Why I Side with William James and Not Sam Harris

In his famous book on The Varieties of Religious Experiences (James, 1902/2002) William James has been quoted as saying:

[T]o study religion from a psychological point of view the best one can do is to study the most religious man in his most religious moments.

I can't find the actual quote in the text, though it does seem many people have cited it (including Jerome Bruner).

Let's start with James' definition of religious experience:

Religion, therefore, as I now ask you arbitrarily to take it, shall mean for us the feelings, acts, and experiences of individual men in their solitude, so far as they apprehend themselves to stand in relation to whatever they may consider the divine. Since the relation may be either moral, physical, or ritual, it is evident that out of religion in the sense in which we take it, theologies, philosophies, and ecclesiastical organizations may secondarily grow. In these lectures, however, as I have already said, the immediate personal experiences will amply fill our time, and we shall hardly consider theology or ecclesiasticism at all. (pg. 29-30)

This is crucial. James distinguishes religious experience from the secondary structures (i.e., religions) that are built upon the subjective experience. He is clear that the subject of his interest is the subjective experience of the mystic while s/he is experiencing the divine.

This is not a distinction that people such as Sam Harris (see The God Fraud, 2010), despite his dabbling in meditation, would generally make - and one that Dan Dennet (Consciousness Explained, 1992) would never make in that he rejects the validity of qualia (subjective experiences).

Much later in the book, in his Conclusions, James does make the following statements:

Summing up in the broadest possible way the characteristics of the religious life, as we have found them, it includes the following beliefs: —

1. That the visible world is part of a more spiritual universe from which it draws its chief significance;
2. That union or harmonious relation with that higher universe is our true end;
3. That prayer or inner communion with the spirit thereof — be that spirit “God” or “law” — is a process wherein work is really done, and spiritual energy flows in and produces effects, psychological or material, within the phenomenal world.

Religion includes also the following psychological characteristics:

4. A new zest which adds itself like a gift to life, and takes the form either of lyrical enchantment or of appeal to earnestness and heroism.
5. An assurance of safety and a temper of peace, and, in relation to others, a preponderance of loving affections. (pg. 375)

A short time later he makes the following statements, of which the unverified quote I began with might be seen as a summary:

I reply that I took these extremer examples as yielding the profounder information. To learn the secrets of any science, we go to expert specialists, even though they may be eccentric persons, and not to commonplace pupils. We combine what they tell us with the rest of our wisdom, and form our final judgment independently. Even so with religion. We who have pursued such radical expressions of it may now be sure that we know its secrets as authentically as any one can know them who learns them from another; and we have next to answer, each of us for himself, the practical question: what are the dangers in this element of life? and in what proportion may it need to be restrained by other elements, to give the proper balance?

But this question suggests another one which I will answer immediately and get it out of the way, for it has more than once already vexed us.1 Ought it to be assumed that in all men the mixture of religion with other elements should be identical? Ought it, indeed, to be assumed that the lives of all men should show identical religious elements? In other words, is the existence of so many religious types and sects and creeds regrettable?

To these questions I answer “No” emphatically. (pg. 376)

Item #3 in the list above reads as equivalent to the idea of involution.

In integral thought, involution is the process by which the Divine manifests the cosmos. The process by which the creation rises to higher states and states of consciousness is the evolution. Involution prepares the universe for the Big Bang; evolution continues from that point forward. The term involution comes from the idea that the divine involves itself in creation. After the creation, the Divine (i.e. the Absolute, Brahman, God) is both the One (the Creator) and the Many (that which was created).

This process continues as a part of the evolutionary process through the attainment of religious experience and mystical states. Involution is a purely subjective experience that can never demonstrate objective proof - each is of different experiential realms.

In defining the mystical states of experience, however, James gives us something we can begin to look for in the experience of others, the exhibition of which would be objectively indicative of a truly religious experience.

I will do what I did in the case of the word “religion,” and simply propose to you four marks which, when an experience has them, may justify us in calling it mystical for the purpose of the present lectures. In this way we shall save verbal disputation, and the recriminations that generally go therewith.

1. Ineffability. — The handiest of the marks by which I classify a state of mind as mystical is negative. The subject of it immediately says that it defies expression, that no adequate report of its contents can be given in words. It follows from this that its quality must be directly experienced; it cannot be imparted or transferred to others. In this peculiarity mystical states are more like states of feeling than like states of intellect. No one can make clear to another who has never had a certain feeling, in what the quality or worth of it consists. One must have musical ears to know the value of a symphony; one must have been in love one’s self to understand a lover’s state of mind. Lacking the heart or ear, we cannot interpret the musician or the lover justly, and are even likely to consider him weak-minded or absurd. The mystic finds that most of us accord to his experiences an equally incompetent treatment.

2. Noetic quality. — Although so similar to states of feeling, mystical states seem to those who experience them to be also states of knowledge. They are states of insight into depths of truth unplumbed by the discursive intellect. They are illuminations, revelations, full of significance and importance, all inarticulate though they remain; and as a rule they carry with them a curious sense of authority for after-time.

These two characters will entitle any state to be called mystical, in the sense in which I use the word. Two other qualities are less sharply marked, but are usually found. These are: —

3. Transiency. — Mystical states cannot be sustained for long. Except in rare instances, half an hour, or at most an hour or two, seems to be the limit beyond which they fade into the light of common day. Often, when faded, their quality can but imperfectly be reproduced in memory; but when they recur it is recognized; and from one recurrence to another it is susceptible of continuous development in what is felt as inner richness and importance.

4. Passivity. — Although the oncoming of mystical states may be, facilitated by preliminary voluntary operations, as by fixing the attention, or going through certain bodily performances, or in other ways which manuals of mysticism prescribe; yet when the characteristic sort of consciousness once has set in, the mystic feels as if his own will were in abeyance, and indeed sometimes as if he were grasped and held by a superior power. This latter peculiarity connects mystical states with certain definite phenomena of secondary or alternative personality, such as prophetic speech, automatic writing, or the mediumistic trance. When these latter conditions are well pronounced, however, there may be no recollection whatever of the phenomenon, and it may have no significance for the subject’s usual inner life, to which, as it were, it makes a mere interruption. Mystical states, strictly so called, are never merely interruptive. Some memory of their content always remains, and a profound sense of their importance. They modify the inner life of the subject between the times of their recurrence. Sharp divisions in this region are, however, difficult to make, and we find all sorts of gradations and mixtures.

These four characteristics are sufficient to mark out a group of states of consciousness peculiar enough to deserve a special name and to call for careful study. Let it then be called the mystical group. (pg. 294-296)

In looking at mysticism, James is looking at "the most religious man in his most religious moments," essentially looking at the ways in which religious experience is positive, transformative, and compassionate in nature.

On the other hand, Harris, Dennet, Dawkins, and Hitchens (The Four Horsemen of Atheism) are looking at the most fundamentalist expressions of institutionalized religion, not at the nature of religious experience itself. They are condemning all religious experience and expression by looking at the worst of religion on its worst days.

Is that fair? Many people would say YES! absolutely, because on religion's worst days, thousands of people may be killed in the name of some form of dogmatism.

However, it might be an equivalent approach to condemn ALL science because some science has been used to create nuclear weapons, chemical weapons, various poisons that kill people and pollute nature, powerful guns that can penetrate any form of armor, and on and on. The history of science might be viewed, if one were so inclined (and I am not, just to be clear), as the endless progression of new and more efficient ways to kill human beings. The examples of horrible things created by science, and the deaths that have resulted, could fill many volumes.

Yet no one (well, almost no one) will want to end all science because of these creations - yet the atheists want to do away with all religion because of the violent few, or because of their generally harmless magical thinking (harmless, that is, until imposed on others against their will).

To quote my mother, the new atheists want to throw out the baby with the bathwater. Silly.

I'll stick with my buddy, William James.

Tags: Religion, Spirituality, Science, Philosophy, mysticism, William James, The Varieties of Religious Experiences, Sam Harris, new atheists, The God Fraud, involution

Sharp Brains - Daniel Goleman: Yes, You Can Build Willpower (meditate on neuroplasticity!)

Another older article (from this summer) that I somehow missed the first time around, posted at Sharp Brains, a very good psychology blog. [More info is available from the National Association of Scholars, where I found the image, on neuroplasticity.]

Daniel Goleman: Yes, You Can Build Willpower (meditate on neuroplasticity!)

By: Greater Good Magazine

(Editor’s note: Daniel Goleman is now conducting a series of audio interviews including a great one with Richard Davidson on Training the Brain. We are honored to bring you this guest post by Daniel Goleman, thanks to our collaboration with Greater Good Magazine.)

—

Yes, You Can:

New research suggests we can build our willpower

– By Daniel Goleman

Those of us who struggle to resist junk foods or otherwise suffer a lack of willpower will be heartened by some good news from neuroscience. But there’s some bad news, too.

First, the bad news. A slew of studies suggest that we each have a fixed neural reservoir of willpower, and that if we use it on one thing, we have less for others. Tasks that demand some self-control make it harder for us to do the next thing that takes willpower.

In a typical experiment on this effect, one group of people was made to watch a video of a boring scene; another was not. Then both groups had to circle every “e” in a long passage of writing. The result? The people who had to first sit through the boring video gave up faster. The same loss of persistence has been found when people try to resist tempting foods, suppress emotional reactions, or even make the effort to try to impress someone.

This all suggests we have a fixed willpower budget, one we should be careful in spending. Some neuroscientists suspect that self-control consumes blood sugar, which takes a while to build up again; thus, the depletion effect.

But the good news is that we can grow our willpower; like a muscle, the more we use it, the more it gradually increases over time. But doing this takes, of all things, willpower.

As the muscle of will grows, the larger our reservoir of self-discipline becomes. So people who are able to stick to a diet or an exercise program for a few months, or who complete money-management classes, also reduce their impulse-buying, junk food consumption, and alcohol intake. They watch less TV and do more housework. And this ability to delay grasping at gratification, much data shows, predicts greater career success.

This round-up of thinking on willpower comes courtesy of Sandra Aamodt and Sam Wang, whose recent book, Welcome to Your Brain, details the evidence about willpower. But, writing in The New York Times, the duo poses a puzzle: While it’s clear that willpower has limits, what brain mechanisms let us build it up?

That question brought to mind a recent conversation I had with Richard Davidson, the director of the Laboratory for Affective Neuroscience at the University of Wisconsin. Davidson’s research these days focuses on neuroplasticity—how our experience shapes the brain throughout life. One surprise: though most of us learned that we have a fixed number of brain cells when we are born, and that we lose them steadily until we die, brain science now tells us the brain makes about 10,000 new cells every day, and that they migrate to where they are needed. Once there, each cell makes around 10,000 connections to other brain cells over the successive four months.

Davidson’s research finds that the left prefrontal cortex—the brain’s executive center located just behind the forehead—is a key site for helping us build willpower. Our plans and goals hatch here, and impulses are executed via this zone. There is a neural circuit in the prefrontal cortex that inhibits emotional impulse, and can be strengthened by a range of methods.

One of these methods, Davidson explained to me, is mindfulness training, a secular form of meditation widely used in settings from businesses to outpatient clinics. This is confirmed by a great deal of research. My own doctoral dissertation found (as have many others since) that the practice of meditation seems to speed the rate of physiological recovery from a stressful event. A string of studies have now established that more experienced meditators recover more quickly from stress-induced physiological arousal than do novices.

Research shows that other kinds of training can have similar effects, and the more time we devote to any of these trainings, the greater the result in the targeted areas of the brain. Brain imaging studies show that the spatial areas of London taxi drivers’ brains become enhanced during the first six months they spend driving around that city’s winding streets; likewise, the area for thumb movement in the motor cortex becomes more robust in violinists as they continue to practice over many months. A seminal 2004 article in the Proceedings of the National Academy of Science found that, compared to novices, highly adept meditators generated far more high-amplitude gamma wave activity—which reflects finely focused attention—in areas of the prefrontal cortex while meditating.

And so it makes perfect sense that we can build our willpower over time if we are committed to doing so, a process that changes our brains right down to the cellular level. Simply being consistently self-disciplined seems to help—going to the gym every day for months, or completing projects you begin—and so does mindfulness meditation. There are ways, it seems, to make it easier to “just say no” when we need to.

– Daniel Goleman, Ph.D., is the author of the bestsellers Emotional Intelligence and Social Intelligence. His website is www.danielgoleman.info. Goleman’s full conversation with Richard Davidson can be heard as part of the audio series Wired to Connect: Dialogues on Social Intelligence, available through More than Sound Productions.

We bring you this post thanks to our collaboration with Greater Good Magazine, a UC-Berkeley-based quarterly magazine that highlights ground breaking scientific research into the roots of compassion and altruism.

Tags: brain, Psychology, will, meditation, Sharp Brains, Daniel Goleman, You Can Build Willpower, meditate, neuroplasticity, Greater Good Magazine, gamma wave activity, attention, mindfulness training

NPR On the Media - The Art of Diagnosis (on the DSM-V)

I found this by accident, and it's from 2008, but since there is so much secrecy surrounding the revision of the DSM (form IV-TR to V), due now in 2013 (to allow more time to work through the issues), the info is still interesting and useful.

I've included some of the transcript, as well as the audio.

The Art of Diagnosis

December 26, 2008

Does very severe PMS constitute a mental disorder? That's one of many questions facing psychiatrists as they work to revise the Diagnostic and Statistical Manual of Mental Disorders or DSM, the definitive compendium of our psychic maladies. Because the DSM influences not just doctors and patients but medical research, insurance companies, the pharmaceutical industry, advertising and the culture at large, controversy surrounding its new edition abounds. Brooke looks at this powerful book.

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BROOKE GLADSTONE: There’s a saying that goes, “A good book is the best of friends, the same today and forever.” But books that are periodically revised can be even better. Consider the Diagnostic and Statistical Manual of Mental Disorders, or DSM, the catalog of mind-based maladies designated by the American Psychiatric Association.

Plagued by fears or fantasies, bad thoughts or bad behaviors? If the problem’s in your head, it’s in the DSM, charting your psychic pain since 1952.

The next edition, the fifth in 60 years, isn't due out until 2012, but now’s the time when new disorders are debated, tested and prepped for their debuts in the

DSM-V. The world consults this book. This is a very big deal -

DR. DARREL REGIER: - because the disorder definitions that we provide are used by the FDA to determine whether or not new medication might have an indication for treatment.

BROOKE GLADSTONE: Dr. Darrel Regier is the vice-chair of the DSM-V Task Force.

DR. DARREL REGIER: It’s used by the NIH to assess the type of disorder that somebody is asking to research. It’s also used by Medicare, Medicaid and insurance companies to identify the condition that somebody is requesting payment of treatment for.

BROOKE GLADSTONE: Most important, it’s used by doctors to define what’s normal and what’s not. It was the DSM that officially declared homosexuality a mental disorder, and then in 1973 officially undeclared it.

It’s defined an ever-expanding range of phobias and addictions that we're still arguing about, but this time, demands for more transparency aim to crack open the window on DSM-V deliberations so interested parties can weigh in before they are enshrined – because once they are, the FDA approves drugs to treat them, and any further debate is drowned out in the flood of direct-to-consumer ads.

[CLIPS]:

[MUSIC UP AND UNDER]

WOMAN: If you are one of the many who suffer from overwhelming anxiety and intense fear of social situations with unfamiliar people -

MAN: You know when you’re not feeling like yourself. You’re tired all the time. You may feel sad, hopeless, and lose interest in things you once loved. You may feel anxious.

WOMAN: You can feel it in so many ways. Cymbalta can help. Cymbalta is a prescription medication that treats many symptoms of depression.

[END CLIPS]

BROOKE GLADSTONE: One controversial diagnosis up for inclusion is gender identity disorder. For social conservatives and some religious groups, this is a definite thumbs-up for inclusion in the DSM. If you think you’re a woman trapped in a man’s body or vice versa, you have a disorder.

But Dr. Michael First, who worked on the last two editions of the DSM, says that for those in the transgender community it’s not so simple.

DR. MICHAEL FIRST: People who want sex reassignment surgery, who are transgendered so much so that they feel like they have to go all the way and actually change their gender - they need to view this as a disorder in order to qualify for the surgery.

BROOKE GLADSTONE: You mean to get insurance to cover it.

DR. MICHAEL FIRST: Insurance, and also social acceptance. The people who are against it are people who see being transgendered as a lifestyle choice and part of the normal variation, and they just see the stigma.

BROOKE GLADSTONE: Similarly, feminists stand on both sides of the debate over a form of PMS affecting five percent of menstruating women that is so severe it impairs their ability to function. It’s called PMDD, or -

[CLIP/MUSIC UP AND UNDER]:

WOMAN: Premenstrual dysphoric disorder, a distinct medical condition. It causes intense mood and physical symptoms right before your period. Doctors can now treat PMDD with Sarafem, the first and only prescription medication for PMDD.

[END CLIP]

STEF PROSE: When the Sarafem commercials came out was when I got, you know, the ah-ha!

BROOKE GLADSTONE: Stef Prose was being treated for depression, even though she rejected that diagnosis and felt stigmatized by it. When she saw the Sarafem ad depicting her debilitating mood swings, her rages and her guilt, she finally felt she had a real diagnosis and was deeply relieved and grateful.

STEF PROSE: Somebody knows actually what I'm talking about. And immediately I called my doctor and said, this is what I have. I want depression [LAUGHS] taken off the record.

BROOKE GLADSTONE: Like so much in the DSM, diagnosis is a judgment call, but Stef Prose, who now blogs about PMDD at Lifewpmdd.com, has no trouble passing judgment on whether it should be in the DSM.

STEF PROSE: My answer is yes. Trying to go to work every day and getting the energy to do it, it does, it affects you every single day. And to me, that is a disorder.

BROOKE GLADSTONE: PMDD has languished in the appendix of the DSM, signifying that the jury is still out. It is a hot-button issue because, you know, this one’s just for the ladies, and it could be used against them – all of them.

But the political ramifications don't worry Stef Prose.

STEF PROSE: I hadn't really thought about it. I guess the way I look at it is, it is kind of a sexist disease. [LAUGHS]

BROOKE GLADSTONE: Sarafem, just Prozac in pink, is still available, but the FDA demanded that Eli Lilly pull the ads because they described the symptoms of PMDD so broadly they were virtually indistinguishable from what most women experience as PMS, a condition not currently up for inclusion in the DSM.

DR. JONATHAN METZL: If we are in the business of treating PMS with psychiatric drugs, in part what we're saying is that there is a level of insanity to the suffering of [LAUGHS] PMS.

BROOKE GLADSTONE: Jonathan Metzl, psychiatrist and author of Prozac on the Couch: Prescribing Gender in the Era of Wonder Drugs.

DR. JONATHAN METZL: Historically speaking, psychiatric drugs have been used to convey the message that if you’re not just suffering from an illness but if you’re not a good mother, if you are not a good wife, these are all conditions that can be treated with psychiatric medications.

And I can say that historically the blurriness of that line has gotten psychiatry into a lot of trouble. The “mother’s little helper” phenomenon in the '70s is one example of that.

BROOKE GLADSTONE: Valium.

DR. JONATHAN METZL: Correct. We know that when the industry drives diagnosis, there’s a process that happens that Peter Kramer, in Listening to Prozac, beautifully described as “diagnostic bracket creep.” People start to come into doctor’s offices and say, I know this drug is indicated for a particular illness, but I've kind of got that. And the doctor says, that sounds good enough. We'll give you this medication.

And what happens over time is that the diagnostic boundaries expand and expand and expand so that a drug that was indicated for a very small subset of people over time becomes indicated and used for a much wider category.

CHRISTOPHER LANE: Fifty percent of the population defines itself as shy.

BROOKE GLADSTONE: Christopher Lane is the author of Shyness: How Normal Behavior Became a Sickness.

CHRISTOPHER LANE: An enormous number of people have a profound dislike of speaking in public but that doesn't mean they suffer from a psychiatric condition. And the effort on the part of these psychiatrists and the APA to broaden the net and include Internet addiction and compulsive buying disorder and apathy disorder, relational disorder, all of these are basically codes for everyday experiences and fears and anxieties that should not be represented in a psychiatric bible.

BROOKE GLADSTONE: Lane says the media compound the problem by reporting only the upper range of the estimate of those who may suffer from a potential disorder and by failing to report the size of the field studies, which often are quite small.

CHRISTOPHER LANE: I mean, one of the studies – it was a telephone survey to 526 urban Canadians – came out with self-reported accounts of social anxiety that ranged from 1.9 percent to 18.7 percent, but only the higher figure was reported in the subsequent media literature.

And what happens is then the public reads that, or hears it on the radio, and decides this is potentially a problem, certainly with social anxiety disorder because the drug maker in question, GlaxoSmithKline, spent over 94 million dollars on what it called a “public awareness campaign” for the disorder in question.

It wanted people basically to rethink whether they were suffering from just shyness and to ask themselves whether it might be something more serious, like social anxiety disorder.

DR. MICHAEL FIRST: The issue with all mental disorders is they're defined in terms of symptoms that we all experience every day as part of normal living.

Read the rest.

Tags: NPR, On the Media, The Art of Diagnosis, DSM-V, Diagnostic and Statistical Manual of Mental Disorders, Psychology, books, DSM, mental disorders, BROOKE GLADSTONE, Dr. Darrel Regier, Dr. Michael First, PMDD, Stef Pros, Jonathan Metzl, psychiatric drugs

Jessa Crispin Reviews "The Master and His Emissary: The Divided Brain and the Making of the Western World"

From The Smart Set, Jessa Crispin reviews The Master and His Emissary: The Divided Brain and the Making of the Western World by Iain McGilchrist. I have previously posted a review from the Guardian UK which was quite positive.

Half and Half
The brain's sides have a relationship. Like most, it's complicated.

By Jessa Crispin of Bookslut

Back in junior high school health class, we were told that the brain has two different hemispheres — the left and the right. The left brain, the textbook stated, is responsible for language, math, and science, logic and rationality. The right brain was the artistic one, the creative half of the brain. But that's not quite true. Neuroimaging and experiments on patients with split brains and brain damage to only one hemisphere have allowed a much more detailed, and fascinating, accounting of how the two parts interact with the world, and how they combine to become a unified consciousness (and, in some cases of mental disorders, how they occasionally don't). Iain McGilchrist has combined scientific research with cultural history in his new book The Master and His Emissary: The Divided Brain and the Making of the Western World to examine how the evolution of the brain influenced our society, and how the current make up of the brain shapes art, politics, and science, as well as the rise of mental illness in our time — in particular schizophrenia, anorexia, and autism.

• The Master and His Emissary: The Divided Brain and the Making of the Western World by Iain McGilchrist. 608 pages. Yale University Press. $38.00.

That eighth-grade level science textbook was kind of correct. While the left brain does contain much of the language center of the brain, a person cannot understand context without the right hemisphere. Metaphor, irony, and humor are all processed by the right brain. When engaging in face-to-face conversation, it processes facial expressions to add depth to the meaning. Most activities, from painting to mathematics, are processed by both the left and the right hemispheres of the brain. The differences between them have to be defined in a different way. The left brain brings precision, focus, abstraction, rationality, and fixity. The right brain has a more open view of the world. It provides context, whether finding humor in a punch line or bringing a sense of history to a question posed to it. In a healthy, functioning brain, the right hemisphere sends information about a situation to the left hemisphere, which "unpacks" the information using its tools to find clarity, and then it vocalizes the response, either in thought or expression.

When we look at unhealthy, nonfunctional brains, however, the two halves become much more complex. Patients with only one fully functioning hemisphere or those who have had their corpus callosum (the area that bridges the two hemispheres) severed — either because of injury or as a way to treat debilitating seizures — tell us a lot about the personalities of the two hemispheres. And they do have personalities. When presented with a illogical scenario, the left brain creates logical black holes to convince itself and others it is correct, and it is so swayed by authority that it refuses to correct obvious wrongs. People who only have functioning right hemispheres might have less access to rational thought, but when Russian scientists tell them that a porcupine is a monkey (an actual study cited in The Master and His Emissary), they don't believe it's true. People using only their left hemispheres do. They also refuse, or may actually be unable, to admit they are wrong. They are overly confident of their abilities and intelligence, and they can justify nearly everything to themselves by creating strings of false logic. (As in, monkeys climb trees. Porcupines climb trees. A porcupine must be a monkey.)

Another example of this complexity is the way a person's relationship to his body changes with damage to the right hemisphere. People who have suffered a stroke will often have disabilities on the opposite sides of their bodies. When the right hemisphere is left intact, it acknowledges the damage and almost obsesses over it. The left hemisphere will disown a weakened left arm or leg, to the point of believing that the real arm, according to a woman who had a right brain stroke and is quoted by McGilchrist, is hiding "under the bedclothes" and this arm attached to her body "is my mother's. Feel, it's warmer than mine." Other patients with similar damage report that their body parts have been replaced with wood, or they will simply not admit they are disabled. When presented with the proof, their twisted limb held up for them to see, the patient will turn his head or close his eyes.

For a long time, the left brain has been viewed as being the dominant, more highly evolved, more useful part of the brain, possibly because, as McGilchrist says, we are "trapped inside a culture that is so language-determined." We think in language, and with the advent of e-mail and text messaging we communicate in written language more than ever before. The right brain may communicate to us through intuition, but we can, and do, often override that with logic. For a long time it was believed that the corpus callosum's primary focus was the communication between hemispheres. While that is partially true, most of what it does is allow one hemisphere to inhibit the other. This is primarily so that both hemispheres do not attempt to perform the same task (a problem you frequently see in patients with severed corpus callosums — more on that in a minute), but it can also mean that a hemisphere that is not suited for a task can "claim" it anyway, and inhibit the proper hemisphere from contributing. Which hemisphere dominates more tasks than the other can vary from person to person — there are a multitude of horrible online quizzes that will tell you which hemisphere rules your decision making processes — but on a larger scale, you see a pattern forming with certain cultures and with variations depending on where humans have been in their evolutionary history.

Watching experiments with split brain patients from the 1970s, you'll see scientists referring to the right brain as the "silent" and "feminine" side of the brain. It deals with emotions and empathy, and all of that useless stuff. But in reality, McGilchrist reports that patients with damage to their left hemisphere — even to the point of removing the entire hemisphere and with it their ability to communicate with language, and even sign language — actually function better in the world than those with right hemisphere damage. It's not just scientists, but artists, writers, philosophers, religious leaders, and politicians who have created an environment in which the right brain is seen as being weak, and left brain concepts and systems are viewed as being the ideal: logic over intuition, the pursuit of money over community, brain over body, industry over nature. This devaluing of the contributions of the right brain has created a shift in the way we interact with the world. We have created a society that is completely reliant on the left hemisphere, on logic and materialism and abstraction, and in doing so we have created what McGilchrist calls "the predominantly left-hemisphere phenomenon of a competitive, specialised, and compartmentalised world."

It's difficult not to agree that right brain territory has been hijacked by the left brain. Visual art is dominated with abstraction and shocking imagery. (The left brain, hungry for stimulation, prefers the shocking and the novel to the beautiful.) Religion has seen the rise of the super-rational atheist movement while spirituality has been overrun by materialism, another abstract left brain concept. The Secret would have you believe that the entire purpose of divinity is to make you rich and thin, and even the evangelists preach that Jesus wants you to have that nice house in the suburbs. Social anxiety disorder would seem to be the domain of the left brain, completely unable to read social cues, trying to interact with other people. It overthinks things, misreads situations, and creates awkwardness by being too self-aware and not letting the right hemisphere do what it does best.

Every age has its own range of mental disorders. We don't suffer much from hysteria anymore, just like we don't hear of the Victorians battling autism as we now do. Some of that is just diagnosis: There may have been autistic men and women in the world before today, but they may have been called something else. McGilchrist, in consensus with many psychiatric historians, believes our society creates specific mental illnesses. McGilchrist just takes it a little further, believing it is how the brain of that age functions that defines its dysfunctions. The way we receive information, the language we use, the environment in which we live, the values of our culture — all of these things influence the way we use our brains, and this creates a feedback from the culture back to the brain. Certain eras, such as the Romantic period, praised nature and held ideals about love and beauty and wrote poetry. As a result, the right brain was much more active, and the reigning disorder of the day was melancholia, a problem of the right brain.

Our contemporary culture, with its loneliness and its materialism and disjointed nature, is typical of left brain dominance. As such, we have autism, which is an almost total dysfunction of the right brain: an inability to read facial expressions, a lack of empathy, failure to recognize metaphor or irony. Schizophrenia is a disorder where logic runs mad. Faulty connections are made, false conclusions drawn, and yet the disordered cannot release themselves from the grip of the delusion because to them it makes perfectly logical sense. Anorexia is a hatred, a mistrust, and a warping of the image of the body. These are left-hemisphere ways of thinking taken to their extreme, and never in the history of mankind have we been afflicted with disorders quite like these. Consider them warning signs, if you will, about what could lay ahead if progress continues in this direction.

But McGilchrist believes the pattern of the evolution of the human brain is circular. Domination of one hemisphere will be checked by the growth of the neglected hemisphere. Life with a dominant right brain is not much better, unless mass suicide inspired by a romantic Goethe novel is your thing. The ideal is the harmonious workings of both hemispheres, as life appeared to be in pre-Socratic Athens. In that time, strides were made in drama and poetry in the right hemisphere, and philosophy and the written language in the left. There are signs we could swing that way again, with most of the scientific advances being made in the very uncertain, quite illogical realm of quantum physics. The left brain hates uncertainty, and while it may be true that you can know where a particle is located or how fast it is moving, but not both at the same time, it doesn't make sense. There's a reason why scientists like Wolfgang Pauli made breakthroughs in the quantum field due to visions and dreams — it's processing done by the right hemisphere, because it warps the boundaries of the scientific method. The advances in neuroimaging can also lead us back to our belief in the power of the right hemisphere as we can now see it at work when we can't hear it. It is not the weaker half — in fact it possesses what we think of first when we are listing the things that separate us from animals: empathy, art, humor, culture, and wisdom. • 21 December 2009

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Jessa Crispin is editor and founder of Bookslut.com. She currently resides in Berlin, but spent many years in Chicago.

Tags: books, Psychology, brain, evolution, Jessa Crispin, Review, The Master and His Emissary, The Divided Brain and the Making of the Western World, Bookslut, The Smart Set, brain hemispheres, culture

Psychological Treatments of Binge Eating Disorder (Research Review)

The Archive of General Psychiatry recently posted the following article, which I want to talk about a little bit since binge eating disorder (BED) is something about which I have some strong opinions.

Psychological Treatments of Binge Eating Disorder

G. Terence Wilson, PhD; Denise E. Wilfley, PhD; W. Stewart Agras, MD; Susan W. Bryson, MA, MS

Arch Gen Psychiatry. 2010;67(1):94-101.

Context Interpersonal psychotherapy (IPT) is an effective specialty treatment for binge eating disorder (BED). Behavioral weight loss treatment (BWL) and guided self-help based on cognitive behavior therapy (CBTgsh) have both resulted in short-term reductions in binge eating in obese patients with BED.

Objective To test whether patients with BED require specialty therapy beyond BWL and whether IPT is more effective than either BWL or CBTgsh in patients with a high negative affect during a 2-year follow-up.

Design Randomized, active control efficacy trial.

Setting University outpatient clinics.

Participants Two hundred five women and men with a body mass index between 27 and 45 who met DSM-IV criteria for BED.

Intervention Twenty sessions of IPT or BWL or 10 sessions of CBTgsh during 6 months.

Main Outcome Measures Binge eating assessed by the Eating Disorder Examination.

Results At 2-year follow-up, both IPT and CBTgsh resulted in greater remission from binge eating than BWL (P < .05; odds ratios: BWL vs CBTgsh, 2.3; BWL vs IPT, 2.6; and CBTgsh vs IPT, 1.2). Self-esteem (P < .05) and global Eating Disorder Examination (P < .05) scores were moderators of treatment outcome. The odds ratios for low and high global Eating Disorder Examination scores were 2.8 for BWL, 2.9 for CBTgsh, and 0.73 for IPT; for self-esteem, they were 2.4 for BWL, 1.9 for CBTgsh, and 0.9 for IPT.

Conclusions Interpersonal psychotherapy and CBTgsh are significantly more effective than BWL in eliminating binge eating after 2 years. Guided self-help based on cognitive behavior therapy is a first-line treatment option for most patients with BED, with IPT (or full cognitive behavior therapy) used for patients with low self-esteem and high eating disorder psychopathology.

Trial Registration clinicaltrials.gov Identifier: NCT00060762

Author Affiliations: Rutgers, The State University of New Jersey, Piscataway (Dr Wilson); Washington University School of Medicine in St Louis, St Louis, Missouri (Dr Wilfley); and Stanford University School of Medicine, Stanford, California (Dr Agras and Ms Bryson).

Binge eating disorder (BDE) was added the DSM-IV as a new (and provisional) diagnosis in 1994. Since then, as the article points out, the diagnosis has shown itself to be a reliable and valid diagnosis.

From the introduction:

Binge eating disorder is characterized by frequent and persistent episodes of binge eating accompanied by feelings of loss of control and marked distress in the absence of regular compensatory behaviors. The disorder is associated with specific eating disorder psychopathology (eg, dysfunctional body shape and weight concerns),⁴ psychiatric comorbidity, and significant health and psychosocial impairments.⁵ Binge eating disorder is also linked with overweight and obesity.⁶

In general, as with most diagnoses, cognitive behavioral therapy (CBT) is the most widely used therapeutic approach, and the most tested. In this study they used CBT with a "guided self help" twist on the model, alongside behavioral weight loss approaches (BWL - this is what you might get from a nutritionist, focusing on nutrition, calorie restriction, and exercise), and interpersonal psychotherapy (IPT), which like CBT is a "reliably effective in eliminating binge eating and reducing associated psychopathology in the short- and longer-term."

Here is how they define the IPT model they used:

Interpersonal psychotherapy for BED was formulated by Wilfley.^{7, 26} It was based on the treatment developed by Klerman et al²⁷ for depression, and Fairburn²⁸ later adapted it for the treatment of bulimia nervosa. The treatment is manualized. The first phase is composed of 4 sessions and is devoted to a detailed analysis of the interpersonal context within which the eating disorder developed and was maintained. This leads to a formulation of the current interpersonal problem areas, which then form the focus of the second stage of therapy aimed at helping the patient make interpersonal changes in the specific area or areas identified. The last 3 sessions are devoted to a review of the patient's progress and an exploration of ways to handle future interpersonal difficulties. Although links are made throughout treatment between interpersonal events and binge eating, the therapy does not contain any of the specific behavioral or cognitive procedures that characterize CBT. In the current study, all sessions were individual and 50 to 60 minutes long except for the first, which was 2 hours long. The first 3 sessions were scheduled during the first 2 weeks and were followed by 12 weekly sessions and the final 4 sessions at 2-week intervals, for a total of 19 sessions during 24 weeks. The total therapy time was the same as that for BWL.

The CBTgsh model they used is described here:

This intervention is derived from manual-based CBT. The primary focus is developing a regular pattern of moderate eating using self-monitoring, self-control strategies, and problem-solving. Relapse prevention is emphasized to promote maintenance of behavioral change. The principal role of the therapist is to explain the rationale for the use of the self-help manual, generate a reasonable expectancy for a successful outcome, and to motivate the patient to focus on using the manual. There were 10 treatment sessions, each lasting approximately 25 minutes, except for the first session, which was 60 minutes long. The first 4 sessions were weekly, the next 2 occurred at 2-week intervals, and the last 4 occurred at 4-week intervals. The therapists were first- or second-year graduate students with no experience in CBTgsh or treating BED, 4 at Rutgers University and 4 at Washington University. Dr Fairburn conducted initial training in CBTgsh in a 3-hour workshop. The therapists did not receive regularly scheduled supervision. As with the other 2 treatments, quarterly meetings across sites were held throughout the study.

This is an interesting study and it proves that a psychotherapy approach is superior to behavior modification in controlling binge eating behavior. In the comment section of the paper they discuss the outcome:

Consistent with some previous studies,^{11, 13} ours found no difference among the 3 interventions at posttreatment on binge eating; specific eating disorder psychopathology of body weight, shape, and eating concern; or general psychopathology. At the 2-year follow-up, however, both IPT and CBTgsh were significantly more effective than BWL in eliminating binge eating. This superiority of a specialty therapy over BWL for BED is supported by 2 recent short-term studies. Munsch et al³⁶ found that CBT was significantly superior to BWL, and Grilo and Masheb¹⁷ showed that a self-help version of CBT was significantly more effective than self-help BWL. Devlin et al,^37-38 in a randomized double-blind placebo-controlled study, found that the addition of CBT—but not antidepressant medication—to BWL treatment significantly enhanced outcomes at posttreatment and 24-month follow-up. Interpersonal psychotherapy was also more successful in retaining patients in the trial than BWL or CBTgsh. Our dropout rate for BWL was consistent with previous research.^{36, 39} The CBTgsh attrition in our study was greater than in others (eg, Grilo and Masheb¹⁷) possibly because it was contrasted with longer, more "face valid" treatments. This might also explain the difference in suitability ratings.

It's good that they compared the three approaches, although the IPT and GBTgsh approaches were not different enough to me to generate significant differences in results. As someone who works with clients on binge eating behaviors, this study proves to me that many of my clients need therapeutic intervention in order to overcome this behavior issue - BWL efforts are not nearly enough.

However, I would recommend a completely different approach. It seems there was very little effort to look at the etiology of the binge behavior in autobiographical details. In general, I think this is necessary, while also acknowledging that the current managed care situation requires very short-term therapeutic approaches such as the ones used in this study.

My sense is that binge behavior is a symptom of pervasive but low-grade depression, dysthymia, often with an early onset (APA, p. 380-381), meaning that the behavior begins in the teen years. Many clients may also exhibit more severe depression, anxiety, or other psychological issues, as well as having experienced childhood trauma, neglect, or abuse.

There has been very little research into the connections between binge-eating disorders (BED) and dysthymia, although Kristin Moerk has conducted a preliminary study that deserves follow-up (Moerk, 2002). She offers the following summary of her dissertation:

Many of the personality traits selected as candidate potentially relating to high comorbidity between BED and depression were linked only to depression and not observed at higher level in the pure BED group than in the control group. These traits included: perfectionism, low self esteem, sociotropy, autonomy, dependency, and self criticism. (Moerk, 2002, p. 7)

These findings are consistent with my sense that binging clients exhibit low self-concept, perfectionism, and self criticism. The Moerk study included dysthymics in the depressed group, so her research can be extended to include this population as well as those more severely depressed. Other researchers have found that dysthymia was more strongly correlated with binge eating and bulimia than major depression (Geist, Davis, & Heinmaa, 1998; Perez, Joiner, & Lewinsohn, 2004).

Dysthymia seems to respond best to a combination of anti-depressants and therapy (Grohol, 2008), with cognitive behavioral therapy (CBT) being the most widely studied psychotherapy approach for this disorder. The study presented above is notable in that there was not a drug group, as is generally the case. I was glad to see that they were willing to avoid the money that comes from drug companies to fund such research.

My bias would be to use Richard Schwartz’s Internal Family Systems Therapy (IFS), which was developed during work with survivors of child abuse and has proven successful with bulimics and anorexics, as well as less challenging clients—he includes a whole chapter detailing his work with a bulimic client in his book (Schwartz, 1995, p. 61-83). Essentially, IFS is a form of parts work, not dissimilar to Ego States work (Watkins & Watkins, 1997) or the Voice Dialogue model (Stone & Stone, 1989).

Using the IFS model, the binging behavior is not seen as the primary issue, but rather as a coping mechanism (what IFS terms “firefighter” behavior in that the binging “part” responds to pain by trying to “put out the fire” through addictive behaviors). In employing the IFS model, the client becomes aware that the behaviors—the parts, schemas, ego states, or subpersonalities—are not who she is as a person but, rather, are merely wounded parts that need to be “unburdened.”

Therapy begins with an exploration of the most dominant parts, often that would include the “Perfectionist” and the “Inner Critic,” parts that are known as “managers” because their role is to keep the self-system functional by pushing out negative feelings, such as depression. The “firefighters” (or binging behaviors) are activated when the managers fail to keep the “exiled” feelings or “parts” out of consciousness. The exiles are the wounded parts that carry the burden of dark emotions, such as sadness and depression (or more significantly, trauma, abuse, and neglect), that the managers are afraid will take over the self-system if they are not exiled.

Therapy consists of systematically negotiating with managers and firefighters to uncover and unburden the exiles. Once the exiles and other parts are unburdened, they typically adopt new and more functional roles in the self-system (Schwartz, p.53).

Finally, the client learns to differentiate her parts from the inner core of Self—also known as Atman, Buddha-nature, Soul, and so on—so that she can learn to become Self-led (Schwartz, 41). When the client can become Self-led, individual parts, even if they are not fully unburdened, no longer are as capable of hijacking the self-system. Developing access to the Self can be an invaluable tool in coping with both the dysthymia (or depression, anxiety, trauma, and so on) and the binge behavior.

It is worth noting that Schwartz also advocates working to create some contact with the Self very early in therapy so that is can act as a co-therapist in the process. In his model, much of the healing comes from the client's Self doing internal attachment work with the wounded and burdened parts (Harryman, in press).

I would really like to see someone put this model up against CBT and pharmaceuticals. I think it will prove superior.

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text Revision). Washington, DC: Author.

Geist, R., Davis, R., & Heinmaa, M. (1998). Binge/purge symptoms and comorbidity in adolescents with eating disorders. Canadian Journal of Psychiatry, 43, 507–512.

Grohol, J. M. (2008). Dysthymia treatment. Retrieved November 28, 2009, from http://psychcentral.com/lib/2008/dysthymia-treatment/

Moerk, K. C. (2002). Personality in binge eating disorder and depression: Do similarities in personality traits partially account for comorbidity findings?. Unpublished doctoral dissertation, State University of New York at Stony Brook, New York.

Perez, M., Joiner, T. E., & Lewinsohn, P. M. (2004). Is major depressive disorder or dysthymia more strongly associated with bulimia nervosa?. International Journal of Eating Disorders, 36(1), 55 - 61.

Schwartz, R. (1995). Internal family systems therapy. New York: Guilford Press.

Stone, H., & Stone, S. (1985/1989). Embracing our selves. Novato, CA: New World Library.

Watkins, J. G., & Watkins, H. H. (1997). Ego states: Theory and therapy. New York: W. W. Norton & Co.

Tags: Psychology, eating disorders, therapy, depression, dysthymia, binge eating disorder, APA, Internal Family Systems Therapy, IFS, Richard Schwartz, Psychological Treatments of Binge Eating Disorder, Archive of General Psychiatry, Interpersonal psychotherapy, Behavioral weight loss treatment, guided self-help, cognitive behavior therapy, DSM-IV criteria for BED, JAMA, G. Terence Wilson, Denise E. Wilfley, W. Stewart Agras, Susan W. Bryson, parts work

Dialogical Self Theory

I stumbled upon this relatively new theory of self in the course of researching something else. I'm not fully clear on the whole thing yet, but it's interesting. It seems to be a cross between cultural psychology and constructivist psychology, but I have more reading to do.

This all comes from Wikipedia:

Overview

Dialogical Self Theory (DST) weaves two concepts, self and dialogue, together in such a way that a more profound understanding of the interconnection of self and society is achieved. Usually, the concept of self refers to something “internal,” something that takes place within the mind of the individual person, while dialogue is typically associated with something “external,” that is, processes that take place between people involved in communication.

The composite concept “dialogical self” goes beyond the self-other dichotomy by infusing the external to the internal and, in reverse, to introduce the internal into the external. As functioning as a “society of mind”^[1], the self is populated by a multiplicity of “self-positions” that have the possibility to entertain dialogical relationships with each other.

In Dialogical Self Theory (DST) the self is considered as “extended,” that is, individuals and groups in the society at large are incorporated as positions in the mini-society of the self. As a result of this extension, the self does not only include internal positions (e.g., I as the son of my mother, I as a teacher, I as a lover of jazz), but also external positions (e.g., my father, my pupils, the groups to which I belong).

Given the basic assumption of the extended self, the other is not simply outside the self but rather an intrinsic part of it. There is not only the actual other outside the self, but also the imagined other who is entrenched as the other-in-the-self. An important theoretical implication is that basic processes, like self-conflicts, self-criticism, self-agreements, and self-consultancy, are taking place in different domains in the self: within the internal domain (e.g., “As en enjoyer of life I disagree with myself as an ambitious worker”); between the internal and external (extended) domain (e.g., “I want to do this but the voice of my mother in myself criticizes me”) and within the external domain (e.g., “The way my colleagues interact with each other has led me to decide for another job”).

As these examples show, there is not always a sharp separation between the inside of the self and the outside world, but rather a gradual transition ^[2]. DST assumes that the self as a society of mind is populated by internal and external self-positions. When some positions in the self silence or suppress other positions, monological relationships prevail. When, in contrast, positions are recognized and accepted in their differences and alterity (both within and between the internal and external domains of the self), dialogical relationships emerge with the possibility to further develop and renew the self and the other as central parts of the society at large.

Historical background

DST is inspired by two thinkers in particular, William James and Mikhail Bakhtin, who worked in different countries (USA and Russia, respectively), in different disciplines (psychology and literary sciences), and in different theoretical traditions (pragmatism and dialogism). As the composite term dialogical self suggests, the present theory finds itself not exclusively in one of these traditions but explicitly at their intersection. As a theory about the self it is inspired by William James, as a theory about dialogue it elaborates on some insights of Mikhail Bakhtin. The purpose of the present theory is to profit from the insights of founding fathers like William James, George Herbert Mead and Mikhail Bakhtin and, at the same time, to go beyond them.

William James (1890) proposed a distinction between the I and the Me.

William James (1890) proposed a distinction between the I and the Me, which, according to Morris Rosenberg ^[2], is a classic distinction in the psychology of the self. According to James the I is equated with the self-as-knower and has three features: continuity, distinctness, and volition ^[3]. The continuity of the self-as-knower is expressed in a sense of personal identity, that is, a sense of sameness through time. A feeling of distinctness from others, or individuality, is also characteristic of the self-as-knower. Finally, a sense of personal volition is reflected in the continuous appropriation and rejection of thoughts by which the self-as-knower manifests itself as an active processor of experience.

Of particular relevance to DST is James's view that the Me, equated with the self-as-known, is composed of the empirical elements considered as belonging to oneself. James was aware that there is a gradual transition between Me and mine and concluded that the empirical self is composed of all that the person can call his or her own, "not only his body and his psychic powers, but his clothes and his house, his wife and children, his ancestors and friends, his reputation and works, his lands and horses, and yacht and bank-account" ^[4]. According to this view, people and things in the environment belong to the self, as far as they are felt as 'mine'. This means that not only “my mother” belongs to the self but even “my enemy”. In this way, James proposed a view in which the self is 'extended' to the environment. This proposal contrasts with a Cartesian view of the self which is based on a dualistic conception, not only between self and body but also between self and other. With his conception of the extended self, that defined as going beyond the skin, James has paved the way for later theoretical developments in which other people and groups, defined as “mine” are part of a dynamic multi-voiced self.

Hubert Hermans wrote the first psychological publication on the “dialogical self” in 1992.

In the above quotation from William James, we see a constellation of characters (or self-positions) which he sees as belonging to the Me/mine: my wife and children, my ancestors and friends. Such characters are more explicitly elaborated in Mikhail Bakhtin's ^[5] metaphor of the polyphonic novel, which became a source of inspiration for later dialogical approaches to the self. In proposing this metaphor, he draws on the idea that in Dostoyevsky's works there is not a single author at work--Dostoyevsky himself--but several authors or thinkers, portrayed as characters such as Ivan Karamazov, Myshkin, Raskolnikov, Stavrogin, and the Grand Inquisitor.

These characters are not presented as obedient slaves in the service of one author-thinker, Dostoyevsky, but treated as independent thinkers, each with their own view of the world. Each hero is put forward as the author of his own ideology, and not as the object of Dostoyevsky's finalizing artistic vision. Rather than a multiplicity of characters within a unified world, there is a plurality of consciousnesses located in different worlds. As in a polyphonic musical composition, multiple voices accompany and oppose one another in dialogical ways. In bringing together different characters in a polyphonic construction, Dostoyevsky creates a multiplicity of perspectives, portraying characters conversing with the Devil (Ivan and the Devil), with their alter egos (Ivan and Smerdyakov), and even with caricatures of themselves (Raskolnikov and Svidrigailov).

Inspired by the original ideas of William James and Mikhail Bakhtin, Hubert Hermans^[6] wrote the first psychological publication on the “dialogical self” in which they conceptualized the self in terms of a dynamic multiplicity of relatively autonomous I-positions in the (extended) landscape of the mind. In this conception, the I has the possibility to move from one spatial position to another in accordance with changes in situation and time. The I fluctuates among different and even opposed positions, and has the capacity to imaginatively endow each position with a voice so that dialogical relations between positions can be established. The voices function like interacting characters in a story, involved in processes of question and answer, agreement and disagreement. Each of them have a story to tell about their own experiences from their own stance. As different voices, these characters exchange information about their respective Me's and mines, resulting in a complex, narratively structured self.

Construction of assessment and research procedures

The theory has led to the construction of different assessment and research procedures for investigating central aspects of the dialogical self. Hubert Hermans^[7] has constructed the Personal Position Repertoire (PPR) method, an idiographic procedure for assessing the internal and external domains of the self in terms of an organized position repertoire.

This is done by offering the participant a list of internal and external self-positions. The participants mark those positions that they feel as relevant in their lives. They are allowed to add extra internal and external positions to the list and phrase them in their own terms. The relationship between internal and external positions is then established by inviting the participants to fill out a matrix with the rows representing the internal positions and the columns the external positions. In the entries of the matrix, the participant fills in, on a scale from 0 to 5 the extent to which an internal position is prominent in the relation to an external position. The scores in the matrix allow for the calculation of a number of indices, such as sum scores representing the overall prominence of particular internal or external positions and correlations showing the extent to which internal (or external) positions have similar profiles. On the basis of the results of the quantitative analysis, some positions can be selected, by the client or assessor, for closer examination.

From the selected positions the client can tell a story that reflects the specific experiences associated with that position and, moreover, assessor and client can explore which positions can be considered as a dialogical response to one or more other positions. In this way, the method combines both qualitative and quantitative analyses.

Psychometric aspects of the PPR method

The psychometric aspects of the PPR method was refined a procedure proposed by A. Kluger, Nir, & Y. Kluger^[8]. The authors analyze clients' Personal Position Repertoires by creating a bi-plot of the factors underlying their internal and external positions. A bi-plot provides a clear and comprehensible visual map of the relations between all the meaningful internal and external positions within the self in such a way that both types of positions are simultaneously visible. Through this procedure clusters of internal and external positions and dominant patterns can be easily observed and analyzed.

The method allows researchers or practitioners to study the general deep structures of the self. There are multiple bi-plots technologies available today. The simplest approach, however, is to perform a standard principal component analysis (PCA). To obtain a bi-plot, a PCA is once performed on the external positions and once on the internal positions, with the number of components in both PCA’s restricted to two. Next, a scatter of the two PCAs is plotted on the same plane, where results of the first components are projected to the X-axis and of the second components to Y-axis. In this way, an overview of the organization of the internal and external positions together is realized.

The Personality Web assessment method

Another assessment method, the Personality Web, is deviced by Raggatt^[9]. This semi-structured method starts from the assumption that the self is populated by a number of opposing narrative voices, with each voice having its own life story. Each voice competes with other voices for dominance in thought and action and each is constituted by a different set of affectively-charged attachments, to people, events, objects and one’s own body.

The assessment comprises two phases.

• In the first phase, 24 attachments are elicited in four categories: people, events, places and objects, and orientations to body parts. In an interview, the history and meaning of each attachment is explored.
• In the second phase, participants are invited to group their attachments by strength of association into cluster analysis and multidimensional scaling is used to map the individual's web of attachments.

This method represents a combination of qualitative and quantitative procedures that provide insight in the content and organization of a multi-voiced self.

Self-Confrontation Method

Dialogical relationships are also studied with an adapted version of the Self-Confrontation Method (SCM).^[10]

Take the following example. A client, Mary, reported that she sometimes felt a witch, eager to murder her husband, particularly when he was drunk. She did a self-investigation in two parts, one from her ordinary position as Mary and another from the position of the witch. Then, she told from each of the positions a story about her past, present, and future. These stories were summarized in the form of a number of sentences. It appeared that Mary formulated sentences that were much more acceptable from a societal point of view than those from the witch. Mary formulated sentences like “I want to try to see what my mother gives me: there’s only one of me” or “For the first time in my life, I’m engaged in making a home (“home” is also coming at home, entering into myself),” whereas the witch produced statements like “With my bland, pussycat qualities I have vulnerable things in hand, from which I derive power at a later moment (somebody tells me things that I can use so that I get what I want) ” or “I enjoy when I have broken him [husband]: from a power position entering the battlefield.”

It was found that the sentences of the two positions were very different in content, style, and affective meaning. Moreover, the relationship between Mary and the witch seemed to be more monological than dialogical, that is, either the one or the other was in control of the self and the situation and there was not no exchange between them. After the investigation, Mary received a therapeutic supervision during which she started to keep a diary in which she learned to make fine discriminations between her own experiences as Mary and those of the witch. She became not only aware of the needs of the witch but learned also to give an adequate response as soon as she noticed that the energy of the witch was upcoming. In a second investigation, one year later, the intensely conflicting relationship between Mary and the witch was significantly reduced and, as a result, there was less tension and stress in the self. She reported that in some situations, she even could make good use of the energy of the witch (e.g., when applying for a job). Whereas in some situations she was in control of the witch, in other situations she could even cooperate with her. The changes that took place between investigation 1 and investigation 2 suggested that the initial monological relationship between the two positions changed clearly into a more dialogical direction.

The Initial Questionnaire method

Under the supervision of the Polish psychologist Piotr Oleś, a group of researchers^[11] constructed a questionnaire method, called the Initial Questionnaire, for the measurement of three types of “internal activity” (a) change of perspective, (b) monologue and (c) dialogue. The purpose of this questionnaire is to induce the subject’s self-reflection and determine which I-positions are reflected by the participant’s interlocutors and which of them give new and different points of view to the person.

The method includes a list of potential positions. The participants are invited to choose some of them and can add their own to the list. The selected positions, both internal and external ones, are then assessed as belonging to the dialogue, monologue of perspective categories. Such a questionnaire is well-suited for the investigation of correlations with other questionnaires.

For example, correlating the Initial Questionnaire with the Revised NEO Personality Inventory (NEO PI-R), the researchers found that persons having inner dialogues scored significantly lower on Assertiveness and higher on Self-Consciousness, Fantasy, Aesthetics, Feelings and Openness than people having internal monologues. They concluded that “people entering into imaginary dialogues in comparison with ones having mainly monologues are characterized by a more vivid and creative imagination (Fantasy), a deep appreciation of art and beauty (Aesthetics) and receptivity to inner feelings and emotions (Feelings). They are curious about both inner and outer worlds and their lives are experientially richer. They are willing to entertain novel ideas and unconventional values and they experience positive as well as negative emotions more keenly (Openness). At the same time these persons are more disturbed by awkward social situations, uncomfortable around others, sensitive to ridicule, and prone to feelings of inferiority (Self-Consciousness), they prefer to stay in the background and let others do the talking (Assertiveness)”^[11].

Other methods

Other methods are developed in fields related to DST. Based on Stiles’ assimilation model^[12], Osatuke et al. describe a method that enables the researcher to compare what is said by a client (verbal content) and how it is said (speech sounds)^[13]. With this method the authors are able to assess to what extent the vocal manifestations (how it is said) of different internal voices of the same client parallel, contradict or complement their written manifestations (what is said). This method can be used to study the non-verbal characteristics of different voices in the self in connection with verbal content.

Dialogical Sequence Analysis

On the basis of Mikhail Bakhtin’s theory of utterances, Leiman ^[14] deviced a Dialogical Sequence Analysis. This method starts from the assumption that every utterance has an addressee. The central question is: To whom is the person speaking?

Usually, we think of one listener as the immediately observable addressee. However, the addressee is rather a multiplicity of others, a complex web of invisible others, whose presence can be traced in the content, flow and expressive elements of the utterance (e.g., I’m directly addressing you but while speaking I’m protesting to a third person who is invisibly present in the conversation). When there are more than one addressees present in the conversation, the utterance positions the author/speaker into more (metaphorical) locations. Usually, these locations form sequences, that can be examined and made explicit when one listens carefully not only to the content but also the expressive elements in the conversation. Leiman’s method, which analyzes a conversation in terms of “chains of dialogical patterns,” is theory-guided, qualitative and sensitive to the verbal and the non-verbal aspects of utterances.

Fields of application

It is not the main purpose of the presented theory to formulate testable hypotheses, but to generate new ideas. It is certainly possible to perform theory-guided research on the basis of the theory, as exemplified by a special issue on dialogical self research in the Journal of Constructivist Psychology (2008)^[15] and in other publications (further on in the present section). Yet, the primary purpose is the generation of new ideas that lead to continued theory, research, and practice on the basis of links between the central concepts of the theory.

Theoretical advances, empirical research, and practical applications are discussed in the International Journal for Dialogical Science^[16] and at the biennial International Conferences on the Dialogical Self as they are held in different countries and continents: Nijmegen, The Netherlands (2000), Ghent, Belgium (2002), Warsaw, Poland (2004), Braga, Portugal (2006), Cambridge, United Kingdom (2008) and Athens, Greece (2010)^[17] The aim of the journal and the conferences is to is to transcend the boundaries of (sub)disciplines, countries, and continents and create fertile interfaces where theorists, researchers and practitioners meet in order to engage in innovative dialogue.

After initial publication on DST^[6], the theory has been applied in a variety of fields: cultural psychology ^{[18] [19]} psychotherapy^[20]; personality psychology ^{[21] [11]};psychopathology^{[9] [22]}; developmental psychology^{[23] [24] [25]}; experimental social psychology^[26]; autobiography^[27]; social work^[28]; educational psychology^{[29] [30]}; brain science^[31][32]; Jungian psychoanalysis^[33]; history^[34]; cultural anthropology^{[35] [36]}; constructivism^[37]; social constructionism^[38]; philosophy^{[39] [40] [41]}; the psychology of globalization^[24][20] cyberpsychology^{[42] [43]}; media psychology^{[44] [45][46]} and literary sciences ^[47].

Fields of applications are also reflected by several special issues that appeared in psychological journals. In Culture & Psychology (2001)^[48], DST, as a theory of personal and cultural positioning, was exposed and commented on by researchers from different cultures. In Theory & Psychology (2002)^[49], the potential contribution of the theory for a variety of fields was discussed: developmental psychology, personality psychology, psychotherapy, psychopathology, brain sciences, cultural psychology, Jungian psychoanalysis, and semiotic dialogism. In the Journal of Constructivist Psychology (2003) researchers and practitioners focused on the implications of the dialogical self for personal construct psychology, on the philosophy of Martin Buber, on the rewriting of narratives in psychotherapy, and on a psycho-dramatic approach in psychotherapy. The topic of mediated dialogue in a global and digital age was at the heart of a special issue in Identity: An International Journal of Theory and Research (2004) ^[50]. In Counselling Psychology Quarterly (2006) ^[51], the dialogical self was applied to a variety of topics, such as, the relationship between adult attachment and working models of emotion, paranoid personality disorder, narrative impoverishment in schizophrenia, and the significance of social power in psychotherapy. Finally, in the Journal of Constructivist Psychology (2008) ^[52] and in Studia Psychologica ^[53] (2008), groups of researchers addressed the question of how empirical research can be performed on the basis of DST. With a link to the website of this special issue.

Evaluation

Since its first inception in 1992, DST is discussed and evaluated, particularly at the biennial International Conferences on the Dialogical Self and in the International Journal for Dialogical Science. Some of the main positive evaluations and main criticisms are summarized here. On the positive side, many researchers appreciate the breadth and the integrative character of the theory. As the above review of applications demonstrates, there is a broad range of fields in psychology and other disciplines in which the theory has received interests from thinkers, researchers and practitioners. The breadth of interest is also reflected by the range of scientific journals that have devoted special issues to the theory and its implications.

The theory has, moreover, the potential of bringing together scientists and practitioners from a variety of countries, continents and cultures. The Fifth International Conference on the Dialogical Self in Cambridge, United Kingdom attracted 300 participants from 43 countries, mainly focussing on DST and on dialogism as one of the related fields. Some researchers appreciate the potential of the theory to incorporate ideas from post-modernism, like the attention to the decentralization of the self and the historical context, while at the same time, by its focus on dialogue, going beyond the notion of fragmentation and the radical decentralization of the self. Recent work by John Rowan has resulted in the publication of a book by him entitled - 'Personification: Using the Dialogical Self in Psychotherapy and Counselling' published by Routledge. This shows how the concept can be used in many creative ways by those working in the therapeutic field.

Criticism

The theory and its applications have also received several criticism. Many researchers have noted a discrepancy between theory and research. Certainly, more than most post-modernist approaches, the theory has instigated a variety of empirical studies and some of its main tenets are confirmed in experimental social-psychological research^{[54] [26]}. Yet, the gap between theory and research still exists.

Closely related to this gap, there is the lack of connection between dialogical self research and mainstream psychology. Although the theory and its applications have been published in mainstream journals like Psychological Bulletin and the American Psychologist, it has not yet led to the adoption of the theory as a significant development in main stream (American) psychology. Apart from the theory-research gap, one of the additional reasons for the lacking connection with mainstream research may be the fact that interest in the notion of dialogue, central in the history of philosophy since Plato, is largely neglected in psychology and other social sciences. Another disadvantage of the theory is that is lacks a research procedure that is sufficiently common to allow for the exchange of research data among investigators. Although different research tools have been developed (see the above review of assessment and research methods), none of them is used by a majority of researchers in the field.

Investigators often use different research tools which lead to a considerable richness of information but, at the same time, creates a stumbling block for the comparison of research data. It seems that the breadth of the theory and the richness of its applications has a shadow side in the relative isolation of subfields of research in the DST field. Other researchers find the scientific work done thus far of a too verbal nature. While the theory explicitly acknowledges the importance of pre-linguistic, non-linguistic forms of dialogue^[33], the actual research is typically taking place on the verbal level with the simultaneous neglect of the non-verbal level (for a notable exception cultural-anthropological research on shape-shifting)^[55]. Finally, some researchers would like to see more emphasis on the bodily aspects of dialogue. Up till now the theory as focussed almost exclusively on the transcendence of the self-other dualism, as typical of the modern model of the self. More work should be done on the embodied nature of the dialogical self (for the role of the body in connection with emotions^[56].

Here are some articles from people in the field (these are all pdf web pages).

THE DIALOGICAL SELF AND THE RENEWAL OF PSYCHOLOGY
Henderikus J. Stam

INTERPERSONAL COGNITION AND THE RELATIONAL SELF:
PAVING THE EMPIRICAL ROAD FOR DIALOGICAL SCIENCE
Maya Sakellaropoulo and Mark W. Baldwin

WHERE IS CULTURE WITHIN THE DIALOGICAL PERSPECTIVES
ON THE SELF?
Jaan Valsiner & Gyuseog Han

DIALOGICAL CHANGE PROCESSES, EMOTIONS,
AND THE EARLY EMERGENCE OF SELF
Andrea Garvey & Alan Fogel

Tags: Psychology, Self, consciousness, culture, Dialogical Self Theory, William James, Mikhail Bakhtin, Hubert Hermans, self/object