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G. S. Brindley made one of the most important contributions to the treatment of erectile dysfunction. He discovered that injecting papaverine into the penis causes an erection. He announced this discovery — in a rather unique way — in 1983 at a meeting of the Urodynamics Society. Laurence Klotz was at that talk and described Brindley’s eccentric (and to some audience members, horrifying) presentation in a paper published in 2005. Here is an extended excerpt from that paper:

In 1983, at the Urodynamics Society meeting in Las Vegas, Professor G.S. Brindley first announced to the world his experiments on self-injection with papaverine to induce a penile erection. This was the first time that an effective medical therapy for erectile dysfunction (ED) was described, and was a historic development in the management of ED. The way in which this information was first reported was completely unique and memorable, and provides an interesting context for the development of therapies for ED….
The lecture was given in a large auditorium, with a raised lectern separated by some stairs from the seats….
Professor Brindley, still in his blue track suit, was introduced as a psychiatrist with broad research interests. He began his lecture without aplomb…. His slide-based talk consisted of a large series of photographs of his penis in various states of tumescence after injection with a variety of doses of phentolamine and papaverine….
The Professor wanted to make his case in the most convincing style possible…. He had, he said, therefore injected himself with papaverine in his hotel room before coming to give the lecture, and deliberately wore loose clothes (hence the track-suit) to make it possible to exhibit the results. He stepped around the podium, and pulled his loose pants tight up around his genitalia in an attempt to demonstrate his erection….
At this point, I, and I believe everyone else in the room, was agog. I could scarcely believe what was occurring on stage. But Prof. Brindley was not satisfied. He looked down sceptically at his pants and shook his head with dismay. ‘Unfortunately, this doesn’t display the results clearly enough’. He then summarily dropped his trousers and shorts, revealing a long, thin, clearly erect penis. There was not a sound in the room. Everyone had stopped breathing…..
He then said, with gravity, ‘I’d like to give some of the audience the opportunity to confirm the degree of tumescence’. With his pants at his knees, he waddled down the stairs, approaching (to their horror) the urologists and their partners in the front row. As he approached them, erection waggling before him, four or five of the women in the front rows threw their arms up in the air, seemingly in unison, and screamed loudly….
The screams seemed to shock Professor Brindley, who rapidly pulled up his trousers, returned to the podium, and terminated the lecture.

B1

Figure 1. What Professor Brindley’s clothed erection may have looked like at his 1983 talk.

You may contact me at drjeffryricker@gmail.com

Reference

Klotz, L. (2005), How (not) to communicate new scientific information: a memoir of the famous brindley lecture. BJU International, 96, 956–957.  doi: 10.1111/j.1464-410X.2005.05797.x

Note: A pdf of the paper can be found at: http://onlinelibrary.wiley.com/store/10.1111/j.1464-410X.2005.05797.x/asset/j.1464-410X.2005.05797.x.pdf?v=1&t=hfjwg8vk&s=c47fb9dd39977745ce58b0994331feb5154737ef

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Anecdotes, the topic of the post at this link, are often used as evidence for claims, even though they have weaknesses that limit severely their value as evidence. Anecdotes are important for another topic we’re discussing in my PSY 101 course: the confirmation bias, which is a strong tendency to readily accept evidence that seems to support beliefs we already have (i.e., our preconceptions) and to examine closely evidence that seems to contradict our preconceptions in order to find problems with the disconfirming evidence that allow us to discount it.

Figure 1. Discounting evidence that disconfirms one's preconceptions can lead to the development of bizarre beliefs that people hold fervently.

Figure 1. Discounting evidence that disconfirms one’s preconceptions can lead to the development of bizarre beliefs that people hold fervently.

In everyday life, however, we often do not even become aware of disconfirming evidence. Sometimes, this is because we can easily avoid it (e.g., we might avoid watching certain news programs that we know will make claims that contradict our beliefs). Other times, our cognitive limitations make it difficult for us to notice the disconfirming evidence (i.e., it doesn’t reach the conscious level). One example of the latter involves the belief that washing our cars causes it to rain. Many of us are able to point to occasions (anecdotes) on which it rained after we washed their cars, which seems to be compelling evidence of the truth of this belief. We often fail, however, to notice (and, therefore, don’t remember) occasions on which these events didn’t occur together. In order to get better evidence for the accuracy of the belief, we would need to make the kinds of observations indicated in the following table.

Table 1. Each cell of this table indicates the observations that would need to be made to determine if washing one's car causes it to rain.

Table 1. Each cell of this table indicates the observations that would need to be made to determine if washing one’s car causes it to rain.

In making observations that would allow us to fill in the cells of the table, we force ourselves to pay attention not only to evidence that supports our belief, but also to evidence that might disconfirm that belief:

  • The cell labelled A shows the number of times we washed the car and it rained.
  • The cell labelled B shows the number of times we washed the car and it didn’t rain.
  • The cell labelled C shows the number of times we didn’t wash the car and it rained.
  • The cell labelled D shows the number of times we didn’t wash the car and it didn’t rain.

Let’s say that we make the relevant observations for one year and get the following results.

Table 2. The cells of the table show, for a one-year period, the proportion (percentage) of days we either washed or did not wash the car and it either rained or did not rain.

Table 2. The cells of the table show, for a one-year period, the proportion (percentage) of days we either washed or did not wash the car and it either rained or did not rain.

Was it more likely to rain on the days we washed the car?

  • Cell A shows that, on 20% of the days, we washed the car and  it rained.
  • Cell B shows that, on 80% of the days, we washed the car and it didn’t rain.
  • Cell C shows that, on 20% of the days, we didn’t wash the car and  it rained.
  • Cell D shows that, on 80% of the days, we didn’t wash the car and it didn’t rain.

Thus, regardless of whether we had just washed our car or not, it rained on 20% of the days that year (and it didn’t rain on 80% of the days). In other words, washing our car was not associated with whether or not it rained.

The confirmation bias is caused, in part, by our unconscious tendency to ignore, avoid, or distort information that would show a preconception to be wrong. In the present example, people tend to pay attention only to the first cell of the table and to ignore the rest. This is because, in general, we are much more likely to notice when something happens than when something doesn’t happen. By forcing ourselves to pay attention to all relevant information in such situations, we are more likely to realize when our preconceptions are inaccurate.

I_Want_To_Believe_01

To summarize: Cognitive researchers have found that we have an automatic (unconscious) tendency to seek out and readily accept information that agrees with (confirms) our preconceptions, and to ignore, distort, or discount information that contradicts (disconfirms) them. This confirmation bias serves to maintain and strengthen our preconceptions: we are much more likely to perceive and remember experiences that confirm our prior beliefs, and to discount or reinterpret those that disconfirm them. Thus, over time, the confirmation bias results these beliefs becoming so well established in our minds that eventually we consider them to be common sense (i.e., obviously true). If we wish to minimize the effects of the confirmation bias, we must force ourselves to look for and examine closely both confirming and disconfirming evidence.

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In my PSY 101 class, we recently discussed some problems with using anecdotes and testimonials as evidence for claims. In this post, I want to begin to explore this issue in more depth. In future posts, I will discuss further some of the issues touched upon here.

Anecdotes

One afternoon, Eileen Lipsker was sitting in her family room watching Jessica, her red-headed five-year-old daughter, play with her friends. Eileen later reported that she felt “spaced out” and was “thinking of nothing.” Lenore Terr (1994), a psychiatrist who spoke with her on many occasions, described what Eileen said happened next:

Jessica twisted her head to look at her mother. To ask something? Her chin pointed up in inquiry. She looked up and over her shoulder. Her eyes brightened. How odd! The young girl’s body remained stationary, while her head pivoted around and up…. And at exactly that moment Eileen Lipsker remembered something. She remembered it as a picture. She could see her redheaded friend Susan Nason looking up, twisting her head, and trying to catch her eye.

Eileen, eight years old, stood outdoors, on a spot a little above the place where her best friend was sitting. It was 1969, twenty years earlier. The sun was beaming directly into Susan’s eyes. And Eileen could see that Susan was afraid…. [Eileen] looked away from those arresting eyes and saw the silhouette of her father. Both of George Franklin’s hands were raised above his head. He was gripping a rock. He steadied himself to bring it down. His target was Susan. (pp. 2-3)

Eileen told Terr that this is how she first recovered her repressed memory of Susan Nason’s murder by her father. Eileen’s recounting of the memory recovery is an example of an anecdote: a brief story told by an individual about a personal experience. No matter how interesting or compelling an anecdote may be, it doesn’t provide good evidence for a claim because it is based on interpretations and memories of personal experiences. In other words, an anecdote is inadequate evidence for a claim because it does not control for factors that affect how a personal experience is (a) initially perceived and interpreted, and (b) eventually remembered.

Figure 1. An example of an anecdote used to support the claim that extraterrestrials visit earth

Figure 1. An example of an anecdote used to support the claim that extraterrestrials visit earth

Testimonials

Autistic Disorder is a severe mental disorder that develops in children before the age of three years. It has three main symptoms: a severe impairment in social interaction, a severe impairment in the ability to communicate, and a severely restricted range of interests, activities, and behaviors. On occasion, new treatments for autism are announced that seem to offer hope for either a cure or, at least, a dramatic reduction of symptoms. One such well-publicized treatment used injections of secretin–a hormone that assists in the digestion of food. Some have claimed that secretin improves the social and language skills of autistic individuals by affecting specific behaviors such as the amount of eye contact made, the level of awareness of one’s surroundings, the degree of sociability, and the amount of speech. One proponent of secretin therapy provided the following evidence for this claim:

The good news is that confirmatory evidence of the power of secretin keeps coming. A national newspaper told of Florida pediatrician Jeff Bradstreet’s own four-year-old son, Matthew, shocking his parents by holding his first normal conversation with them the day after his first secretin infusion. And Virginia pediatrician Lawrence Leichtman told me of his “miracle case”: a five-year-old who had previously said only two words amazed all in the office by saying, 15 minutes after his infusion, “I am hungry. I want to eat.” Most cases are much less dramatic, but the autism world is excited, and for good reason. (Rimland, 1998, p. 3)

Is this good evidence for the effectiveness of secretin in the treatment of autism? The evidence consists of two testimonials. A testimonial is an anecdote that describes the supposed merits of a product or service. Testimonials are not good evidence for a claim because they are anecdotes and, as stated above, anecdotes don’t control for factors that might distort our observations and interpretations of a personal experience, as well as how we remember it later on. For example, we may misremember exactly what happened during the event, or may have misinterpreted what we observed during the event.

Figure 2. A testimonial from a celebrity about a brand of cigarettes

Figure 2. A testimonial from a celebrity about a brand of cigarettes (circa 1951)

In testimonials about therapeutic treatments, one very important factor that causes distortions of perceptions, interpretations, and memories is people’s expectations for the treatment. These expectations may cause them to conclude that their symptoms improved or disappeared even when they haven’t. This generally happens in one of two ways:

  1. The expectations may cause observers (e,g, patients, family members, doctors) to misperceive or misinterpret the behavior of those receiving a treatment, thereby concluding that the behavior has changed when it really hasn’t.
  2. The expectations may cause observers to experience improvement that has nothing to do with the nature of the treatment itself (e.g., the placebo effect or a self-fulfilling prophecy; see later posts in this series).

Specific examples of some of the problems mentioned here will be described in future posts.

You may contact me at drjeffryricker@gmail.com

References

Pendergrast, M. (1996). Victims of memory: Sex abuse accusations and shattered lives (2nd ed.). Hinesburg, VT: Upper Access.

Rimland, B. (1998). The use of secretin in autism: Some preliminary answers. Autism Research Review International, 12(4), 3. Retrieved January 23, 2013, from http://legacy.autism.com/ari/editorials/ed_secretinfindings.htm

Terr, L. T. (1994). Unchained memories: True stories of traumatic memories, lost and found. New York: BasicBooks.

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One of the major goals of this website is to help people learn about scientific research in psychology and how it can help all of us to better understand why we do what we do in our everyday lives. This goal requires that we learn about some of the attitudes and assumptions indispensable to doing good research in the behavioral sciences. In this post, I will argue that two essential attitudes for scientific researchers are skepticism and empiricism. In fact, these attitudes form the foundation of the scientific approach to understanding ourselves and the world around us.

Evaluating Claims About Mind and Behavior

Angel Therapy works on the belief that everyone has guardian angels, and these angels perform God’s will of peace for us all. When we open ourselves to hear our angels’ messages, every aspect of our lives become more peaceful…. You can connect with your angels and guides. According to the therapy, everyone has at least 2 guardian angels, and a variety of spirit guides, souls who have agreed to work with you throughout your life. These angels and guides are loving entities, and are here to help you in every aspect of your life. They are believed to be the source of intuition and inspiration, and there to support you during times of need. (Quoted from The Body Guide website)

Three main claims are made in this passage. (1) We all have at least two guardian angels as well as countless other angels and spirit guides that we can “connect with.” (2) These supernatural beings want to help us in every aspect of our lives. (3) This help can be therapeutic: it can reduce or eliminate psychological problems and even provide “intuition and inspiration.”

But what is the evidence that these supernatural beings actually exist and that, if they do, that they want to help us? Susan Stevenson, a therapist, has claimed that the evidence is all around us, but that we need to pay close attention to see it:

My life seems to be teeming with angelic connections, and the momentum is building. Have you noticed this in your own life? Angelic reminders that they are with us- ‘whispers’ in our ear, ‘taps’ on the shoulder, brushes of air across your skin or changes in air pressure, ‘flutters’ from deep inside, glints of light and color- all these gentle hints to pay closer attention to their presence. Think back- have you been paying attention, listening, responding? (Carroll, 2012)

When one makes a claim, one is stating that something is a fact. In other words, a claim is a statement that is thought by at least one person to be true; but of course, it may turn out to be false. Claims often involve interpretations of experiences. For example, you may interpret a “brush of air” across your skin as an angel who has just passed by, or you may interpret it as a breeze that has wafted through the room from an open window. A glint of light may be the sign that an angel is nearby, or it may be the sign that sunlight just reflected off a passing car. In other words, two people may interpret the same experience in different ways. In deciding which interpretation is more likely to reflect reality, we need to evaluate the different interpretations. We do this by examining relevant evidence.

In your everyday life, you probably often have heard claims made about psychological problems and psychological therapies; and you probably think that you already know quite a bit about psychology. In order to get a sense of what you might know, please take the following brief quiz.

Which of the following claims are true?

  • dream images are known to have particular meanings that involve unconscious desires and conflicts
  • eating sugar causes children with attention-deficit hyperactivity disorder to become even more hyperactive
  • a person who commits suicide must have been clinically depressed
  • a 40-year-old man who has sex with a 15-year-old girl would be diagnosed with pedophilia
  • there are more admissions to mental hospitals during full moons than at other times
  • unconscious memories of traumatic events can be remembered in detail with hypnosis
  • a person who exhibits two or more personalities is diagnosed with schizophrenia
  • low self-esteem is known to cause most self-destructive behaviors
  • most mental disorders can be cured by remembering and mentally reliving distressing past experiences

You may be surprised to learn that none of these claims is known to be true. In fact, all but a few are known to be false, and the remaining ones are controversial at best. In order to avoid basing important decisions on false claims, clinicians (professionals who study and treat psychological problems), or those who aspire to be clinicians (perhaps you), need to learn to think critically about claims made about psychological problems and their treatments. Of fundamental importance to this goal is the development of skeptical and empirical attitudes regarding claims.

Skepticism

In some religions, a shaman is said to be a mediator between the visible natural world and an invisible supernatural world. The shaman claims to be able to journey to the supernatural world in order to help heal the ill, foretell the future, and control natural events. Some mental-health workers use shamanic journeying to help those suffering from psychological problems. Sharon Van Raalte (1998) gave an example of her shamanic work with a client:

Through image and symbol, the shamanic journeys revealed levels of knowing that were often beyond what could be perceived or expressed by the clients or the psychiatrist. For example, Luke was dying from a brain tumor. An early journey suggested that I teach his wife, Suzanne, to work with him. Learning to journey to find her power animal proved to be helpful when it came time for her husband to die. At another point, I was journeying on a question for myself, when the focus abruptly changed. I found myself sitting with [Luke and Suzanne] in a boat that began moving to a farther shore. On the other side, Luke got out of the boat and went toward a group of people waiting to greet him. I had the sensation that the pain they had caused him in his life was washed away as they surrounded him with love. The classic shamanic experience (known as conducting the souls of the dead) had come unbidden. (p. 164)

In other words, Van Raalte claimed that she and Suzanne had accompanied Luke to the “other side” as he was dying, and then saw him being reunited with others who had died before him. An apparent confirmation of this interpretation came later:

Only after I had reported this journey to the psychiatrist did I learn what had literally happened. In his delirium as he was dying, Luke had called out the name of his dead sister, with whom he had had a painful relationship. Drawing from the experience of her single [shamanic] journey, Suzanne knew what he was seeing and urged him to run to his sister. (p. 164)

In these passages, Van Raalte is making a number of claims: (1) She is able to journey to a spirit world. (2) She saw Luke being reunited with his dead sister. (c) Shamanic journeying is an effective treatment for at least some psychological problems. When hearing claims such as these, scientific psychologists are trained to be skeptical–to doubt the claim unless it is supported by adequate evidence. These particular claims may be true, but we need to see good supporting evidence before we accept them. As an ideal, we should be skeptical of any claim that may have an important impact in our lives, even a claim that seems on its surface to be convincing. It probably is impossible to reach this ideal, but we should strive to develop our skepticism as much as we can in order to improve our decision-making and problem-solving abilities. And it should be incumbent upon people who work in mental-health fields, especially those offering therapeutic services, to develop their skepticism as fully as they can since their beliefs and actions have important consequences for those with psychological problems.

When confronted with a claim, a skeptical thinker needs to do two things. First, because a claim is based on a particular interpretation of an experience, a skeptical thinker always needs to consider other possible interpretations of that experience. For example, a shamanic therapist who claims to be journeying to a supernatural realm may actually be doing so. On the other hand, she may only be vividly imagining that she is doing so, or she may be experiencing hallucinations. By considering other interpretations, a skeptical thinker is less likely to automatically accept the claimant’s interpretation and more likely to examine carefully the various alternatives.

Second, a skeptical thinker needs to determine if there is any evidence that contradicts the claim. For example, Van Raalte stated that she saw Luke being greeted by a “group of people,” all of whom had caused him pain during his life. However, the psychiatrist with whom Van Raalte worked stated that, at the time of his death, Luke mentioned only his sister’s name and was urged to run to his sister. This evidence seems to contradict the claim made by Van Raalte that she had seen Luke with a group of people at the time of his death. Without further clarification and more evidence, it is difficult to know whether to accept or reject her claim.

Empiricism

Evidence consists of observations that allow us to evaluate whether a claim is likely to be true or false. Let’s consider a very simple claim that probably everyone believes is true: “The sun will rise tomorrow morning.” For me, this claim is based on the following evidence:

  • As far back as I can remember, I have seen the sun rise each and every morning of my life.
  • No mention has ever been made in any historical document that the sun has ever failed to rise. It seems likely that something as significant as the sun not rising would have been recorded and reported.
  • Scientists and other experts tell us that the sun rises each morning because the Earth rotates on its axis, and that it should continue to do so for billions of years.

From all this evidence, it seems reasonable to infer that the sun will rise tomorrow morning. If someone claimed that he knew that the sun was not going to rise tomorrow morning, you would immediately ask him why he believed this claim (this is equivalent to asking him for his evidence). If he stated that he dreamed that this would happen and that his dreams often come true, most of us would be skeptical: the supporting evidence (his dream) does not seem adequate to accept his claim.

What is the best kind of evidence for supporting a claim? Should we rely upon what an expert tells us? Should we accept a person’s intuition? Are the statements of a channeled spirit guide acceptable evidence for a claim? Regarding the nature of evidence, scientific psychologists are trained to be empirical–to make direct observations of events in the natural world that are relevant to evaluating the claim. Empiricists do not consider statements made by authorities, armchair speculations, dream interpretations, or messages supposedly obtained from supernatural beings, to be adequate evidence for a claim. Instead, empiricists must see for themselves whether a claim is likely to be true or false. For example, in testing the claim that shamanic journeying is an effective treatment for at least some psychological problems, an empiricist would want to measure directly the severity of clients’ symptoms both before and after being told what was discovered about them during a shamanic journey. If their symptoms improved relative to those of a second group of clients who were told things about themselves that were not discovered during a shamanic journey, then this would be evidence that shamanic journeying (for whatever reason) is an effective therapeutic technique.

You may contact me at drjeffryricker@gmail.com

References

Carroll, R. T. (2012). Angel Therapy. The Skeptic’s Dictionary. Retrieved November 9, 2012, from http://skepdic.com/angeltherapy.html

The Body Guide. (2012). What is Angel Therapy? November 9, 2012, from http://www.thebodyguide.co.uk/AZTreatment.aspx?Tid=554

Van Raalte, S. (1998). Direct knowing. In W. Braud & R. Anderson (Eds.), Transpersonal research methods for the social sciences (pp. 163-166). Thousand Oaks, CA: Sage Publications.

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