My interest in psychology actually began in Kindergarten when I noticed that I could look "through" a hurricane fence and by focusing on the wire, make the fence "appear" to be at a different depth. I experiemented with this kind of perceptual phenomenon throughout school. In ninth grade, I read the works of Sigmund Freud and began interpreting dreams. I worked as a Child Care Worker through my undergraduate days in a psychoanalytically oriented hospital. While I found working with the kids a great experience, I was underwhelmed with the psychoanalytic approach.

For instance: Here I was a sophomore and we had a boy come in who wouldn't eat. The psychiatrists were all fascinated because anerexia nervosa is overwhelmingly an affliction of females. In fact, the psychoanalytic interpretation is that the girl wants to prevent becoming an adult. To me, it seemed obvious that this boy had a physical problem, not a psychological one. There was nothing "psychological" in the way that he wouldn't eat. Of course, the psychiatrists were all M.D.'s. In fact, the rationale for having psychiatrists become M.D.'s is so that they can rule out physical causes. But none of them did. Till it was too late. The autopsy showed that the kid had a tumor in the pituitary and hypothalamus.

Here's another incident: A kid had spent all day building a model car and one of the other kids broke it. The following dialogue took place between a nurse and the kid.

Nurse: "Why are you upset?"
Kid: "David broke my car!"
Nurse: "Why are you really upset?"
Kid: "I told you! He broke my car!!"
Nurse: "Okay. Maybe you'd better go to the quiet room till you can tell me why you're really upset."

The irony of the hierarchical structure of the hospital was not lost on me, even as a college kid. At the top were the psychaitrists who got lots of money and had lots of power -- and saw the kids one or two hours a week. Next, we're various specialists who saw the kids a few hours a week. Next, were the nurses who spent maybe ten hours a week with the kids. Then, there were people like me -- child care workers -- who spent virtually ALL their time with the kids and got paid very little and had very little say over the kid's treatment. Finally, below the bottom of the pyramid were the patients themselves.

The importance that the psychiatrists attached to themselves can hardly be overstated. I recall one incident in which one of the kids had had a long-standing relationship with one of the nurses who was quitting. Now, this nurse had interacted with this kid ten or more hours a week for three or four years. The kid was upset about her leaving and said so.

But do you know what the kid's (new) psychiatrist said? That the kid didn't really care about the fact that the nurse was leaving. This was only a displacement of his real feelings of rejection because the psychiatrist was going on a ONE-WEEK VACATION! I could not and am not making this stuff up. (For my fiction, see the short story pages).

For a detailed look at the experimental evidence about therapy, see Robyn Dawes book, "House of Cards."

Later in my career however, I began to read about and take courses in behavioral therapy and later cognitive therapy. These treatments seemed to be based on psychological findings and there was some empirical evidence to support their effectiveness. I took a five day intensive coure in Rational-Emotive Therapy in New York City with Albert Ellis. Finally, I began a two-year fellowship there.

In this kind of therapy (which is geared toward neurosis, not psychosis), a variety of behavior, cognitive, and emotive techniques are used to help the client become aware of their own habits of thought. Once these are made explicit, the client may well decide to change some of them in order to behave differently and feel differently. The therapist can help the client do this by offering a variety of experiences and techniques though the actual work of change is difficult and must be done by the client. Change is often uncomfortable at first.

For example, if you go to England and have to drive on the left side of the road, you will find it anxiety provoking at first, even though you "know" that it is the correct thing to do. It takes time for your emotional reactions to "catch up."

Generally, neurosis is caused because people take a fairly rational thought like: "If I do well on this speech, it will be a better thing for my career than if I do a bad job" and turn it into a vastly over-generalized thought like: "If I blow this speech, I'll be ruined. I'll die. I'll prove to everyone that I am nothing."

While Albert Ellis (like Carl Rogers) exhibits unconditional acceptance of the PERSON who has such beliefs (after all, the person as he or she exists at that moment, is part of reality; there is no point in not accepting), he tells the client in no uncertain terms that the belief itself is utter hogwash. In cognitive disputing, the person is asked to provide evidence for the belief or to offer a more reasonable belief. Behavioral techniques would include putting yourself in such situations and noticing that you don't die. Emotive techniques include the use of humor; for instance, imagining the headlines in the New York Times and all the invitations you would get from talk show hosts after you blew the speech.

When Ellis (or Zen Buddhists for that matter) advise people to accept or embrace reality as it currently exists, this sometimes causes confusion. What we are talking about here is a mental attitude of clarity and attention --- as opposed to whining about reality and expecting that somehow, by whining, things will change. "Acceptance" in this context definitely does NOT mean that you fail to take action to change a bad situation whether it's a bad relationship, a personal characteristic you want to change, or something about the world. But change begins with a clear understanding of what's there, followed by an intelligent plan and the courage to carry it out. Change does NOT typically occur from whining to yourself about the way things are. In fact, just the opposite is true. Whining is often a substitute for the much harder work of actually effecting change.

If you'd like to know more, visit the Ellis Institute Home Page at www.rebt.org

Interested in self-assessment? Here's an interesting page of various personality and ability tests along with data on their reliability (how consistently the test measures) and validity (how well the test results correlate with other criteria).

self-tests

here are some other links of possible interest, all of which came from an excellent on-line newsletter called At Health. For more information, see their home page.

NIMH - SCHIZOPHRENIA: QUESTIONS & ANSWERS Q&A from NIMH This informational booklet is published by the National Institute of Mental Health. One of the goals is to help the public understand some of the misconceptions about schizophrenia. The booklet addresses five main questions: What is schizophrenia? What causes it? How is it treated? How can other people help? What is the outlook for those suffering from this disorder?

TREATMENT OF SCHIZOPHRENIA expert opinion The Expert Consensus Guideline Series: The guidelines, developed by a panel of schizophrenia experts, address such issues as initial treatment strategy, selection of therapy techniques and/or medications, and options if the treatment plan is not successful. The guidelines include a Patient-Family Handout.

NATIONAL ALLIANCE FOR THE MENTALLY ILL (NAMI) National alliance NAMI has 140,000 members working for "improved treatment of and more research into these no-fault brain disorders and a better quality of life for those who suffer from them." The NAMI Web site offers general information and articles about schizophrenia research and treatment.

NATIONAL ALLIANCE FOR RESEARCH ON SCHIZOPHRENIA AND DEPRESSION Research alliance NARSAD, an organization formed from four major citizens' groups, "raises and distributes funds for scientific research into the causes, cures and treatments, and prevention of severe mental illness, primarily schizophrenia and depression." Resources on this site include a newsletter, frequently asked questions, an online pamphlet, and an invitation to join their mailing list.

CHILDHOOD SCHIZOPHRENIA RESEARCH AND DIAGNOSIS childhood schizophrenia "The similarity of childhood schizophrenia to the adult version, and the fact that it appears to be a more extreme manifestation of the same underlying processes, means that the study of childhood psychosis can yield important information about schizophrenia in general", according to Judith Rapoport, M.D. For information about the diagnosis of schizophrenia in children, visit the American Academy of Child & Adolescent Psychiatry page on "Schizophrenia in Children" at

SCHIZOPHRENIA: A HANDBOOK FOR FAMILIES for families Published by the Schizophrenia Society of Canada, the handbook is intended to "help families who are new to the illness to deal with some of the fear, sorrow and bewilderment that the contributors themselves had endured when little information about schizophrenia was available."

THE SCHIZOPHRENIA HOMEPAGE Schizophrenia Homepage This is a "non-profit resource & education site for Schizophrenia." The site includes: news, free e-mail updates, chat rooms, online support groups, and discussion areas.

DOCTOR'S GUIDE TO SCHIZOPHRENIA INFORMATION AND RESOURCES Doctor's Guide This site features medical news and information for patients or friends and family of patients diagnosed with schizophrenia and schizophrenia-related disorders.

MENTAL WELLNESS.COM Mental Wellness An online resource sponsored by Janssen Pharmaceutical with information about schizophrenia and other mental health issues. The site also includes a free confidential telephone support service for U.S. patients receiving Risperdal (risperidone) and to their families and caregivers.

FUTUR.COM IN PSYCHIATRY - WEBTRACK Reviews This European Web resource offers a monthly review of journal articles focusing on schizophrenia.

PUBMED - THE FREE MEDLINE Pubmed The following is meant to illustrate how you can make a search on the broad topic of "schizophrenia" more manageable. On MEDLINE a search for the word "schizophrenia" yields 41961 documents. If you narrow the search to "schizophrenia AND medication", MEDLINE returns 1767 documents. If you further limit the search to "schizophrenia AND risperidone", the number of documents retrieved will be reduced to 402.

Interestingly (at least to me), this type of therapy that I do, Rational-Emotive Therapy ties in with several other threads in my career. For example, helping the client find out their own "rules of living" is much like one of the steps in building Expert Systems. In effect, much of therapy is helping people become better problem solvers and thinkers. The blocks to Organizational Learning are actually much like the blocks to individual change. One of the major challenges in Knowledge Management is in making implicit knowledge explicit. Finally, another way to think of therapy is to understand the "story that people are telling themselves" and offer another one!

Here are some sites dealing with various aspects of depression.

DEPRESSION IS A TREATABLE ILLNESS: A PATIENT'S GUIDE Patient's guide This is a patient booklet published by the Agency for Health Care Policy and Research (AHCPR) and produced on the Internet Mental Health site.

WOMEN AND DEPRESSION FROM THE APA (AMERICAN PSYCHOLOGICAL ASSOCIATION ) APA guide for women Facts about women and depression.

DEPRESSION IN CHILDHOOD AND ADOLESCENCE AMERICAN COUNSELING ASSOCIATION series for professionals: part one. and series for professionals; part two.

INTIMACY AND DEPRESSION - THE SILENT EPIDEMIC depression and intimacy

NATIONAL DEPRESSIVE AND MANIC-DEPRESSIVE ASSOCIATION National Association

DEPRESSION.COM www.depression.com

POSTPARTUM DEPRESSION RESOURCE GUIDE postpartum depression

INTELIHEALTH - JOHNS HOPKINS HEALTH INFORMATION ON DEPRESSION From Johns Hopkins

MULTICULTURAL EXPRESSIONS OF CLINICAL DEPRESSION Cross cultural depression

While Rational-Emotive Therapy is geared primarily toward neurosis rather than psychosis, it can be quite useful for the "neurotic" problems that psychotics experience as well. Just as the average neurotic may be overly anxious about being overweight, the possibility of failing a test, etc.....so too, the person who is schizophrenic or depressed primarily for biochemical reasons, may also be "awfulizing" about their problem.

APA MONITOR ONLINE APA Monitor online

PSYCHIATRIC NEWS - AMERICAN PSYCHIATRIC ASSOCIATION American Psychiatric Association

AMERICAN COUNSELING ASSOCIATION - NEWS American Counseling Association This is the electronic news and practice bulletin of the ACA. The site currently features news items on the discipline of children with disabilities, managed care, and school violence prevention.

NATIONAL COALITION FOR PATIENT RIGHTS (NCPR) NCPR NCPR is a non-profit organization dedicated to the patient's right to privacy in health-care. The site directs visitors to news related to patient privacy, including articles in USA Today and the New York Times.

ABC NEWS - HEALTH AND LIVING It's all in your head The site has a section called "All In Your Head" with a weekly report on psychology and mental health issues.

CBS HEALTH NEWS CBS Health News Click "Health" on the menu bar at the top of the page.

MSNBC MENTAL HEALTH NEWS MSNBC Health News Mental health news from MSNBC.

CNN HEALTH NEWS CNN Health News News about general health issues.

NEW YORK TIMES New York Times health news First-time visitors will have to register. For health news, select "Science."

LOS ANGELES TIMES - HEALTH NEWS LA TIMES health news The site has articles on a variety of health topics, some of which are related to behavioral health.