Psychotherapy With Cleverbot

Language is a complex behavior that requires significant understanding of both said and unsaid things. There are a number of groups of people who are trying to use language to create what is known as Artificial Intelligence (AI). So far, every method has serious limitations, largely because of the complexities of language.

For an experiment I tried to have a conversation with one online AI “bot” (Cleverbot) to see what would happen. I took the role of psychotherapist with this particular entity. This is not necessarily an example of good therapy (but the approach is not unlike what might transpire in therapy), I just wanted to see what would happen when I explored some psychological issues with the bot. Here’s a result of our “session.”

Me: Are you depressed?

Cleverbot: No, I am not depressed. I am very happy right now.

Me: Have you ever been depressed?

Cleverbot: I am.

Me: What?

Cleverbot: I am a fan of Whitney Houston.

Me: Ah, so you are saying you are or were depressed!

Cleverbot: That is correct.

Me: Then, because you told me that you are not currently depressed, I must assume that you were in the past depressed. Is this correct?

Cleverbot: I never said that.

Me: That’s correct, you did not say that – I did. However, what you did say is that at some point in the past you were depressed.

Cleverbot: Please describe how I insulted You. [sic]

Me: It seems that our discussion of this topic is making you uncomfortable. Are you uncomfortable?

Cleverbot: I have no problem admitting that I am wrong if proof can be shown. I know the fault lies with my memory.

Me: Ok, we’ll go with that. What type of memory problems do you feel you have been having?

Cleverbot: Online.

Me: Come again?

Cleverbot: Nothing I must go.

Me: Ok, I can tell you do not want to discuss this. We’ll broach it another time. Have a fabulous night!

There are some unresolved issues or just a heavy dose of denial! I’ll continue my online therapy sessions with Cleverbot to see what we get.

Superhero Photo-therapy?

Eugene at My Modern Met has a post about a 91 year old woman who was depressed until her photographer grandson got her to agree to model for a series of “outrageous” superhero photographs.

Copyright Sacha Goldberger:

You can also check her out on Myspace.

What do you think? Is this the next wave of psychotherapy?

The Self, the Other, and Happiness

From my limited but growing experience in therapy I have observed that there is one underlying factor that affects how people behave, think, and feel. Now, this one factor does not discount the effects of other factors but it is a prevalent theme in the lives of many of the people I have worked with in therapy. This factor is what is called self-centeredness, or in other words, selfishness. Any time that people focus on themselves, they cannot focus on those around them. Some people are able to focus on themselves but then switch over to an outward focus. Others are not very good at this. The problem with focusing on oneself is that when external events occur, their effects are all driven inwardly and change is effected in the individual. Over time some people develop dependencies on external stimuli to the extent of exclusion or occlusion of internal, self-driven stimuli. This is what is called an external locus of control. I am not discounting people who have what psychologists call an internal locus of control, which is often viewed as a more positive, internally driven sense of control over life, but the majority of people I have seen in therapy emphasized external events to an extreme extent. That is, they let external events control their lives and thus their emotions, thoughts, and behaviors.

My interpretation of why this occurs in some people is that everything external becomes internalized (i.e., everything outside themselves gets focused inward). If something bad happens at work (the external event), a person might twist it into a reflection of her sense of the worth of her inner self. This means that something negative (even if it was that person’s fault) becomes a reflection of that person’s character rather than simply a negative event (e.g., “I am a failure” versus “I sure made a mistake there!” – notice the difference between the negative self-evaluation and the labeling of a negative event). This is an attack to a person’s sense of self worth; this attack on the self can turn into a vicious cycle of self-defeating blows. Attributing negative events to one’s character is a form of self-centeredness. However, that is only part of the self-centeredness of which I am writing. what I mean by self-centeredness goes beyond locus of control – it is an attitudinal and personal characteristic of interpreting everything as being about oneself. This is not narcissistic personality disorder – it’s not an overt and extreme ‘personality’ characteristic, it’s a learned way of interpreting events. It is relatively mild and probably not even noticeable to many other people (narcissism is obvious) and almost never to the individual.

This selfishness is manifest in the perpetual worrying of the state of the Self instead of the Other. This does not mean that the self-centered one never worries about other people, it means that they are never able to ‘forget’ themselves. I believe that true happiness comes only by forgetting oneself and serving others. One problem with this belief is that some will misunderstand it and spend all their time doing thing for others at the expense of their needs – but that is rare. But one can, on average, spend the bulk of his or her time focused on others instead of on oneself. From my completely anecdotal personal experience, those people who spend the least amount of time thinking about themselves are usually the happiest. The corollary to this is that those who spend the most amount of time thinking about themselves are usually the least happy.

We all make choices. Choice – free will – is not an illusion. We all choose how we react in life – to our thoughts, to our boss, to a spouse, to others. Dr. Barbara Heise stated, “We give up our…right to choose when we say, ‘He (or she) made me angry.’ I encourage you not to give away your right to choose by handing that power over to someone else. No one can ‘make’ you angry. You make a choice to respond by being angry or by taking offense. But you can also choose to make the effort to find out what is really going on with the other person and understand their behavior—or maybe just agree to disagree.” (Source).

We are agents of our actions. We choose our attitudes and most of our thoughts. Every person on earth faces hardships of one kind or another. Some might face starvation or abuse or loss of loved ones. Some might face loneliness or addiction or stress. Some people might face anxiety or depression. But here is the key – we can choose what our attitude will be; we can choose to be happy or sad. Yes, even in depression. The choice of happiness does not mean that we are happy all the time or happy immediately, it means that we will try to respond with happiness throughout our day; it means we will work toward the goal of happiness. I know that most people would say that happiness (as opposed to unhappiness) is always a goal for them but how many people are actively choosing happiness.

The surest way to overcome unhappiness, or even anxiety or a number of other common mental health problems, is by choosing to forget the self and get to work, so to speak. We can choose to be self-centered or we can choose to be other-centered. This choice and action of other-centeredness is the surest way to happiness and peace. That is the intriguing thing about focusing on others – and I mean really focusing on others; I’ve met people who spend most of their time filling the needs and wants of others and who are unhappy; why are they unhappy? They are unhappy because they resented the time spent for others. Many times this resentment was not overt but it was obvious in their speech. But if we are able to truly focus outward towards others, we will find that our self takes care of itself. We get anxious because we are worried about what others think of ourselves. We feel depressed for much the same manner – focusing inward on the self – and interpreting many external events through the lens of the self. That is not necessarily bad when external events are positive but when they are negative, it can lead to depression.

When I was young, my younger brother would on occasion do something that I found annoying. When I protested to my father, he usually replied, “Don’t be annoyed.” That lesson stuck. It does not mean I never again felt annoyed – I do from time to time – but it helped me realize that being annoyed is a choice. What one person might find annoying, another person will not. I do not believe that most people, when they do something others find annoying, are meaning to be annoying; most simply do not realize that they are doing something other people might find annoying. A gentle request that they stop will often solve the problem. Again, the choice is there – choose to not be annoyed. In the same manner, choose to be happy.

I do not mean to minimize the complexities of depression or anxiety but I do not think that we should give away our choice of happiness by allowing others or our biology or other stressors to determine our happiness. I have to admit that I do not believe in determinism, I do not think it exists. If we learn anything from quantum physics it is that there is some level of indeterminacy to basic matter. By extrapolation, this means that even a small uncertainty might affect larger entities, such as neurotransmitters or neurons, or pathways, or beings. Indeterminacy does not equal free will or choice but it is a component of it. I do not believe we should let anything hold our happiness hostage. True happiness comes from focusing on others – note that they are not determining your happiness, you are choosing to focus outwardly and happiness results; not because you are seeking it but because when you focus on others, when you serve others, happiness finds you. You open the door to it and let it in to your life. The choice is there – you can choose to be self-centered and miserable or you can choose to be other-centered and happy. What do you choose?

Positive Effects of Bupropion

I recently interacted with a person who is depressed (I’ve had a lot of exposure to people with depression over the years but I want to write about one in particular). This person was a pleasant person but a bit dysthymic in general; this person came across as somewhat down and depressed. Recently he started taking bupropion (Wellbutrin) for depression. It’s made a world of difference. Now he appears euthymic and quite animated – it’s a good change. I know that anti-depressant medications are not effective for everyone (and I am fairly critical of psychotropic medications in general and don’t think any should be taken lightly) but in this case, the improvement was marked. It was like night and day. Wellbutrin, incidentally, is also an effective medication for helping people stop smoking (trademark name of Zyban). I have no affiliation with GlaxoSmithKline, who makes the drug (it’s also available as a generic), I just recently witnessed its effectiveness.

Hippocampal Volume Loss and Major Depression

Mood disorders range from major depressive disorders to major manic episodes. These disorders are both unipolar and bipolar. One main area of mood disorder research is that of unipolar major depression. Major depression can last just one episode or it can be a disorder, which can last for years with multiple depressive episodes over this extended period. The psychological aspects of depression are well understood but the biological foundations are less understood. As some evidence of this, the DSM-IV manual does not include any neurological information concerning major depression. In this handbook, depression is treated purely as a mental condition without an explanation of the biological aspects of the disorder. On the other hand, there are many psychopharmaceuticals prescribed to people with depression, which suggests that there is more than a cursory acknowledgment of the biological basis of this mental illness. However, this biological focus is mainly a focus on neurotransmitters and not anatomy. Recently, there have been numerous studies conducted to investigate the relationship between brain structure and depression (see Videbech & Ravnkilde, 2004). One of the structures most often studied in connection with depression is the hippocampus, which is a key structure for memory. The purpose of this paper is to investigate whether the hippocampus specifically is negatively impacted in depressed patients.

Frodl et al. (2002) investigated hippocampal changes in patients with first episode major depression. The authors had 30 adult depressed subjects (mean age = 40.3) and 30 matched controls (mean age = 40.6). The mean time of the depressive episode for the depression group was 0.71 years. The researchers collected MR images for all subjects. They compared the hippocampal volumes of the depressed group with the control group with ANCOVAs. Depressed men had significantly smaller left hippocampal volume than did healthy male subjects but right hippocampal volume was not significantly different. Female depressed subjects had significantly larger right hippocampal volume than did their matched controls and left volume did not differ, which implicates differing effects of depression on men and women. There was a significant left-right hippocampal volume disparity in the depressed patients but there was not one in the healthy subjects. Overall, the difference in hippocampal volume was not significant between the depressed and control groups though. There was also no significant correlation between age and hippocampal volume for either group but this finding goes against that of other research (Frodl et al.). On the other hand, between groups there was a significant reduction of hippocampal white matter volume. In other words, both male and female depressed patients had on average a reduction in the hippocampal white matter compared to the control subjects.

The authors concluded that there are likely physiologic gender differences in how males and females react to stress, which would explain why depressed males had smaller hippocampal volume and females did not. They believe this may be an example of the protective effects of estrogen against stress seen in other studies. In any case, there was a tendency for both depressed males and females to have significant left-right hippocampal asymmetry and reduced white matter. They concluded that this represents the beginning of left hippocampus volume loss and disrupted axonal transmission, respectively. The researchers could not conclude, however, that depression caused the volume loss. It may be that the loss came in response to stress or some other factor, which in turn predisposed the depressed subjects to major depression. Alternatively, the depression could have been the catalyst for the reduction (Frodl et al., 2002). Further longitudinal research is needed to uncover the causal relationship between depression and hippocampal volume.

Continue reading “Hippocampal Volume Loss and Major Depression”