Trust Me, I’m a Doctor
Seeking to reduce confusion in the mixed health messages provided in today’s media, this series uses doctor-hosted experiments to provide answers to common health questions. Amongst a host of other items in this episode (Series 2, Episode 3) was something of particular interest to me as a physical activity researcher. Can your weekly household chores help you ‘cheat’ your way to the recommended 150 minutes of moderate to vigorous physical activity (MVPA) a week in adults? Activity monitors were worn by a sample of eight participants ‘of a range of shapes and sizes’ whilst completing various chores on a cross-sectional basis. Tasks such as mopping, hoovering, car washing and mowing were found to reach the metabolic rate classified as target MVPA. Participants’ self-reported time performing these weekly tasks suggest that they can indeed reach the weekly requirement largely through chores alone – hurrah! Doing the chores you ‘hate’ is celebrated as a great alternative to the gym, before a swift transition to the next item.
I was left feeling frustrated and angry at such a premature conclusion. Given a well-documented activity crisis in the UK and years of hard work dedicated to promoting activity, this brief item seemed hugely dismissive. Individuals watching this may well increase their self-efficacy for activity, in becoming aware of their daily tasks as being physically active. However, the overarching theme common in media and society persists here: activity is a chore and something to be avoided. Although supposedly aiming to clarify messy health media for consumers, I fear this item has done the opposite. Despite news items regularly promoting the positive effects of exercise on health and well-being, this was promoting daily tasks alone as sufficient. The weak cross-sectional evidence was unwisely described to have unwarranted conclusions extending far beyond its minute sample. Physical activity is fun and beneficial for the body and mind and should be promoted as such, not as a chore. Programmes advertised as science-based such as these, have a responsibility to present well-validated research and prevent premature conclusions in their narrative and for their viewers.
Reviewed by Emma Norris who is a PhD student at University College London and Associate Editor (Reviews)
At ease, at last?
Warriors and Worriers: The Survival of the Sexes
Joyce F. Benenson
This book turns a well-held (and widely researched) belief completely on its head. Professor Benenson courageously asserts a new notion: women are more competitive than men while men are more sociable than women. While not attempting to draw new battle lines between the sexes, Benenson’s theories in Warriors and Worriers instead suggest how the genders could begin easing any friction between their emotional behaviours.
Historically, the accepted academic interpretation of human evolution describes males travelling out into the wilderness alone to hunt for food while females are safely ensconced together around camp fires, gathering berries from bushes, awaiting their return. However, Benenson’s observations of survival experiences in Uganda, as well as three decades spent studying children and chimpanzees, offer new insight into how males and females think, emote and behave. By forming socially cooperative ingroups males keep outgroups out (warrior enemies) while, conversely, females attempt to protect their children and parents and compete for mates by rejecting other females (worrisome competition). Suggesting that gender behaviour evolves to prevent death.
Reflecting on the connection between Benenson’s research and today’s society, there appears an all-too-familiar resonance to it. Could this explain why women can often experience the emotional ‘green-eyed-monster’ and possibly how men are often found in ‘packs’ in bars, on battlefields and around balls (of the sporting kind)? Initially, this concept seems hard to grasp, however, much of Benenson’s thorough research appears to confirm the claims made and it proves insightful reading for therapists counselling challenging couples.
Oxford University Press; 2014; Hb £16.99
Reviewed by Kaye Bewley who is a psychotherapist working for the British Army
Simple take-home messages
Professor Stuart Biddle: Myth-busting Sports Medicine
As a landmark figure in physical activity psychology, Professor Stuart Biddle outlines some issues and recommendations for behaviour change in physical activity (PA) and sedentary behaviour (SB) in this podcast.
Biddle argues that a public health approach is required, addressing the obesogenic environment from multiple angles and modifying lifestyles at a population level. This is a huge challenge, especially when considering the multifaceted influences on individual activity choice.
Discussion is directed to motivation in activity, with three key myths being addressed. First, Biddle argues that motivation is not just about quantity – being more motivated doesn’t necessarily mean you will start running regularly. More important and effective is the quality of this motivation: having a focus on a specific activity and goal.
Second, the importance of recognising different types of motivations is described. More awareness is arguably needed of the differences between extrinsic (e.g. ‘I ought to run to meet the 150 minutes recommended weekly level) and intrinsic (e.g. ‘I want to run as I enjoy it) motivational categories. Encouraging individuals to shift from external to internal motivational focuses provides greater, longer-lasting activity change.
Finally, the myth of high willpower levels being sufficient to engage individuals in activity and structured exercise is tackled. Instead, reflecting on ‘Nudge’ theory, Biddle describes how we must work towards developing environments where activity is easier and more pleasurable: providing healthier options without individuals having to make conscious decisions on their uptake. Examples include cycle hire schemes such as London’s ‘Boris’ Bikes: making cycling facilities available, accessible and appealing to the general public.
The podcast ends with two simple methods for individuals to improve their activity behaviours. First, Biddle stresses self-monitoring of your own sitting and moving behaviours as a useful start, combined with goal-setting and giving yourself feedback on your actions; for example, assessing how long you spend sitting at work and developing goals to go for walking or stair-climbing breaks at regular intervals. Second, he advises that individuals should focus on activities most realistic and attractive to them. It is simply no good to hold hugely intensive or unappealing exercises on a pedestal, as this will only serve to demotivate individuals.
These simple take-home messages are something that I feel should be stressed more in physical activity interventions: the need for fun, variety and relevance for the target population. Although the podcast’s title is somewhat misleading, focusing on public health rather than sports per se, I really recommend this great overview of current research priorities in physical activity.
Reviewed by Emma Norris who is a PhD Student at University College London and Associate Editor (Reviews)
False dichotomies laid bare
A Sociology of Mental Health and Illness (5th edn)
Anne Rogers & David Pilgrim
The fifth edition of Rogers and Pilgrim’s A Sociology of Mental Health and Illness is a timely contribution to current debates surrounding mental health theory and practice; particularly considering the social, political and economic upheaval that has been ongoing since 2008, its impact on the psychological health of the nation and our ability as practitioners to respond. Rogers and Pilgrim examine the causes and meanings of mental health and illness using a sociological perspective, pointing a critical finger at, among other things, the machinations of social context, institutions and mental health professionals; the impact of gender, race and life course on mental health; and the often detrimental effects of treatment and attitudes to mental health. In the new preface Rogers and Pilgrim appropriately scupper the aspirations of certainty and definitive accounts, and state that the book ‘raises important ethical and political challenges for trainees in “mental health work”’ – this does not go far enough, as the book should raise challenges for the qualified practitioner as well. Although the book is not targeted at psychologists specifically, there is no question that the topics covered would resonate with practitioner psychologists of all persuasions.
One weakness of the book is the absence of a chapter on methodology and research. As explained by the authors, there is a considerable bibliography in this new edition as theories and research in sociology and mental health are constantly revised and evolving. It is strange that there is no critical discussion on the nature of evidence in mental health theory and research, as one would imagine that what is determined to be ‘appropriate’ evidence is arrived through social consensus, therefore making it sociological. By omitting evidence as an area of critique it is almost as if Rogers and Pilgrim tacitly endorse a correspondence theory of truth with regard to the research they cite, which would not be in keeping with the critical stance taken by the authors in the rest of the book. Perhaps this is something to debate in the sixth edition.
Nevertheless, A Sociology of Mental Health and Illness is an excellent introductory textbook; perhaps its greatest contribution is that it lays bare the false dichotomy between sociology and ‘psy’ disciplines such as psychology. If this book is indeed intended for trainees in mental health work, then the earlier that unhelpful dichotomy is dissolved in their minds the better.
Open University Press; 2014; Pb £28.99
Reviewed by Patrick Larsson who is a counselling psychologist working in the NHS
Needs working onWorkOut (app)
Reach Out Ireland
This ‘mental fitness’ resource, developed by Inspire Australia and the Brain and Mind Research Institute in Sydney, also includes a supplementary iPhone app built by Reach Out Ireland, a mental health organisation for young people. In a nutshell, the WorkOut app involves users completing a series of mental health-related questionnaires and activities in the mental fitness themed areas of ‘being practical’, ‘building confidence’, ‘taking control’ and ‘team player’. The app provides feedback based on the users’ scores and displays a Life Wheel chart so users can see what areas need to be worked on.
We thought that the app made great use of colour, metaphors and usability. It appeared that the developers of the app favoured clinical health measures such as the Rosenberg Self Esteem Scale over positive health measures such as the Oxford Happiness Questionnaire. We felt that vulnerable young people accessing clinical questionnaires may not be the most optimal resource if increasing the well-being of young people is the general goal of the app. Therefore, we suggest an emphasis on positive measures for future development. Furthermore, limiting the app to iPhone users, and physically using the app in an unsupervised non-therapeutic environment, may decrease the efficacy of this app as a mental health resource. Lastly, we suggest that the developers consider improving the interactivity and enjoyment of the app in order to encourage multiple usages.
2014; Free on Apple App Store
Reviewed by Derek Laffan, Breanna Coyle and Juliette Salmon of the Dún Laoghaire Institute of Art, Design and Technology, County Dublin, Ireland
Gap in the market
The Psychology of Babies
I’m an occupational psychologist – so why am I reviewing this book? Well, I have a 15-month-old baby and was eager to read more about how babies develop. My knowledge of child development is patchy to say the least – there is not much beyond what I remember from my first degree over 20 years ago.
I loved this book – as a mum and as a psychologist. It’s very well structured, covering the key areas, and is highly engaging. The points in the text are continually illustrated with picture sequences showing different babies behaving in response to different situations and people, which is invaluable – it definitely brings it alive, and I could easily relate it to my son’s behaviour. It has also given me some ideas about how to support his development more effectively.
Intellectually I found it stimulating, and it made me think about aspects that I could relate to as an occupational psychologist. For example, thinking about how the quality of daycare will be influenced by how staff are treated by their organisation. It also reminded me of the instinctive ways we have of learning – babies are hard-wired to explore things, to be experimental, and to imitate others and look for social reinforcement. Sometimes we lose that natural curiosity as adults, and certainly some development activities forget about tapping into these natural ways of learning, and instead try and impose a very unnatural approach.
This book covers a gap in the market – there is a lack of books covering this period of child development – and I would thoroughly recommend it.
Robinson; 2014; Pb £16.99
Reviewed by Emily Hutchinson who is an occupational psychologist at EJH Consulting and Senior Lecturer University of Gloucestershire
Comedy, melancholy and mental health
Robin Ince’s Tears of a Clown
BBC Radio 4
This hour-long programme, examining the relationship between sadness and comedy, is both thoughtful and thought-provoking. Its focus is on stand-up comedians, but its insights go wider to consider the fundamental human conditions of sadness, loss and the use of humour to cope with some of the darker aspects of life.
Ince was inspired to create the documentary after the death of Robin Williams. ‘Robin Williams was a very important influence on me, and I happened to be doing a stand-up event about comedy and therapy when I heard Robin Williams had killed himself,’ Ince told me. ‘I started to mull over the truth, fiction or in-between of the image of the miserable clown.’‘For most of my life, comedy has been one of my main obsessions, and for half of my life I have made a living from it,’ said Ince. ‘The older I become, the more I wonder why it is what I have always wanted to be and why I can’t imagine being anything else.’
Ince doesn’t come up with a pat conclusion or a list of psychological research that answers all the questions he raises, and the programme is much richer for this. He uses beautifully selected interview footage from a range of brilliant comedians, talking seriously about comedy as therapy and therapy itself. Ince describes how hard it was to edit the show to an hour with so many thoughtful interviewees: ‘Ten minutes before the deadline we were still trying to fit it all in.’
Jo Brand is one of the interviewees, explaining bipolar disorder and extremes of emotion eloquently. Whilst she doesn’t think all comedians experience bipolar, she wonders if they go to slightly higher highs and lower lows in mood than many. Psychotherapist Philippa Perry 22 interviewed too, with a lightness of touch but depth of theoretical knowledge. Ince has researched what few psychological studies there have been on comedians and he peppers these in as he goes.
The documentary is fascinating from a psychological perspective, but also from a human perspective, providing an opportunity to think about how deep and dark emotions can fuel creativity. Ince says he is pleased that the documentary has inspired others to talk about melancholy and mental health.
On the use of humour in general, Ince thinks it has many functions, both positive and negative: 'It can be used to confirm our beliefs or it can be used to question them. It can be a valve and it is a release of frustrations. Sometimes it reveals our petty-mindedness and insularity, at others it is a celebration of our empathy and altruism.'
Ince said he often returns to a quote from George Carlin: 'Humour is a low art, but a very potent art.' However you see the use of humour, this documentary is definitely worth a listen.
Reviewed by Lucy Maddox who is a clinical psychologist (see @lucy_maddox and https://psychologymagpie.wordpress.com
The only way over it, is through it…
The Trauma of Everyday Life
Trauma comes in various guises, inflicting people from all walks of life but providing opportunity for positive change. Epstein skilfully combines his knowledge of Buddhism and psychotherapy to explore this phenomenon, emphasising how trauma can be used for the mind’s development.
Whilst sparse in descriptions of client work, this book is rich with stories from both the life of the Buddha and Epstein’s personal experiences. Through these stories Epstein expertly highlights a key message: pain becomes bearable when we do not run from it. But how does Epstein propose we bear this pain? Through mindfulness we nurture ‘a spy consciousness in the corner of the mind’ from which we can acknowledge dissociated painful feelings. Epstein teaches us how our mind can learn to hold our distress and how, in the process of doing this, we enhance our ability to relate to ourselves and others with compassion and connectedness.
Epstein writes with honesty and charm whilst discussing his journey to understanding Buddhism and his frustration in mastering meditation. This provides the reader with reassurance that their own struggle with such practices is not an isolated one. Epstein transports the reader on a philosophical journey, leaving one feeling pensive and enlightened upon its conclusion. If you are a practitioner seeking to understand how Buddhism may apply to developmental trauma, a trainee wishing to grasp Buddhist principles behind mindfulness (like me), or simply an individual navigating through the ‘trauma of everyday life’, this book is for you!
Hay House; 2013; Pb £12.99
Reviewed by Fiona Broderick who is a trainee clinical psychologist at Staffordshire and Keele Universities
The Therapist’s Treasure Chest: Solution-oriented Tips and Tricks for Everyday Practice
Andrea Caby & Filip Caby
Any book that labels itself a treasure chest is setting itself a pretty high bar in my view, but surprisingly, despite weighing in at 319 pages (sans bibliography, references, etc.), this one seems to hit the mark. Of course, opening with a quote from Goethe is always a strong move, but the true sign came when I felt my fingers itching for highlighter pens.
The book starts with a very brief introduction to the models behind the approach before leaping right in to some useful advice for clinicians regardless of theoretical stance. The rest of the book is dedicated to introducing techniques, recommendations for specific clinical issues, and problem solving things that may come up during the course of therapy.
The Therapist’s Treasure Chest is aimed at those working in child and adolescent services, and you might have some trouble explaining why you have a box of finger puppets in supervision if you work outside of these specialities. This being said, a lot of the techniques can be slightly adapted (the authors often comment on these as they along) and it only really becomes rather blatant once you start getting into Part 3 ‘Indications: What Works Best When?’.
It’s well structured, and peppered with case studies to further expand on the techniques. Overall, the book encourages a creative, empowering and respectful approach to clinical work and is a useful resource and reference for those who work primarily in other models.
Norton; 2014; Pb £17.99
Reviewed by Luke Allinson who is a Senior Assistant Psychologist in Long Term Health Conditions, LIFT Psychology Wiltshire
Fascinating and convenient
The Mind is Flat: The Shocking Shallowness of Human Psychology
Future Learn, and the University of Warwick
What a marvellous opportunity – an interesting free psychology course, available to study online at any time of day or night! This was the first MOOC (Massive Open Online Course) that I had studied, and although familiar with distance learning, I found the convenience and interactive nature fascinating.
FutureLearn started free online courses from UK and international universities in the autumn of 2013. Over the last year the number of courses appears to increase exponentially, so take the plunge and try one (www.futurelearn.com/courses/upcoming).
The Mind is Flat (www.futurelearn.com/courses/the-mind-is-flat) was one of the first of the FutureLearn courses and continues to be repeated. Nick Chater, Professor of Behavioural Science at Warwick Business School, leads this course. The main principle, which is elucidated and then argued cogently, is that we make decisions in a surprisingly uninformed manner. Strangely, as a relatively careful individual interested in facts, I found this information surprisingly reassuring and believable. Many concepts described will be well known to psychologists, such as present behaviour is strongly influenced by past behaviour. Yet, it is argued, decisions remain superficial, based on present evidence available and the views of others.
This course covering six weeks is entertaining with a series of short videos or text, with tests, and the opportunity each week to state your views and comment on those of others.
Reviewed by Kathryn J. Fraser who is a Chartered Psychologist
Positive and reassuring
The Teenage Guide to Stress
Having enjoyed Blame my Brain: The Amazing Teenage Brain Revealed, I was excited to read Nicola Morgan’s new book on the subject of teenage stress. I was not disappointed. Morgan’s writing is clear and engaging, making it an accessible and enjoyable read.
The book is split into three sections; the first describes what stress is and how it affects teenagers specifically. The middle section covers a wide range of issues that teenagers face. The cyberbullying, social media, sleep and exam sections were particularly interesting and informative. Each topic is followed by tips and advice to help with that particular issue. The third section goes into more detail about stress management strategies teenagers can utilise as well as advice on how to generally look after their mental health.
This book is positive and reassuring and gives teenagers, and the adults who support them, practical strategies to manage stress. Talking about and acknowledging teenage stress and encouraging good mental health is undoubtedly positive as it can stop young people developing more severe difficulties. This book is a fantastic starting point to encourage this and is a useful read for teenagers, parents and those working with teenagers.
Walker Books; 2014; Pb £7.99
Reviewed by Susanne Litts who is a Primary Mental Health Worker, NHS Child and Adolescent Mental Health Service
For a fast-growing profession
What Is Clinical Psychology?
Susan Llewelyn & David Murphy (Eds)
Clinical psychology is one of the fastest-growing health professions all over the world including Britain. Clinical psychologists were recognised within the NHS for the first time in 1952 and a separate Division of Clinical Psychology was established within the BPS in 1966 (at the moment the Division has approximately 10,000 members). Since 1952 and 1966 the number of people working in the field of clinical psychology has expanded hugely due to success in delivering high-quality and effective clinical services. So it is a relative newcomer to health care compared to the giants of medicine and nursing, but thanks to all developments it claims its own unique contribution as an applied science, drawing on the science of psychology.
The first edition of What Is Clinical Psychology? was published in 1987, and since then the number of professionals in the UK has more than quadrupled. The profession has extended into a wide range of new settings and client groups. Therefore the fifth edition since 1987 contains new chapters on new developments while remaining chapters have been significantly updated. By doing so, the content of this book represents a comprehensive and contemporary account of the profession today. It covers all the major domains of clinical practice ranging from primary care to severe and enduring mental health problems; from clinical psychologists working in forensic settings to psychologists in leadership positions. The book begins with an overview of professional practice and a clear introduction to the major competencies and theories used by practitioners, while it concludes with a consideration of likely future developments and challenges. In an appendix it also provides guidance on training routes. By doing so, What Is Clinical Psychology? is vital reading for anyone teaching, considering, or working alongside the profession of clinical psychology.
Oxford University Press; 2013; Pb £24.99
Reviewed by Dr Giovanni Timmermans who is a clinical psychologist working in health care in the Netherlands
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