm experienced by today’s prostitutes, this documentary serves as more of an advert for potential male customers and future sex-workers. Little consideration is given to the physical, sexual or psychological harm dealt with by prostitutes in more typical sex-work environments. Equally little airtime is given to the realities of research and outreach work involved in helping such women. Such a positively skewed view towards the modern face of prostitution will likely only serve to further sustain this ever-controversial industry.

- Reviewed by Emma Norris who is a postgraduate student at University College London and Associate Editor for ‘Reviews


Seeing it all from differing perspectives…
What the Thunder Said
Ed Harris 

Commissioned by professional theatre company Theatre Centre, What the Thunder Said by Ed Harris is the product of a year-long project with developmental psychologists from Birkbeck (University of London) and King’s College London.

The psychologists aim to identify ways productions such as this might help children deal with feelings associated with witnessing violence in their community, on television or in computer games. In March and April it toured primary schools in Birmingham, Cardiff, Leeds, Liverpool, London and Manchester. Here we present three different perspectives.

The psychologist: Dr Natasha Kirkham, Department of Psychological Sciences, Birkbeck, University of London

Until now, my research has been solidly experimental, investigating theories on attention and learning. This project opened my eyes to just how important it is for developmental scientists to get out of the lab and into the field, to listen to individual children and to shake up their methods. And to remind ourselves that development does not happen in a vacuum. These children were extraordinary – tough, interesting, heart-breaking and funny – and all of them had thoughtful, strong opinions about the very real bullying in their environments. I learned about ‘circle of friends’ (peer-groups assigned to befriend and look out for each other), I learned about the role of humour in the lives of these children (both appropriate and inappropriate), and I learned how easily these children shift between reality and fantasy (seamlessly moving from laughing about parents in prison to discussing Xbox characters). Importantly, I learned that with bullying, ‘walking away’ does not always work.

This experience was personally and professionally cathartic for me, offering new insights into modern-day parenting, coping strategies (for children and teachers) and developmental resilience. Ultimately, it proved to me that a lot of our ideas about how to deal with bullying need to be re-worked.

We hope that the pre- and post-play surveys will show a significant shift in people’s perspective on community violence and the effects of bullying, and provide some evidence for theatre-based intervention in areas rife with violence and trouble.

The playwright: Ed Harris, award-winning playwright, radio dramatist and poet.

Violence is a confusing subject for kids. X’s dad says walk away, but Y’s mum says hit them back. Violence is bad, yet it appears in a wide range of entertainment. Violence is bad, yet slapstick is funny. Violence is bad, yet the hero kills. Violence is bad, yet you can’t look away.

Have we been so busy promoting the superficial message that violence is bad that we’ve stopped listening to the kids’ questions and concerns? When we began interviewing the kids, we didn’t have any preconceived ideas about what the play’s message should be. We wanted to hear what children thought if we stopped telling them what we’d like them  to think.

We learned about how frustrated kids were because they couldn’t talk to their teachers or parents without being met with the conversational equivalent of an e-mail auto-respond: ‘Thanks for your question. I'm afraid your teacher/parent isn’t available to talk about the grey-areas of bullying or violence’. And of course we heard horrible stories: children who have witnessed intimidation, assault and even murder. Kids whose worlds are rough and violent, and who are fully conscious that, when they get a bit older, they’re going to have to join a gang in order to survive. And one of the truly upsetting things was that the kids asked simple questions we couldn’t answer, like ‘What should I do?’ or ‘What would you do if you were me?’.

The play is based on their questions and experiences, and, where it can, offers answers, ideas and choices. But there isn’t one way to deal with bullies or ‘bad guys’, and we know ‘walking away’ never worked. The more we promote a one-size-fits-all solution, the less we’re preparing our children for the world.

The teacher: Sarah Geddis, Assistant Headteacher, St Peters RC Primary School, Rochdale

The current Year 6 cohort has always been challenging and had problems with getting along. The run-up to Christmas was particularly gruelling. Behaviour and attitude to learning was a significant problem for a large group of boys. They appeared disengaged and lacked motivation in terms of their attainment and achievement across the curriculum.

We introduced a wide range of measures, but as a drama specialist I understand the power of drama as a tool for learning and engaging pupils. I found out about Theatre Centre from the internet and contacted a member of the team to enquire about their new project. From reading a synopsis of the content I knew that this play would reflect the issues that we were dealing with and give all members of the class an opportunity to explore their own personal feelings.

The performance and the quality of the acting were out of this world. The Year 5 and Year 6 classes were engrossed from the first scene and got so much from the workshops. My class, for the first time, were able to reflect on the problems that we had experienced before Christmas and understood the power of their personal choices.

As a result of the consistent hard work of the school team and the involvement in the theatre in education project, behaviour and attitudes have greatly improved and the pupils are now on track to meet national standards by the end of Year 6.

For more information see www.theatre-centre.co.uk/shows/2013/what-the-thunder-said

 

A reminder of relevance
Woman’s Hour
BBC Radio 4

Psychology is often featured on Woman’s Hour, and the two programmes I caught recently were no exception. On 21 March a new Sutton Trust report was under scrutiny, considering implications of the findings that 40 per cent of children do not form secure attachments to their parents. The discussion focused on how parenting is not an innate ability, with parents needing to learn techniques to aid the development of more securely attached infants in order to avoid possible future social and economic issues.

The programme visited a Parents Early Education Partnership class, where parents can learn techniques to bond with their child. One mother admitted to being in ‘shellshock’ in her infant’s first days. This seems especially concerning when considering parents’ influence upon attachment in the first few hours of life, more so when Jenni Murray paraphrases Phillip Larkin’s poetic assertion that some children are ‘mucked up’ by their parents.

Unfortunately, some elements of the discussion lacked scientific clarity. Children with non-secure, but functional attachment styles are categorised under the umbrella term ‘non-secure attachment’ alongside children with the more serious disorganised attachment styles. Also, as Judy Williams (child and adolescent psychotherapist) establishes, the majority of research on the attachment of infants ignores those children with healthy attachments to other caregivers besides the mother.
Ultimately and disappointingly, the extract skirted vaguely around the subject of providing parents with the support to scaffold secure attachments with their child, failing to convincingly expand on what improvements can be made to tackle the attachment issue.

The following day’s programme, however, provided an interesting insight into the minds of men who pay for sex. Although more politically focused, Woman’s Hour heard from men who had paid for sex, and touched on psychological implications, regarding the risk assessment these men make, and how the ‘hunt’ for such women can be a thrill and a de-stressor for some. It was an insightful contribution, also acknowledging the possible damage done in pursuing such activities, such as guilt and the difficulties of forming new and future relationships.

Overall, BBC Radio 4’s Woman’s Hour does provide an interesting listen, and as a psychology undergraduate it truly reminds me how relevant psychology is in everyday life.

- Reviewed by Bethany Dimmock who is a psychology undergraduate at the University of York

Flagging up the warning signs 

Red Flags in Psychotherapy
Patricia Keith-Spiegel 

Given the nature of ethical guidelines, it could be assumed that reading a book on the subject would be a laborious but necessary task. Red Flags in Psychotherapy outlines a long list of warning signs – ‘red flags’ – for therapists to be aware of when working with clients, presenting 11 engaging case studies.

Each case stands alone, covering a range of violations, some of which would be obvious to those in psychology, such as violating client confidentiality. The case exploring a psychologist’s right to a private life is particularly pertinent in light of the current trends in social media and can offer guidance to those new to providing therapy.
The cases are presented from the perspective of those who have violated the ethics code and those sitting on the panel, providing narratives and information on how the decisions were made, bringing seemly abstract concepts into real life situations, taking in details that decide the penalties issued, if any. Each chapter concludes with thought-provoking questions to aid reflection for anyone with interests in psychology, regardless of their background and experience.

Routledge; 2014; Pb £27.99
Reviewed by Kathy Williams who is an assistant psychologist in learning difficulties and adult mental health 

 

An eye-opening documentary
Undercover Doctor: Cure Me, I’m Gay
Channel 4

I have to admit that I was more than a bit hesitant when I heard the controversial title of Dr Christian Jessen’s latest one-off documentary. This features the popular Harley Street television doctor visiting US and UK vendors of ‘de-gaying’ remedies, mostly for a princely fee. Some of these techniques are utterly outrageous and are quite an uncomfortable watch.

In an attempt to firstly ascertain his suitability for the task as a gay man, Christian undertakes Cornell University’s sexual orientation eye-tracking test. In the only scientific element to the show, eye and genital-tracking measurements are taken whilst viewing heterosexual, homosexual and neutral images. All this confirms that Christian is ‘100 per cent gay’. Happy with this confirming diagnosis, Christian then undergoes ‘aversion therapy’: available on the NHS as a homosexual remedy until the 1980s. This is undoubtedly the most shocking element of the show and definitely not for the weak-stomached! After being given a drug to make him vomit, Christian is sat in front of homo-erotic images and instructed not to move from his seat. The experience is evidently and understandably humiliating. The rationale behind this treatment was to condition patients to associate homosexuality with violent illness. However, a doctor having previously administered the treatment in the 1970s could recall no anecdotal evidence of its effectiveness.

Next, Dr Jessen samples a range of US remedies. With a large anti-gay Christian movement prominent in the southern states, there is unfortunately a large market of homosexuals suffering mental anguish and willing to pay over the odds to be ‘cured’. He visits a retired ‘gay rehab’ facilitator, who is himself gay. This $3000 treatment involves being isolated of all ‘gay’ clothing, images and entertainment. Christian is evidently uncomfortable in the lack of control he has over his appearance and activities.

He also meets a ‘reparative therapist’: providing talking therapy to uncover the ‘causal’ natures of previous experiences. Lost years of love and bonding from the father or sexual abuse from a male are deemed by this therapist to be typical causes; with him adamant that there is no biological basis. Perhaps the most bizarre approach shown is ‘right brain therapy’, as touted by Zimbabwe-born Dr Jerry Mungadze. Christian goes undercover to see his approach in action. This basically involves paying $150 an hour to colour in brain diagrams with crayons in what is called a ‘natural MRI’. The colours and areas you select are said to correspond with homo- and heterosexual hormones in the brain. Comically, Dr Mungadze is himself colourblind, has no medical training and describes the adrenal and thyroid glands as in the brain. Christian emerges from the session understandably visibly angry at this false representation of the medical profession.

Case studies and discussions with Christian groups are dispersed throughout. These include the ‘Ex-gays’ movement campaigning in Washington, DC for the provision of homosexuality aversion therapy. Christian invites these ‘converted homosexuals’ to prove their newfound heterosexuality via the Cornell eye-tracking test. They appear eager at the rally, although none take him up on his offer.

Finally and back in the UK, Christian meets an east London pastor who delivers exorcisms for a range of anxiety conditions, as well as homosexuality. What is shocking here is the pastor’s constant proclamation of medical diagnoses surrounding homosexuality. These unfounded words are dangerous to promote to desperate people who may be easily convinced. Worryingly, this approach is apparently increasing popular in the UK. It seems for some experiencing trauma from their sexual orientation: desperate times are calling for desperate measures.

One unfailing bias with this documentary is that Dr Jessen has no wish to be ‘cured’. However, you can forgive this for the efforts he takes to test each therapy, regardless of its efficacy. His transformation from typical calm doctor to a vomiting, weeping and abused patient is shocking and bravely displayed on national television. His clear dedication in bringing these heinous techniques out into the public consciousness is surely commendable. Perhaps what is missing from this programme is more of a professional, scientific opinion such as from a psychologist. This would have been particularly timely, given that leading UK psychological professions, including the British Psychological Society, recently published a consensus statement denouncing conversion therapy (tinyurl.com/qekhonw). However, I would definitely recommend this as an eye-opening documentary.

Reviewed by Emma Norris who is a postgraduate student at University College London and Associate Editor for ‘Reviews’

 

Open-access answer to a traditional problem
Noba Project
www.nobaproject.com
 

At Aberdeen, as I am sure is the case at most institutions, every few years the issue of changing the introductory textbook raises its head. This year was the lucky year, predominantly driven by new lecturers and new lecture topics that were not covered adequately by the existing textbook. It is a common complaint by students that they can spend huge amounts of money on textbooks in the first year only to find that their use amongst different lecturers is inconsistent at best. It can be easy to ignore these complaints. Textbooks are recommended, not mandatory. We provide multiple copies in the library. They should read the course guide to determine which lecturers plan to assign reading from the textbook and make informed purchasing decisions. To take this approach is to forget what it was like to be 18 and excited about university. It can also be easy for students to blame their lecturers and expect that all sections of a course will draw equally from the same text. To take this approach is to entirely misunderstand the nature of higher education.

Whilst we were discussing possible textbook options, I saw a post on Twitter about the Noba project, an open-access resource that allows you to build a custom textbook from chapters written by experts in their respective fields. Noba passed the first test – content. To date there are 88 chapters to choose from and a number of lecturers indicated that the Noba chapters were as good as, if not better, than comparable chapters of the traditional textbook. The second test, accessibility, also passed with flying colours. Once you have built your textbook you are provided with a URL to access an html version or you can download a pdf. We plan to e-mail all students with the pdf textbook in the first week of term as well as hosting a copy on the VLE.

More broadly, the ability to custom-build a textbook allows us to provide students with a resource that is tightly focused on the content that they will actually encounter. The Noba chapters do not cover the course comprehensively, some lecturers will use chapters as recommended reading, some only as further background reading for those interested. Noba won’t eradicate the issue of consistency of use, but it does mean the removal of a financial penalty to students.
Generally, our attitude towards Noba is very positive and has been helped by the willingness of the editors to answer our questions via e-mail. However, there are a number of reservations that mean rather than offering Noba as the sole course textbook we have decided to give students the choice and present Noba and the traditional textbook in parallel.

First, there is an issue of prestige and quality control. We know what it means that Elizabeth Loftus co-authored the chapter on eyewitness testimony, but this is unlikely to have the same impact with the average fresher. How will the students react to the lack of a highly polished expensive tome? More importantly, Noba has the ability to update chapter content, be it minor corrections or more substantial revisions, and these updates are automatically reflected in the html versions of the textbooks. It has not yet been decided how users will be informed of what changes have been made, which is a cause for concern.

Second, although the written content of chapters is excellent, there is a noticeable lack of images, particularly of the high-quality type that litters most introductory texts. For courses like perception or biological psychology that benefit hugely from images
of visual illusions or diagrams, this is problematic. One of the reasons for retaining the use of the traditional textbook was the use of the image bank that accompanies it.

Third, the ability to provide a textbook that is closely focused on the content of the course is a double-edged sword. By being so focused students may lose out on having a more general overview and not read as widely as they would with a traditional textbook. We could publish one of the Ready-Made te

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