Book Review-Science and Pseudoscience in Clinical Psychology

To say that sometimes my reading list slips off into the odd is an understatement. Sometimes I’m reading some really clinical research based books. I’m trying to make sure that I’m really understanding a topic and I realize that I may be reading more about psychology than most practitioners, but I believe that there are key insights to be gained. This time I’m looking at the Science and Pseudoscience in Clinical Psychology. Last time I was looking at The Heart and Soul of Change: Delivering what Works in Therapy. This follows on the heels of The Cult of Personality Testing where I got to see some of the underbelly of the psychological assessment part of the industry. I needed to learn more about just how bad the work on personality testing was – and to pick up a broader perspective of the issues in the industry.

The book is organized into chapters with specific focuses. As a collection of works from various authors, there’s not a great deal of tie-in between chapters so here I’ll address some general issues with pseudoscience in clinical psychology and from there I’ll walk through the topics of the chapters by indicating the chapter subject in headings.

Pseudoscience

Mutual fund managers have been shown to be no better at predicting the market than an index fund. (See Do Active Mutual Fund Managers ‘Beat the Market’?) When there is ambiguous or inconsistent feedback one can easily delude themselves into believing that it’s their skill that allowed them to earn money in the market. This is true even when a more detailed look at the evidence shows that few (if any) will beat the market.

Thinking, Fast and Slow calls this a zero-validity environment. That is there is no reasonable way that they can make the kind of predictions necessary to accurately forecast – and therefore capitalize on – the opportunity.

The problem isn’t that the problem is unsolvable, it’s that people believe they’ve solved it. Whether it’s the Rorschach Inkblot test or the Thematic Apperception Test (TAT) there’s no reference by which to measure it and so the clinician can’t get reliable clues or feedback from their clinical practice in sufficient quantity and reliability to determine that the results are little better than chance.

Worse yet, despite having a battery of tools – some effective and some not – most of the social issues that we’re most concerned with – such as abusive parents – will demonstrate no mental defects that are detectable on the instruments that we have – including the Rorschach which has a noted bias to overpathologize subjects.

Science and Pseudoscience in Psychology says “Munchausen mothers force doctors to impose treatments on their children by interpreting ‘borderline’ medical conditions as problems needing intervention.” Clinicians have ineffective tools to determine whether the medical condition is real or “borderline” and whether the treatment is appropriate or not. Diagnosis of ADHD and the subsequent prescription of stimulants to children and adolescents has made stimulants more prescribed for these individuals than antibiotics.

Depression effects approximately 8% of the population today. (CDC, 2011) From 2005-2008 1 in 10 (10%) of Americans 12 and older took an antidepressant. And yet, only 43% of the studies of antidepressants sent to the FDA showed any statistically significant benefit compared to a placebo.

In short, clinicians don’t know what works and what doesn’t. They’ll prescribe a SSRI (Selective Serotonin Reuptake Inhibitor) because they don’t know what else to do to make the depression better.

If the result of science is the development of techniques which have reliable and predictable outcomes, then there is still a great deal of pseudoscience in psychology. Whether it’s anti-depressants that have dubious effectiveness or testing techniques that have minimal external and internal validity, pseudoscience is still rampant.

Controversial and Questionable Assessment Techniques

Do you ever look at your horoscope? Do you ever wonder how the horoscope seems to have something applicable to you? Do you feel like it is a truth? Or perhaps you feel, as I do, that it’s an interesting diversion that sometimes causes me to remember to live out my values. Either way, horoscopes are perceived by many to have some things that resonate. However, so do cold readings – that is a technique that psychics and fortune-tellers use to encourage their subjects to believe they know more than they actually do.

They throw out a topic and try to get the subject to fill in the information. The subject fills in information and the psychic moves forward in that line of thinking. If they get something wrong, they redirect and try to get the subject to believe that they have some extrasensory understanding of the situation.

It turns out that personality tests are much the same thing. Subjects were randomly assigned to two groups. One group received a “Barnum” profile which was designed to “give a little something to everyone” or an Adult Child of an Alcoholic (ACOA) profile. The Barnum profile – named after P.T. Barnum – was general in nature and not specific to any one person. Of the ACOA in the study, 79% of them said the Barnum profile described them very well or better. Of the Non-ACOA participants 70% the Barnum profile described them well. Of those receiving the ACOA profile, 71% of the ACOA participants rated the profile very well or better. Of the non-ACOA subjects in the ACOA profile group 63% said it described them very well.

There are a few conclusions to draw from this. First, people are eager to say that a personality profile matches them. Second, ACOA subjects liked a fictional, non-specific profile 8% more than one which was founded on the characteristics found in most ACOA subjects. In short our ability to discern whether a profile is accurate or is just interesting is questionable.

I’ve so extensively covered the issues with testing in The Cult of Personality that I won’t revisit the additional criticism leveled here, except to say that every so called projective test suffers from reliability problems.

Expert Testimony

Perhaps the most challenging aspect of expert testimony is what constitutes an expert. If so many people believe they’re in the top of their field how do you know who really is – and who is not? In the context of legal proceedings the answer is supposed to be that they rely on sound scientific principles under their opinions and beliefs. While they’re not required to initially disclose how they formed their opinions, they may be required to divulge this information on cross examination.

The standard for evidence – at a federal level – are the Federal Rules of Evidence and the major decisions in the cases summarized as Daubert, Joiner, and Kumho. Daubert sets the four major factors for evaluation of a trial judge which are:

• The theory or technique is scientific knowledge that is testable;
• The theory or technique has been subjected to peer review;
• The rate of potential error is known; and
• The theory or technique has gained general acceptance in the field.

Daubert says that the expert’s opinion must rest on a reliable foundation and must be relevant to the task at hand.

Joiner affirms the weaker decision in Daubert and says “trial courts have broad discretion to reject proffered expert opinions if they are inadequately supported by the data.” In short, if the expert can’t provide that they have a reasonable foundation, it can be rejected.

Kumho further broadens the trial judge’s ability by allowing the trial judge to reject testimony that is considered “technical” as well as scientific.

In the end, experts are supposed to be able to provide a reliable foundation for their testimony. Sadly in many cases, particularly where protective tests are used no reliable foundation exists (based on the research data) and yet the experts are allowed to proffer their beliefs. Though “It is incumbent on expert witnesses to acknowledge the limits of their competence and the evidential bases of their opinions, defend the data on which they rely to support their conclusions, and, to the extent possible, buttress their opinions with rigorous research findings” few actually do.

Science in Psychotherapy

We’d like to think that in psychotherapy – like medicine – that psychologists would be seeking out new research on treatment techniques and efficacy of the treatments they’re already using to continuously improve their practice. However, as was mentioned earlier, doctors with less experience and more training are more likely to use ECT appropriately. In 2000 a survey of 891 psychologists indicated that 47% never use evidence-based psychotherapy treatment manuals in their practice. In other words, it appears that efforts to encourage appropriate continuing education are currently insufficient to keep practitioners up with the latest scientific findings.

Like mentioned in The Heart and Soul of Change effectiveness is determined to a significant degree on patient-therapist alliance. The main three themes of which are defined as:

• the collaborative nature of the relationship;
• the affective bond between patient and therapist; and
• the patient’s and therapist’s ability to agree on treatment goals

The factors that impact the results of therapy are most notably alliance and secondarily the effect of the therapist. However, knowing someone is good and proving that they’re good are two different things.

Novel Unsupported Therapies

I firmly believe that modern medicine and psychotherapy don’t have people “all figured out.” The gaps that exist in our knowledge may be shrinking but with each discovery we realize how little we actually know. It’s no surprise then that people would seek therapies that offer answers that modern medicine can’t provide. The New Age movement (or so it is sometimes called) is focused around non-traditional attempts to provide remedies. Some of these rely upon old eastern medicine practices and some are focused on the holistic person more so than western medicine but the ability to determine the efficacy is dubious.

Some of the items discussed in this category are scientific in their origins – like Hubbard’s E-meter – but their ability to indicate anything useful or to treat a patient are unclear. For instance, techniques like the Emotional Freedom Technique (EFT) often known as tapping were studied and were found to have no therapeutic value. However, some of these ideas persist in practice and in the minds of adults.

Another example comes from Harvard Psychology Professor Richard J. McNally who noted, “The notion that traumatic events can be repressed and later recovered is the most pernicious bit of folklore ever to infect psychology and psychiatry. It has provided the theoretical basis for ‘recovered memory therapy’—the worst catastrophe to befall the mental health field since the lobotomy era.” Recovered memory “therapies” have harmed a great many people when the memories that were “recovered” were subsequently discovered to be false – as we’ll see in the next chapter.

Constructing the Past

Have you ever wondered why you can’t spontaneously remember everything from the moment of your birth? If our memories really work like a video cassette recorder shouldn’t everything that we have experienced be available to us? As it turns out, not only does our memory not work like a tape recorder but we also didn’t have the ability to record events in a way that can be recalled for the first 24 months of life. The structural changes in the brain which are required to store and recall complex events doesn’t typically develop until about the 24 month mark. And yet, recovered memories are reported to come as early as in utero – or from prior lives. This of course accepts that reincarnation is true which while may be acceptable to the Dalai Lama – it’s not been proven. (Then again no one has proven that God exists either.)

So what happens when you introduce hypnosis into the mix of memory “recovery”. The answer seems to be confabulation. There is research that asserts that the recall ability of someone in hypnosis is equivalent. What does happen, however, is that subtle hints provided by the hypnotist are expanded upon. In general, ideas introduced into our memories through others – whether accurate or inaccurate — tend to take on an air of accuracy.

Consider the research where family members were told to “remember” a story about an adult when they were a child which was false. After the story was told to the adult they began to believe it as truth – and remember it. They couldn’t in fact distinguish between the memory that was told to them by their family from a real memory. We often can’t remember the source of our memories.

Self-Help Therapy

It’s 1969 and George Miller has been elected president of the American Psychological Association and in his presidential address he encourages the members to “give psychology away.” Psychologists are investigating how to convert their treatment programs into self-help systems that would allow anyone to leverage the power of psychology to improve their lives. The self-help movement didn’t start with Miller’s address. There were books available since the 1950s including Norman Vincent Peale’s The Power of Positive Thinking that were already creating the self-help category. Miller’s address simply encouraged psychologists to bring their training to bear on the market.

Unfortunately, there were numerous problems that occurred in the market. First, the claims made by books and programs weren’t regulated or monitored by anyone and thus outlandish claims were printed on some materials. What’s worse even if the materials were based on sound, well-researched psychological treatments their conversion to self-help form seemed to render them ineffective – or worse. So there was little possibility to ensure that the self-help being produced would create any positive effect.

Trauma-Related Stress Disorders

There’s a strong desire to help folks who have been through trauma. If you’ve never been close to the death of someone or to seeing some of the inhumanities of man then it’s hard to explain the profound loss you feel. Over the years several techniques have developed for the treatment of trauma related stress disorders. I discussed one called Critical Incident Stress Debriefing (CISD) in my review of Redirect. CISD was found to be less effective than nonintervention or an alternative intervention. While an opportunity to free journal write about an incident seemed to be helpful, CISD seemed to create problems.

Other treatments, like Anxiety Management Training (AMT) does have research to support that it is an effective therapy. It is a set of cognitive and behavioral strategies designed to reduce symptoms of anxiety, irritability, and hyperarousal.

Alcohol Use Disorders

Alcoholics Anonymous (AA) is perhaps the most widely known programs for alcoholics and addiction resistance in general. Though the research is mixed on its effectiveness – in part due to the anonymous and distributed nature of the group – there’s some agreement that it’s a cost effective resource since there are no dues or fees and the groups are largely self-supporting. It’s believed that AA participation reduces overall health care costs.

However, AA isn’t the only game in town. There are numerous boot camps and programs like Drug Abuse Resistance Education (DARE), Scared Straight, and locally developed programs. Most of these programs, particularly DARE and Scared Straight-like programs are actually harmful. Specifically, The US Surgeon General has classified DARE as a potentially harmful treatment. So despite the relative ease of implementation, the affinity from the communities where it is tried, and the satisfaction of the officers participating in the program, it doesn’t work.

However, there are less popular approaches – such as controlled drinking – that are effective despite being shunned by the community or members of stricter programs. Controlled drinking in particular seeks to teach folks the skills to only drink in moderation and there by seeks to minimize the trap that total abstinence folks are put into. By making alcohol a shameful activity the first drink leads to a downward spiral of shame and coping – which controlled drinking avoids.

Herbs and Antidepressants

If I were to tell you that depression was one of the most widespread psychological disorders, it’s unlikely that you’d be surprised. If I told you that St. John’s Wort (hypericum) was as effective as some (if not most) of the antidepressants on the market – at a substantially lower cost – you might be surprised.

It’s rare that herbal remedies have the level of research to support their efficacy in clinical settings. It’s similarly rare for an entire class of medicines (antidepressants) to have such a strong placebo effect that the impacts of the drugs are often difficult to distinguish from placebo. So it seems that if you’re facing depression, a good place to start might be to get some St. John’s Wort.

However, there are some supplements, like Ginkgo Biloba that while they have medicinal uses, those uses have been harder to quantify. Sold as an aid to slow down the aging process, it’s effectiveness at improving standard cognitive tests hasn’t been exciting. Some newer approaches to measurement are showing some promise.

Attention-Deficit/Hyperactivity Disorder (ADHD)

ADHD is being diagnosed in record numbers. While at some level I believe we all have some level of ADHD, DSM-V has established criteria for diagnosing the condition. Historically the treatment was stimulants. While some non-stimulant treatments have become available for treating ADHD, they’re in the significant minority. For the most part psychology based treatments haven’t shown great promise at mitigating the disorder.

However, Behavioral Therapy (BT), particularly as it relates to educating the adults working with ADHD impacted children have been effective at managing the day-to-day symptoms of ADHD but unfortunately the effects are not lasting. It appears that BT can’t spare an ADHD child from the long-term negative outcomes associated with the disorder.

Autism Spectrum Disorders

Perhaps the greatest medical sham that’s been foisted on the public in the last 50 years is the one perpetrated by Andrew Wakefield. In an article (since retracted) in the prestigious medical journal Lancet, Wakefield and his colleagues asserted a causal relationship between vaccines and autism. Unknown to Wakefield’s colleagues he had a conflict of interest in the study. The investigation about the article concluded that Wakefield falsified the medical histories of 12 of the children in the study. Wakefield lost his medical license. However, unfortunately the stigma has remained. Untold numbers of children aren’t receiving vaccinations for important diseases because of Wakefield’s article.

Numerous therapies have been suggested for Autism spectrum disorders. Many like Dolphin-Assisted Therapy (DAT) have no scientific basis and seem to have been by perhaps well-meaning people trying to find a way to improve the situation using unsupported approaches.

Attachment Therapy

Sometimes things go wrong in medicine. Sometimes treatments don’t go as planned or aren’t sufficient to resolve the issues in the body of the patient and the patient dies. However, in psychotherapy it’s quite rare for things to go so wrong that a death is the result. However, Attachment Therapy (AT) has managed to have deaths and injuries as a result of the procedures and the “extensions” that some of the therapists have applied to AT.

Whether it’s rebirthing or another offshoot from AT that caused the issues, at the heart of the debate is the approach in AT of restraining the patient. While Attachment Disorder (AD) is real and a treatment is needed, AT seems to be risky. Several proponents including Zaslow and Cline have surrendered their licenses due to injuries to patients as the result of the treatment.

Antisocial Behavior

Persistent and serious forms of antisocial behavior are estimated to be perpetrated by 5-10% of children in developed Western countries. That’s a lot of kids who are struggling to adapt to society. Other estimates place the referrals to treatment are 33-50% from antisocial kids. The financial impact on society is staggering. There are numerous factors that lead to antisocial behavior in children and adolescents and not a lot of clear resolutions. (See Our Kids for more on the impacts of under-supported children.)

Wrapping It Up

There is too much pseudoscience in clinical psychology and not enough real science. Perhaps if you read Science and Pseudoscience in Clinical Psychology you’ll be able to spot the difference, and get to better outcomes.

Book Review-Mistakes Were Made (But Not by Me): Why We Justify Foolish Beliefs, Bad Decisions, and Hurtful Acts

It’s shocking really. The lengths that we’ll go to when defending our position. It’s scary to think that one small move begets the next move and so on such that most people will administer what they believe to be life threatening levels of electrical shock to another human being. Milgram’s experiment placed students in the position of administering what they thought were shocks to a person in the other room of larger and larger voltages as a part of a research study. Little did they know it was their behavior that was being researched not the behavior of the person who was reportedly receiving the shocks. 65 percent of the students administered what they were thought to be lethal shocks without any persuasion. That number climbed to as high as 90 percent if a collaborator was added to the experiment.

At the end of the experiment, the behavior of the students would have objectively been measured as wrong but they obviously weren’t in the minds of the student at the time. It’s this slippery slope that Mistakes Were Made (But Not by Me) examines. (For more on the Milgram experiment see Influencer.)

Benevolent Dolphins

We’ve seen the news story. Some guy or gal is lost at sea in a boat, life raft, or surf board and there’s video of a dolphin leading them safely towards land. Flipper would be proud that one of his distant relatives rescued a helpless human. This story, and the copy-cat clones of it, lead us to believe that all dolphins are interested in the health and safety of humans. It represents the best of the What You See Is All There Is (WYSIATI) rule as discussed in Thinking, Fast and Slow.

There aren’t a lot of stories about the guy or gal who was led out to sea to their death by a mischievous dolphin. Those don’t make the news. We don’t know about them. They might be happening. They may not be happening. We simply don’t know. Because we don’t know if there are mischievous dolphins or the ratio between benevolent and mischievous dolphins we can’t know whether we should follow one should we be lost at sea.

Shortcuts

Whether we call them rules of thumb or stereotypes, we all leverage shortcuts to allow us to cope with the information overload we encounter every day (See The Information Diet and The Paradox of Choice for more on information overload.) The mental shortcuts we use are neither good nor bad. They’re useful and necessary to allow us to survive in the world. However, as stereotypes they cause us to make unfair assessments of people who are in a class other than ours. How other? is defined is irrelevant. By mere fact that we’re lumping a group of people together we’re eliminating the possibility for truly great people in the class.

Shortcuts are below our consciousness. Al Campanis knew his friend Jackie Robinson and defended him as a great baseball player while at the same time believing that black men couldn’t be managers. He used the mental shortcut (stereotype) of race to determine eligibility for baseball management.

It is because we use shortcuts that we’re particularly vulnerable to biases and blind spots.

Biases and Blind Spots

Al Campanis didn’t realize that he was unfairly categorizing black men as incapable of baseball management. He didn’t see his bias any more than we can see the blind spots in our eyes where the optic nerve connects. (See Incognito for more on how our brain lies to us about our visual system.) Even enumerating a list of biases like I did in my review of Thinking, Fast and Slow doesn’t make us immune to the effects. In fact, the more certain that we become that we understand the effects of biases the more susceptible to them that we may become. The way that we best manage the impact of biases best is being watchful for them.

Being watchful is about accepting our fallibility and vulnerability. (See Trust=>Vulnerability=>Intimacy and Change or Die for more on vulnerability and fallibility.) The more certain that we become that we’re infallible the more likely it is that our faults will show themselves. So paradoxically we’re the most immune to blind spots when we are the least confident. Certainty is a box that prevents us from seeing reality.

The Anatomy of Peace spoke of boxes that we get in. These boxes distort our perception of the world. They prevent us from being true and authentic with others and ourselves. The Anatomy of Peace also lays out a technique for evaluating whether we’re in the box – and how to get out of it.

Memory is Not Memorex

There used to be a commercial for a brand of audio and video cassette tapes asking “Is it live or is it Memorex?” implying that one could not tell the difference between the live event and the recording. It would be great if our memories worked this way. It would be great if we could recall with absolute precision the events of every day of our lives. Unfortunately, this isn’t the case. Our memory isn’t like a data bank, a video recorder, or a book. The pages of our memories aren’t invariant. Our memories – we know – are fallible.

I’ve built an entire system around my memory for researching books. The process is the one that I described in Research in the Age of Electrons. If I need to review a book or evaluate my thoughts about something I’ve got the text from the book, my notes, and my blog posts. It’s striking to me how many times I find myself not remembering what I wrote about a book even a year ago.

Given the research says that one has little better than a chance of explaining what they might have said about themselves in their youth, I feel good that I mostly remember what I wrote.

Still this process is extremely time consuming and I only do it for the books I read. I have no way of recording all of the conversations that I have, or the things that I do on a daily basis.

The Dangers of Dehumanizing

Milgram’s experiments came on the heels of World War II and the holocaust. Many people were asking just how it was possible that people could treat other people so badly. How could so many people take roles in the extermination camps? Victor Frankl in Man’s Search for Meaning never wondered how people could be complicit in the camps – he focused on what it took to survive. The twists and turns of the psyche that allowed people to accept these conditions and to inflict them on others was the point of Milgram’s work.

As he discovered to his horror, the distance between enlighten society and the depravity of exterminating people is very short. The distance could be as short as the next room. When we’re able to dehumanize the person in the next room to demonize them, we’re able to do unspeakable acts. We demonize them to justify our acts against them.

We setup a viscous self-reinforcing system (See Thinking in Systems for more on self-reinforcing systems.) We do something bad to someone (or a class of people). Justification kicks in and we demonize and dehumanize them. We do even more awful things because they’re now less human. This is the cycle that created the atrocities of the holocaust. However, there is a way to prevent this from happening. (For more on demonizing see Crucial Conversations and The Anatomy of Peace).

The solution to the problem is compassion – love for everyone. However, compassion relies on changing the ratio of us vs. them.

Us vs. Them

We’re all looking for belonging and we’ll define ourselves fluidly into groups of our own making. If your children go to one high school and your friend’s children go to another, you may find that you identify with your children’s high school vs. your friend’s children’s school during a game or competition. You’ll define “us” as the group that includes the people that your children go to school with. If you and your friend live in the same state, you’ll define both you and your friend in the same “us” group for the state. If you both live in the same city you might both belong to the same “us” city group.

The beauty of this is that you can quickly include people into your “us” group – instead of the “them” group by simply changing the way that you’re grouping or your scope. The tragedy is that the “them” group is vilified. They’re the bad guys riding on their horses with black hats. The” us” group are the good guys wearing white hats and out to save the day. Research says that just the concept of “us” vs. “them” causes us to react differently.

We tend to want to support and protect the people in the “us” group. We’re neutral or negative towards the “them” group.

One of the definitions for the “us” group that Buddhists use is the “us” group of humankind. This is a powerful “us” group because it includes everyone and it fosters compassion to everyone in the world. This definition of an “us” group leads to greater love and empowerment.

Exposing Alien Abduction

It’s got to be spooky. You see lights and you feel like you can’t move. You’re trying to figure out what’s happening and ultimately you settle on the idea that you must have been abducted by aliens who were using some sort of a force field to keep you still. After all, no matter how hard you tried to move you didn’t make any ground.

You’ve seen the stories in the news. People who were driving out in the country late at night and they were suddenly taken. They described their experience and they even said they saw aliens. You saw shadows but you don’t clearly recall any aliens directly.

However, like many of the Unidentified Flying Objects (UFO) sightings there’s a rational explanation and one which doesn’t rely on confusingly silent intelligent life from other planets. When folks are in that land between awake and asleep dreams can invade our conscious thoughts. (See Incognito for more of the games our brain plays on us.) When you couple this with the awareness that our brains shut down our ability to control movement when we’re in the deepest part of our sleep cycles you can start to see how people who were unable to move were really unable to move because their brains had shut down the ability to control movement. This is quite helpful when you’re dreaming so you’re not hurling yourself around the house as you are being chased by giant pink elephants. (Or is that just me?)

It turns out that the need for justification and rationalization leads us to some rather unexpected conclusions.

Interrogating Innocent People

Sometimes the impact of what we’re doing isn’t readily apparent. As with the students at the beginning of this post who continued to escalate the voltage until seemingly lethal doses were being administered, we’re in the pursuit of a lofty and noble goal and along the way we get lost into a set of approaches, tactics, and techniques that are far from our noble purposes.

When it comes to getting bad guys off the street, there are few of us that would waver in our belief that we should do everything possible to catch them and lock them up. However, do we really mean “do everything possible?” We’ve developed a system of presumed innocence even as interrogation tactics that we use are designed to elicit a guilty confession from the suspect – even if he hasn’t committed a crime.

What if you really believe that someone is guilty. You can’t find the evidence but you just know that they’re guilty. Should you plant a bit of evidence so you don’t have to find the real evidence? What if it gets one bad guy off the street and you were sure that it was right? The next time that you’re a little less sure that someone is guilty you might be inclined to plant evidence again – because it worked last time.

What about those interrogations? Are you a failure because you didn’t elicit a confession from the innocent man you’re interrogating? Who wins if you’re able to use your understanding of psychology and interrogation techniques to coerce a confession out of an innocent man? But that could never happen you say. Innocent people don’t confess. You would be wrong. Innocent people when confronted with confusing and contradictory evidence (or bluffing) will create a story to make the information make sense – and if the only story is the one the interrogator is sharing then they may just accept it.

To protect yourself you decide that you don’t interrogate innocent individuals. You lie to yourself so that you can reconcile your behaviors with the honorable person that you believe yourself to be.

Mistakes Were Made

Ultimately the truth of our situation is that all of us – every one of us has biases in how we relate to others. We are subject to the biases that all humans are subjected to – whether we have a PhD or we’re a high school graduate. Sometimes we have to say that “Mistakes were made”. If we’re brave enough to behave like John F. Kennedy, we’ll say end with “by me” instead of “but not by me.” If you’re willing to see how biases influence you, perhaps you should read Mistakes Were Made (But Not by Me).

Book Review-Rising Strong (Part 2)

In part 1 of this review of Rising Strong, I focused on the background. The topics of the progression of Brown’s work, learning from failure, the need for an integrated self image, the idea of sanctuary, how we tend to gold plate grit (our struggles), discomfort and our emotions, and fear and courage. In this part of the review we’ll focus on the core – and subtitle – of the book.

The Reckoning

Brown says that men and women who want to rise strong are willing to reckon with their emotions. She speaks of the nautical and aeronautical term of dead reckoning – knowing where you are by where you were and the motion that you’ve taken. This is, however, a way of introducing the need to be self-monitoring and self-aware. It’s about learning to understand what happens to us when we’re triggered.

Done at its best I see reckoning like the scene in The Matrix when Neo is being shot at and he sees the bullets, stops them, and ultimately plucks one out of the air inspects it and drops it. I’ve used this analogy with numerous people as they’ve learned to be able to see when situations might normally trigger them. Watching this happen with other people is amazing. You can literally see them stop the hurled bullets, put them down, and respond calmly to the person who is firing at them.

This isn’t the first step in reckoning but the last. It’s not learning to see your emotions but it’s the result you get (most of the time) when you’ve learned what triggers you and why. You begin to see the bullets coming and you can stop them. I say most of the time because everyone who has learned to reckon with themselves is surprised from time-to-time. A bullet is fired from someone you didn’t expect or in a way that you’ve not had happen before and you have to learn how to stop it – and deal with the pain it caused when it hit you.

The Rumble

When our dog Nyx is frustrated, scared, or vaguely of the mind that she thinks that you might hurt her human pack, she emits a low rumble. It’s not a growl as much as it is just her entire body shaking and vibrating. To anyone who has been face-to-face with her when she starts it, it’s a terrifying sound. While I know that she won’t initiate anything, those who are in her gaze don’t. The rumble is a scary place. It’s a place where you might get hurt. However, you can develop a relationship with the rumble where you know you may get hurt but not critically so and on the other side you’ll be a little stronger and a little wiser.

The rumble allows us to reevaluate our perspectives and see if we’re right. It’s a reality check for life. If you don’t believe that your perspective can be warped, take a look at this familiar monument.

From this perspective (taken from the visitor’s center) the “faces” are huge. In truth their 60 foot height is impressive when considered from a neutral position but when viewed from the ground below them, they take on a massive perspective. Take a look at the same monument a day or two later, but this time from the air.

What a difference the perspective makes. Here while the monument is still impressive, the larger perspective shows that it is small compared to the mountains which it lives in. Instead of being the largest thing in the world, it’s simply large. Instead of being immense, it’s just impressive.

The rumble invites us to challenge our perspectives. Not that there is a right perspective and that the one that we currently hold is wrong but rather that there are other perspectives that can help us to better understand the world that we live in. (See Incognito for how we make a world from our perceptions.) Reckoning is opening up to the ability to see the different perspectives the rumble is reconciling them into a single view.

We rumble with our boundaries. (See Boundaries and Beyond Boundaries for more on what boundaries are) Are we defining our boundaries in healthy ways? Are we establishing temporary boundaries in ways that are respectful to others and protect our needs? Are we defending or supporting our boundaries appropriately?

We rumble with forgiveness. How do we forgive those who have wronged us? How do we prevent them from wronging or harming others. Are we practicing vengeance – or are we truly protecting others?

We rumble with our willingness to blame others. We rumble with the shame we can’t let go of. We rumble with the resentment we feel towards others. We rumble with our heartbreak and the heartbreak we’ve inflicted on others. We rumble to reality check ourselves, to challenge ourselves, and to decide that we want to know the true story, not the story we’ve been telling ourselves.

The Revolution

I used the word repent earlier in this post. It’s a word that has attached to it some negativity. In a literal sense it means to turn away or to change direction. However, we often think about it from the context of a criminal or sinner and their need to repent. This really just means to turn away from – to find a new direction. That is the revolution that Brown speaks of. It’s not an incremental improvement on the way that we are living our lives, it’s a revolutionary change.

The paradox in this is that while it’s revolutionary – it comes in a series of turns – not one 180 degree turn. Here Brown and I disagree. She believes the revolution is “Unlike evolutionary change, which is incremental, revolutionary change fundamentally transforms our thoughts and beliefs.” I believe that revolutionary change comes through evolutionary change. Birds came from reptiles – over a long period of time. While I believe that we can experience earth shaking rumbles which shift our thinking dramatically and radically, my experience with people who are regaining their lives is that they work in the individual decisions and that there’s not one revolutionary change that suddenly changes their lives.

Let’s use as an example an alcoholic. They make the decision not to drink. (In twelve step terms they turn over their life to their higher power to relieve their powerlessness to stop drinking.) Most of the “recovering” alcoholics who I’ve met – who have experience in AA – didn’t just stop drinking. They decided to stop drinking and that small change unlocked the opportunity for another small change in the way that they related to others or how they accepted responsibility or how they dealt with stress. It wasn’t that surrendering drinking was the end. It was the beginning.

It’s my belief that there’s no revolutionary war battle that leaves the stars and stripes flying in the end. It’s my belief that there are numerous skirmishes – the rumbles – each which redirect those who are willing to learn. One day after many, many rumbles and a great deal of soul searching you tread back into a place where you haven’t been in a long time and you see the place differently. You realize that your life is no longer ruled by fear and shame. You suddenly see the light through the clouds of the previous way of living.

It’s a strange sense of clarity that things are radically different. They’ve changed – or rather you’ve changed. The circumstances are still the same circumstances. However, you’re different and are more able to respond appropriately to the world around you.

Surrendering to Uncertainty

Sometimes the nuggets of gold aren’t in the broad themes of the book but are instead in the undercurrent. They’re in the unstated truths that underlie the surface only appearing for a moment above the water line. Such is the case with the idea that we must surrender to uncertainty. Our egos don’t like uncertainty. They want to believe that we can make it – not that we might make it. When our egos are calling the ball, we’re certain that we’ll win, that we’ll conquer, that we’ll prevail. However, our rational side knows – even if you’ve not had a class on statistics – that there are always probabilities and unconstrained variables.

In my business, I truthfully don’t know where our customers and projects will come from. I get referrals all the time from existing and former customers. However, by the nature of my work customers don’t need my help for years at a time. I don’t know which customers will need to get an upgrade this year or who will deepen their use of the technologies that we provide.

Most of the time, I’m OK with this. It’s a frightening experience to be sure but it’s rare that it keeps me up at night. I’ve surrendered to this uncertainty. I still do marketing and sales. I still respond to inquiries and RFPs. However, I recognize that there are many factors of where the business will come from which are outside of my control – and that I have to surrender the idea that I have control of the situation.

Surrendering to uncertainty is easy when the stakes aren’t that high. You can buy a lottery ticket and accept the uncertainty because the stakes aren’t that high. One could argue with a billion-dollar prize on the line that the stakes are quite high. However, as we learned in Thinking, Fast and Slow we’re wired to find negative consequences more impactful. In the case of a lottery ticket there’s little risk to our daily lives if we don’t get it. When, however, the stakes are higher – like a job or a marriage – accepting uncertainty is much harder.

You may be thinking that surrendering to the unknowns of business might be like the uncertainty of losing a job or my job being changed. To an extent this is true but it differs in a few critical ways. First, business can go poorly for a very long time before it will impact my ability to eat or keep the lights on. The actual stakes are relatively low. Second, because it’s a diffuse situation where one big thing isn’t likely to happen to create a real problem, the stakes for each day’s surrender aren’t that large.

In The Paradox of Choice we learned that we can be a maximizer or a satisficer. The satisficer lives with good enough. The maximizer is a perfectionist where only perfect is acceptable. We’re not one or the other but rather we’re on scale between these two points – and we’re on a different scale for each thing. We can be a maximizer on the kind of watch we wear or the type of car we drive and be a satisficer when it comes to buying food.

Surrendering to uncertainty is letting go of the maximizer. Surrendering to uncertainty is accepting that we’ll be OK. It will be good enough. This is the stance of the satisficer. This is accepting that there will be things that aren’t perfect but that’s OK.

Surrendering to uncertainty is also at the heart of vulnerability. Being vulnerable (strong vulnerability) is knowing that you may get hurt but choosing to allow it to happen because you are willing to accept that as a possible outcome – because the other positive outcomes are more likely and they outweigh the risk. (See Trust => Vulnerability => Intimacy for more on this.)

Doing the Best They Can

Riding a subway one day a man sits through a stop where a father and his children board the train. It doesn’t take long before the children are loud and begin to annoy and harass the other passengers. After some time and aggravation, the man walks up to the father and asks him “Can’t you see your children are running amuck, can’t you get them under control?” The father looks up and says with a trembling and timid voice “Oh, I’m sorry. I just lost my wife. We’re coming back from the funeral now and I don’t know what I’m going to do.”

This is a variation on a story I heard some time ago. It reminds me that we never know what is going on in someone else’s life. We never know what they’ve been through or how they’re hurting. All we see is their actions and how they’re impacting – and often hurting – us. It’s hard to understand how a father could allow his children to be so wild – until you understand his circumstances at the moment. I think this is at the heart of learning to be compassionate and to love everyone where they are.

You have to accept that you don’t know their circumstances and there are actually many circumstances that can explain (but not justify) their behavior. Kurt Lewin described behavior as a function of both person and environment. That is to say that while our fundamental attribution error (see Crucial Conversations, The Advantage, Switch, and Beyond Boundaries for more on fundamental attribution error.) wants us to believe someone else’s behavior is because of their character it can also be because of their circumstances or environment.

Curiosity and Control

Do you ever feel like you’re in control? Do you ever feel like “I’ve got this?” We all have. We’ve all had the feeling of self-confidence that allows you to feel like you’re recovered, you’re healed, and that you’re capable of handling anything.

What about the moments when you’re brought to tears? Whether it’s a scathing comment, a moment of intense pain, or simply an emotional flood while watching a movie, we’re startled that we can become overwhelmed with our emotions in a moment. How can this be possible when we’re so sure that “I’ve got this.”

At some level there’s the awareness that our rational selves aren’t really in control, that we’re riding atop of our emotions – which are more than capable and willing to lie to us. (See the Elephant-Rider-Path model in Switch and The Happiness Hypothesis. Also see Thinking, Fast and Slow for how our automatic system can lie to our rational processing.) Paradoxically in order to become more in control of ourselves and our situations we need to become less sure in ourselves. We need to become curious about how we think, where we need to grow, and how we can improve.

Book Review-Rising Strong (Part 1)

Perhaps the greatest challenge with life is that it’s not perfect. I’m not perfect. My wife isn’t perfect. My kids aren’t perfect. That means that at times we’ll all fail. We’re all going to miss the mark. We’re all going to experience bitter disappointment. The trick isn’t in getting things to perfect because that’s an impossible goal. The trick is to learn to try, fail, try again, and eventually succeed. That’s what Brown’s book Rising Strong is all about – trying, failing, learning, and trying again. Because there’s a great deal of content I want to share about Rising Strong, I’ve broken this review into two parts. This is the background.

The Progression

Brown’s work is on shame and guilt. I’ve read and reviewed her previous book Daring Greatly in the context of preparing for my Trust => Vulnerability => Intimacy post. She focused on being completely engaged in life. She touched on wholehearted living. However, one particular focus of Daring Greatly was on the concept of vulnerability and that being vulnerable is a strength not a weakness. In my review I made the point about weak vulnerability and strong vulnerability (the kind that Brown is focused on.)

Her previous book – which I’ve not yet read – The Gifts of Imperfection – she describes as about learning to be you. While I’ve not read the book, I have studied what it takes to be you – the real you. While I generally don’t often find myself in the must-be-seen-as box (see The Anatomy of Peace for more on the box), I do recognize that it’s difficult to be the authentic you that you’re meant to be.

So we go from being yourself (The Gifts of Imperfection) to being wholehearted or all in (Daring Greatly) to the awareness that being all in means you’re going to fail – and what you have to do about it (Rising Strong).

The problem is that failure isn’t an option. It’s a requirement. It’s a requirement if you’re willing to try something new or to expand yourself and your world. Edison is the classic example of failure and persistence. 1,000 ways not to make a lightbulb is a lot of failure still he categorized it positively and from the perspective of learning.

I mentioned in my review of Changes that Heal that a friend of mine has told me once that I never fail and that I roared with laughter because I fail all the time. I’ve got conversations and entire relationships that I’ve flubbed. I’ve got more failed commercial attempts than I can remember. I have no idea of how many failures I’ve racked up in my life because I’m not all that interested or focused on them – I’m focused on the next attempt.

Learning from Failure

The goal isn’t failure though we may end up there frequently. The goal is success. That takes hard work and learning. Learning about ourselves, our character flaws, our blind spots. We all have blind spots both figuratively and literally. (See Incognito for more on our literal blind spots.) Our ego doesn’t want to allow us to realize our faults. (See Change or Die for a discussion of The Ego and Its Defenses)

Josh Waitzkin speaks of his need to learn from his failures in The Art of Learning. The child prodigy of chess explains how he used his setbacks to grow and become a better competitor both at chess and at martial arts. It wasn’t that the folks whom we believe are greats are immune to failure. Rather they need failure to learn how to grow and become better than they were.

Brown is clear that we need to be willing to get into the arena to try and fail – and get back up again.

Integrated Self Image

Jim Collins speaks of the Stockdale Paradox in Good to Great. The idea is that on the one hand you have to have unwavering faith in what you’re doing and on the other you need to accept and integrate feedback from others. This is two views of what you’re doing. The honorable one – the one which is right and correct. The other view is the vulnerable view. It’s the view that wonders if there’s a better answer or fears that there is. The Stockdale Paradox is integrating these two views of the initiative so that they’re fused together into one thing.

I’ve spoken about an integrated self-image and its importance in my reviews of Schools Without Failure, Compelled to Control, and Beyond Boundaries. It’s a recurring concept. I believe developing an integrated self-image is at the heart of Brown’s work and writings. The process that she describes as the reckoning, the rumble, and the revolution is the process of integrating different views of ourselves. It’s recognizing our goodness and acknowledging that we do bad.

The Chinese philosophy of Yin and Yang shows this struggle. It describes how we see forces in ourselves to be disconnected when really they’re connected, complementary, and interdependent.

Sanctuary

A sanctuary is where you go to rest and recharge. It’s a spring of life giving peace. It’s a place where you can relax your guard and know that you’re OK. The original meaning of sanctuary included sacred. The need to rest and recharge is built into the biblical calendar – and on the seventh day God rested. There’s observing the Sabbath in both Judaism and Christianity.

However, sanctuary can have a different – interpersonal – meaning. In this context, sanctuary is someone with whom you can let down your guard and be who you are. You know that they’ll accept you. You know that they understand you and your situation. They’ve walked a path similar to yours and they understand the self-doubt, the fear, and the fury. (They exhibit the five As from How to Be an Adult in Relationships.)

We all need people who can be a sanctuary for us. We need to be connected to others and to feel safe with them. In High Orbit – Respecting Grieving I spoke extensively about Robin Dunbar’s work and the idea that we have different “rings” of relationships with people. The people in your “inner five” should be people with whom you can have sanctuary. As How to Be an Adult in Relationships observed, we shouldn’t get more than 25% of our nurturance from another person. It’s not that you should be able to create a sanctuary with every one of your inner five in every situation but rather that you can generate the healing and restorative properties with the people who are the closes to you when you need it.

Gold Plating Grit

When I recount most stories I neglect and leave out entirely the failures that occurred along the way. I may be good at building computers but that’s from many upgrades over the years that didn’t add the value that I had hoped that they would. In my video editing computer, I have two NVidia graphics cards connected via the SLI interface that is supposed to allow the cards to work together. I’ve found that even though I have software that supports the NVidia cards CUDA standard they won’t use more than one card in the system. Effectively I’ve wasted a few hundred dollars on the second video card. When I talk about building the computer, I typically leave out this detail.

There are many situations where we end up skipping over the hard parts. We skip over the places when we didn’t know if it was going to work. The SharePoint Shepherd’s Guide for me has been very profitable over the years – but it wasn’t for the first 18 months and I was wondering if it was going to be a success or not. I don’t share that much – but even one of the most profitable things that I’ve ever done – I didn’t know if it would work or not.

While suppressing some of the self-doubt and struggle may be helpful from the perspective of allowing us to try the next thing, when we do this with our successes we rob others of the awareness of the great effort necessary to try, fail, learn, and grow. This is gold plating grit – making our successes sound like they were easier than they were.

As I stand in the midst of launching our Kin-to-Kid Connection brand of products, I can tell you that I am wondering if I should be putting more energy into that project. I still am committed to it – but also vulnerable as people share their thoughts about why it can’t or won’t work.

Discomfort and Emotions

Most of us know what it’s like to be hungry. If you’ve ever been on a diet you know that your goal in the diet – at some level – is to lose weight while not feeling hungry. Hunger is discomforting. It’s not something you want to feel – but sometimes in the service of a greater goal – getting to or maintaining a healthy weight – it is the right answer. The interesting thing about hunger is that although it’s uncomfortable it’s not a warning sign from the body.

Hunger sometimes precedes a loss of blood sugar that people can recognize through irritability or other means. However, hunger itself means very little more than your digestive system is bored and has nothing to do. Yet as was pointed out in Willpower, it’s very difficult to be on a diet at least in part due to hunger as a signal.

We’ve been taught that hunger is a bad thing that it means we need to eat. We’ve also been taught to clean our plate – ostensibly because children are starving in Africa. However, never once do I remember Sally Struthers stopping by our house to pick up food or my family creating a care package for these children that my mom kept talking about.

We’re not taught to lean into our discomfort or as John Gottman would say to step into those sliding door moments. (See The Science of Trust for more on sliding door moments.) Instead we’ve been allowed to – and thus learned – not to confront our uncomfortable emotions. Few of us have been forced to rumble with the way that we feel and to truly feel it.

The result is that the saying “hurting people, hurt people” from 12 step programs is all to true and because too many of us were never taught how to deal with our hurt we take a long time to heal and thus hurt many people along the way. Instead of accepting our pain we deflect it and in the process inflict pain on others.

The people Brown has interviewed that she calls the “badasses” are those people who are curious about the emotional world and who face discomfort head on.

Comfort, Fear, and Courage

All of us want to be comfortable. We want to avoid our discomfort. As a result, we will avoid our fears – our fears of making a mistake of causing damage to a relationship, our fears of ruining some situation or product. Avoiding our fears is understandable. After all we call the physiological response to fear “fight or flight.” However, the people who can look past their fear and move forward in courage are those who rise strong.

Courage requires fear. To proceed forward isn’t courage. Courage is only what it is when we acknowledge our fears and move forward in spite of them. That is courage. (See Find Your Courage for more on the meaning of courage.)

Ultimately the place that takes the most courage to explore is the depths of our souls and our most intimate relationships. Our ego gets nervous when we start digging around because it realizes that some of the defenses that it uses will fade in the light of day. When we’re willing to challenge our assumptions and beliefs we’ll discover the lies that our ego has told us.