Friday, May 24, 2013

Why Machines May Be The Best Therapists


Yesterday I talked about adolescents with BPD using technology to aid in therapy and recovery. Along that vein is this article that is discusses the possibility of computerizing therapy as a whole. Personally I think this is a horrible idea but let’s see what they have to say. It’s always good to be aware of what it is going on in the psychiatric community.

Why Machines May Be The Best Therapists

Robots can be trusted more than humans—especially where memories are concerned.
Published on February 23, 2013 by Christopher Badcock, Ph.D. in The Imprinted Brain


Research by Elizabeth Loftus over thirty years established that eye-witnesses’ recall of incidents could be influenced by the language of their interrogation: for example, using words like “smash” in relation to a car accident instead of “bump” or “hit” causes witnesses to report higher speeds and more serious damage. But more recent research has revealed that this so-called misinformation effect is not found if a robot does the questioning.

A group with a human and another with a NAO robot interviewer illustrated here were asked identical questions that introduced false information about a crime that the subjects had viewed. When posed by humans, the questions caused the witnesses’ accuracy of recall to drop by 40 per cent compared with those that did not receive misinformation as the former group “remembered” objects that were never there. But misinformation presented by the robot had no such effect despite the fact that the scripts were identical and that the experimenters told the human interviewers “to be as robotic as possible”.

The explanation presumably lies in the fact that, although the 23-inch high android robot has eyes, a synthesized voice, and is capable of gestures, it is not able to bring the subtle expressions to an interview that a human being could—and is certainly not capable of sophisticated mentalistic responses that might exert further, even more sensitive effects on those being interviewed. As the lead researcher points out in New Scientist, (9 February, p. 21) “We have good strong mental models of humans, but we don’t have good models of robots.”

In fact, we relate to them rather as would to aliens, and to the extent that robots like these mimic what we might expect of an encounter with an alien, they have the same “autistic” effect: diminishing mentalism but encouraging the kind of mechanistic, computer-like memory you typically find in autistic savants like Kim Peek.

Elizabeth Loftus went on to research so-called “false memory syndrome” and did much to discredit the paranoia of child sex abuse witch-hunts. But these remarkable findings suggest that, were psychotherapy to be entrusted to suitably programmed computers, there would be much less risk of false memories being reported in the first place. And if being interviewed by a robot makes such a difference to the accuracy and objectivity of a person’s memory, what more could be expected where other aspects of mentalism were concerned, such as emotion, sociability, subjectivity, and self-consciousness? At the very least, a mechanistic psychotherapist would counter-balance the hyper-mentalism of psychotics, and even autistic clients might relate to it much better than to a human one.

It is now widely recognized that classical psychoanalysis is not an effective treatment for psychotics. Indeed, as a recent account points out: “The classic psychoanalytic approach (including free association and having the patient lying prone on a couch with the therapist out of sight) is contra-indicated.” Furthermore, “Therapists who work with schizophrenia patients need to have a high level of frustration tolerance and not have a need to derive narcissistic gratification from the patient’s efforts or progress.” Clearly, the role of the psychotherapist—and perhaps that of the psychoanalyst especially—is open to abuse and exploitation by the therapist for whatever reason—and there a lot of them!

But no conceivable computerized psychotherapist would be subject to similar temptations. On the contrary, intelligent interfaces that might develop into computer psychotherapists could exploit their very weaknesses where absence of real human motives, memories, needs, emotions, and ego were concerned to guarantee levels of objectivity, impartiality, and rationality to which few if any human psychotherapists could aspire. At the very least, their never-tiring silicon circuits would certainly guarantee a high level of frustration tolerance, and narcissistic gratification is something that only a hyper-mentalizing human being with an agenda of personal aggrandizement would seek!

Instead, like an alien intelligence from outer space, the machine mind would be ideally qualified to explore human mentality with an objectivity, detachment, and impartiality that no human being could ever achieve. Even better, the wholly mechanistic basis of the machine’s mind would mean that it was ideally tailored to help where psychotics need help the most: in de-hyper-mentalizing and re-balancing their cognitive configuration in the mechanistic direction.

So not just in general terms, and in relation to the human race as a whole might the alien invasion of the future—intelligent, Turing-tested machines—be crucial where our understanding of ourselves is concerned: it could transform individual psychotherapy and give those who needed it unique and otherwise unobtainable insights into themselves—something psychoanalysis always promised, but seldom if ever delivered.

(With thanks to Steven M. Silverstein, whose remarkable research on blindness and risk of psychosis was the subject of a previous post.)

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So what do you think about that my fellow Borderline friend? How would feel about talking to a robot shrink? Any feasibility here? Okay I kind of feel like this article was written with a bit of tongue in cheek. At least I hope it was, except considering it’s source and the fact that it was written by a prominent Doctor of Psychiatry and published makes me fear it was not.

On an intellectual level. I get it. It also makes me understand why some women are drawn to sociopaths. From a purely analytic stand point, yes, for assessment and diagnosis sure, robots might be an excellent aid. A tool in the therapeutic process. But the Therapist themselves? Hell no. They would be an utter failure. Especially for people like us.

They could spit out a pre-ordered list of behavioral techniques and advice when certain keywords are triggered, but other than that???

How would a robot offer true guidance? How would a robot offer comfort and security? How would a robot establish a therapeutic relationship? AGAIN, this concept of therapy ONLY works on the idea that people will take quickly and easily to the idea of therapy and compile quickly. What part of psychotic or disordered makes you believe that this will happen? At all?

Not to mention, I would just feel a little bit silly talking to a box with eyes. I’d rather put in the work with a real human being. Especially in the case with BPD it’s really important that we learn how to develop healthy functioning relationship skills. Having a robot therapist is pretty much the definition of how NOT to do this, haha. 

As a screening tool? Sure. A diagnostic aid? Great! As an actual therapist? Don’t be lazy.

What do you think? 

Music from the Borderline: Factotum - Slow Day

I haven't done this for a while. Don't worry I'll post later as well, but this is how I've been feeling for a while relationship-wise. Life-wise though everything has been pretty fabulous. I think I know where I need my changes.







FACTOTUM - SLOW DAY 

It's just a slow day
Moving into a slow night
It doesn't matter what you do

It's just a slow day
Moving into a slow night
It doesn't matter
It doesn't matter what you do

Everything just stays the same
The cats sleep it off, the dogs don't bark
Everything just stays the same
There's nothing even dying

Waiting through a slow day
Moving into a slow night
It doesn't matter what you do

Its just a slow day
Moving into a slow night
It doesn't matter
It doesn't matter what you do

Everything just stays the same
You don't even hear the water running
Everything just stays the same
The walls just stand there and the doors don't open

More waiting through a slow day
Moving into a slow night
Like tomorrow's never going to come
Its just a slow day
Moving into a slow night
It doesn't matter
It doesn't matter what you do

Just a slow day
Moving into a slow night
It doesn't matter what you do

Its just a slow day
Moving into a slow night
Like tomorrow
Like tomorrow's never going to come

And when it does
When it does
It'll be the same damn, damn thing

Thursday, May 23, 2013

Borderline and Adolescent? Ideal For Computer Psychotherapy!


Hey Everyone. I’m alive just a bad bit of food poisoning. Anways, back to Hyper-mentalism!


The Imprinted Brain
How genes set the balance between autism and psychosis
by Christopher Badcock Ph.D

Borderline and Adolescent? Ideal For Computer Psychotherapy!
Hyper-mentalism is confirmed as the cause of BPD and computer therapy indicated.
Published on March 9, 2013 by Christopher Badcock, Ph.D. in The Imprinted Brain


previous post flagged up some remarkable findings derived from use of the Movie for the Assessment of Social Cognition (MASC), which confirmed the prediction of the diametric model where hyper-mentalizing in Borderline Personality Disorder(BPD) was concerned. Now—and for the first time ever—a further study has used similar means to try to ascertain whether a reduction in hyper-mentalizing is achieved following treatment of adolescent BPD inpatients and whether other forms of mentalizing are also reduced.

The first major finding of the study was a specific relation between borderline traits and symptoms on the one hand and hyper-mentalizing on the other that appears to be independent of most other anomalies of mentalizing—again confirming that hyper-mentalism is the problem.

The second major finding of this study was that the tendency to hyper-mentalize “was malleable by inpatient treatment,” and as I pointed out in the previous post, suitably programmed computers might help. Indeed, adolescent BPD patients might be ideally suited to computerized psychotherapy for three very good reasons.

First and foremost, their age: Adolescents today are already familiar with computer technology of all kinds, and so would not experience the difficulties that older patients might in being confronted with it.

But age cuts both ways. The problem here is that, in accordance with the Flynn effect, there has been “a huge adult vocabulary gain of 17.80 points” averaging 0.328 points per year since 1950 in the USA. Flynn adds that “What was unanticipated is the huge difference between adult gains and child gains: adults have opened up a gap of 13.40 IQ points or 0.893 SDs.” He concludes:

"Circa 1950, when parents addressed their teenage children the latter understood them and answered in kind. Today, their children understand them. But to a significant degree, they cannot answer in kind or use their parents’ vocabulary when talking to their peers or anyone from the adult world."

Psychotherapists also belong to the adult world, and so this is another reason why they should consider computerized alternatives. You could design systems to which adolescents would be better able to respond than they would to an actual adult!

Finally, BPD might be particularly susceptible to computerized psychotherapy because it represents a high-functioning form of psychotic spectrum disorder (PSD).

Where autism spectrum disorder (ASD) is concerned, high-functioning subjects are most likely to be helped by mentalistic and social skills training, simply because their IQ is in the normal range (or even above it) and because their deficits are not too disabling. Exactly the same would apply to high-functioning PSD—except of course that it would be mechanistic and anti-hyper-mentalistic skills training that would be indicated, and no better way of delivering it can be found than computers. Indeed, something like MASC would lend itself very readily to computer-based, self-paced de-mentalizing training.

As I have commented before: computerized psychotherapy has a great future and will probably become the therapy of choice for PSD as well as ASD, albeit for diametrically opposite reasons!


(With thanks to my colleague and co-author of the imprinted brain theory, Bernard Crespi.)


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Yet another argument for active parenting, earlier therapy for adolescents and adolescent diagnosis of Borderline Personality Disorder. Even if it's determined that labeling the diagnosis is not the best course of action, active therapy to work on the symptoms is still probably going to do a world of good.... you know, if you can manage to get your teenager to stop rebelling long enough to listen to you, stop yelling, and actually go to therapy long enough to actually get anything accomplish. Goodness knows my parents couldn't. So yeah, easier said then done. In theory it is yet another argument. 
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