In the first study of its kind, researchers have asked people to describe in their own words what it’s like to live with Avoidant Personality Disorder (AVPD) – a diagnosis defined by psychiatrists as “a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation”. Like all personality disorder diagnoses, AVPD is controversial, with some critics questioning whether it is anything other than an extreme form of social phobia.
To shed new light on the issue, lead author Kristine D. Sørensen, a psychologist, twice interviewed 15 people receiving outpatient treatment for AVPD: 9 women, 6 men, with an average age of 33, and none of them in work. Writing in the Journal of Clinical Psychology, Sørensen and her colleagues said the overarching theme to emerge from the in-depth interviews was the participants’ struggle to be a person. “They felt safe when alone yet lost in their aloneness,” the researchers said. They “longed to connect with others yet feared to get close.” In the researchers’ opinion, the participants’ profound difficulties with their “core self” and in their dealings with others do indeed correspond to “a personality disorder diagnosis”.
With the number of referrals to the UK’s only gender identity development service (GIDS, at the Tavistock and Portman NHS Trust) increasing sharply in recent years – a pattern seemingly mirrored in other European countries and the US (anecdotally, at least — many countries don’t keep comprehensive data the way the UK does) – debate has inevitably intensified over how best to help transgender and gender nonconforming (TGNC) youth. As some expert clinicians have pointed out, there has been a tendency for commentators, campaigners and the general public to adopt an oversimplified view in which therapists are seen as fitting one of two categories: those who don’t believe their clients when they say they are trans (and who are therefore condemned by trans advocacy groups for practicing conversion therapy), and others who simply accept their clients’ statements about their gender, and who are therefore affirming or affirmative.
The clinical reality is more complicated: these days, there is a welcome consensus against actual conversion therapy — forcing a young person to “go back” to being cisgender — but at the same time responsible clinicians do not simply nod along to what a young person with gender dysphoria says. There are complexities inherent to childhood and adolescent development, and many experts warn it’s important not to accidentally medicalise perfectly normal qualms about growing up, hitting puberty, and being exposed to powerful and often frustratingly restrictive gender roles. Young people present at gender clinics with a wide variety of issues ranging from comorbid mental-health issues to unexamined trauma, and the process of helping them determine the best path forward, particularly with regard to medical interventions like puberty blockers or cross-sex hormones, is a lot more complicated than making a rapid decision to deny or approve such interventions.
Indeed, in an open-access practice review published in the BMJ last year, clinicians at UCL, GIDS and Great Ormond Street Hospital explained that the thorough psychosexual assessment period for such clients “usually takes 6 months or more over a minimum of four to six sessions” and involves a range of psychometric measures and interviews, covering the client’s expectations and understanding of social and physical transition, their mood and emotional functioning. The review adds that, “With the adolescents, there is an in-depth consideration of their sexuality and fertility, and possible preservation approaches are discussed. The attitude of important people in the child’s life towards gender dysphoria needs to be explored and understood.”
Now a study published in Psychology & Sexuality by a pair of Norwegian researchers, Reidar Schei Jessen and Katrina Roen, has explored these complexities from clinical psychologists’ perspective, including what it means to help a young person work through the issues they are facing and to make important decisions about medical treatment.
If you contemplate how a person’s life would be changed by starting to hear or see things others can’t, can you imagine it could offer anything good? A research team from Hull university and the surrounding NHS trusts suggest that among the tumult, hallucinations can also offer opportunities for growth. Writing in the Journal of Psychology and Psychotherapy, lead author Lily Dixon and her team detail the experiences of seven people who have lived with verbal or auditory hallucinations and how, amid the struggles, their journeys have taken them to some positive places.
Psychotherapists are devoted to improving people’s psychological health, but sometimes their efforts fail. A new qualitative study in Psychotherapy Research delves into what therapists take away from these unsuccessful experiences.
Andrzej Werbart led the Stockholm University research team that focused on eight therapy cases where the clients – all women under the age of 26 – had experienced no improvement, or in three cases, had deteriorated. This was based on comparing their pre- and post-therapy symptom levels following one to two sessions per week of psychoanalytically-focused therapy for about two years, to deal with symptoms such as depressed mood, anxiety, or low self-esteem.
Many training programmes for psychotherapists and counsellors include a mandatory personal therapy component – as well as learning about psychotherapeutic theories and techniques, and practising being a therapist, the trainee must also spend time in therapy themselves, in the role of a client. Indeed, the British Psychological Society’s own Division of Counselling Psychology stipulates that Counselling Psychology trainees must undertake 40 hours of personal therapy as part of obtaining their qualification.
What is it like for trainees to complete their own mandatory therapy? A new meta-synthesis in Counselling and Psychotherapy Research is the first to combine all previously published qualitative findings addressing this question. The trainees’ accounts suggest that the practice offers many benefits, but that it also has “hindering effects” that raise “serious ethical considerations”.
Many millions of people around the world have taken the “implicit association test (IAT)” hosted by Harvard University. By measuring the speed of your keyboard responses to different word categories (using keys previously paired with a particular social group), it purports to show how much subconscious or “implicit” prejudice you have towards various groups, such as different ethnicities. You might think that you are a morally good, fair-minded person free from racism, but the chances are your IAT results will reveal that you apparently have racial prejudices that are outside of your awareness.
What is it like to receive this news, and what do the public think of the IAT more generally? To find out, a team of researchers, led by Jeffery Yen at the University of Guelph, Ontario, analysed 793 reader comments to seven New York Times articles (op-eds and science stories) about the IAT published between 2008 and 2010. The findings appear in the British Journal of Social Psychology.
Although psychotherapy is effective for many people, it doesn’t help everyone. In fact, in some cases it can do more harm than good. And while clinical researchers publish many studies into the outcomes of different therapeutic approaches, such as CBT or psychoanalytic psychotherapy, we actually know relatively little about the specific therapist behaviours that clients find beneficial or unwelcome.
A new study in the Journal of Clinical Psychology, although it involves only a small sample, has broken new ground by asking clients to provide detailed feedback on a second-by-second basis of their experience of a recent therapy session, and to explain their perspective on what took place. Intriguingly, the very same therapist behaviours were sometimes identified as helpful and at other times as a hindrance, showing just what a challenge it is to be a therapist.
“It is important to recognise that all therapists are going to make mistakes,” write Joshua Swift at Idaho State University, and his colleagues. “Perhaps the success of the session does not depend on whether errors are made but on the frequency of mistakes and how quickly therapists are able to repair them.”
We’re all familiar with the idea that nature can be psychologically uplifting. But for some people, a single, brief “peak experience” in a natural setting, lasting mere seconds or minutes, changes their view of themselves or their relationships with others so profoundly that their lives are positively transformed as a result. A new study in the Journal of Humanistic Psychology explores exactly how and why this happens. The researchers LIa Naor and Ofra Mayseless at the University of Haifa, Israel, advertised on the internet for people who felt they’d had a transformative experience in nature to get in touch for an interview. “It was not difficult to find participants; in fact many people replied and were eager to share their experience,” they wrote.
The experiences of people who’ve been through a gender transition have been studied and analysed by psychologists – showing, for example, improved psychological wellbeing and self-esteem after hormone treatment. But when it comes to their partners, there’s been much less research. According to a new study in the Journal of Social and Personal Relationships, though, they often go through a kind of life transition of their own, and while there are certainly challenges, there are often positive changes, too.
Deep brain stimulation is a medical procedure that involves implanting electrodes permanently into the brain and using them to alter the functioning of specific neural networks. A battery inserted subcutaneously in the chest provides the device with power. One application of the technology is as a treatment for Parkinson’s Disease, a neurodegenerative condition that causes tremors and difficulties moving. While the treatment can bring about an impressive alleviation of symptoms, research suggests that Parkinson’s patients often struggle to adjust psychologically. Now a case study published in the British Journal of Health Psychology has provided some of the first insights into what it’s like for a patient to contemplate undergoing surgery for deep brain stimulation, and then to adjust in the immediate aftermath.