Mental Health and Social Care

Don’t forget about my other book – also available from The Care Guy website.

MH and SC simple lessons meme

This easy to follow book has been written with social care support workers in mind. It’s jargon free and packed with reflection points, tips and exercises to guide you through the social care process from basic principles to support planning and relapse profiling. What’s more – it only costs a tenner. You can download a sampler here.

The author, Stuart Sorensen has many years experience of working in mental health and social care. Drawing on past experience of ‘real world’ care services he boils down the complicated theory of mental health care into the fundamental principles of best practice. The result is an easy to follow book that explains what mental disorder is, what recovery really means and what social care staff can do to help

Behaviours that challenge

It’s taken me a while to finish this but my new book ‘Behaviours that challenge’ is now on sale on The Care Guy website. Only a tenner plus P&P.

Go on, you know you want to

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Often the advice given to social care workers about behaviours that challenge makes their problems worse instead of better. This easy to follow workbook is full of no nonsense tips, techniques and ideas for dealing with the behaviours YOU face at work (and at home).

Contents

Introductory questionnaire
What is Challenging Behaviour?
Legal principles
Theories of behaviour and interaction
Different types of Challenging Behaviours
Its only behavioural
Philosophy and challenging behaviour (rights, paternalism and intervention – people are just people)
Assertiveness – as opposed to aggression, passivity and passive-aggression
Assessing behaviour – ABC, the Pleasure Principle, lessons from research
Basic behavioural management – classical and operant conditioning, reinforcement, gradual progression
Boundaries and the escalation or recession of inappropriate behaviours
The importance of the whole team approach
The problem with punishment
Expectations
Questionnaire
Answers to safeguarding quiz

Improving the mental health worker’s guide

Pic 1I’m remaking the video versions of ‘The guide’ in a more interesting, ‘documentary’ style. Hopefully that will make them a bit more user-friendly. It’s also turning out to be a lot of fun and seems to me to be a useful long-term project/hobby.

I’ve only managed to make the first 5 minutes of the initial ‘overview of mental disorder’ (I expect each one to last between 10 and 15 minutes) but I’m putting it out for comments. I’d really appreciate constructive criticism. I really want to make these as good as I can.

Please have a look at the unfinished movie file and let me know what you think.

Cheers,

Stuart

Woohoo! Welcome back, Inspector Brown

Inspector Michael Brown is back!

Within the last hour @MentalHealthCop resumed on Twitter and announced that the Mental Health Cop blog is available for public scrutiny again.

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This is truly fantastic news.

If mental health and/or rights interest you go and have a look. Follow @MentalHealthCop on Twitter too. You won’t be disappointed.

Come back soon Mental Health Cop

I still can’t quite understand this.

Yesterday, along with many others in the online mental health community I learned that the Mental Health Cop (AKA Inspector Michael Brown) had disappeared from the internet. Michael’s multi award winning blog (www.mentalhealthcop.wordpress.com) has been a truly incredible resource for anyone interested in or professionally concerned with the interface between mental health care, law and police intervention.

I really don’t know what has happened except that Michael’s employer (West Midlands Police) appears to have had an issue with something he wrote on line. The upshot is that his blog has gone and his twitter account (@mentalhealthcop) is also inaccessible at present. Up to the minute news will be available via the #mentalhealthcop hashtag on Twitter as literally thousands of subscribers to Michael’s blog follow events.

I sincerely hope that this matter is resolved quickly and that Michael is able to resume his fantastic work very soon. More than that though I’d just like to add my voice to the many who wish Michael well personally. He is very definitely one of the good guys.

Come back soon Mental Health Cop. We miss you.

Safeguarding 8: Psychological/Emotional abuse

“for there is nothing either good or
bad, but thinking makes it so”

William Shakespeare, Hamlet, Act 2, Scene 2

With this simple line Shakespeare’s Hamlet summed up the basic notion behind psychological and emotional abuse. Eleanor Roosevelt said it rather differently three and a half centuries later when she pointed out that an insult only hurts if we agree with it. What both of these different expressions of the same principle have in common is this:

If I want to change the way you feel I must first change the way you think, either about yourself or about your situation.

thumbnailCA3H80ASAnything that causes distress or confusion or that misleads the other person causes psychological and or emotional harm. If the behaviour that causes that harm cannot be justified then it is also abusive.

The distinction between ‘harm’ and ‘abuse’ is as important here as anywhere. After all you can’t please all of the people all of the time and people do sometimes become upset for their own reasons even though no-one has done anything wrong. If a person becomes upset because you’re carrying out your legitimate duties then that’s not your fault.

For example the relative who chooses to become angry or distressed because the carer refuses to do what they demand is not being abused. They have no right to demand that they obey them – your duty is to the service-user, not the carer and so you are not being abusive by doing what you think is right, whatever the carer’s opinion might be.

However sometimes our dismissal of others opinions, wants and needs really is abusive. The service-user who becomes distressed when the carer insults or ridicules them is a victim of emotional and psychological abuse. We may not be able to please all of the people all of the time but that doesn’t excuse meanness.

Deliberately misleading, isolating or demeaning another person is likely to be psychological abuse as are intimidation, over use of criticism and hostility. If these things are done from a position of authority they may well also meet the European criteria for torture precisely because of the distressing impact they have on the victim. Repeatedly focussing upon distressing situations for no good reason such as constantly surprising dementia sufferers with the news of their parents’ death for example is a form of psychological/emotional abuse too.

Earlier we made the point that abuse is a violation of an individual’s rights. Rights are not only about the things we shouldn’t have to put up with – they’re also about our entitlements. For example service-users have the right to experience a stimulating environment (so long as they can cope with it). Endless hours of daytime television is not really appropriate psychological stimulation which is one reason why so many people in residential care or long term hospital placements become clinically depressed. What would happen to your mood if all you had to occupy your mind were chat shows relating to a world you no longer felt part of? Physical and environmental circumstances have psychological and emotional impact, for better or for worse.

Over-stimulation due to noise, overly bright lights or even simply too much frenetic activity can cause psychological harm. Critical, demeaning staff or dehumanising routines create difficulties too, particularly in relation to self-esteem. Consider the psychological impact of having someone else make your basic decisions such as what you wear or eat, what time you get up, when you bathe and even when you go to the toilet. Imagine someone else feeding you.

Of course it is undeniable that many people in our care need a great deal of support and assistance with all these things and more. However – when they are able to exercise choice about when and with whom for example they are much more likely to maintain a sense of independence and control than when they are simply factored into a routine that is decided ‘in the office’.

To the busy care worker these things are functional – they’re just routine and can become no more than ‘tasks’ to be performed in the minds of the staff. To the incapacitated patient or resident they may be the last aspect of independence supporting their self-esteem. Even routine can be a form of psychological abuse. We’ll explore this concept a little more when we cover Institutional abuse shortly.

As with so many aspects of abuse it’s always worth wondering how you would feel if you were in that situation. If you’d become distressed, depressed, angry or humiliated then there’s a good chance that the same will be true for your service-users.

The fact that they may not complain is no guarantee that they are satisfied. It is usually the most depressed and/or dehumanised people who complain the least because they have simply given up. That’s one reason why health and social care inspectors monitor complaints about a service. The service that has no complaints is often the service chosen for an inspection visit simply because it is impossible to please all of the people all of the time and so if nobody is complaining the inspectors often want to know why not.

About the Safeguarding series

This blog series first appeared on Stuart’s personal blog early in 2010. It has been reposted here as part of a process of ‘rationalisation’ in which work from several blogs has been removed and reposted on only two.

Fallacies 18: Appeal to authority

In the last ‘Fallacies’ entry we considered the appeal to popularity. In this entry we’ll look at a similar tactic known as the appeal to authority. This is a common argument used to shortcut any analysis of the issues and jump straight to the conclusion:
“Professor such-and-such thinks this is right so who are we to argue?”

There is some merit in this line of argument, especially when discussing complex issues about which most people know very little. We need to rely upon the judgement and opinions of experts simply because nobody has the time to study everything in enough depth to make informed decisions on all the topics that come up in modern society.

But if we don’t know enough to make our own decisions then we need some way to judge which expert does. This is no easy task.

It’s an old question that was first discussed (to the best of my knowledge) by Plato, an ancient Greek philosopher who covered it in his ‘Discourses’. Plato came to a rather unsatisfactory conclusion. He argued that the only way to judge the value of expert opinion is to become an expert yourself.

As we have seen this isn’t really an option. But if we want to make sense of the world we have to try because let’s face it – even experts can be fallible.

We have several basic problems here…

Expert in the right field

An expert in one field isn’t necessarily an expert in another. Indeed – the time and effort required to become an expert in any field means that it’s very unlikely that most people will be able to do it in more than one area of study. But it’s not enough to have a Ph.D. – you need to have the right Ph.D.

For example it is not uncommon for creationists to argue that some (admittedly not all that many) leading scientists deny evolution. But you’d be hard pushed to find an evolutionary biologist (or even a general biologist) to take their claims seriously. This was the crux of the problem with the 2005 school curriculum trial in Dover, Pennsylvania.

Although some members of the community and the school board wanted ‘Intelligent Design’ (the new incarnation of creationism) to be pushed on to the vulnerable minds of children in science classes, those who understood the issues (the teachers) refused. The case went to Court and (of course) the teachers won.

Is your expert authority skilled in the right field?

Is your expert authority skilled in the right field?

It’s not enough to cite an expert – it must be an expert in the appropriate area of study because nobody knows everything.

This was the problem with Bjorn Lomborg’s controversial work on climate change (The Skeptical Environmentalist, 2001 and Cool it, 2007). Lomborg is not a climate scientist, he has a Ph.D. in political science. The overwhelming majority of actual climatologists (those who understand climate science) reject his work out of hand and it’s not hard for even a layman to understand why.

His arguments contradict themselves (he can’t even make up his mind whether or not global warming is a good thing) and the evidence he uses to uphold one argument is conveniently ignored when he tries to make a different point without the merest hint of explanation.

None the less climate change deniers and right wing politicians regularly cite his work as an ‘appeal to authority’. This would be like asking someone with a Ph.D. in theology to recommend treatments for psychiatric patients, a ridiculous situation indeed. It isn’t reasonable to expect someone with no knowledge of the relevant field to be taken seriously when they make recommendations. None the less this is precisely what Archbishop John Sentamu did when he suggested in the UK’s House of Lords that exorcism should be available to psychiatric patients on the National Health Service.

Archbishop Jphn Sentamu thinks people with mental health problems should be subjected to (NHS funded) exorcism

Archbishop Jphn Sentamu thinks people with mental health problems should be subjected to (NHS funded) exorcism

Authority in the organisation

There are other types of authority to be wary of though. There’s the authority that comes from organisational structure – the boss.

As we all know people rise through the ranks in organisations for a variety of reasons and they’re not always the best person for the promotion. Managers are promoted because someone owes them a favour, because nobody else wants the job, because they have a good relationship with powerful outside funders or supporters or sometimes even because they know stuff.

Often though they are just in the right place at the right time. That’s not exactly a qualification for the status of expert. I’m sure I’m not the only person who has worked for incompetent managers and spent significant amounts of my time sorting out the messes they created.

The Peter Principle is the phenomenon of promoting people to the level of their own incompetence. The fact that John is a good technician doesn’t mean he will be able to manage other technicians or run a departmental budget. But he gets promoted (because of his technical ability) into a job that requires a completely different skillset – and John just can’t cut it.

But he doesn’t get sacked or demoted back to his former position. He just stays where he is. He’ll never climb any higher because he’s not good at his lower management job so he just stays there – perhaps for decades – making poor decisions and holding back his department’s progress. That’s the Peter principle at work. You’d be a fool to trust John’s judgement about anything to do with management. He’d be great at answering technical questions though. That’s his real area of expertise.

Experts are fallible

Even true experts are fallible. That’s why Alfred Russel Wallace (co-discoverer of the theory of evolution) was suckered by spiritism and spent much of his life vociferously supporting fraudulent mediums. He was good at what he did but he was far from perfect – just like the rest of us.

Whenever we try to assess the credibility of experts we come up against these sorts of problems and it’s genuinely difficult to know who to trust. It’s almost impossible to make that decision with absolute certainty. But there are some questions we can ask ourselves that may help:

Is this expert skilled in this particular area?
What do the majority of similairly trained experts think?
What does the evidence say?
How often has this person been right/wrong in the past?
If they’ve been wrong before have they been prepared to admit it?
Is this person ideologically driven?
Is this person financially driven to say this stuff?
Are there any other forms of bias you are aware of?
Does the expert use real data as evidence or just rely on stories and anecdote (you can make any point you like in a story)?
If you follow them and they are wrong – will there be a cost?
If you don’t follow them and they are right – will there be a cost?
What research could you do to check out their assumptions?

You see there’s much more to being right than merely being an expert or a boss.

The appeal to authority has merit – in fact it would be impossible to function in the modern world without trusting someone but it’s always a good idea to think carefully about which authority you choose to follow.

Endnote

We have now reached the end of this blog series as originally planned. However I’ve enjoyed writing it so much I’m sure I’ll be adding to the ‘Fallacies’ blog category as time progresses.

About the ‘Fallacies’ series

The ‘Fallacies’ project was built up from a series of instalments that first appeared online during the summer of 2012. It is republished as part of a larger set of changes intended to rationalise the contents of several different blogs into just 2. The other remaining blog focuses mainly upon social care and mental health related issues. It can be found at http://www.TheCareGuy.com

Fallacies 15: Correlation = causation

One of the first symptoms of the bubonic plague that caused so much devastation throughout Europe was the sensation of a sweet smell. This was not caused by an actual scent in the air but rather by physical processes related to the illness.

But, because the smell always accompanied the plague (was correlated with it) people assumed that it was the cause. They also likened the sores that appeared on the bodies of victims to flowers because they bore a superficial similarity to them. This is why physicians adopted large beak-like masks which they filled with sweet scented flowers. It was an attempt to ‘fight fire with fire’ and drive away the scent of the illness with sweet scents of their own devising. It also prompted people to carry sweet smelling flowers around in their pockets hence the rhyme:

A ring, a ring of roses,

A pocket full of posies,

Atishoo, atishoo,

We all fall down.

Of course, with the benefits of modern scientific understanding we know that flowers have nothing to do with plague and that carrying roses around in your pocket or donning a beak filled with scent won’t prevent it. It was a pointless exercises but understandable in the circumstances. After all – people didn’t know what else to try. So they relied upon the only correlation they could think of and based their remedies upon the desperate hope that correlation somehow would equal causation. Unfortunately for the many who died, it didn’t – and it still doesn’t.

That’s all very interesting but it’s hardly relevant today. We know that illness isn’t driven off by sweet smelling flowers and the follies of the past don’t really apply to the modern world. Or at least we’d like to think they don’t. In reality the correlation – causation fallacy still persists even though modern examples of it may be different.

thumbnailCA3H80ASA relatively recent illustration of this was the widespread assertion (which appeared to originate with research conducted by the Chinese government) that prolonged internet use caused depression. This conclusion was reached because the researchers had discovered a correlation between depression and time spent on the worldwide web.

For the moment we can leave aside the possible motivation of the Chinese government in claiming that internet use is unhealthy. That may be a factor to consider when evaluating this research but it’s not the focus here. I’m going to assume that the correlation exists just as the researchers claimed.

Based upon this correlation the researchers concluded that the internet causes depression but could there be another explanation?

We know that one of the symptoms of depression is withdrawal.
We know that people who withdraw tend to find things to do that don’t really involve face to face contact with others.
We know that it is very easy to find relatively passive distractions on the internet.
We know that in mild depression people don’t tend to sit around and do nothing – they simply find passive things to do instead.

We can see then that we have a typical ‘chicken and egg’ quandary here. Does the internet use cause depression or does the depression prompt increasing use of the internet as an alternative to real world contact?

Of course it’s also true that increasing isolation can deepen depression but that still doesn’t mean that the internet is the cause. The same thing would probably happen if the depressed person sat and drew pictures or watched TV all day long. The internet may just be incidental.

To be fair I have no way of knowing whether or not the internet is significant. It might be but there isn’t nearly enough information to make a judgement. We have only a correlation and correlation isn’t causation.

We could just as easily claim that since there is a correlation between short-sightedness and wearing glasses that glasses cause short-sightedness. Perhaps using crutches is a clear cause of broken legs too.

Correlation isn’t causation. This is obvious in the two examples above (short-sightedness and broken legs) because we know enough to understand the cause and effect. But when we don’t understand that relationship in advance it’s very dangerous to draw any conclusions. Particularly if all we have is evidence of correlation.

Fallacies 9: The ‘single cause’ fallacy

Everyone has a place in the world. They don’t always like it – but they have a place none the less. And everyone arrived ‘where they are’ because of a complex combination of circumstances, choices and characteristics that all contribute to whatever it is that makes us who we are.

For example….

I am occasionally asked why I chose to become a mental health nurse. The usual answer I give (the shorthand version, if you like) is that I find mental health work (either as a practitioner or a trainer) both fascinating and rewarding. But actually there’s more to it than that.

To really understand why I drifted in to mental health care you’d need to know how a number of very different causative factors came together to bring me to that point. These include…

Lincoln YMCA

Lincoln YMCA

Volunteering as a teenager in an elderly care day centre (primarily because I was bored);
Not being talented enough to realise my teenage dream of becoming an actor;
Leaving home in search of a theatrical career and becoming homeless;
Living either on the streets or in hostel accommodation during my early twenties;
Eventually finding employment in the hostel I lived in (Lincoln YMCA);
Being ‘thrown in at the deep end’ with a number of mentally disturbed hostel residents;
Witnessing a woman jump to her death from a multi-storey car park near the hostel;
Subsequently taking a series of care assistant jobs in mental health, elderly care and learning disabilities services;
Meeting and becoming engaged to a care assistant who was about to begin nurse training;
Following her into nurse training (to be together);
Entering mental health nursing (mainly because I didn’t fancy adult nursing).

So you see, although the shorthand answer is that I love mental health work the actual answer includes many more causes than that alone. In truth I drifted into this field as much by chance as anything else. I would never have imagined myself doing anything like this when I was at school. And that’s how it is for most people.

There is no single cause!

Of course we all understand this when we think it through. Almost nothing significant happens because of a single event. There are always other underlying conditions that make it possible. Unfortunately though we all tend not to think it through quite so often as we should.

Continuing for the moment with the theme of mental health I’d like to pose a question….

What causes schizophrenia?

If you were to ask 100 people that question you may not get 100 different answers but you’d find that a number of contradictory themes kept cropping up over and over again. Let’s look at two of these themes….

“It’s a biological brain disease”

This means that schizophrenia (the tendency to experience hallucinations, delusions and thought disorders) is caused by something in the person’s body or brain. Different people will offer slightly different versions of this explanation – some will talk about genes and heredity whilst others will attribute schizophrenia to chemical processes resulting from substance use or dietary processes. What brings them all together is the unifying belief that hallucinations, delusions and thought disorders are caused by physical issues and so physical remedies are required. The ‘single cause’ is assumed to be biology.

That’s why doctors prescribe medications for people diagnosed with schizophrenia. It’s a chemical remedy intended to ‘fix’ or ‘manage’ a chemical problem.

“It’s caused by social exclusion”

People who believe this will not focus upon trying to alter the workings of the brain and/or body. They’ll concentrate their efforts upon more social, cultural and environmental variables and try to solve the problems service-users experience through interaction and coping skills development.

There is extremely good evidence for this sort of intervention and it really can work wonders.

The problem with both of these approaches, at least in my opinion is that they are too superficial and self-limiting. They both fall into the trap of the ‘single cause fallacy’ and because of this they are both essentially inadequate explanations. There is more to schizophrenia than just biomedical (nature) or socio-cultural (nurture) causes in isolation and until we abandon single cause explanations and explore the totality of causes we’re doomed to fail . More significantly we’re also doing our service-users a major disservice. I’ve explained more on this topic in my commercial blog:

Why I’m not ‘anti-psychiatry’

But that’s not really the topic of this entry – it’s just an example. Another example comes from the world of politics and the ‘single cause’ explanations that politicians of all stripes would like us to accept. For example…

A little over a year ago the United Kingdom (or at least England) was blighted by riots in several major cities. The reasons for this seem complex and almost certainly include (among other things):

Poverty and alienation;
Disenchantment;
Opportunism;
An increasing sense of hopelessness;
Disregard for the rights and welfare of others;
Lack of cohesion within the larger community;
The psychological need of desperate people to scapegoat ‘the other’.

Nick cleggThe leader of the Liberal Democrats, Nick Clegg famously predicted that there would inevitably be riots if the Conservatives won the 2010 general election. He understood the link between the ruthless capitalism of Conservative ideology, widespread poverty and the desperation of the masses all too well.

And yet both during and immediately after the riots (and after he’d led his party into coalition with those same Conservatives) he conveniently forgot all that in favour of the party line about ‘lack of respect’ and ‘mindless yobs’. Even when directly asked to comment upon any other possible causative factors he declined to do so.

Whenever someone tries to convince you of a ‘single cause’ for a serious event ask yourself :

What aren’t they considering?

The more we allow ourselves to be drawn into the ‘single cause fallacy’ the more vulnerable we become to manipulative arguments from others, be they politicians, internet bloggers like me (yes I can fall into the same traps as everyone else) or the bloke ‘holding court’ in your local pub.

So the next time someone tells you that disabled people are all benefit scroungers who don’t want to work or that the global economic crisis was caused by the UK’s previous prime minister stop and think for a moment before you fall victim to their particular brand of superficiality.

What aren’t they telling us?

Of course, as another blogger reminded me earlier this week, ‘We don’t know what we don’t know’. It can be difficult to work out just what the other person isn’t telling us because, by definition, we don’t know. But there are a few questions you can ask yourself that may help:

If this was a debate what would the other speaker have said?
If I had to explain this what would I have said?
Does this explanation fit with what I already know about the world?

The trick, as ever, is to think for ourselves. The single cause fallacy isn’t only widespread – it’s dangerous too.

About the ‘Fallacies’ series

The ‘Fallacies’ project was built up from a series of instalments that first appeared online during the summer of 2012. It is republished as part of a larger set of changes intended to rationalise the contents of several different blogs into just 2. The other remaining blog focuses mainly upon social care and mental health related issues. It can be found at http://www.TheCareGuy.com

Fallacies 8: Some common thinking errors

I think therefore I am.

And all that I am is dictated by my thought.

Thought breeds opinion, opinion belief,

Belief engenders attitude and attitude: behaviour.

Therefore in order to live well

A man must first strive to think well.

His thought must be fluid and well conceived.

It must be as a strong fortress to withstand the onslaughts of derision and dogma

And yet welcoming enough to admit the arguments of reason.

Thought must not be fixed but it’s foundations must be firm.

And thought belongs to us all.

According to the late Albert Ellis (creator of ‘Rational Emotive Therapy’) there are three ‘general’ thinking errors that crop up time and time again in the development of emotional distress. These are much less specific than his famous collection of twelve irrational beliefs and are more to do with thinking ‘style’ than with any specific belief but they are, nevertheless a reasonable place for us to begin this little post on the link between cognition (thinking) and emotion.

The three ‘general thinking errors’ are….

Ignoring the positive

Whether you tend toward anxiety, anger or depression you’ll find it much harder to maintain emotional stability if you ignore the positive aspects of life. Like many of the thinking errors we’ll consider this simple truth is both obvious and depressingly common (pun intended).

Exaggerating the negative

As if ignoring the positive wasn’t bad enough, many people have developed the thinking habit of exaggerating the negative. The net result is that not only do they see the bad in their lives but they also have an even more negative view because they blow things out of all proportion until it seems as though they are overwhelmed by negativity.

Overgeneralisation

This thinking error becomes habitual and remarkably destructive. This is the thinking habit that prompts people to believe that all aspects of their life are unsatisfactory when in fact only a small part of it may be. This is the sort of thinking error that prompts people to expect ‘one of those days’ simply because they spill the milk at breakfast. The misfortune is generalised to include the whole day.

On a related point I often wonder why they choose to generalise only to the whole day. Why not to the whole week or month? Maybe even their whole life. Either one makes as much sense as the others.

Or maybe they could try relating the misfortune to the whole of the time it takes them to clean up the spilled milk and then move on. After all:

There’s no use crying over spilled milk!

Yes – I know. I couldn’t resist that!

Other errors that psychologists have identified include:

Catastrophisation

An inevitable result of Ellis’ 3 general thinking errors above is the way that people take a minor problem and blow it out of all proportion. This is what happens when a person argues with their partner and then convinces themselves that the whole relationship is over. Most of us have done this at one time or another – especially during our teenage years but by the time we become adult we should have plenty of evidence to show us that it’s not inevitably so. Yet – by ignoring the positive evidence and exaggerating the negative implications of the situation we convince ourselves that the worst is about to happen.

Arbitrary inference

Catastrophisation often relies upon this process of arbitrary inference to make it happen. This is the way we draw conclusions from very limited evidence to support our basic assumptions.

The problem is compounded by the extremely common habit of inference chaining where a series of arbitrary inferences are linked together to create anxiety, depression, anger or even psychotic states such as paranoia and other delusions. For example:

Joan and David live together and have done for eight years. They are happy and regularly go out as a couple to the local cinema as well as restaurants and other places. They have two small children, Anna and Michael who they adore.

This afternoon David tells Joan that he is planning to go to the cinema with some male friends from work. Joan becomes distressed by this, much to David’s confusion because he doesn’t understand the arbitrary inference chain that has developed in Joan’s head. It goes something like this:

David’s going to the cinema without me

That means he doesn’t want my company

That means he doesn’t love me

That means he will leave me soon

That means I’ll be on my own with two children

That means I’ll never find anyone else. Nobody will want to take on the kids as well

That means I’ll be alone

That means I’m a failure because I couldn’t keep him

That means I’m useless

Obviously this chain of ideas may well be distressing but these thoughts don’t really reflect reality. This thinking style of arbitrary inference is extremely destructive and unnecessary. It often has the feel of predicting the future. Assuming claIrvoyance another of Ellis’ irrational beliefs. One simple trick to get to the bottom of inference chains that therapists use a lot is to keep asking:

If that were true, what would it mean for you?

It is truly amazing to discover the assumptions people make based upon the flimsiest of evidence or the most innocuous of events.

Determinism

Determinism comes in many forms but they all have the same ‘feel’. This is the assumption that the outcome is inevitable because of some other, often irrelevant, circumstance. Determinism makes us powerless because it tells us that there is no hope. This belief discourages us from trying to improve our situation. Common examples of determinism include:

I’m bad tempered because my parents were Irish;
I failed at school so I’ll never make anything of myself;
I’m unemployed so I must be miserable
I was traumatised as a child so I’ll never be happy;
Of course I can’t look after myself – I’ve been diagnosed with schizophrenia.

Selective abstraction

This thinking error is very similair to arbitrary inference. The difference is that it’s often a more conscious process of ‘self-censorship’. It’s the process by which people ignore evidence that doesn’t fit with their preferred beliefs and opinions. They acknowledge only the evidence that supports their preconceived notions and so they fail to grow, to develop and ultimately to learn how best to survive in the world. In everyday language this is what we mean when we say that someone is ‘burying their head in the sand’. This is the sort of thinking error that allows:

Racists to ignore the evidence that people from other racial groups are just the same as people from their own;
Politicians to draw different conclusions from the same evidence;
People to blame others for their emotions in spite of their own self-destructive thoughts and behaviours.

Global thinking

This is one of the most common thinking errors. It’s the habit of applying a single principle to a total situation. It’s one of the most destructive thinking habits, especially when people apply it to themselves.

The man who finds himself out of work following a spate of redundancies is not a total failure.
The girl who finds herself taken advantage of after a drunken night out is not a whore.
The woman diagnosed with depression is not completely unable to function in the world.

All of these people may face some very real difficulties but that, in itself, does not negate all the other aspects of their personalities and circumstances that make up who they are. Global thinking, when applied to ourselves or others, is always far too superficial. It’s the sort of thought process that leads people to write off small children as evil and a host of other, equally superficial judgements with no real understanding of the complexity of human beings and their capacity to behave in a variety of ways given the right circumstances.

Dichotomous thinking

Also known as ‘black and white’ thinking, this is the belief in extremes. The world is full of shades of grey but the dichotomous thinker can see only definites. Dichotomous thinking is common among children – in fact it’s a vital stage in cognitive development but it isn’t the end result. Dichotomous thinking gives rise to attitudes such as:

With us or against us
 Good and evil
 Us and them
 Good people and bad people

The reality is much more complex than that.

Magical thinking (the Wizard did it)

Magical thinking is the opposite of the ‘cause and effect’ principle that rationalism is based upon.

Rather than take the time to understand how the world works people assume a magical connection or a guiding force instead. They put their faith in a form of wishful thinking and trust to ‘luck’ or to ‘God’ instead of doing the work needed to make lasting change. The irony is that when they don’t get the job or the advice of the pendulum they swung turns out to be false the same magical thinking provides them with some sort of solace through the belief that:

It wasn’t meant to be.

Magical thinking prevents people from taking responsibility because they attribute success or failure to the magical force of their choice. Consequently they stop trying to understand and ignore the real ’cause and effect’ lessons that would actually help them to achieve their goals.

Personalisation

Some people go through life believing so completely in their own importance that they think everything is about them. The majority of people really aren’t all that important and most people we come across are far too wrapped up in their own lives to devote much attention to us, our characteristics or the state of our hair.

One excellent thing to keep in mind is this:

I’m not special – I’m unique, like everybody else!

About the ‘Fallacies’ series

The ‘Fallacies’ project was built up from a series of instalments that first appeared online during the summer of 2012. It is republished as part of a larger set of changes intended to rationalise the contents of several different blogs into just 2. The other remaining blog focuses mainly upon social care and mental health related issues. It can be found at http://www.TheCareGuy.com

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