Category: Most important psych experiment never done?

Caring for psychotic patients with maximum kindness and minimum medication

Richard Bentall: “It is difficult to decide on the most important psychology experiment that has never been conducted, but the most important one in psychiatry is not hard to identify. Since Haenri Laborit discovered the psychological effects of chlorpromazine in the late 1940s, anti-psychotic medication has been the first-line (and often only) treatment offered to psychotic patients throughout the world. The evidence from clinical trials in favour of this approach appears impressive at first sight, but the drugs have terrible side effects, and their continued use at high doses is associated with a demonstrable reduction in life expectancy (Waddington et al. 1998). Because they are so unpleasant to take, often causing dysphoria and loss of motivation, many patients discontinue them, and this is true of the new atypical anti-psychotics despite their alleged kinder side effect profiles (Lieberman et al. 2005). Although patients who stop their medication in this way have a high probability of relapse, some of the exacerbations of symptoms that are observed are probably a rebound effect caused by the treatment rather than a return of a pre-existing illness – there is evidence that long-term anti-psychotic use leads to a proliferation of dopamine D2 receptors, thereby increasing the sensitivity of the dopamine system and exacerbating the very physiological dysfunction that the drugs are designed to treat. Hence patients who withdraw gradually are less likely to relapse than those who stop their medication suddenly (Moncrieff, 2006).

Bola (2006) recently reported a meta-analysis of clinical trials in which the majority of patients were experiencing their first episode of illness, in which some patients were unmedicated, and in which the follow-up period was at least one year. Amazingly he could identify only six studies that met these criteria and the evidence suggested that unmedicated patients did at least as well and possibly better than medicated patients in the long-term. One of the studies was the controversial Setoria project devised by Leon Mosher (1999), who devised a system of caring for acutely distressed psychotic patients with maximum kindness and minimum medication. No formal psychotherapy was provided, and the patients were looked after by untrained graduates who dealt with their difficulties with acceptance and emotional support. Despite evidence that Setoria patients did as well as first-episode patients treated in conventional psychiatric services, and the fact that Mosher was director of schizophrenia research for the US National Institute of Mental Health, NIMH closed down the project, probably because of pressure from the pharmaceutical industry (Whitaker, 2002).

In Britain, over the last decade, clinical psychologists have pioneered the development of cognitive-behavioural interventions for patients with psychosis, with promising results (Tarrier & Wykes, 2004). However, CBT has always been offered in combination with conventional antipsychotic drugs. Even though Soteria and CBT come from different philosophical roots, close examination of the two approaches reveals many common features, including acceptance and the normalization of symptoms. Psychiatric patients need to know the results of a clinical trial in which a CBT version of Soteria is compared to treatment as usual. Unfortunately, given the corrupting influence of the pharmaceutical industry (Angell, 2004) they are likely to have to wait for a very long time.”


Professor Richard Bentall is at the University of Wales, Bangor, and is the author of several books on the topic of mental illness, including ‘Madness explained; psychosis and human nature‘.

Personal psychology experiments

Will Meek: “When asked to share my thoughts on the most important psychology experiment that has never been done, my mind went wild. Could it be a more intensive follow-up to the famous Milgram or Zimbardo studies that would be completely unethical? Could it be something more practical but visionary like a gigantic international clinical trial testing the efficacy of non-directive insight-oriented psychotherapy for depression? Could it be something completely impossible, which hypothetically-speaking would be the most important experiment of all time? Like determining the effect of culture on personality?

Instead, when I really think about “psychology”, the study of the mind and behaviour, I think about individuals and the personal science we all utilize to understand our unique lives. We experiment constantly to explain, grow, create meaning, and move toward fulfilment, wholeness, aliveness, self-actualization, or whatever other word you can use to describe this process.

Based on this, the greatest psychology experiment never (not yet) done is the next experience, challenge, or adventure that You have yet to attempt that will take you to the next level of your life. It may be something that will test your strength, identity, and spirit; it may take place individually or interpersonally; and it may be pleasant or painful, but ultimately it will be something to advance You.

We all may have personal “important experiments” that we decided not to conduct (e.g. moving against the Zeitgeist of our industry, or expressing a complicated feeling to a partner for the first time) and an infinite amount more that are on our radar screens or just beyond. Most of these experiments are never discussed or shared, they aren’t written about or published in journals, and some are even conducted outside of our awareness, but this experimental process is an essential part of our existence.”

Dr Will Meek is a post-doctoral fellow at the University of Delaware Centre for Counselling & Student Development (USA), and writes weekly at staffpsychologist.com.

Watching death

Susan Blackmore: “What happens when we die? Surely everyone wonders about this very human question, and it’s certainly caused much dissent between religion and science. While most scientists think that death must be the end of personal consciousness, most religious believers expect their soul or spirit to survive.

How can we find out the truth?

We know that roughly ten per cent of people who come close to death have “near-death experiences” (NDEs) in which they seem to travel down a dark tunnel towards a bright, warm light; see their body from above; experience vivid memories; and even enter another world or meet gods, angels or spirits. A few have mystical experiences of oneness with the universe, or experience the dissolution of the illusory self.

All these experiences can be accounted for, in principle, by disorganised activity in the dying brain. Yet this argument does not convince believers who argue that after all the brain activity stops, the soul or spirit still carries on.

Then there are claims that NDEers have observed details of the accident scene, hospital ward, or medical apparatus that they could not have seen with their physical eyes because they were unconscious at the time. These claims depend critically on timing, with believers saying the experiences happen during unconsciousness or clinical death, while sceptics argue they occur just before or afterwards. But without any means of timing the experiences this cannot be tested.

Some experimenters have placed concealed targets in cardiac care units, hoping that patients close to death may be able to see them, so proving they have really left their body, but no positive results have been obtained. This is what the sceptics would expect but is no proof that they are right.

So the impasse remains.

The most important experiment that’s never been done is to take fMRI or PET scans of people as they die; either those who really do go on to die, or those who suffer clinical death but are resuscitated. If this were done we would be able to test theories about how NDEs and mystical experiences are generated in the dying brain, and answer questions about the timing of the experiences. Perhaps even this would not resolve the final question once and for all, but it would certainly bring us a lot closer to knowing what happens when we die.

And why has it not been done? Because when someone is dying it is far more important to try to save their life than to do a scientific experiment. Nevertheless it could be done, and I hope that one day the technology will be so unobtrusive and easy to use that the ethical problem will disappear and we will be able to watch the dying brain as easily as we can now watch the living brain.

I think it would help us face death with more equanimity.”

Dr Susan Blackmore is a freelance writer, lecturer and broadcaster, and a Visiting Lecturer at the University of the West of England, Bristol. (Photo credit: Jolyon Troscianko).

A 2 x 3 x 3 x 2 x 2 x 3 x 2 x 3…experiment on the effects of contact on reducing prejudice and discriminatory behaviour

Pam Maras: “Social Identity Theory (SIT, Tajfel and Turner 1979) has been dominant in social psychological research for nearly 30 years, initially in Britain but now more widely. It has evolved and nuanced but is essentially still based on fundamental principles that we categorise ourselves and others and this affects the way that we think about other people and affects our own social lives. SIT has been suggested as a basis for reducing prejudice (Hewstone and Brown, 2005) in conjunction with Contact Theory (Allport, 1954). However, although supported by a wealth of experimental studies and increasingly complicated experimental designs, SIT has rarely, if ever, managed to achieve Tajfel’s main aim to explain large-scale human discriminatory behaviour such as found in WW2.

For me, the most important experiment that was never done would be on contact, and would include independent variables to meet all of Allport’s criteria: equal status, valued differences, cooperation and institutional support (at the highest level) for the contact situation. Dependent measures would be specific and generalised attitudes and behaviour towards a stigmatised group, as well as levels of anxiety about the contact.

Will my experiment ever be carried out? Probably not in a lab, and there lies a dilemma for experimental social psychology. My most important experiment would have an infinite number of cells, be ethically unsuitable and those factors essential to Allport’s theory would be impossible to manipulate as they are embedded in history and culture and not the increasingly sophisticated tool-kit of experimental psychology and intergroup relations. However, my experiment is already happening in the day-to-day lives of people and communities across the world. So the only way to run my experiment meaningfully would be in a real life context in specific real life situations (e.g. see Maras & Brown, 1996; 2000) or in large-scale applied studies in collaboration with scientists from other disciplines such as economics, anthropology, social welfare and political sciences (e.g. see Silbereisen’s 2005 study with sociologists and economists on adolescent development in the wake of German unification). Will my real life experiment ever be unnecessary? Personally, I hope so, but there is the conundrum because if Allport’s criteria are correct and met what would we have left to research?”

Professor Pam Maras is President of the British Psychological Society.