IF YOU GOT "HAPPY" WOULD YOU KNOW IT?

The Satisfaction with Life Index. 

Blue through red represent most to least happy respectively; grey areas have no reliable data available.

The second of these “domains” that the psych people are trying to think their way through organizing is “Positive Valence Systems.”  There are a number of problems, some of which are listed in the NIHS minutes of discussion and some of which are not really considered.  http://www.nimh.nih.gov/research-priorities/rdoc/development-and-definitions-of-the-rdoc-domains-and-constructs.shtml

Notoriously, it is far more difficult to define mental health positives than negatives, though people since Maslow have been working at it.  “Negative Valence Systems”, the first one tackled by the National Institute of Mental Health (NIMH) in terms of reconciling and consolidating it with the new neurology science was easier in part because of decades of research by Joe LeDoux and his colleagues, specifically about fear and anxiety pathways.  Anyway, people who are maladjusted, hurting, or a pain-in-the-butt to others tend to seek out researchers in hope of relief.  Happy people are fine until there is some sweeping change to the world (climate change, political grid lock, economic hardships) that interferes with them.  These forces have been at hand recently.

http://www.cns.nyu.edu/home/ledoux/

Here’s what NIMH has so far.  It’s packed with jargon which I’ll try to paraphrase, but remember that I’m not a psych professional and might get their Latinate multisyllabics all wrong.  The acronym they’re using for this project is “RDoC” in case you’re trying to use search engines.

Approach Motivation Systems: 

Rather than asking, as Maslow did, what are the characteristics of a happy and healthy person, this category is more about how people go towards behavior that works in favor of growth and health.  It's a subtle difference.  “This is a multi-faceted Construct involving mechanisms/processes that regulate the direction and maintenance of approach behavior influenced by pre-existing tendencies, learning, memory, stimulus characteristics, and deprivation states.”  So these are the conclusions one’s brain has come to and stored to guide the management of what one does. 

“Approach behavior can be directed toward innate or acquired cues (i.e., unconditioned vs. learned stimuli), implicit or explicit goals; it can consist of goal-directed or Pavlovian conditioned responses.” Below are eight sub-categories, proposed so far.

"Eat your Wheaties, kid!"

Reward valuation. Processes by which the probability and benefits of a prospective outcome are computed and calibrated by reference to external information, social context (e.g., group input, counterfactual comparisons), and/or prior experience. This calibration is influenced by pre-existing biases, learning, memory, stimulus characteristics, and deprivation states. [Whatever makes you think this is a good thing to do.]

Effort valuation/Willingness to work. Processes by which the cost(s) of obtaining an outcome is computed; tendency to overcome response costs to obtain a reinforcer.  [Why get up in the morning? How much effort will you put in?  Will you accept the cost of an education?]

Expectancy/Reward prediction error. A state triggered by exposure to internal or external stimuli, experiences or contexts that predict the possibility of reward. Reward expectation can alter the experience of an outcome and can influence the use of resources (e.g., cognitive resources). [If things get tough, how much frustration can you tolerate?  What if the reward you expect just doesn’t materialize?]

Action selection/Preference-based decision making. Processes involving an evaluation of costs/benefits and occurring in the context of multiple potential choices being available for decision-making. [Making a career choice.  Choosing one of three doors.]

Initial responsiveness to reward attainment: Mechanisms/processes associated with hedonic responses—as reflected in subjective experiences, behavioral responses, and/or engagement of the neural systems to a positive reinforcer—and culmination of reward seeking.  [Why do they insist on using the word “hedonic”? What’s wrong with “pleasure?”  Having said that, we get pleasure from different things that may not be frivolous or obvious.] 

http://www.slideshare.net/bright9977/10-leadership-lessons-from-genghis-khan

Sustained/Longer-term responsiveness to reward attainment: Mechanisms/processes associated with the termination of reward seeking, e.g., satisfaction, satiation, regulation of consummatory behavior.  [ How much is enough? The opposite of addiction.]

Reward Learning: A process by which organisms acquire information about stimuli, actions, and contexts that predict positive outcomes, and by which behavior is modified when a novel reward occurs or outcomes are better than expected.   [When good things happen and rewards appear, do they register with you?  A lot of people can’t handle good times, praise, or security.  It feels stuck, boring.]

Habit: Sequential, repetitive, motor, or cognitive behaviors elicited by external or internal triggers that, once initiated, can go to completion without constant conscious oversight. Habits can be adaptive by virtue of freeing up cognitive resources.  Related behaviors could be pathological expression of a process that under normal circumstances subserves adaptive goals. [So -- you learned to do something so well that you barely know you are doing it, but now it doesn’t fit the situation.  It's a drag and a drain.  Can you get it up to consciousness and extinguish it?]

I’ll make my own list of comments:

1.  The main thing about positive rewards is distinguishing between those that address simple existence, like food or shelter, and those that are only rewards to some people.  Is opera a reward or a punishment?

"Then I thought: Why not me? I hemmed and hawed. 

I wanted to go, but debated. The cost of BART. Lunch out. 

But mostly it was the word: OPERA."

2.  This group of people doing the thinking has a particular set of experiences and therefore assumptions.  A high-end shrink with a proper couch and high fees is going to see a population that is VERY different from those of a prison chaplain or a Medecins sans Frontieres fighting ebola.  Beyond that, to achieve the level of education that qualifies people to be on these sorts of committees means that they have been socialized to accept a very specific set of beliefs about what to do and how to do it.  The existence of this boundary (frontieres?) means that they are excluding many -- maybe infinite -- points of view and sources of information.

3.  It is surprising that often the neurology structures that light up on fMRI's and so on for negatives are the same ones that light up for positives!  (S/M folks are not surprised.)  It's the SYSTEM.  This is the sort of thing that has to build up considerable credibility before it can have impact on what’s always been accepted as truth.  Organic neurology research has reached that point and the NIMH is forced to take it into account.

4.  Keeping track of the interaction between culture and pleasure is much more difficult because culture is constantly affecting what is success, why it’s success, and the consequences of success, which might be rewarding and punishing at once.  (Consider a top ballerina who is admired but who suffers physically in order to achieve.)  This is complicated again by overlapping cultures which contradict each other, like a ghetto kid whose peers think success in school is a marker of weakness while the kid’s mother is determined that success is only possible through education.  And what if the kid is dyslexic?  

ballerina feet

“Success” beyond simple survival is a slippery concept.  We tend to measure it with money, security, status, authority over others, admiration from those we care about.  What about contributions to society, cultural insight, or simply being virtuous -- except "virtue" takes us back to the same slippery ground as success.  Both are defined by participating in a culture, but cultures are incredibly various and contradictory.  In fact, the “standing order” of mental health systems may try to destroy this RDoC enterprise .  My guess is that there’s enough of a sub-culture -- humanistic, progressive, clinical -- to keep the project alive.  But not easily.  We should support this enormous re-framing.

PARADIGM SHIFT, SEA CHANGE, SCIENTIFIC ADVANCE.

"Sea Change" by Lynne Taetzch

Most of this post is taken from the online notice about a paradigm shift in the convictions of the British Psychological Society about psychosis and schizophrenia.  The British Psychological Society has released a remarkable document entitled “Understanding Psychosis and Schizophrenia.” Its authors say that hearing voices and feeling paranoid are common experiences, and are often a reaction to trauma, abuse or deprivation.

The report says that there is no strict dividing line between psychosis and normal experience.  The report adds that antipsychotic medications are sometimes helpful, but that “there is no evidence that it corrects an underlying biological abnormality.” It then warns about the risk of taking these drugs for years.

And the report says that it is “vital” that those who suffer with distressing symptoms be given an opportunity to “talk in detail about their experiences and to make sense of what has happened to them” — and points out that mental health services rarely make such opportunities available.

This is a radically different vision of severe mental illness from the one held by most Americans, and indeed many American psychiatrists. Americans think of schizophrenia as a brain disorder that can be treated only with medication. Yet there is plenty of scientific evidence for the report’s claims.

. . . For decades, American psychiatric science took diagnosis to be fundamental. These categories — depression, schizophrenia, post-traumatic stress disorder — were assumed to represent biologically distinct diseases, and the goal of the research was to figure out the biology of the disease.  That didn’t pan out. . . . 

Out goes all those often pejorative labels and the diagnostic handbook that no one but insurance companies liked.

Under a program called Research Domain Criteria, all research must begin from a matrix of neuroscientific structures (genes, cells, circuits) that cut across behavioral, cognitive and social domains (acute fear, loss, arousal). To use an example from the program’s website, psychiatric researchers will no longer study people with anxiety; they will study fear circuitry.

The major RDoC research domains:

Negative Valence Systems

Positive Valence Systems

Cognitive Systems

Systems for Social Processes

Arousal/Modulatory Systems

. . . The implications are that social experience plays a significant role in who becomes mentally ill, when they fall ill and how their illness unfolds. We should view illness as caused not only by brain deficits but also by abuse, deprivation and inequality, which alter the way brains behave. Illness thus requires social interventions, not just pharmacological ones.

ONE outcome of this rethinking could be that talk therapy will regain some of the importance it lost when the new diagnostic system was young. And we know how to do talk therapy. That doesn’t rule out medication: while there may be problems with the long-term use of antipsychotics, many people find them useful when their symptoms are severe.

The rethinking comes at a time of disconcerting awareness that mental health problems are far more pervasive than we might have imagined. The World Health Organization estimates that one in four people will have an episode of mental illness in their lifetime. Mental and behavioral problems are the biggest single cause of disability on the planet. But in low- and middle-income countries, about four of five of those disabled by the illnesses do not receive treatment for them.

T. M. Luhrmann, quoted above, is a contributing opinion writer and a professor of anthropology at Stanford.

Below is a working list from the British Psychology Society

• Hearing voices or feeling paranoid are common experiences which can often be a reaction to trauma, abuse or deprivation. Calling them symptoms of mental illness, psychosis or schizophrenia is only one way of thinking about them, with advantages and disadvantages.

• There is no clear dividing line between ‘psychosis’ and other thoughts, feelings and beliefs: psychosis can be understood and treated in the same way as other psychological problems such as anxiety or shyness. . . 

• Some people find it useful to think of themselves as having an illness. Others prefer to think of their problems as, for example, an aspect of their personality which sometimes gets them into trouble but which they would not want to be without.

• In some cultures, experiences such as hearing voices are highly valued.

Can a French shrink understand a Piegan?

("Jimmy P," a movie)

• Each individual’s experiences are unique – no one person’s problems, or ways of coping with them, are exactly the same as anyone else’s.

• For many people the experiences are short-lived. Even people who continue to have them nevertheless often lead happy and successful lives.

• It is a myth that people who have these experiences are likely to be violent.

• Psychological therapies – talking treatments such as Cognitive Behaviour Therapy (CBT) – are very helpful for many people. In the UK, the National Institute for Health and Care Excellence recommends that everyone with a diagnosis of psychosis or schizophrenia should be offered talking therapy. However most people are currently unable to access it and we regard this situation as scandalous.

• More generally, it is vital that services offer people the chance to talk in detail about their experiences and to make sense of what has happened to them. . . 

• Many people find that ‘antipsychotic’ medication helps to make the experiences less frequent, intense or distressing. However, there is no evidence that it corrects an underlying biological abnormality. Recent evidence also suggests that it carries significant risks, particularly if taken long term.

• The British Psychological Society believes that services need to change radically, and that we need to invest in prevention by taking measures to reduce abuse.

Walking the road . . .  ("Anne of Green Gables")

In my coming-to-consciousness years, even the ones before adolescence hit, I was aware that a person was unique and that society didn’t much like that unless a person is exceptional as an achiever.  The pattern was still left from wartime when there were soldiers -- obedient, predictable, uniform -- or officers -- who were expected to be brilliant and brave way above the norm. I rejected that pattern.  I wanted to take the side path.  Maybe it was the influence of Lucy Maude Montgomery and her “Anne of Green Gables” paradigm.  I didn’t pick up on romantic wandering in the blooming orchard so much as Anne cracking her slate over the head of Gilbert when he teased her.  But she did turn out to be exceptional.

The endless (literally -- they were played in a loop) newsreels that preceded today’s television news did not spare us the misery of WWII -- though any place not in contention was just a sort of blank and there were plenty of heroes.  Between the two factors of taking whatever action was necessary and high awareness of mass misery, both of which have remained part of me, this remarkable sea change in understanding psychological dilemmas and reconciling them with the new brain studies is very welcome. 

"Thousand yard stare"  By Tom Lea

I’ll research each of these domains named to see what they are talking about.  One post per domain might work.  Or things might turn out to be unexpected for everyone.  One development might be recognition of how much industrial chemicals are infiltrating our bodies and what they do to our minds, our genders, and our survival.  It may turn out that the pervasive plastics are as significant as viral infections.  Our true drug-induced madness may be food additives.  Or we may have just become allergic to ourselves.