Prescription Privileges for Psychologists

In the last month, a bill has been introduced to the California state assembly regarding prescription privileges for psychologists. Similar bills have already passed in New Mexico and Louisiana. Now, in case you didn't know, psychiatrists are medical doctors and have the ability to prescribe medications while psychologists do not. However, this bill would change that by allowing psychologists to gain prescription privileges (RxP) by undergoing a two-year post-doctoral education that involves both didactic instruction and practicum. The American Psychological Association is lobbying for this bill to pass under the auspices that psychologists can help meet the needs of underserved populations, particularly in rural areas. However, it seems that the true purpose is to gain a clear distinction for psychologists from other mental health workers - in other words RxP is for economic purposes. The bill is opposed by psychiatrists and some other members of the medical field.

I want to bring up a few key issues why I think it is a bad idea for California to allow psychologists to gain RxP.

1. There is little evidence to show that psychologists can provide quality medical care. 50% of all mental illnesses are associated with an underlying general medical condition. Psychologists may not be able to understand all of the nuances of these conditions to treat properly. The real problem is we do not know if psychologists will provide quality care, we should wait to see how it goes in New Mexico and Louisiana.
2. The reasons for pursuing RxP, particularly meeting the needs for clients in rural areas, may be a fallacy because it seems that most psychologists who pursue the further education will want to work in urban and suburban areas.
3. The training program may be too short to properly train. The APA is lobbying for a training plan but the plan is much different from the one that the Department of Defense used to train psychologists to prescribe. Again, it's a question of knowing whether or not it will work.
4. The occupation of the psychologist will work best if there is unity within the members. RxP will cause a disunity as psychologists choose to either pursue RxP or get left behind. As a field, psychologists need to stick together.

In the end I recognize that there are problems with the system we currently have. There are not enough psychiatrists and most prescribing is done by general practitioners who have little training in psychopharmacology (i.e. meds for mental health issues). This is a problem. But I don't think RxP is the solution at this time. Psychologists already have the ability to gain RxP through gaining an advanced nursing degree, which takes about three years, so proposing a separate avenue is premature at this point in time.

A Critique of Christian Apologetics

In high school I had a stage where I got very interested in apologetics. If you don't know what it is, Christian apologetics is making an argument for Christianity based on logic and reason. But I no longer get much comfort from most of the philosophical arguments that are made. Why? Here's a few reasons:
1) A great deal of apologetics is based on "straw-man" arguments. By straw man I mean that Christians will misrepresent the secular viewpoint as being simplistic and then will make easy work of demolishing "their" viewpoint.
2) Apologetics is often based on poor interpretations of science. I will limit my argument to evolution. Evolution does not mean that humans were created by chance. Evolution is a systematic law that makes sense. One can argue that it would take tremendous time to come together or that their would be roadblocks to evolution (like human consciousness) but that is based on solid science. Again, this is creating a straw man but it is particularly aggravating to me when science is portrayed as being irrational.
3) Arguments often rely on intuition and pathos. The one I hate is "I can't believe we evolved from monkeys." Like it or not, that doesn't influence it's truth.
4) Most importantly, apologetics look primarily at the God of creation but not at the God of Subsistence. Sure, we can argue for a first cause of the universe till the cows come home, but where is God in the world today? In a world where science seems to have an explanation for everything, where does God fit in? I want to know that God is present in my life and hears my prayers.

While I've found great comfort in a limited amount of apologetics, particularly reasons to believe in the resurrection of Christ (particularly relevant considering the latest archaeological "findings"), I am in a place where I must rely in part on a non-rational faith. Instead of knowing the truth, I must live the truth. I do not know that God truly exists but I have chosen to live His life, accepting the truth as best I can, because the one thing I do know is that my life is better when I live it as he revealed it to us. I cherish that Paul commanded us to be "stewards of God's mysteries." (1 Corinthians 4:1)

Knowledge without Deeds is Dead

As my research project develops, one of the issues that comes to the forefront is that there is a divide between theoretical research and actual practice. Tens of thousands of psychological articles are published every year but perhaps only about 1 in 100 actually impact practice in some shape or form. It seems that researchers in psychology are spending all their time delving deeper and deeper into understanding an issue without every taking the time to work out how it could affect actual practice. Although we can get into trouble by making recommendations without proper theory to base it on, psychologists simply can't neglect this part of research.

I'm So Left Brained

I first must warn you this is hardly profound or insightful (am I ever??) but you may get a kick out of it all anyways.

So in my neuropsychology class it had been suggested that people have assymetrical facial expressions. I just reviewed about 20 pictures of me and I am now convinced that the right side of my face is more expressive than my left. I have a "good side." And if I remember right, facial expressions are contralateral (but it could be ipsilateral) and so this is just confirmation that I am left-brained (logical).

If you want to test this out go to my profile and look at my picture (my right side is on the left in the picture). If you can't tell by my smile then look at the creases in my cheek.

Actually this may explain why I think I look better in pictures than I do in the mirror. In pictures my right side of my face is on the left side but in the mirror my right side is on the right side. Now our right hemisphere processes facial expressions better than our left hemisphere. And since the left visual field (which would see the right side of my face in pictures) connects with the right hemisphere, it would make sense that I would appear happier and better looking in pictures than in the mirror. Haha - this all must sound so vain!!! Well I found it interesting and so you may too.

I should not I just watched A Scanner Darkly, a Philip K. Dick novel turned movie, that talks about split brain stuff which sorta triggered my desire to check this out for myself.

Indifference on Genocide

Pastors, political activists, and concerned citizens beware! Alerting others to mass atrocities may not be the best manner to engender concern and compassion to people in need, according to a recent research article. My suggestion to the natural human reaction to be overwhelmed by mass suffering would be to focus specifically on an individual case of suffering rather than presenting numbers of how many people are actually suffering. I don't think preaching at our need to become sensitive to the actual numbers will work - that is to say I don't think you should force your numbers on people to make them comply. Instead, by focusing on an individual it becomes possible to address larger concerns regardless of this phenomenon.

Not Crazy, Just Insane

I often wonder what it means when people refer to another's behavior as being "crazy"? If you ask them you will get a variety of responses ranging from doing risky behavior to following their dreams to hearing voices. Obviously there is no consensus on what constitutes crazy behavior. And, in my opinion, any time a word has such a vague meaning we should be hesitant to use.

Albert Einstein once said "The definition of insanity is doing the same thing over and over again and expecting different results." While I don't think we need to start thinking of ourselves as crazy or insane, I do think it can help us when we recognize that we do things that might be a little crazy - or perhaps irrational is a better term.

I think of all the times I have thrown a tantrum in the hopes that I will make somebody listen to me and how rarely it works. I think of all the times I've procrastinated only to be miserably stressed out later. And the list of old mistakes can go on and on. Those mistakes would certainly qualify under Einstein's definition of insanity.

I like to admit that I'm a little insane. While I don't think calling myself crazy is helpful (because it is so vague) I know what I mean when I say I'm a little insane. This kind of joking self-deprecation keeps me humble and eases the discomfort I feel around my mistakes. And if I can laugh about it, then I can share about it and allow others the chance to encourage me to change.

I'm not crazy, just insane.

On Anger and Fury

I hope you first read my previous blog on Resentment before reading this as it sets up the distinction between anger and resentment. I begin with Ephesians 4:26, "In your anger, do not sin." This surprises some who associate anger with sin. But there are numerous records of people in the Bible, including God himself, who use anger to make an appropriate action.

Anger is an internal marker that something is not right. Now I nearly added "with the world" but I quickly recognized that would not be exactly right. I can become angry at the good works of others because of jealousy, greed, and a number of reasons. And this is important because we must not assume that, when we are angry, some injustice has been done to us. As I said in the previous blog, we must begin with self-reflection. Once we know ourselves then we can proceed in the confidence that what we want to reconcile is actually a problem with the world.

Anger is a terrific motivator. We do things that we would otherwise would never do - and we do them with flair so as to make sure we are noticed. This is important because we could otherwise ignore the harm that is being done to our selves. And others would never know they were doing something that was hurtful to you! Anger makes sure we take care of ourselves and helps others act with love towards us.

Anger can communicate to others that what they are doing to us is hurtful. Sometimes another person's behavior is completely appropriate but we still respond in anger. For example, some people have different relational styles that conflict - neither is wrong but one person may become angry at the other person. Anger, properly expressed, can communicate that you need the other person to adjust how they relate to you. This can be a wonderful experience that brings two people together as they adjust to the needs of one another.

So what about righteous anger you might ask? Well, first of all, righteous anger assumes character. We should be careful if we ever excuse our behavior simply as righteous indignation. Sure, Jesus showed intense anger and violence but can we assume to know when this is appropriate in our contexts? By taking the posture that our anger is our reaction and not the direct result of another person's actions, we prepare ourselves to find what the evil is in the world and what the evil is inside of us.

If I could sum it all up I would say: Anger motivates people to communicate that they are hurting. The offense may be real or imagined but the hurt is always real. By learning what angers us and learning how to better communicate our anger to others, we can see the world and ourselves truthfully. This truth allows us to better love the world and to be loved by it.