Veronica Pamoukaghlian, MA – Brain Blogger Health and Science Blog Covering Brain Topics Wed, 30 May 2018 15:00:03 +0000 en-US hourly 1 Is Your Brain Male or Female? Sat, 06 Jun 2015 14:00:36 +0000 In his book The Essential Difference: Male And Female Brains And The Truth About Autism, Simon Baron-Cohen opens with a phrase capable of causing infinite controversy: “The female brain is predominantly hard-wired for empathy. The male brain is hard-wired for understanding and building systems.”

When I first became interested in gender differentation in the brain, after reading about prairie voles and how oxytocin made them more nurturing as parents (in Steven Johnson´s book Mind Wide Open), I started commenting on new findings about the female brain with friends and acquaintances. The response I got was usually rather skeptical. This was especially the case when I tried to bring the subject up with women.

Apparently, after fighting for equal rights for centuries, many women were reluctant to acknowledge significant differences between the male and female brain. The popularization of neuroscience, aided by advances in the research, have conquered only a fraction of that skepticism. But the truth is that none of it is justified.

Vasopressin and Empathy

Structural differences between the male and female brain, most prominently connectivity between the hemispheres, are well known, while many aspects about the way each one of them works are still a mystery.

A recent study focusing on the synthesis of neuropeptides vasopressin (VP) and oxytocin (OT), which are involved in a large number of social behaviors including mate bonding and parental care, concluded that VP and OT systems frequently mediate sex differences in such behaviors.

Another study from earlier this year found that intranasal VP, yet not oxytocin, altered empathic behavior in both men and women. VP systems in male and female brains have shown many differences across different species of rodents, yet the way these differences affect VP release in the brain is still unknown. At any rate, in spite all the uncharted territory, it would seem that when Baron-Cohen attributed empathy to females, he was not too far from the truth.

Creativity in the Male and Female Brain

One of the things scientists observe most frequently when doing fMRIs of the female and male brain executing the same activities is that different areas of the brain tend to “light up.” While one sex seldom outperforms the other, the way men and women solve a problem, recall certain types of memories, or engage in creative processes appears to be quite different.

During a study focusing on creative processes, such as creative conceptual expansion and general divergent thinking, men and women showed indistinguishable performance levels across the different tasks proposed. However, fMRIs revealed profound strategic differences between the genders. For example, while in men, brain areas related to semantic cognition, rule learning, and decision making were primarily engaged during conceptual expansion, in women there was higher activity in regions associated with speech processing and social perception.

Oxytocin and Parenting

More popular than differences in empathic behavior and creativity strategies, oxytocin is the unquestioned star when it comes to making a name for itself in pop culture. Oxytocin is connected with nurturing and caring behaviors towards offspring. Research has shown that besides playing a key role in childbirth and early mother-child bonding, oxytocin release, alongside dopamine release, may also result from rewarding interactions with infants. It has actually been observed that fathers who spend time with their kids may stimulate the oxytocin-dopamine reward system in their brains.

In fact, evidence points to the possibility to “rewire” the male brain to accommodate parenting styles similar to those associated with females. For example, in one study, a vole from a species that is not nurturing with offspring was placed among a group of nurturing voles. The result was that regardless of its neurological predisposition to be less nurturing, the vole learnt from the individuals around it and became a nurturing parent.

When Babies Cry

The question is, if males can acquire characteristics associated with the female brain, why is gender differentiation in the brain still such a big deal?

Well, there is still more functional differentiation to go. Several studies have analyzed the reactions of both mothers and fathers to the crying of their infants. Scans have revealed a greater activation of amygdala and basal ganglia in brand new mothers compared with fathers, which is consistent with mothers being more preoccupied than fathers in these circumstances. Responses to baby stimuli have also been linked to OT pathways, as mothers who give birth through vaginal birth, which stimulates oxytocin release, show greater brain activity in response to the cries of their own babies versus other babies.

Arguably, parenting styles and how they originate in brain function may be the most salient aspect of male-female differentiation in the brain. However, much of the evidence in these respect points to fathers simply being slower learners. For example, when it comes to baby cry stimuli, it may take fathers between 6 to 18 months to match the level of brain activation shown by mothers, but they eventually get there.

The Extreme Male Brain

With as many champions as detractors, Baron-Cohen is still a top expert in the field. His theory of the extreme male brain may be the culprit of the passions his work never fails to excite. Basically, he proposes that the autistic brain is the “full-on” male brain, namely, zero empathy, all systemization.

In a study published earlier this year, Baron-Cohen and his colleagues presented new evidence for the extreme male brain theory in the shape of hemodynamic response measurements during second-order false-belief task and coherent story task performances. Since the measurements revealed “sex difference in the neural basis of Theory of Mind (a cognitive component of empathy) and pragmatic language,” the researchers concluded that this was in line with the extreme male brain hypothesis; a conclusion that seems slightly far-fetched. While the findings do not disprove the extreme male brain theory, they seem to contribute not much more than a grain of sand in the building of a giant castle.

What About the Gay Brain?

An interesting question that surfaces whenever the male and female brain are discussed is what happens with the gay brain? In other words, do homosexual women have a brain more akin to men´s and vice versa?

A research team tried to answer this question by studying functional cerebral lateralization for the processing of facial emotions. The sample comprised 30 heterosexual males, 30 heterosexual females and 40 gay males. Results revealed that while men were right-lateralized when viewing female faces, homosexual men were as left-lateralized as women during the same activity. Thus, researchers concluded that “gay men are feminized in some aspects of functional cerebral lateralization for facial emotion.”

Perhaps the future of male-female brain differentiations studies lies in the understanding of brain formation and development. A study from Beijing University, which appeared in Acta Radiologica earlier this year, attempts to draw conclusions from studying the brains of 400 young adults. The authors observed significant topographical differences between the sexes, including gray matter volume and cortical thickness, both larger in females, and posed a question neuroscientists will bust their own brains – whether male or female – trying to answer in the years to come: Does the difference in the topological architecture represent underlying behavioral and cognitive differences between genders?

As with many areas of neuroscience, when it comes to gender differentiation in the brain, experts today seem to have many more questions than answers, but this is precisely what makes the field so exciting.

Meanwhile, common people continue to devour books about the male and the female brain, in the hopes of understanding the other sex better, a pursuit as likely to be crowned with success anytime soon as the full understanding of the brain itself.


Abraham A, Thybusch K, Pieritz K, & Hermann C (2014). Gender differences in creative thinking: behavioral and fMRI findings. Brain imaging and behavior, 8 (1), 39-51 PMID: 23807175

Dumais KM, & Veenema AH (2015). Vasopressin and oxytocin receptor systems in the brain: Sex differences and sex-specific regulation of social behavior. Frontiers in neuroendocrinology PMID: 25951955

Frank CK, Baron-Cohen S, & Ganzel BL (2015). Sex differences in the neural basis of false-belief and pragmatic language comprehension. NeuroImage, 105, 300-11 PMID: 25264229

Hu Y, Xu Q, Shen J, Li K, Zhu H, Zhang Z, & Lu G (2015). Small-worldness and gender differences of large scale brain metabolic covariance networks in young adults: a FDG PET study of 400 subjects. Acta radiologica (Stockholm, Sweden : 1987), 56 (2), 204-13 PMID: 24763919

Nakstad, P. (2015). Gender differences in the human brain Acta Radiologica, 56 (2), 131-132 DOI: 10.1177/0284185114562993

Rahman Q, & Yusuf S (2015). Lateralization for Processing Facial Emotions in Gay Men, Heterosexual Men, and Heterosexual Women. Archives of sexual behavior PMID: 25564038

Swain, J., Kim, P., Spicer, J., Ho, S., Dayton, C., Elmadih, A., & Abel, K. (2014). Approaching the biology of human parental attachment: Brain imaging, oxytocin and coordinated assessments of mothers and fathers Brain Research, 1580, 78-101 DOI: 10.1016/j.brainres.2014.03.007

Image via Andrey Arkusha / Shutterstock.

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Amyvid Alzheimer´s Testing – To Be Or Not To Be? Mon, 14 Oct 2013 11:00:06 +0000 The FDA approved Amyvid for Alzheimer´s testing in April 2012, yet Medicare and Medicaid denied coverage for it last July. The new brain imaging drug helps detect beta-amyloid neuritic plaques in the brain, which are associated with Alzheimer´s disease. In the past, in order to detect these plaques, a biopsy had to be performed. But the test remains controversial — will it be taken up?

There are about five million Americans suffering from Alzheimer´s disease today, and analysts predict that this number could double by 2050. This constitutes a huge market for pharmaceutical companies trying to develop effective drugs against what remains an incurable condition. Amyvid developer Lilly & Co is one of them, and it is currently working on an experimental drug called Solanezumab. While Amyvid testing is now available in numerous locations around the US, coverage would completely change the landscape of Alzheimer´s diagnosis in the country by clearly identifying the markets for solanezumab and other similar drugs. 

Amyvid is a radioactive agent that is injected into patients prior to performing a 30-minute PET scan. The drug directly highlights amyloid neuritic plaques present in the brain. One of the claims Medicare made against Amyvid testing is that it does not directly establish an Alzheimer´s diagnosis, because there are other conditions associated with cognitive impairment that can cause a high density of neuritic plaques in the brain. However, the new brain imaging technique can reliably rule out Alzheimer´s when the plaques are not present. Studies have shown that 20% to 50% of Alzheimer´s patients in America have been misdiagnosed with the disease, and there seems to be a consensus as to the enormous potential of Amyvid testing to reduce this type of misdiagnosis.

A 2011 survey by the Harvard School of Public Health revealed that 85% of respondents would be willing to be tested for Alzheimer´s if they ever exhibited signs of cognitive impairment, such as memory loss. However, as the test is currently not covered by insurance or Medicare, and its cost of $3000 is rather steep, testing is currently limited to those who can afford it.

As Lilly & Co awaits a final decision about coverage in October 2013, Alzheimer´s patients and researchers associations argue that if the new imaging scan were to be covered by health insurance, the data collected from Alzheimer´s patients worldwide would greatly help researchers develop new treatments for this prevalent disease. Medicare representatives, on the other hand, claim that testing can be of no help so long as Alzheimer´s disease remains incurable.

While results for Solanezumab and other Alzheimer´s treatments in development are still far from commercialization, a definite Alzheimer´s diagnosis would be required in order to treat patients with these drugs. Although there is some truth to Medicare´s argument about neuritic plaques proliferating in the brain in patients with conditions other than Alzheimer´s, the fact is that Amyvid has revolutionized Alzheimer´s diagnosis. Amyvid testing may not be perfect, but it is surely a huge step forward in Alzheimer´s research, and it has great potential to aid the development of new treatments for this prevalent disease.


Blendon, R. J. et al. Key Findings from a Five-Country Survey of Public Attitudes about Alzheimer’s Disease. Poster presented at AAIC, July 2011.

Gandhi, H.; Hewing, D.; Botkin, C.; Hubble, W.; Turner, J.; Osman, M. (June 2013). Amyvid: A Review and assessment of clinical implementation. Journal of Nuclear Medicine and Molecular Imaging Meeting.

US Food and Drug Administration. Press Release (April 2012): FDA Approves Imaging Drug Amyvid.

American Academy of Neurology (2011, February 24). Alzheimer’s disease may be easily misdiagnosed. ScienceDaily.

World Health Organization fact sheet (February 2007). The top ten causes of death.

Alzheimer’s Association (2011). Alzheimer’s Disease Facts and Figures

Image via SFAM Photo / Shutterstock.

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Male Domination and the G-spot Thu, 01 Aug 2013 11:00:38 +0000 Ever since the somewhat magical concept of the G-spot appeared in the 1950s, laymen and scientists alike have been on a blind chase after it. In 2012, Dr. Adam Ostrzenski created a media circus with his reported discovery and dissection of a specimen of the G-spot. In order to understand the true motives of the quest for the G-spot, it is essential to go back to the time where it came from.

According to popular myth, the G-spot would have the power of giving women much more powerful orgasms than the clitoris. The catch is that, also according to this myth, which is widely accepted outside scientific circles, not all women would be privy to the secrets of the G-spot, in fact, some might not even possess this magic source of endless pleasures at all. Despite reliable reports and anecdotal testimonials, objective measures have failed to provide strong and consistent evidence for the existence of the famed G-spot.

While Dr. Ostrzenski´s article on having found a G-spot specimen was published by the prestigious Journal of Sexual Medicine, and it also landed him on US prime time television, a large portion of the scientific community reacted to his reported discovery with a high level of healthy skepticism. Based on the research that has been carried out to date, the evidence of the existence of the elusive G-spot is considered anecdotal at best. Considering that Dr. Ostrzenski based his discovery on visual observation of a single specimen, it is very hard to imagine that his findings might be significant enough to outweigh decades of serious research.

As Dr. Harriet Hall, one of the researcher´s fierce detractors states: “The author declared it was a G-spot based on visual inspection of the specimen alone; he said it was an 8.1 mm sac-like structure with a head, body, and a rope-like tail that disappeared into surrounding tissues. After excision, it could be stretched to 33 mm.  He said the walls of the structure resembled fibroconnective tissues and resembled erectile tissues. Both? Apparently he didn’t even bother to take the most obvious, rudimentary next step of examining slices of the specimen under a microscope (with appropriate staining) to determine what kind of tissue it was.”

Although there is no mention of it in Ostrzenski´s study, researchers who claim to be certain of the existence of the G-spot have often referred to the phenomenon known as female ejaculation as an irrefutable proof that there is, in fact, another kind of female orgasm, reserved only for a few lucky members of our sex. But while many women have claimed that they ejaculate during sex, there is still some debate as to the nature of the fluid secreted, according to a review of the literature, most researchers appear to agree about the cause of the secretion.

Some have identified it as urine, and as a fluid released from the Skene’s glands, similar to that produced by the male prostate. Thus, the term ejaculation would not apply to this fluid, as it does not seem to be connected to the female orgasm at all.

As far back as 1968, feminist thinker Anne Koedt wrote an influential work entitled; The myth of the vaginal orgasm. She examined the constructions about female sexuality of a culture dominated by men, analyzing assumptions about female frigidity and the female orgasm: “Frigidity has generally been defined by men as the failure of women to have vaginal orgasms. Actually the vagina is not a highly sensitive area and is not constructed to achieve orgasm. It is the clitoris which is the center of sexual sensitivity and which is the female equivalent of the penis.”

In order to better understand Koedt´s views, it can be helpful to learn about what sexual health professionals thought about the female orgasm in her time. In many ways, in spite of the advancement of science, popular culture seems to have retained many of these outmoded assumptions: “…whenever a woman is incapable of achieving an orgasm via coitus, provided the husband is an adequate partner, and prefers clitoral stimulation to any other form of sexual activity, she can be regarded as suffering from frigidity and requires psychiatric assistance.”

Following Koedt´s reasoning, which was created to challenge those views, we could say that the anecdotal evidence that has been used over the years to proclaim the existence of the G-spot might have been directly influenced by dominant man´s desperate desire to blame the lack of vaginal orgasms on women´s “underdeveloped” G-spots, as opposed to an anatomical limitation that would render them virtually unable to give women orgasms through penetration, without clitoral stimulation.

In this respect Koedt says categorically: “Rather than tracing female frigidity to the false assumptions about female anatomy, our “experts” have declared frigidity a psychological problem of women. Those women who complained about it were recommended psychiatrists, so that they might discover their “problem” — diagnosed generally as a failure to adjust to their role as women. The facts of female anatomy and sexual response tell a different story. Although there are many areas for sexual arousal, there is only one area for sexual climax; that area is the clitoris. All orgasms are extensions of sensation from this area. Since the clitoris is not necessarily stimulated sufficiently in the conventional sexual positions, we are left “frigid.””

In a way, if there were no “sexual politics” behind it, the lack of evidence of the existence of a G-spot might have truncated this line of research altogether many years ago, making it impossible for the likes of Ostrzenski to thrive in any scientific medium. However, for as long as men ignore the true nature of the female anatomy by calling women unable to achieve orgasm through penetration “frigid,” studies about the possible existence of the mythological G-spot are likely to proliferate.


Caprio, Frank S. “The Sexually Adequate Female” New York: Citadel Press, 1953

Koedt, Anne. The Myth of the Vaginal Orgasm (1968). Notes from the First Year, New York Radical Feminists, New York.

Leiblum, S., & Needle, R. (2006). Female ejaculation: Fact or fiction Current Sexual Health Reports, 3 (2), 85-88 DOI: 10.1007/s11930-996-0007-5

Ostrzenski A (2012). G-spot anatomy: a new discovery. The journal of sexual medicine, 9 (5), 1355-9 PMID: 22781083

Image via Luskutnikov / Shutterstock.

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New Imaging Techniques to Unlock Brain Disorders Tue, 04 Dec 2012 12:00:59 +0000 A study published in recent issue of Neuron describes a very promising new imaging technique, which has successfully charted complex neural reactions and could lead to the detection of brain activity patterns associated with certain psychiatric disorders, including autism and obsessive-compulsive disorder.

Neuroscientists have made some spectacular breakthroughs over the last decade. Imaging techniques have combined with complex cell-labelling methods to enable the visualization of events in living brain cells at both cellular and sub-cellular levels. The MIT-lead team´s contribution to brain imaging opens some new and exciting paths in the visual documentation of neural processing.

Using calcium ion recognition in the brains of genetically-engineered mice, a team of scientists from some of the top brain research institutes in the US was able to track the brain circuit activity that occurs in the brain when, for example, a certain smell is perceived. MIT has made a video relating these experiments available online.

One of the authors of the study, Guoping Feng, from the Stanley Center for Psychiatric Research, explains,

To understand psychiatric disorders we need to study animal models, and to find out what’s happening in the brain when the animal is behaving abnormally. This is a very powerful tool that will really help us understand animal models of these diseases and study how the brain functions normally and in a diseased state.

Basically, the electrical signals that neurons generate prompt an influx of calcium ions when a cell becomes active. The calcium is dyed, in order to make it visible through imaging. However, in the past, this method couldn´t be used to focus on specific kinds of cells, because the dye was absorbed by all of them alike.

The paper´s authors developed a new calcium-based imaging technique using a green fluorescent protein (GFP). Although similar techniques have been used before, one of the MIT team´s greatest breakthroughs has been the development of a new, improved type of green fluorescent protein, which is powerful enough to be used in living animals.

Once the new GFP was ready, genetically-engineered mice were used to track activity in pyramidal cells, and the scientists were able to identify activity in these neurons as a response to certain stimuli. For example, they tracked down activity following the touching of a mouse´s whiskers or the perception of certain smells.

The next step for the research team is the development of a new set of transgenic mice which they believe will allow them to compare activity in the brains of autistic and obsessive-compulsive individuals to that which occurs in the brains of normal mice.

According to Dr. Feng,

Right now, we only know that defects in neuron-neuron communications play a key role in psychiatric disorders. We do not know the exact nature of the defects and the specific cell types involved. If we knew what cell types are abnormal, we could find ways to correct abnormal firing patterns.

While the paper´s findings may appear far from spectacular to the non-informed observer, its implications for the future of brain imaging may well represent an unparalleled advancement for the understanding of psychiatric disorders at a neuronal level.


Chen Q, Cichon J, Wang W, Qiu L, Lee SJ, Campbell NR, Destefino N, Goard MJ, Fu Z, Yasuda R, Looger LL, Arenkiel BR, Gan WB, & Feng G (2012). Imaging Neural Activity Using Thy1-GCaMP Transgenic Mice. Neuron, 76 (2), 297-308 PMID: 23083733

Feng G, Mellor RH, Bernstein M, Keller-Peck C, Nguyen QT, Wallace M, Nerbonne JM, Lichtman JW, & Sanes JR (2000). Imaging neuronal subsets in transgenic mice expressing multiple spectral variants of GFP. Neuron, 28 (1), 41-51 PMID: 11086982

Becker K, Jährling N, Saghafi S, Weiler R, & Dodt HU (2012). Chemical clearing and dehydration of GFP expressing mouse brains. PloS one, 7 (3) PMID: 22479475

Image via Marcio Jose Bastos Silva / Shutterstock.

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Cognitive Behavioral Therapy for Bulimia Nervosa – A Success Story Fri, 05 Oct 2012 11:00:45 +0000 When I was researching to write this article, I found a piece entitled Fifteen years of bulimia, then came the miracle of CBT. The article told the story of a woman who had “seen the light” through cognitive behavioral therapy (CBT), and linked to the clinic where she had been treated in Spain. While CBT may be the most effective treatment for bulimia nervosa (BN), this type of — most certainly paid — advertising only does the treatment a poor service.

Whoever thinks CBT is going to solve all their problems, with little effort, ignores the most fundamental thing about CBT, namely, it is really hard work, and patients need to apply themselves, in order to see the “fast CBT results” everyone has been raving about over the last couple of decades.

All that said, the evidence supporting the positive outcome of CBT treatments for patients diagnosed with BN is overwhelming. After carefully reviewing the literature, I am presenting here a review of a variety of studies (based on both qualitative and quantitative elements) analyzing the short and long term results of CBT for bulimia and binge eating disorder (BED).

Study Details and Results

1. Group cognitive-behavior therapy for bulimia nervosa: Statistical versus clinical significance of changes in symptoms across treatment

Location: UK

Year: 2004

Method: 29 patients diagnosed with bulimia were assessed using the Stirling Eating Disorder Scales, the Beck Depression Inventory, and the Beck Anxiety Inventory at four different points: assessment, pre CBT, end of CBT, and at 6 months follow-up. Symptom change was measured.

The treatment: 12 weekly group sessions lasting 90 minutes each. Treatment lead by a cognitive behavioral therapist assisted by a dietitian. Individual meetings with both professionals were held before the beginning of the group sessions, and one follow-up group session plus one final individual meeting with the therapist. Total number of sessions was 16.

Treatment included the following elements:

  • sessions on body image and interpersonal/relational issues
  • cognitive-behavioral challenges
  • asking patients to keep ‘‘food and feelings’’ diaries to track disordered behaviors and psychological factors, which were shared during part of the sessions
  • dealing with the diet/binge cycle
  • stress management
  • managing myths & reality
  • challenging negative thinking workshop
  • maintenance and relapse prevention

Results/conclusions: An overall improvement maintained after 6 months was observed in dimensional measures of bulimic and restrictive attitudes and behaviors, and there were clinically significant changes in bulimic behaviors. Depression was targeted much more effectively than anxiety, and there was a significant reduction of self-directed hostility. Deterioration in terms of all bulimic symptoms was minimal.

After 6 months, 20.7% of participants believed that they had recovered and 44.8% believed that they were much improved. These self-evaluation figures closely matched the analysis of clinically significant change.

2. Cognitive-Behavioral Therapy for Bulimia Nervosa: An Empirical Analysis of Clinical Significance

Year: 2003

Method: Fifteen different treatment outcome studies of CBT for BN were assessed, using the reliable change index and normative comparison analyses, in order to reach a conclusion about the clinical significance of the treatment.

Results/conclusions: Clinically significant change was observed for several treatment outcome measures.

3. Investigating the use of CD-Rom CBT for bulimia nervosa and binge eating disorder in an NHS adult outpatient eating disorders service

Location: UK

Year: 2011

Method: Considering the high dropout rates for outpatient treatments for BN and BED, a program offering CD-Rom CBT, self-help treatment for these disorders was devised.

40 patients assessed by the National Health Service as having either of the disorders followed the 8 sessions, CD-Rom program, later attending an evaluation meeting.

Results/conclusions: Both the BN and the BED groups showed significant improvements in well-being and functioning and significant reductions in problems and risk. A significant reduction was also observed on the “Bulimic Subscale” of the EDI. The use of self-help multimedia programs for binge-related eating disorders was evaluated as “very promising.”

4. A multicenter comparison of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa.

Location: US

Year: 2000

Method: Two hundred twenty patients recruited at two treatment sites (Stanford and Columbia Universities) meeting DSM-III-R criteria for BN were allocated 19 sessions of either CBT or interpersonal psychotherapy (IPT) over a 20-week period, followed by a 12-month post-treatment evaluation.

Results/conclusions: CBT was found to be significantly superior to IPT at the end of treatment point in terms of:

  • Percentage of patients recovered 29% for CBT vs 6% for IPT
  • Remittance 48% vs 28%
  • Meeting community norms for eating attitudes and behaviors 41% vs 27%
  • No significant differences were observed in terms of recovery at the follow-up evaluation point.

The researchers recommended CBT for treating BN, due to the rapid improvements observed in patients, when compared to IPT. Data showed that IPT doesn´t ensure more long-lasting results than CBT.

5. Cognitive-behavioral therapy for bulimia nervosa: Time course and mechanisms of change.

Location: US

Year: 2002

Method: Analysis of results of a randomized control trial comparing CBT with IPT in BN treatments, focussing on mediators of change and time course of action.

Results/conclusions: Reduction in dietary restraint as early as week 4 was observed to mediate posttreatment improvement in binge eating and vomiting. At midtreatment, measures of self-efficacy regarding maladaptive eating behaviors, negative affect as well as body image and weight were also seen to mediate posttreatment improvement. The effect of CBT was observed to be much significantly more rapid than IPT. There was no evidence that the therapeutic alliance mediated treatment outcomes, which, interestingly enough, clearly indicates that the benefits were directly connected with the type of treatment.

6. Bulimia nervosa treatment: A systematic review of randomized controlled trials

Location: Worldwide

Year: 1980-2005

Method: Forty-seven studies (published between 1980 and 2005) of bulimia treatment outcomes were selected according to a set of inclusion criteria, which put the focus on medication only treatments, behavioral interventions only, and combined medication with behavioral interventions for both adults or adolescents.

Results/conclusions: Analysis of the included studies revealed that, in the short term, fluoxetine (60 mg/day) reduces core symptoms and associated psychological, while Cognitive behavioral therapy has a similar effect in both the short and the long term. The authors concluded that there was sufficient evidence for the treatment of BN with medication and/or behavioral therapies.

7. Relapse Predictors of Patients With Bulimia Nervosa Who Achieved Abstinence Through Cognitive Behavioral Therapy

Location: US

Year: 2002

Metod: The sample comprised 48 patients with BN who had been assessed as having achieved abstinence (no binges or purges) after CBT and were available for assessment 17 weeks later. This was a multisite study conducted at: Weill Medical College of Cornell University, the University of Minnesota and Rutgers University.

Results/conclusions: 17 weeks after treatment, 44% of the patients in the sample had relapsed. Identified relapse predictors included a higher level of preoccupation and ritualization of eating and a lesser motivation for change, as well as a shorter period of abstinence maintained during treatment.

Although the sample was small to draw universal conclusions, the authors suggest that the identified predictors can help single out patients who might need additional treatment for relapse prevention.

8. Meta-analysis of CBT for bulimia nervosa: investigating the effects using DSM-III-R and DSM-IV criteria.

Location: Worldwide

Year: 1986-1998. Published in 1999.

Method: The meta analysis included 7 empirical, randomised, and controlled studies published between 1986 and 1998, investigating the use of CBT for BN, diagnosed according to DSM-III-R or DSM-IV, where the frequency of binge eating and purging had been assessed. The studies selected included comparisons between CBT and other treatments.

The authors used statistical analysis to calculate the effect size of CBT for binging and purging behaviors based on both between-group (treatment vs control) and within-group (pre- vs post-treatment) comparisons

Results/conclusions: In view of the superior results (in terms of measured effect sizes) of CBT for treating BN, the authors recommended it as the treatment of choice for this disorder.


Given the consistency of rapid, positive short and long term results observed when treating bulimia nervosa with CBT, throughout the world, I believe that the best path to recommend for anyone suffering from this disorder is to find an accredited cognitive behavioral therapist with experience in the field, a group CBT program, or even a self-help CBT program.

As for therapists, whatever their therapeutic convictions may be, in view of the overwhelming evidence, they should all be aware and try to keep informed about the methods and tools developed by CBT for the treatment of Bulimia Nervosa, as they may be of use within a variety of therapeutic contexts


Openshaw C, Waller G, & Sperlinger D (2004). Group cognitive-behavior therapy for bulimia nervosa: statistical versus clinical significance of changes in symptoms across treatment. The International journal of eating disorders, 36 (4), 363-75 PMID: 15558655

Lundgren JD, Danoff-Burg S, & Anderson DA (2004). Cognitive-behavioral therapy for bulimia nervosa: an empirical analysis of clinical significance. The International journal of eating disorders, 35 (3), 262-74 PMID: 15048942

Graham L, & Walton M (2011). Investigating the use of CD-Rom CBT for bulimia nervosa and binge eating disorder in an NHS adult outpatient eating disorders service. Behavioural and cognitive psychotherapy, 39 (4), 443-56 PMID: 21208485

Agras WS, Walsh T, Fairburn CG, Wilson GT, & Kraemer HC (2000). A multicenter comparison of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa. Archives of general psychiatry, 57 (5), 459-66 PMID: 10807486

Wilson GT, Fairburn CC, Agras WS, Walsh BT, & Kraemer H (2002). Cognitive-behavioral therapy for bulimia nervosa: time course and mechanisms of change. Journal of consulting and clinical psychology, 70 (2), 267-74 PMID: 11952185

Shapiro JR, Berkman ND, Brownley KA, Sedway JA, Lohr KN, & Bulik CM (2007). Bulimia nervosa treatment: a systematic review of randomized controlled trials. The International journal of eating disorders, 40 (4), 321-36 PMID: 17370288

Halmi KA, Agras WS, Mitchell J, Wilson GT, Crow S, Bryson SW, & Kraemer H (2002). Relapse predictors of patients with bulimia nervosa who achieved abstinence through cognitive behavioral therapy. Archives of general psychiatry, 59 (12), 1105-9 PMID: 12470126

Ghaderi A, Andersson G. Meta-analysis of CBT for bulimia nervosa: investigating the effects using DSM-III-R and DSM-IV criteria. Scandinavian Journal of Behaviour Therapy 1999; 28(2): 79-87.

Image via cla78 / Shutterstock.

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The Cognitive Behavioral Miracle – Controlling your Emotions Tue, 05 Jun 2012 22:55:53 +0000 Most people who have never experienced a cognitive behavioral therapy (CBT) session, or at least read about it, tend to share the notion that what psychologists do is pretty much listen to your problems, sometimes offer advice and different points of view, and make you think about your feelings, actions, and emotions. In this popular view of therapy, the patient (or client) is a rather passive subject, and the therapist is the one doing the work. Personally, I don’t think there has been a more profound revolution in the study of human psychology as the cognitive behavioral revolution.

I first became fascinated with CBT while translating and editing some course materials for the director of the CBT Institute in Ireland, Sylvia Buet. I then discovered that when one mentions behavioral, most people would think of Pavlov-style basic stimuli-response training; while CBT was in reality much more complex. Buet in particular teaches her CBT students to ask clients to sign a contract at the beginning of therapy, which binds them to work to solve their own problems. Esteban Mello, the director of the CBT Institute in Uruguay, consistently uses half of each session to explain the tasks the consulting individual will be expected to perform before their next appointment. In this scenarios, the stereotypical idea of a person who goes to therapy to “take a load off” every week becomes completely obsolete.

In a nutshell

The principles of CBT are based on a very simple idea: we feel according to what we think, in other words, our thoughts and cognitive constructions are at the root of our emotions and behavior patterns. CBT is based on three fundamental propositions:

  1. Cognitive activity affects behavior;
  2. Cognitive activity may be monitored and altered; and
  3. Desired behavior change may be effected through cognitive change.

The original theoretical framework of CBT stems from two main sources, Ellis’ rational emotive behavioral therapy, known as REBT and Beck’s cognitive therapy. Drawing from a concept already present in ancient Greek philosophy, Ellis established the A-B-C-model, where A stands for adversity/activating event, B stands for beliefs and C for consequences. The idea is that while people think that they get upset (consequence) because of an adversity (A) (i.e. something “bad” that happened to them), in reality they get upset because of their beliefs (B) about what happened, and everything negative they associate with the event in their minds, and not because of the adversity itself.

On the other hand, Beck developed cognitive therapy (CT), which focused on the identification of dysfunctional thinking, behavior, and emotional responses, emphasizing on patient-therapist collaboration and a belief-testing dynamic.

Today, CBT encompasses a variety of therapies that share a basic core, one of the most salient characteristics all of these therapies have in common is their standardised protocol of testing and measuring results before any treatment is approved. This means that specific randomized controlled trials must yield significantly positive results, in order for treatments to be adopted. Only when consistently positive results are observed when comparing to treatments based on other therapeutic approaches, can the prospective CBT treatments become an acceptable option.

Problem classification

There are different classes of CBT that are used to deal with different kinds of problems. Cognitive behavioral therapists classify problems according to the degree of influence the individual has on them and their outcomes. While coping skills are the main focus when treating problems which are caused and governed by external factors, cognitive restructuring is the method of choice when dealing with problems that originate from the individual.

One of the first things Mello teaches his patients is to class problems in three different categories:

  1. Problems upon which the individual has no control whatsoever;
  2. Problems that depend partially on the individual and partially on external factors; and
  3. Problems that depend solely on the individual.

For example, a death in the family would be a problem of the first kind. However, if we feel that having a good time after our loved one’s passing implies that we have no respect for them, or that we didn´t love them enough; we may be developing a problem of the second kind, where we have a certain control of the situation, though there are some factors over which we can have no influence. In these cases, CBT will focus on altering these beliefs, so that the person can continue to have a normal, healthy life, without feeling guilty about it.

If we asked the person in this last example, what they are upset about, they would most likely answer “because so-and-so died.” They would thus be focusing on Ellis’ A or adversity, when in reality, what is making them upset is B (i.e. their own beliefs about their loved one´s death´s meaning).

Proven results

According to the Beck Institute, over 500 scientific studies have proven that CBT has had significantly better results than any other therapeutic approach for a growing number of disorders and problems. These include obsessive compulsive disorder, general anxiety disorder, post-traumatic stress disorder, bulimia, drug and alcohol abuse, social phobias and dissociative disorders, among many others.


CBT is a fundamentally empowering approach, in that it has successfully identified certain ways of thinking that can make the difference between sanity and insanity, between happiness and unhappiness, and it has developed a variety of techniques to teach patients to substitute these dysfunctional patterns of thinking, which are often at the root of their problems.

As research progresses and the theoretical framework expands and evolves, and judging from its past evolution, it is possible to predict that CBT will continue to develop more and more effective techniques and strategies to help patients dealing with all kinds of psychological and psychiatric problems.


Dobson KS. Handbook of cognitive-behavioral therapies (3rd ed.). New York, 2009: Guilford Press.

Ellis, A. (1980). Rational-emotive therapy and cognitive behavior therapy: Similarities and differences Cognitive Therapy and Research, 4 (4), 325-340 DOI: 10.1007/BF01178210

Warren R, & Thomas JC (2001). Cognitive-behavior therapy of obsessive-compulsive disorder in private practice: an effectiveness study. Journal of anxiety disorders, 15 (4), 277-85 PMID: 11474814

Quinn TP. The effect of cognitive behavioral therapy (CBT) on driving while intoxicated offenders. PhD Dissertation, State University of New York at Albany, 2011.

Image via Kovalchuk Oleksandr / Shutterstock.

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Intelligence – Do You Need it to be Successful? Sun, 13 May 2012 12:00:46 +0000 As early as 1976, the Carnegie Institute of Technology presented a study that attributed 85% of financial success to human engineering skills, namely, self-management and relationship-management, rather than intrinsic or hereditary qualities such as IQ and analytical abilities. Over the last decade, popular culture has embraced the notion of emotional intelligence as a set of skills central to achieving happiness and attaining personal goals. However, popular belief seldom associates emotional intelligence with success in business; it is most often assumed to be connected to success in interpersonal relationships and thought to be more relevant to succeeding in the home than at the office.

According to Sternberg, the conventional notions of intelligence tend to favor people who are strong in memory and analytical abilities, while they disfavor those who aren´t. Sternberg concludes that,

The result is that individuals who may have the talents to succeed in life may be labeled as unintelligent, whereas some of those labeled as intelligent may be less endowed with such talents.

For the purposes of his own research, Sternberg has defined intelligence as the ability to adapt to the environment and to learn from experience and successful intelligence as,

  1. the ability to achieve one’s goals in life, given one’s sociocultural context;
  2. by capitalizing on strengths and correcting or compensating for weaknesses;
  3. in order to adapt to, shape, and select environments; and,
  4. through a combination of analytical, creative, and practical abilities.

In this context, the assessment of intelligence should rely on whether an individual´s chosen goals are coherent with the methods selected to achieve them and the skills demonstrated in that process.

Naturally, a person who desires to become a successful banker will not need the same set of skills as someone wishing to become the world´s most famous violinist. However, Sternberg´s vision of intelligence would encompass both of these goals. In other words, it would take an intelligent person, in the Sternbergian sense, to achieve either of these goals, which do not necessarily require the individuals to excel at analytical skills or possess a superior memory, as the traditional notion of intelligence would have it.

The Gift of Basic Abilities

A 2011 article by Hambrick and Meinz presents evidence from the field of music training that basic abilities — the kind people are endowed with from birth — can predict success in a wide range of extremely complex tasks. In a study designed to assess whether deliberate practice might overcome the decisive effect of working-memory capacity in sight-reading for pianists (i.e., the ability to play a piece without any prior preparation), their findings indicated that working-memory capacity was “a positive predictor of performance above and beyond deliberate practice” and that there was no substantial evidence that more deliberate practice could reduce the effect that working-memory capacity had on performance.

In other words, according to Hambrick and Meinz, practice can’t make perfect, without a little help from mother nature.

Intution vs. Cognition

Best known for being the founding father of modern behavioral economics, Nobel Laureate Daniel Kahneman believes that humans resort to two different modes of reasoning, which he has labelled as intuitive (System 1) and deliberative (System 2). Kahneman’s research has lead him to conclude that individuals most often allow their fast intuitions, or the first ideas and solutions that come to mind, to supersede deliberation. Even in situations that seem to call for deliberate thinking and careful assessment, we seem to be letting everything that is heuristic and affective rule over our more rational side.

Presenting a very simple mathematical problem to the likes fo Princeton University students, Kahneman found an astoundingly elevated rate of errors, where even the slightest deliberation would have shed light on the right solution, even among people with only basic education and mathematical skills. According to Kahneman, this goes to show just how little we monitor the results of careless and effortless associative thinking, and how often we appear “content to trust a plausible judgment that quickly comes to mind.

In the light of Kahneman´s proposed theoretical framework and empirical findings, and drawing from Sternberg’s concept of intelligence, it would seem that the ability to set goals, find coherent ways to achieve them, and monitor intutitive reasoning enough along the way, can lay the true foundations of personal success. Naturally, as Hambrick and Meinz have shown, a little help from mother nature might not hurt at all.


Neale, S., Spencer-Arnell, L., Wilson, L. (2009). Emotional intelligence coaching: Improving performance for leaders, coaches and the individual. London: Kogan Page.

Sternberg, R., & Grigorenko, E. (2002). The theory of successful intelligence as a basis for instruction and assessment in higher education New Directions for Teaching and Learning, 2002 (89), 45-53 DOI: 10.1002/tl.46

Kahneman, D. (2011) Thinking, fast and slow. New York: Farrar, Straus and Giroux.

Hambrick, D., & Meinz, E. (2011). Limits on the Predictive Power of Domain-Specific Experience and Knowledge in Skilled Performance Current Directions in Psychological Science, 20 (5), 275-279 DOI: 10.1177/0963721411422061

Image via silver-john / Shutterstock.

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From Nymphomania to Hypersexuality Fri, 20 Apr 2012 12:00:04 +0000 The concept of nymphomania dates back to Victorian times. It was then described as a “female pathology of over-stimulated genitals” and an “illness of sexual energy levels gone awry, as well as the loss of control of the mind over the body.” Some of the behaviors that lead to this classification, such as women taking of their clothes in public or grabbing at the first man who came into sight, are consistent with the manic states of bipolar disorder, among many other pathologies. In fact, in those days, women run the risk of being treated for nymphomania if they bore children out of wedlock or were discovered masturbating. Historians and medical researchers today argue that the concept of nymphomania was largely derived from the tension of Victorian gender oppression, and it might have had little to do with an actual medical condition.

Popular culture has embraced the concept of nymphomania, and the description of the symptoms in the collective consciousness today doesn’t much differ from that of Victorian times: a nymphomaniac is a woman who constantly wants to have sex with any man that crosses her path, more or less. Many films and books in popular culture have helped maintain this tradition; for example, the best-selling novel “Diary of a nymphomaniac,” the autobiography of a rather contented prostitute.

From Sex Addiction to Hypersexual Disorder

Reality is much more complex than both Victorian diagnoses and popular belief. Even today, there is much argument as to what constitutes pathological sexual behavior, namely, where to draw the line between personal preferences and habits and an illness that truly affects the individual’s well-being. There is also an issue of comorbidity; namely, research has shown a clear tendency for hindering sexual compulsive behaviors to coexist with bipolar disorder, anxiety, depression and substance abuse, among a variety of other problems and pathologies. This makes sexual compulsions even harder to pin down.

While the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition DSM IV describes sex addiction as “distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used,” the proposed revision for DSM V includes the creation of a new category called hypersexual disorder.

The traits of hypersexual disorder are much broader and encompassing than the descriptions in the current DSM. First of all, the proposed category establishes that the symptoms must have been observed consistently for at least six months. These symptoms include experiencing, “recurrent and intense sexual fantasies, sexual urges, and sexual behavior,” where excessive time is consumed in both fantasies and sexual activity, sometimes in response to stressful life events, and both the physical and emotional risks of such activities for oneself or other are consistently disregarded. It is also established that these sexual behaviors shouldn’t have been caused by substance abuse or a manic episode.

The behaviors and practices used in this category definition include masturbation, pornography, sexual behavior with consenting adults, cybersex, telephone sex, and frequenting strip clubs. Interestingly enough, some of those wouldn’t have made one qualify as a nymphomaniac during Victorian times, but, alas, times have indeed changed.

In the Virtual World

An educational set of guidelines for assessment of sexual addiction presented during the 2011 US Psychiatric Health Congress focuses largely on some of the behavioral patterns mentioned in the proposed DSM V categorization. Actually, the protocole largely addresses a masculine population who conceal their use of Internet pornography, prostitutes, cybersex and the like from their female partners. Again, it points to the instant gratification of orgasm, appearing in a vicious cycle in moments of distress, and consequentially begetting more distress.

The internet has created a whole new arena for people to express their unfulfilled urges and desires, sometimes with dramatically negative consequences for their daily lives, creating a dissociation that further estranges them from their partners.

The Death of the Myth

Current research on hypersexual disorder focus largely on men. It would seem that, for all the talk about nymphomania, contemporary men are doing much more to fit the description than women.

Although conclusive research has not yet been published, regarding the nature, diagnosis and treatment of hypersexual disorder, and in spite of the fact that the “sexual addiction” term has been rejected by the scientific community, there is no doubt that several complex stand-alone and comorbid disorders exist, involving compulsive behaviors associated with both actual and simulated or imaginary sexuality, which can greatly hinder an individual’s psychological and even physical well-being. As of the present moment, the diagnosis of some of these elusive conditions remains at the discretion of the therapist, while their prevalence seems to be perpetually on the rise.


Goldberg, A. Sex, Religion, and the Making of Modern Madness. New York: Oxford University Press, 1999.

Grant JE, Potenza MN. The Oxford Handbook of Impulse Control Disorders. Oxford University Press; 2011.

DSM V Proposed revisions section

Kingston, D., & Firestone, P. (2008). Problematic Hypersexuality: A Review of Conceptualization and Diagnosis Sexual Addiction & Compulsivity, 15 (4), 284-310 DOI: 10.1080/10720160802289249

Levine, S. Sexual Excess Syndromes or Sexual Addiction. Presentation from the US PSYCHIATRIC AND MENTAL HEALTH CONGRESS 2011.

Image via karam Miri / Shutterstock.

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Mind Games – Science’s Attempts at Thought Control Wed, 28 Dec 2011 12:00:05 +0000

If both the past and the external world exist only in the mind, and if the mind is controllable – what then?
— George Orwell, in 1984

The concept of brainwashing was first used to describe certain obscure procedures carried out in early Communist China, but the idea of “cleansing the mind” can be traced back all the way to fourth century Confucian thinkers.

In Popular Western culture, the word immediately evokes George Orwell’s dystopian novel 1984 and experiments by Nazi scientists and the CIA, as well as Soviet intelligence services. Science’s interest in the possibility of controlling the mind dates back some 20 years before Orwell’s publication of his novel. The first published research on the subject was Chaffee and Light’s A Method for Remote Control of Electrical Stimulation of the Nervous System from 1934. The article recounted experiments carried out on animals using brain implants and electric waves to control brain and motor functions, including getting a monkey to sleep or inducing gastric secretions in a dog.

Electromagnetic Control (EMR)

In 1964, electromagnetic-response researcher Dr. José Delgado from Cordoba, Spain, performed one of the most spectacular public acts of thought control ever, climbing into a bullring and halting the bull in its tracks by pushing a button that controlled an electrode implanted in his brain.

In the US, research on EMR techniques was largely carried out under the wing of the CIA, and the information was classified as top secret for several decades. However, in the 1990s, the US military admitted having worked on developing EMR weapons. When the USSR’s system collapsed, Russian “mind control” research was exposed. Named acoustic psycho-correction, the Russian research program involved developing the capability to control minds and alter behavior through the transmission of:

specific commands via static or white noise bands into the human subconscious without upsetting other intellectual functions.


Within the CIA’s program MK-ULTRA, the infamous Dr. Ewen Cameron used electro-shock therapy, LSD and other psychotropic drugs and various forms of psychological torture on children and adults, trying to de-program the brain in order to re-program it with new information. The aims of these experiments were varied, including the extraction of information from spies and war prisoners and the programming of individuals to carry out counter-espionage missions and attacks, without their consent.

MK-ULTRA was proven to have performed all sorts of damaging tests and experiments on humans without their consent, with devastating effects for their lives, in many cases, including death and suicide.

Weapons Targeting the Brain

As early as 1994, Dr. Barbara Hatch Rosenberg referred to non-lethal weapons in the Bulletin of the Atomic Scientists:

Many of the non-lethal weapons under consideration utilize infrasound or electromagnetic energy (including lasers, microwave, or radio-frequency radiation, or visible light pulsed at brain-wave frequency) for their effects. These weapons are said to cause temporary or permanent blinding, interference with mental processes, modification of behavior and emotional response, seizures,severe pain, dizziness, nausea and diarrhea, or disruption of internal organ functions in various other ways… The current surge of interest in electromagnetic and similar technologies makes the adoption of a protocol explicitly outlawing the use of these dehumanizing weapons an urgent matter.

According to the latest issue of Synesis, which was entirely devoted to Neurotechnology in National Security, Intelligence and Defense, drugs that can be useful in combat or special operations include:

  • cognitive and motor stimulants
  • somnolent agents
  • mood altering agents, some of which can induce paranoia in larger doses
  • “affiliative” agents
  • convulsants

The review of the current military implications of neurotechnology goes on to affirm that,

while some of these agents can be used to enhance the neuro-cognitive and motor performance of (one’s own) troops (e.g., low does of stimulants, mood altering drugs, etc), others have apparent utility against hostile forces (e.g., somnolent, psychotogenic, af? liative, and convulsant agents).

With the first of these objectives in mind, the US military implemented the Comprehensive Soldier Fitness program earlier this year, which uses cognitive behavioral principles, instead of drugs, to “better prepare” soldiers and families for war. Although this type of “programming” is seen as a less harmful form of mind control, the program has also encountered many detractors.

The Smirnov Way

In 2007, the US Department of Homeland Security closed a deal with Moscow’s Psychotechnology Research Institute. Now run by his widow, Professor Russalkina, the institute’s achievements were largely the work of Dr. Igor Smirnov.

Using electroencephalography (EEG), Smirnov had measured brain waves to create a map of the subconscious. Later, he used recorded subliminal messages to physically alter that landscape by means of the power of suggestion. Some of Smirnov’s reported experiments include using visual and aural subliminal messages to re-program a drug addict to become more interested in the upcoming birth of his son than in securing his next dose of heroin.

The Homeland Security Department became more interested in the Institute’s work on account of their Semantic Stimuli Response Measurements Technology (SSRM) Tek project. This is a software-based “mind reading” technology which tests a subject’s involuntary responses to subliminal messages. The idea is to use it, for example, at airport screening posts, flashing subliminal images, such as photos of Bin Laden and the World Trade Center, as part of an innocent videogame. Passengers’ involuntary responses are said to be different for regular people and those plotting a terrorist attack.

Although there are companies working on further research and the practical implementation of SSRM Tek, such as Canada’s NORTHAM Psychotechnologies, it hasn´t been used for mass-screening at airports as yet.

The Future

Ever since tetraplegic patient Matthew Nagle was able to control a cursor with his brain, through neural implants in 2004, it would seem logical that the reverse processes of having external agents controlling the mind should no longer be the stuff of science fiction.

In a way, knowing everything that was achieved scientifically in terms of thought control and brain programming as early as the 1950’s and 60’s, many people wonder that very little progress has been made since Dr. Cameron’s times. However, one can naturally assume that the problem has much more to do with the secrecy of military programs than with a slow scientific development.

The ethical questions are, of course, the central issue here. While Dr. Smirnov claimed that he had often refused offers by Russian mob types to help them tweak reluctant business associates’ wills; many researchers have historically had no problem selling their information to the highest bidder.

In fact, the ethical problems associated with this type of research today have more to do with where the financing can come from. Although techniques that might permit control over the human brain’s reactions might be extremely beneficial to treat certain chronic psychiatric conditions, it has been largely military and intelligence services that have been willing to fund this research with a very different agenda altogether. Scientists are faced with the difficult choice between working for government organizations, knowing full well what their research will be used for, or cutting down their experiments, for lack of funding.

Today, the horrifying landscapes that Orwell imagined are all scientifically plausible — the thought police might be implemented and thought crime might be discovered by scanning a subject’s brain; there is no scientific impediment for all that. The question lies simply with who has access to the technology and what are they prepared to use it for.


Taylor, K. (2004). Brainwashing: the science of thought control. Oxford, Oxford University Press.

Hatch Rosenberg, B. “Non-lethal” weapons may violate treaties. Bulletin of the Atomic Scientists. 1994;(50)5:44.

Giordano, J, Wurzman, R. Neurotechnologies as weapons in national intelligence and defense – an overview Synesis [PDF], 2011.

Chomsky, N. (1989). Necessary illusions: Thought control in democratic societies. Toronto,
Canada: CBS Enterprises.

Schell BH (1994). The ominous shadow of the CIA has imprinted itself on the brain research community. The journal of the California Alliance for the Mentally Ill, 5 (1), 38-40 PMID: 11653317

Moreno, J.D. (2000) Undue risk: secret state experiments on humans. New York: W.H. Freeman and Co.

Image via Justin Huang / Shutterstock.

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Bibliotherapy – The Healing Power of Books Thu, 15 Dec 2011 23:37:38 +0000

A book must be an ice-axe to break the seas frozen inside our soul.
— Franz Kafka

In this era of tablets, videogames and virtual reality, it may seem anachronistic for kids to be told that “reading is good for you.” Though there are many ways in which reading can be beneficial for the education of youth, there are other ways in which books can improve our lives.

Bibliotherapy uses books to address a variety of psychological problems. There is a clear initial distinction to be made between the bibliotherapy that uses self-help type books, and the one that tries to heal more indirectly by having people read other types of fiction and non-fiction books, the content of which is expected instigate transformation. Many scientific studies have been carried out since the late seventies which bear testimony to the positive effects of bibliotherapy for mental health.

Books against international students’ depression

A 2010 study targeting Japanese students at American universities showed significant improvements for depression and stress related to living and studying away from Japan after reading an Acceptance and Commitment Therapy self-help book. Scientists concluded that bibliotherapy was responsible for an overall improvement of mental health and psychological flexibility, in the case of Japanese international students.

Bibliotherapy for kids

As early as 1983, Robert Douglas Ray and Donavon D. Lumpkin presented an influential study relating the use of bibliotherapy for kindergarteners. The procedure involved reading by teachers, retelling of stories by the children, and a number of follow-up activities. Researchers measured the effects of bibliotherapy on children’s self concept and reading readiness, and their conclusion was that it had an extremely positive impact on pupil perceptions and achievement.

Another interesting study, also from the 1980s, tried to establish whether bibliotherapy might be used to improve children’s perceptions of disabled individuals. The research findings found that although teachers and students found the reading program useful and enjoyable, it was largely the students who had been most exposed to disabled individuals during their school years had the most positive views about themselves, regardless of whether they had been reading about the topic or not.

Effects on depressed old adults

A 2011 study used bibliotherapy to treat very old adults with subthreshold depression, concluding that there were no significant positive results, and that bibliotherapy might be more effective on highly motivated individuals.

Books for life

Aside from cognitive behavioral uses of bibliotherapy, literary crowds are starting to take these matters into their own hands, on the edges of the scientific world. In London, a group of writers started the School of Life offering bibliotherapy prescriptions tailored to clients’ individual needs. Though this type of bibliotherapy seems to be in fashion, there have been no scientific studies trying to establish whether potential murderers might be deterred by reading Crime and Punishment.

While bibliotherapy seems to hold great potential for treating psychological problems, more modern controlled studies are required, and more specific texts may need to be written in order to establish it as a clear treatment alternative for a variety of psychological problems. In the meantime, although there is no scientific reason to explain it, it might be healthy to just enjoy a good book that breaks those frozen seas inside our soul, as Kafka would have it.


Muto T, Hayes SC, & Jeffcoat T (2011). The effectiveness of acceptance and commitment therapy bibliotherapy for enhancing the psychological health of Japanese college students living abroad. Behavior therapy, 42 (2), 323-35 PMID: 21496516

Joling, K., van Hout, H., van?t Veer-Tazelaar, P., van der Horst, H., Cuijpers, P., van de Ven, P., & van Marwijk, H. (2011). How Effective Is Bibliotherapy for Very Old Adults With Subthreshold Depression? A Randomized Controlled Trial American Journal of Geriatric Psychiatry, 19 (3), 256-265 DOI: 10.1097/JGP.0b013e3181ec8859

Ray, Robert Douglas. The relationship of bibliotherapy, self concept and reading readiness among kindergarten children. Ball State University, 1983.

Agness, Phyllis Jean. Effects of bibliotherapy on fourth and fifth graders’ perceptions of physically disabled individuals. Ball State University, 1980.

Image via Lobke Peers / Shutterstock.

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The Taste of Immorality in the Brain Tue, 29 Nov 2011 12:00:14 +0000 Immorality is inevitably tied to social constructions and our value system. Ultimately, it is defined by the idea of morality inherent to our social context. We seldom stop to think about what the intrinsic idea of immorality actually means in the mind. In a way, if our brain reacts to something that can be called immorality in a particular way, these reactions define our personal views of what is moral or immoral, sifting the general accepted beliefs of society through the filter of our own psyche.

A recent study published in Frontiers in Evolutionary Neuroscience attempts to pin down whether there is a consistent activity pattern in the brain in response to “immoral stimuli.”

The study’s subjects were presented with verbal and visual stimuli, for example, relating to incest, violence, and many acts generally considered immoral. For control purposes, individuals were also given non-immoral stimuli.

Verbal stimuli included the following:

Sexual immoral acts — You giving your sister an orgasm, you watching your sister masturbate, you fondling your sister’s nipples.

Non-sexual immoral acts — You burglarizing your sister’s home, you killing your sister’s child, you knocking your sister down the stairs.

Researchers found a consistent left-hemisphere bias for processing different kinds of immoral stimuli. Interesting as the results may be, this is only the tip of the iceberg. The implications of understanding how the brain actually processes immoral stimuli could have a tremendous value for both neurological study and psychology. Opening up multiple possibilities for future research, the study pointed to a consistent pattern of brain response to “immorality,” as the left-hemisphere activity was observed in the case of both sexual and non-sexual immoral stimuli.

While the study of reference was carried out on healthy individuals, Dr. Robert Hare, a researcher who studies psychopathic behavior, measured the brain activity of psychopaths when exposed to different kinds of verbal stimuli. He found that the brain activity in psychopaths showed no variations when this type of subjects were exposed to words like “cancer” and “death.” These findings are consistent with the idea that words don’t carry as much meaning for psychopaths as for healthy people, hence their ability to lie and manipulate others.

The brain doesn’t process moral and immoral thoughts the same way under different circumstances. Curiously, a study from earlier this year showed that drinking something bitter deepens the perceived immorality of a certain event. When researchers asked a group of undergraduates to rate their moral distaste for various acts generally perceived as distasteful, including bribes, shoplifting, a man eating his dead dog, and two second cousins having sex. During the questioning, subjects were offered bitter, sweet or neutral drinks, the latter being water. The moral disapproval was 17% greater for those sipping bitter drinks, pointing to a possibly much greater influence of sensory experiences on our perceptions of immorality than we might have ever imagined.

Aside from the somewhat humorous fact that it might be better to offer people a sugar-packed drink before confessing a slip from morality’s path, it would seem that mapping out immoral thoughts in the brain could even lead us to identify people who might be more prone to committing immoral acts. However, the portion of what happens in the brain that we currently understand is still so little, that we won´t be seeing anything like the prescient murder convictions depicted in futuristic movies like Minority Report anytime soon.


Cope, L., Borg, J., Harenski, C., Sinnott-Armstrong, W., Lieberman, D., Nyalakanti, P., Calhoun, V., & Kiehl, K. (2010). Hemispheric Asymmetries during Processing of Immoral Stimuli Frontiers in Evolutionary Neuroscience, 2 DOI: 10.3389/fnevo.2010.00110

de Oliveira-Souza, R., Hare, R., Bramati, I., Garrido, G., Azevedo Ignácio, F., Tovar-Moll, F., & Moll, J. (2008). Psychopathy as a disorder of the moral brain: Fronto-temporo-limbic grey matter reductions demonstrated by voxel-based morphometry NeuroImage, 40 (3), 1202-1213 DOI: 10.1016/j.neuroimage.2007.12.054

Eskine KJ, Kacinik NA, & Prinz JJ (2011). A bad taste in the mouth: gustatory disgust influences moral judgment. Psychological science, 22 (3), 295-9 PMID: 21307274

Image via Csaba Peterdi / Shutterstock.

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Women After Sex Tue, 01 Nov 2011 12:00:27 +0000 First there was mystery. Why do women want to cuddle and men want to hit the road (after sex), then there was brain scanning and evolutionary psychology, and the mystery was no more. According to a groundbreaking study from the Journal of Sex Research, it would seem that when it comes to post-coital behaviors, men and women could well belong to different planets.

The study begins by presenting the evolutionary perspective of sexual behaviors that we are all more or less familiar with — males have more reproductive power than females, hence, it is an instinctive thing for the preservation of the species that they should frequently seek multiple partners, instead of long-term relationships.

The study becomes much more interesting when scientists start asking men and women, including college girls and boys, who willingly enter into the short-term sexual relationship/one-night-stand arena on a regular basis, how they behave after sex.

According to the results, even girls who are having a one-night-stand want to cuddle and kiss and become anxious about what their male partner is thinking of them, or whether they still find them attractive. On the other hand, the interviewed men largely declared that they usually wanted to eat, urinate or sleep after sex.

Overall, our study demonstrated that post-coital behaviors related to pair-bonding after sex seem to be initiated and preferred by females far more so than by males, and this was the case for not only long-term, but also for short-term, mating.

Interestingly enough, men were found to initiate kissing primarily before sex, while it was mostly women who were responsible for it after sex. The conclusion seems to be that men would be using kissing as a road to sex, while women would be using it as a an emotional display with bonding purposes.

Even when these patterns are obviously not exclusive and genre differences are nowhere near clear-cut in this area, according to the study’s findings, women will bond, while men will satisfy their immediate sexual and non-sexual needs. It would seem that not all of women´s liberation can change what is written in our genetic codes.


Hughes SM, & Kruger DJ (2011). Sex differences in post-coital behaviors in long- and short-term mating: an evolutionary perspective. Journal of sex research, 48 (5), 496-505 PMID: 20799133

Campbell, A. (2008). The Morning after the Night Before Human Nature, 19 (2), 157-173 DOI: 10.1007/s12110-008-9036-2

HASELTONU, M., & BUSS, D. (2001). The affective shift hypothesis: The functions of emotional changes following sexual intercourse Personal Relationships, 8 (4), 357-369 DOI: 10.1111/j.1475-6811.2001.tb00045.x

Image via Liv friis-larsen / Shutterstock.

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The Era of Procrastination Mon, 17 Oct 2011 12:00:36 +0000 Although procrastination is conceived as a problem by the scientific community, there is not much consensus regarding the nature of this issue. Scholars have been arguing for decades whether procrastination is a rather uncontrollable phenomenon that happens merely on a whim or if it can be classified as arousal, avoidant, or decisional, for example. In any event, statistics since the early 1970’s have consistently shown an alarming prevalence of procrastination reaching over 70% among college students and starting at 20% in the general population.

The basic definition of procrastination is quite simple: putting things off. The problem starts when this putting off has dramatic effects on our lives, for example, when it has to do with our health or work.

Much of the latest research on procrastination has focused on the internet, which has often been called “the procrastination superhighway.” In the case of academic procrastination, the web plays a key role — it is the most direct and readily available “escape” students have to pass time and avoid task completion.

In an online survey of 2,700 people with procrastination problems, 46% of subjects said that their procrastination had a negative impact on their happiness. Treatments for procrastination often involve trying to understand the reasons behind it and simple things like breaking down tasks, making lists, and keeping an appointment book.

The meta-cognitive approach of behavioral therapies has proven successful in treating procrastination in which subjects deconstruct the mental processes that cause their procrastination and having them make contracts with themselves that help keep track of what they have set out to do, and when and how they are going to achieve it.

To a greater or lesser degree, we all indulge in procrastination once in a while. However, when it starts affecting our happiness and well-being, it may be time to consult a therapist. The Rational Emotive Behavior Therapy (REBT) website offers a worthwhile guide to identifying and dealing with procrastination.


Rice, K., Neimeyer, G., & Taylor, J. (2011). Efficacy of Coherence Therapy in the Treatment of Procrastination and Perfectionism Counseling Outcome Research and Evaluation DOI: 10.1177/2150137811417975

Steel, P. (2010). Arousal, avoidant and decisional procrastinators: Do they exist? Personality and Individual Differences, 48 (8), 926-934 DOI: 10.1016/j.paid.2010.02.025

King, M. The Procrastination Syndrome: Signs, Symptoms, and Treatment. Innovative Leader, 7(11); 1998.

Harriott, Jesse, & Ferrari, Joseph R (1996). Prevalence of procrastination among samples of adults Psychological Reports, 78 (2), 611-616

Image via l i g h t p o e t / Shutterstock.

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The Love Drug Thu, 22 Sep 2011 00:46:02 +0000 Since man first walked the Earth, the quest for love has been a constant preoccupation and the loss of love has been a source of the most dramatic events, including suicide, homicide, and even terrible wars. Breakups can be perceived as failure and a promise of future loneliness, and they can have severe consequences such as depression and anxiety. Rejection in love can in fact be so dramatic, that it has been compared to withdrawal from addictive substances.

Characteristics of romantic love that make it akin to an addiction include mood swings, obsession, emotional dependence, loss of self-control and other potentially dangerous behavior patterns. According to Dr. Helen Fisher, a reputable expert on love and the brain, this addiction can become very destructive when the object of love is withdrawn, much in the same way as what happens when addicts stop taking their drug of choice.

In fact, a recent study published in the Journal of Neuropsychology attempted to prove that what happens in the brain after a breakup is very similar to what takes place during an addict’s withdrawal period. This was done by comparing brain imaging from people going through a breakup with similar data from cocaine craving individuals, which showed some remarkable coincidences.

The scientists behind this research believe that their findings present further evidence that the passion of romantic love is not an emotion but rather “a goal-oriented motivation state,” as stated by Dr. Arthur Aron of Stony Brook University as early as 1991.

Although the samples of this and other similar studies are rather small, the neurological evidence does present a very strong case. In fact, when subjects were shown photographs of their former lover, the areas of the brain appearing stimulated included:

  • the ventral tegmental, which is in control of motivation and reward;
  • the nucleus accumbens and orbitofrontal/prefrontal cortex, which are associated with the dopaminergic reward system of cocaine addiction; and
  • the insular cortex and the anterior cingulate, both associated with physical pain and distress.

In a rather remarkable turn of events, it would appear that romantic love, arguably the highest of human emotions has been proven to have some very politically incorrect connections with certain drugs that enjoy a far less flattering reputation.

For all the different assumptions and anxieties people from all the different cultures of the world may encounter in the quest for a soulmate and for all the high art that romantic love has fathered throughout history, it would seem that, after all, we may well be all addicted as Cerati claimed in his song.


Aron A., Aron E. Love and sexuality. In: Sexuality in Close Relationships, edited by McKinney K., Sprecher S. Hillsdale, NJ: Erlbaum, 1991, 25–48.

Fisher HE, Brown LL, Aron A, Strong G, & Mashek D (2010). Reward, addiction, and emotion regulation systems associated with rejection in love. Journal of neurophysiology, 104 (1), 51-60 PMID: 20445032

Bartels A, & Zeki S (2000). The neural basis of romantic love. Neuroreport, 11 (17), 3829-34 PMID: 11117499

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Behind the Masks – The Mysteries of Dissociative Identity Disorder Sun, 28 Aug 2011 12:00:55 +0000 While Toni Collette may have pulled off making dissociative identity disorder (DID) look glamorous and sexy in the recently cancelled Showtime series United States of Tara, the reality of this disorder is much more complex. As fun as it is to watch an actress play five different parts in one show, for people with DID, the shifting is no fun at all.

One thing the show did get right is the fact that most people with DID develop it as a response to trauma, especially early childhood abuse from a parent or caregiver; studies have consistently reported this in 95-98% of the cases. People develop this disorder in order to distance themselves from the traumatic experience, by way of creating other personalities. While momentary dissociation is a technique that normal people use to cope with traumatic situations; in the case of people with DID, this dissociation goes beyond the moment, creating a whole new persona that has not been affected by the abuse, as an escape mechanism.

The prevalence of DID in the general population has been established at 1%, making it far more common than popular belief would have it. Nevertheless, the allure of the “exotic” continues to surround this condition, for example, because hypnosis is commonly used to gain access to the alters, as the different personalities are called. A scientifically accepted technique, hypnosis still remains, in the public mind, a practice bordering the world of the occult, found more at home in magic show than in the therapist´s office.

Perhaps because of its assumed rarity, it is the diagnosis of DID that poses one of the biggest problems. In 1993, a Dutch study of 71 DID patients established that:

Patients had spent an average of 8.2 years in the mental health system prior to correct diagnosis. Patients presented with many different symptoms and frequently received other psychiatric or neurological diagnoses.

Over the years, studies carried out in other parts of the world have yielded similar results, raising awareness about DID and the methods that could be used to identify it, separating it from other disorders, some of which can sometimes be comorbid with it, thus further complicating an effective diagnosis.

According to DSM IV, DID can be diagnosed whenever there is a coexistence of:

  • The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).
  • At least two of these identity or personality states recurrently take control of the person’s behavior.
  • Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness and not due to the direct effects of a substance (e.g. blackouts or chaotic behaviour during alcohol intoxication) or a general medical condition (e.g. complex partial seizures).

While some alters can be harmless, a study on DID and suicidality found a strong correlation between the disorder and repeated suicide attempts, as well as the risk of causing harm to others. As the DID patient does not control the alters, this presents a great danger. In fact, DID patients have often been involved in crime investigations, and North American law has even recognized the right of the different personalities to have different attorneys, outlining a plot fit for the ultimate trial film from Hollywood. Courts have also been known to take the testimonies of the different alters as if they were actually different people, especially in cases in which one of the “bad” alters has committed a crime that neither the patient´s main personality nor the other alters have a recollection of.

Many times, people have ended up going to jail for crimes committed by one of their alters. Even today, with all the developments and research carried out by the scientific community, it seems that DID remains as mysterious as ever, and people continue to suffer from this disorder without even being aware of it, all over the world.

For those who have been successfully diagnosed, the International Society for the Study of Dissociation (ISSD) has developed a phasic treatment framework for dissociation disorders, including DID. The three phases are:

  • safety, stabilization and symptom reduction
  • working directly and in depth with traumatic memories
  • identity integration and rehabilitation

A recent study by DID expert Bethany Brand and some of her colleagues concluded, after analyzing most of the current literature and research pertaining to DID treatment results, that the three-phase treatment has been widely effective, bringing about a reduction of “symptoms of dissociation, depression, general distress, anxiety and PTSD.”


Korol S (2008). Familial and social support as protective factors against the development of dissociative identity disorder. Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD), 9 (2), 249-67 PMID: 19042777

Koopmans, C. (1994). Multiple Personality Disorder in The Netherlands Tijdschrift voor Psychotherapie, 20 (4), 169-171 DOI: 10.1007/BF03079185

James, D.V. Multiple personality disorder in the courts: a review of the North American experience. Journal of Forensic Psychiatry 1998, 9: 339-361.

Foote B, Smolin Y, Neft DI, & Lipschitz D (2008). Dissociative disorders and suicidality in psychiatric outpatients. The Journal of nervous and mental disease, 196 (1), 29-36 PMID: 18195639

Sinason, V. Attachment, Trauma and Multiplicity: Working with Dissociative Identity Disorder. New York, 2011: Routledge.

Brand, B & Loewenstein, RJ. Dissociative disorders: an overview of assessment, phenomenology and treatment. Psychiatric Times. October, 2010.

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