Archive for March, 2010

"Dear Zachary: A Letter to a Son about his Father"

One of my readers reminded me of this movie. It is a beautiful, but heart wrenching documentary created for a son, about his father.


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American restlessness, American unhappiness?

Imagine you are a high school basketball player, and a pretty good one. You are a senior, and right now you are the starting point guard for the Rochester Eagles. Last year you started for the Lexington Cougars, in a different state, and the year before that you played the same position for yet another squad, the Flyers of Pottsville. Your family moves a lot because of your father’s work, but you’ve managed to win a spot on the local team wherever you land.

So how do you think of yourself at the moment? Do you identify yourself as a proud Rochester Eagle? Or do you think of yourself as simply a talented point guard?

Well, if you’re like most people, you think of yourself primarily as a journeyman point guard, not as a member of the Eagles—or of any local team for that matter. That’s because you’ve learned from experience that group membership doesn’t last; teams and communities are fleeting. What endures are your grit, and your leadership skill, and your fast hands. In short, you.

This example comes from the work of University of Virginia psychological scientist Shigehiro Oishi, who has for some years been studying the mental and emotional consequences of residential mobility. America is one of the most mobile societies in the world, which means that lots of people are living different versions of the itinerant hoopster’s experience. Surprisingly, psychologists have not paid much attention to this common American experience. But as Oishi’s studies are showing, mobility shapes everything from our sense of identity to our friendships—and even our happiness.

It all starts with basic sense of self. Oishi studied a large sample of American college students, some of whom had moved around a lot before college and others of whom had pretty much stayed put. When he asked these students to describe themselves—their most important attributes—the itinerants were much more likely to mention personal traits, while less mobile students were more apt to mention important group affiliations. In fact, the mobile students didn’t belong to many groups; they weren’t joiners. And this tendency weakened their overall sense of community identity.

Mobility appears to affect the nature of friendship as well, in a variety of ways. In one study, for example, college freshmen who had moved around a lot reported having more friends—as measured by their Facebook friendships—and they also added more new friends after arriving on campus. But it’s not just the size of the social networks, Oishi has found. Mobile Americans are more likely to form “duty free” relationships, without the deep sense of social obligation that characterizes traditional friendships. Duty-free friendships are based on more on shared interests and similarities of personality, rather than group membership.

So who’s happier, those who ramble or those who stay close to home? One would guess that more mobile people might be happier, since that’s why many people move—to find a new life, perhaps a better job or a safer community. But the results are more mixed than that. As Oishi describes in the journal Perspectives on Psychological Science, adults who move often for work feel they have more interesting lives and are more satisfied with their marriages and family life. But itinerant adults also report more frequent health issues, like stomach aches and shortness of breath, than do less mobile adults. It’s possible that when people pull up stakes for a better life, they overestimate the novelty and opportunity of moving, and underestimate the social disruption and its consequences.

The stomach aches and other ailments may be the tip of the iceberg. When Oishi analyzed a decade of data from 7000 adults, he found that those who moved frequently in childhood were more likely to have died during the course of the study. Perhaps unsurprisingly, introverts suffered more from the negative consequences of mobility, including increased mortality. In short, the American pattern of residential mobility may have a dark side that has yet to be fully revealed.

When the French social critic Alexis de Tocqueville traveled in U.S. in the 1830s, he was struck by Americans’ restlessness, even in the midst of their prosperity. He was also struck by the “cloud” that darkened many American faces. This sadness, he believed, was explained by the fact that Americans are constantly thinking about the good things they might be missing.

Tocqueville didn’t have the advantage of modern genetics to help him understand the paradoxical American character. Today we know that nations founded by immigrants—like the United States and Australia—have much higher rates of mobility than older nations, such as China and Germany. Population geneticists now believe that these national differences might be explained by the genetic distribution of personality traits, and indeed a cluster of novelty-seeking genes has been found in populations that have migrated long distances. It’s possible that these genes were adaptive when Americans were a migratory people. Whether or not they remain adaptive is an open question.

Versions of “We’re Only Human” appear in the Huffington Post and Scientific American Mind. Wray Herbert’s book, On Second Thought: Outsmarting Your Mind’s Hard-Wired Habits, will be published by Crown in September.

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ObamaMama it’s Health Care Reform!


In case you haven’t heard, we’ve got ourselves health care reform.
What do you think?
Will this be a good thing for psychiatric patients?
Will this be a good thing for psychiatric docs (the shrinks among us?)

Personally, it’s been so much commotion and so many pages, it’s been way too much to follow (and no one asked my opinion anyway). I think I’m happy for movement, we’ve been stuck for so long with a system that just doesn’t make sense. I’m told most people are happy with their health insurance. Are you?

Go for it, write in our comment section!

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Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail.

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I Like To Paint Flowers


The title of this post comes from one of the questions in the Minnesota Multiphasic Personality Inventory, which I had to take when I applied to medical school. And I do like flowers. One of the things I like about the place where I work now is the fact that it’s filled with plants—I don’t know enough about horticulture to say what they are—but I think they are mother-in-law’s tongue, ferns, philodendrons and other bushy green things. In front of the hospital there’s a bed of tiger lillies and I can’t wait for them to start blooming now that it’s Spring.

Our hospital has a horticulture program. Patients who have worked their way up through the privilege level system and are safe enough to leave the ward are allowed to tend the many green plants lining the hallways and windows of the hospital. They do a terrific job and the place is beautiful and warm. I appreciate this a lot because I have a black thumb. When I walk into a nursery the plants scream and run for cover.

I think the patients appreciate the program because being able to participate is a sign of progress. Being able to gain some freedom and be responsible for another living thing gives a sense of independence and responsibility. It’s also quite relaxing and peaceful to be surrounded by beauty.

Psychiatric hospitals and prisons have frequently used agriculture or horticulture for therapy and rehabilitation. I know of a maximum security prison where inmates with the highest privilege level are allowed to participate in a bonsai program, growing miniature trees.

Nineteenth century psychiatric hospitals relied upon hospital farms to provide for the needs of the patients. They grew their own food and milked their own dairy cows, which for some patients I’m sure was a source of self-sufficiency and pride. One former hospital farm, the Brattleboro Retreat Farm, still exists and is open to the public. In 2008 the New York Times published Tara Parker-Pope’s article Better Mental Health, Down On The Farm in which commenters talked about their own experiences caring for animals during episodes of mental illness. One commenter talked about his horses as “a reason to go on” while depressed, because he had to feed and groom them even in bad weather.

While I didn’t grow up on a farm, I did live in a rural community and many of my friends were farm kids. I still get teased for commenting on the progress of the corn crops as I drive through the country. I know farm life is not for everyone. The NYT article mentioned a Norwegian study that compared psychiatric patients treated with standard pharmacotherapy versus a group given standard therapy along with a “farm intervention”, where they were asked to work with cows, sheep and horses for three hours a week over a 12-week period. By the end of that time the patients with farm experience had significantly higher self-efficacy and coping skills. Coincidentally, the farm group also had a higher dropout rate. The article didn’t mention why the patients dropped out, but I can imagine why—-cow pies are definitely not therapeutic.

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Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail.

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Fast food, racing thoughts

Fast food is unhealthy.

I know, I know. Few of us need convincing of that fact any more. But as unassailable as it is, the brief against fast food has for years focused almost entirely on the food in fast food—the high fructose corn syrup and artery-busting fats and nutritional bankruptcy of burgers and French fries and soft drinks. But what about the fast in fast food?

New science is now suggesting that fast food may be doubly unhealthy—not only nutritionally damaging but psychologically detrimental as well. Indeed, the Colonel and the Golden Arches and the rest of America’s fast-food culture may be unconsciously triggering a general impatience with life that leads to wrongheaded decisions going way beyond food. In short, fast food may lead to fast and frenzied live-for-today lifestyles that may be just as unhealthy as bad cholesterol.

At least that’s the theory, which psychologists Chen-Bo Zhong and Sanford DeVoe of the University of Toronto have been exploring using an idea called behavioral priming. This is just a jargony way of saying that cues in our everyday world subliminally spark ideas, which in turn shape our behavior. The Toronto scientists wondered if symbols of our ubiquitous fast-food culture might spark thoughts of time pressures and efficiency—and cause us to act urgently and impatiently.

Here’s an example of how they tested this notion in the laboratory. They recruited a large group of volunteers to perform a computer task. The task involved an image at the center of the screen, but other images also flashed very rapidly on the periphery of the screen—so rapidly that the conscious mind could not possibly notice them. Some of the volunteers “saw” familiar fast-food logos—KFC, Taco Bell, McDonald’s, and so forth—while others simply saw neutral images.

After this priming, all the volunteers were told to read a short descriptive prose passage. Unbeknownst to them, the researchers were timing them—in order to see if the unconscious thoughts of fast food caused them to read faster. And they did. Even though they were told to take as much time as they liked, those thinking of fast food read much faster than the controls—and faster than they did without any unconscious priming. In other words, the Golden Arches and similar symbols made they feel time pressure where there was none.

Now let’s be clear. Sometimes urgency and deadlines are appropriate and needed. We read quickly when we are taking a timed exam, for example, just as we walk quickly when we need to be somewhere soon. So speed is not in itself bad. But this was like speed-reading Emily Dickinson; it doesn’t make any sense. And in fact it’s unhealthy: One measure of Type A personality is speed and impatience in leisure activities like eating and walking and reading.

These findings were intriguing, but the psychologists wanted to reexamine the question a different way. So in a second experiment, they again used fast food imagery to prime volunteers’ unconscious thoughts of time and urgency. But this time they rated the desirability of common household products, only some of which were time-saving products. For example, the volunteers might choose a four-slice toaster or a single-slice toaster; a two-in-one shampoo or a regular shampoo. And so forth. The idea was to see if those primed with fast food imagery were more likely to pick an efficient product than were the others. And that’s exactly what they found: Memories of Big Macs sparked a generalized impatience which in turn increased desire to complete household tasks as quickly as possible.

I don’t know about you, but I find this alarming. And it gets worse. In a final experiment, the scientists went far afield, testing whether our fast-food culture might actually determine whether or not we save for the future. As they explain it, saving requires delaying gratification, denying one’s needs today for a bigger payoff later on. Failure to save is impatience writ large—over the lifespan. Like the ethos of fast food, lack of financial planning is all about immediate gratification.

And the experiment’s findings were unambiguous. As reported on-line last week in the journal Psychological Science, the volunteers primed with fast-food logos were much more likely to accept a smaller amount of money now rather than wait for a larger payment in a week. In short, mere exposure to fast food symbols made people impatient in a way that could threaten their future economic security.

It’s hard not to savor the irony in these findings. Fast food was invented to save us time—to get us away from the drudgery of the kitchen so we could enjoy more leisure time. But today, the mere idea of fast food automatically triggers our unconscious sense of haste and urgency and pressure—feelings that shape not only the way we eat, but nearly every aspect of the way we live our lives, including our leisure.

Wray Herbert also writes regularly for the Huffington Post, where this article first appeared.

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A Picture is Worth a Thousand Words

While I was away, ClinkShrink did a Spectacular job of keeping up the blog. And the rare moments I could get computer access, for 20 shekels a shot, I got to play beat-the-clock attempting to get through my email. There were about a zillion in response to Clink’s posts. Great posts (and beware the surgeon who dares to lie to Dinah)…but no pics? Why no pics, dear ClinkShrink? Ah, but it’s not too late— I will help her out here.
Dinah’s back…..

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Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail.

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Trauma Nightmares and Lucid Dreaming

Trauma nightmares can not only rob you of sleep but make you dread going to bed at night. They can become a force that destroys you mentally and emotionally. It’s important to learn techniques for handling them so they don’t handle you.


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ADHD Medications Do Not Effect School Performance

A recent article on the Child Psychology Research Blog, “ADHD Medications and School Performance” cites a research study which shows that “medication alone may not have a significant impact on” the childrens’ school functioning.


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Anxiety: Nature vs. Nurture

The New York Times has a wonderful article on anxiety, “Understanding the Anxious Mind” which seems to suggest that we are born with an anxious temperament. Personally, I wonder.


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My Three Shrinks Podcast 50: More About Geeks

In this show we continue with our guest Dr. Pat Barta of the Adventures in Telepsychiatry blog.

We talk about electronic health information systems and Clink continues her rant which she started in her post Rage Against The Machine. Roy mentions the Certification Commission for Health Information Technology and the American Recovery and Reinvestment Act which provides funding incentives for doctors who use health information technology. We cover developing standards for behavioral health information technology, including personal health records which allow patients to store their own information voluntarily “in the cloud”, on a server. Dr. Pat Barta talks Open source health record systems and information security.

Health Data Rights is an organization that developed a proposed declaration of rights for patient data. Another organization addressing this is SpeakerFlower, of which Roy is the spokesperson.
Dinah talks about her blog postWhat’s An Emergency? and wonders how flexible psychiatrists should be when a patient says they need to be seen right away. Which situations are truly emergencies? What should you do if a patient turns down multiple appointments offered for that same day? Should your office voicemail tell people to call 911?
Finally, Dinah wonders what has happened in states with medical marijuana laws. She mentions KevinMD’s blog post Medical Marijuana Has Doctors Asking Questions. Should marijuana be prescribed for attention deficit disorder? How do you do clinical research on a controlled substance?
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Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail.

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