EK

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This is a page in which when I have time I like to make a note of psychological ideas and issues that pique my interest, and perhaps yours too.

Cognitive Bias

Cognitive bias's distort our ability to think clearly, and figure largely in the work of psychologists like Daniel Kahneman's. They tend to be the default response to a given situation and are in my opinion directly linked psychological development. 

The development of personality is highly complex with more than one system identified. Psychologists like Daniel Khaneman (2011) posits that there are two systems dominant in the psyche, system one which automatically responds to environmental triggers and information, and system two which is the cognitive function, also used in cognitive behavioural therapy to attempt corrections to system one.

 

Abductive reasoning might lead us to believe that system one is broadly linked with the limbic system of the brain and system two the pre-frontal cortex, however in reality the brain is far too complex to identify specific regions to cognitive functioning as a whole. For example, research shows that mathematics is associated with the intraparietal sulcus (Dastjerdi et al.,2013), an area also associated with attention and hand/eye movement.  This is a problem with biological modelling and psychology as small areas of the brain can show involvement in more than one function and thus identifying ego states with particular parts of the brain is problematic.

 

In Khaneman’s work system one and two is differentiated in part by attention. The more aware we are of something/the more attention we pay to it, the more conscious we are of it. So, in reality we have a spectrum of attention from system 1 to 2. The more attention you pay to an issue the more energy and concentration you will devote to it. However, as the research shows this does not exclude a range of cognitive biases or emotional bias rooted in earlier psychological adaptions.

 

 

While system 2 is governs functions such as mental arithmetic and logical functioning, system one has much more control over the day today and is likely influenced by early life development. Many psychologists also suggest this is the source of automatic emotional responses that govern behaviour, and the formation of beliefs. It is this part that the psychotherapist attempts to deal with by addressing early life attachment issues, trauma and other developmental issues that influence self-esteem and emotional state.

 

Qualitative psychological theories go much further, identifying possible sub personalities or ego states that influence and in some circumstances, can dominate behaviour for a time. These states should be differentiated from mood swings and are best viewed as nodes in the psyche which differ from the dominant ego state, they may exhibit different behaviours, be driven by different beliefs and contain discreet memories not available to the dominant ego state. In my experience these are much more common than one might believe. 

Loss Aversion

 

I wanted to write something about the psychology of loss versus gain. It is based on the premise that we fear loss much more than we appreciate gain. A popular example used is that the loss of £100 is felt more keenly than the positive feelings attached to being given £100 by a factor of 2:1.

This is a powerful force in psychology and probably has its roots in evolutionary biology, the cost of making a mistake in nature is often the last. Of our ancestors those who were reckless might die before reproducing and passing the behaviour down to the next generation, those who were more cautious survived. We are perhaps their descendants. Think of the phrase ‘you have nothing to lose’, an invitation or justification to take a risk that would perhaps normally fall outside of this cautious behaviour. The root of the word ‘decide’ comes from the latin ‘decidere’, from de-(off) and caedere (to cut). There is loss, not gain implicit in the meaning.

 

In psychotherapy I would suggest this can take the form of resistance to change, a psychological investment in who we are now and the status quo. We may not like who we are and we may like the idea of change, but what if we lose something when we change? There is often a strong motivation not to lose anything.

 

My experience of the human psyche suggests that nothing is lost per se, but rather qualities change or transform within the psyche, part of the experience of therapy is to let go of the resistance and allow ourselves to change. The alternative as I have experienced is that the psyche slowly hardens like clay in an oven, with all the risks that come with this.

 

Anxiety and Anger

 

Depression has sometimes been described as anger turned inwards but is there a relationship between anxiety and anger? People who are anxious are sometimes surprised when I explore this in a session. Anger expressed is an active release; one could say the expression itself is the release valve open. There is big difference with between this and  angry thoughts that are not expressed but experienced as internal dialogue , here the anger is contained and the person may have a strong need to supress active expression.

 

Unconscious or split off anger is the problem and that is what I want to focus on here. If the anger is conscious and we aware of it, then it gets managed by the ego and will appear as irritation and natural expression without being too destructive. We moderate it naturally. However, when a quality like anger is split off in the psyche which usually happens over a long period in our formative years, it can activate an anger/anxiety polarity/see-saw in the psyche. In other words we can switch from one mode to the other very quickly.

 

The effort of containing unconscious anger will manifest as the experience of tension and pressure in the psyche. You will probably feel stressed and tired a lot of the time. In these situations we have less capacity to deal with external pressures as much of our energy is being devoted to dealing with our internal world. It will therefore take less external pressure to increase feelings of anxiety or anger to acute levels.

 

Let’s take a fictional example which is based on my experience of dealing with similar issues as a therapist from a wide range of different client experiences. 

 

When John was a child he learned that anger was not allowed in the house, whilst there was always tension especially between his parents it was never expressed in the presence of the children. When the family were going through difficult times, his fathers redundancy and money worries it put enormous pressure on the parents relationship and sometimes John heard them argue but not in front of him.

 

His own anger was met with stern disapproval and he remembered sitting alone in his room furious but unable to do anything about it. Over time he learned to suppress his anger but  as an adult often experienced a furious stream of inner dialogue, he would imagine himself telling his boss what he really thought of him, when he saw something in the news he didn’t like he would react strongly, but never show it. The outside world would trigger this all the time, the kind of inner dialogue experienced as follows :

 

Watching the news : ‘Bloody politician’s, liars the lot of them, should be rounded up and shot’. While walking down the street : ‘Look at that ***hole over there with a baseball cap on the wrong way around, probably a drugs dealer’. News again : ‘Religion, what a ****ing mess, it should be banned, why are they so stupid it’s bloody obvious, they can’t all be right’. Driving : ‘Hey, he cut me up the stupid son of a bitch’. On the train : ’Why can’t she shut her kid up, stupid cow I am trying to read’.

 

However, despite experiencing this raging internal dialogue none of this was expressed out loud, society would certainly not approve and he put a lot of effort into containing it. In this situation society, and the behavioural restrictions associated mirrored the parenting experience of the client.

However, to the outside world he looked nervous and anxious much of the time. He was an apologist, helpful, holding the doors open, nervous at meetings, he was good at persuading but very frightened and when he perceived a threat. When this happened the angry thoughts would disappear and he would find himself feeling numb and terrified. He was bullied at school and remembered being threatened and sometimes beaten so became very sensitive to potential threats, and a little paranoid. A frightened anxious child again.

 

He got a job as a salesman persuading people to buy cars, but often felt angry when he failed to sell a car, he was frightened of poor performance and anxious about meeting his targets, he avoided direct confrontation. He had a series of relationships with women and identified with being a feminist, he tried to please his partners but often experienced angry feelings about his partner and other times, acute anxiety once the relationship moved beyond dating.

 

Disturbed sleep was common-place, he had violent nightmares, and could not understand why. Eventually at 40 he felt he had to find some answers, he was single, with few friends and not much to show for 40 years of life. He decided to try therapy.

 

Of course there are a miriad of ways something can be split off, this is just fictional example. The problem with suppression is that whatever the quality  it tends to split off from the psyche and take on a life of its own, waiting to be activated. Is John perhaps really angry at his parents and would expression of this help?, maybe, but this can be a red herring in therapy. There may be no catharsis to be had there.  The problem is the original suppression, the split that follows, and finally rapid movement between anger and anxiety. Depression can also be co-morbid in these situations, another mood swing.

 

So should we split off a quality which should form part of a healthy psyche it can work against us by appearing as a separate ego state when triggered by events in the outside world. So what to do?  I am an integrative therapist and there is the clue. What is split off needs to be re-integrated in order for balance to be restored. This work is highly intuitive, involves a strong therapeutic alliance between therapist and client and a willingness to explore, therapy is highly individual so while we have our tool box as therapists no treatment is ever the same.

 

I do believe that the psyche is always trying to restore balance and heal itself and if we can engage this intuitive process we can re-integrate and the associated symptoms are reduced until a new balance is achieved.

 

 

Self Help
 

Once again I must apologise for the long delay in updating, I am currently working on some research which is taking up much of my spare time.n

 

I have read a lot of self help books over the years, I am often curious as to the contents. Some are undoubtedly helpful, teaching meditation, helping to manage our thoughts, and as a common denominator they all offer renewed hope for the future. They often contain simple positive affirmations, and may tell us that the key to success is waiting to be 'unlocked' within. It has also often occurred to me if they worked the new ones would cease to sell. Some are better than others, mindfulness certainly has its place even, as is often the way, it is an old idea re-framed for a modern audience. In reality I believe they sell hope, but in my view they nearly all fail to have a lasting effect as they do not take into account the power of early life conditioning on the ego.

 

Freud's super ego is alive and well in most of us, some psychologists call this our internalised parents, although it is more than that. Various approaches have different labels but it's the internal voice in our head that has the power to command. You should do this, you must do that, it's our  inner critic. Formed over many years it reflects who we were told we were as children., and who we were told we were not.  It contains the messages from our early life environment. It is also resistance to change, and often comes up as a block in therapy. 

 

It is not a popular view but sometimes we cannot go forward without looking back first and dealing with the past. Unblocking and unlocking feelings that we have stored up for many years, releases a new vigour into our psyche, makes us larger, more powerful. Self help books sometimes offer the magic of change without cost, sadly in my experience the human psche does not change like this, if it did perhaps the world would be a simpler place.

 

 
Suicidal Ideation
 

​This year has been in the busiest to date for me as a clinician, which is one of the reasons for my blog here being rather quiet. For the last few years whilst working as a clinical manager at BUPA pyschological services, I have observed a steady increase in the numbers of serious and complex cases accessing the service, together with a significant increase in the number of people experiencing suicidal ideation (suicidal thoughts) over the period. 

 

Experiencing suicidal ideation is in fact more common than you might expect, around 140,000 people are hospitalized annually in England and Wales after suicide attempts, there is no measure for how many people actually experience suicidal thoughts but only a small minority go on to attempt it. I believe the increase is due to a number of factors, the reduction in NHS mental health resources  (http://www.bbc.co.uk/news/health-24537304), together with the fallout from the banking crisis of 2008. In the working populdation suicidal thoughts are not necessarily connected with long term mental illness, they often arise due to significant life changing events such as overwhelming work load (a common presenting problem at the moment as organisations try and squeeze more out of fewer staff), losing your job, relationship break down, and finincial difficulties. These events could easily be connected. The other major increase I noticed is in the number of cases involving child abuse coming for counselling following the Saville scandal.

 

Following an intense twelve months I am currently in the process of moving to another provider as a clinical manager and I am increasing the time I devote to private practice which is wear my heart really lies.

 
Nature vs Nurture


I am somewhat overdue an update. This is in part due to my current employment in the field of EAP and health insurance. As with many businesses and organisations psychological service provision is coming under increased pressure, having to do more with less, and with increased demand for services. I have also been looking into PHD courses with a view to starting a research based thesis next year if time allows, building on my on-going study into the psychology of belief.



I recently attended workshop run by the psychologist Oliver James, in part the focus was on the recent genetic research and the implications for mental health and developmental psychology. The results surprised me. In short this concerns the idea that variations in our genetic makeup have a profound effect on the development of our personality. For instance if a certain gene is switched on this will cause us to lose or gain attributes or psychological features. For example, being unable to empathise (psychopathology); or perhaps more subtle differences in personality.


Science it seems has now given up on the idea due to lack of evidence after decades of research and admitted defeat. In short this means the nature vs nurture debate is now pretty much over, with nurture an outright winner. Genetic determinism is dead in the water as a theory. Science is now shifting its focus to how environmental factors shape psychological development. It also leaves us with more questions than answers. The evidence points to conditions such as schizophrenia being a result of serious psychological damage in childhood. But conditions such as autism are much more difficult to explain. Of course just because it’s not caused by differences in DNA does not mean there are other biological factors at play. It’s an uncomfortable scenario as we are pre-disposed to want an answer, and if one is not forthcoming we usually align ourselves with a theory that offers one.


It also affects the practice of psychotherapy, if genetic determinism were true psychotherapists in some cases would be simply trying to paper over the cracks of underlying genetic issues. Many practitioners, myself included have known that psychotherapy works and in many cases can have a profound positive and long lasting effect on people’s lives. So perhaps this is the answer I should have expected, but in fact like many I was a believer until I saw the facts. Perhaps also because I wanted to believe that there was a measurable scientific answer. For further reading you might want to start with the article called ‘It’s the environment stupid’ in the journal or child psychology and psychiatry.

 

Bridging the Gap
 

​If we describe what is unconscious, or as Freud would put it 'repressed', as essentially unknown to the conscious mind. It follows that we have a separation. The dividing wall is often fear based. We can imagine that if we lift the lid on this pandora's box it could be dangerous. The problem is that the qualities we repress are not negative any more than any quality can have a negative or positive extreme. They may appear so but this is in fact only because they are polarised to the extreme in our minds. For instance, we may fear to get angry and be overtaken by rage. The fear itself puts the cork firmly in the bottle, and ensures psychological separation. Expression of anger is natural and usually only becomes dangerous when repressed. If expressed unconsciously it can be very dangerous. If expressed consciously it is far less likely. Catch 22. Making something conscious again is a process of returning to the middle ground. The feeling is moderated as it is no longer bottled up. It's part of our natural state of being and our range of natural emotions once more. How then do we bridge the gap. There are lots of ways therapists can facilitate this, talking therapy is perhaps the most common, but art therapy, and using creative imagination is perhaps one of the most powerful. Separated unconscious qualities form archetypes and symbols which often inhabit our dreams and imagination. Working with these and the associated fears in therapy is one way of bridging the gaps we have created in our psyche.

 

 

​Time


In the modern world we spend much of our time in the past and future. Indeed much time and effort is often spent to enable us to be present in a moment. Think of how much time and effort is spent organising an event like a wedding. Months in the planning, for people to come together in the present to witness a special day. We also spend much of our time avoiding the present, and thus seek to alleviate any psychological discomfort with distraction. This is why there is television etc. These devices are for the most part avoidance mechanisms to allow us to relax and 'switch off'. Otherwise the mind moves away from the present motivated often by anxiety, we then try to plan and scheme in order to alleviate a perceived threat. It is little wonder that most of us spend so little time in the here and now. Turn off the TV and just sit quietly, and observe your mind and what it begins to focus on. Part of the therapeutic experience is to bring people back into the present, to draw attention to themselves. People often only come into therapy when there is something that can no longer be avoided or suppressed that is invading their daily experience of life and it won’t go away, like a re-occurring nightmare. Therapy enables an exploration and in time, hopefully, a resolution. However I would say there is a caveat, which is around expectation. If you have been a certain way for the last twenty years you will not be able to address this in a few sessions. This is in part because you have invested yourself and so much of your sense of self into being this way, which related to the point I made above.

 

 

Double Bind​

Double bind theory put forward by the English anthropologist Gregory Bateson is I believe often present in our psychology. The theory revolves around contradictory demands being made on us. In childhood it can build into a profound psychological conflict. The recipient receives contradictory messages, for instance love may be expressed in words but if the emotional communication or physical circumstances do not reflect this, it creates a theoretical double bind. Adults can sometimes walk away from situations like this, but children cannot, they are trapped in what Bateson referred to as the communication field and so the conflicted communication becomes ingrained. Failure to fulfil the demands leads to punishment which re-enforces the psychological conflict. A child will lack the insight to be able to see this and will try and fail to adapt. This is one way parents often unwittingly pass down their own unresolved neurosis and inner conflicts to their offspring.

 

This is also closely linked to the idea of splitting, which refers to the unconscious failure to integrate aspects of self or others into a unified whole. This comes from psychodynamic theory and refers to an unconscious ego defence mechanism. The unacceptable or bad aspects are split off and rendered unconscious, which is also related to Freud’s idea of repression. The split results in two opposing realities, for example a good mother and bad mother. It is thought that extreme degrees of splitting can result in the fragmentation of the psyche. You may be thinking multiple personality disorder, but many people who are less conflicted engage in endless debate with themselves. Sometimes there may be no debate and every now and again we may enter an altered state of personality, helped along by alcohol or some other mechanism for a time. This is in part why I believe some people experience very strong emotions like anger when drinking, or experience a change in personality noticed by others.

​Children in particular are being programmed or conditioned all the time, they will readily adapt to any belief system, no matter how bizarre adopted by the parent in the right circumstances. Their ability to apply logic or the rules of rational thought are not yet present. Their goal is more likely based around survival and adaption in order to get their needs met. Once a belief has been absorbed it can last largely unchallenged for life, as long as it is regularly re-enforced. Children require consistent reflection and modelling, hopefully balanced by the reason of the parent, if this is missing there will be problems in later life. As E.O. Wilson renowned biologist said, 'beliefs are merely enabling mechanisms for survival, thus does ideology bow down to its hidden masters the genes'.(E. Wilson 1978,4).  This would certainly seem true of childhood, and leads us to some interesting speculations about how and why we experience the world in the way we do.The goal of our genes being based around survival and propagation via adaption to our environment. ​

 
 
 A little Philosophy


This is a section I intend to update from time to time. A little blog of sorts with snippets and thoughts which may be of interest from the world of psychology and philosophy.



Today psychology is a vast field with many specialisations, and psychotherapy is just one way of applying this in the world. There are many current links to other fields of research, in particular neuroscience. Psychology as specialised field did not really gain any ground until the late 19th/20th century, Emile Kraepelin for the development of psychiatry, it was he who came up with dementia praecox, which would later become a diagnosis of schizophrenia and it is from him we get the idea of labels, diagnosis and the diagnostic manuals. Then there is his great rival at the time, Sigmund Freud, who developed psycho-analysis, a branch of which later became psychotherapy. It was also his dream to turn psychology into another science, but this did not happen in his lifetime. During the 20th century I believe philosophy was more influential as philosophy explores the nature of being and so alters our perspective on the world.



Philosophy itself is a broad and contentious subject, full of differing views and arguments that often seem to occur in the world of academia as people invest themselves in one belief system or another. I would like to focus briefly here on the rift that formed in the enlightenment between the empiricists and rationalists, which later turned into a broad split between analytical and continental philosophy. It is worth going into this in more detail as it has a direct influence on psychological models and thought today.



In the 17th century, John Lock, one of the founders of empiricism speculated that the human mind starts out as a tabula rasa 'a blank tablet'. Through sensory perception and reflection we form an idea of ourselves, in modern terms we can call this conditioning. Lock and David Hume, another of the great philosophers believed that all knowledge is subjective, our beliefs are more a result of accumulated habits and process, developed in response to accumulated sense experiences. Pure objective knowledge is therefore not possible. This opened the door to atheism since it was argued we can be certain about nothing. Indeed the 20th century philosopher Bertram Russell re-stated this position stating that we must hold the possibility that all of our beliefs may be wrong. Empiricism has its roots in scepticism which originated in ancient Greek philosophy and is still very much present today.



The other opposing view, rationalism, espoused famously by Rene Descartes 'I think therefore I am', and supported by great philophers such as Baruch Spinoza, Gottfried Leibniz and Emmanuel Kant. The basic premise is that all knowledge, including scientific knowledge can be gained through the use of reason alone. Rationalism is predicting and explaining behaviour based on logic. Oddly the rationalist position in the 18th and 19th centuries favoured the existence of God, whilst the empiricist’s could only hold the concept as an idea and usually a faulty one at that. This split later evolved into the broad churches of continental empiricism and analytical (rationalism). Any philosopher reading this will probably wince as there is in fact much overlap in schools of thought and I know the above is overly simplistic but I believe it does outline the difference in brief.



In neuroscience, which is a rationalist by nature as is most science, we have what might be described as genetic memory, a pre-disposition for certain behaviours and indeed there is growing evidence for genetic memory. i.e. the passing down of  specific behaviours through generations. Incidentally one of the current problems with modern neuroscience is memory. Science knows quite a bit about genes, but while we can identify what parts of the brain appear to be part of a specific living process, like moods or sensory perception, there is as yet not much idea as to how memory is stored. Brain cells do not store information as such for more than a fraction of a second. I do favour the idea of a circuit or loop, which is maybe why we hold fixed ideas about ourselves. But I am not a neuroscientist, although the area is of great interest to me.



Having said that the argument for psychological conditioning (with its roots in empiricism) is still very strong, and forms the foundation of many psychological approaches. How we form our sense of self comes at least in part from our experience of life in our formative years. This can result in all sorts of problems in later life and influence choice of career, choice of partner, pre-disposition to moods or mood swings, and many of the presenting issues I see in my practice today. I am very interested in the concept of belief, and how we form them, and as a result I am working on a book focussing on the nature of belief itself.

 



 



 
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