The Perniciousness of Positive Thinking (Hanna Rosin & Barbara Ehrenreich)

[Bloggingheads]

[nikkibong]

Yay! Barbara Ehreinreich!

Apologies for the positive thinking - I'm a big Ehrenreich fan - and she's got a great Alma Mater, to boot.

[TwinSwords]

Originally Posted by nikkibong

Yay! Barbara Ehreinreich!

Apologies for the positive thinking - I'm a big Ehrenreich fan - and she's got a great Alma Mater, to boot.

And a great Blogginghead for a daughter (as you know), too!

[TwinSwords]

Wow! Barbara Ehrenreich! Welcome to BhTV! It's great to have you here!

[claymisher]

The power of positive thinking has creeped me out since I was a little kid. What a terrific subject for a book! Can't wait to hear this one.

[Winspur]

Thank you for a great diavlog. Barbara's explication of Calvinism, Christian Science, and the prosperity gospel was really interesting (my grandmother was an ardent Christian Scientist). How creepy that the megachurches have stripped all Christian symbols from their interiors--the better to worship Mammon, I guess.

[Ocean]

Interesting daivlog. I haven't read the book, but I saw Barbara when Jon Stewart interviewed her a couple of weeks ago. At the time I was rather disappointed in what she said. I'm glad I had the opportunity to hear about her book in this diavlog, as her argument seems more reasonable now. Barbara seems to emphasize --and reject-- in her book, the more extreme forms of "positive thinking", from its religious origins to its business derivatives. She didn't seem to be very balanced in her appreciation of "positive thinking" and health, or in the context of self help groups of cancer patients. She apparently encountered people that represented the more radical positions. Patients that deal with cancer go through the regular Kübler Ross stages of grief. Anger is certainly a legitimate phase and suppressing it isn't conducive to wellbeing. By the same token, getting stuck in that phase, feeling sorry for oneself, or feeling overwhelmed by pessimistic possibilities isn't going to help. When I think about positive thinking when it refers to cancer or other serious illnesses, I don't think about some magical cure but rather about a coping skill, a strategy to overcome, from a psychological perspective, a very difficult life circumstance.

I appreciated Hanna's very effective interventions in giving context and perspective. Hanna and Barbara make the distinction between the application of psychology to clinical populations (from subnormal to normal), and psychology as a way of improving well being (from normal to supranormal). I would guess that there are legitimate and illegitimate trends in both areas. Identifying the fringes or the illegitimate approaches shouldn't invalidate the legitimate ones.

Towards the end Hanna brings up positive thinking as part of cognitive-behavioral therapy, which is the application that I'm familiar with. Just as an aside, although in its origin and for some of its defenders, cognitive behavioral therapy can be viewed as "a reaction to" psychoanalytic therapies, in fact it is not. These are two different treatment modalities. Each has its indication which is dependent on the specific psychological problem to be addressed, as well as on the individual receiving the treatment.

Overall, a thought provoking diavlog.

[ledocs]

Ocean said:

Just as an aside, although in its origin and for some of its defenders, cognitive behavioral therapy can be viewed as "a reaction to" psychoanalytic therapies, in fact it is not. These are two different treatment modalities

.
If I am reading this correctly, you concede that cognitive behavioral therapy can be seen historically as a reaction against psychoanalysis. But then you go on to say that this is irrelevant to its clinical applicability. The therapist has a toolkit, examines the patient, and applies the appropriate tool. I have a problem with what you seem to be saying about the history of the underlying psychological theory. That is, I don't see how that history can be irrelevant, and, when the therapist chooses what tool to use, she must be making an implicit theoretical judgment about what is going on in the patient's head. The other possibility would be that the therapist accepts the Freudian theoretical framework but thinks that cognitive behavorial therapy is a good way to treat certain manifestations of the Freudian machinery, a better way than psychoanalytic talking therapies. This other possibility is a coherent way of thinking, but I'm guessing that not many therapists hold this view, either in theory or in clinical practice. In short, cognitive behavioral therapy would represent a rejection of psychoanalytic theory in almost all instances when it is used.

[Ocean]

Bonjour Ledocs,

You did a pretty good job of squeezing some meaning out of my two sentences. Thank you for that.

Originally Posted by ledocs

.
If I am reading this correctly, you concede that cognitive behavioral therapy can be seen historically as a reaction against psychoanalysis. But then you go on to say that this is irrelevant to its clinical applicability. The therapist has a toolkit, examines the patient, and applies the appropriate tool.

Yes, I said that.

I have a problem with what you seem to be saying about the history of the underlying psychological theory. That is, I don't see how that history can be irrelevant, and, when the therapist chooses what tool to use, she must be making an implicit theoretical judgment about what is going on in the patient's head.

The therapist has to make an assessment about what the problem to be addressed in treatment (disorder, symptoms, etc,), practical considerations about length of treatment, resources, and the personality structure (or character traits if you like) of the patient are. Based on those he/she would choose which therapeutic approach may be more effective, and this would involve choosing a theoretical framework that best matches the clinical situation as described above.

The other possibility would be that the therapist accepts the Freudian theoretical framework but thinks that cognitive behavorial therapy is a good way to treat certain manifestations of the Freudian machinery, a better way than psychoanalytic talking therapies. This other possibility is a coherent way of thinking, but I'm guessing that not many therapists hold this view, either in theory or in clinical practice.

First, I usually try to stay away from referring to psychoanalytic/ psychodynamic theory as Freudian, because there have been many extremely valuable contributions to this theoretical framework that came after Freud. There's been generations since the "father of psychoanalysis" started this theory. Although some of Freud's general ideas still hold, this framework wouldn't have survived without the later developments.

I agree with the rest of your statement above. It is indeed regrettable that not too many therapists are able to use the different treatment modalities comfortably. This brings us to what you referred to before. Each psychotherapeutic approach includes, basically, two aspects. One is a theory of how the psychological problem developed, how the mind works. The other is a theory of how the treatment should be carried. Many therapists are trained in one or the other framework, or they like one versus the other, and don't seem to be able to reconcile the various frameworks for their clinical applications. I think it's not only possible but highly desirable that they did.

In short, cognitive behavioral therapy would represent a rejection of psychoanalytic theory in almost all instances when it is used.

No, I don't agree with this statement. I will grant that some therapists may reject psychoanalytic theory, but most likely they only reject some aspects of it, they have a poor understanding of it, they don't feel comfortable using its principles clinically, or what have you. A legitimate possibility is, as above, that in a particular clinical situation one treatment modality is more appropriate than the other. Sometimes different approaches can be used with the same patient at different stages of treatment.

For clarification, I want to add that we have only been addressing the psychological aspects of clinical work, without any reference or implications for the biological/neurotransmitter aspects of treatment, which are more or less parallel in most instances.

Just to end, as an aside, it looks like you didn't realize that I am not rcocean. I'm Ocean. Two different people.

[QUOTE=Ocean;135677] For clarification, I want to add that we have only been addressing the psychological aspects of clinical work, without any reference or implications for the biological/neurotransmitter aspects of treatment, which are more or less parallel in most instances. [QUOTE]

Sorry to butt in, but this statement shocked me. What do you mean when you say that the biological/neurotransmitter aspects of treatment are more or less "parallel?" If you mean the administration of psychotropic drugs, if that is the correct term, what possible connection could there be to a "talking cure" à la Freud or even to some kind of behavioral therapy?

[Ocean]

Originally Posted by Francoamerican

Sorry to butt in, but this statement shocked me. What do you mean when you say that the biological/neurotransmitter aspects of treatment are more or less "parallel?" If you mean the administration of psychotropic drugs, if that is the correct term, what possible connection could there be to a "talking cure" à la Freud or even to some kind of behavioral therapy?

What I meant is that there is no direct connection. The patient's symptoms may be such that medications could be beneficial. However, that doesn't change any of the above considerations in terms of talk therapy. They are parallel processes, for the most part they don't interfere with each other, like lines that don't cross.

Originally Posted by Ocean

What I meant is that there is no direct connection. The patient's symptoms may be such that medications could be beneficial. However, that doesn't change any of the above considerations in terms of talk therapy. They are parallel processes, for the most part they don't interfere with each other, like lines that don't cross.

I see. Concurrent, but non-interfering. That would still surprise me, but what do I know..... I am a reader of psychologists and psychiatrists. I have never had to deal with patients. But it seems to me, as a student of philosophy, that a treatment that aims to suppress the symptoms of a psychic disorder is rather different from a treatment, such as psychoanalysis, that seeks to make the patient conscious of what causes the symptoms?

[Ocean]

Originally Posted by Francoamerican

I see. Concurrent, but non-interfering. That would still surprise me, but what do I know..... I am a reader of psychologists and psychiatrists. I have never had to deal with patients. But it seems to me, as a student of philosophy, that a treatment that aims to suppress the symptoms of a psychic disorder is rather different from a treatment, such as psychoanalysis, that seeks to make the patient conscious of what causes the symptoms?

In order to be clear about this we would have to address specific disorders, but I'll give it a try.

Many disorders that are treated in psychiatric practice have what I will call a biological/ neurotransmitter defect. This defect is the final common path by which many different problems can manifest clinically, the symptoms being anxiety, depression, psychosis, etc. Whether this defect is originated in a genetic disposition, the effect of an external agent (drugs, other diseases), the effect of an external 'traumatic' event or a combination of all those factors is independent of the benefit that medications may provide. Medications don't make that distinction (as to the cause or causes of the problem). Medication will act on the respective neurotransmitters to alleviate the symptoms.

Some of the psychiatric disorders are predominantly "biological". That means that the most important defect is neurochemical, and the use of medications is necessary to treat them. The typical example is psychosis.

Other psychiatric disorders may have a biological component but also be heavily influenced by psychosocial factors, such as stress, trauma, losses, etc. In those cases there may be role for both medications and psychotherapy, in order to address the multiple factors. A typical example may be depression.

In other cases the psychological issues are primary and central to the problem. There may or may not be a role for medications, but psychotherapy is essential to addressing the main problem. Here you have a wider spectrum, from hypochondria, to phobias, to personality disorders, to addictions and many more.

I hope that made it clearer...

[Wonderment]

Some of the psychiatric disorders are predominantly "biological". That means that the most important defect is neurochemical, and the use of medications is necessary to treat them. The typical example is psychosis.

Other psychiatric disorders may have a biological component but also be heavily influenced by psychosocial factors, such as stress, trauma, losses, etc. In those cases there may be role for both medications and psychotherapy, in order to address the multiple factors. A typical example may be depression.

In other cases the psychological issues are primary and central to the problem. There may or may not be a role for medications, but psychotherapy is essential to addressing the main problem. Here you have a wider spectrum, from hypochondria, to phobias, to personality disorders, to addictions and many more.

I hope that made it clearer...

That is clear and consistent with what I know (as a layperson) about current practices. I would stress that although professionals may be out there who feel meds are sufficient unto themselves, I never heard of anyone who doesn't also recommend talk therapy as a component in a treatment program, even for a psychosis that responds well to meds. The pros seem to have the numbers to back talk+pills as leading to the most effective outcomes.

I also think Franco is over-emphasizing the role of psychoanalysis. From my understanding, analysis plays little to zero role in most modern therapies (who can afford it, for one thing?). I wouldn't be surprised at all, for example, if most Marriage and Family therapists nowadays had never read Freud, Jung et al or barely remember them from a college course they once took.

Freud's influence, of course, is immeasurable, even among people who never read him, but the model of a patient on a couch talking about his oedipal complex is obsolete.

Originally Posted by Wonderment

That is clear and consistent with what I know (as a layperson) about current practices. I would stress that although professionals may be out there who feel meds are sufficient unto themselves, I never heard of anyone who doesn't also recommend talk therapy as a component in a treatment program, even for a psychosis that responds well to meds. The pros seem to have the numbers to back talk+pills as leading to the most effective outcomes.

I also think Franco is over-emphasizing the role of psychoanalysis. From my understanding, analysis plays little to zero role in most modern therapies (who can afford it, for one thing?). I wouldn't be surprised at all, for example, if most Marriage and Family therapists nowadays had never read Freud, Jung et al or barely remember them from a college course they once took.

Freud's influence, of course, is immeasurable, even among people who never read him, but the model of a patient on a couch talking about his oedipal complex is obsolete.

In France, there are still psychoanalysts and still people who take them seriously. As I am sure you can imagine, I couldn't care less about what passes for the truth in the US.

Added: Whether psychoanalysis is affordable is a question quite independent of whether or not Freud was correct in assuming that the "child is father to the man."

[Wonderment]

In France, there are still psychoanalysts and still people who take it seriously. As I am sure you can imagine, I couldn't care less about what passes for the truth in the US.

Really? Is it covered by national health insurance? If so, you shouldn't pass up an opportunity like that to get your head screwed on right. Bon chance!

Originally Posted by Wonderment

Really? Is it covered by national health insurance? If so, you shouldn't pass up an opportunity like that to get your head screwed on right. Bon chance!

The correct spelling is bonne chance. Same to you, you silly old goose.

[Ocean]

Originally Posted by Wonderment

That is clear and consistent with what I know (as a layperson) about current practices. I would stress that although professionals may be out there who feel meds are sufficient unto themselves, I never heard of anyone who doesn't also recommend talk therapy as a component in a treatment program, even for a psychosis that responds well to meds. The pros seem to have the numbers to back talk+pills as leading to the most effective outcomes.

Yes, that's correct for the most part. But when you think about this remember that the vast majority of people who receive medications for a psychiatric problem receive them from their primary care physician and they are not necessarily referred for therapy.

I also think Franco is over-emphasizing the role of psychoanalysis. From my understanding, analysis plays little to zero role in most modern therapies (who can afford it, for one thing?).

Psychoanalysis has always been for those who can afford it. Still it has become less popular in the last decade or so. When I mentioned psychodynamic therapies, I didn't refer to psychoanalysis only, but rather to the entire group of therapies that are based on psychoanalytic principles.

I wouldn't be surprised at all, for example, if most Marriage and Family therapists nowadays had never read Freud, Jung et al or barely remember them from a college course they once took.

I don't know how these therapists are trained. But if they really have so little training on one of the main aspects of psychological development, I can only frown on the quality of their work. They may be able to learn the trade, like learning a recipe, but we can't call them chefs!

Freud's influence, of course, is immeasurable, even among people who never read him, but the model of a patient on a couch talking about his oedipal complex is obsolete.

Yes, it is obsolete for the most part. As far as I know, the couch has become rare in practice. And although discussing the oedipal complex may be relevant for some people, there are many more issues that are far more common than that. That's why I said before, you can't talk about psychoanalytic theory and limit it to Freud. Many others built on his basic theoretical principles.

[Wonderment]

Yes, that's correct for the most part. But when you think about this remember that the vast majority of people who receive medications for a psychiatric problem receive them from their primary care physician and they are not necessarily referred for therapy.

Here in California, I think there may be a requirement for MDs to refer a patient to a psychiatrist if the meds are more than a short-term deal. Not entirely sure about that, but in every case of a family member of mine being treated for depression, there was a) the unequivocal recommendation of counseling and b) a referral to the shrink for med management.

The huge scandal, of course, is that mental health treatments other than pills are often denied by the insurers. If you're lucky, your plan may give you a few therapy sessions per year; our "Cadilac plan" offers none.

[Ocean]

Originally Posted by Wonderment

Here in California, I think there may be a requirement for MDs to refer a patient to a psychiatrist if the meds are more than a short-term deal. Not entirely sure about that, but in every case of a family member of mine being treated for depression, there was a) the unequivocal recommendation of counseling and b) a referral to the shrink for med management.

There's a huge variation from place to place. I saw a big difference between East and West coast. Just think of what it's like outside the large urban areas, where there's a shortage of specialists. I don't think we can generalize in the least.

The huge scandal, of course, is that mental health treatments other than pills are often denied by the insurers. If you're lucky, your plan may give you a few therapy sessions per year; our "Cadilac plan" offers none.

I haven't heard of therapy as not being covered at all. The most common scenario is that there are limited mental health benefits or limited number of sessions per year.

Originally Posted by Ocean

In order to be clear about this we would have to address specific disorders, but I'll give it a try.

Many disorders that are treated in psychiatric practice have what I will call a biological/ neurotransmitter defect. This defect is the final common path by which many different problems can manifest clinically, the symptoms being anxiety, depression, psychosis, etc. Whether this defect is originated in a genetic disposition, the effect of an external agent (drugs, other diseases), the effect of an external 'traumatic' event or a combination of all those factors is independent of the benefit that medications may provide. Medications don't make that distinction (as to the cause or causes of the problem). Medication will act on the respective neurotransmitters to alleviate the symptoms.

Some of the psychiatric disorders are predominantly "biological". That means that the most important defect is neurochemical, and the use of medications is necessary to treat them. The typical example is psychosis.

Other psychiatric disorders may have a biological component but also be heavily influenced by psychosocial factors, such as stress, trauma, losses, etc. In those cases there may be role for both medications and psychotherapy, in order to address the multiple factors. A typical example may be depression.

In other cases the psychological issues are primary and central to the problem. There may or may not be a role for medications, but psychotherapy is essential to addressing the main problem. Here you have a wider spectrum, from hypochondria, to phobias, to personality disorders, to addictions and many more.

I hope that made it clearer...

Somewhat, but I have heard it all before. Your distinctions between psychological, psychosocial and biological causes of psychic disorder are so vague as to border on the meaningless. As if human beings could be compartmentalized in that way---the body, the soul, society.... In the absence of a scientific, i.e. strictly deterministic account of the mind, you might as well be talking about phlogiston. Since there is no science of the soul or mind (=psychology) these distinctions mean very little.

That said, I have nothing against drugging people into oblivion.

[AemJeff]

Originally Posted by Francoamerican

Somewhat, but I have heard it all before. Your distinctions between psychological, psychosocial and biological causes of psychic disorder are so vague as to border on the meaningless. As if human beings could be compartmentalized in that way---the body, the soul, society.... In the absence of a scientific, i.e. strictly deterministic account of the mind, you might as well be talking about phlogiston. Since there is no science of the soul or mind (=psychology) these distinctions mean very little.

That said, I have nothing against drugging people into oblivion.

In light of her specific disclaimer:

Originally Posted by Ocean

In order to be clear about this we would have to address specific disorders, but I'll give it a try.
...

is this really a fair criticism?

Originally Posted by AemJeff

In light of her specific disclaimer:



is this really a fair criticism?

A valid point.

I think, though, in the light of this particular dialogue, which emphasized the role of history and culture ("positive thinking") in determining how some Americans think and feel about themselves, there are very strong reasons to doubt biological determinism.

[Ocean]

Originally Posted by Francoamerican

A valid point.

I think, though, in the light of this particular dialogue, which emphasized the role of history and culture ("positive thinking") in determining how some Americans think and feel about themselves, there are very strong reasons to doubt biological determinism.

Read my response to your other comment.

[Ocean]

Originally Posted by Francoamerican

Somewhat, but I have heard it all before. Your distinctions between psychological, psychosocial and biological causes of psychic disorder are so vague as to border on the meaningless. As if human beings could be compartmentalized in that way---the body, the soul, society.... In the absence of a scientific, i.e. strictly deterministic account of the mind, you might as well be talking about phlogiston. Since there is no science of the soul or mind (=psychology) these distinctions mean very little.

That said, I have nothing against drugging people into oblivion.

Meaningless to you, Franco.

But, I admit that I'm used to explain these topics to people who accept the assumptions on which the theories of the mind are based.

I agree with you that people can't be compartmentalized. However, in order to understand the multiple factors that influence the final product of our psychological function, it is helpful to describe them separately. Do you doubt that our biological make up affects how our mind works? How about our environment, does that have any impact? How about our personal experiences, how we relate to others?

What's so difficult to understand? Please explain, or accept what I say without the arrogant stance.

By the way, it's always a pleasure to argue with you.

Originally Posted by Ocean

Meaningless to you, Franco.

But, I admit that I'm used to explain these topics to people who accept the assumptions on which the theories of the mind are based.

I agree with you that people can't be compartmentalized. However, in order to understand the multiple factors that influence the final product of our psychological function, it is helpful to describe them separately. Do you doubt that our biological make up affects how our mind works? How about our environment, does that have any impact? How about our personal experiences, how we relate to others?

What's so difficult to understand? Please explain, or accept what I say without the arrogant stance.

By the way, it's always a pleasure to argue with you.

See my reply to aemjeff.

There is no arrogance in my stance. There is, however, much arrogance in the stance of psychologists who confuse the suppression of a psychic disorder with the understanding of it.

[Ocean]

Originally Posted by Francoamerican

See my reply to aemjeff.

There is no arrogance in my stance.

Your answers often come across as arrogant even if you don't intend them to be. I would blame it on the French style of discourse...

There is, however, much arrogance in the stance of psychologists who confuse the suppression of a psychic disorder with the understanding of it.

I'll obviate the arrogance part of your sentence, and I'll get to the only part that seems interesting to me which is the second one. You say that (some) psychologists confuse the suppression of a psychic disorder with the understanding of it. I guess that is possible, but who/ what are you talking about? Who is confusing those two?

Originally Posted by Ocean

Your answers often come across as arrogant even if you don't intend them to be. I would blame it on the French style of discourse... ?

Maybe. The French style of discourse is brief and to the point, sans périphrase inutile. The assumption is that the reader is intelligent. You may find it arrogant. I find the verbosity of many Americans even more insulting besides being boring.

Originally Posted by Ocean

I'll obviate the arrogance part of your sentence, and I'll get to the only part that seems interesting to me which is the second one. You say that (some) psychologists confuse the suppression of a psychic disorder with the understanding of it. I guess that is possible, but who/ what are you talking about? Who is confusing those two?

I was referring to the treatment of mental illness by drugs, which suppress or alleviate symptoms without helping patients understand what ails them---why they are depressed, or why they are angry, or why they engage in self-destructive behavior, or why they suffer from addictions etc. etc.. How many "disorders" now have been catalogued by the American Association of Mental Health Care Providers? 500? The assumption that the cause of every mental disorder is biological or physiological seems to me arbitrary and unfounded but, as I said, I have nothing against drugging people into oblivion. It certainly makes life easier for psychiatrists and psychologists.

Obviously, there are some mental illnesses that may very well be genetic in origin and hence beyond comprehension or treatment except by medication.

[Ocean]

Originally Posted by Francoamerican

I was referring to the treatment of mental illness by drugs, which suppress or alleviate symptoms without helping patients understand what ails them---why they are depressed, or why they are angry, or why they engage in self-destructive behavior, or why they suffer from addictions etc. etc..

Some of your examples are typical cases for which the best treatment would have to include psychotherapy. The main reason for understanding what ails the patients is that they can do something to change those conditions. In the old classification of psychiatric disorders they used to talk about 'endogenous' vs. 'exogenous' depression. Endogenous meant that it was caused by some internal obscure defect, while exogenous meant there was an external stressor that at least triggered the depression. The former was believed to be more amenable to pharmacological treatment, more biological in origin. The second one was considered to be more "psychological" in nature. However, both forms respond to medications. Once the severity of depression is such that it becomes a clinical syndrome, the neurochemical changes in the brain are probably very similar if not the same. For endogenous depression, knowing the cause, for example a genetic predisposition wouldn't help. On the other hand, helping the patient abandon self defeating thoughts and behaviors would improve the symptoms regardless of the cause.

How many "disorders" now have been catalogued by the American Association of Mental Health Care Providers? 500? The assumption that the cause of every mental disorder is biological or physiological seems to me arbitrary and unfounded ...

I don't think that is the prevailing understanding of psychopathology. Let's look at post-traumatic stress. The cause is external. It's a traumatic event which is massive in severity and occurs in a circumstance where the patient has no opportunity to use his/her usual defenses. This psychological 'shock' will cause a number of neurochemical changes in the brain, which in turn will create symptoms, such as intrusive memories, nightmares, anxiety, depression, etc. The patient can receive medication for the symptoms of anxiety or depression or sleep medications that will take care of the nightmares. It is symptomatic treatment. The best treatment would involve to allow the patient to re-process the events of the initial trauma in order to permanently relieve the symptoms.

... but, as I said, I have nothing against drugging people into oblivion. It certainly makes life easier for psychiatrists and psychologists.

That doesn't seem to be a legitimate goal of treatment.

Obviously, there are some mental illnesses that may very well be genetic in origin and hence beyond comprehension or treatment except by medication.

That's correct.

[claymisher]

I kinda think everybody's talking past each other here, or has a lot more to say than they can fit in a post. I do. So in that spirit, my points:

- positive thinking approaches that make supernatural claims ("The Secret", Norman Vincent Peale, "I visualized a Ferrari and the universe provided," etc) are dangerous and often cruel because when it doesn't work it's blamed on a lack of positivity. That's awful.

- A lot of people get hung up on the word happiness. I get it. I'm suspicious of people who are happy all the time too. But I think when people are talking about happiness that's just shorthand for "not being dragged down by depression, chronic stress, anxiety, panic attacks, etc." You know, just being normal. It's not like walking on sunshine all the time. But "how to be normal" ain't as appealing as "how to be happy."

- I don't want to vouch for everything that calls itself positive psychology, but I like the basic idea that mental health isn't completely about eliminating bad things, but also about increasing good things (you don't maximize profits by minimizing costs. Revenue counts too). I think this is really important in relationships. You're always going to have some problems but that's okay if you've got enough good stuff in the bank (see cheesy but useful book).

- I really enjoyed Timothy Wilson's book "Strangers to Ourselves." The gist is that people are more or less incapable of understanding themselves accurately, that people are most introspective at the worst possible time (when they're depressed), and that introspection usually just makes you feel worse. There's a lot more to it than that, but I'm trying to keep it short here. David Rakoff wrote about it here.

- I've heard great things about CBT from people who've struggled with really serious anxiety problems for a long time and who have been more or less cured by CBT, after years of no progress with other forms of therapy and drugs.

[Ocean]

Originally Posted by claymisher

I kinda think everybody's talking past each other here, ..

Not really, but we did go out on a tangent.

or has a lot more to say than they can fit in a post.

That's certainly the case.

I do. So in that spirit, my points:

- positive thinking approaches that make supernatural claims ("The Secret", Norman Vincent Peale, "I visualized a Ferrari and the universe provided," etc) are dangerous and often cruel because when it doesn't work it's blamed on a lack of positivity. That's awful.

Yes, that's exactly what Barbara talks about here and in her book.

- A lot of people get hung up on the word happiness. I get it. I'm suspicious of people who are happy all the time too. But I think when people are talking about happiness that's just shorthand for "not being dragged down by depression, chronic stress, anxiety, panic attacks, etc." You know, just being normal. It's not like walking on sunshine all the time. But "how to be normal" ain't as appealing as "how to be happy."

Ahhh, the definition of happiness! I think that ultimately you have to come up with your own definition of 'normal' and 'happiness'. But it's probably more a state of mind than an absence or presence of something else.

- I don't want to vouch for everything that calls itself positive psychology, but I like the basic idea that mental health isn't completely about eliminating bad things, but also about increasing good things (you don't maximize profits by minimizing costs. Revenue counts too). I think this is really important in relationships. You're always going to have some problems but that's okay if you've got enough good stuff in the bank (see cheesy but useful book).

Certainly mental health isn't only absence of mental illness. I haven't read the book, but I may have a general ideas about 'the bank'.

- I really enjoyed Timothy Wilson's book "Strangers to Ourselves." The gist is that people are more or less incapable of understanding themselves accurately, that people are most introspective at the worst possible time (when they're depressed), and that introspection usually just makes you feel worse. There's a lot more to it than that, but I'm trying to keep it short here. David Rakoff wrote about it here.

I haven't read the book. It's true that people are more introspective when they are (somewhat) depressed. But introspection doesn't always make you feel worse. If you only examine yourself at the worst of depression, most likely you will only see the worst aspects of yourself and that will increase your depression. However, if you are in a less negative mood, less depressed, it can offer a great opportunity. The best would be to engage in introspection when you are not depressed. But most people would prefer to invest their time doing something else.

- I've heard great things about CBT from people who've struggled with really serious anxiety problems for a long time and who have been more or less cured by CBT, after years of no progress with other forms of therapy and drugs.

Yes, CBT is a great tool for therapy. It's effective and pretty fast when it's used for the right kind of problems.

[Me&theboys]

Originally Posted by claymisher

(........).... I really enjoyed Timothy Wilson's book "Strangers to Ourselves." The gist is that people are more or less incapable of understanding themselves accurately, that people are most introspective at the worst possible time (when they're depressed), and that introspection usually just makes you feel worse. There's a lot more to it than that, but I'm trying to keep it short here. David Rakoff wrote about it here.

Some great points, Clay. The book above looks interesting. I just finished reading Robert Burton's On Being Certain (which is really about how ludicrous it is to think we can be certain, given how little we know of how our minds form opinions and process information and react to the world). Similar basic concept taken along a different path of thought, it seems.

Ocean writes....

Thank you for your thoughtful reply. Perhaps claymisher is right and we are talking past one another. My comment was inspired by an article I read some time ago in the NYR of Books on the history of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Between the 1952 edition and the 2000 edition the number of "mental disorders" increased from 106 to 297, and the number of pages from 130 to 886). Now this might look like progress, but according to the Wikipedia article on the DSM:


"By design, the DSM is primarily concerned with the symptoms of mental disorders, it does not attempt to analyze or explain the conditions it lists or even to discuss possible patterns or relationships between and among them. As such, it has been compared to a naturalist’s field guide to birds, with similar advantages and disadvantages. The lack of causative or explanatory material, however, is not specific to the DSM, but rather reflects a general lack of pathophysiological understanding of psychiatric disorders. As DSM-III chief architect Robert Spitzer and DSM-IV editor Michael First outlined in 2005, "little progress has been made toward understanding the pathophysiological processes and etiology of mental disorders. If anything, the research has shown the situation is even more complex than initially imagined, and we believe not enough is known to structure the classification of psychiatric disorders according to etiology."The DSM's apparent superficiality is therefore largely a result of necessity, since there is no agreement on a more explanatory classification system."

I am only a tourist in your specialty, but the last statement is amply borne out by my ramblings through psychology and psychiatry.

[bjkeefe]

Originally Posted by Francoamerican

... but according to the Wikipedia article on the DSM:

"... As such, it has been compared to a naturalist’s field guide to birds, with similar advantages and disadvantages. The lack of causative or explanatory material, however, is not specific to the DSM, but rather reflects a general lack of pathophysiological understanding of psychiatric disorders. [...]"

Seems to me that most, if not all, fields of science have gotten started this way -- people record observations, gather them up, try to create taxonomies, try to discern patterns, try to fit as many of the observations into a larger theoretical structure as is possible, and so forth. There doesn't seem to be any other obvious way of going about it.

Maybe we will never get to the point where we can reduce understanding of human minds to the proverbial set of equations that will fit on a T-shirt, but that's no reason not to continue to try to improve our understanding, and if all we can do now is, in effect, add pages to the field guide, well, so be it. Better than nothing.

Originally Posted by bjkeefe

Seems to me that most, if not all, fields of science have gotten started this way -- people record observations, gather them up, try to create taxonomies, try to discern patterns, try to fit as many of the observations into a larger theoretical structure as is possible, and so forth. There doesn't seem to be any other obvious way of going about it.

Maybe we will never get to the point where we can reduce understanding of human minds to the proverbial set of equations that will fit on a T-shirt, but that's no reason not to continue to try to improve our understanding, and if all we can do now is, in effect, add pages to the field guide, well, so be it. Better than nothing.

Not necessarily. Wrong classifications can be deadends and impediments to understanding. Besides, science as currently understood is either deterministic or it is nothing.

[bjkeefe]

Originally Posted by Francoamerican

Not necessarily. Wrong classifications can be deadends and impediments to understanding.

Sure. We don't always get things right the first time around. But we have yet to find a better approach to getting started. Or, put another way, we've had most of our successes in science starting this way.

Besides, science as currently understood is either deterministic or it is nothing.

No reason to think that we might not get there someday in understanding how brains work, and there do already seem to be at least some deterministic aspects that have been uncovered in this field.

Originally Posted by bjkeefe

Sure. We don't always get things right the first time around. But we have yet to find a better approach to getting started. Or, put another way, we've had most of our successes in science starting this way.

No reason to think that we might not get there someday in understanding how brains work, and there do already seem to be at least some deterministic aspects that have been uncovered in this field.

We? Who? Psychologists or neuroscientists? Starting with Wm James there is a long line of psychologists and philosophers (of mind) who would dispute the very idea that the mind (or consciousness) and the brain are the same thing, hence the possibility of a naturalistic or materialistic account of the former, which is what determinism would require. You would have to assume that materialism is true in the first place, but that, as James pointed out, is not science: "To explain our phenomenally given thoughts as products of deeper-lying entities is metaphysics."

[bjkeefe]

Originally Posted by Francoamerican

We? Who?

By "we" I meant "people of a scientific bent."

As for what philosophers from past centuries have said about the mind, the brain, or the mind/brain, well ... I expect you already know how much stock I place in those, as far as making scientific progress goes. Maybe we'll never understand human behavior as well as we understand physics, maybe it'll even turn out that we can never get a handle on it, but until we've hammered at the problem for a good while longer, I will retain my assumption that it's a field amenable to the scientific process.

Originally Posted by bjkeefe

By "we" I meant "people of a scientific bent."

As for what philosophers from past centuries have said about the mind, the brain, or the mind/brain, well ... I expect you already know how much stock I place in those, as far as making scientific progress goes. Maybe we'll never understand human behavior as well as we understand physics, maybe it'll even turn out that we can never get a handle on it, but until we've hammered at the problem for a good while longer, I will retain my assumption that it's a field amenable to the scientific process.

As I said, quoting James, your position isn't scientific. It is metaphysical, indeed it is superstitious because you assume that the only valid explanation is in terms of matter (=the brain). There is an enormous literature on the mind/body problem that extends right up to the present.

[bjkeefe]

Originally Posted by Francoamerican

As I said, quoting James, your position isn't scientific. It is metaphysical, indeed it is superstitious because you assume that the only valid explanation is in terms of matter (=the brain).

Incorrect. I do not believe this. What I do believe is that it seems plausible to think that we might one day be able to understand human behavior, at least better than we do now, in scientific terms.

This is also the approach I am most interested in, as we have spent all of recorded history talking about this topic in other terms ...

Originally Posted by Francoamerican

There is an enormous literature on the mind/body problem that extends right up to the present.

... and while some of it is appealing, it is ultimately unsatisfying to me.

I must say that attempting to belittle my preference for a different approach as a "superstition" carries about as much water as someone insisting my atheist attitude is a "faith," which is to say, about as much as a fork.