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Posts Tagged ‘therapy’

Dropping the Rope of Addiction

September 25th, 2011 No comments

Individuals seeking help in overcoming substance abuse often fall into three categories: the perpetual quitter, the negative and bitter, and the home run hitter. The home run hitter does just that – tries to quit and hits a home run, quitting right away. The negative and bitter don’t believe that they will overcome their addictions and they try to blame other people or entities for their problems; they play the victim card, often without facade of personal responsibility. The perpetual quitter always quits but never succeeds. It is those people I want to address.

Erase Addiction

Photo by alancleaver_2000: http://www.flickr.com/photos/alancleaver/4104954991/

The following vignette is fictional but not atypical of people seeking smoking cessation treatment. Ralph was a 53 year old male with a 35 year history of smoking 1-2 packs of cigarettes per day. He recently had a chest scan that revealed a spot on a lung. His doctor told him he needed to stop smoking. Ralph wanted to quit – cigarettes were becoming just too expensive. He had a daughter he was trying to help through college and as he neared retirement he not only wanted to have more money upon which to retire but he also wanted to live long enough to retire. Ralph had been trying to quit for years; he was successful in reducing his pack consumption from 2 packs a day down to around 1 pack. Ralph had tried patches, pills, and going cold turkey. Each time he slipped and started smoking. He meant well but Ralph could never quite quit.

Ralph believed that he could win the battle over smoking on his own; yes, he would supplement his efforts with patches or pills but he thought he would be able to slay the giant himself. He couldn’t. Few people have that strength and willpower and those who do, usually developed it through practice of self-control.

Addiction is like playing tug-of-war with a monster on the other side of a gorge. We think we can pull it in but it’s stronger than we are. We might even think that we can cross the chasm and fight it (maybe the other side looks greener) – we will lose. The only way to conquer it is to let go of the rope and live our lives on our side of the chasm. Then the monster will walk away as we stop fighting it. In this we are not just ignoring it, we are simply choosing to stop fighting it so that we can move on to greater goals.

This concept of overcoming addiction can be quite successful because when we fight things, we dwell on them. If we play tug-of-war with the monster of addiction we focus all our energy on it. In doing so, we allow it to have power over our lives. That’s the irony of fighting the monster; we might think that we are choosing to battle it, that it is a fight on our chosen ground and at our chosen time, but the monster stands there, waiting for us to fight it – it enjoys the contest. This is a fight few can win.

Should we cross over the bridge to attack the enemy there? No. Once again, that places our focus on the monster; plus then we are in its territory. That is not the way to win. Once again, by striving to do so we focus on the monster. It’s like me telling you to not think about purple bunnies. Of course, the first things you think about are purple bunnies. The more you try to suppress the thought, the worse it gets. Addictions are the same way.

We need to drop the tug-of-war rope and walk away. We acknowledge the monster, we do not ignore it. Ignoring it does not solve our problems either because then we are in denial and in the river of denial we usually end up eaten by crocodiles. So instead of just ignoring the monsters we say, “I know you are there; I know that you are a terrible thing in my life; I know that you want to fight me and I want to fight you but I cannot win. I embrace you and let you go.” Instead of straining and putting all our efforts on fighting the bad in our lives, we acknowledge it, and then fill our lives with good.

That’s really the key to overcoming the monster of addiction – establishing positive goals and working towards those goals more than fighting against the monster. The goals could be family, work, hobby, service, church, or community related for a start. It is in striving towards good goals that the monster of addiction finally goes away.

For all the perpetual quitters out there – if you are trying to overcome addiction of any sort (and it could be anything physical or emotional) but find yourself constantly quitting with little success, it is time for a shift in tactics. That shift could be to acknowledge the monster, drop the rope, walk away, and work towards positive goals in your life. In this manner does the addiction no longer have any power over you. This is not an easy thing to do if there are years of addictions to overcome but it is a simple process.

Psychotherapy With Cleverbot

September 11th, 2011 2 comments

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.

The Death of Psychotherapy

September 16th, 2008 1 comment

I’m going to preface my post by stating that the following post was written to help me think through the relationship between neuroscience and therapy. As such, it is a philosophical journey through some of my thoughts and is not even necessarily what I really believe because I’m still working on discovering what I believe. Thought processes like this are one way I try to keep some of my beliefs about psychology and neuroscience balanced. If I start leaning too strongly one way, I’ll start looking for things that disconfirm those beliefs and see what I discover. It’s a bit of playing the Devil’s Advocate with myself and a bit of philosophizing. Some of my friends and I used to do things like this in junior high and high school – having philosophical discussions where we discussed things and even tried to argue for things that we didn’t necessarily believe (e.g., classic topics such as supposing that this world and universe really aren’t real but are just reflections of reality. Again, that’s not something I believe but we would speculate). What does this all have to do with psychology and neuroscience?

The brain is what drew me to psychology initially. However, I vowed I would never go into clinical psychology because I didn’t think I would like therapy or dealing with people’s problems. Over time I discovered neuropsychology. Most neuropsychologists are clinical psychologists so in order or me to be a neuropsychologist, I had to be trained as a clinical psychologist. There are many things I enjoy about clinical psychology but therapy is not one of those things. Granted, most neuropsychologists do not actually do therapy, but we have to be trained in it. I enjoy talking with people in sessions but I haven’t been that impressed with therapy as a whole so far. Maybe that’s just because I haven’t exactly found the particular type of therapeutic method that really “clicks” with me. Cognitive-behavioral therapy is fine but so much of actual therapy in practice is just plain common sense. However, not everyone has a lot of common sense so they need some training in it. Part of me recognizes the validity of therapy but another part of me struggles with it. Now on to my main article.

The more I study the brain and the more exposure I have to therapy (giving, not receiving), the more biased towards the brain I become. What I mean is that we continue to discover more about the brain and as we discover more, the more behavior we can explain based on biology or neurophysiology and the less important I think therapy is. I’ve written about this topic in the past but wanted to briefly revisit it. This is somewhat of a second chapter to that post. Before I continue I wanted to expose one of my biases; I believe humans have free will. Even though some of my beliefs about the brain could be seen as mechanistic and deterministic, I do not believe that a strongly-biological foundation for behavior rules out free will. You can still assume biological foundations without assuming determinism. If, for example, you have a monistic set of assumptions that incorporates both mind – “nonmaterial” – and body – “material” – in one. [I have quotes around nonmaterial and material because mind is not necessarily nonmaterial and body is not necessarily material, well at least philosophically speaking]. Monism is a similar idea to a unified field theory (e.g., Grand Unified Theory) or the Theory of Everything for which some theoretical physicists are searching. That’s not what I’m going to write about and if it didn’t make sense, then don’t worry about it (I discussed this topic in a couple different posts: here {I linked to that post previously} and here). To summarize, I view behavior through a strong biological bias but I do not assume determinism.

As I said earlier, the more I learn about the brain and behavior (through research and observation), the more I lean towards neuroscience and away from “traditional psychology.” However, I still appreciate the psychosocial aspects of behavior; the nature versus nurture dispute will never be resolved because both are important. The environment is important  – all external stimuli are important – but the problem with downplaying biology is that it is the medium of behavior. What I mean is, everything we think, sense, perceive, or do is translated and transmitted through the firing of neurons. This means that all abnormal behavior, which is what psychologists often are interested in, originates in a neuron or related cell. Whether or not the cause of that behavior was internal or external is irrelevant. All events and stimuli are translated into patterns of neuronal firings.

This is why I think that understanding the biology of the brain is the best way to understand a person’s behavior. However, because we have an imperfect understanding of the biology of the brain, we have an imperfect understand of the biological foundations of behavior. This means that until we have a perfect understanding, we cannot ignore the psychosocial aspects of behavior; even with a perfect understand we couldn’t either because even if we understand the “translation” process we may not understand the origin of what needs to be translated. This is where traditional talk therapy can be most beneficial. However, I still believe less and less that talk therapy is the best solution for dealing with many psychological issues. Over time as we discover more and more about the brain, therapy will become even less important.

That is a fairly radical position to take as a student of clinical psychology – it’s more in line with psychiatry, or rather, I believe it’s more in line with neuroscience. I’m not saying that therapy is useless, I’m just saying that as we gain a more perfect understanding of the brain and how various chemicals interact in the brain, we will have less need for people to help others by “talking” through their problems. The better we understand the physiology of the brain, the more natural our pharmaceuticals will be. In other words, it will be easier to mimic and create normal brain functioning. Of course, many will ask, “What is normal?” That’s a good question.

Some may argue that with depression, for example, many people will have negative image and self-evaluations, which can lead to depression. That is true but it’s the classic chicken and egg question. Which came first? Did the negative thoughts cause the depression or did the person experiencing negative thoughts have a biological predisposition to those thoughts and depression? In other words, it is possible that biology originally led to the negative thoughts and not vice versa. This is all speculation but I think there is increasing evidence for this view.

The big problem with my point though is that at some point, it does become a deterministic system in that it’s possible that we could medicate away people’s free will. This is an unacceptable outcome. There would be a lot of power with this knowledge and many opportunities for abuse. That’s an ethical discussion for a later time.

To summarize, I think that as we (speaking in the collective) gain a more perfect understanding of the brain (and even individual differences in the brain) we will be better able to eradicate and prevent many or most psychological disorders. We could potentially stop schizophrenia through genetic engineering or other modifications. Again, I’m not addressing whether or not we should but I believe we will have the ability to at some point. This is why, at the moment I lean more towards neuroscience than I do psychotherapy. Of course, tomorrow I could [I won’t] write a post that completely contradicts this one. As I said, this is a process. I think it’s important to argue both sides of the issue.