Tuesday, December 29, 2015

Outdated Psychology Practices of the Past & Obsessive-Compulsive Disorder

Nothing in life is to be feared, it is only to be understood. - Marie Curie


Well, my semester has come to its conclusion, and I did not make another post following my initial introductory blog post. I think this result could be indicative of the amount of academic work I had prior to the end of October. Additionally, I think I was somewhat overwhelmed by the wealth of information that I have learned this semester worthy of sharing. The content I've had the privilege to study this semester has far surpassed any of the content that I had learned in my undergraduate degree in its ability to intrigue and fascinate me.

In my subjective opinion, this semester was a success. I wrote two long papers, one I shall talk about later in this post and another in a subsequent post. I also did two presentations.

I have definitely enjoyed this holiday break, so far. During the weekdays, I enjoy leisure time with my family and sleeping in late. On the weekends, I am working a couple shifts at the place I had worked last summer, Home on the Range. It's a youth placement facility located across the border from Wibaux, in Sentinel Butte, North Dakota. It has been pleasant to see my co-workers again, as well as the youth residents I had worked with this summer.

For this post, I have decided to share some interesting bits of information pertaining to the history of Psychology, followed by a clarifying section on Obsessive-Compulsive Disorder.

On a fundamental level, psychology is so fascinating due to the fact that we are using our mind to understand itself.



I was continuously reminded of this fact during my course in Human Neuropsychology this semester. There is so much we do know about the brain and how it operates, but at the same time we still do not know everything when we observe it at a cellular, neuronal level. We have come a long way in the last hundreds of years. For example, in the past, we have compared the brain to different objects and tools relevant to the time in history. We have compared the brain to:
  • A sewer system
  • An assembly line
  • Wheels, levers, and pulleys
  • A clock
  • And, most recently, a computer
Though these do help us to understand the brain and further progress our knowledge, we must understand that at a basic, fundamental level, the brain is much different. When we compare the brain to a computer, we must note that:
  • Neurons are much slower than computer chips
    • Events of neurons occur in a matter of milliseconds, while RAM access is a matter of nanoseconds
      • So, a computer is much faster than the human brain at processing information, but....
  • Computers can only process ONE operation at a time. If the human brain could only perform one operation at a time, you would stop breathing while you read this blog post.
    • Our brain can do this due to the Cortex using parallel circuits
  • Brains also differ from a computer in that it can...
    • recover from injury
    • grow and develop
    • brains do not problem solve with algorithms like computers, therefore they are more diverse in their problem-solving
    • Anatomical flexibility
      • when a solution to a problem cannot be solved with the existing neuronal connections in the brain, the brain can change its physical connections to accommodate the new problem. This ability is termed neuroplasticity.
Psychology Practices of the Past

When looking at the history of psychological disorders, we have progressed in both diagnosis and treatment. I found it intriguing to learn about the somewhat comical ways in which we treated and thought about certain mental disorders.For example, hysteria is defined as exaggerated or uncontrollable emotion or excitement, which is a symptom of various disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), written by the American Psychiatric Association.

Back in 500-336 BC, hysteria was once believed to be caused by a displaced uterus. It was the general belief that the uterus could move freely, similar to an "animal within an animal", and cause havoc, thereby thought to be the cause of a large number of pathologies in women, such as "choking, sleepiness, loss of speech, vertigo, knee problems, headaches, heartburn, pulse irregularities, and death. It was thought that the empty uterus wandered to various parts of the body in search of conception. The prescribed cure might be marriage or, occasionally, fumigation of the vagina to lure the uterus back to its natural location. It is somewhat hilarious to think that they truthfully believed this. I often find myself pondering which beliefs of ours future generations will disprove and find comical.

Another theory and practice that seems silly now, comes from a Roman physician named Galen (A.D. 129-198). He created what is known as the humoral theory of disorders. In this theory, Galen expanded on the work of Hippocrates and assumed that normal brain functioning was related to four bodily fluids or humors: blood, black bile, yellow bile, and phlegm. Blood came from the heart, black bile from the spleen, phlegm from the brain, and choler or yellow bile from the liver. As a result, physicians believed that disease resulted from too much or too little of one of the humors. For example, too much black bile was thought to cause melancholia (depression). In fact, the term melancholer means "black bile". The four humors were related to the Greeks' conception of the four basic qualities: heat, dryness, moisture, and cold. Each humor was associated with one of these qualities. The term sanguine, which literally means "red, like blood", describes someone who is ruddy in complexion, presumably from copious blood flowing through the body, and insomnia and delirium were thought to be caused by excessive blood in the brain. This would lead to a treatment called bloodletting, which is the extraction of blood from patients, which was assumed to help restore the balance of the humors. Similarly, depression was thought to be caused by black bile flooding the brain.

Another interesting theory comes from Paracelsus, a Swiss physician who lived from 1493 to 1541. Rejecting the notions of his time that possession by the devil caused abnormal behavior, he suggested that the movements of the moon and stars had profound effects on people's psychological function. He speculated that the gravitational effects of the moon on bodily fluids might be a possible cause of mental disorders. This theory inspired the word lunatic, which is derived from the word luna, meaning "moon". Although no scientific evidence has ever confirmed this connection, the belief that heavenly bodies affect human behavior still exists. For example, you may hear one of your friends explain something crazy they did one night by saying, "It must have been the full moon." This false belief is also noticeable today in followers of astrology, who hold that their behavior and events in their lives can be predicted by their day-to-day relationship to the position of the planets. 



Obsessive-Compulsive Disorder

I wanted to do a post on this disorder because I often hear people demonstrating a fundamental misunderstanding of the symptoms and diagnostic criteria for this disorder as defined by the American Psychiatric Association in the DSM-5. It also has a personal relevance to me, which I will write about towards the conclusion of this post. I wrote a final paper on Obsessive-Compulsive Disorder for my Abnormal Psychology class and I will attempt to attach it to this post for those of you interested in reading it.




Obsessive-Compulsive Disorder can be characterized by the presence of obsessions and compulsions. Obsessions are intrusive and mostly nonsensical thoughts, images, or urges that the individual tries to resist or eliminate. The thoughts are typically uncomfortable or displeasing to the individual and the feelings resulting from having the thoughts could be those of shame, embarrassment, fear, or anxiety. Generally speaking, there are four categories of these unpleasant thoughts:
  • Symmetry obsessions (26.7%)
    • Symmetry refers to keeping things in perfect order or doing something in a specific way
  • Forbidden thoughts or actions (21%)
    • Fears or urges to harm self or others
    • Fears of offending God
  • Cleaning and contamination (15.9%)
    • Fears of germs of contaminants
  • Hoarding (15.4%)
    • Fears of throwing anything away
Compulsions are the thoughts or actions used to suppress the obsessions and provide relief. They can include:
  • Putting things in a certain order or repeating rituals
  • Checking, avoidance, or repeated requests for reassurance
  • Repetitive or excessive washing
    • Using gloves, masks to do daily tasks
  • Collecting/saving objects with little or not actual or sentimental value such as food wrappings
Certain kinds of obsessions are strongly associated with certain kinds of rituals. For example, the forbidden thoughts or actions seem to lead to checking rituals (checking if the door if it is locked, if the stove is turned off). These checking rituals serve to prevent an imagined disaster or catastrophe even though the catastrophe and the ritual are not logically related. Some can be logical, such as repeatedly checking the stove to see whether you turned it off, but severe cases can be illogical. "Don't step on a crack or you'll break your mother's back" seems like a relevant childhood one if taken seriously or obsessively.

A couple other examples would be believing that if you do not eat in a certain way you might become possessed or if you don't take small steps and look back, some disaster might come to your family. This is brought on by the fact that the person intensely fears being possessed or a disaster coming to his or her family. Since preventing these catastrophic events are next to impossible, the person performs rituals to get rid of the anxiety and the thoughts that they so desperately want to be rid of.



In addition to the previously mentioned rituals, mental acts such as counting, can also be compulsions. Obsessions with symmetry may lead to ordering and arranging or repeated rituals. Obsessions with contamination may lead to washing rituals that may restore a sense of safety and control. Many patients have several kinds of obsessions and compulsions. Though some of us may have some of these symptoms, the severity is crucial when it comes down to a diagnosis.

To satisfy a diagnosis of OCD, the symptoms need to be time-consuming, taking more than 1 hour per day. Additionally, the symptoms need to cause clinically significant distress or impairment in the social, occupational, or other areas of of a person's life.

Though there could be multiple causes for this disorder, one cause has gotten the majority of recognition. This hypothesis states that when an individual is subject to a religion or belief system in which one's thoughts are judged and separated into good and evil thoughts, the individual is pre-disposed to developing OCD. For example, an individual may believe that merely thinking of having an abortion is the moral equivalent of having an abortion. Another individual may have homosexual thoughts that are unacceptable to the individual and their religion, who may believe the impulses are sinful in nature. From that point, the individual performs rituals to absolve themselves of the anxiety, guilt, and shame he or she feels for the "sinful" thoughts that they have.

In reality, the activity of suppressing thoughts has been proven to be counterproductive and unsuccessful. Here is a portion from my paper on OCD:

In a famous study, (Wegner, 1989) it was shown that thought suppression is not effective or realistic. The theory of “ironic processes” was developed to explain why it’s hard to tamp down unwanted thoughts (Wegner, 1989). Evidence was found that when one tries not to think of something, one part of the mind does avoid the forbidden thought, but another part “checks in” every so often to make sure the thought is not coming up, therefore bringing it to mind (Wegner, 1989). For this reason, mindfulness therapy has been speculated to be effective with this disorder.
Wegner asked participants to verbalize their stream of consciousness for five minutes, while trying not to think of a white bear. If a white bear came to mind, he told them, they should ring a bell. Despite the explicit instructions to avoid it, the participants thought of a white bear more than once per minute, on average. Next, Wegner asked the participants to do the same exercise, but this time to try to think of a white bear. At that point, the participants thought of a white bear even more often than a different group of participants, who had been told from the beginning to think of white bears. The results suggested that suppressing the thought for the first five minutes caused it to "rebound" even more prominently into the participants' minds later.
As the study showed, the suppressing strategies ultimately become compulsions as they backfire, and actually increase the frequency of the thought. It is more effective and healthy not to obsess over the thought and let it pass along down the stream of consciousness.

In severe instances, intervention is necessary. The individual is closely watched and their behavior is intervened. In this treatment, the individual is prevented from performing the ritual, which includes taking away the materials necessary to carry out their ritual. For example, if the ritual is hand-washing, the sink handles are taken away. If the ritual is clapping a certain number of times, the individual is prevented from doing so. The idea behind this is that the individual will eventually realize that the ritual has no logical connection to the unpleasant thoughts in which they have, and that doing the rituals does not prevent the unpleasant thoughts to happen.

On a personal level, I think I experienced a moderate case of this disorder in the past. Some symptoms I recall:

  • Performing tasks in order, such as always putting my left shoe on before my right
  • Touching an object the same times with my left hand or foot as with my right (symmetry)
    • Taking the same number of steps on my left as my right side
  • Counting to certain "good" numbers instead of "evil" or "bad" numbers in my head
    • This includes performing repetitive tasks such as clapping to a designated "good" number during applause at an event or counting in my head to a certain number
  • Checking if the door is locked or checking under my bed for a potential intruder
  • Ritualistic repetitive praying before bedtime so as to prevent a catastrophic event
  • Not stepping on cracks when walking on a sidewalk
Most of these compulsions and rituals were fueled by thoughts of catastrophic or unpleasant events happening, such as my Mom being harmed while on duty as a police officer, an intruder coming into the house to kill my family, or demonic spirits coming to attack me in the night. Other compulsions were fueled by anxiety, which stemmed from religious principles that labeled certain thoughts sinful.

I cannot say whether or not my case would have been diagnosable. Most of my symptoms have long subsided, but I do find myself still counting to myself when doing repetitive things such as clapping during a period of applause at an event. The counting is still there, but the knowledge that it is illogical is also there now. The difference is that I now see there is no logical connection between the ritual I perform and the prevention of the hypothetical catastrophic or unpleasant event occurring. The difference is that I know I have no control over the matter and I need not have anxiety over it.

If you're still reading, I hope that this information has some relevance to your life. At the very least I hope that it was an interesting read, or that you learned something new. I look forward to writing more of these posts, hopefully more brief than this one. I think I will write more about my Human Neuropsychology class and the study of the brain at a neuronal level. Until then, may the force be with you. Go and see Star Wars Episode VII, I highly recommend it!

If you would like to read my full paper on Obsessive-Compulsive Disorder, the link is below.

https://drive.google.com/file/d/0B5U2qD43Bf5nVmh1TUgxMzhvbmc/view?usp=sharing

Also, here is a bulletin board I created, which sits outside of the Diversity Center office where I work. It is Hunger Games themed and equipped with study tips - one for each of the 13 districts!





Wednesday, October 28, 2015

New Man on Campus

"Be a student as long as you still have something to learn, and this will mean all your life." – Henry L. Doherty

Hello friends, family, and psychology enthusiasts. Welcome to my new and first-ever blog. There are a few reasons that I have decided to start this blog. One of them being that I want to share the incredibly interesting bits of information that I am learning in my Graduate Program in Psychology. I think that the topic I am studying is applicable to all of our lives, whether directly or indirectly. For some reason, this information remains esoteric and the general population does not learn of the most current findings in studies and experiments. So, be prepared for some truly superb Psychology posts.

Another reason for starting this blog, is that I have recently had this feeling of being disconnected from friends and family that I do not get the privilege to see often. The superficial way that other social media outlets are set-up may contribute to this feeling. A blog seemed like an ideal way to get detailed information about my life, what is on my mind, what I'm learning in grad school, and what I truly care about to my loved ones; an avenue in which to be honest and genuine.

Lastly, the written word is my favorite form of communication. I highly value the skill of generating thoughts and organizing them into written words. We should invest some of our time to be creative in this way, as it is an essential skill in this world.

In this first post, I'd like to catch everyone up on my life. At this time a year ago, I was in the middle of my Student Teaching Experience. It was a great experience and I learned so much from those 3-4 months. I'm grateful that I had the privilege to do that and I was fortunate to have such exceptional mentors and teachers. That said, I realized that teaching was not something that I could see myself doing for the rest of my life, or even a year or two. If I'm going to do something, I need to be fully invested and completely enjoy it.

There were several aspects of teaching that I did not enjoy. I did not enjoy being around 20-30 children almost all day, 5 days a week. I respect and admire the current teachers that can do that, like my Dad and his Kindergarten students. Dad, you are awesome and your students love you so much, as do I.

As someone that has an unquenchable thirst for knowledge, I also did not enjoy teaching students information that I had already learned and mastered. I desire and enjoy learning new information or taking ideas and theories to a deeper level. I could not see myself teaching sports and fitness to children for the rest of my life. When I chose my major, I was very into fitness. I think I realized that I had reached the end of what I could learn in that field and soon got tired of the topic.

In 2010, when I chose my major of study, I believe that I did not know much about myself or what I wanted. I think this could be partly contributed by being so closeted and secretive about my sexuality. I believe that carried into my life in general. I did not take the time to think about what I wanted to accomplish in life, and instead I preoccupied myself with attempts to hide my true self from the world. After 2 semesters I felt pressure to settle on a major of study and I chose teaching after insufficient introspective thought. I see that pressure as a major problem in today's higher education system.

Fortunately, I had a substantial amount of time after graduation in December to think about what I truly desired in life. I finally had the time to attempt to truly know myself. It was the opportune time for me to do this in the first 4-5 months after I moved to Billings in January. I honestly do not think I ever took the time to do this during my undergraduate experience. I just pushed on, not giving a second thought to whether I truly enjoyed teaching or not. In life, sometimes we just do what we need to survive. Thankfully, I had the courage to pursue something different, something I am passionate about, and I did not have to remain "boxed in" to a career path.

Other than that, I truly have some issues with the way the school system is in the U.S. I think that we can do much better. I can affect more lives, more change by the route I have now decided to pursue. I much prefer the thought of influencing individuals one on one, rather than 20-30 students at a time.



That said, I'll explain the graduate program, my goals, and aspirations. The MSU-Billings M.S. Psychology program is set up for approximately 2 years. Each semester we take 9-12 graduate credits which is the equivalent of 3 classes, give or take an internship experience. The classes I am taking this semester are Human Neuropsychology, Intro to Post Traumatic Stress Disorder (PTSD), and Abnormal Psychology. Neuropsychology (though absolutely fascinating) is proving to be the most challenging class for me this semester. Intro to PTSD is probably my favorite class. In this seminar format class, we are reading "The Body Keeps the Score" by Bessel A. Van Der Kolk. In future posts I will be sharing more details one what we have been learning.

Upon Graduation, I will be applying for further schooling out of state in order to pursue my goal of a PhD. In the broad subject of Psychology, I would like to pursue the area of Industrial-Organizational Psychology. Here is a quick description of an Industrial-Organizational Psychologist: http://psychology.about.com/od/iopsychology/f/organizational.htm

In this niche, I see myself enjoying a career employed by a large business or university as a researcher. The job outlook for this career is growing according to a few sites, and the salary is decent. This career would satisfy my need for constant learning and inquiry.

Other than graduate school, I am working on campus about 20 hours a week. I am the Graduate Student Coordinator of the Diversity Center and Student Union. I am currently updating the website, as it was outdated when I stepped into this position. Here is a link to myself and the 4 wonderful undergraduate peer mentors that I coordinate. http://www.msubillings.edu/diversity/PMPTeam.htm
Here is what the Diversity Center does on campus: http://www.msubillings.edu/diversity/PMPServices.htm

Currently, I am working on planning a Day of the Dead Celebration for next Monday. Additionally, I am on the team for planning Power of One Week on the MSU Billings Campus. This week is the first week that students are back for Spring Semester in January. At this event, we will have some amazing events that I will write about later. The topic will be LGBT issues, gender equality, and other important subjects. Below is a bulletin board that I created recently. It is designed to be a reminder for using inclusive language and staying away from language that stereotypes, stigmatizes, or excludes groups of people.

If you're still reading, I want to thank you for taking the time to read this. Time is finite for everyone and to give of your time is to give of yourself. That is about all I have for now. I shall now get back to studying for my Mid-Term exam in Neuropsychology, as I should be doing. I have to try my best not to get distracted by the adorable group of elderly women having a book club next to me in the coffee shop. Have a great week and feel free to reach out and connect with me if you so desire. I am always happy when I can hear about from my friends and family. Have a great Halloween and/or El Dia De Los Muertos!