Daily Archives: September 8, 2010

Reorganize your life: thinking ~> doing ~> being


The “thinking ~> doing ~> being” equation really resonates with me.  I believe it is an apt way to portray the global process of transitioning from thought to action.  Perhaps more importantly, it provides us with a vehicle to reflect on the significance of the action and if we are lucky, subsequently tie significance back to the original thought.  Although I hadn’t considered it until I wrote this essay, it could be one of the universal truths we all endeavor to seek out.  It passes the common sense test… that’s more than I can say for most equations I have encountered in my day.

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Before we attempt any action, that action is always preceded by an idea or creative thought process.  In my own personal life, I tend to be analytical and weigh potential benefits vs. potential negative ramifications.  If the decision at hand has potential positive value, I suggest we strike while the iron is hot.  Buckingham and Clifton (2001) might attribute that process to the signature theme of “strategic.”  For me, it’s a matter of asking myself (even if unconsciously)… “What if?”  I guess the point is, if there is one, is that the action is always preceded by a process by which the potential outcomes are sorted, weighed, and accessed.

Acar & Runco (2010) suggest that a style of thinking can have significant impact on future experience, and that past experience can have even greater impact on the present course of thought.  And so, my thoughts right now are governed by my experiences of yesteryear, and my thoughts tomorrow are influenced by my thoughts today.  Moreover, the ability to seamlessly transition between and among personality traits, such as extraversion and introversion, may suggest an individual possesses characteristics of a multidimensional personality conducive to both creativity and complexity.  (Haller & Courvoisier, 2010)  Shouldn’t we all aspire to learn how to drive a vehicle with 3 on the tree or 4 on the floor?  I guess it all depends on whether or not value better gas mileage?  Perhaps it’s more fun to drive than an automatic?  Whatever our reasoning, being able to seamlessly adapt to situations in the now is the measure of your ability to control your tomorrow.  Worst case scenario we score a new ride with those new paddle shifters!  Wishful thinking can produce optimism in light of success, or pessimism in the darkness of defeat.  (Vosgerau, 2010)  If I sign and drive today, I still have to make 60 monthly payments… so I am hesitant to get ahead of myself.  What if?  Select.  Strike.

The process of doing translates into putting a plan or process into action.  Furthermore, it’s a process of learning by trial and error.  I am of the opinion that mistakes can be our greatest teachers.  Research seems to support the old adage that people learn faster by doing when compared to (learning by) viewing.  (Stull & Mayer, 2007)  Perhaps more importantly, our thoughts and actions are often governed by what we think people THINK we are doing.  (Kozak, Marsh, & Wegner, 2006)  I don’t underestimate the power of approval or under-appreciate the significance of supervision.  Certainly, this paper would look much different if I knew you would never read it.  Perhaps that’s the challenge… to resolve the discrepancy between actions under supervision and actions while left alone with the cookie jar.  If there is a significant difference between what we would do under the bright lights, as compared to what we would do under the shroud of darkness, perhaps we should turn our attention to the last part of the equation… being.

Can you really claim “being” if there is any discrepancy between thought, action, and intent?  What are you “being” if there is a discrepancy?  Do we all aspire to be something different, or is there a common denominator that we share simply because we are all human?  In my mind, “being” is the process of learning to associate thoughts with actions, and learning to associate effects with causes.  Being is something we all do inadvertently, but seldom recognize the significance of.  The concept of being is full of more questions than answers for me, but I can’t resist the temptation to suggest that there is some common denominator that we all share simply by using and understanding the word…

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References

Acar, S., & Runco, M. A. (2010, Aug). Do tests of divergent thinking have an experiential bias?. Psychology of Aesthetics, 4(3), 144-148. doi: 10.1037/a0018969

Buckingham, M., & Clifton, D. O. (2001). Now, discover your strengths. New York: The Free Press.

Haller, S. C., & Courvoisier, S. D. (2010, Aug). Personality and thinking style in different creative domains. Psychology of Aesthetics, 4(3), 149-160. doi: 10.1037/a0017084

Kozak, M. N., Marsh, A. A., & Wegner, D. M. (2006, April). What do i think you’re doing? Action identification and mind attribution. Journal of Personality and Social Psychology, 90(4), 543-555. doi: 10.1037/0022-3514.90.4.543

Stull, A. T., & Mayer, R. E. (2007, Nov). Learning by doing versus learning by viewing: Three experimental comparisons of learner-generated versus author-provided graphic organizers. Journal of Educational Psychology, 99(4), 808-820. doi: 10.1037/0022-0663.99.4.808

Vosgerau, J. (2010, Feb). How prevalent is wishful thinking? Misattribution of arousal causes optimism and pessimism in subjective probabilities.. Journal of Experimental Psychology, 139(1), 32-48. doi: 10.1037/a0018144

The Standard Family – S. Freud vs. E. Erikson: An analysis


The following vignettes are developed from a hypothetical scenario described by Doris Bergen in Human Development: Traditional and Contemporary Theories (p. 52-53). For benefit of the reader, I have included a “family tree” with the associated Freudian and Erikson-ian developmental stages.  (Just a heads up, you may need to click on the picture below to and open it in a separate browser window to grasp the rest of this article…)

The_Standard_Family

Janet and Henry getting divorced is about as close to worst possible scenario I can predict for their 5 kids, who range in age from 2 to 20.  Donnie may find his will significantly impacted, thereby leaving him unsure of himself and dependent on others’ evaluation of this worth.  It’s hard to say whether he will be the most effected or the least effected since, technically, he is probably too young to remember the divorce if it happens immediately.  I can also see potential for Donnie to be raised by one of his siblings, perhaps holly, since Janet will effectively be a single mother… although that all moves under the assumption that all the kids end up in custody with Janet.  Jason may have his ability to take on leadership roles impacted, and he may harbor feelings of guilt due to the divorce.  As mentioned previously, I believe it’s likely that Holly will fall into the unenviable position of taking on mother role for Donnie due to Janet being overwhelmed, but there are too many variables to predict exact outcomes.  She’s the only girl, my assumption that she will take on this role might be too biased or superficial… Furthermore, under the increased pressure, Erikson would suggest that it is likely that she will give up easily, refuse to make an effort at all, or feel less than competent at many aspects of her life.  Alan may find a lack of direction, feel unproductive, and be unsure of his own strengths as a direct result of unsuccessful resolution at the adolescent stage.  Brad is another quandary.  Part of me wants to believe he will be the least effected since he is likely already out of the house, but it really does depend on where he is at emotionally, financially, etc.  He may have relationship problems, become territorial or possessive.  He may find difficulty with the concept of love, which is unfortunate.  It will suffice to say that all the children will be significantly impacted.  It may also have a significant impact on Grandma Mildred Standard as she mulls over the legacy she has left this world.  Last but not least, there may be some residual effects on the rest of the family, but the interrelationships between and among the family members are not defined well enough to make reasonable predictions about the aftershock of the divorce between Janet and Harry.

Freud would certainly have a different take on the divorce when compared with Erikson.  Freud might suggest that little Donnie would end up being selfish, wasteful, or overly aggressive.  Jason would likely have sexual problems.  Holly may ultimately have difficulty attracting and retaining a sexual partner of her own.  Alan and Brad, according to Freud, would probably remain largely unaffected.  Although I hesitate to generalize or otherwise stereotype, I believe these effects could potentially be more pronounced in family centric cultures (i.e. The Chu Family, or the Ramierez family).  I would be interested in getting feedback on this, as I am suitably unfamiliar with the role of multiculturalism in this area.  Also, take note that this scenario is firmly rooted in the context of the time when the theory was written… we can only suppose the changes that “modern culture” has made on the potential effects of divorce on children.  Because divorce is so common today, it is reasonable to suggest that effects would be more pronounced (say, in the 1930s) as compared to today.  I believe this generalization holds true to all the scenarios, so for the sake of brevity, I will only address multiculturalism once… but for the inquisitive reader, please feel free to make the same basic assumptions about the remaining 6 scenarios…

If Brad graduates from college, I can see this having a huge impact on the entire family.  Brad sets the tone or an example for his 4 younger siblings.  Furthermore, being the oldest, he has the potential to greatly affect his parents since they are currently working through the process of helping and guiding the next generation (him).  His success or failure is inevitably his parents success or failure… funny how that works.  Brad’s success may have a significant impact on the marriage of Henry and Janet, and it will certainly have an impact on how they continue to raise the 4 younger children.  I would be led to believe that if Brad graduates from college, it might be fair to assume that Henry and Janet are doing something right.  If it’s not broke, don’t fix it.  Conversely, if he turns into a career criminal, I can see a very different upbringing for the younger kids.

In contrast to Erikson, Freud may see this event contribute to successful resolution of the younger children’s respective conflicts.  Donnie learns how to give and receive, Jason develops a stable gender identity, Holly is subsequently able to focus on school and learning, and Alan develops the ability to have adult intimacy.  It would appear that the weight of the world rests on Brad and his ambition to graduate from college…

If Howard comes down with Alzheimer ’s disease, there are a number of different effects that might come as a result.  The most impacted individual will be Sally, his new wife.  She is so much younger than him; I have to wonder if she would reconsider marrying a man that was 22 years older than her.  They are in two totally different categories, assuming pigeon-hole the couple based on age alone… 22 years is quite a gap.  Furthermore, I can see Sally being more concerned with guiding Sue than taking care of Howard.  There’s a storm brewing there.  Grandma Mildred may be effected to some degree because she is a member of the same cohort… it would frustrate and scare me that a peer came down with Alzheimer’s, I couldn’t resist the temptation to think “Am I next?”  Add to that the fact that Grandma Mildred is a widow, and it only compounds the health related concerns for her.  Freud didn’t really address much at this developmental stage, so we’ll leave the conjecture to Erikson.

The one I couldn’t resist is the scenario where Sue starts dating John.  Wow, what a mess.  I am not sure how far you have to be removed to consider yourself “far enough” to be dating a family member, but a marriage there could really twist up the relationships.  I can imagine that it would affect Bill and Ann the most, since they are the people responsible for guiding John in his intimacy vs. isolation struggle.  It would probably have a significant impact on the relationship of Howard and Sally… I can definitely see it making family reunions quite the rumor fest.

If Donnie was diagnosed with autism, I can see major changes in store for all the siblings, as well as for Henry and Janet.  I can see Jason suffering from a significant rivalry with his younger brother, fighting for attention.  Holly may come to find that she has little support (lack of attention and focus) on the part of her parents and her self-esteem will likely suffer as a result.  It’s difficult to know how Alan will be affected because he may be in the process of reexamining a lot of things in his life right now.  Lack of guidance may cause Brad to have difficulty forming intimate relationships or friendships.  Freud would definitely have something to contribute in this scenario.  In short, Donnie is probably in big trouble, hypothetically speaking… depending on his current level of development, he may be stuck at the oral phase and end up being a chain smoker, alcoholic, or a glutton.  If he managed to progress to Freud’s anal stage, Freud might suggest that he may have significant difficulty controlling aggressive impulses.  It stands to reason that the other children may also suffer the negative effects highlighted with in the section covering the divorce of Henry and Janet, although the influence would be from the other direction.  It leaves me curious, how would Freud’s explanation change if it were a sibling that caused the trauma, as compared to a parent?

Finally, if Grandma Mildred has an operation, she is the common denominator between and among all the members of the family.  Her death might cause a two-way or a three-way split in what is currently perceived as a single family system.  Her children, while still in their middle adulthood, may see themselves transitioning to “old age thinking” faster than they wish due to complications with their mom.  It appears unlikely that is Mildred passes away that Howard and his wife and step-daughter will be at the next reunion.  However, if the situation is simply surgery, sometimes family systems have a way of bonding in crisis… so I have confidence that this family system can make it through that trial.

Reference

Bergen, D. (2008). Human development: Traditional and contemporary theories. Upper Saddle River, NJ: Pearson Prentice Hall.

Eating Disorders


“Eating disorders (EDs) are polysymptomatic syndromes, defined by maladaptive attitudes and behaviors around eating, weight, and body image.”  (Blaney & Millon, 2009, p. 431)  The primary disorders in this category are anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders no otherwise specified (EDNOS).  Examples of EDNOS might include “AN-like” with preoccupations with thinness, normal-weight people purging food without binging or simply binging without purging (Binge Eating Disorder, or BED).  (Blaney & Millon, 2009, p. 432)

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Epidemiological data suggests that EDs occur more often in women than in men (by a factor of roughly 10); although there is some evidence indicating that the gender gap is closing.  Although AN/BN tend to be most prevalent in late adolescence and early adulthood, BED defies the stereotype by manifesting in an older age group (typically around 40 years of age).  There is also little linkage to socioeconomic status, despite the common belief that Eds are disorders of the affluent.  (Blaney & Millon, 2009, p. 433)  This totally astounds me… how can people who are already undernourished give up what sustenance they are offered?

EDs frequently co-occur with mood, anxiety, substance-abuse, personality, and other psychiatric disorders.  There are so many comorbid mood disorders noted in individuals with EDs that it is easier to exclude mood disorder (singular) that is unrelated… bi-polar disorders.  Personally, I believe the single mood disorder that is currently excluded should be considered.  “The disorders are believe to depend on similar family/developmental determinants (e.g., attachment problems or trauma), and both have been thought to have similar neurobiological substrates.”  (Blaney & Millon, 2009, p. 434)  Social phobias and OCD were among the most prevalent anxiety related comorbid disorders.  Since anxiety disorders often precede ED onset, it has been suggested that an anxious or obsessive-compulsive attitude predisposes an individual to ED development.  (Blaney & Millon, 2009, p. 435)

Not only are PTSD and substance abuse disorders often comorbid with EDs, but they are often comorbid with each other.  “Substance abusers in an eating-disordered population show significantly more Social Phobia, Panic Disorder, and Personality Disorders.  In addition, comorbid substance abuse was found to predict elevations in Major Depression, Anxiety Disorders, Cluster B personality disorders, as well as greater impulsivity and perfectionism.”  (Blaney & Millon, 2009, p. 435)

Finally, personality disorders are frequently present in individuals whom suffer from EDs.  Restrictive type EDs seem to be associated with Anxious-Fearful PD diagnosis (anxiousness, orderliness, introversion, preference for sameness and control).  Binge-purge types have a pronounced affinity for the dramatic-erratic PDs including attention/sensation seeking, extroversion, mood lability, and proneness to excitability or impulsivity.  (Blaney & Millon, 2009, p. 435)

EDs are assumed to be multiply determined by complex interactions including constitutional factors, psychological/developmental processes, social factors, and secondary effects in the biological, psychological and social spheres of maladaptive eating practices themselves.  (Blaney & Millon, 2009, p. 443)  All of the above features generally manfest in eating-specific cognitions related to bodily appearance and appetite regulation, body image or weight considerations, and social values that heighten concerns with all of the above.  As a result, it is currently conceived that EDs represent a “tightly woven” expression of causes and symptoms that have an interrelationship between and among each other.

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Reference

Blaney, P. H., & Millon, T. (2009). Oxford textbook of psychopathology (2nd ed.). New York, New York: Oxford University Press.

Sexual Dysfunctions


Sexual dysfunctions are conditions that impair sexual satisfaction.  This can manifest as reduced desire to initiate or sustain sexual activity, or lack of ability to achieve sexual satisfaction.  Epidemiological data suggests that the prevalence rate for all sexual disorders is approximately 31% for men and 43% for women.  (Blaney & Millon, 2009, p. 399)  That rate is given to fluctuate, however, depending on the definition of what a “dysfunction” actually entails.  The reality, for Blaney & Millon, is that any particular label or operational definition is imperfect and subject to alterative interpretations.  The key consideration for the therapist is that we must been seen as nonjudgmental.

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I am not overly surprised by the suggestion that Americans have never learned to be comfortable talking about things sexual.  “Even couples who have been together for many years, and experienced physical intimacy hundreds of times, are still often most reluctant to reveal their sexual desires, fears, and concerns to each other.”  (Blaney & Millon, 2009, p. 400)  This is the 21st Century; it’s perfectly acceptable (even desirable)… this is foreign to me.

“Rewarding sexual activity requires the adequate functioning of at least three organ systems: cardiovascular, hormonal, and neurological.”  (Blaney & Millon, 2009, p. 401)  These systems can be adversely affected by medications, particularly SSRI Antidepressants.  Virtually any medical condition that affects those systems; including illnesses, treatments, procedures, and changes- could also serve as precipitating factors.  Finally, culture and psychosocial variables weigh in as contributing factors, although “many people with sexual dysfunctions report none of these factors and many with one or more of these risk factors report satisfying and functional sexual lives.”  (Blaney & Millon, 2009, p. 402)

If a regular partner is a variable, it is preferable to have them present and willing to participate in the process.  “The involvement of the partner of the symptomatic client in treatment is widely believed to play an important (even critical) facilitative role in sex therapy.”  (Blaney & Millon, 2009, p. 404)  Even if the partner is unwilling or unable to be present for the office visits, partner cooperation and participation (along with sensitivity to partner issues on the part of the therapist) are “good enough” to make reasonable progress.

Knowing what is at stake is a key consideration for therapists to measure or ascertain.  What if they therapy fails?  Will the relationship end or will it continue?  “Having more at stake in treatment (i.e., the continuation of the relationship) can sometimes serve as an important motivator for one or both partners.”  (Blaney & Millon, 2009, p. 404)  However, this presents negative aspects as well… primarily because it is an outward indication that there is serious dissatisfaction with the relationship.

Sexual pain disorders are another dimension of sexual dysfunctions that are often neglected.  Recurrent or persistent genital pain in a female, typed dyspareunia, often causes marked distress.  Vulvodynia, characterized by chronic vulvar discomfort or pain, is also not uncommon.  The third common complaint is involuntary contractions or spasms of the outer third of the vaginal barrel, called vaginismus.  This condition makes intercourse painful or impossible.

Treatment of sexual pain disorders always begins with a careful and comprehensive gynecological exam.  “Among the many medical treatments that have been used, with at least some success, are the following:  topical creams, oral medications, biofeedback, physical therapy, cognitive behavioral sex therapy, pain management, local anesthetic agents, topical estrogen, electrical stimulation of the vestibular area, and surgery.”  (Blaney & Millon, 2009, p. 422)

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Reference

Blaney, P. H., & Millon, T. (2009). Oxford textbook of psychopathology (2nd ed.). New York, New York: Oxford University Press.

Comparing and Contrasting S. Freud with E. Erikson


The course of personality and social-emotional development was permanently altered by writings of both Sigmund Freud and Eric Erikson.  “Although their theories have implications for other developmental areas, their primary focus was on explaining social and emotional developmental states and the personality dimensions that may be formed by experiences encountered in each stage.”  (Bergen, 2008, p. 36)  This essay will attempt to highlight some of the strengths, and some of the criticisms of both Freud and Erikson.

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Rarely is the writing of a single individual so influential on a field that he becomes a household name… such is the case with Sigmund Freud.  We need only refer to a Freudian slip (a verbal mistake that expresses the unconscious mind’s feelings) to get clarity on how deep and wide his influence is.  (Bergen, 2008, p. 43)  “Freud was one of the first theorists who thought that the causes of human behavior could be discovered by scientific methods, and he used the methods that were available in his time to investigate the underlying developmental causes of adult mental health issues.”  (Bergen, 2008, p. 37)  Adult is a key component of that statement, since Freud is best known for his phases of psychosexual development that begin with the “oral” phase (ages 0-1) and culminate with the “genital” phase (age 12+).  There is some irony that Freud worked almost exclusively with adults, yet the bulk of his theory was concerned with childhood.

Another basic construct that is inseparable from Freud is the concept of defense mechanisms.  Rationalization, repression, displacement, regression, projection, identification, reaction formation, and sublimation are all concepts that were born of and nurtured by Freud and his disciples.  He is credited with differentiating between the conscious, the unconscious, and the preconscious (the area between the two).  Freud not only put “the unconscious” on the map but he operationalized it in a new way—as a dynamic unconscious, laying down the foundation of a science of the unconscious.  (Lothane, 2006)  He is generally recognized as birthing of the concepts of id, ego, and superego.  All of these theories were the metaphorical shoulders on which the giants of psychological thought stand today… Alfred Adler, Carl Jung, Anna Freud, Karen Horney, and Melanie Klein are all indebted to the work of S. Freud.  And that influence only takes the metaphorical couch into consideration… Freud’s real legacy lies beyond the couch in the application of psychoanalysis to community problems and social issues.  (Twemlow & Parens, 2006)

As can be expected with any theory or theorist, Freud is not without his critics.  Among the criticism is that his theory does not meet the test of falsifiability, primarily because they are not supported or discounted with empirical evidence.  (Bergen, 2008, p. 42)  Critics levy charges of “circular reasoning,” “predicting backwards,” “denigrating female development” with an overemphasis on male development in the Oedipal phase, and finally as a “dated construct” due to the fact that it was firmly situated in the Victorian society it attempted to describe.  The confusion around Freud and his theoretical constructs is that we appear to be misapplying Freudian concepts at present.  “Psychoanalysts have to decide whether to stay with the original meanings or to choose different and proper terminology to suit their new concepts instead of misapplying the original ones.”  (Fayek, 2002, p. 476)

Eric Erikson, while less known in contemporary layman circles, is no less influential.  “Erikson’s theory draws on many of Freud’s concepts; however, his emphasis is on explaining how healthy personalities develop rather than focusing on unhealthy developmental processes.”  (Bergen, 2008, p. 43)

Like Freud, Eriksons work is increasing seen as dated due to ongoing changes in society at large.  For example, “it is certainly the case that adolescents do ‘try on’ many identities, but because of changing social conditions, they may not do that for a longer period of time without it having unhealthy consequences.”  (Bergen, 2008, p. 50)  Erikson’s discussion of the final two periods of life may also need revision dude to the fact that individuals live longer now than they did previously.  (Bergen, 2008, p. 51)

My biggest issue with Erikson is of a more personal nature.  It is generally well known that Erik Erikson had a 4th child who suffered from Down’s syndrome.  This son, who died at the age of 21, was effectively abandoned by him and his wife.  A psychoanalyst who was famous for effectively treating problem children failed to give even the minimum parental care to his own mentally challenged son.  One might question the integrity of an individual who would do such a thing, but the reality is that this experience shaped some of the critical aspects of Erikson’s theory of human development.  (Paranjpe, 2000)

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References

Bergen, D. (2008). Human development: Traditional and contemporary theories. Upper Saddle River, NJ: Pearson Prentice Hall.

Fayek, A. (2002). Psychic reality and mental representation: Contemporary misapplications of Freud’s concepts. Psychoanalytic Psychology, 19(3), 475-500. doi: 10.1037/0736-9735.19.3.475

Lothane, Z. (2006). Freud’s legacy–is it still with us?. Psychoanalytic Psychology, 23(2), 285-301. doi: 10.1037/0736-9735.23.2.285

Paranjpe, A. C. (2000, Nov). Review of Identity’s architect: A biography of Erik H. Erikson. Canadian Psychology, 41(4), 288-289. doi: 10.1037/h0088184

Twemlow, S. W., & Parens, H. (2006). Might Freud’s legacy lie beyond the couch?. Psychoanalytic Psychology, 23(2), 430-451. doi: 10.1037/0736-9735.23.2.430