Category: Psychology

Preventable Depression?

Business Logo for Psychological and Neuropsychological IssuesA recent review on the prevention of depression was featured in the May issue of the American Psychologist.  The study authors (Munoz, Beardslee and Laykin) were decidedly positive in their appraisal of current prevention efforts.  As the authors point out, prior to the 1980’s, it was the official position of the mental health gods that depression was not preventable.  The last two decades have seen a reversal of this thinking.  Psychologists from around the world have researched programs designed to prevent depression in the general population.  Most of the prevention studies cited by these and other authors share many commonalities.  First, the research subjects are randomly assigned to treatment and no-treatment groups.  Second, the treatment group receives a course on the identification and reduction of depressive symptoms.  The depression group intervention varies from a traditional lecture format to group therapy with an identified leader.  Lastly, the prevention studies compare symptoms of depression at the beginning of the study with symptoms experienced at the end of the study.  The authors then write a report summarizing their positive or negative findings.

Though their intent is certainly noble, the depression prevention researchers have encountered problems with methodology.  The first problem is with the method to recruit and classify the study subjects.  In order to lower the total number of subjects needed to complete the study, psychologists often use “at risk” individuals to populate the study.  The term “at risk” has several meanings in the context of psychological research of this nature.  A research subject may have experienced a prior depressive episode, there’s a family history of depression, they live in poverty, or the subject endorsed subclinical elevations on depression questionnaires.  Subclinical refers to the manifestation of an abnormal number or type of symptom(s), yet they fail to meet the criteria of a known clinical condition.  Unfortunately, the use of “at risk” people lessens the statistical power of the study.  No longer are the study subjects randomly assigned to groups, but selected because of a particular trait.  The psychologist cannot then compare the depression intervention to the general population, rather the comparison may only be drawn to other “at risk” groups.

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It is certainly the author’s hope that depression is at least partially preventable.  Many of the current interventions in use may be valuable, but the present design of these studies limits the power to draw accurate conclusions.  Larger study sizes, that are truly randomized, should be combined with sham group interventions.  Until there is an increased mindfulness of proper investigatory techniques, the current depression prevention results are not convincing.  Stated another way, the correct prevention techniques may already exist, but hard evidence of their effectiveness is lacking.  Let us all hope that psychological researchers discover effective methods to prevent depression, as it would not only benefit commerce, but our everyday social experience as well.

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categories Depression, Psychology | | datetime June 1, 2012 3:43 pm | comments Comments Off on Preventable Depression?

Empathic Listening

Business Logo for Psychological and Neuropsychological IssuesEmpathy may be defined as the identification with the thoughts, feelings and attitudes of another person.  It sounds like something people experience every day, but it is more an exception than the rule.  If empathy was the rule, the norm, the world would be a much different place.  Empathy runs counter to the human need for people to differentiate themselves from other people.  It runs counter to the need for groups to differentiate themselves from other groups.  It is the proverbial act of putting oneself in the shoes of another person.  Psychotherapists often label the active process of  this identification as empathic listening.

The meaning of empathy is not synonymous with sympathy.  Sympathy is to be in agreement with the thoughts and feelings of another; even to share similar thoughts and feelings as the other person.  This is not the goal of most psychotherapeutic schools, since it may bring a loss of objectivity.  For example, a depressed person may engage in many thoughts and beliefs that enable the depression to flourish.  A sympathetic psychologist may become lost in the many instances of bad luck or even tragedy that befall the person.  Sympathy will render the psychologist blind to the maladaptive aspects of the patient’s behavior, since they are actively and uncritically ingesting the depression of their patient.  Similarly, an anxious patient may experience many negative outcomes as a consequence of their anxiety.  A psychologist that chronically feels sorry for their anxiety is certainly sympathetic, and this may serve to validate the patient’s perceptions, but it is unlikely to alleviate their anxiety in a meaningful fashion.

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Empathic listening is less a trait possessed by gifted people than a skill that is learned in a rigorous fashion.  Training to become a psychologist requires many hours of clinical supervision.  Students bring in tapes of psychotherapy sessions and the professors rake the students over the coals of their psychopathology.  It is not uncommon for many students to cry or become angry at the professor’s comments, since they may strike at the heart of what makes us a person.  No one likes to hear someone they respect say, “Why the hell did you say that?”  It is even more threatening when the professor gives a short description of the student’s pathology, and how their mistake will derail the psychotherapy.  It is a highly uncomfortable and valuable process when performed diligently.  It more comfortable and less useful if the professor seeks to spare the student’s feelings-to sympathize with their plight.  Empathic listening is a skill that every competent psychologist must acquire.  Empathic listening is a major factor that differentiates psychotherapy from ordinary conversation.  As a general rule, friends are sympathetic and shrinks are empathetic.

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categories Anxiety, Depression, Psychology | | datetime May 19, 2012 11:18 am | comments Comments Off on Empathic Listening

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