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Psychologists Treatment of Veterans

August 14, 2014 at 3:20 pm

In the years after the war, this shifting emphasis radically altered the nature of the mental health professions, which previously had been more connected with mental institutions, chronic patients, and severe mental illnesses. The psychoanalytical approach, concerned with neuroses rather than severe psychosis, was particularly adept at responding to the psychological needs of soldiers.

soldier in distressRoy R. Grinker, John P. Spiegel, and their counterparts helped to train a new generation of physicians in psychoanalytical concepts. By the end of the war, psychiatry was on equal footing with other medical specialties of the Army Medical Corps and boasted 2,400 members. Military need, combined with evidence of psychiatry’s usefulness to combat veterans, helped to produce greater visibility and acceptance of mental health professionals. It also helped to solidify the idea that environmental factors were at least partially responsible for some mental illnesses.

PTSD Concept.During and after World War II, the term “battle fatigue,” also known as “combat fatigue” or “combat exhaustion,” was developed for conditions that might now be called post-traumatic stress disorder (PTSD). In their 1943 publication War Neurosis, Grinker and Spiegel used psychoanalytical concepts to describe the effect of environmental trauma in developing war neurosis. Battle fatigue was a concept distinct from the concept of “shell shock” developed during World War I because it emphasized environmental factors over biological factors. The unprecedented access of psychiatrists to soldiers brought about further observations of battle fatigue. In an effort to provide relief from the traumas of war, various branches of the military began to implement rotation policies by the spring of 1945 in addition to employing greater numbers of psychiatrists to treat fatigued soldiers in non-institutional settings.

 

Institutions, Professional Organizations, and Legislation

At the beginning of the decade, there were about 560 mental institutions across the United States, about 300 of which were under state, county, and municipal authorities. These institutions housed 469,000 patients and, in 1940 alone, admitted 105,000 new patients. The years during and after World War II saw a substantial increase in patient admittance, culminating in a new patient count of 446,000 in 1946. Institutional treatment peaked in the mid-1950′s, at which time the move away from institutional care began to gather serious momentum.

Habitually understaffed, overcrowded, and underfunded, state institutions lost many of their staff members to the war effort. Although standards set by the American Psychiatric Association required a minimum of one attendant for every six patients, one nurse for every forty patients, and one psychiatrist for every two hundred patients, these standards rarely were achieved. In 1949, the Council on State Governments conducted an investigation into the conditions of state institutions. This culminated in a 1950 report, The Mental Health Programs of the Forty-eight States, that made clear the failing conditions of American mental hospitals.

The American Psychiatric Association was a strong presence in 1940′s American psychiatry beyond the institutional setting, and in 1948 it assigned a small group of members to discuss the regularization and standardization of psychiatric classifications. This effort ultimately resulted in the 1952 publication of the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Although the classification of mental illness had a long tradition, it was not until 1949 that the World Health Organization included mental disorders in its International Statistical Classification of Diseases and Related Health Problems (ICD). This sixth edition of the ICD and the first edition of the DSM established for the first time a national and international regularization of shared psychiatric knowledge.

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The year 1949 also marked the establishment of the Committee for the Preservation of Medical Standards in Psychiatry (CPMSP). Along with the Group for the Advancement of Psychiatry, which was founded in 1946 with army chief of psychiatry William Menninger at its head, the CPMSP made efforts to promote the authority of psychiatry over psychology. Members of the field of psychology, however, had long been at work organizing and expanding. In 1938, the American Psychological Association formed the Committee on Displaced Foreign Psychologists (CDFP) to represent displaced European scholars. By October, 1940, the American Psychological Association had established the Emergency Committee on Psychology (ECP) to assist federal agencies and address issues of civilian morale during the war. The American Psychological Association began to include a section on “Psychology and War” in its official publication, the Psychological Bulletin, and in 1942 formed the Office of Psychological Personnel (OPP). For the American Psychological Association, the war years were important for emphasizing the efficacy of applying psychological theory to social problems, a trend that continued in the postwar years.

During the postwar years, American psychology became increasingly organized and regularized. In 1947, for example, the American Psychological Association established the American Board of Examiners in Professional Psychology. Despite the resistance of some in the psychiatric profession, psychologists increasingly participated in private practice.

During the midst of these professional debates and in response to growing demand for federal intervention, President Harry S. Truman signed the National Mental Health Act (NMHA) into law on July 3, 1946. The act called for the formation of a National Advisory Mental Health Council (NAMHC) and a National Institute of Mental Health (NIMH), and it was designed to help prevent, treat, and research mental illnesses. On April 15, 1949, the NIMH was formally established and replaced the Division of Mental Hygiene, with Robert Felix as its director.

Debates Concerning Treatment and Practice

During the 1940′s, particularly in the postwar years, the professions of psychology and psychiatry experienced increased external influence as well as decreased professional solidarity. A large proportion of internal debates centered on increased interest in biological treatment methods, therapeutic approaches, and the social role of psychiatry and psychology.

One of the most controversial methods of the 1940′s was the treatment of severe psychosis with a neurological surgery known as lobotomy. Walter Freeman, an American neurologist convinced of the somatic, or bodily, origins of mental illness, introduced the surgery to American neurologists and psychiatrists in 1936. In this procedure, the nerves that connect the patient’s frontal lobe to the thalamus are cut. In January, 1946, ten years after he and neurosurgeon James W. Watts performed the first lobotomy in the United States, Freeman performed the first transorbital lobotomy. This procedure was much quicker than the prefrontal procedure, allowing the frontal lobe to be detached by a sharp instrument that could be inserted into the brain through the patient’s eye cavities. By 1949, the number of lobotomies performed annually in the United States had reached five thousand, despite bitter conflicts within the profession.

At nearly the same time that Freeman was introducing American practitioners to the lobotomy procedure, electroconvulsive shock therapy was on the rise. The American Journal of Psychiatry first covered the procedure in 1937, and by 1940 it was widely in use. Over the course of the 1940′s, practitioners attempted various modifications in an effort to reduce the procedural side effects. Modifications included the introduction of muscle relaxants and short-term anesthetics that were thought to make the patient’s experience less frightening. The introduction in 1954 of Thorazine (chlorpromazine), nicknamed the “chemical lobotomy,” ushered in a new era of psychotropic drugs that in many ways replaced earlier and more invasive procedures.

In sharp contrast to the biological emphasis of practitioners such as Freeman and Watts, Karen Horney, a German psychoanalyst, argued that therapeutic approaches should emphasize the workings of the conscious mind and the isolating effects of a highly competitive, modern society. Her early writings on female sexuality successfully destabilized Freudian assessments of female psychology. Horney moved to New York City in 1934 and published her first of five books, The Neurotic Personality of Our Time, in 1937. During the 1940′s, Horney’s work focused on revitalizing psychoanalysis through an emphasis on the ego, or conscious mental awareness, and on developing theories of what came to be known as narcissism. Horney came to be perceived as a radical within the profession, and in 1941 she started the Horney Institute in New York City to promote her ideas.

Like Horney, B. F. Skinner sought to expand the uses and functions of psychiatry beyond the institution. Skinner was an American psychologist who emphasized the interplay between humans and external forces and was most widely known for The Behavior of Organisms (1938) and Walden Two (1948). In the first of those books, he laid out the fundamentals for a behaviorist theory of human nature that emphasized the role of punishment and reinforcement and the interaction between humans and their environment. Walden Two was a utopian novel that conceived of a type of human community that would be governed by the basic principles put forth in The Behavior of Organisms.

Skinner’s ideas on “behavioral technology” represented a greater shift during the 1940′s that sought not only to emphasize environmental factors but also to expand the influence of psychiatry into the realm of the social sciences. The growing emphasis on environmental factors and the widespread acceptance by psychiatrists also opened a space for the increased influence of psychoanalytic and psychodynamic methods of treatment. The emphasis of psychodynamic methods dovetailed with psychiatry’s growing interest in the late 1940′s in psychological life beyond the mental institution. During the last years of the 1940′s, the Group for the Advancement of Psychiatry helped to further the ideas of psychoanalysis by reorienting psychiatry toward a psychosocial model emphasizing community care and social outreach.

Impact

pillsThe expansion of psychiatry, psychology, and psychoanalysis during the 1940′s had great import for the direction of these professions over succeeding decades. Psychoanalytic and psychodynamic methods of therapy dominated the psychiatric profession for decades to come. The late 1950′s and 1960′s saw the widespread use of psychological and psychiatric drugs such as Thorazine and lithium to treat severe psychosis. With the introduction of psychotropic drugs, lobotomies and electroconvulsive shock therapy largely fell out of favor. Large mental institutions came to be viewed as an unnecessary social evil, and professional emphasis continued to shift toward noninstitutional, community-based mental health care. The antipsychiatry movement gained momentum during the late 1950′s and the 1960′s, bolstered by such works as Erving Goffman’s Asylums (1961), Thomas Szasz’s The Myth of Mental Illness (1961), and Ken Kesey’s novel One Flew over the Cuckoo’s Nest (1962), which negatively dramatized inpatient psychiatric treatment. Many social movements of the 1960′s, particularly the feminist and collectivist movements, drew heavily on the works of such notable theorists as Skinner and Horney in their critiques of American society.

 

Further Reading

El-Hei, Jack. The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness. New York: John Wiley & Sons, 2007. A judicious biography of Walter Freeman that details the rise and fall of the use of lobotomy procedures in mid-century medical thought and practice.

Grob, Gerald. From Asylum to Community: Mental Health Policy in Modern America. Princeton, N.J.: Princeton University Press, 1991. A concise yet thorough overview of twentieth century changes and developments in mental health policy.

Hilgard, E. R. Psychology in America: A Historical Survey. New York: Harcourt Brace Jovanovich, 1987. A comprehensive overview of the rise of American psychology.

Jones, Edgar. Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War. New York: Psychology Press, 2005. A comprehensive analysis of twentieth century developments in the treatment of soldiers and war veterans.

Mitchell, Stephen A., and Margaret J. Black. Freud and Beyond: A History of Modern Psychoanalytic Thought. New York: Basic Books, 1996. An overview of major conceptual developments in twentieth century psychoanalytic thought and practice.

Shorter, Edward. A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. New York: John Wiley & Sons, 1997. A concise yet thorough introduction to the history of psychiatry in the United States.

Wallace, Edwin R., and John Gach, eds. Encyclopedic Handbook of the History of Psychiatry and Medical Psychology. New York: Springer, 2007. A highly recommended, wonderfully diverse collection of articles covering the history of psychiatry and psychology.

 

Evolutionary Psychology in our Modern World

June 18, 2013 at 5:41 am

Evolutionary PsychologyHumans exhibit many of the same anatomical and physiological adaptations as other primates. When it comes topsychology and behavior, however, humans are much more complicated. Although we share with other primates basic emotions—rage, fear, sexual desire, and mother love—humans alone can communicate symbolically through written and spoken language, create and disseminate works of mathematics, science, and art, and manipulate the behavior of others with appeals to duty, religion, laws, and promises. And although other primates may be able to deceive one another, language allows us to devise elaborate stories, excuses, and lies. Evolutionary psychologists study the human mental functions that underlie these capacities by drawing on cross-species comparisons, cross-cultural comparisons, case studies (e.g., of brain damage), and laboratory experiments.

Like other evolutionary scientists, evolutionary psychologists generally assume that the attributes of the species they study (in this case, humans) have evolved through natural selection. Specifically, evolutionary psychologists assume that the brain circuitry and processes underlying human behavior include features maintained from our primate ancestry and modifications that were selected because, at the time they evolved, they led to adaptive behavior. It is thus sometimes said that the human brain houses an “adapted mind.” However, evolutionary psychologists do not assume that all human behavior is adaptive. Because the environments we live in today are in many ways dissimilar to the environments that our ancestors were designed to cope with, many of our behaviors may be anachronistic—once adaptive, but now neutral or even maladaptive. It is thus also sometimes said that the human brain houses a “mala-dapted mind.”

The Brain

Physically, the human brain is much like that of all other mammals, consisting of a brain stem, which regulates mostly unconscious physical activity; a subcortical system, which modulates drives, emotions, physical sensations, and memory; and a convoluted cortex, which allows for the handling of greater amounts and complexity of information than is possible by members of other taxa. Primates as an order have brains relatively larger than other mammals of similar body sizes, and the human brain is significantly larger—even in proportion to body mass—than those of other primates. [See Brain Size Evolution.] As mammalian brains increased in size, the cerebral cortex increased relatively more than other parts. It is this expanded cortex that confers on humans great intelligence, a capacity for symbolic representation, and a reflective self-awareness.

Some parts of the human brain are physically distinguishable from adjacent areas, allowing for three-dimensional mapping of subcortical structures as well as two-dimensional mapping of the cortical surface. Boundaries of these structurally distinct areas often coincide with boundaries of functionally distinct areas, leading some theorists to conceive of the brain as not just a single organ, but as many organs or functional “modules” bundled together. These different organs or modules interconnect with one another to varying degrees, allowing both serial and parallel information processing at multiple levels of integration. Consequently, a person can engage in several activities at the same time, and can even experience two or more seemingly contradictory thoughts or feelings simultaneously—such as love and hate or curiosity and fear. Another consequence of this design is that, although some mental activity is available to consciousness, most occurs at a level of physical automaticity. We do not “know,” for example, how we change the focus of our eyes from near to far, or how we retrieve an old phone number out of memory, or how we come to distinguish and prefer chocolate as compared to vanilla—we just do.

Natural selection has responded to the existence of static and predictable stimuli with the evolution of simple low-level processing mechanisms. Collectively, these confer a set of panhuman “instinctive” behavioral responses and psychological preferences. The existence of spatially diverse and temporally dynamic stimuli, in contrast, has led to the evolution of more general and more complex learning mechanisms designed to generate what is statistically likely to be the most adaptive response in each unique or new circumstance. The expanded human cortex, with its increased capacity for associative learning, abstract generalization, and transitive reasoning, is what allows for this adaptive, functional plasticity, and is what underlies the great cultural and individual diversity of the human species.

The Adapted Mind

In stark contrast to Skinnerian behaviorists, who view the infant mind as a tabula rasa, or blank slate, evolutionary psychologists are quick to point out that baby brains are not, in fact, blank or empty; infants come into the world with rudimentary knowledge and specialized information processing systems already “wired in.” Furthermore, although knowledge does increase with experience, certain types of information are absorbed quite readily by the human brain, whereas other types are acquired only with difficulty. From an evolutionary perspective, the differential ease with which we learn about different aspects of our experience reflects their relative importance for our ancestors’ survival and reproductive success.

Emotion

Perhaps the most important psychological adaptation for survival and reproduction is the sense of emotional attachment that develops between an infant and its mother. This is true for other primates as well as for humans, but humans develop motor skills more slowly as infants. Although we wean infants a bit earlier than chimpanzees do, human offspring require intensive investment and supervision long after weaning. Like other primates, young human children left on their own would have been vulnerable to starvation, exposure, predators, and the abuse of intolerant adults throughout evolutionary history. Close bonds between mother and child have thus been in the genetic interest of both mother and child—a bond to keep the child from wandering away from its primary protector and to keep the mother motivated to address the constant demands of what must often have been a distracting and irritating burden.

To this end, infants can recognize their mother’s voice and smell soon after birth, and as soon as their eyes are able to focus enough to discriminate individual faces, they can recognize—and show preference for—that of their own mother. Once human children are old enough to crawl (potentially into danger), babies develop an intense desire to be within sight of their mother, and when temporarily separated, they experience and communicate great distress. Mothers, reciprocally, develop an intense attachment to their child above all others, and they too experience distress upon separation. Attachment, separation anxiety, and the many forms of preverbal communication that mutually reward mother-infant interactions are features of the human psyche that have deep roots in our primate heritage and are both universal and compelling.

Other emotions appear early in life, across cultures, and without having to be learned. These so-called primary emotions include fear, anger, happiness, sadness, surprise, disgust and, according to some, curiosity. The primary emotions are universal not only in terms of our phenomenological experience but also in terms of their outward expression; facial expressions of the primary emotions are consistently performed across cultures and ages even in children blind from birth, and (among the sighted) are recognized quickly and reliably. Babies communicate with facial expression long before they can see the expressions of others, and at about seven months of age when their visual system has developed enough to discriminate facial detail, they are differentially and appropriately responsive to the facial expressions of those around them.

Later in development, children acquire the so-called social emotions, such as guilt, shame, allegiance, vengeance, sympathy, remorse, and gratitude. Unlike the primary emotions, the social emotions require an awareness and appreciation of social context, and so routinely appear only after a child is physically and mentally capable of navigating the social world—around ages four, five, and six. The social emotions are critical for cooperating with nonrelatives and for getting along in large social groups in which people must often depend upon one another. The social emotions motivate us to repeat and to reward mutually beneficial interactions, and to avoid and to punish those who take advantage.

Knowing whom to trust and whom to avoid requires the ability to discriminate between and remember unique individuals, as well as to remember how they behaved in previous encounters. To this end, natural selection has honed in us a rather amazing capacity to recognize individual faces and voices—even after as little as a single exposure and sometimes after as long as decades between encounters. Furthermore, recognition of specific individuals is often associated with an automatically generated emotion—fear, anger, pleasure, anxiety—depending on our past experience with that person. In fact, one of the first human universals to be documented was the facial expression of anxiety upon first seeing a stranger approach, followed by an “eyebrow flash” and a smile of relief and pleasure when he or she appeared close enough to be recognized as a friend.

We even have emotional responses to strangers who look or act like people we have previously met. These “gut feelings” about people (and situations) are, essentially, classically conditioned visceral responses that send us a message that if experience is anything to go by, we should pay special attention because these same conditions were, in our own past, associated with salient outcomes. Emotion, even in the form of such vague “intuitions,” is designed to guide us away from situations that are statistically likely to be harmful, and toward situations that are statistically likely to be beneficial. For evolutionary psychologists, the fact that our emotions and visceral responses are so automatic and so easily conditioned is a legacy of our past that has been built into our adapted brain and our adapted mind.

Cognition

Important aspects of the behavior of the physical world also seem to be innately wired into, or easily acquired by, our adapted brain. Universally, babies appear to experience anxiety about steep drop-offs as soon as they can see them—without having to learn by experiencing a fall. They also flinch or move away from objects that are getting larger on a projection screen and therefore appear to be coming toward them. Although babies cannot count or do mathematics, they very quickly internalize the fundamental concepts of Newtonian mechanics (length, mass, speed, and gravity), as well as the concepts of more and less, larger and smaller. Without having to be taught, all but the most profoundly retarded of individuals automatically acquires, and communicates about, one of the most abstract concepts of all: the relation between past, present, and future.

Language is another kind of complex and abstract knowledge that is second nature to very young children. Across all cultures and language groups, children progress through a regularized series of stages of language development, acquiring the ability to both understand and produce grammatical speech (or, in the case of deaf children, visual signs). To acquire the 60,000-word vocabulary typical of an eighteen-year-old, a person must learn, on average, ten words a day; at their peak, children acquire several new words an hour. That this is a highly specialized kind of learning that is prewired into our adapted mind is evident by the fact that most adults have to work extremely hard to acquire a second or third language, and if they succeed in doing so, they are rarely as fluent as in their first language. Furthermore, it is exceedingly difficult to “teach” the smartest computers and robots how to understand even very elementary forms of speech, and although other animals can be taught the meanings of certain word or symbol sequences, they are unable to acquire the rules of grammar and syntax that come so naturally to human children. Linguistic skill is a human-specific attribute that develops easily and quickly during a critical period of brain development, and once achieved, it is never forgotten. For evolutionary psychologists, language facility is a paradigmatic feature of our adapted mind.

Another feature of our adapted mind is an innate preference for things that were “good” for our ancestors and a distaste of things that were “bad.” We naturally like sweet foods that provide us with the necessary glucose for our calorie-hungry brain and salty foods that provide us with the minerals to run our neuronal sodium pump; yet we have to acquire (and in some cases may never acquire) a taste for bitter foods and for foul-tasting or foul-smelling foods, which signal our brain that they may contain toxins. Even our taste for spices is adaptive: the most commonly used seasonings in cuisines around the world (lemon, garlic, various peppers, and oregano) are those that protect us with their potent antibacterial properties. Our brain also automatically causes us to develop highly ingrained aversions to foods that we ingested several hours before becoming ill. Even in cases when we consciously know that it was not the salad dressing or the broccoli au gratin that actually made us sick, we may still feel nauseous just thinking about the item ten years later. Our adapted mind is watching out for us—motivating us to eat things that we can use and to avoid things that might poison us.

Our adapted mind also demonstrates other kinds of “taste.” Children around the world show a decided preference for parklike landscapes that provide plenty of water, flowers, and foliage, and for forms of play that provide exercise, strengthen muscles, and increase physical coordination. Adults particularly admire the beautiful faces and shapely bodies of the young, healthy, and disease-free—those who are the safest to befriend and most profitable to mate with. And people of all ages have a predisposition to pay attention to, admire, and emulate the practices and preferences of successful peers. These aspects of our psychology are obvious to advertisers who today use outdoor scenes, sports, and sex to get our attention, and who pay movie stars and sporting idols to promote their products, but the reason they exist in the first place is because they helped our ancestors to survive, acquire physical and social skills, find a mate, reproduce, and successfully raise children.

Even our facility at logical reasoning—an aptitude that many philosophers consider to be the hallmark of our species and a measure of our mental flexibility— seems to be in some ways programmed. For example, just as we so readily develop emotional “intuitions” about certain kinds of people and places, we also readily develop mental stereotypes. Stereotypes are basically abstract concepts that arise from the mental integration of experience and that are designed to represent a statistically accurate synopsis of reality. Stereotypes are formed by a process that parallels what we call “inductive reasoning,” but which occurs at an automated rather than accessible level. The automaticity of stereotypes allows us to respond quickly to new stimuli so that we do not waste precious time assessing each nuance of each new minute of our day. In this way, having a mental stereotype is much like having the concept of “more versus less” or “sweet versus bitter”: it is a very gross assessment, but it is often all that is needed.

Deductive logic, too, exhibits features that signal the hand of natural selection. Solution of logic problems involving the classic “if p, then q” form may seem either simplistic or deviously difficult, depending on the specific content of the statements ρ and q. When problems are worded such that the task is to identify people who may be breaking a social rule (e.g., “If you take cake, then you must pay for it”), the solutions are readily apparent: anyone who takes cake (p) must be checked, and anyone who does not pay (not q) must be checked. When, however, problems are worded such that the task is to identify inanimate objects that may be breaking an arbitrary physical or numerical rule (e.g., “If a card is even-numbered, then it must go in a green folder”), the solutions prove to be quite elusive: everyone realizes that they must check for even-numbered cards (p), but a large majority fail to realize that they must check cards in the nongreen (not q) rather than the green (q) folders. That is, despite the identical format of the problems, success is achieved easily only on those that have clear relevance for human social interaction. Our facility for deductive logic is, like our memory and our emotional responsivity, selectively tuned to protect us from situations in which we might be harmed or cheated by other people.

In fact, it might have been the complexity of human social groups and interactions that created the selection pressures that led to our great intelligence. Populations of social species typically have some form of hierarchical organization involving complex, sometimes dynamic, relationships, and youngsters in such groups must learn not simply who is their mother, but who is their mother’s friend and who is their mother’s enemy, who leads the group and who follows, who dominates and who can be dominated. Furthermore, each individual’s status in the group must be continually monitored because relationships may change with age or reproductive status and as enmities and alliances form, dissolve, and reconfigure. Keeping track of all these identities, relationships, and their history requires keen faculties of discrimination, memory, and inference.

Although our highly social primate relatives can do these things to some extent, humans have taken this kind of mental social register to another level altogether. To be able to infer how other people might respond to a contemplated action, and thus to plan or strategize about our own behavior, we rely not only on our knowledge about particular others but also on a “theory of mind.” At about age four, children begin to understand that other people have independent thoughts, feelings, and beliefs—that each person has his or her own mind— and that the contents of each mind are, in fact, different. This critical insight completely changes how the child behaves, for now he or she can attempt to “manage” others by manipulating their feelings and beliefs. It is at this age that human children first start to show sympathy and empathy for others who are in distress, first start to use gifts, promises, and friendship to create alliances, and first start to lie to protect their own interests.

In many ways, our intelligence is really a specialized social intelligence. We devote much of our everyday conscious thought not to how to walk or focus our eyes or do science, but to figuring out how best to deal with others and how to improve our own image and status in their thoughts. We use our amazing gift for language not primarily to discuss philosophy or the structure of matter, but to gossip, seduce, insult, boast, and assign credit and blame. Our television, magazines, books, and newspapers cater to our hunger for knowledge about other people—even make-believe people—over that about other creatures or the physical world. In sum, just as coral polyps have evolved to be natural architects, sheep to be natural lawnmowers, and cats to be natural mousetraps, humans have evolved to be natural psychologists.

Personality

Because predicting other people’s behavior is so important to us, any aspect of a person that is consistent and can help us to predict accurately becomes salient. Such relatively stable behavioral predispositions are what we refer to in everyday parlance as “personality.” We care about others’ personality not only when it comes to important decisions about marriage, politics, and business partnerships, but also when making decisions about everyday social and economic transactions such as with whom to carpool or eat lunch. We have created an expansive lexicon describing intricate nuances of personality, both normal and abnormal, and we use these to label ourselves and others—sometimes for the sake of accurate prediction, and sometimes for more nefarious purposes.

There are many systems that modern psychologists use to discuss variation in personality, but from an evolutionary perspective there are two major dimensions that repeatedly emerge as most important: dominance/ submissiveness and friendliness/hostility. Our special attention to these two dimensions of personality seems to highlight once again the importance of social hierarchies, factions, and alliances to human life.

Also salient to us are some consistent differences between the sexes. Boys and men around the world are, on average, more physically aggressive, more competitive, more impulsive, and more risk-prone than girls and women, who are, on average, more nurturant, more empathetic, more cooperative, and more harm-avoidant than boys and men. These differences manifest in multitudinous ways, including differential representation of the sexes in certain activities and careers, greater participation by males in war and both violent and nonviolent crime, and a longer life expectancy for females with higher death rates for males at every age.

Although human politics and sex role relations are vastly more complicated than those of our primate (and other mammalian) kin, the physical and temperamental differences that underlie human sex differences are also found in other species. Male mammals generally have a higher metabolic rate than females, reach sexual maturity at a later age but at a larger size, are more aggressive, and have a greater ratio of muscle to fat than do females; like human males, they have a shorter life expectancy and higher death rates at all ages. Female mammals generally are more sexually discriminating than males, and in addition to being the sole provisioner of nursing young, are typically the sole social parent as well. These taxon-wide sex differences have evolved as a consequence of intrasexual competition among males and gestation-driven selection in females. Although we humans may exaggerate them or mask them with our cultural inventions, they are a fundamental aspect of our evolved nature.

The Maladapted Mind

Psychologists and psychiatrists are now beginning to apply evolutionary theory to human emotion, cognition, and personality to try to understand how our mental adaptations sometimes go awry in modern society, causing psychosocial dysfunction and pathology.

Of the primary emotions, the one that is most easily recognizable in pathological form is sadness. Clinical depression can become so severe as to culminate in suicide—clearly not an adaptive outcome. The symptoms of depression, however, can be seen to be extensions of normal sadness—an emotion that is designed to orient us away from misadventure after having experienced a loss. It is after having experienced a loss, of course, that further losses would be most costly. Thus, depression may serve as a protective buffer when we are at our weakest. The pathology of modern depression is not that it exists, but that we do not regroup and come out of it in a timely and functional manner. The selective process that finetuned our emotional responsivity could not have foreseen features of today’s existence such as the absence of extended kin support networks and the stress of constantly having to be alert to the behavior and intentions of strangers and modern “institutional entities” (e.g., law, big business, and the stock market). Our fears and anxieties are attuned to an era that is long gone: our (reasonable) fear of steep drop-offs can prevent us from flying, and our (reasonable) anxiety about strangers can give us disabling stage fright and contribute to xenophobia.

Reason itself can also be led astray. As heuristics, stereotypes are designed to work to our advantage, but the “experiences” that now go into our mental computations include not just real experiences that reflect true probabilities but also thousands upon thousands of images of murder and mayhem from movies, newspapers, and television. In fact, the more media a person consumes, the more likely he or she is to have exaggerated fears and inflated estimates of the likelihood of personally experiencing a frequently portrayed tragedy. Similarly, our judgments about our own physical attractiveness and the attractiveness of our partners is radically (negatively) altered by the fact that we are constantly surrounded by (artificially enhanced) images of the most beautiful of the beautiful.

Even personality attributes that may have been adaptive in the past may no longer be so. Aggressive and narcissistic men who are today diagnosed with antisocial personality disorder may have been the successful warrior-kings of old. Harm-avoidant and compulsive women who today succumb to anorexia may have been the best midwives and mothers.

Over a century ago, Charles Darwin predicted that “In the distant future … psychology will be based on a new foundation” (The Origin of Species, 1859). That time has come.

[See also Emotions and Self-Knowledge ; Human Families and Kin Groups ; Mate Choice , article on Human Mate Choice ;Parental Care ; Primates , article on Primate Societies and Social Life .]

Sources & References

Barkow, J., L. Cosmides, and J. Tooby, eds. The Adapted Mind. New York, 1992. A rather technical book that introduced the term evolutionary psychology and first defined this research program.

Baron-Cohen, S., ed. The Maladapted Mind. East Sussex, England, 1997. Each chapter discusses some form of modern psychopathology from an evolutionary perspective.

Buss, D. M. “Evolutionary Personality Psychology.” Annual Review of Psychology 42 (1991): 459–491.

Buss, D. M. “Evolutionary Psychology: A New Paradigm for Psychological Science.” Psychological Inquiry 6 (1995): 1–30. A paper on philosophy and method of evolutionary psychology, followed by peer commentaries and a rejoinder by the author.

Byrne, R. W., and A. Whiten. Machiavellian Intelligence: Social Expertise and the Evolution of Intellect in Monkeys, Apes, and Humans. Oxford, 1988.

Crawford, C, and D. L. Krebs, eds. Handbook of Evolutionary Psychology: Ideas, Issues, and Applications. Mahwah, N.J., 1998.

Cummins, D. D., and C. Allen, eds. The Evolution of Mind. Oxford, 1998.

Damasio, A. R. Descartes Error: Emotion, Reason and the Human Brain. New York, 1994. A premier neuroscientist discusses his compelling work on emotion and cognition.

Eibl-Eibesfeldt, I. Human Ethology. New York, 1989. A comprehensive and detailed documentary of human behavior in comparative perspective. Includes many classic photos and diagrams.

Frank, R. H. Passions within Reason: The Strategic Role of the Emotions. New York, 1988. An evolutionary economist shows how and why humans are not simply “rational” beings.

Gaulin, S. J. C, and D. H. McBurney. Psychology: An Evolutionary Approach. Upper Saddle River, N.J., 2001. An excellent textbook; the most reader-friendly item on this list.

Gazzaniga, M. S., ed. The Cognitive Neurosciences. Cambridge, Mass., 1995. This advanced specialty encyclopedia includes several entries on evolutionary psychology, including those by Premack and Premack (social awareness and theory of mind), Brothers (social awareness and theory of mind), Tooby and Cosmides (functional organization of the brain/mind), Cosmides and Tooby (cognition as mental computation), Gaulin (sex differences in cognition), Preuss (comparative cognitive neuroscience), Gallistel (cognitive modularity), and Daly and Wilson (parental motivations).

Griffiths, P. E. “Modularity, and the Psychoevolutionary Theory of Emotion.” Biology and Philosophy 5 (1990): 175–196.

Hrdy, S. Mother Nature: A History of Mothers, Infants, and Natural Selection. New York, 1999. A best-seller by a premier anthropologist focusing on human and nonhuman primate mother-infant interactions from an evolutionary perspective.

Irons, W. “How Did Morality Evolve?” Zygon: The Journal of Science and Religion, 26 (1991): 49–89.

Katz, L., ed. Evolutionary Origins of Morality: Cross-Disciplinary Perspectives. Essex, England, 2000. Four papers on the evolution of morality, each followed by a series of expert commentaries and a rejoinder by the author. Reprinted in its entirety from a special issue of the Journal of Consciousness Studies (7,1–2 2000).

Lamb, M. E., R. A. Thompson, W. P. Gardner, E. L. Charnov, and D. Estes. “Security of Infantile Attachment as Assessed in the ‘Strange Situation’: Its Study and Biological Interpretation.” Behavioral and Brain Sciences 7 (1984): 127–171. A technical review on attachment followed by a series of expert commentaries and a rejoinder by the authors.

MacDonald, K. B., ed. Sociobiological Perspectives on Human Development. New York, 1988. Includes chapters on adolescence as a life stage, development of cognition, and family interactions.

Mealey, L. Sex Differences: Developmental and Evolutionary Strategies. San Diego, Calif., 2000. Compares human and non-human behavioral and psychological sex differences from an evolutionary perspective.

Nesse, R. M. “Evolutionary Explanations of Emotions.” Human Nature 1 (1990): 261–289. A lucid presentation by an evolutionary psychiatrist; hard to find, but worth reading.

Panksepp, J. Affective Neuroscience. New York, 1998. Advanced text intergrating comparative neuroscience with theories of emotion.

Pinker, S. The Language Instinct. Cambridge, Mass., 1994. The best of the books on the evolution of language.

Scheibel, A. B., and J. W. Schopf, eds. The Origin and Evolution of Intelligence. Boston, 1997. Written at a somewhat less technical level than The Cognitive Neurosciences (above), this collection is also shorter and restricted to evolutionary angles, but authors and topics overlap. Includes Seyfarth and Cheney on monkey minds, Savage-Rumbaugh on ape language, Cosmides and Tooby on modularity, and Pinker on language.

Simpson, J. A., and D. T. Kenrick, eds. Evolutionary Social Psychology. Hillsdale, N.J., 1996. Many chapters discuss cognition in the context of social relationships.

Wilson, M., and M. Daly, “Competitiveness, Risk-taking, and Violence: The Young Male Syndrome.” Ethology and Sociobiology 6 (1985): 59–73. A classic discussion of male risk taking from an evolutionary perspective.

Source Citation   (MLA 7th Edition)

Mealey, Linda. “Evolutionary Psychology.” Encyclopedia of Evolution. Ed. Mark Pagel. Vol. 1. New York: Oxford University Press, 2002. 541-546. Gale Virtual Reference Library.

Understanding Jungian Psychology

June 16, 2013 at 4:59 am

Jungian PsychologyThe psychological approach, known also as analytical psychology, envisaged by Carl Gustav Jung (1875-1961), a Swiss psychiatrist and early proponent of Sigmund Freud’s psychoanalytic theories. The Jungian system adopted a broader perspective than that of Freud by including spiritual and futuristic factors; it also interpreted disruptive emotional processes in the individual as a search for wholeness, termed individuation.

Jung, the son of a Protestant cleric, showed from childhood an inclination toward solitude, daydreaming, and imaginative thinking; he also admired archaeology and hoped to make it his career (but ended up studying medicine and related sciences). These early tendencies greatly influenced his adult work. After graduating in medicine in 1902, Jung developed a diagnostic system in which patients were asked to respond to stimulus words; this technique of “word association” revealed the presence of what Jung called “complexes.” This novel approach became widely adopted and led to a close collaboration with Freud, whose book The Interpretation of Dreams (1900) Jung had read. Subsequently, Jung became one of Freud’s disciples and protégés; Freud referred to him as the “crown prince.”

However, a divergence of views began to grow between the two after a fairly short period of formal association. Perhaps the most basic points of disagreement between Freud and Jung focused on the nature of libido (psychic energy or instinctual manifestations that tend toward life) and the structure of the psyche (mind or personality). Their differences became pronounced with the publication of Jung’s Psychology of the Unconscious, in which he deemphasized the role of sex and expressed a different view of the biological force Freud had labeled the libido. Jung continued on this independent path, and his break with Freud, whom he still admired, became total in 1914. During the next 47 years, Jung cultivated his own theories, drawing on a wide knowledge of religion, mythology, history, and non-European cultures; he observed native cultures in Asia (India), North America (New Mexico), and Africa (Kenya) and found his own dreams and the fantasies of his childhood to be quite relevant to the cultures he was observing. In 1921, he published Psychological Types, in which he dealt with the relationship between the conscious and unconscious and proposed the “extrovert” and the “introvert” personality types.

Whereas Freud saw the libido in predominantly sexual and “savage” terms, Jung perceived the libido to be generalized life energy, with biological-sexual drives constituting only one of its parts. Jung saw this energy as expressing itself in growth and reproduction, as well as in other kinds of human activities depending on the social and cultural milieu. Thus, according to Jung, libidinal energy in the presexual phase (3 to 5 years of age) is basically asexual; it serves the functions of nutrition and growth—not the Oedipal complex, as Freud postulated. Conflict and rivalries develop among siblings dependent on a mother for the satisfaction of such basic needs as food and safety. As the child matures, these essentially nonsexual needs become overlaid with sexual functions. Libidinal energy takes a heterosexual form only after puberty.

With reference to the structure of personality, Jung saw the psyche, or mind, as consisting of three levels: the personal conscious, the personal unconscious, and the collective unconscious. Like a small island in the ocean, the tip visible above the water corresponds to the personal conscious, the submerged portion that can be seen corresponds to the personal unconscious, and the invisible foundation that connects the island to the earth’s crust corresponds to the collective unconscious. This paradigm reflects the influence of archaeological stratigraphy on Jung’s worldview.

Jung’s approach to therapy may be seen as holistic; it rests on a rationale of showing the close parallels between ancient myths and psychotic fantasies and explaining human motivation in terms of a larger creative energy. He aimed at reconciling the diverse states of personality, which he saw as being divided into the introvert-extrovert polarity mentioned earlier, as well as into the four functions of sensing, intuiting, feeling, and thinking. And by understanding how the personal unconscious is unified with the collective unconscious, a patient can achieve a state of individuation, or wholeness of self.

See Also Archetype ; Psychological Approach.

References

Adler, Gerhard. 1948. Studies in Analytical Psychology. New York: W. W. Norton. El-Shamy, H. 1980. Folktales of Egypt.Chicago: University of Chicago.

Jung, C. G., and C. Kerenyi. 1969. Essays on a Science of Mythology. Trans. R. F. C. Hull. Princeton, NJ: Princeton University Press.

Progoff, Ira. 1953. Jung’s Psychology and Its Social Meaning. New York: Grove. Schultz, Duane. 1987. A History of Modern Psychology. New York: Academic.

Source Citation   (MLA 7th Edition)

El-Shamy, Hasan. “Jungian Psychology.” FolkloreAn Encyclopedia of Beliefs, Customs, Tales, Music, and Art. Ed. Charlie T. McCormick and Kim Kennedy White. 2nd ed. Vol. 2. Santa Barbara, CA: ABC-CLIO, 2011. 754-756. Gale Virtual Reference Library.

A Look at New Treatments for ADHD

June 15, 2013 at 9:53 pm
New ADHD TreatmentsQuestion: If some alternative treatments seem to work to help people with ADHD, why are there so few research projects to prove or disprove their effectiveness?

Answer: Research takes funding. While pharmaceutical companies have millions to spend on research to test their products, there is not much funding available to test other forms of treatment like vitamins and dietary changes.

The alternative therapies for ADHD fall into several categories. There are diets that limit certain foods and additives; there are programs advocating various vitamins and supplements, including herbal supplements; and there are programs that offer brain-based therapies, motor therapies, and visual therapies. Of these, it is important to note, the diets probably have the most research to support their claims, and the dietary recommendations, while they may be hard for children to follow, are not harmful. The vitamin therapies are both unproven and some are potentially harmful; they must be undertaken with medical supervision. The other therapies probably do not cause harm but are expensive and generally ineffective.

DIETARY TREATMENTS FOR ADHD

In 1970, a pediatric allergist Dr. Benjamin Feingold theorized that salicylates (a chemical compound similar to that found in aspirin), artificial colors, and artificial flavors caused hyperactivity in children.

Dr. Feingold proposed a diet that was free of such chemicals. In addition to treating ADHD, Dr. Feingold’s followers claim that his diet also helps with asthma, bedwetting, ear infections, eye-muscle disorders, seizures, sleep disorders, and many other conditions.

The diet is usually presented as a two-step process. In the first step, families eliminate artificial colors and flavors, the antioxidants BHA, BHT, and TBHQ—which are used as preservatives—products containing aspirin, and natural salicylates found in food. If the child shows improvement after four to six weeks, some foods may be carefully introduced.

Over the years, many parents have reported significant improvement in their children’s conditions. In 1980, a double-blind study conducted by the Nutrition Foundation concluded that while some children may in fact have sensitivities to food additives, most children showed no significant changes when the additives were removed, then added back into the diet.

Another study in 1983 concluded that about 2 percent of children respond negatively to food additives. A 2007 article published in the medical journal The Lancet noted that artificial colors and additives do seem to increase hyperactivity among younger children. One additive in particular, sodium benzoate, which is used as a preservative in many foods, seemed to have the greatest impact. The yellow food coloring tartrazine (also known as FD&C yellow #5) has also been linked to hyperactivity, although the relationship has not been definitively proven. The authors note, however, that the effects of the additives varied widely, with some children showing a marked increase in hyperactivity after ingesting the additives and others showing little or no effect.

Avoiding Sugar, Wheat, Carbohydrates, and Dairy

Many individuals believe that the symptoms of ADHD can be treated by the avoidance of sugar and artificial sweeteners, wheat, carbohydrates, and dairy products. There has been no research to date confirming any beneficial effect from eliminating any of these foods from the diet. While some children do improve their behavior when one or more of the foods are eliminated, these children are probably among the few who are actually allergic to these foods. Many parents have reported a significant decrease in hyperactivity when sugar is eliminated from the diet, but no study has confirmed this perception. In fact, one study found that mothers reported decreased hyperactivity when they believed their children had been given sugar-free snacks—even when the snacks were loaded with sugar.

VITAMINS AND OTHER SUPPLEMENTS

Because many children with ADHD have been shown to be deficient in iron and omega-3 fatty acids, many people believe that supplementing the diet with these substances will help lessen the symptoms of the condition. There are also those who believe that people with ADHD can benefit by taking magnesium, vitamin-B, zinc, or other supplements. Some people also think that very large doses of vitamins can help.

Iron

There have been several small studies that suggest that people with ADHD who receive iron supplements (ferrous sulphate) show improved concentration and less hyperactivity. More studies are needed to determine if the benefits found in these studies can be generalized to the larger population.

There are significant dangers with iron supplementation, however. Iron accumulates in the body, and if there is too much, it can be very difficult to eliminate. Even small amounts of excess iron in the body can damage the heart and the brain and lead to heart attack and stroke. No one should take iron supplements except under the supervision of a physician.

Omega-3 Fatty Acids

There have been a number of small studies that suggest supplementing the diet with omega-3 fatty acids can be helpful to people with ADHD. Fatty acids help to form brain and nerve tissue in the body and are important for growth, mental function, a healthy immune system, and brain development. The typical American diet is low in omega-3 fatty acids, which are found in salmon, mackerel, sardines, and flax-seed oil. Supplements of omega-3 contain either flaxseed oil or fish oils. Studies conducted to date include one at Oxford University in England, which found that ADHD symptoms in children taking essential fatty acid supplements improved over those taking a placebo. A 1995 study compared essential fatty acid levels in boys with and without ADHD and found that the boys with ADHD had significantly lower levels of the substance. A 1996 study at Purdue University confirmed that boys with low blood levels of omega-3 fatty acids had a higher incidence of ADHD than boys with normal levels.

Overall, however, there have been no definitive studies confirming the benefits of omega-3 fatty acids in the treatment of ADHD. However, it is known that these oils are necessary for good brain and body development and have no harmful side effects. Parents should always consult with a physician before giving any such supplements to children. There have been instances in which omega-3 fatty acids interacted negatively with medications for diabetes and heart disease in adults.

Magnesium

Magnesium is a mineral that is part of more than 300 metabolic reactions in the body. It helps to produce energy, to create nucleic acids, and to conduct nerve impulses. One small study found that children with ADHD who took 200 mg. of magnesium each day had a significant reduction in symptoms. Magnesium is relatively safe and has few side effects, but it can interfere with some medications and should only be taken under the supervision of a doctor.

Zinc

Zinc is also a mineral that serves many functions in the body. Zinc supplementation has few side effects but it can interfere with the absorption of copper, so it might be necessary to also supplement the diet with copper. Zinc can interfere with the absorption of antibiotics, so the two substances should not be taken together.

In a small study, zinc was given along with Ritalin to a group of children with ADHD. Parents and teachers reported improved attention and reduced hyperactivity. The study used 15 mg. of zinc. This is a rather large amount, and such an amount should not be administered without a doctor’s supervision.

B Vitamins

There have been treatment studies using B-complex vitamins or very large doses (megadoses) of B vitamins. The results of the studies have been inconclusive. Some people have been helped, while others showed no improvements. Generally, B vitamins are water soluble and can be easily eliminated from the body, causing few side effects. Still, it is important to remember that large doses of any vitamin should not be given except under the supervision of a doctor. Large doses of vitamin B-6 can cause nerve damage, for example.

SAMe

S-adenosyl-L-methionine, called SAMe and pronounced “Sammy,” is a serotonin precursor that has been used in treating ADHD. A serotonin precursor is a compound that helps to produce the neurotransmitters serotonin, dopamine, and norepinephrine—brain chemicals that affect mood. Six of eight people in a small, preliminary study responded well to treatment with SAMe. SAMe is safe at recommended doses and has only mild gastrointestinal side effects. Rarely, SAMe can cause mania in people suffering from bipolar disorder.

Ginkgo and Ginseng

Another small study of children with ADHD showed that a combination of ginkgo biloba and American ginseng helped to improve symptoms of distractibility and attention after four weeks on the supplements. The dose was 200 mg. of ginseng and 50 mg. of the ginkgo. As with many of the other supplements, ginkgo and ginseng can interfere with certain medications and should not be used without consulting with a doctor.

ART, AUDIO, AND MOVEMENT THERAPIES

Some practitioners believe that children with ADHD can be helped by various alternative therapies. In general, these therapies may be helpful and do not have any negative side effects. Some of them, however, can be quite expensive, and there is no scientific evidence that they work.

Art Therapy

Some experts believe that creative activities such as drawing, listening to music, or dancing help children with ADHD calm down and focus better. George Lynn, a therapist and author, says in Survival Strategies for Parenting Your ADD Child that “Art utilizes the part of the brain that controls emotions. Children with ADHD often have trouble controlling their emotions and these activities can help them.” There are studies that show that music can help children concentrate more easily, but much more research needs to be done in this area. Any kind of exercise, whether dancing or other kinds of “movement therapy,” can help to combat hyperactivity. The deep breathing of yoga has also been shown to help calm hyperactive children.

Fact Or Fiction?

I read somewhere that kids can be cured of ADHD by playing video games.

The Facts: First of all, there is no cure for ADHD. While it is possible to treat some of the symptoms of the condition and improve functioning, there is as yet no treatment that can effect an actual cure. Moreover, there are no video games being used to treat ADHD. Some children are being taught a biofeedback technique in which they can manipulate their brainwaves and see the result on a computer monitor. It is hoped that this ability will help them manage their impulses and emotions better. To some of the children, watching and manipulating their own brainwaves on a computer may seem like a game, but it is not a game in any other sense of the word.

Audio Integration Training

Dr. Guy Berard, a French otolaryngologist (ear, nose, and throat doctor), invented audio integration training (AIT) to help patients with hearing loss or distorted hearing. After using the treatment for many years, Dr. Berard came to the conclusion that such training was beneficial to people with many other disorders, including ADHD, Asperger’s syndrome, dyslexia, and depression. The therapy is designed to normalize how the brain processes auditory signals. Dr. Berard believes that hypersensitivity to certain sounds can lead to overstimulation, agitation, and distractibility.

There is no scientific evidence that AIT works, and some question whether or not it is safe. The American Academy of Pediatrics considers it experimental and the U.S. Food and Drug Administration (FDA) has banned the audiokinetron, a device used to perform the therapy, from being imported into the United States, because there is no proof that the therapy works.

Interactive Metronome™ Therapy

Interactive Metronome™ (IM) is a neuro-motor tool used to assess and treat motor planning and sequencing, which in turn can help with everything from making coordinated movements to formulating a sentence. In IM training, the patient wears headphones and listens to a computer-generated sequence of tones. The challenge is for the patient to move in sync with the sounds, coordinating hand, foot, and body movements. The movements are recorded on a computer screen allowing the patient to evaluate his or her success. The trademarked treatment claims to improve focus and attention, increase physical strength, help people learn to filter out distractions, and improve mental and physical coordination. There are few studies on the effectiveness of IM for people with ADHD, but in one conducted in 2001 and published in the American Journal of Occupational Therapy, Schaffer and others concluded that IM “appears to facilitate a number of capacities, including attention, motor control, and selected academic skills in boys with ADHD.”

BRAIN-BASED THERAPIES

Both biofeedback and what has been called neurofeedback have been used to help treat children with ADHD. For both treatments, there is a great deal of anecdotal or small-scale evidence about benefits, but controlled scientific studies have yet to find any real proof that the treatments work.

Biofeedback

Proponents of biofeedback say that the technique can help children learn to calm down and focus by using a special machine to control the body’s reaction to stress. When the child is connected to the machine, it gives him or her feedback about pulse rate, breathing rate, and muscle tension. The machine tells the child when he or she is stressed and then indicates when he or she has succeeded in bringing these key rates down through relaxation techniques. In this way, the child learns calming techniques that can also be used away from the machine. Preliminary research suggests biofeedback is helpful in treating some symptoms of ADHD, but much more research is needed. Biofeedback is a very time-consuming technique that may not continue to work outside of the laboratory. It may also be ineffective with young children who have less control over their emotions.

Neurofeedback

Neurofeedback is also called neurobiofeedback, neurotherapy, and EEG biofeedback and is similar to biofeedback. With neurofeedback, however, the patient is connected to a computer while wearing sensors on the scalp. A visual display of brainwave patterns is displayed on the computer screen in real time. The patient is trained to control and alter his or her brainwaves. Most patients enjoy the training, as it is something like playing a video game. Neurofeedback has no known negative side effects but it can be very time-consuming—it requires 40 or more one-hour sessions-and expensive.

The best documented use of neurofeedback is in the treatment of ADHD and several studies have shown the technique to be useful in treating the condition, notably one by Steven M. Butnik, “Neurofeedback in adolescents and adults with attention deficit hyper-activity disorder,” published in the Journal of Clinical Psychology in 2005. Neurofeedback has many critics, including the psychiatrist and ADHD expert Russell Barkley, who believes that positive results are primarily the result of the placebo effect. In addition, in most states there are no licensing requirements for using the therapy, and therapists who have little knowledge of physiology or computer technology can use the technique.

Alternative treatments for ADHD run the gamut from the promising to the deadly. Parents and patients must look carefully at what the treatment claims to offer and what research is presented in its support. It is also important to know who is offering the treatment. Is the treatment offered by a doctor or other certified practitioner or by a for-profit organization? People also need to be aware that labeling a supplement natural does not mean it is safe. When it comes to alternative treatments for ADHD, let the buyer beware applies.

See also: ADHD (Attention-Deficit/Hyperactivity Disorder) ; Asperger’s Syndrome ; Bipolar Disorder ; Depression ; Dyslexia