Some Thoughts for The Therapist I’ll Be (Part 1)

I’m looking at grad school [gasps, slams laptop closed], and thinking about careers and plans and futures. (Adulting! It’s scary shit.) Which means lots of reflecting on what I’ve learned and heard about the good and awful things therapists can do. So, some notes, some things I want the future Therapist Kate to remember:

1. I will talk process.

Get an email from a potential client? Those are scary to send. Like, preventatively terrifying. And years from now, I will remember how hard it was to press ‘send’ this year. And then I will respond, right away. Even if it’s that I can’t help, that I’m not taking new clients, I will respond. Because it’s even scarier to have pressed send and never hear back.

2. I will continue to update and talk process in every step of the way.

Going to need a week to figure out my schedule? I’ll make sure to check in and update.

3. I will ask everyone pronouns and then use preferred ones in all notes and files.

Because really. This is just a habit worth developing.

4. I will have multiple avenues of contact.

Making my first therapy appointment involved no less than two websites for health services, three google searches, and one very very scary phone call. (Apologies to everyone who thought Moaning Myrtle briefly occupied the third floor bathroom that day. I didn’t have anywhere else to call from.) Then, to do intake? Another phone call. This time, a long one, conducted from my room. I had a roommate. Not to mention, this just about sums up my feelings about phones.

Email is easy! Email means clients can revise and edit and make sure they’re clearly stating what I need. They can write down lists and then give accurate pictures of their symptoms. I will have multiple ways to be contacted, because the barrier to entry shouldn’t be calling me. (Happy ending: my new counseling center takes–nay, encourages–scheduling via email.)

5. I will remember that I can’t help everyone. 

This is the stray cat principle. As nice as it would be to rescue every feline with big eyes and soft fur, you have a house, apartment, or commune of finite and inchangeable size. You know this. So which cats do you adopt? The ones who get along with your life. The ones who you think won’t tear all the drapes up every night and leave you stressed and angry and neglectful of other cats.

In the same way, I will remember that it’s both unethical and downright harmful to take on clients who have issues you’ve no experience in. It’s not acceptable to take on so many clients that I let them slip through the cracks. That I owe it to my clients to take care of myself, to make recommendations and decline and refer when I think I’m not the best practitioner.

Ideas? Put them in the comments!

Brains Lie

I’m heading into my last year of undergraduate degrees in psychology.* It’s what I’ve always wanted, if you can define ‘always’ as, ‘at least since I’ve had life plans’.

A sneaking suspicion that I wanted to know more about what made people tick in high school, a single psychopathology class during a visit to Stanford (I sat in the back, took six pages of notes, and promptly planned to major in the field), and one early-decision application to the school with my favorite psychology program, and here I am. So what have I learned? Can I guess your deepest motivations? Can I diagnose strangers at fifty paces? What have I gotten out of nine quarters of work and six figures of tuition?

A very valuable lesson, couched in reams of research papers and a small fortune in textbooks:

Brains lie.

They lie often and well and inconspicuously. They lie in beautiful, harmless ways, turning that pattern of dark and light into an optical illusion,giving color to numbers and taste to music, replaying that romantic memory in surround sound.

And they lie in dangerous, scary, unpredictable ways. Distorting memories where they matter most. Creating hallucinations, delusions, biases that lead us down evidentiary rabbit holes, confirm what we think we know, inflate our fears and skew our understanding of statistics. Anxiety. Impostor syndrome.

Brains tell the truth, sometimes, of course. But we know that. We’re much, much worse at remembering how often they don’t. We’re influenced by the order of choices presented to us, the race, age, weight, even accent of the person in front of us. There’s the foot-in-the-door effect, the door-in-the-face, wikipedia lists on lists of biases and loopholes and soft spots in our reasoning. And still we persist in this silly idea that we make independent choices, that no man is an island, but our brains are.

Brains lie.

*I got lucky and fulfilled two full psychology degrees; one in Psychology, one in Human Development & Psychological Services. The first is theory-based, the second geared towards practice. 

Monday Miscellany: Milgram, McCandless, & Radioactive Spiders

This is a link to play Set online. It is endlessly addictive, and if you can forgive the occasional typo, the instructions are simple and easy to understand.

I’m not sure I would go as far as this article does, to say that “the Milgram experiments—however suggestive they may appear at first blush—are absolutely useless.” But, this is new information about the famous conformity research. Well worth reading.

I had this plan to write a blog about failed social programs…but luckily I googled about first and found out that someone else had already written it.

s.e. smith on the ways we endorse problematic police behavior in the media.

Television is the land of nebulously legal police searches. We often see them used, in fact, as the crux of a case, and they’re generally presented in a positive light, as something that viewers should view as completely acceptable. After all, they allow our heroes to solve the crime and end up on top, bringing the bad guy in for punishment. They certainly aren’t something we should question or feel uneasy about, and the evidence uncovered during such searches should absolutely be valid in court because it was discovered in pursuit of justice.

Except that search and seizure isn’t about justice and who’s heroic.

Education needs more radioactive spiders. (Bear with me, this metaphor is excellent and involves very few actual arachnids.)

Now, Peter Parker was a good student. He had a real knack for chemistry, mathematics, mechanics, biology, physics, and photography. But he lacked confidence, drive, and self-belief. He was bullied constantly by the other students. He was lonely, shy, and socially isolated.

One day in high school, he attended a science exhibition about radiology. In a moment, something happened that forever transformed him.

He got bit by a radioactive spider.

This changed everything. He suddenly realized he had all these powers. He was much stronger and quicker than he ever realized.

I’m convinced that there is so much more possibility in all students than we realize. Imagine what would happen if educators helped all students see in themselves what is possible, and then helped them integrate that into the core of their identity?

I bet we’d have a lot more superheroes.

Speaking of bugs, this one has a gear in its leg!

The IgNobels happened! I’m quite proud of psychology for winning with “Beauty Is in the Eye of the Beer Holder’: People Who Think They Are Drunk Also Think They Are Attractive.”

We talk a lot around here about how skepticism and atheism need feminism. But it’s not a one-way street. Feminism needs skepticism. And if it results in articles like this: Dissecting “Sweetening the Pill,” a Completely Frustrating New Book on Birth Control…then, yesplz.

I like the skeptic movement. But I think th best thing we can offer the world is more work like this–using research to improve how we approach persuasion–in this case, convincing parents to vaccinate their children by understanding their motivations.

At nearly every atheist conference I attend, someone brings up cats. Yes, cats. Most particularly, why do all the atheists we know love (and own several) cats? Oh, we have research on that?

I don’t know if I’ve mentioned this here, but I do contract work for the Secular Student Alliance. (yes, they’re amazing. yes, even more awesome than you think.) It’s been an especially great week because we’ve appeared in the Southern Poverty Leadership Center’s blog, and The Atlantic. Oh, and this happened.

How Chris McCandless Died. Decades after writing Into the Wild, Krakauer pursued the question, testing his own conclusions, and eventually finding them to be incorrect. This article is his update.

What have you been writing recently?

Pages Updated: Brain Self Help & Decompressing

Just some housekeeping here!

I’ve added more resources to the Brain Self-Help tab at the top of the page. Links are intended to provide resources for when you cannot access therapy, want to try something on your own time, or just find that therapy isn’t helping in the ways you want it to. The Anxiety and Depression sections have been combined (because most of the resources applied to both) and a number of books and applications have been added.

Need to decompress? That page has also been expanded, with about eight new fiddly or calming things to do when you really just need to shut your brain up for a few.

Have ideas for either page? Please, please, please comment below. 

Intake Ramblings

The ramblings part of the title is veeeery accurate here! This is about my experience with intake and therapy and (1) I most certainly do not want to discourage you from seeking therapy if you have access to it! Intake may suck, but it is (usually) worth it. (2) I wrote this last night and refused to let myself do anything fun until I’d sent in my therapist request. So these are Thoughts and Feelings, but they are also out of date. 

It’s 2 a.m. and I can’t sleep. It feels a little like the insomnia is coming back. 2:30 am last night. Probably even later tonight. And awake at six, disoriented, but not exhausted.

There’s no AC, and a hot day turned into a warm and sticky night. So I’m on the couch, and I can’t sleep, with a mug of tea that won’t help.

I need to send in a request for assignment to a school therapist. I’ve been delaying. Again. I was late last year, too. My file will get a little bit longer, and a small and silly part of me thinks that’s worse than the feelings.

Eating disorder. Then, eating disorder again, with a new year and a new therapist, and a footnote–obsessive tendencies?
This year: anxiety.  Maybe. Probably.

I’m going to have to do intake again and auuuuugh. I will sit in a room and cross my legs and quietly spell out the last few years. I will ramble a little, because you’re speaking into silence and getting nods in return and I want to sound functional, but I need them to help me, and that means finding the worst parts.

“I believed I had the tendencies under control when I left for college.”
“And by the end of that year I was unable to keep from swinging between bingeing and depriving.”
“Invasive thoughts…trouble leaving my house once or twice.”

There will be a series of questions when I stop talking. I’ve sat on the other side and asked them myself, ticking boxes and nodding. I know what they are, and I know why they’re asked and I will still feel weird and shift uncomfortably, even as I answer honestly.

Have you ever felt suicidal?

Have you ever been sexually assaulted? Raped?

And then they will nod and smile and thank me for sharing, as though I’d set pretty cupcakes on the table between us, instead of my insides.

They’ll let me know when they have a therapist for me, they say as we shake hands. I’ll go sit in the campus garden for a bit when I leave. It’s become a ritual, this. The story, the niceties, the third bench on the right, behind the tulips, letting the feelings crash down.

And then, in a week or so, I’ll get an email from my new therapist. She’ll have my file, but she’ll ask me to explain why I’m there, and I will retell the story again. And then, finally, the work will begin.

 

The Social Psychology of Sportsball

Photo credit: wikimedia commons

Social psychology is a weird and confusing bird. Humans, as you might imagine, are complicated.  And so it goes that the most interesting research results usually have caveats in caveats, beginning with “well, we did this once in a lab with college sophomores” and ending with “….and it may or may not replicate”.*

Which is why the research on black jerseys and sports is so very fascinating. We’ve studied it from a few angles. We’ve looked at it in real life. It’s replicated, to an extent.

When teams wore black jerseys, they played more aggressively, getting more penalties. Okay, cool, maybe that’s a thing, you say, all skeptical-faced. But what if it’s just coincidence? Or what if there’s some mitigating factor?

Well, researchers looked at sixteen seasons of data from the National Hockey League (NHL) and National Football League (NFL). In both cases, teams have two uniforms: one with primarily white, and trim in the team color, the second in the team color with white trim.  In each case, the teams with black as the main color in their colored jerseys received more penalties when dressed in black.

Okay, but what if it’s just where the black jersey’s are worn? After all, NFL players traditionally wear their black jerseys at home games and the predominantly-white ones for away games. (The reverse is true for the NHL) What if it’s just a matter of the team playing more aggressively when home (in the NFL) or away (in the NHL)?

Well, that was examined, too! During the sixteen year sample, several teams switched uniform colors from non-black to black. In each case, there was an immediate uptick in penalties. This was even seen in one case where the switch happened mid-season–meaning that management and players hadn’t changed. When teams exchanged their black uniforms for different colors, there was an immediate decrease in penalties. This finding has also been replicated in other studies, where teams are randomly assigned a uniform color, then swap uniforms.

Common objection: Black jerseys are easier to spot–so referees are more likely to call penalties. 

Status: seems to be false. Even when players wore other dark colors, black uniforms had significantly more penalties.
Caveat: Jerseys that were perceived to be black, notably the Chicago Bears’, appeared to have the same status as black jerseys. So, dark jerseys don’t behave like black ones…unless they’re dark enough to appear black. That’s a bit of a fuzzy boundary.

Potential mechanism driving the black jersey effect: Black is seen as a symbol of malevolence and aggression.

Status: Somewhat supported, less replicated than the black jersey effect. The researchers who did the original research with the NHL and NFL also got naive participants (those who didn’t have any sports experience or recognition) to rate the ‘malevolence’ of players pictured in black and non-black uniforms. They consistently rated those in black uniforms higher.
Caveat: Small sample size, undergraduates, and heavily skewed towards women participants.

Further reading at NPR and PubMed.

*This is an unqualified dig; I actually adore social psychology. It’s messy and frustrating and often conflicts and makes sweeping claims, but it studies some of the most interesting subjects on the planet: us. 

Monday Miscellany: All Caps-y BRAINS Edition

Pete Etchells takes a look at what data we have on screen-time and mental health. (Spoilers: it’s not as simple as TV = bad.)

Miri on making the normal abnormal.

Here is a “normal” thing in our society: a young woman walks down the street at midnight, one hand clutching her keys and the other holding her pepper spray with her finger poised on the trigger. Her heart pounds and she walks as fast as possible. Few other women are still out, but plenty of men hang around, walking freely down the street. A few of them shout sexual comments at the woman just for shits and giggles.
[…]
So what I want to do is to get people to look at this differently. I want them to see how weird, how artificial, how bizarre this actually is. I want them to imagine a sentient alien species visiting Earth and furrowing their brows (if they have brows) and wondering, “Wait, so, you divide your species in half and one half can’t walk down the block without getting harassed or threatened by the other half? And your solution to this is not for the ‘men’ to stop harassing and threatening, but for the ‘women’ to stop walking alone?!”

GUYS. WE MADE A BRAIN-LIKE THING IN A LAB. It’s a bit of a proto-brain, without neural networks, but it is SO. COOL.

Pretty is a set of skills.

Have spare time? Want a less-jargony intro to artificial intelligence risk? Robby has curated one for you. I’m only on Part II–much like Wikipedia, I get lost in links within the linked articles.

Give people time to be stupid: compassion in the face of questions.

Haters gonna hate? Yeah, there’s a psychological explanation for that.

Poverty increases cognitive load, leading to a decrease in mental ability.

In a series of experiments run by researchers at Princeton, Harvard, and the University of Warwick, low-income people who were primed to think about financial problems performed poorly on a series of cognition tests, saddled with a mental load that was the equivalent of losing an entire night’s sleep. Put another way, the condition of poverty imposed a mental burden akin to losing 13 IQ points, or comparable to the cognitive difference that’s been observed between chronic alcoholics and normal adults.

The finding further undercuts the theory that poor people, through inherent weakness, are responsible for their own poverty – or that they ought to be able to lift themselves out of it with enough effort. This research suggests that the reality of poverty actually makes it harder to execute fundamental life skills. Being poor means, as the authors write, “coping with not just a shortfall of money, but also with a concurrent shortfall of cognitive resources.”

Binge-eating and the ‘rewards’ system.

 

In Which I Accidentally Test My Previous Post

Yesterday I posted about reducing a somatic symptom of anxiety. Today, I accidentally gashed myself with a knife and found myself quite panicky at the injury and blood and in the emergency room….retesting all that advice I was handing out*. Empiricism!

However, this also serves as an announcement that blogging, if it occurs, will be short and possibly typo-prone. My left hand looks a bit like a sewing project, and I’ve just sent my computer into the shop for a few days. The WordPress app on my phone isn’t bad, but the links feature is buggy, and composing is slow.

* I tried all suggestions in sequence and found the most immediate relief from the cool cloth on the back of my neck, but want to compare it to an ice pack in the same location. Even more helpful was the friend who talked cheerfully about her summer without needing much response from me–distracting me for the entire procedure. She’s going to be a brilliant doctor.

[Mental Health Hack] Cooler Heads Prevail

Note 1: I’m baaaaack! (I hear this carries more weight when you don’t have to say it every time you write a post.)

Note 2:  An obvious but important disclaimer: I am not a doctor, therapist, or the delightful mishmash of the two, a psychiatrist. I am but a lowly psych-student-sometimes-social-services-intern blogger. Calibrate appropriately, consult doctors when necessary, and full steam cautiously ahead. 

Welcome to Mental Health Hacks, a when-the-hell-ever-ly feature on making your life easier, brainwise. Each post will be short, science-based ideas for life hacks for the neuro-typical and atypical. Your mileage may vary! Your topic suggestions are encouraged!

—–

I mean, you can totally panic if you want to. But here’s something that might help you panic more effectively.

Around the time I started having troubles with [sub-clinical] levels of anxiety, I noticed something weird. When I got anxious (and very occasionally, before I realized I was high-anxiety), I would feel too warm. WAY too warm. Not sweaty, not that the room was too warm, just a slow burning under my skin. The nearest comparison I could give is the shame-heat of feeling humiliation or embarrassment.

In retrospect (or maybe just in confirmation bias), I can recall being scared or stressed as a child and feeling that slow flare. When I felt too warm, it was hard to concentrate on the task at hand, resulting in a frustrating loop of “Too warm, can’t think! But if I can’t think, I can’t finish this project!”…resulting in STRESS SPIRALS. Not fun.

As it turns out, this is quite common. The theory (annoyingly, all behind paywalls) is that stress-motivated vasoconstriction–when blood vessels contract–is to blame. Despite sounding a wee terrifying, the vascular contraction isn’t terribly dangerous in small amounts. Similar results can be achieved by caffeine. Scientists argue, each with pet data, whether the reaction is found in people with panic disorder and not in those with generalized anxiety disorder or the reverse.

But! Everybody seems to agree that in some subset of people, being anxious means feeling uncomfortably warm, and that sometimes the sensation of heat precedes the emotional aspect.  (With fascinating anecdata about severe anxiety leading to a phobia of blushing.)

Okay, so then what?

Reducing the immediate internal inferno can give you the space needed to deal with people and situations. It’s nigh on impossible to respond peacefully and reasonably when EVERYTHING IS HOT AND AWFUL. So–we make it less hot and awful. Additionally, brains are not so great at determining cause and effect with emotions. There’s a high probability that just feeling less heated can reduce your net anxiety.

[PAUSE: Stick a pencil or pen between your teeth. I promise this is relevant.]

Things I’ve found to work:

-A cool or cold washcloth/paper towel/anything on the back of the neck. This also eases dizziness, which usually comes knocking when I’m anxious.

-A fan or cool breeze pointed at my face (good) or back (better).

-Fanning myself with whatever’s closest at hand. This one sounds particularly obvious, but has the added advantage of giving you a way to avoid eye contact.

I’ve also heard that standing with a freezer or fridge door open (or walking into one, if you’re in food service) can help. My experience is that airflow trumps the air’s temperature, but whatever tips your cow.*

*This is why I love the Midwest.

Monday Miscellany: Futuristic Love Letters, Grilled Cheese, & Social Isolation

Metadata is a love note to the future.

Sometimes a story just rips you apart. This one, of Liz, once the life of the party, and the sister given power of attorney, did. [Content note: brief mention of an eating disorder, extended discussion of suicide.]

Because there weren’t enough things that are bad for you, here’s another: social isolation.

Coming-of-age stories tend to portray young adulthood as a time when we “find ourselves,” whatever that means. But that model ignores the fact that, for better or worse, the very stuff of our selves—our personalities, our preferences, and even our core values—has a remarkable capacity for change. Our task is to make sure that some semblance of self stays intact as we age. It’s hard because we tend to renounce our Past Selves (those haircuts!), and we have a hard time envisioning our Future Selves at all. In real life, this proliferation of selves can cause continuity problems. (Certainly I don’t recognize the Me who once owned a pink pleather skirt.) On Buffy, despite the limitations of its 45-minute format, the characters juggled multiple versions of themselves all the time, constantly grappling with the contradictions, anxiety, and consequences surrounding who they had been, who they were, and who they would become in a surprisingly cogent way.

Vampire-slaying as a better model of life than most television teen stories.

Being gay is not an insult, but accusing a straight man of being gay to pressure him to fuck you is right out of the Verbal Abuser’s Handbook of Unsavory Sexual Pressuring Tactics. Does that scare you? It should.

Damn if I don’t love Captain Awkward.

Speaking of which, last week my dearly beloved friend Miri moved to New York City to start her graduate degree. So, for Miri and all the lovely friends in your lives, dear readers, a reminder about grilled cheese valentines.

The neuroscience of social influence…is really interesting. It appears that social influence (that is, being able to spread ideas), has little to do with ‘traditional intelligence’, and more to do with being able to display the right emotions, be motivated, and consider how other people will react.

Alex has 10 alternatives to the ‘coming out’ narrative of queer identities. Numbers 2 and 4 are my favorite.

And finally, Criptiques, a planned anthology of disability stories.