4 posts tagged “psychology”

Meaning, Medicine and the 'Placebo Effect' (Cambridge Studies in Medical Anthropology)

Daniel E. Moerman

While not as good overall as Howard Brody's placebo response book that I reviewed here this book is a good complement since it discussed how culture affects the placebo response.

The placebo response is based on the release of various body control chemicals by the brain in response to expectations. The brain is forming expectations and acting on those expectations all the time. In vision it fills in the retinal blind spot where the optic nerve leaves the eyeball. The brain also fills in the gaps between image updates to provide an appearance of continuous motion. If the medio-temporal area of the cortex is damaged the patient sees the world in a strobe light fashion as a series of disconnected images (Quest for Consciousness by Cristof Koch, page 140)

The color and number of pills affects the placebo response (page 47). American medical students were given either one or two pink or blue pills  before a lecture and told one would be a stimulent and another a sedative but not told which was which. In reality the pills were inert. So the study consisted of four groups. The groups who received the two pills had a greater response than those that took one pill (6 out of 119 had severe responses with one pill while 26 out of the 119 had a severe response with two pills). In addition 66% of the students who took the blue tablet reported boredom from the lecture while only 26% of those who took the pink tablet reported boredom. The blue innert tablets enhanced the sedative effect of the lecture while the pink tablets acted to counter-act the lecture's sedative effect.

Shots are more effective than pills. In a study of a blood pressure reducing medication those receiving pills of both the drug and the placebo did not have much of a response but those that instead received shots had a significant response. Those getting the shots of both of the drug and placebo (sterile saline solution) every other week for 12 weeks had significant reductions in blood pressure for 47 (drug) to 59 (placebo) weeks. (page 52). Yet in Europe shots are no better than pills in triggering placebo responses showing how culture can affect expectations (page 79)

Chapter 8 is a very good chapter showing how placebo effects interact with the known neurochemical pain pathways in the brain. This shows better than anything else the connection between mental expectations and neurochemistry.

This is a little experiment in cross posting to find out the main reasons why you identify yourself with your religion. This is not meant to be a discussion comparing the religions, it is only meant to identify the main features of your religion that really "get to" you. As such it is more of a psychological investigation.

So why are you Atheist, Buddhist, Christian, Muslim, Pagan, or Wiccan?

While not a book this is an excellent review of the recovered memory controversy which is posted online here. I refer everyone to the original paper for the references mentioned below.

In terms of traumatic experiences this is their conclusion:

"Most fundamentally, to demonstrate that memories can be repressed and later
recovered, at least three things must be verified: (a) that the abuse did take place,
(b) that it was forgotten and inaccessible for some period of time, and (c) that it
was later remembered (see, e.g., Pope & Hudson 1995). Studies used to support
repression generally do not meet these criteria."(page 471)

Those memories of abuse that seem to be verified have the following pattern and do not seem to have been completely forgotten, perhaps only partly forgotten with the most anti-paradigm parts not fully adressed:

"Brenneis (2000) analyzed “verified” case histories provided by Schooler et al.
(1997) and others, noting that the most adequately verified accounts tend to share
several features: (a) the memories were typically not (with one exception) recovered
in the context of therapy, and in all cases the moment of recovery was
unrelated to any therapeutic activity, (b) the memories were triggered by external
events that “reminded” the person of the original abuse, (c) once prompted,
the memories “completely unwound instantly” (Schooler et al. 1997, p. 271) and
required no interpretation or deciphering, (d) the memories were mostly for single,
not repeated, events, (e) assailants were primarily nonfamily members, and
( f ) the events dated from age 9 and older. Finally, information from friends and
relatives often revealed that despite the person’s claim of amnesia, the event had
been discussed with others during the period of claimed amnesia. These features
stand in contrast to the typical pattern for memory recovery in therapy, which
involves very effortful and gradual recovery through extremely suggestive therapeutic
processes and memory recovery procedures. When memories emerge in
this context, they tend to begin as vague and lacking detail but to unfold and
become more vivid and elaborate over time. Further, Brenneis (2000) noted that
“this constellation of features—multiple events over long periods of time, beginning
in early childhood, involving bodily penetration, and enacted by male family
members—is seldom if ever found among verified recovered memory cases”
(p. 75)." (page 475)

"For most claims of massive repression and recovery, there is little confirming
or disconfirming evidence. But some “memories” can be shown to be factually,
psychologically, geographically, or biologically impossible. As with case histories
of alleged lost and recovered memories, those of false memory for trauma must
also meet stringent criteria of proof: both that the person did have memories for the
trauma in question and that the event actually did not happen. Indeed, many such
case histories are available for abuse- and nonabuse-related trauma (see reviews in
McNally 2003b; Schacter 1996, 2001), such as being kidnapped and held hostage
(something that happened to classmates instead of oneself), being gang-raped by
Satanists (although one’s hymen remains intact), enduring the surgical removal of
one’s clitoris (contradicted by the patient’s gynecologist), witnessing the sacrificial
killing of persons later found alive, and even for having committed heinous crimes
such as murders or sexual abuse (Henkel & Coffman 2004, Kassin 2006, Wright
1994)."(page 476)

"Among the most frequently reported impossible false memories of trauma are
those of abduction by space aliens. Although approximately 17% of Americans
believe that aliens have abducted humans (and presumably returned them alive),
we assume that memories of such events are clearly false. Nevertheless, large
numbers of patients have reported memories of alien abductions that have largely
developed in therapy and under hypnosis or while the patient was subject to other
methods used in recovered memory therapy (see Mack 1994, McNally 2003b).

A large category of false memories concerns various forms of satanic ritual
abuse reported by patients in recovered memory therapy. Alleged acts included
gang rape; sacrifice of babies and other ritual murders; consumption of blood and
human waste; forced pregnancies or abortions; dancing, chanting, and other Satan
worship activities; and brutal torture designed to cause victims to forget all they
endured (see Loftus & Ketcham 1994, Noblitt & Perskin 2000, Ofshe & Watters
1994, Scott 2001).

Such cases had so permeated our culture that as of 1991, the
American Bar Association reported that 25% of prosecuting attorneys had handled
cases involving satanic abuse (Qin et al. 1998). In a 1996 survey of clinicians from
the American Psychological Association (Bottoms et al. 1996), 13% had cases
involving children and 11% had cases involving adults with claims of satanic ritual
abuse (with some therapists reporting more than 100 cases). None had obtained
convincing verification of the abuse, nor have subsequent attempts to examine
the validity of such claims found reliable evidence (see, e.g., La Fontaine 1998,
Lanning 1991, Weir & Wheatscroft 1995).One recent survey found that satanic
ritual abuse was reported in 19% of more than 1700 cases involving families
who reported false allegations of abuse against a family member (McHugh et al.
2004). Across studies, 95% to 100% of patients had no recollection of abuse prior
to therapy (McNally 2003b). Despite vigorous protests from recovered memory
therapists (Terr 1994, Whitfield 1995), there are cogent reasons to believe that
almost all such claims are false (see McNally 2003a,b)." (page 477)

Most false memories seem to be implanted during psychotherapy.

"In the l990s, hundreds of individuals who had been persuaded that they had repressed
and recovered memories of abuse began to realize their memories were
false, and many sued their former therapists for planting false memories. Scores
were studied by psychologists trying to gain insight into the processes by which
the patients developed and later retracted their beliefs (see, e.g., De Rivera 1997;
Lief & Fetkewicz 1995; Nelson & Simpson 1994; Ost et al. 2001, 2002). These
studies revealed that the modal retractor first sought therapy for depression and
then recovered “memories” of abuse during therapy, but later came to believe the
“memories” were actually products of therapeutic suggestion. More than 90% recovered
their memories in therapy; in one study (Lief & Fetkewicz 1995), 48%
recovered memories of satanic ritual abuse and 38% recovered memories of witnessing
murder. The vast majority had undergone suggestive procedures such as
hypnosis. Retractors reported substantial pressure to recover memories, and noted
that when they expressed doubts in their new memories, they were told that such
doubt is common but not a sign of inaccuracy. Most reported that outside pressure
played little to no role in their retractions (see, e.g., Ost et al. 2002)." (page 477)

"Research in the past several decades has shown that it is relatively easy to change details
of memories for previously experienced events (see reviews in Davis & Loftus
2006; Loftus 2005; entire Handbook of Eyewitness Psychology, Vols. I and II),
but it is also possible to implant entirely false autobiographical memories, even of
highly implausible or even impossible events. Using strong forms of suggestion
in a paradigm known as the “familial informant false narrative procedure” or simply
the “lost-in-the-mall” technique (Lindsay et al. 2004, Loftus 1993, Loftus &
Pickrell 1995), people have been led to believe that, as children, they were lost in
a shopping mall for an extended time, had an accident at a family wedding, were
the victim of a vicious animal attack, nearly drowned and had to be rescued by
a lifeguard, etc. These false memories can be planted by telling individuals that
their relatives have provided the information and then suggestively interviewing
the individuals to try to elicit memory reports.

Across many studies utilizing the lost-in-the-mall procedure, an average of
approximately 30% of subjects have developed partial or complete false beliefs
or memories (Lindsay et al. 2004), although these rates can vary from 0% with
relatively implausible events (receiving a rectal enema; Pezdek et al. 1997) to
more than 50% for more mundane events (a ride in a hot air balloon; Wade et al.
2002). Techniques such as those involving guided imagination (e.g., Libby 2003),
suggestive dream interpretation, or exposure to doctored photographs have also led
subjects to believe falsely that they experienced events in their distant and even in
their recent past (Loftus 2003). Some develop false memories right away, whereas
others begin with little memory but after several suggestive interviews begin to
recall false events in great detail (Ost et al. 2005)." (page 478)

"Several criticisms have been lodged regarding the autobiographical memory
implantation research. Most prominent are (a) that we often cannot know for sure
(despite familial reports otherwise) that those who develop “false” memories did
not experience the target event, and (b) that target events in such experiments
are less traumatic and more plausible than those commonly “recovered” in therapy.
In response to such criticisms, researchers have endeavored to implant both
impossible and highly traumatic or “implausible” autobiographical memories.

To address the criticism of verification, for example, Braun et al. (2002) led
subjects to believe the impossible event that they had met Bugs Bunny (a Warner
Brothers character) at a Disney resort (after exposure to fake Disney ads featuring
Bugs Bunny). These authors found that a single fake ad led 16% of subjects to claim
they had met Bugs. Even higher rates of false belief were obtained by Braun-LaTour
et al. (2004), and ads containing pictures of Bugs produced more false memories
than those with only verbal mention of him. The criticism involving the degree of
trauma has been more widely addressed. Although researchers have not attempted
to plant memories of abuse, they have attempted to plant memories for relatively
unpleasant, and in some cases fairly traumatic, events such as hospitalizations,
medical procedures, near drowning, or vicious animal attacks. Finally, researchers
have planted highly implausible memories for both mundane (e.g., rubbing chalk
on one’s head or kissing a plastic frog) and strange and dramatic (witnessing
demonic possession as a child) events (Loftus 2003)." (page 479)

Prominent in the memory recovery arsenal is hypnosis. Interestingly,
however, as reviewed by Mazzoni et al. (2006), both memory-enhancing and
memory-distorting functions of hypnosis have been recognized and employed
by therapists beginning with Freud, Janet, and other early psychotherapists. Therapists
have used hypnotic memory retrieval in two opposite ways, without any
apparent awareness of the implications that one use had for the other. That is,
while they viewed hypnosis as an excellent memory recovery tool to recover accurate
memories, they also deliberately used hypnosis as a suggestive memory
confabulation tool to create “healing” positive pseudomemories to replace “true”
traumatic memories previously “recovered” through hypnosis. Indeed, modern
research has verified both functions. Hypnosis can lead to retrieval of greater numbers
of or increased detail for accurate memories as well as to greater production
of false memories. Persons under hypnosis have developed a number of bizarre or
impossible memories, such as memories of satanic ritual abuse (described above),
impossible memories from infancy (Spanos et al. 1999), memories from previous
lives, sexual abuse during past lives (Stevenson 1994, Spanos et al. 1991), and
even memories from one’s own future (see reviews by Kihlstrom 1997, Mazzoni
et al. 2006, McNally 2003b). Hypnotic age-regression, a procedure commonly
employed by recovered memory therapists (see Poole et al. 1995), is subject to
the same distortions as hypnotic memories of recent events (see Nash 1987). As
Mazzoni et al. (2006) point out, if hypnosis is not a reliable means of recovering
memories of recent events, there is no reason to expect it to be more effective for
memories of the distant past or childhood. Nor is there any reason to expect that it
can facilitate retrieval of memories beyond the veil of infantile amnesia." (page 484)

"Therapists commonly employ various imaging activities in
their sessions and in homework assignments for clients. Guided imagery, whereby
a client is asked to actively try to imagine and create images of past events, is
viewed by researchers as dangerous in that these vivid and elaborate images may
later become confused with memories. Indeed, memory researchers have shown
that imagining events tends to inflate perceptions of the likelihood they had actually
occurred—an effect generally referred to as “imagination inflation” (Garry
et al. 1996), and a host of studies have shown that active imagination/visualization
of events, objects, or persons can lead to false memories of having actually seen,
performed, or experienced them. Imagination has produced false memories for
simple perceptions, such as having seen or heard objects or sounds, as well as for
more complex recent personal actions (such as having said or done something,
both mundane and bizarre) and distant autobiographical memories for a range of
events (see reviews by Davis & Loftus 2006; Johnson et al. 1993; Mazzoni &
Memon 2003; Schacter 1996, 2001; Thomas & Loftus 2002). Even paraphrasing
event descriptions or explaining how an event might have happened can produce
inflation (see, e.g., Sharman et al. 2004, 2005). Techniques emphasizing imagination
not only can generate false memories, but also can inflate confidence in
those memories (see Arbuthnott et al. 2001 on imagery, Mazzoni et al. 2006 on
hypnosis, Spanos et al. 1999 on age regression)." (Page 486)

"One might expect patients to
be generally more susceptible to influence, and particularly from therapists from
whom they are seeking answers. As Brainerd & Reyna (2005) note, “Confused and
uncertain people are looking for information that will shed light in dark corners, and
they may believe that it can be found in therapy.To find answers, however, they must
adopt attitudes of openness, exploration, and discovery with respect to the events
of their lives, and they must trust in the wisdom and experience of their therapists.
Obviously, these latter characteristics are not commensurate with a narrow, realitybased
perspective on memory. Rather, the perspective is a much broader one that
searches for answers and solutions in the events of one’s life, which is not precisely
the same thing as searching for autobiographical facts” (pp. 386–387)." (page 490)

Recovered Memories, by Elizabeth F. Loftus and Deborah Davis, Annu. Rev. Clin. Psychol. 2006. 2:469–98

The Structure of Scientific Revolutions

Thomas S. Kuhn

Science like any other form of human mental activity works within a certain cultural context, a certain world view of how things work, or in other words it works within a certain paradigm.

Thomas Kuhn states that "normal science" is essentially a puzzle solving profession since it works within the paradigm of existing theories. Things may not be known such as the function of a certain DNA sequence or how many planets orbit distant stars but these facts do not contradict any existing theory. Data that does not fit any theory is often ignored. Data that contradicts a theory may also be ignored unless the experiment is very clear (a rarity). These the author labels as anomalies.

Thomas Kuhn says this about paradigms:

"... one of the things a scientific community acquires with a paradigm is a criterion for choosing problems that, while the paradigm is taken for granted, can be assumed to have solutions. To a great extent these are the only problems that the community will admit as scientific or encourage it members to undertake. Other problems,  including many that had previously been standard, are rejected as metaphysical, as the concern of another discipline, or sometimes as just too problematic to be worth the time." (page 37)

Since this book was first written in 1962 this situation has become much worse, especially in the natural sciences. The fields have further specialized with their own journals and funding champions. Graduate students must specialize quickly and that means narrowly in order the reach the frontiers of knowledge so they can establish their career. In addition, too many qualified students are chasing too few academic jobs which is making science highly political and ruthless. It leads to conservative normal science studies mixed with hype claiming discoveries are much more than they are in order to get fame and funding. Academic institutions today are really quite tribal and certainly suitable for investigation by modern day anthropologists.

Yet at least, science makes progress because all theories must answer to controlled experiments. Old "experts" die leaving younger scientists who do not have as much vested in the status quo to make the case for new theories. More often than not these theories are created by people outside or at least not completely inside the "establishment" since they are most likely to see the "crisis" as it is called by the author. Their minds have not yet been trained enough, or emotionally committed enough by money and status concerns to be blinded by the existing paradigm. Einstein was a young patent clerk when he developed his first ideas of Relativity. Aeronautics was developed by two young bicycle mechanics named Wright.

Theories are important and paradigm defining because they tell us what is possible and what is not in a compact way. The goal of modern scientific theories is unification with the underlying objective reality given by the information processing described by quantum mechanics. At no other time in human history has such a unification even been in view. Yet we are still stuck with religions that ignore and even insult science out of ignorance.

 Compare this with nonscientific fields of human inquiry. The ideas (I hesitate to raise them to the level of theory) may get more complex as time goes on but nothing really advances. Nonscientific paradigms in religion and spirituality are solely based upon how well they satisfy one emotionally. What one wants to believe does not necessarily make them true. Yet having said that not everything is accessible to scientifically controlled experiments, especially when it comes to mental states and conscious sensations. In this case the best we can do is come up with ideas that are intellectually plausible in that they do not contradict any scientific theory.