Friday, June 06, 2008

No to talk therapy

Eysenck showed the uselessness of talk therapy in the 1940s but it is a monster that refuses to die

Britain's traditional stiff upper lip may be a better strategy for dealing with shock than letting your feelings spill out, a new study claims. The popular assumption is that talking about a terrifying experience, such as a terrorist attack or natural disaster, can be therapeutic and helpful. But new evidence suggests "getting it off your chest" may not be the right thing to do.

Psychologists in the US used an online survey to test people's responses to the September 11 2001 terrorist attacks on New York and Washington. Those who chose to express their thoughts and feelings were compared with those who did not over a two-year period. To their surprise, individuals who bottled up their feelings ended up better off. They suffered fewer negative mental and physical health symptoms than people who were willing to talk.

The results have important implications for expectations about how people should react to collective trauma that affects a whole community or nation, said the researchers. It also called into question the pleas made to people caught up in shocking events to come forward and "open up". After last year’s Virginia Tech University shootings in the US, numerous "media-doc" psychiatrists told how important it was for the students to express their feelings.

Dr Mark Seery, from the University of Buffalo, New York State, who led the new research, said: "This perfectly exemplifies the assumption in popular culture, and even in clinical practice, that people need to talk in order to overcome a collective trauma. "Instead, we should be telling people there is likely nothing wrong if they do not want to express their thoughts and feelings after experiencing a collective trauma. "In fact, they can cope quite successfully and, according to our results, are likely to be better off than someone who does want to express his or her feelings." The findings are published in the June issue of the Journal of Consulting and Clinical Psychology.

Dr Seery stressed it would be wrong to say people recovering from trauma should never express their feelings. "It's important to remember that not everyone copes with events in the same way, and in the immediate aftermath of a collective trauma, it is perfectly healthy to not want to express one’s thoughts and feelings," he said.


Another comment:

It would be hard to pinpoint exactly the death of the British stiff upper lip, but I would hazard it happened around the death of Diana, Princess of Wales. What with hours of television shows devoted to personal problems and acres of self-help manuals filling the shelves, its demise had been coming for some time; but the Princess's death opened the floodgates and we haven't stopped having sizeable feelings from that day.

Feelings, of course, are often quite unavoidable. Equally, though, they are a rather cumbersome replacement for thoughts. Yet people increasingly believe that if they can only say what they feel, then all anxieties will magically vanish.

Not so, according to this month's issue of the Journal of Consulting and Clinical Psychology. It turns out that - contrary to every mother's advice, and every episode of the Oprah Winfrey Show - there are serious health benefits to be enjoyed from bottling things up. Not speaking about one's worries is a reliable way of getting over them; while the highly profitable culture of Yak Yak Yak has done quite the opposite, making people altogether more worried about the bad things that have happened, or are happening, or are likely to happen in the next 50 years.

Laying it all out on the table over a nice cup of tea was nothing short of a health hazard: it might have offered the instant sensation of a burden lessened, but doctors now believe that too much talk about worries can exacerbate them to the point where they seem out of control.

Science and I don't often agree - which is good news for science and bad news for me - but I've been arguing for the return of the stiff upper lip for some time. I hate all those TV programmes where people line up on stage to ask their daddy why he didn't love them enough.

For a start, one can usually understand quite quickly why the daddy didn't, and second (perhaps more scientifically) the people on those shows don't seem to benefit from the spectacle of unburdening.

In the old days, when people's daddies didn't love them enough, they felt a bit sad about it and tried to do better with their own children. Or they sought ways to bear it.

Bear it! Now there's an outmoded concept. Surely there's something to be said for gearing oneself up for a bit of disappointment in life, to say nothing of pain, rather than bleating every time you realise that a perfect life is not something that follows on naturally from excessive moaning.

Yet misery memoirs are now among the nation's national tonics, even though any number of them have proved to be works of fiction aimed at a gullible and needy public. Tonics, in my view, are something best taken with a glass of gin and a slice of lemon, helping one towards the refreshing conclusion that solutions to intractable problems might often be found in a combination of acceptance and forgetting, as opposed to endless wallowing.

Being "self-aware" - ie, droning on about feelings - has, among other things, threatened to kill the art of conversation and normal social interaction. The proper response to, "How do you do?" is "How do you do?", not, "Well, actually, I have a tummy-ache," or, "I am prey to unbearable anxieties about my childlessness".

It used to be considered insufferably self-regarding to answer any polite query about one's health with anything other than a cheery, "Fine, thank you," even if one were riddled with necrotizing fasciitis and had mere moments to live. Today, anyone who inquires about anyone else's well-being needs to brace themselves for an onslaught of unlovely detail.

While it is rather sad if your mummy never kissed you goodnight - and such sadness can lead to great heights of human expression, see Proust - too much wallowing can cheapen emotion, and common complaints transform into little arias of self-importance.

You'll notice that the expression "sob story" has recently fallen out of common parlance and that's because everybody is now assumed to have one: you can't turn on the radio without hearing some allegedly successful person wailing about the fact that there was never a sweetie in their tuck box.

How much more impressive (and heartening, and a real tonic) it is to come across people who have surmounted incredible difficulties and can still get on with their lives. People in wheelchairs find love; people with no voice become politicians and speak for masses - with nary a complaint or a memoir along the way - while every day we are invited to commune with some perfectly endowed individual who wants us to feel her pain about not being able to find a boyfriend.

The stiff upper lip doesn't seek to deny sadness, but rather acknowledges it quietly, takes control of it, and allows one to survive and move on. The person who ends each telephone conversation - with everyone from their mother to their plumber - with "Love You" is not necessarily the supremely well-adjusted hero you might think. This is to put sentimentality before real feeling; sometimes holding back is simply a way of allowing your emotions their true weight.

For the sake of your health, get buttoned up, though please don't expect to win any national talent contests if you do so.


Vaccine for brain tumor may double survival

An experimental vaccine designed to treat the most common and deadly brain tumor has more than doubled the survival of patients, according to results of a small clinical study. The vaccine, produced by the US firm Avant Immunotherapeutics Inc, stimulates the immune system to attack the glioblastoma multiforme (GBM) tumor. The clinical trial involved 23 patients with large GBM tumors. The patients treated with the vaccine lived an average of 33 months while those receiving standard treatment typically live for an average of 14 months, said Dr John Sampson, of Duke University in North Carolina who presented the results Monday at the annual conference of the American Society of Clincial Oncology in Chicago.

The study also showed the vaccine slowed the return of the tumor after surgery. The tumor for those treated with the vaccine reappeared in 16.6 months compared to the usual six months. The GBM is an aggressive cancer with a poor prognosis, brain specialist Mark Gilbert of the M.D. Anderson Cancer Center in Texas told reporters. The tumor kills 50 percent of patients during the first year after diagnosis and few live beyond three years. Without treatment the tumor grows back between two to three months after being surgically removed.

The GBM tumor is the same that afflicts longtime US Senator Edward Kennedy who underwent surgery on Monday in Durham, North Carolina. When asked about Kennedy's case which has generated national media attention, Gilbert said that the senator could possibly benefit from the vaccine if surgery succeeds in completely removing his tumor.

The experimental vaccine, administered with chemotherapy to stimulate an immune response, is aimed at proteins linked to tumor cells. A much larger clinical trial was planned for later this year, Gilbert said.

About 22,000 cases of malignant tumors of the brain and bone marrow will be diagnosed in 2008 in the United States and 13,000 people will die, according to the American Cancer Society. Pfizer has acquired exclusive licensing rights for the vaccine.


1 comment:

Anonymous said...

One of your linked essays: " I hate all those TV programmes where people line up on stage to ask their daddy why he didn't love them enough."

In the USA one of the top TV shows was about the mafia, in which Tony Soprano, who sexed his secretary over the desk regularly and had various inconvenient people assassinated...actually had as its main story besides all the sex and guns, his surreally lit weekly sessions with his THERAPIST (who he of course falls in love with).

Oddball non-academic originator of cultish NLP, Richard Bandler was often fond of calling them by the term: "Psycho the Rapist."

From what I've heard, PSTD is a *uniquely* treatable condition, using eye-wiggle therapy, in which the victim literally follows the therapists back and forth swinging finger with his eyes as he recalls traumatic incidents. This seems to (and makes some sense) weaken the connection between memory and emotion by having the brain concentrate on something trivial as the memories are recalled.

But what I also heard was that after finally studying it, the great embarrassment was not that "talk therapy didn't work," but that it worked in some low percentage (30?), independent of what *school* of therapy it was. Yet newer, thought-based therapies did work better than emotion-based ones, in that thought has more effect on emotion than emotion does on thought. Thus Cognitive Behavioral Therapy (CBT) is now king of the hill, and it has none of the social change baggage that former schools had so much of.

Classic age old self-help business books such as "Think and Grow Rich" by Napoleon Hill were basically CBT.