Monday, May 30, 2011

Introversion, Extroversion, or Both? (in which I get my geek on)

Before I launch into today's festival of nerdishness, I'd like to:
  1. Thank all the individuals, past and present, who have served in the United States military, and on this day, remember and honor those who gave their lives in the service of this country. Amidst the barbeque and the giddiness over the beginning of the summer season, let's take some time to remember the reason this day is a holiday.
  2. Thank each of you. Saturday was my six-month blogoversary, and since the end of last November, nearly 300 of you have become followers of this blog. I'm really touched by all your comments and participation, and I'll keep working hard to make The Strangest Situation worth your time.
NOW: Introversion vs. Extroversion.

On Friday, I asked you if you were one or the other or both. A significant majority of you (24 out of 37, or 65%), indicated you were introverts. Many of you used phrases like "100%" or "hands down", indicating you're quite definitely introverted. Several of you referenced your Myers-Briggs Type (I have GOT to do a post on that thing, and I will sometime this summer)--and they all started with "I".

Now, this shouldn't be surprising, right? Most of us are writers. And ... generally, writing is a pursuit that includes a lot of activity between the ears. Yes, to be good, you've got to get out of your own head and get others involved, but a lot of the process is solitary. In other words, we are NOT a randomly selected sample. If you polled individuals in the House of Representatives or actors on Broadway, you'd probably get a different result.

If any of you are wondering, yes, I am most definitely an introvert. When I was in college, I took Personality Psychology, and the professor handed out personality inventory results for the entire class (we'd all been assigned numbers, so no one was publicly outed or anything). But my number ... was on the extreme end of the continuum. According to that test, I was the most introverted person in that class of 40 people.

That doesn't mean I'm not socially skilled or don't enjoy being with other people. I do. I'm also quite a good public speaker, and I actually enjoy that kind of thing as long as I know what I'm talking about. However--I dislike parties and crowds. They wear me out quickly. I am easily overwhelmed by both the social expectations and the sensory stimulation. And in general, I am happiest when I have A LOT of alone time.

Many of you said very similar things. Quite a few of you were asking questions or stating you had tendencies toward both extraversion and introversion. In other words, you were saying you didn't fall neatly into either category. A lot of you were really trying to puzzle out "which one" you were--introvert or extrovert.

Now--if you are to believe a lot of these "personality type" tests, personality traits would be distributed like this:

This is a cute little bimodal distribution.

If this was the reality, most people fall into one category or another, and only a few people would fall in between. But is that the way things are?

No. Here's the way things are:


Personality traits like introversion-extroversion are normally distributed. MOST people fall somewhere in the middle (about 68%). In other words, if you randomly selected a hundred people from the general population and gave them a test that measured introversion-extroversion, only a few would come out as extremely introverted or extroverted.

Admittedly, if you take our little sample, our curve would probably look more like this:

This is an adorable positively skewed distribution.
As a group, we are probably more introverted than the general population. Even so, most of us will have scores that fall somewhere in between. We're not one or the other!

We're on a continuum.

 So! Don't feel bad if you couldn't figure out what type you are, or if you felt like you had qualities of both, or if you are an introvert in some situations/moods and not in others. I'm quite sure you're right. And if you think about this as a continuum, it might make it easier.

On Wednesday, I'll talk more about introversion-extroversion as it relates to social media.  But for today--does this make sense? Are you more comfortable thinking about introversion-extroversion (or any persoanlity trait) as a continuum rather than a category you have to fall into? Or do you feel more comfortable as a "type"?

Friday, May 27, 2011

You Tell Me: Introvert or Extrovert?

First, huge thanks to Carolyn Kaufman for guest blogging, and thanks to all of you who stopped by and asked questions! If you haven't checked back yet, Dr. Kaufman answered them in the comments.

The winner of the signed copy of The Writer's Guide to Psychology is:

LINDA GRAY
Congrats! Please email me with your address so we can send you the book!

Now I give you this:

Extroversion: "the state, act, or habit of being predominately concerned with and obtaining gratification from what is outside the self." Enjoying time spent with other people more than time spent alone. An extrovert fades when alone and is easily bored without other people around.

Introversion: "the state or tendency toward being predominately concerned with and interested in one's own mental life." Enjoying time spent alone over time spent with others. An introvert tends to fade when with other people and may become easily overstimulated with too many others around.

Now I ask you this:

Which are you? One or the other? Both? Somewhere in between? And: has social media (Facebook, blogging, Twitter, etc.) changed your interaction style? Has it enhanced it or enabled you to compensate for it somehow?

Next week I'll talk a bit about these personality traits, but first I'd love to hear what you have to say about yourselves! (and if you share, I'll tell you where I fall on this continuum next week)

OH, and if you're commenting through Blogger/gmail, unclick "keep me signed in" if it asks you to log in again. See if that works. Sorry, folks. I have no idea what Blogger's problem is lately!

Wednesday, May 25, 2011

Dr. Carolyn Kaufman Guest Blogs: 21st Century Treatments for Depression

Hi everyone! On Monday I talked about how The Writer's Guide to Psychology is useful and generally fabulous. Today, the author, Dr. Carolyn Kaufman, is here to tell you about cutting edge treatments for depression.

I don't know if you folks know this, but Dr. Kaufman is an assistant professor at Columbus State Community College and also teaches classes at Otterbein College. She'll stop by later to answer any questions you have, but as a result of her teaching schedule, it will probably be in the afternoon and evening.

In addition, she's giving away one signed copy of The Writer's Guide to Psychology to one of my commenters today! I'll be announcing the winner Friday. And without further ado ...

If your character has a serious problem with depression, you probably think she has two options for treatment: psychotherapy or medications.  And you’d be right – sort of.  Those are the first two things a good therapist will try. But what happens if neither approach works?  Are there cool new 21st-century alternatives?
You bet there are.
Now, in most cases, your character will start with psychotherapy, and in many cases, psychotherapy alone is sufficient.  Sometimes, however,  medications warrant serious consideration; here are a couple of examples of situations when your therapist will want to consider referring to a psychiatrist:
  1. The client is so depressed that she’s unable to really get much out of therapy – she needs additional help.
  2. The client has numerous close family members who are taking medication for the same condition – and they’re benefitting from that medication or medications.
Once in a while, however, an individual has what we call Treatment-Resistant Depression (TRD), which means that various psychotherapeutic approaches and medications have been inadequate to help the person.  Research suggests that for these people, Treatment as Usual (TAU) may only be successful in about 7% of cases.
The Old Standard
Traditionally, electroconvulsive therapy (ECT) has been used as a last-ditch effort in these situations.  The good news is that ECT is not the brutal, barbaric thing portrayed in most movies, where the wide-awake patient is strapped down and subjected to painful, terrifying shocks that cause convulsions.  Rather, the person is both asleep (thanks to a general anesthesia) and still (thanks to a muscle relaxant). Miraculously, some people feel significantly better after a single treatment, but for most people, several weeks’ worth of treatments are necessary.  After that, medications and psychotherapy are usually effective.
 The biggest downside of ECT is that it interferes with what we call the “consolidation” of memory.  In other words, over the few weeks that you’re doing ECT, you may have trouble storing information in long-term memory. That can certainly make it hard to remember your next appointment if you don’t have it written down!
Though most people say they would do ECT again if they needed it, and though it has been called “no more unpleasant” than going to the dentist (?!), some people have really bad experiences with it. For example, once in a while people who have undergone ECT say that they have problems with anterograde memory loss (which means they have trouble remembering things even after the ECT is done). Others say they have retrograde amnesia, which means they have forgotten chunks of their past.  The hard thing about these situations is that normally ECT is only done when the doctors don’t know what else to do to keep someone alive.  So which is worse – being dead, or having some memory loss?  The answer genuinely depends on the person. 
But scientists have been working on new, drug-free biological treatments for people with TRD.  Here are three.
Transcranial Magnetic Stimulation (TMS)
Transcranial Magnetic Stimulation is the least invasive of the three new treatments I want to discuss.  Unlike the other two, there is no surgery and no implantation of a device.
During TMS, the client sits in a chair that resembles a dentist’s chair (I know, what’s with the recurring dentist theme?), and an electromagnetic coil is placed near the left front of the head. The coil turns on and off rapidly, creating a magnetic field that stimulates the brain’s cells (called “neurons”) to release brain chemicals like serotonin and norepinephrine. (In people who are depressed, serotonin and norepinephrine levels are too low.)
The machine makes a very loud (and unpleasant) tap-tap-tap-tap sound as the electromagnetic coil is turned on and off, so both client and doctor wear earplugs. Many people experience prickling or discomfort of the scalp under the coil, and some experience twitching of facial muscles or headaches afterward. Research suggests, however, that about half of the people who undergo TMS experience some relief of their depression symptoms.
Vagus Nerve Stimulation (VNS)
Both Vagus Nerve Stimulation and the next treatment we talk about, Deep Brain Stimulation, involve a bigger commitment than TMS.  Both involve the surgical implantation of an expensive pacemaker-like device under the collarbone. 
With VNS, wires run from the main device up into the neck  and are wrapped around the vagus nerve, which travels up into the brain and down into the body.  Every five minutes, the VNS unit emits a mild electrical pulse.  At first, this pulse is noticeable: it feels like a very mild shock accompanied by the requisite prickle of electricity on the left side of the voice box.  Over time, however, the body adjusts and the individual is no longer aware of the pulses unless she’s paying close attention, exercising heavily, or speaking loudly (the pulse makes some people’s voices a little bit husky or hoarse). The prickling sensation goes away, and the pulse itself feels like a finger laid very lightly against the left side of the voice box.
The effects of VNS take time, and patients may take up to a year to get the full effects.  The battery in the unit is said to last up to 7 years in some patients; when it runs out, a whole new pacemaker-like device has to be implanted.
Research argues that significantly more people with TRD respond to VNS therapy than treatment as usual (ie therapy and medication alone), with about a third of patients getting significant relief and up to 80% of patients getting some relief.
Deep Brain Stimulation (DBS)
Still in the experimental stages, Deep Brain Stimulation also involves the implantation of a pacemaker-like device under the collarbone.  Rather than wrapping around the vagus nerve, however, the electrodes are placed directly into the brain.  Patients are awake when the electrode is actually inserted, and many, fascinatingly, report an immediate lifting of their depression.  Early research has shown that patients have remained in remission while the current is left on, but experience a return of symptoms when the current is switched off.
What makes DBS unique is that it may help people for whom electroconvulsive therapy has not been effective.  TMS and VNS are not usually helpful for this group.
Since DBS has not been proven in large groups of people, it has not yet been approved for depression in North America.
Particularly with the last two treatments, you may think that you wouldn’t want someone implanting anything in your body – and especially in your brain – for any reason! But for people for whom depression is an unrelenting specter, these treatments offer new hope.  Unfortunately, although both TMS and VNS  have been FDA-approved for depression in the US, insurance companies aren’t usually willing to pay for them, forcing individuals to find ways to pay for them out of pocket.
For more information on TMS:
Neurostar (company that makes the TMS machine): http://www.neurostartms.com/Home.aspx
For more information on VNS:
VNS and Me: Wordpress Blog of someone who was implanted with the VNS device: http://vnsandme.wordpress.com/
Cyberonics (company that makes the VNS device): http://us.cyberonics.com/en/vns-therapy/
For more information on DBS:

What do you think? Had you heard of these treatments? What questions do you have for Dr. Kaufman (they don't have to be limited to these treatments--feel free to ask general questions or anything about The Writer's Guide)? Remember--one commenter will win a signed copy of The Writer's Guide to Psychology, so ask (or just comment) away! She'll stop by after 3pm (EST) to answer!
And finally, on the Sisterhood of the Traveling Blog front, Deb Salisbury is posting today about what she does when she loses her writing mojo. Please check it out!

Monday, May 23, 2011

A Psychologist's Thoughts on The Writer's Guide To Psychology

For me to really convey how much I appreciate the mere existence of a book like Dr. Carolyn Kaufman's The Writer's Guide to Psychology, I have to briefly tell a seemingly unrelated story.

I've just finished a project in which some of the main characters work as paramedics in a very chaotic and violent place. After doing the very best job I could, including  some online research, I sent it to my sister for critique; she's been a medevac helicopter pilot in the army for the last six years and just got home from Afghanistan. She knows some stuff about emergency medical procedures in chaotic and violent places.

And wow, was I glad I did, because she identified inaccuracies I'd never have noticed or thought of. She said stuff like, "a medic would NEVER [blahblahblah]" or "this is how we really do [XYZ]." To her, some of the stuff I'd put in was laughable, and worse, annoying. I felt sort of silly, like I should have known better, but there's no way I really could have. I had to ask. I had to go deeper than my shallow knowledge and assumptions.

It was a great lesson in perspective, because I've been on the other side of that equation a lot. The reason is simple--people love writing about psychological issues and portraying them on television, and they often get it WRONG. Sometimes it's simple stuff, like hearing Dr. Lance Sweets on a recent episode of Bones describe someone's symptoms as "disassociative" as opposed to "dissociative." Or seeing someone on the AW forums casually referring to a character with schizophrenia as "schizoid." Sometimes it's BIG stuff, like mixing up schizophrenia and dissociative identity disorder as a major plot element.

Let me tell you--there are enough inaccuracies about psychology in books and movies to tell me it's possible to sneak stuff by. I blogged about this recently. However, I will also say this--agents and editors are getting increasingly savvy (as is the general population), and many of them can quickly recognize an ignorant, insensitive, or flamingly inaccurate depiction of mental illness, therapy, or other psychological stuff. And they will hit the REJECT button fast. Further, having an agent myself, I can tell you that she vets and researches even the most random stuff EVERYTHING in my projects to make sure things are accurate. People take this stuff seriously, and if you're writing about psychological issues, you should, too.

So! As many of you have seen if you read this blog regularly, it's hard to get this stuff exactly right. There are a lot of oft-repeated misconceptions. The solution? Research! And what will make this research a trillion times easier?

The Writer's Guide to Psychology.

Yes. I am telling you now. If you are writing about any mental health issue, including diagnosis, therapy, psychiatric medications, psychiatric hospitalizations, psychopaths and serial killers, personality disorders ... I beg you, get this book. It's going to increase the likelihood that you're going about it the right way. It's going to make it more likely that you won't shackle yourself to an indefensible, implausible plot device. It's going to help you succeed.

The book itself is thoroughly engaging. As I was reading it, I was kind of boggled by the number of movie and book references--this isn't a dry, boring text. It's connected to the things a writer is interested in. [For you Twilight fans and haters, Dr. Kaufman even calls out a little psychological terminology inaccuracy in one of the books in that series.]

As a psychologist myself, I can tell you this is good stuff. Well-informed, accurate, and at the same time, pretty entertaining. Dr. Kaufman can tell you what a real therapy session would look like--depending on the theoretical orientation of the therapist. She'll even give you examples of what a therapist from a particular orientation might say or ask. Her sections on psychopathology (different diagnoses) are excellent, particularly because she doesn't just tell you a few facts about each disorder; she discusses the overlap with other disorders and how to tell the difference.

There are sections on childhood and adolescent disorders, but I would say most of the focus is on adult psychology (that usually includes older adolescents). I noticed that because I'm a child psychologist, and I think Dr. Kaufman would probably agree with me that The Writer's Guide to Psychology is an excellent start to your book research (and will often be sufficient)--but you might have to do additional research if you're writing in depth about a particular disorder. Fortunately, Dr. Kaufman provides a complete bibliography of her own resources. She also offers her website: http://www.archetypewriting.com/, which is just. Wow.

Clinical psychology, and human psychology in general, is a vastly complicated, ever-evolving field. A simple Google search might give a researching writer very contradictory results (try this with "attachment disorder" and you might see what I mean). Having a book like The Writer's Guide can take a lot of the risk and confusion out of the research process (and while you're researching, you can indulge in a collegial little snicker at mistakes made by some very famous writers).

And with that, I am EXTREMELY excited to announce that Dr. Carolyn Kaufman will be guest blogging here on Wednesday. She'll be discussing some cutting edge treatments for depression. On top of offering some pretty rich plot fodder, it's just fascinating, wild stuff. She'll check in on Wednesday to answer your questions, and we'll be giving away a signed copy of The Writer's Guide to Psychology to one of the Wednesday commenters--so please come back and see what Dr. Kaufman has to say!

Remember to drop by Lydia's blog for her Medical Monday post and Laura's blog for her Mental Health Monday post!

So--do you have The Writer's Guide to Psychology? Have you heard about it? Do you write about psychological issues? Mental illness? Therapy? How do you research the issues you write about? And--how do you know if you're accurate or not?

Friday, May 20, 2011

The id picks a WINNER! Also, I answer a few questions.

All right! While I was sick last week, my id took over the blog and offered up a contest. All you guys had to do was recommend a book or ask a question, and WOW! Both your recommendations and your questions were amazing. Thank you. It spared me a giant headache, and now my id is tucked safely away in my unconscious where she belongs.

So ... the winner (chosen, of course, using a random number generator):
ASHELYNN HETLAND
Congrats! Please email me and let me know if you'd like the 10-page critique or the $20 Amazon gift card.

As for the rest of you:

Some of you recommended books I've read and reviewed already here on the blog (Harmonic Feedback, The Marbury Lens, Before I Die, Cracked Up To Be, and Living Dead Girl). And to that I say: You have great taste! I loved each and every one of those books.

Some of you recommended books I haven't yet read. And to that I say: I'm on it! I'll read them and discuss them here, one by one. If you asked a diagnostic question related to the book, I'll answer it.

Some of you asked general psych questions or questions about my work as a psychologist. For each of those, there will be a future post!

And some of you asked questions about my writing. I will answer a few of those below and save the rest for posts of their own ...

Ashelynn asked: "How many novels have you written, or is the one you snagged your agent with the first one?"

I wrote one novel before I wrote Suicide Gates (the manuscript I used to snag dearest KOrtizzle). That first novel is trunked, but I may cannibalize the idea someday because I think it's cool.

After Suicide Gates, I wrote another YA. It's a sort of sci-fi thriller type thing, and I'm currently polishing it up. I've also just written an adult urban fantasy/romance and am in the process of getting beta feedback. This summer, I'm planning to start work on another YA project that I am EXTREMELY excited about. I'm starting to do some research to get ready.

Mandie asked: "What kind of books do you write?"

Suicide Gates is YA horror that also happens to include a lot of romance and action. And also, knives.

Then there's the YA sci-fi thriller that also happens to include a lot of romance and action. And also, a group home for individuals with severe, chronic mental illnesses.

And then there's the adult urban fantasy ROMANCE that includes a lot of ACTION. And also, paramedics. And canals.

Finally, my new project ... IS A SEKRIT. Somewhat. But there will be romance for sure. And action.

Obviously, there are some common themes.

Laura asked: How do you find the time to juggle work, family, blogging, and writing?

Sigh. This is not easy. First, I work at the office only three to four days/week. Second, I only blog three times a week. Third, my children are young and go to bed early. Fourth, I often forgo sleep. Fifth, I type REALLY fast.

OK, folks, I think that's enough for now! If any of you ever have questions about psychology/writing stuff, please email me. I love answering questions. If any of you asked questions that you'd like answered sooner rather than later, please do let me know. There were so many awesome ones!

Thanks to every single one of you who entered the contest, and welcome to all of my new followers who have arrived here more recently! You guys (and your fascinating blogs) make every minute I spend blogging worth it. Have a great weekend!

Wednesday, May 18, 2011

Churn, Baby, Churn: What I Do When I've Lost My Writing Mojo

This month's Sisterhood of the Traveling Blog question came from Laura: "What do you do when you lose your writing mojo?"

Laura's response can be found here, and Lydia's response is here.

The thing about mojo ... it's all about your thoughts--both the ones you can access and the ones you can't.

Mojo Jojo says, "Now, if you'll excuse me,
I have a manuscript to take over."
And what I mean by that: You can't have mojo 24-7.  (unless you're this guy-->)


Nonstop MOJO is just not possible. Even if you're the type who writes every day, some days are going to be ON, and some days are gonna suck in any number of ways, for any number of reasons. Sometimes you might have a number of days like that in a row.

When that's happening, you have two tasks:
  1. Let your brain do what it needs to in order to get you ready for that next blast (or trickle or flow or whateva--we're all different) of productivity. Let things churn. Be at peace with the churning.
  2. While your ideas are churning, DO NOT fall victim to your Sneaky Brain (my post about what it can do to a querying writer is here, and my post about how to put it in its place is here).
That "churn" is what your brain does in the background while the rest of you is busy getting on with life. It has to happen. There has to be a space where you process and digest all the stuff you're thinking in the foreground, and you can't do all that systematically and deliberately. It's messy. Sometimes it takes a bit of time.

What interferes with this awesome process are those thoughts from your Sneaky Brain. You know the ones.
  • This isn't churning; this is writer's block. You have it. You. Have. Writer's. Block. Writer's! Block!
  • You will never have another good idea again. And that's because you suck. No, really. You do.
  • This is the only book you'll ever write, and if you don't figure this out, your writing career is OVER.
  • You see all those other writers out there? They've had ten ideas in the time it's taken you to polish off that plate of onion rings.
  • Your brain is flat and you've just reached the edge of it. Prepare to fall into the abyss of NO MOJO!

Now imagine your poor, brilliant brain, churning away, and then WHAM! It gets attacked by these sneaky thoughts. It's like throwing a rock in those gears.

Knowing that, this is what I try to do, and it's what I'd tell anyone who asked: When you have times when you're less productive, or not productive at all, let it happen.

Don't panic. Let things churn. Just because it doesn't feel like something's happening doesn't mean there's nothing happening. Sometimes it means the opposite.

But when you get sucked in by the Sneaky Brain's shenanigans, it gets harder to relax and let yourself go along. You get anxious. You get depressed. And those gears might get gummed up--you might end up sabotaging yourself, and your churning could turn in to a full-on slump. So you have to kick those sneaky thoughts away--don't let them interfere with whatever your brain is doing to get you back on track.

Concretely, here's what I do when I have no ideas, when I feel uninspired, and when the words are not flying from the tips of my fingers: I read. I open my eyes and pay more attention to the world. (I read) I listen more carefully. I reach out to my friends. (I read some more) I listen to music. I try to relax, and I remind myself my brain is churning, and that it's a pretty good brain, and that, when it's ready, I'll be ready, too.

On a related note, Kim Harrington, the author of CLARITY, had an excellent post on writer's block this past Monday (and she quoted me, which made me blush and go all giggly). She has thoughts on how to push through tricky writing problems by having a quiet mind.

What about you? When you lose the mojo, how do you think about it? Are you prone to panic or peace? If you've recovered from a time of mojolessness, how did you do it? Do you think you've ever made a patch of mojolessness longer by falling victim to the Sneaky Brain?

Oh! And while you're here, please enter my id's giveaway so it doesn't give me a headache with all its whining. What's in it for you: a chance to win a $20 Amazon gift card or a 10-page crit, your choice. You have until tonight at midnight (EST) and winners will be announced Friday--when I'll also start answering some of your fabulous questions!

Monday, May 16, 2011

Laughter is the Best Medicine


Lydia and Leigh are hosting today's nifty blogfest! All of us are supposed to post a joke related to writing or our jobs, so here's mine (please note that I did not write this myself, but instead scavenged it from the deepest tubes of the interwebz):

A psychologist was walking along a Hawaiian beach when she kicked a bottle poking up through the sand. Upon opening it, she was astonished to see a cloud of smoke and a genie smiling at her.

"For your kindness," the genie said, "I will grant you one wish!"

The psychologist considered for a moment, then replied, "I have always wanted a road from Hawaii to California."

The genie grimaced. "Listen, I'm sorry, but I can't do that! Think of all the pilings needed to hold up the highway and how long they'd have to be to reach the bottom of the ocean. Think of all the pavement. That's too much to ask."

"OK," the psychologist said, not wanting to be unreasonable. "I'm a psychologist. Make me understand my patients. What makes them laugh and cry, why are they so difficult to get along with, and what do they really want? Basically, teach me to understand what makes them tick!"

The genie sighed. "Did you want two lanes or four?"


What do you think? Funny? Lame? Uncomfortably accurate?

While you're here, please go enter my id's giveaway to prevent it from having a temper tantrum. All you have to do is ask a question or recommend a book, and you'll be entered to win a $20 Amazon gift card or a 10-page crit, your choice. Giveaway ends Wednesday night and winner announced Friday!

Now--go visit some of the other participating bloggers and see what they've come up with!

Friday, May 13, 2011

The Id Takes Over the Blog and OFFERS YOU A PRIZE.

Hi, everyone! This is Sarah's id. This week has been INSANE at her day job, and on top of that, she has a terrible cold. While the rest of her is passed out somewhere, just trying to recover, I have taken on blog duty. And you know what? My mouth is stuffed so full of marshmallows that I can barely think past the pillowy-gooey-deliciousness.

So help me out here.

I cracked into Sarah's plastic, and I'll award a $20 Amazon gift card or a ten-page crit, your choice, to one of you (she'll be doing the crit, not me. The only thing I'm good for is watching Vampire Diaries, eating onion rings, and other activities of instant gratification).

All you have to do:

1. Ask a question (you could ask just about anything about her work as a psychologist, her writing, a psychological question about something you're working on, or a psychological question about something you've just kinda wondered about).

OR

2. Recommend a YA book that contains a character with a mental/emotional/developmental disorder or just involves interesting psychological issues.

That's all. Oh, and if you become a new follower of the blog or on Twitter, or if you RT the contest, or if you are a current follower and remind her of this fact in the comments, she'll give you extra entries. She's more organized than I am.

This giveaway thing will end next Wednesday, May 18th, at midnight EST. Winner (who will be selected randomly, cuz' that's how I roll) announced Friday, May 20th.

Fire away. I'm off to find me some fried food.

Oh, one more thing. Justine Dell is having her 300 followers contest HERE. It's extraordinarily easy to enter and there are tons of nifty prizes. I'm going to enter Sarah when she's not looking *crosses fingers for the Livia Dane short story* (psst ... if you don't know what I'm talking about, you'll want to find out!).

Wednesday, May 11, 2011

Character Diagnosis, Parker Fadley: Obsessive Compulsive Personality Disorder

Cracked Up To Be, by Courtney Summers, is about Parker Fadley, who used to be popular and perfect. But now her parents are watching her. School personnel are watching her. The perfect boyfriend she dumped is watching her. All of them are pretty much scratching their heads because she fell apart in a truly spectacular way, and the real reason why is something she can't even admit to herself.

Cracked Up To Be is about the aftermath of something BIG, but as I read the book, I was struck with how much Parker was already dealing with before that event. She was obsessed with being perfect. No one could do things right, so she had to do them herself. It enraged her when anyone suggested she should lighten up and relax her standards.

According to the DSM-IV, the diagnostic criteria for Obsessive Compulsive Personality Disorder are as follows:

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency. Symptoms must emerge by early adulthood, be present in a number of settings, and manifest in four or more of the following ways:
  1. preoccupation with lists, rules, order and organization (to the point that the major purpose of the activity is lost)
  2. perfectionism that interferes with task completion
  3. excessively devoted to work to the exclusion of leisure activities and friendships
  4. overly conscientious, scrupulous, and inflexible on matters of morality, ethics, or values
  5. inability to discard seemingly worthless objects, even if they have no sentimental value
  6. reluctance to delegate tasks or to work with others unless they submit to exactly his/her way of doing things
  7. adopts a miserly spending style toward both self and others
  8. shows rigidity and stubbornness
Remember, to be diagnosed with this or any disorder, there has to be significant impairment. In addition, to be diagnosed with this personality disorder, there can't be another Axis I disorder that better accounts for the symptoms (like depression or anxiety).

Now, Parker's clinical presentation is quite complex. First, she's got this pattern of rigid, perfectionistic behavior, as characterized by (in my opinion) symptoms 2, 3, 6, and 8 above. Symptom 4 is debatable as well. And there's no doubt these patterns of behavior and thinking were causing significant conflict in her relationships. After the inciting event, she's got other symptoms, too, including the aforementioned panic attacks and other anxiety symptoms (like repetitive snapping), substance abuse, and some depressive symptoms (which may be explained by something else, but I won't spoil this book for you!). If she went to see a mental health professional, that person could administer a measure like the Structured Clinical Interview for DSM Disorders to sort all the diagnoses out.

Please keep in mind: Obsessive Compulsive Personality Disorder IS NOT THE SAME THING AS Obsessive Compulsive Disorder! OCD is an anxiety disorder--an Axis I disorder--and it involves having obsessions and compulsions, including rituals like the ones Jake Martin has in Heidi Ayarbe's Compulsion, which I blogged about a few weeks ago. Obsessive Compulsive Personality Disorder is a personality disorder, an Axis II disorder. If a person has obsessions or compulsions, OCD is probably more appropriate to diagnose than OCPD.

In addition, people with OCD tend to seek therapy because they're distressed by their symptoms, while people with OCPD seek therapy because of conflict in relationships caused by the perfectionism and rigidity.

Parker does have a somewhat unusual profile--people with OCPD are actually at less risk for substance abuse than those with other personality disorders, because of their need for control. However, it's clear throughout Cracked Up To Be that Parker's obsessed with being perfect, and she even says she has to mess her life up "perfectly" and completely.

Cracked Up To Be is an excellent book to read if you're wondering how to make a potentially unsympathetic character understandable, palatable, and relatable. Have no doubt: Parker can be hard to take. But Courtney Summers does such a beautiful job of showing the reader how Parker is suffering--even when Parker is unable to admit it to herself--which I think takes real skill and discipline. You may not agree with the choices Parker makes and you might cringe at the way she treats people, but you understand it, and you root for her to find her way through. Also, OCPD does not define Parker; she's a lot more complex than that, and Cracked Up To Be makes for a fascinating character-study.

The treatment for OCPD is effective psychotherapy. OCPD is considered one of the more treatable personality disorders, and for obvious reasons, individuals with this disorder are often relatively high-functioning (apart from conflict-filled relationships and inefficiency).

Have I answered your questions about Obsessive Compulsive Personality Disorder? For those of you who have read Cracked Up To Be, do you agree with my "diagnosis"?

It's Wednesday, Sisterhood of the Traveling Blog day, so head on over to Lydia's blog to see how she answers the question, "what do you do when you lose your writing mojo?" Laura gave her answer last week, and I'll be up next week.

Monday, May 9, 2011

The (Extremely) Quick and Dirty on Personality Disorders

What do you guys know about personality disorders? My guess: not a whole lot. And not because you're not a well-informed bunch of people, because of course you are! It's just ... I think there's a lot of confusion out there about them.

First, let me explain something. When we diagnose (using the DSM-IV, which is not the only diagnostic system, but is the most commonly used among American mental health professionals), we do so on five "axes". I'll explain the whole system in a future post, but basically:
  • Axis I disorders are considered "clinical" disorders, that is, in need of clinical attention. Things like anxiety, depression, schizophrenia, and bipolar disorder are Axis I disorders.
  • Axis II disorders are of two types: mental retardation and personality disorders.

Personality disorders signal that a person is showing a relatively inflexible pattern of behaviors, thoughts, and emotions across most of his/her environments, and that inflexible pattern is almost certainly causing the person some trouble in terms of occupational, personal, and relational functioning.

There are three "clusters" of personality disorders outlined in the DSM-IV (and a few more identified in other diagnostic systems, but I won't get in to those today). Below is a tiny snippet about each--keep in mind that, to be diagnosed with a personality disorder, the behavior has to cause impairment, AND it has to be out of the norm for one's culture and society.

Cluster A (the odd or eccentric patterns):
  • Paranoid Personality Disorder--irrational suspicions and extreme distrust of others
  • Schizoid Personality Disorder--extreme lack of interest in other people and relationships
  • Schizotypal Personality Disorder--odd behavior and thinking

Cluster B (the dramatic, emotional, or erratic patterns):
  • Antisocial Personality Disorder--pervasive disregard for the law and rights of others
  • Histrionic Personality Disorder--pervasive attention-seeking behavior (i.e., inappropriate sexual seductiveness and shallow, exaggerated emotions)
  • Borderline Personality Disorder--instability in self-image, relationships, and identity often resulting in impulsivity and self-harm (I'll bet nearly all of y'all have heard of this one)
  • Narcissistic Personality Disorder--grandiosity, need for admiration, lack of empathy

Cluster C (the anxious or fearful patterns):
  • Avoidant Personality Disorder--social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation
  • Obsessive-Compulsive Personality Disorder--precoccupation with orderliness and interpersonal control at the expense of flexibility, openness, and efficiency
  • Dependent Personality Disorder--extreme psychological dependence on other people

These disorders really shouldn't be diagnosed until late adolescence or adulthood. The prognosis depends on the disorder. Most people with these disorders don't seek treatment until their behaviors have caused them some real suffering and turmoil in their lives. Studies show that adolescents with personality disorders are twice as likely to develop an Axis I disorder (like depression or anxiety) in adulthood when compared to their non-personality-disordered peers.

In other words, personality disorders make a person more vulnerable to other bad stuff. And also harder to treat.

I'll be doing posts on nearly every one of these personality disorders at some point. Although these disorders are not pleasant in real life, they could really make for some powerful, interesting characters in a novel, and you'll see an example of this Wednesday, when I will post about Obsessive-Compulsive Personality Disorder.

So ... are you familiar with the term "personality disorder"? Were you aware it was actually numerous disorders? Which ones have you heard of, and which ones are new to you? Are there any in particular you'd like to know more about sooner rather than later? Have you ever written a character with a personality disorder (either intentionally or unintentionally)?

Today's Monday, so remember to visit Lydia to read her Medical Monday post, and Laura for her Mental Health Monday post.

Friday, May 6, 2011

About Panic Attacks

I recently read Cracked Up To Be, by Courtney Summers. It's a truly fabulous book, an intense psychological portrait of a young woman, Parker, who is dealing with the aftermath of A MAJOR THING that gets revealed as the book progresses. I'm going to devote another post to discussing this book, which was recommended to me by the always-thoughtful aspiring_x, who wrote, "I'd love to know what's going on with Parker." I'll give you my theories and a potential diagnosis (or two) next week.

Today, I'll keep my scope narrow and focus on one thing that Parker has to deal with in the book: panic attacks.

She has several of them, some worse than others. Here's an example of the start of one of them:

I inhale. How can the auditorium be only half full and have all the air gone from it like that? I'm not getting any air. As students continue to mill into the auditorium, it gets smaller and smaller and my heart beats this insane rhythm in my chest. I rub my palms on my skirt. They're sweaty. I really can't breathe. No, I can.

I just think I can't.

Everyone's in. The teachers line up on either side of the walls, ready to shush us should the need arise. The lights overhead dim, but the stage remains bathed in an eerie golden glow. I take a few short breaths in and bring my hand to my chest because I'm afraid my heart is going to pop out of it. The tips of my fingers are tingling.

According to the DSM-IV (the diagnostic manual for psychological disorders) a Panic Attack is a period of intense fear or discomfort, during which at least four of the following symptoms develop abruptly and reach a peak within ten minutes:
  1. accelerated heart rate, pounding heart, or palpitations
  2. sweating
  3. trembling or shaking
  4. sensations of shortness of breath or smothering
  5. feeling of choking
  6. chest pains or discomfort
  7. nausea or abdominal distress
  8. feeling dizzy, unsteady, lightheaded, or faint
  9. feelings of unreality or being detached from oneself
  10. fear of losing control or going crazy
  11. fear of dying
  12. numbness or tingling sensations
  13. chills or hot flushes

As you see in the above passage from Cracked Up To Be, poor Parker experiences symptoms 1, 2, 4, and 12 in just a paragraph or two. After some of her panic attacks, she ends up in the nurse's office.

And during at least two of them ... she faints.

Now here was where I had to take a little pause, and I'll tell you why: people having panic attacks almost never faint*.

Fainting only occurs if there's some underlying medical problem or if something else is wrong. A person having a panic attack might FEEL like she is going to faint. It usually occurs because the person is hyperventilating, which fills the body with too much oxygen and too little carbon dioxide, and that results in a feeling of lightheadedness.

Hyperventilating is part of the body's natural fight-or-flight response, but if you're not doing one of those two things, all that oxygen has nowhere to go. So it builds up in your blood and makes you dizzy. Feeling faint is one of the common symptoms of panic attacks, and fainting is something many people with panic attacks fear (which causes even more anxiety).  But it basically never happens.

Actual fainting occurs with a sudden drop in blood pressure. During a panic attack, a person's blood pressure usually increases a bit. So ... no fainting.

The lifetime prevalence of panic attacks is about 1 in 20. In other words, A LOT of people have them! They're so frightening, and sometimes people are certain they're having a heart attack. People who have this type of episode should, of course, get checked out by a doctor, but the vast, vast majority of panic attacks are NOT medical problems.

And how do you deal with them? Live through them.

There are drugs you can take, and research shows some of them are effective. Research also shows that cognitive-behavioral therapy (CBT) is effective, and that its results are longer-lasting (and without side effects). Part of CBT would be learning to understand exactly what goes on during a panic attack (things like even though it feels like you're going to faint, you WON'T). Another part involves living through the episode without trying to escape the situation. The therapist might even ask you to intentionally cause some of the physical sensations of a panic attack. In fact, I've been in a training on treating panic where I had to hyperventilate, breathe through a tiny coffee straw, shake my head back and forth for a full minute, jog in place, etc. (now imagine a room full of mental health professionals doing it ... I'm surprised something like that hasn't ended up on YouTube). But I digress.

So ... how important is it to you that a novel represents mental health/psychological disorders completely accurately? What if that inaccuracy serves the plot?

*please note I said "almost never", because there are exceptions to every rule, and anyone with panic attacks who faints (or who has chest pain) should be examined by a physician.

Wednesday, May 4, 2011

Step Away From The Marshmallow. And The SEND Button.

On Monday, we watched a little video. Weren't those kids cute? Most of them were doing everything they possibly could to resist eating the oh-so-tempting marshmallow (except that little redhead who was like, "yeah, lady, blah blah OY! MARSHMALLOW! GET INTO MAH BELLEH!"). My personal favorite was the kid who puckered up and kissed it.

The original mashmallow experiment was conducted by Walter Mischel and colleagues at Stanford University in 1972. Preschoolers were seated at a table in a small room and given a marshmallow. They were told that if they waited to eat the marshmallow until an adult returned, they could have two marshmallows. You know how long these four-year-olds had to sit there? Fifteen minutes. That's a loooooong time for a small child.



Some of them ate the marshmallow instantly. Some lasted a few minutes. Some held out for the entire time. The ones who did better effectively distracted themselves, focusing on something else, or, at minimum, NOT focusing on the potential deliciousness of the marshmallow in front of them.

Ten years later, Mischel followed up with a number of kids from the original study (there's a fascinating New Yorker article about it here). It turned out that the length of time a kid was able to keep from eating the marshmallow was related to social and academic competence. The kids who were able to delay gratification also had higher SAT scores and fewer behavior problems.

Yeah. One marshmallow and fifteen minutes predicted the kids' test scores over ten years later.

Now, I likened the whole experimental situation to the query process. I could also liken it to the revision process (because that's my current delay-of-gratification challenge). Really, this can apply to writers at any stage of the game. When we've written something we're really excited about, it's hard for many of us to keep from hitting the send button (including on follow-up nudges). The marshmallow is the pleasure that comes from dreams and hopes of getting a positive response. We want it NOW.

I confess to being one of these people. Sometimes I get so passionate and excited about stuff I've written that it's hard for me to see the flaws.

UNTIL I LET IT SIT.

When I step back and really leave something alone (which is, admittedly, hard for me to do), I ALWAYS find something wrong with it when I open it up again. Every. Single. Time. I'm often amazed I didn't spot particular things before--especially because I am rather obsessive about editing and consider myself pretty hardcore about grammar and punctuation. It never fails, though. Letting things sit helps me make things better. Waiting for feedback helps me make things better.

Hitting the send button prematurely? Doesn't help me make things better.

Or, at least, not without some costs (the most obvious being flat-out rejection).

You've all heard this advice from more credible sources than me. Agents. Editors. Published authors. Veteran writers. So have I. But there was something about that marshmallow video that really brought it home for me. When the possible reward is so great, why would I want to settle for an immediate--but much smaller--reward?

No reason ... except the temporary thrill of sending something off. It's not nearly good as knowing I've given my beloved story every chance to succeed.

What can we learn from the marshmallow experiment? Follow-up studies showed that delaying gratification is mainly about controlling thoughts and attention.

Focusing on the "hot" feelings and thoughts about the potential reward makes it MUCH harder to delay gratification. Effectively distracting yourself from the hot stuff and finding other ways to think about it (and other things to do) helps you hold out. For you querying writers, that means:

IF you focus on how awesome it's going to feel when that agent falls in love with your manuscript and heaps sticky mounds of delicious praise upon it before offering up her first born just for the chance to rep you and sell your future guaranteed-best-seller ... it's going to be hard to hold back.

IF you focus on what you KNOW you need to do to get there, send your project off for feedback, do some beta-reading for others (just one example of focusing your attention elsewhere), revise a bit, close the file, whine to your CPs, brainstorm ideas for your next project, remind yourself that taking your time will be worth it, revise and edit, eat some pizza, cruise the forums/Twitter/blogosphere for advice and support, offer some support and advice of your own, send your project off for final feedback, write your query, remind yourself that the agents will still be there when you're ready to roll, pay attention to query feedback and think about whether the criticism applies to the entire story (this is SO often true), comb through the project to find the tiniest of typos, ET CETERA ... unfortunately, even then, there's no guarantee of success.

But your probability of ending up with two marshmallows will greatly increase.



OK, so. What do you think? I say:
  • Kids who fondled the marshmallow = Folks who are dying to hit "send" but vet their queries at the forums
  • Kids who picked tiny bits off the marshmallow = Folks who send out those "test queries"
  • Kids who took bites out of the marshmallow but put it back on the plate = Folks who send out a batch or two of queries before realizing they have more work to do
  • Kids who ate it before the experimenter left the room = Folks whose books will most likely sleep with the fishes. Fishes who live in trunks.
  • Kids who, despite craving that marshmallow so bad it caused them to do funny hand-waving dances, held out until the bitter end = IF YOU DON'T KNOW BY NOW, I CAN'T HELP YOU.
In the comments, please help your fellow writers by offering up your best strategies for delaying gratification!

I'll go first. In order to focus your attention on something other than sticky mounds of agent-praise, go check out Laura's Sisterhood of the Traveling Blog post for the month of May, wherein she answers the question, "What do you do when you lose your writing mojo?"

Monday, May 2, 2011

Should You Send That Query? What We Can Learn From The Marshmallow Test.

I know many of you are writers who plan to query or are querying, so this one is for you. However, today's topic applies to just about every area of our lives, so ... I guess this is actually for everyone, but we'll use the road to publication as an example.

Let's say you write a novel. You think it's a good novel. You read over it a few times, and you're amazed this riveting combination of drama and suspense and romance and intrigue could have flown from your fingers. Your mom reads it, and she agrees! She thinks you're the next ________________(insert the name her favorite published author here). Your heart beats faster. Your thoughts whirl with possibilities. You could really do this--you could share your work with the world and make it as a writer. With dreams of making the NYT Best Seller List dancing in your head, you do a little research on how to get published.

What you decide to do next and the implications of that decision can be nicely summed up with the following video.

Let me set this up for you.

You = Kid
Experiment = Query Process
Marshmallow = YOU TELL ME AFTER WATCHING THIS:




On Wednesday, I'll talk more about this experiment, what it tells us about impulse control, and what it could mean for querying writers (and everyone else).

Please stop by Laura's blog to check out her ever-intriguing Mental Health Monday post, and go to Lydia's blog to read her always-awesome Medical Monday post.

Now tell me--what does the marshmallow represent?