Letters

TO THE EDITOR…

Letters should be marked clearly ‘Letter for publication in The to be published.The editor reserves the right to edit, shorten or Psychologist’ and addressed to the editor at the Society office in publish extracts from letters. If major editing is necessary, this will Leicester. Please send by e-mail if possible: [email protected] be indicated. Space does not permit the publication of every letter (include a postal address). Letters over 500 words are less likely received. Letters to the editor are not normally acknowledged.

Prescription rights – Are we ready for change? T is ironic that in trying to placed to administer medical justifies their control of disorders’ or as treatments for I make a case for prescribing and psychological (moral) both forms of treatment; that ‘symptoms’ of diagnosable rights for psychologists (‘To treatments to ‘mad’ people. combining the two in one disorders. prescribe or not to prescribe Like the 19th century doctors profession is more efficient; Resnick is also mistaken in – Is that the question?’, April before him, Resnick argues and, of course, that it would his (rather arrogant) assumption 2003), Robert Resnick should that a combination of be to the benefit of patients. that in opposing rely so heavily on a rhetoric treatments is obviously The arguments lacked him, Lucy of progress and looking to the preferable to either alone; substance then and they lack future. His arguments are, in that a combination approach substance now. They obscure fact, remarkably similar to is justified by the interaction the lack of evidence for the those used by 19th century of mind and body; that the validity of psychiatric doctors trying to persuade the superior knowledge and diagnostic systems and the public that they were best training of their profession lack of any coherent biological theory of psychological distress or ‘abnormal’ behaviour. And Johnstone and although Resnick is not keen to Jim Orford are BLACK AND WHITE make the point explicit, the behind the credibility of prescribing rights times – A GREY AREA depends on such evidence, or (‘[their] at least a belief in its existence, positions are Jim Wood (Letters,April 2003) wrote suggesting that the words and not on the obvious fact that reminiscent black and white should be avoided in The Psychologist in phrases brain, emotion and behaviour of American where the connotations are respectively negative and positive. interact. of We asked what other readers thought.The letters we received Certainly, drug companies 25Ð35 years were evenly divided between those for and against the are acutely aware of this. In ago’). US suggestion. Here are extracts from some of the letters. advertising psychotropic drugs clinical Richard Velleman (Avon & Wiltshire Mental Health Partnership NHS Trust and directly to the US public via psychology has University of Bath): The language we use should not equate ‘white’ with television and magazines, they indeed changed ‘positive’, or ‘black’ with ‘negative’. Hence it is inappropriate to write of strongly emphasise the ‘official’ in the last 25 illegal markets as ‘black markets’, or of the illicit economy as the ‘black DSM ‘disorders’ which their years, in the direction of greater economy’, or as Jim Woods points out, to use ‘white’ for ‘pure, or to use drugs ‘treat’; they even provide medicalisation and dependence ‘black’ for ‘pessimism’. On the other hand, it is completely appropriate to diagrams of chemically on the DSM, but those changes ask for one’s coffee to be black. imbalanced synapses which owe little to scientific progress Peter Storr (London W1): To say that phrases such as ‘whiter than white’ or their drugs may correct (and and a great deal to medical ‘the future looks black’ are referring to anything to do with race is at best drawings, too, of balanced insurers’ insistence on the use unhelpful, and at worst diluting the importance of outlawing genuinely synapses). Of course, they of DSM categories as a basis offensive statements. carefully avoid saying which for reimbursement to Suvarna Sansom (Open University): I think that Jim Wood makes an insightful chemicals are unbalanced, or professionals. In other words, observation here and I would like to see the Society’s style guide and that suggesting that anyone sets many US psychologists’ of Commission for Racial Equality reviewed to take into account that their doctor the hopeless task livelihoods depend on their language ‘does things’, that language does not simply reflect society as it is of demonstrating the imbalance using DSM diagnoses. in terms of concrete structures. before the drug is prescribed UK psychologists, free of and the balance afterwards. such restrictions, have been far Helen Ross (University of Stirling): A colleague who works on a language As Lucy Johnstone points better placed to develop project in Kenya assures me that the indigenous people have no qualms out, psychotropic drugs sedate, critiques of diagnostic about using black and white as evaluative expressions. He points out that tranquillise and stimulate in approaches and alternatives to the metaphorical use probably stems from basic terms like night/day or non-specific ways, and those them; they have done both with dark/light rather than skin colour. English is rich in metaphors, and contains who advocate prescribing rights vigour and creativity. It is this some reverse meanings for black and white. In financial matters it is good to be ‘in the black’; and we all deplore a cover-up or ‘whitewash’. could at least be open about this growing conceptual gulf which Psychologists should concentrate on practical issues, and stop attempting rather than depicting drugs as Resnick seems unaware of; to ruin our language. ‘proven treatments for proven indeed, as Orford points out, he

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seems unaware of the maintain an ongoing assumptions which inform his collaborative relationship with PETER WASON (1924–2003) arguments. the healthcare practitioner who ETER Wason’s research impossible to match him in By all means let us have a oversees the patient’s general P and writings from the either regard. debate about prescribing rights, medical care. There also has to late 1950s until his Wason ran most of his but let’s not obscure it with talk be malpractice insurance in retirement in the early 1980s experiments personally and of progress, quality care and place that will cover the challenged the orthodox always one-to-one. He UK psychologists ‘evolving’ to practitioner as a prescribing rationalist views of his time, disliked group testing and was meet their US counterparts. Let psychologist. presented the first major us instead be open about the Prescribing psychologists bewildered by the introduction studies of cognitive biases in of computer-delivered tests by conceptual assumptions which are subject to current ‘best the UK, and effectively inform the debate and about the practice’ guidelines, and in the other reasoning researchers founded the modern study of towards the end of his career. actual rather than claimed NHS this would include those thinking and reasoning. He actions of psychotropic drugs. produced by the National Although he performed was exceptionally creative Above all, let us ask an Institute for Clinical statistical tests for the benefit and developed a series of informed public how they see Excellence. I am not of journal editors, he loathed reasoning problems that are the ‘unmet mental health necessarily discouraging still in use today, most them, and his papers are full needs’ which Resnick refers to. clinical psychologists from notably the 2-4-6 and THOG of clinical observations about I very much doubt that these obtaining prescribing rights, problems, and of course the his subjects, as they were then will include a need for more but these issues of regulation four-card selection task that called. Paradoxically, while drug prescribers. do need to be addressed. features in more published Wason hated mathematics to Mary Boyle In psychiatric practice the point of phobia, he was Department of Psychology the other powerful force for papers than any other a brilliant chess player, a game University of East London medical control, besides method in the psychology he would play only by medication, is through the of reasoning. HE debate about Mental Health Act. The current For those who knew him correspondence as he regarded T prescription rights reform of the Mental Health personally, the phrase ‘officer over-the-board play as too insufficiently addresses the Act has proposed that the and gentleman’ might well stressful. He even wrote a issue of professional influence clinical supervisor is normally spring to mind. On discharge book (with William Hartson) and power. For example, if a consultant psychiatrist, but from the army in 1945 he read on the psychology of chess, clinical psychologists have may also include a consultant first a degree in English at unwisely denouncing the prescription rights within the psychologist. I wonder how Oxford, before making a new ‘artificial stupidity’ of chess- NHS should they be paid the Lucy Johnstone and Jim start with a degree in playing computer programs, same as psychiatrists? Orford view this potential psychology at University which by now have beaten the I am a psychiatrist, who extension of clinical College London. He arrived at world champion. has been called more of a psychologists’ professional UCL in 1950 and stayed there On his retirement in 1982 until his retirement, for the psychologist because I take influence. Peter Wason told me that he most part as Reader in the a biopsychological approach to Personally I am keen to ‘had made his contribution’ Department of Linguistics. He psychiatric practice. I am also facilitate the increasing role and intended to play no a member of the Critical of clinical psychologists in the told me he left the Psychology further part in the field, Psychiatry Network. Such a mental health field, because Department because ‘he concentrating instead on stance can lead to conflict, for they tend to identify with my refused to teach’ and indeed example when working with biopsychological approach. somehow managed to avoid chess. While he largely stuck more biomedically minded If they do take on the undergraduate teaching and to this resolve for the past 20 GPs, who continue to treat responsibilities of psychiatrists, administration his entire years of his life, his death was patients in primary care they should also be eligible for career. As a PhD supervisor, a very sad event for all of us referred to specialists like the same professional prestige however, he was inspirational who knew him well and owed myself in secondary care. and authority, including salary. and fiercely loyal to his own him so much. He was a great Under the New Mexico Duncan Double students. He taught creativity psychologist, and a great man. legislation, the prescribing Norfolk Mental Health Care in research and clarity in Jonathan St B.T. Evans psychologist still has to NHS Trust writing, although it was University of Plymouth

…but one change at a time, please the equally contentious powers Ð legal responsibility proposal that psychologists for the care plans of people WAS very interested to read probably know that the British could become ‘clinical receiving mental health care. I your series of articles on the Psychological Society is supervisors’. I have no particular point of possibility of psychologists currently working closely with These proposals look almost view on the question of having prescribing privileges. the Department of Health with certain to become law. It has psychologists’ prescription As your readers will realise, respect to the proposed caused some debate and privileges, but I am slightly this issue is itself contentious. reforms to the Mental Health concern that psychologists concerned that we are debating Your readers will also Act. These reforms include could have such statutory the pros and cons of running

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before we have learned to walk. can predict substantial changes. ECT, etc. The reforms of the Mental It is usually unwise to change Health Act with the new two things at once. I wonder UCY Johnstone’s statutory responsibilities of whether we should, as a L excellent critique (‘A psychologists, have not yet profession, take stock of one shocking treatment’, May occurred, and we are many set of changes before 2003) cites some research years from knowing fully how discussing another. I was involved in (Rogers et those changes will affect our Peter Kinderman al., 1993), in which over a profession and our clients. We University of third of respondents (37.1 per cent) reported ECT to be distressing. On the other hand, 18.6 per cent said that it interventions may be QUESTION TIME was ‘very helpful’, with some experienced as being attributing it with almost acceptable and appropriate, How does Derren Brown of Channel 4’s Derren Brown: Mind Control magical curative properties. but they may not always be programme do his psychological tricks and illusions? We found that it provoked the effective. For example, most polarised user-appraisal, generally, talking treatments DERREN Brown does not claim to be using psychic ability, but what he across treatments. are anxiously sought and does claim appears to be almost as amazing. Can he really be achieving all If service quality is not gratefully received. However, of those mind-boggling effects by the application of psychological science reduced simply to not all of their practitioners are alone – or is he perhaps sometimes exploiting the standard techniques of professionally defined clinical benign and efficient, the the conjuror? effectiveness, such as the Royal efficacy of some types remains In a sense, of course, conjuring is a form of , especially that branch of conjuring known as mentalism, specialising in the College of Psychiatrists’ unproven, and deterioration illusion of mind-reading and prediction. It may be of some relevance that position on ECT, then effects occur in all forms of Brown, like Uri Geller, already had a pretty successful career as a conjuror contradictions ensue. Some therapy for some patients. before he started claiming that he was producing his effects in a different way. NFORMATION I have a professional interest in the psychology of deception.Are there I ways that someone could appear to have psychic ability when in fact they ■ THE Standing Committee Forensic Day Centre in Clacton- do not? Indeed there are.The technique of ‘cold reading’ allows you to for the Promotion of Equal on-Sea.We offer a service to convince complete strangers that you know all about them (Hyman, Opportunities is exploring the offenders, ex-offenders, those at 1989).A full description of this technique is beyond the scope of this reply issue of psychologists who risk of offending and families of but the technique does make use of some non-verbal cues – but only to a work via interpreters and offenders.We have limited extent.As far as I am aware, no one could successfully use such what the associated training opportunities for people to join cues alone to reliably obtain information that is as specific as that typically needs may be for members.We our staff team (on a voluntary identified by Brown. If any readers (including Brown himself) could point would invite comments, practice basis).The centre provides me to scientific studies showing that I am mistaken, I would be most experience and research from valuable experiences for grateful. any individual or organisation. students/graduates pursuing I think it is pretty unlikely that the ‘mind-reading’ effects are produced We would welcome comments careers in forensic simply by using an actor or by selective editing of film. It seems far more covering work that is both psychology.Volunteers need to likely that much of the relevant advance preparation for the effect was verbal and non-verbal in nature. be available for six hours per simply never filmed at all. Please send your comments to week.Travel expenses will be If Brown really has successfully developed techniques to discern the Felicity Hector reimbursed. contents of people’s minds in the way that he claims, he has single- ([email protected]) at the Sarah Tomlinson handedly achieved in a few years more than the collective attempts of Leicester office. 85–87 Pier Avenue psychologists over many decades. Maybe he has – but I won’t really be Richard Beckett Clacton-on-Sea CO15 1QE convinced until I see him do it under properly controlled conditions. SCPEO Tel: 01255 423466; e-mail: Christopher French [email protected] Goldsmiths College ■ I AM a second-year undergraduate studying ■ I AM currently compiling Reference psychology at the University of a book on the placement Hyman, R. (1989). The elusive quarry:A scientific appraisal of psychical research. Buffalo, NY: Plymouth. I am seeking work experiences of Prometheus. experience for the summer counsellors/counselling 2003 in the Plymouth area. psychologists in training. I am ANSWERS, PLEASE… Any opportunities would be seeking a half dozen counselling I’M sitting on a train, lost in my own thoughts, my eyes resting on but not gratefully received. psychologists in training who looking at a person who is engrossed in reading a book. Suddenly the Suzanne Czerwinski are progressing either through person stops reading and looks at me directly, almost aggressively. It seems 15 Gifford Place the independent route or that he has become aware that I am looking at him, even though I’m not Plymouth PL3 4JA through a BPS-accredited trying to attract his attention or even study him. How does that person Tel: 01752 662013; e-mail: programme to contribute know that I’m looking at him? [email protected] material for several chapters. Dorothy Rowe mouth.ac.uk The aim is that you would be 40 Highbury Grove able to provide a chapter London N5 ■ I AM the manager of a approximating 4000 words on

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Inconvenient as it is for our polypharmacy and megadosing professional interests, we have created a global pandemic STRAIGHT TO THE POINT… cannot always claim that of movement disorders, with ■ Sue Paulson (Cambridge) on our interview with Phil Salmon (April 2003): What a ‘biological = bad, and millions of patients left delightful interview. It is refreshing to hear of a supervisor so concerned about psychological = good’. disabled or dead by them in the her research students’ welfare and ultimate success. Her present work with All interventions for mental last 40 years (Fisher & victims of torture shows her deep concern for others, even during her health problems need to be Greenberg, 1997). ECT needs retirement. It must be a privilege to work with her. appraised honestly and any to be taken to task, but so do form of service contact all forms of therapy. ■ Michael Shayer (Cambridge) on the results of our poll to find your top 10 considered sceptically by its David Pilgrim psychologists (April 2003): Who can supply me with an answer to this paradox? users, especially when coercion Blackburn with Darwen PCT Despite the vote putting Piaget at the top, and despite the justifiable reasons is a constant backdrop to offered by Elliot Turiel,citing Piaget as part of one’s theory base guarantees that the referees of any American journal will reject the paper (one of my reasons professional action (Rogers & Fisher, S. & Greenberg, R.P.(Eds) (1997). for deciding to publish only on this side of the Atlantic). Pilgrim, 2003). Arguably, the From placebo to panacea: Putting psychiatric drugs to the test. New York: most damaging psychiatric Wiley. treatment has been the ‘old Rogers,A., Pilgrim, D. & Lacey, R. (1993). If you read an article in The Psychologist that you fundamentally antipsychotics’ (major Experiencing psychiatry: Users’ views of services. Basingstoke: Macmillan/MIND. disagree with, then the letters page is your first port of call: tranquillisers), given the sheer summarise your argument in under 500 words. But if you feel you scale of their iatrogenic toll. Rogers,A. & Pilgrim, D. (2003). Mental health and inequality. Basingstoke: Palgrave have a substantial amount of conflicting evidence to cite and High prescription prevalence, Macmillan. numerous points to make that simply cannot be contained within a letter, you can submit a ‘Counterpoint’ article of up to 1500 words – but we need to receive it within a month of the publication of the DEADLINE original article.We hope this format will build on the role of The Deadline for letters for possible publication in the August issue is 4 July Psychologist as a forum for discussion and debate.

one specific placement you group, we would be delighted to ■ I AM a second-year Otyehel (0151 471 2611) or Helena experienced. hear from you. Call Laura Edgar on undergraduate student studying Ramos (0151 472 4551). Paul Mason 01252 737377 or e-mail her at psychology and anthropology at Helena Silveira Ramos E-mail: [email protected] [email protected]. Oxford Brookes University. I am Ashworth Sylvia Horner looking for any volunteer Parkbourne ■ I AM a second-year clinical Quintec Associates Ltd opportunities that would give me L31 1HW psychology trainee who would be Farnham experience in the psychology field interested to hear from any Surrey during the summer of 2003 in the ■ I AM a second-year undergraduate, assistant, trainee or Bristol or Somerset area. undergraduate psychology student qualified psychologist from an ethnic ■ I AM a graduate of psychology Lindsay Young at the University of Leeds and am minority for my third-year research and am seeking voluntary work 1 Starrs Close looking for voluntary work submission. I would like to interview experience in Axbridge experience over summer 2003 you (face-to-face or on the phone) either within a healthcare setting or Somerset BS26 2BZ (June–September) in forensic about issues to do with ethnic in a research capacity, hopefully in E-mail: [email protected] psychology or a related discipline, diversity amongst the profession. South Yorkshire. I have experience preferably in West Yorkshire. Your help would be greatly of working with young adults with ■ I AM a psychology graduate (2:1) Bryony Crisp appreciated. learning disabilities and with seeking voluntary clinical work E-mail: [email protected] Lisa Rajan research into areas of child experience in the Berkshire area. Flat 3 The Azure psychology. Please contact me I have worked within the criminal ■ MY PhD is funded by the Bath Buildings Helen Ball justice system and with substance National Probation Service in Montpelier 240 Lancing Road misuse and would like to widen the London and aims to help improve Bristol BS6 5PT Sheffield S2 4EX scope of my experience. services for victims of crime. Tel: 0117 923 2253; 07961 154366; E-mail: [email protected] Hazel Dunbar Following a pilot survey, I have e-mail: [email protected] Tel: 0118 939 4893; e-mail: developed a questionnaire which ■ I AM a second-year student of Hazel.Dunbar@Thames- I intend to distribute to over 500 ■ THE Human Factors group psychology at Bristol University and Valley.probation.gsx.gov.uk victims of crime.The data collected at Quintec will be celebrating its am keen to gain a work will inform an assessment tool that 50th year in September 2004. experience placement in clinical ■ WE are working at the will aim to help criminal justice It is our intention to hold a psychology any time during the Psychology Service at Ashworth agencies assess and support victims. celebration, possibly in west London, period of August to October 2003 Hospital.We are interested in If you would like to take part in this for all of our current and past summer vacation in the Cardiff area. finding a screening tool for adults research, please get in touch. members, together with some Joanne Western with autistic spectrum Rania Marandos distinguished guests from the 86 St David’s Way disorders/Asperger’s syndrome Research & Information Unit Ergonomics Society, the MoD and Watford Farm (published or otherwise). London Probation Area other relevant organisations. If you Caerphilly CF83 1EZ If anyone has any information on Tel: 020 7960 1123 have ever been employed within this Tel: 029 2085 1060 such a tool, please contact us: Beth E-mail: [email protected]

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