Online Courses and CE: We offer a series of online educational programs for professionals and the public. Visit us here for previews and discounts on our online programs.

Follow PsychologySalon on Facebook: Become a fan of the PsychologySalon page; updates will appear in your news feed.

Looking for a therapist? We have eleven registered psychologists in our clinic, and we are accepting new clients. For information, visit www.changeways.com.

Wednesday 14 September 2016

Why is North Carolina Making Sexual Assault Easier? The Mystery of the Bathroom Bill

An alternative: The Toronto approach.
Unless you have been living under a rock, you have no doubt heard about North Carolina Governor Pat McCrory and his government’s House Bill 2, the Public Facilities Privacy and Security Act. This bill states that people can only use public restrooms and changing rooms corresponding to the gender on their birth certificates.

The point of the bill is to prevent transgender people from using the restroom associated with their gender identity. The rationale is that this protects women and children from the risk of sexual assault in public restrooms.

But it doesn’t. HB2 (and related bills proposed in other states) makes sexual assault easier. Much easier. And it does so in such an obvious way that, no matter how thick-headed, every legislator proposing or voting in favour of it knew what they were doing.

Back up. Is this really a problem?

Well, there are two possible avenues.

  1. A male to female (MTF) transgender individual commits an assault in a women’s facility.
  2. A non-transgender male pretends to be a trans woman in order to gain access to a women’s facility and commits an assault.

Every so often, someone panics over a crime that you have never heard of. Sometimes, it’s a crime that has never actually happened. In discussions of the issue in North Carolina, no one could point to a single case in which a trans woman, or anyone pretending to be one, has assaulted a person in a women’s restroom.

No matter. It was a crisis as far as Pat McCrory was concerned, and he was not about to let its mythological nature deter him from protecting the women of North Carolina. (Next year, they may outlaw the riding of unicorns on state highways.)

Let’s try to imagine scenario #2 for just a moment.

A male sexual offender wannabe decides to assault a woman, and chooses the one location where he will be most conspicuously out of place: a women’s washroom. In order to gain access to said facility, he dresses as though he was MTF trans. Hair. Clothing. Close shave. Makeup. Shoes.

He’s probably not very good at it – and in fact the bill presumes he isn’t. If he “passes” as female, no one will be the wiser and the law won’t make any difference. If he’s not very good at it, he’ll be conspicuous. People will notice him in the area, and remember which way he went.

But now he can’t do that.

Right. He doesn’t need to disguise himself as a trans woman. No need for the dress, the hair, the shave, the makeup, the shoes.

He can disguise himself as a trans man instead.

Under the new law, he can sport a full beard, ripped t-shirt, and blue jeans, and walk straight into a women’s restroom. If he’s challenged, Pat McCrory has given him his story.

“This is the washroom for my birth gender. The governor says I have to use this one.”

Then he can carry out his mission, exit, and walk away. He’ll only be conspicuous for the moments when he is actually going in or out the restroom door.

So much easier. It’s as though the Sexual Assault Association of North Carolina (SAANC) was a lobby group. “Hey, governor, could you make it easier to get into women’s washrooms? These shoes are really a pain.”

Let’s be clear: Trans men are no more of a risk than trans women are. It’s the imposters that could conceivably be a problem – though they haven’t been so far. And they’ve just made the imposter job easier.

How did they miss that?

They didn’t.

There are MTF transgender people, and FTM – as everyone knows. Even if you are a North Carolina legislator. Ban trans women from women’s washrooms, and you force trans men to use them. It’s obvious and unmissable. So it wasn’t missed.

The bill has nothing to do with preventing sexual assault. The bill is a straightforward expression of disapproval aimed at transgender citizens, voters, and taxpayers.

Governor McCrory and his associates passed a bill out of nothing but transphobia, justifying it by saying that they were protecting women while knowing that, if anything, they were making women less safe.

But this wasn’t a problem. The protection of women was never the point. It was just lip service. Again.

*   *   *

My book How to be Miserable: 40 Strategies You Already Use is on sale now at bookstores and online booksellers.

YouTube VLog

I have now launched a YouTube VLog on psychological topics called How to be Miserable, with new posts every Tuesday and occasional Thursdays! Come take a visit and see what you think. Consider subscribing (just press the big red SUBSCRIBE button on the page) to ensure that new videos appear in your YouTube feed.  Here's the intro video:


Monday 11 July 2016

Forget the Inner Child. What about the Inner Adult?


Sometimes steering is important.
In the book How to be Miserable: 40 Strategies You Already Use, we acknowledge the grinding tedium of the quest for a better life, and provide tips to adopt a more miserable one instead. Those recalcitrants unwilling to relinquish the upward path can always do the opposite…

One sunny spring day in the early 1990s I was walking the hospital grounds with a colleague on one of his periodic cigarette breaks between clients. We were talking about the then-fashionable concept of the inner child, based on the idea that many adult problems are the product, at least in part, of trauma and shame from childhood. It is a reasonable and useful concept.  
"I don’t know,” he said. “More of the people I see need to find their inner adult, not their inner child.”

It sounds as though he was slagging his clients, making one of those remarks that sometimes flow from the mouths of clinicians on the edge of burnout.

He wasn’t. He was one of the most compassionate – and effective – clinicians I have had the pleasure of working with.  He was making a valid point.

Sometimes we run into emotional trouble when we lose track of our childhood selves, our true desires and interests, the sources of energy and drive in our lives. We base our behavior entirely on the demands of the moment, the expectations of others, or the norms of our society. As we do so, the life leaks out of our lives like helium from a balloon. We have become, to use a half-joking psychodynamic expression, disconnected from our ids. Therapy consists of an effort to become id-connected once more.

But often a disconnection with our childhood self is not the problem – or not the main one. Instead, our lives have gone astray because we have handed control over to our emotions and impulses, allowing them to determine our course and actions. The therapeutic mission is to get our hands on the tiller and steer.

Everyone’s life wobbles.

We fantasize about finding the key to existence, the one true path, the inner sense of direction that will allow us to relax and coast without constantly having to adjust our course.

This is a lost cause. Just as the direction of a sailboat needs constant adjustment if one is to reach one’s destination, our lives require conscious attention as we notice ourselves slipping to one side or the other.  My colleague was not speaking only of his clients. He was acknowledging a general principle of existence.

I can detect it in my own life. Sometimes my mood begins to go astray because I have been too relentlessly focused on the demands of my life. I have been managing the clinic, ensuring the taxes and recordkeeping are up to date, mowing the lawn, and behaving like an overly responsible adult - doing nothing for the sheer fun of it. It is at times like these that I need to go on an Easter egg hunt for the inner child.

Just as often, however, the problem lies in the other direction. I have been putting off responsibilities, allowing needed repairs to go unattended, and allowing chores and paperwork to build up until they are overwhelming. The problem of these times is not to access the inner child, but to develop a stronger relationship with an equally important aspect of the personality: my inner adult.

The inner adult is the part of all of us that enables us to override our immediate impulses. To say "Why yes, I would like another beer. But no, I don’t think it’s a good idea so I’ll pass.” To take the car in for an oil change when we would rather sit and surf the Internet. To get ourselves to exercise when we would prefer to do almost anything else.

We need both: the inner child AND the inner adult. For the past 40 years in psychotherapy we have tended to emphasize the former, and to treat the latter as more of a barrier to be overcome. The inner adult is regarded as the inner schoolmarm, or the inner party pooper: a conservative, anal, soulless advocate of conformity and boredom.

Perhaps it is this demonizing of the inner adult that accounts for the frequency with which its absence sabotages people’s lives. After all, if you have been told for decades that if it feels good, you should do it, this can become one of your guiding and unquestioned life principles.

If the id or the inner child is the source of energy, drive, and selfish pleasure, then how can downshifting its balancing force be a road to misery? Take a look at the difficulties for which people seek out therapy.

  • The overindulgence in mind altering substances. 
  • The inability to control impulsive anger. 
  • The tendency to put one’s life in the control of fears that one knows to be irrational. 
  • Difficulties getting to work on genuinely held but often difficult life projects. 

These are the mission specialties of the inner adult. It is the inner adult who leaves the marshmallow on the plate until the experimenter returns with the second one. It is the inner adult who opens the calculus textbook when The Simpsons is on. It is the inner adult who strives to understand your partner’s point of view instead of simply lashing out.

It is even the inner adult who does the hard work of therapy, facing fears and difficult truths, building gradual change, and excavating past the settlement of life’s demands in search of its balancing force, the inner child.

So to be miserable, view adulthood as the enemy. Ignore the importance of fortitude, reliability, courage, and dedication. If it doesn’t feel good every moment, don’t do it. View the child and adult as implacable enemies rather than as partners in the creation of a fulfilling life.

In sailing, port and starboard are both essential principles. Ignore port and indulge only starboard, and your journey will be in circles.


Saturday 25 June 2016

The $10 Million Question: What if you could win lots of money by making yourself feel worse?


Even seasoned clinicians often find the first session of group therapy daunting. The participants are new to the room, new to the approach being taken, and new to each other. They sit eyeing one another with deep reserve.

It is the job of the group leader to stitch this collection of strangers together into a functioning group. But in those first moments there is scant sign that such a transformation is possible. If the participants are clinically depressed, the oppressively flat energy in the room can add to the challenge. And if they are just out of hospital, well … it can seem all but hopeless.

That’s the scenario that faced us when the Changeways Program staff began offering our post–hospitalization depression groups. Most of the clients had been in therapy before, and virtually all had tried a variety of medication-based approaches. They were understandably skeptical that anything that might happen in our little group would have much of an effect on their lives. We could try cheerleading them, extolling the wonders of cognitive behavior therapy, but this was unlikely to get them charged up.

Instead, we tried to going in the opposite direction.

“Did you happen to see the $10 million sitting there in the middle of our table?”  I would ask.

The clients would glance quickly down at the empty conference table and narrow their eyes at me suspiciously.

“Imagine that you could win all of that money tomorrow morning. All you would have to do is make yourself more depressed than you are now. More depressed than you have been all this week. How would you do it?”

A few clients would reject the idea. Still not worth it.

One client observed, wryly, “So far, I have been doing this for free. $10 million? Fine.”

We would go around the room and get one idea from each person. Then we’d throw the floor open and ask for more. The answers would come haltingly at first, then would spill out in a rapidly developing flood. The leaders, writing the ideas on the board, would be straining to keep up. And despite the contrary nature of the exercise, the emotional tone in the room would lighten.

What was the point of this foolish question?

First, most of our clients felt that they had no control over their emotions. The exercise proved to them that this was false: they could make themselves feel even worse if for some reason they wanted to do so.

Second, they invariably noticed something. They were already doing many of the things on the list. Staying in bed. Isolating. Eating junk food, or eating not at all. Focusing on the negative. Ignoring the positive. Anticipating future disasters. Rehearsing past losses. If these truly were paths toward lower mood, perhaps their depressed state was somewhat less mysterious.

But wait. If they were choosing to do these things, did this mean that they wanted to be depressed? Almost certainly not. Depression affects not only our mood, or our thoughts. It changes our motivations as well. Normally we might look forward to the family barbecue this evening. When our mood is low, its appeal will vanish and the quiet solitude of our bedroom may sing its siren song to us instead.

This seems to be a standard principle not only of depression but of low mood in general. As our emotional tone darkens, we become motivated to do precisely that which will make us feel even worse. If we follow our temptations, we will skip inadvertently downhill. Arresting the decline may first involve stopping what we are doing, then turning around and doing the opposite.

Today, the $10 Million Question has become a standard part of my repertoire, whether I am seeing someone suffering from clinical depression, or a person just feeling vaguely blah about life, the energy slipping out of them like helium from a balloon. The path upward often seems obscure and unknowable.  The path downward, however, is easy to find. And, given that it is a two-way street, the two routes are one and the same.

A Game Anyone Can Play

Try it yourself. Sit down with pen and paper and ask what you would do if it was your agenda to feel worse, to lose direction in life, to deflate your enthusiasm. How would you think? What would you do?

Some of the answers you arrive at may be unique to you. Most will not be. Modern culture trains us in a wide variety of methods of cultivating unhappiness. We engage in them unintentionally and share them with others.

Come up with 10 strategies. Then sit a little longer and come up with 10 more. Give yourself at least 20 minutes. Then carry around pen and paper for three days. Having asked the question, answers will pop into your head long after you thought you were done.

And Then What?

Each of the strategies that you come up with is a choice point. Having found the road, you can turn right or left.  Upward or downward. It may not be easy to choose the unfamiliar path. But the first step is simply to recognize the choice.

In weeks and months ahead we will examine some of the most effective strategies for becoming more miserable. Some of these will be individual. Some may be in relationships. Some may be cultural. A few will involve paying too much attention to mental health “experts” like me.

You may think that we are doing nothing but creating a map of life’s potholes. You would be right. So if you want to find pothole, you’ll know where to come.

But if you want to avoid them, you’ll have to know where they are.

What are your strategies?

Write to let me know what brings you down, and to ask questions you think might relate to the topic of this blog. I can’t give clinical advice relating to a specific problem you face – this isn’t an Agony Aunt column, after all, and I haven’t met you and don’t know all the details of your life. But I’d like the dialogue to be two-way if possible.

I can be reached at drrandypaterson@gmail.com. Please understand that time and professional constraints mean that I cannot reply personally, but a selection of comments and questions will appear in the blog from time to time.

The $10 Million Question is central to the ideas behind my new book, How to be Miserable: 40 Strategies You Already Use (New Harbinger) - now available from Amazon, Barnes & Noble, Indigo, and booksellers everywhere.


Sunday 12 June 2016

And in America, Gunshot. Again, and again, and again. A repost.


Recent tragic events have reminded me of something.

In the late 1980s I briefly worked part time on a spinal cord injury rehabilitation unit. The majority of patients were young males – which, I understand, is common for these units. I worked with patients on adjustment to their injuries and the requirements of their altered lives.

The head of our service had worked there for a number of years. I asked him to tell me the most common accidents that would bring people to the unit. He said something that stuck in my mind.
Then I heard someone else, at another facility, say exactly the same thing. I began listening for the list, and heard it over and over again.

“Motor vehicle accident, work-related injury, sporting accident.  And in America, gunshot.”

And in America, gunshot. Those four words, repeated virtually verbatim, again and again.

I saw people injured in motor vehicle accidents. This was, far and away, the most common route of entry to our unit. I saw people who had been injured on the job. I saw two who had athletic injuries (one hockey, one diving). But I never saw anyone who had received the injury via gunshot.

An Ontario study of the epidemiology of spinal cord injury (Pickett et al, 2006) seems to bear out the Canadian impression.  Of patients aged under 65, 43% received their injury in motor vehicle accidents, 24% from falls of various sorts, 12% from accidents involving other vehicles (bicycles, ATVs, and so on), and 9% in sports-related incidents. Only 5% were injured as a result of violence of any kind; it was not mentioned how many of these were gunshot-related.

A review of US data (DeVivo, 2012) confirms a much higher incidence of violence-related spinal cord injury, though this appears to have been declining in recent years (12% since 2000, but 21% in the 1990s). Given that military personnel (at risk for violence-related spinal cord injury on the battlefield) are typically seen in their own hospitals, the actual figure may be somewhat higher. And the reduction in the percentage may not translate into a reduction in actual numbers, given that the overall incidence of spinal cord injury is increasing.

It sticks in the mind, that phrase.  And in America, gunshot.

Particularly when grown adults continue to stand on their hind legs and argue that arming high school staff will prevent school shootings.

Apparently not always. Columbine High School had an armed guard. And of course, most mass shootings don’t happen within schools. Restricting ourselves just to the ample list from the past few weeks in the USA, we’d have to arm cinema staff, retail clerks, and all homeowners as well.

Odd that despite the fact there are so many more armed guards and armed private citizens in the US, it continues to suffer so many incidents like these. We are not immune to them in other countries. Canada had an incident in Montreal in 1989, and there have been others. Even placid Norway has had a horrific example. But the rate does seem lower in developed nations other than the US.

A moment of opportunity seems to have arisen after the most recent school shooting. The NRA’s spokesman made his fatuous point and was widely and rightly ridiculed for it.

America may be ready to shake off its traditional explanation for these events: “We are simply worse people. More prone to violence, less able to solve matters like adults, less caring of one another’s welfare.”

Maybe it’s not true. Maybe it was never true. Maybe it was the guns after all.

References

DeVivo, MJ (2012). Epidemiology of traumatic spinal cord injury: Trends and future implications. Spinal Cord, 50, 365-372.

Pickett, GE, Campos-Benitez, M, Keller, JL, & Duggal, N (2006). Epidemiology of traumatic spinal cord injury in Canada, Spine, 31, 799-805.

Tuesday 7 June 2016

The Art of Manliness: Interview

The Art of Manliness is a website and podcast designed to help users explore and navigate the ins and outs of being male in the 21st century. They invite speakers from diverse perspectives to share their views on a wide variety of issues - not all of them directly related to gender.

I spoke with interviewer Brett McKay about my new book How To Be Miserable: 40 Strategies You Already Use. Here's a link to the resulting podcast:

http://www.artofmanliness.com/2016/05/26/podcast-204-how-to-be-miserable/

How to be Miserable is available for pre-order from Amazon.comAmazon.ca and other online booksellers now.

To Get Happier, Focus on What Makes You Miserable: New York Magazine

Last week I spoke with David Marchese from New York Magazine about my new book How To Be Miserable: 40 Strategies You Already Use.

Here is a link to our interview:


http://nymag.com/scienceofus/2016/06/to-get-happier-focus-on-what-makes-you-miserable.html

How to be Miserable is available for pre-order from Amazon.comAmazon.ca and other online booksellers now.

How to be Miserable: Outside The Box

A few weeks back I spent some time in Toronto working on the release of How To Be Miserable: 40 Strategies You Already Use. While there I had a request to meet with the people at Context With Lorna Dueck for an episode of Outside the Box. I spoke with Sheldon Neil.

Here's the interview:



How to be Miserable is available for pre-order from Amazon.comAmazon.ca and other online booksellers now, as well as at bookstores.

Tuesday 31 May 2016

YouTube Revisited

At last, the YouTube channel featuring all of the promos for PsychologySalon's online courses has been revamped and relaunched. Here it is:

www.youtube.com/channel/UCMamfNEZjh8ui2g_tdNySPA

As you'll see, the host site for the online courses has also changed and is much improved. Here it is:

psychologysalon.teachable.com

Easy to remember. Just insert "teachable" in the middle of Psychologysalon.com.

The YouTube channel also has a few travel-related videos uploaded purely for interest's sake. In late December of last year I visited Bodhgaya in India. This is the site where the Buddha is said to have sat for 49 days under the Bodhi tree. There is a descendent of that tree on site, and people, naturally enough, sit under it. Here's a video:



By the way...

My new book "How to be Miserable: 40 Strategies You Already Use" is increasingly available in stores, and is also available online in print and as an e-book.

Friday 13 May 2016

The Misery List, Part Six: Strategies to Make Things Worse

It's out! On May 1 New Harbinger Publications released my latest book, How to be Miserable: Forty Strategies You Already Use. In it, I invite readers to contemplate how they could reduce their happiness and life satisfaction if, for some reason, that was their goal.

Why bother? Most of us spend much of our lives trying to arrange things so that we feel happier and more contented with our lives - and often we feel stuck or frustrated. We never ask ourselves how we could feel worse. But doing so can illuminate a road that runs in both directions. By understanding how we could lower our mood, we can often see more clearly how to raise it.

Here are the answers from 10 more attendees at these talks. Look at the repetition in the answers - despite the fact that people fill in the survey BEFORE the talk.


  • Spend less time with my kids
  • Spend more time watching TV/Internet.
  • Stay inside more and only wear figure-hugging clothing when out.

  • Make a list of all of my failings and shortcomings and pin it on the fridge.
  • Call my mother - and hope she has changed!
  • Stay at home, not get dressed, order food in all week, and stop taking calls from friends.

  • Spend more time sitting on my butt.
  • Less face time, more screen time.
  • Striving to be happier.

  • Decrease the frequency of going outside, meeting with friends and family.
  • No physical activity.
  • Worry all the time.

  • Dwell on failures in my past.
  • Fuel resentments against injustices.
  • Give up.

  • Feel that I have to stay home to clean house and cook meals.
  • Do nothing that I like to do or gives me joy.
  • Listen more to others about what I want, instead of myself.

  • Focus on what I don't have, and forget totally about what I have and am happy about having.
  • Focus on what I can't do - my limitations.
  • Follow what others expect me to do or be, and lose or forget about my real self.

  • Conform to society's ideals, not your own, while sitting on the couch and watching TV.
  • Develop a chronic dependency.
  • Never fall in love again, or ever.

  • Become isolated - avoid connections with people and stop spending time with family and friends.
  • Stop being 'healthy' - stop exercising and eating well.
  • Allow myself to dwell on negative thoughts.

  • Eat crap food, lots of it, and stop exercising.
  • Cut off all communication with friends and family.
  • Spend all my money on frippery and run up the credit cards to the max.


What about you? If you could change only three things in the quest for unhappiness, what would YOU do?

How to be Miserable is available for pre-order from Amazon.comAmazon.ca and other online booksellers now.

Thursday 5 May 2016

Why Mental Health Screening Won't Prevent Mass Murder in the USA

What, again?
In the past couple of decades, mass murder has become virtually a daily occurrence in the United States. This has led to calls from some quarters for some kind of blanket mental health screening – particularly of youth – to attempt to identify those who are at risk of committing these crimes.

When people object to the invasion of privacy that this would involve, they are dismissed. Surely the prevention of these terrible tragedies would justify a minor intrusion in the form of a screening tool.

The focus on privacy and rights issues is reasonable. But it ignores a more difficult statistical issue that would almost certainly doom to failure any form of mental health screening.

Let’s see why.

Imagine that the number of people who will commit mass murder is 0.1% of the population – meaning that one in a thousand will someday take out their guns and start shooting.

In fact, the number is much, much smaller than this. If there were so many perpetrators the murder rate would be enormously higher than it is. Having an inflated figure like this minimizes (rather than exaggerates) the problem we’re going to focus on, however, so it’s a good working estimate.

Next, imagine that psychologists have developed a screening tool that is 90% accurate at identifying people who will become mass murderers. In fact, this is hugely optimistic. Few psychological tests have this level of accuracy and it is virtually inconceivable that we will ever have one so good at identifying the propensity to mass violence.

So: a 90% accurate test. What’s the error rate in people identified as being at risk?

If you said 10%, you’re wrong.

The correct answer is “It depends on the proportions of targets (truly dangerous people) and misses (people who will never do this) in the population.”

In this example, the error rate is about 99.1%.

It can’t be.

It is. Let’s see how this comes about.

Imagine a town of 10,000 people (or a school district with 10,000 students, if all we care about is school shootings). We’re going to test everyone.

We know that 0.1% will go on to commit mass murder if we don’t intervene. That’s 10 people in this idealized town. The test is 90% accurate, so it correctly identifies 9 of them as being at risk. One of them is missed. He (let's assume he's male for the moment) is a false negative.

We know that 100% - 0.1% = 99.9% of people will never commit this sort of crime. In a town of 10,000, that’s 9,990 people. Our test has a 10% error rate, so it mis-identifies 999 people as being at risk. These are our false positives.

How many people does the test say are at risk overall? 999 (the false positives) + 9 (the real targets) = 1008.

Of this 1008, what proportion are really the people we want? 9 / 1008 = .0089 = 0.89%.

How many are errors? 100% - 0.89% = 99.11%. We’re going to intervene with over 1000 people in this town even though we know that 99.1% of them are misidentified.

There’s the rights issue.

(Of course, we have also correctly identified 8,991 people as not being at risk, and they're not. Pretty good. But we could do even better if we did no testing and assumed no one was at risk, and our error rate overall would only be 0.01% - but then we'd miss all of our problem people.)

The error rate for our positives (the false positives) doesn't include all of our mistakes, because we also missed one of the ten who are at risk. This is a false negative (the test declared them safe even though they weren’t).

Okay, but this is an artificial example. What if we plug in figures that are closer to the real world?

The proportion of errors increases the more rare the targets are in the tested population. So if mass murder is only committed by 1 in 10,000, or a slightly more likely 1 in 100,000 (lifetime), the error rate rises enormously.

The errors are also higher if the test is less accurate – which is likely. As I’ve said, it’s vanishingly unlikely that we will ever have a test as accurate as 90%. As the accuracy declines, the error rate also rises.

Some readers will point out that there are two types of error:  false positives (the 999 citizens said to be at risk who are not) and false negatives (the 1 in 10 future shooters who is missed). I’ve assumed that these two error rates are the same – 10% in both cases. Can we really assume this?

Actually, no.

But if you increase the sensitivity of the test to ensure that everyone at risk is identified, you also increase the number of false positives. So the 99.11% error rate would be even higher.

And if you decrease the sensitivity of the test so that fewer people are mistakenly identified as being at risk, you also start missing the real targets. So the whole point of the screening is quickly lost.

The result: mass screening of a population to identify relatively low-frequency targets simply does not work well unless you have a near-flawless test – and usually you don’t.

Does this apply elsewhere?

I’ve used mass murder for the example, but the same principle operates in all forms of testing for low-frequency characteristics in a population: suicide, psychosis, other forms of mental illness – and many types of physical health screening as well.

This is why we keep hearing that many of the screening tools used in physical medicine are problematic. Even if the tests are reasonably good, they often produce high numbers of false positives among the healthy population. It may still be useful to use many of them, but one has to keep in mind the true error rate. We cannot assume that if a test is “90% accurate” that this means it will have only 10% errors. In most cases, the error rate will be much higher.

What does this say about psychology’s ability to prevent mass murder?

The prevention of these crimes is an extremely difficult task. As I’ve said elsewhere ("Tragedy and Mental Health"), the idea that mental health services, properly enhanced, will reduce the rate of mass murder is simply mistaken.

Distress, depression, bullying, and mental illness are common aspects of the human condition. For the most part, they do not result in mass casualty events.

If we want to take mass murder seriously, we need to stop pointing to the mental health professions as the potential saviors. We are not, and in my view we never will be.

But what else can we do?

Well, uh, about those guns …

Why are you on about this?
Stop looking at us.
There is no "other."

Every time there is a mass murder in the United States, people point to the problems associated with the gun culture. They argue that putting some sensible restrictions on gun availability, registration, and ownership is the only reasonable step.

Then the National Rifle Association winks, Yoda-like, and says “No, there is another” and they look sidelong at the mental health professionals over in the corner.

Well, you can stop winking, Yoda. We'd love to help, but we do not have the Force on our side.

We are not your solution, and we never will be.

In case you missed it ...

My new book, How to be Miserable: 40 Strategies You Already Use has hit the bookstores, Amazon,  Indigo, and other outlets.

Sunday 1 May 2016

How to be Miserable, Take Five: Do we see themes yet?

Today is the day!

Today, May 1, New Harbinger Publications is releasing my latest book, How to be Miserable: Forty Strategies You Already Use. In it, I invite readers to contemplate how they could reduce their happiness and life satisfaction if, for some reason, that was their goal.

Why bother? Most of us spend much of our lives trying to arrange things so that we feel happier and more contented with our lives - and often we feel stuck or frustrated. We never ask ourselves how we could feel worse. But doing so can illuminate a road that runs in both directions. By understanding how we could lower our mood, we can often see more clearly how to raise it.

Here are the answers from 10 more attendees at these talks. If you've been reading along for the past few posts, are you starting to see repetition? Keep in mind that people complete these forms BEFORE the talk begins, so these are independent ideas.


  • Never be allowed to sing along to a song again.
  • Lose the relationship with my partner.
  • Have to look at the blank page every day that I promised would be a book someday.

  • Work late on a regular basis.
  • Stay in the house on weekends.
  • Take my holidays in pay instead of time.

  • Ruminate more on negative things that I can't change.
  • Sit more; do and move less.
  • Be who you think others want you to be and not who YOU actually want to be.

  • Stop attending night school to achieve my goals - no reading, lectures, books, workshops, or conversations.
  • Stop singing - no choir practice, no concerts to enjoy.
  • Stop volunteering - no presentations, stop organizing programs, stop serving coffee for church outreach program.

  • Ignore my health.
  • Eat more steak.
  • Pay to be entertained.

  • Gain five pounds.
  • Drink alcohol every night.
  • Force self to stay awake as long as you can every night but get up at the same time.

  • Continue to overeat compulsively.
  • Worry about my adult daughter's ADD and "recreational" drug use.
  • Continue to worry about my own health issues.

  • Read the newspaper and watch the news.
  • Walk through the downtown eastside district.
  • Sleep less and work more.

  • Try to gain weight more and more.
  • Don't contact family and friends.
  • Do not plan anything for the future, even just for tomorrow.

  • Stop spending time outside.
  • Stop exercising.
  • Stop spending time with friends and animals.


What about you? If you could change only three things in the quest for unhappiness, what would YOU do?


As of today, How to be Miserable is available from Amazon, other online booksellers, and your local bookstore.

Monday 25 April 2016

How to be Miserable, Take Four: 10 More Plans

On May 1 of this year New Harbinger Publications will release my latest book, How to be Miserable: Forty Strategies You Already Use. In it, I invite readers to contemplate how they could reduce their happiness and life satisfaction if, for some reason, that was their goal.

Why bother? Most of us spend much of our lives trying to arrange things so that we feel happier and more contented with our lives - and often we feel stuck or frustrated. We never ask ourselves how we could feel worse. But doing so can illuminate a road that runs in both directions. By understanding how we could lower our mood, we can often see more clearly how to raise it.

Here are the answers from 10 more attendees at these talks. How do they compare with your own?


  • Spend time with my ex-husband.
  • Overwhelm myself with tasks I can't fulfill, or commit to a mundane project.
  • Spend too much money.

  • Have only negative thoughts.
  • Do nothing; be inactive.
  • Get no sleep and eat crappy food.

  • Don't do what I want.
  • Become too emotional.
  • Care too much what others think of me.

  • Drink all night long.
  • Go to a party with teenagers.
  • Spend time with very young children.

  • Not being able to do what makes me who I am.
  • Not being able to see my friends.
  • Not cooking for myself and not having my small glass of wine when I want.

  • Live in the street.
  • Sleep for an hour a day.
  • Not talking with anybody.

  • Constantly live in isolation.
  • Always focus on feeling persecuted.
  • Talk negatively to myself.

  • Do the same things every day with no ultimate goals.
  • Have no emotional involvement with anyone.
  • Make no progress toward my goals.

  • Alienate myself from others and become socially isolated.
  • Gain weight.
  • Become ill and unable to have free movement.

  • Don't go to my parents' for dinner.
  • Don't read.
  • Don't go to dinner with my meetup group.


What about you? If you could change only three things in the quest for unhappiness, what would YOU do?



How to be Miserable is available for pre-order from Amazon and other online booksellers now.

Sunday 24 April 2016

Prince, Psychotherapy, and Joy

Musician clinician?
In the late 1980s a colleague of mine told me, over a beer, that she had recommended a new and unorthodox intervention to some of her clients. These were individuals for whom the joy of life had vanished, replaced by a dishwater-grey humdrum existence that left them feeling flat and unfulfilled.

She suggested that when they got up in the morning they should put Prince’s Purple Rain album on, crank the volume, and allow themselves to dance in their underwear as they prepared for the day.

“Allow” is an important word in this. There are some types of music where dancing is not something that must be produced, or forced, or initiated. It is enough to drop one’s embarrassment, shame, and self-consciousness and the dancing will simply happen. Prince’s album, for most people, was firmly and clearly of this sort.

I admired her for her nerve. I was always too cautious, back then, to colour this far out of the lines of standard protocol. As tends to happen, my love of orthodoxy has waned with age.

My friend made no claim that she had discovered a miracle cure. Human lives are difficult and complicated. Most problems require a bit of slogging to get through. But the slogging is easier if you can awaken a sense, however slight, of joy and energy – preferably at the beginning of the day.

There are people, doubtless, who would have been deeply offended by her advice. At the time we talked about it, she seemed to have chosen well. She said that everyone who actually complied with the prescription reported feeling better. Not just while the album played, but for the day.

Psychotherapy often tries to connect people with buried parts of themselves. Often this is done by step-by-step reconnection with life, or by gradually working through the backlog of chores and problems, or by mounting an intellectual challenge to instinctive self-loathing.

Sometimes, though, a different and more direct approach can work wonders. Experiencing a bodily connection with energizing music can be more powerful than all of the cognitive restructuring we can bear. Music, being a human production, can help us tap into the wellspring of shared experience. The energy of a musician like Prince can evoke reverberations of our own buried vitality.

Different people will, doubtless, respond to different musicians or genres. For some it’s Vivaldi, for others Iggy Pop. Some will appeal to a tiny slice of humanity, others to a wider swath. Prince, at his Dionysian and dangerous best, found a potent vein of buoyancy that reached within and set the spinal column vibrating for millions, many of whom responded despite their surface disapproval.

When someone like Prince passes, it can be hard to decide how to mark the event. Is it silly to dissolve into grief for someone you never met? There’s no loyalty in it – and the man would probably not have cared anyway.

Maybe there’s another ritual of which he might have approved. And the required ceremonial objects are as close as your underwear drawer.

Upcoming: My new book, How to be Miserable - 40 Strategies You Already Use will be released May 1. Available for pre-order from Amazon and other booksellers now.

Monday 15 February 2016

How to be Miserable, Take Three: 10 More Replies from Audiences

On May 1 of this year New Harbinger Publications will release my latest book, How to be Miserable: Forty Strategies You Already Use. In it, I invite readers to contemplate how they could reduce their happiness and life satisfaction if, for some reason, that was their goal.

Why bother? Most of us spend much of our lives trying to arrange things so that we feel happier and more contented with our lives - and often we feel stuck or frustrated. We never ask ourselves how we could feel worse. But doing so can illuminate a road that runs in both directions. By understanding how we could lower our mood, we can often see more clearly how to raise it.

Here are the answers from 10 more attendees at these talks. How do they compare with your own?

  • Set my expectations too high.
  • Beat myself down.
  • Try to change other people.

  • Be physically inactive.
  • Don't talk to anyone.
  • Get a job that starts at 7 am.

  • Work all the time; no play or stuff I love.
  • No exercise or time in my body or in nature.
  • No time with family and friends.

  • Eat high cholesterol food.
  • Stay indoors too much.
  • Do not participate in your own life; do not listen to your own desires.

  • Do nothing but eat and sleep with as little activity as is humanly possible.
  • Complete isolation.
  • Watch a Canucks game.

  • Cut off my whole 12 step recovery support group.
  • Stop taking my depression meds.
  • Take myself more seriously.

  • Break someone's heart.
  • Cut off my access to nature.
  • Cut my sleeping time in half.

  • Spend more time on the Internet (browsing mindlessly).
  • Spend less quality time with close people.
  • Do not be open to learn new things.

  • Be in a circle of unhappy people.
  • Do not get what I aimed for in any mission or step taken.
  • Become unable to move ahead with my goals.

  • Get more hours of work.
  • Drop all activities.
  • Waste time on the Internet and television.


What about you? If you could change only three things in the quest for unhappiness, what would YOU do?

How to be Miserable is available for pre-order from Amazon and other online booksellers now.

Sunday 31 January 2016

How to be Miserable, Take Two: What 10 People Advise

On May 1 of this year New Harbinger Publications will release my latest book, How to be Miserable: Forty Strategies You Already Use. In it, I invite readers to contemplate how they could reduce their happiness and life satisfaction if, for some reason, that was their goal.

Why bother? Most of us spend much of our lives trying to arrange things so that we feel happier and more contented with our lives - and often we feel stuck or frustrated. We never ask ourselves how we could feel worse. But doing so can illuminate a road that runs in both directions. By understanding how we could lower our mood, we can often see more clearly how to raise it.

At talks on this topic I invite attendees to list their own top three ways to become miserable. In a recent post I provided 10 sets of replies. Here are the answers from 10 more attendees. How do they compare with your own?
  • Do not talk to friends and family.
  • Be stuck at home where I can't walk on the seawall.
  • Watch television for the whole week.

  • Question your own abilities and lower your self-esteem.
  • Avoid friends and family.
  • Be scared or fearful to live life.

  • Surround myself with people who only focus on the negative.
  • Do not have genuine friends or relationships.
  • Do not have aspirations or goals.

  • Stop talking to friends and family.
  • Stop exercising.
  • Eat at McDonald's every day.

  • Stop reading (I am a passionate reader; I live to read!)
  • Stop learning.
  • Never go outside, especially avoid natural environments.

  • Become unable to read books, ever.
  • Not being able to hear music again.
  • Having to live in a messy and disorganized environment.

  • Cancel Internet access.
  • Cancel public library card.
  • Resign from my volunteer organization.

  • Compare myself to other people, particularly friends.
  • Doubt and judge myself.
  • Try to be perfect in every way.

What about you? If you could change only three things in the quest for unhappiness, what would YOU do?

How to be Miserable is available for pre-order from Amazon and other online booksellers now.

Friday 15 January 2016

How to be Miserable, Take One: What would you do if you wanted to be LESS happy?

On May 1 of this year New Harbinger Publications will release my latest book, How to be Miserable: Forty Strategies You Already Use. In it, I invite readers to contemplate how they could reduce their happiness and life satisfaction if, for some reason, that was their goal.

Why bother? Most of us spend much of our lives trying to arrange things so that we feel happier and more contented with our lives - and often we feel stuck or frustrated. We never ask ourselves how we could feel worse. But doing so can illuminate a road that runs in both directions. By understanding how we could lower our mood, we can often see more clearly how to raise it.

I have been giving talks on this topic for the past few years, and as a part of the presentation I invite the audience to write down their own ideas, with one restriction: They can only change three things about their lives. What would help the most?

Here are the verbatim answers from 10 of these individuals. How do they compare with your own?
  • Live in a place with no view: claustrophobic and little outside light.
  • Find out that the person you just met and thought was terrific is actually controlling and erratic.
  • Spend more money than you have coming in.

  • Spend endless hours reliving all of your past mistakes.
  • Surround yourself with miserable and angry people.
  • Have no goals for yourself.

  • Lose all my old friends and don't make new ones.
  • Work longer hours doing things I dislike for less money.
  • Do not progress through life goals, instead only moving further away from them.

  • Choose not to forgive people: Friends, family, co-workers, strangers, etc.
  • Get stupidly, wildly in debt by purchasing things I don't need (a mortgage would be okay though).
  • Become an atheist.

  • Don't drink coffee for the rest of my life.
  • Stop using the computer.
  • Spend less money.

  • Watch more television.
  • Go shopping all day, every day.
  • Eat whatever I crave, whenever I want.

  • Participate only in activities I have no interest in.
  • Associate only with inauthentic people.
  • Get very drunk every day.

  • Isolate myself from communication with others.
  • Limit my finances.
  • Limit my mobility.

  • Live in an area with more traffic and other city pollution without the possibility of getting out.
  • Sit for more than four hours a day in the basement suite.
  • Have no vision, goals, or daily "tasks" to follow.

  • Eat only chocolate.
  • Stop smiling and talking to others.
  • Stop being grateful.


What about you? If you could change only three things in the quest for unhappiness, what would YOU do?

How to be Miserable is available for pre-order from Amazon and other online booksellers now.