Are psychology students more neurotic than the general population?

Are psychology students more neurotic than the general population?

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Using the NEO-FFI to measure Big Five personality traits among students from our faculty, we found that students of psychology are more neurotic (t = -2.34, p = .02) and less open (t = 5.98, p < .001) than the general population. Are there published studies that verify these results?

In general, females score higher on neuroticism and psychology students are predominantly female.

In some young adult norms that I've seen in the NEO-PI-3 test manual, females score about two-thirds of a standard deviation higher on neuroticism.

In my experience at the undergraduate level, about 70% to 85% of students are females. For example, in my most recent paper using a third-year Australian undergrad psych sample (n = 393), we had 79% females (Horwood & Anglim, 2018, JHB).

I believe also that neuroticism declines with age ( e.g., ) and psychology students as with other university students tend to be 18 to 25 or so.

You'd have to look a little further to see whether there are differences after controlling for age and gender differences; i.e., whether there's a deeper reason for any differences.

Summary Report, Graduate Study in Psychology 2017: Student Demographics

The 2017 Graduate Study in Psychology Summary Report reflects data collected from more than 500 departments and programs offering master’s and doctoral degrees in psychology and related training. Participating departments and programs are listed in the annual Graduate Study in Psychology book, published each August as a joint effort of the APA Office of Graduate and Postgraduate Education & Training and the APA Office of Publications and Databases. The 2017 book and this report represent data from the 2014-2015 academic year and aggregate these data in the areas of gender and race/ethnicity. Where meaningful, descriptive statistics are reported by type of department (e.g., university-based, professional school) and/or institution type (e.g., public, not-for-profit), as reported by the department.

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Each January, the APA Education Directorate contacts chairs of graduate psychology departments regarding the upcoming annual Graduate Study in Psychology survey. In February, chairs receive a secure URL to access and complete the survey. Up to five reminders are sent to departments until the survey is completed. Departments not updating information for two subsequent years are removed from the database and their information not included in the updated version of the book. Information not updated in a single year is incorporated in that year’s edition, but notated that data are from the prior year in the publication.

For the 2017 survey, 509 departments offering graduate degree programs in psychology or related training (e.g., mental health counseling, marriage and family therapy) provided complete responses to the survey reflecting information from the 2014-2015 academic year. Table 1 breaks out the participation by the self-reported type of college/school/institution in which the department is housed. A substantial majority of departments (62 percent) were located within a university college of arts and sciences followed by university college/schools of education (18 percent).

Table 1. Departmental Participation in 2017 Graduate Study in Psychology Survey by Department Location

University College of Arts and Sciences

University College/School of Education

Free-standing Professional School

University-based Professional School

Medical School/Health Sciences University

N=509. Values may total to greater than 100 percent due to rounding. Departments not identifying an institutional location were excluded from analysis.

This summary report also utilizes data from the 2007 and 2012 Graduate Study in Psychology books (reflecting information from the 2004-05 and the 2009-10 academic years, respectively). In 2007, 530 departments completed the survey in 2012, the total was 494 departments.

Because of fluctuations in response rates across the years, all data here are presented in percentages rather than whole numbers. Students whose ethnicities are reported as ‘unknown’ are excluded from this analysis.

The gender breakdown of men and women in psychology departments is approximately 75 percent female students to 25 percent male students. This three-to-one ratio has remained constant over a ten-year timeframe, when data from 2004-05 and 2009-10 is analyzed with the current year’s data.

Figure 1 presents the gender of students in psychology departments by type of degree offered -- whether the department offers only a master’s degree, only a doctoral degree, or both terminal master’s and doctoral degrees – by year. The departments with the greatest percentage of male students were doctoral-only departments, which were approximately 72 percent female and 28 percent male over this ten-year timeframe.

Figure 1. Gender of Psychology Graduate Students by Year and Type of Degree Offered

Figure 2 presents the gender of students in psychology departments by year and institution type. Public institutions show a growing percentage of male students over this ten-year timeframe, from 26.5 percent in 2004-05 to nearly 28 percent in 2014-15. Correspondingly, the percentage of male students in private institutions has declined by almost the same percentage during this same time period.

Figure 2. Gender of Psychology Graduate Students by Year and Institution Type

Figure 3 presents the percentage of racial/ethnic minority students in psychology departments over a ten-year timeframe, with data from 2004-05 and 2009-10 added to the current year’s data. Increases were seen across almost all racial/ethnic groups in this time period, with the exception of American Indian/Alaska Natives, which experienced a slight decrease. The largest increases were seen with students reported as multi-ethnic, at 50 percent, and Asian/Pacific Islander, at 23 percent. The African-American/Black student population also increased by 14% over this ten-year time frame.

Figure 3. Percentage of Racial/Ethnic Minority Graduate Students by Year

Over the same time period, the percentage of Caucasian/White students decreased, from 73.7 percent in 2004-05 to 70 percent in 2014-15.

Figure 4 presents the racial/ethnic breakdown of all students by degree offered in the department – that is, whether the department offers only a master’s degree, only a doctoral degree, or both terminal master’s and doctoral degrees – for 2014-15 only. As compared to the doctoral-only departments, the master’s only and both master’s and doctoral departments have a higher percentage of African-American/Black and Hispanic/Latino students together, these groups comprise approximately 20% of the students in these two departments. Conversely, the doctoral-only departments have a higher proportion of Asian/Pacific Islander students.

Figure 4. Race/Ethnicity of Students in 2014-15 by Type of Degree Offered

Figure 5 displays the racial/ethnic breakdown of only first-year students in 2014-15 by degree offered in the department. As with Figure 3 above, departments that offer only master’s degrees or both terminal master’s and doctoral degrees have a greater proportion African-American/Black and Hispanic/Latino students than departments that only offer doctoral degrees. The percentage of first-year African-American/Black and Hispanic/Latino students in these departments is slightly higher than for all students. Accordingly, the percentage of first-year Caucasian/White students in all departments is marginally lower than for students overall.

Figure 5. Race/Ethnicity of First-Year Students in 2014-15 by Type of Degree Offered

Tables 2 and 3 present the racial/ethnic breakdown of all students and only first-year students, respectively, for 2014-15 by the college/school/institution in which the department is located. University colleges of arts and sciences and medical schools/health sciences universities have the highest percentage of students that are Caucasian/White, at approximately 75 percent this is higher than the average of 70 percent Caucasian noted above. Free-standing professional schools, by contrast, have the lowest percentage of Caucasian/White students, at slightly less than 60 percent, more than 10 percentage points lower than in any other category.

Table 2. Percentage of Students by Race/Ethnicity in 2014-15 by Department Location
University College of Arts and Sciences University College/ School of Education Free-standing Professional School University-based Professional School Medical School/ Health Sciences University Other
African-American/Black 6.1 8.6 15.8 7.9 12.0 9.1
American Indian/ Alaska Native 0.7 0.7 0.6 0.5 0.1 0.8
Asian/Pacific Islander 8.3 7.5 7.8 7.9 7.7 7.8
Caucasian/White 75.1 71.5 58.0 72.6 74.8 68.9
Hispanic/Latino 7.5 8.4 13.4 8.5 4.0 10.9
Multi-ethnic 2.3 3.3 4.4 2.6 1.4 2.5
Total 100.0 100.0 100.0 100.0 100.0 100.0

As presented in Figure 4, the first-year student population is comprised of a greater proportion of racial/ethnic minority students as compared to students overall (the exception being departments located in university colleges/schools of education, where the two groups are comparable).

Table 3. Percentage of First-Year Students by Race/Ethnicity in 2014-15 by Department Location
University College of Arts and Sciences University College/ School of Education Free-standing Professional School University-based Professional School Medical School/ Health Sciences University Other
African-American/Black 7.1 8.0 19.3 8.9 18.1 10.2
American Indian/ Alaska Native 0.6 0.7 0.5 0.4 0.0 0.5
Asian/Pacific Islander 8.2 7.2 6.8 8.4 5.2 7.0
Caucasian/White 71.9 71.4 53.0 71.1 70.5 67.0
Hispanic/Latino 9.3 8.7 15.2 9.2 5.2 12.6
Multi-ethnic 2.9 4.0 5.2 2.0 1.0 2.7
Total 100.0 100.0 100.0 100.0 100.0 100.0

American Psychological Association
Education Directorate
Office of Graduate and Postgraduate Education & Training

Caroline Cope, MA
Daniel S. Michalski, PhD
Garth A. Fowler, PhD

Tables and figures contained in this report are reflective of the self-reporting of participants. As such, analyses are drawn from the subset of those departments and may not be generalizable to the population of graduate departments with psychology offerings. Where indicated, some data are reported at the departmental level and others at the program level. Information on master’s programs housed within doctoral departments or part of doctoral degrees (i.e., non-terminal master’s degrees) is included in doctoral department data. Master’s-level information in departments where the master’s is the highest degree offered and some terminal-level master’s program information are presented by that level of training. Please direct any questions to Caroline Cope, MA. or Daniel Michalski, PhD, with the APA Office of Graduate and Postgraduate Education & Training.

This report was produced by the Office of Graduate and Postgraduate Education and Training and reviewed by the Center for Workforce Studies within the APA Education Directorate. We are grateful for the support of Cynthia D. Belar, PhD, ABPP, Interim Chief Executive Officer of the APA, Jasper Simons, Executive APA Publisher, and Jaime Diaz-Granados, PhD, Executive Director of the APA Education Directorate. Most importantly, we recognize the department chairs, program directors, faculty, and staff who take the time each winter to participate in the Graduate Study in Psychology survey and assist prospective psychology students with selecting programs.

Essay Contents:

  1. Essay on Unipolar Disorder
  2. Essay on Bipolar Disorder
  3. Essay on Dysthymic Disorder
  4. Essay on Cyclothymic Disorder
  5. Essay on Rapid Cyclers

1. Essay on Unipolar Disorder:

This is one of the commonest psychiatric disorders.

(a) Unipolar and bipolar mood disorders:

Unipolar those with a history of at least three separate episodes of retarded/psychotic depression, complete remission in between and no episode of mania.

Bipolar those who had at least one episode of depression and one of mania where repeated manic episodes occur, the disorder is also classified bipolar.

(b) Psychotic versus neurotic:

Confusing because psychotic does not necessarily describe the presence of delusions, hallucinations.

(c) Endogenous versus exogenous (reactive):

Table 16.2 shows the differences between endogenous and exogenous depression.

Clinical Picture:

The common symptoms are:

(ii) Loss of interest or pleasure

(iii) Changes in psychomotor activity:

Changes in psychomotor activity. There may be—Agitation, Retardation.

(iv) Changes in appetite and weight:

There is usually loss of appetite and weight. Occasionally there may be increased appetite and weight.

Insomnia but sometimes with hyper­somnia.

There is often lack of interest.

(vii) Sense of worthlessness, hopelessness, helplessness or excessive guilt.

(viii) Cognitive impairment.

(ix) Thoughts of death or suicide.

Other features menstrual or sexual disturbances, revival memories, sense of “presence”, fear, brooding, excessive concern with physical health and even mood-congruent and less often mood-incongruent delusions or hallucinations (hallucinations when present are transient, not elaborate and involve voices that criticize the individual for his or her shortcomings or sins).

(xi) Atypical Depression:

These are depressive syndromes which do not have classical or typical feature of depression. There may be depression with predominant anxiety, phobic anxiety depersonalization syndrome (described by Roth), non endogenous depression (due to stress) or hysteroid dysphoric syndrome.

(xii) Double Depression:

Major depressive episode on underlying dysthymia.

(xiii) Cotard’s Syndrome (Nihilistic delusions):

It is characterized by delusions of negative, to a varying degree. Patients may believe that their bodies or self has disappeared and they no longer exist, even that the whole universe no longer exists.

Differential diagnosis of major depressive episode:

(a) Organic Mood (Affective) Syndrome with depression.

(b) Primary Degenerative or Multi infarct Dementia.

(e) Dysthymic and Cyclothymic disorders

(f) Chronic Mental Disorders

(h) Uncomplicated bereavement

(i) Others, e.g. Primary hypochondriasis, traumatic neurosis or Adjustment disorder with depressive features.

2. Essay on Bipolar Disorder:

This is characterized by episodes of severe mania and severe depression.

There are episodes of hypomania (not requiring hospitalization) and severe depression.

Mild condition, characterized by predominant euphoria, over activity and dis-inhibition.

Severe condition, showing transient grandiose delusions, a labile mood and sometimes incoherent talk.

(iii) Delusional mania:

Characterized by less excitement, more persistent grandiose delusions and even occasional hallucinations.

(iv) Bell’s mania or delirious mania:

Frenzied over activity, (depression, panic to excitement), variable delusions, vivid hallucinations, disorientation for time and place together with dehydration and lack of drinking and eating.

(v) Secondary mania:

Mania can be due to drugs (tricyclic antidepressants, MAO inhibitors, cortcosteroids, amphetamines, L- dopa and INH), thyrotoxicosis, acute and chronic organic mental syndrome, influenza, encephalitis, multiple sclerosis, rheumatic chorea, cerebral tumours and temporal lobe epilepsy.

(vi) Chronic mania:

The patients lose their euphoria, become irritable and resentful and acquire a paranoid-like attitude.

Clinical Picture:

Mood elevation Euphoria (mild elevation or Stage I), Elation (moderate or Stage II), Exaltation (severe or Stage III), ecstasy (very severe elevation or Stage IV), irritable or infectious, labile.

(ii) Psychomotor Activity:

Psychomotor Activity is often increased, increased sociability, buying sprees, reckless driving, foolish business investments and promiscuous sexual behaviour.

Speech is typically loud, rapid and difficult to interrupt (i.e. pressure of speech). Sounds rather than meaningful conceptual relationships may govern word choice (clanging).

Thinking there is flight of ideas (i.e. nearly continuous flow of accelerated speech with abrupt changes from topic to topic usually based on understandably associations, distracting stimuli or plays on words).

Distractibility is usually present.

There is inflated self-esteem.

(viii) Lability of Mood.

Differential diagnosis of manic episode:

(a) Organic Mood (Affective) Syndrome

(c) Schizo affective disorder

A reliable detailed history, mental state examination, and clinical response usually with full remission help diagnosing an affective disorder.

Laboratory tests which can be used in the diagnosis and treatment of depression are:

(i) Dexamethasone Suppression Test (DST):

About half of depressed patients respond normally but the other half fail to suppress Cortisol production.

(ii) TRH (Thyrotrophic releasing hormone) Stimulation Test:

TRH (Thyrotrophic releasing hormone) Stimulation Test 30 – 40%, depressives fail to increase the levels of TSH.

(iii) Alteration in Sleep:

Decreased REM latency, increased density of REM sleep in the first half of sleep, decreased percentage of deep sleep.

Substance abuse, financial losses, illegal activities, sexual promiscuity, assaults and suicide, homicides and drug abuse.

3. Essay on Dysthymic Disorder (Depressive Neurosis):

The essential feature of this disorder is a chronic disturbance of mood (depressive) of at least two years duration but not of sufficient severity and duration to meet the criteria of a depressive syndrome.

4.5% to 10.5% (ratio of females: males is 2-3:1).

The symptoms are less severe and are not pervasive (as in major depression) and of more than two years duration. There are also normal periods which may last a few days to a few weeks. If the remission is more than a few months, then the diagnosis is not made.

There are no delusions or hallucinations.

Differential Diagnosis:

(a) Major depressive episode

(b) Other personality disorders e.g. Borderline, Histionic and dependant personality disorder.

(c) Chronic mental disorders. Alcohol dependence with depressive symptoms.

(d) Normal fluctuations of mood.

4. Essay on Cyclothymic Disorder:

The essential characteristic of this disorder is a chronic mood disturbance of at least two years duration, involving numerous periods of depression and hypomania, but not of sufficient severity and duration to meet the criteria for a major depressive or a manic episode.

Less than 1% of the population, more common in females.

Clinical Features:

The clinical features of depressive aspect of cyclothymic disorder are same as discussed for dysthymic disorder. There is also hypomanic episode which is similar to manic episode except that the individual does not suffer marked impairment of functioning.

Differential Diagnosis:

Major mood disorders, personality disorders and substance abuse disorder.

5. Essay on Rapid Cyclers:

In 1974, Dunner and Fieve coined the term ‘rapid’ cyclers to describe a subgroup of bipolar patients who have frequent affective episodes (more than four or more per year) and often respond poorly to lithium carbonate prophylaxis.

Etiology of Mood Disorders:

(a) Biochemical theories Neurotransmitters:

(i) Deficiency of Norepinephrine and Serotonin has been found in depressed patients.

(ii) Levels of norepinephrine, 5-HT and its metabolites are elevated in mania.

(i) In First Degree Relatives, prevalence is approximately 20% for bipolar disorder, 10- 15% for unipolar disorder with 1-3% in general population.

(ii) Twins: Monozygotic versus Dizygotic: 68: 20%.

(iii) Genetic marker is linked to short arm of Chromosome II.

(c) Psychological theories:

(i) Early Childhood Experiences:

b. Prolonged absence of a parent

(iii) Behavioural:

Depression is conditioned by the repeated losses in the past.

(iv) Psychoanalytic theories:

i. Depression results due to loss of a ‘love object’.

(v) Premorbid personality:

i. Cyclothymic personality.

(iv) Neurological, Epilepsy, Encephalitis, Head injury, Stroke.

(v) Drugs e.g., reserpine, alpha-methyldopa, clonidine, L-dopa, steroids, barbiturates, amphetamines, alcohol, neuroleptics (cause depression), anti-depressants (mania) etc.

(vi) Others e.g., Dialysis, chronic renal failure, cerebral ischaemia, Porphyria, temporal arteritis, Wilson’s disease etc.

(e) Biological theories:

(i) Circadian rhythm:

Disruption in circadian rhythms.

(ii) Seasonal affective disorder:

A subgroup of depressed individuals who are afflicted only during the months with fewer hours of sunlight known as seasonal mood disorder have been identified. These patients have been treated with increased exposure to light.

(iii) Anatomical studies:

The lesions in frontal or temporal region may be associated with affective disorders (left-sided associated with depression and right sided with mania).

15-25% of the patients show enlarged venricles.

Both major depressive episodes and mania remit spontaneously in a majority of cases, but have tendency to relapse. An untreated manic episode lasts for about 6 months whereas an untreated depressive episode lasts for about 9 months.

Psychology Secrets: Most Psychology Studies Are College Student Biased

Psychology, like most professions, holds many little secrets. They&rsquore well known and usually accepted amongst the profession itself, but known to few &ldquooutsiders&rdquo or even journalists &mdash whose job it is to not only report research findings, but put them into some sort of context.

One of those secrets is that most psychology research done in the U.S. is consistently done primarily on college students &mdash specifically, undergraduate students taking a psychology course. It&rsquos been this way for the better part of 50 years.

But are undergraduate college students studying at a U.S. university representative of the population in America? In the world? Can we honestly generalize from such un-representative samples and make broad claims about all human behavior (a trait of exaggeration fairly commonplace made by researchers in these kinds of studies).

These questions were raised by a group of Canadian researchers writing in Behavioral and Brain Sciences journal last month, as noted by Anand Giridharadas in an article yesterday in The New York Times:

Psychologists claim to speak of human nature, the study argues, but they have mostly been telling us about a group of WEIRD outliers, as the study calls them &mdash Westernized, educated people from industrialized, rich democracies.

According to the study, 68 percent of research subjects in a sample of hundreds of studies in leading psychology journals came from the United States, and 96 percent from Western industrialized nations. Of the American subjects, 67 percent were undergraduates studying psychology &mdash making a randomly selected American undergraduate 4,000 times likelier to be a subject than a random non-Westerner.

Western psychologists routinely generalize about &ldquohuman&rdquo traits from data on this slender subpopulation, and psychologists elsewhere cite these papers as evidence.

The study finds that American undergraduates may be particularly unsuitable &mdash as a class &mdash for studies about human behavior, because they are so often outliers in their behavior. Both because they are American (yes, it&rsquos true, American behavior is not equal to all human behavior on Earth!), and because they are college students in America.

I don&rsquot know about you, but I do know that my interaction with others, the world around me, and even to random stimuli is very different now in my 40s than it was when I was a young adult (or teenager, since most freshmen are only 18 or 19). We change, we learn, we grow. Generalizing human behavior from people of such a young and relatively inexperienced age appears short-sighted at best.

Scientists in most fields typically look for what&rsquos called a randomized sample &mdash that is, a sample that reflects the population at large. We hold large corporations accountable to this gold standard &mdash the randomized sample &mdash and the FDA demands it in all drug trials. We&rsquod be aghast if the FDA approved a drug, for instance, upon a biased sample made up of people not representative of those who might end up being prescribed the drug.

But apparently psychology has been getting away with something far less than this gold standard for decades. Why is that?

  • Convenience/laziness &mdash College students are convenient to these kinds of psychology researchers, who usually are employed by universities. It takes a lot more work to go out into the community and garner a randomized sample &mdash work that takes a lot more time and effort.
  • Cost &mdash Randomized samples cost more than convenience samples (e.g., college students at hand). That&rsquos because you need to advertise for the research subjects in the local community, and advertising costs money.
  • Tradition &mdash &ldquoThis is the way it&rsquos always been done and it&rsquos been acceptable to the profession and journals.&rdquo This is a common logical fallacy (Appeal to Tradition) and is a weak argument to continue a flawed process.
  • &ldquoGood enough&rdquo data &mdash Researchers believe that the data they gather from undergraduates is &ldquogood enough&rdquo data to lead to generalizations about human behavior more globally. This would be fine if specific research existed to back up this belief. Otherwise the opposite is just as likely to be true &mdash that this data is fatally flawed and biased, and generalizes only to other American college students.

I&rsquom certain there are other reasons researchers in psychology continuously rationalize their reliance on American college students as subjects in their studies.

There&rsquos little to be done about this state of affairs, unfortunately. Journals will continue to accept such studies (indeed, there are entire journals devoted to these kinds of studies). Authors of such studies will continue to fail to note this limitation when writing about their findings (few authors mention it, except in passing). We&rsquove simply become accustomed to a lower quality of research than we&rsquod otherwise demand from a profession.

Perhaps it&rsquos because the findings of such research rarely result in anything much useful &mdash what I call &ldquoactionable&rdquo behavior. These studies seem to offer snippets of insights into disjointed pieces of American behavior. Then someone publishes a book about them, pulling them all together, and suggesting there&rsquos an overarching theme that can be followed. (If you dig into the research such books are based upon, they are nearly always lacking.)

Don&rsquot get me wrong &mdash it can be very entertaining and often interesting to read such books and studies. But the contribution to our real understanding of human behavior is increasingly being called into question.

Adlerian Psychotherapy

Adlerian Psychotherapy

The following section is a summary of the six stages of Adlerian psychotherapy, which was developed by Stein and Edwards (2002). These stages serve as a guide, since every individual’s journey will have a slightly different path.

As Adler (2013a) put it, “Just as one cannot find two leaves of a tree absolutely identical, so one cannot find two human beings absolutely alike” (p. 102).

Since in Adlerian psychology, the goal is for the patient to feel competent and connected, the overarching goal of Adlerian psychotherapy is to help the patient overcome feelings of inferiority.

  1. To reduce the inferiority complex of exaggerated feelings of inferiority to a normal and helpful size, where the patient strives for significance but is not overridden
  2. To reduce and banish the superiority complex of constant striving for superiority over others and
  3. To promote feelings of community and equality.
Phase 1: Establishing the Therapeutic Relationship

For the psychotherapy to be effective, it is essential that the therapist and the client commence with a healthy working relationship. There must be a “warm, empathetic bond” which opens the door for gradual progress.

This bond is created by genuine warmth and compassion expressed by the therapist, in addition to the trust of the client in the relationship.

Phase 2: Assessment
  • Feelings of inferiority
  • Fictive goal, defined as “an imagined, compensatory, self-ideal created to inspire permanent and total relief, in the future, from the primary inferiority feeling”
  • Psychological movement, defined as “the thinking, feeling, and behavioral motions a person makes in response to a situation or task”
  • Feeling of community
  • Level and radius of activity
  • Scheme of apperception
  • Attitude toward occupation love and sex and other people

These assessments are done through various methods, including the projective use of early memories in addition to intelligence, career, and psychological testing.

Phase 3: Encouragement and Clarificationp

The process of encouraging the client helps them reduce feelings of inferiority. The therapist can start by acknowledging courage that the client has already shown, and continue by discussing small steps the client can take towards getting to a more confident place.

For instance, if the client has a limited radius of activity, the client and the therapist might discuss ways to broaden their activity.

The second crucial aspect of this phase is to clarify the client’s core feelings and beliefs regarding the self, others, and life in general. This is done using Socratic questioning.

Through this method, the therapist challenges the clients’ private logic and focuses on psychological movement around his fictive goal.

Phase 4: Interpretation

Once the therapy has reached the point where the client has made some progress, and he and the therapist have examined the meaning of his movement in relation to his goals, the therapy is ready to begin interpreting the client’s style of life.

This must only be done when the client is encouraged sufficiently, and this must be done with significant care.

Discussing and recognizing topics such as the inferiority complex can be difficult for the client, but new insight can be transformative.

Phase 5: Style of Life Redirection

Now that the client and the therapist have recognized the issues with the client’s style of life, the task becomes to redirect the style of life towards life satisfaction.

This involves reducing and productively utilizing feelings of inferiority, changing the fictive final goal, and increasing feelings of community.

This is accomplished using different methods, depending on the specific needs of the client.

Phase 6: Meta-therapy

Finally, some clients may wish to seek further personal development, towards higher values such as truth, beauty, and justice.

Towards this end, the therapist can provide stimulation for the client to become the best version of himself.

This process is certainly challenging and requires a deep understanding of the individual client.

Why Shrinks Have Problems

By Robert Epstein Ph.D. and Tim Bower published July 1, 1997 - last reviewed on June 9, 2016

In 1899 Sigmund Freud got a new telephone number: 14362. He was 43 at the time, and he was profoundly disturbed by the digits in the new number. He believed they signified that he would die at age 61 (note the one and six surrounding the 43) or, at best, at age 62 (the last two digits in the number). He clung, painfully, to this bizarre belief for many years. Presumably he was forced to revise his estimate on his 63rd birthday, but he was haunted by other superstitions until the day he died—by assisted suicide, no less—at the ripe old age of 83.

That's just for starters. Freud also had frequent blackouts. He refused to quit smoking even after 30 operations to correct the extensive damage he suffered from cancer of the jaw. He was a self-proclaimed neurotic. He suffered from a mild form of agoraphobia. And, for a time, he had a serious cocaine problem.

Neuroses? Superstitions? Substance abuse? Blackouts? And suicide? So much for the father of psychoanalysis. But are these problems typical for psychologists? How are Freud's successors doing? Or, to put the question another way: Are shrinks really "crazy"?

I myself have been a psychologist for nearly two decades, primarily teaching and conducting research. So the truth is that I had some preconceptions about this topic before I began to investigate it. When, years ago, my mom told me that her one and only session with a psychotherapist had been disappointing because "the guy was obviously much crazier than I was," I assumed, or at least hoped, that she was joking. Mental health professionals have access to special tools and techniques to help themselves through the perils of living, right?

Sure, Freud was peculiar, and, yes, I'd heard that Jung had had a nervous breakdown. But I'd always assumed that—rumors to the contrary notwithstanding—mental health professionals were probably fairly healthy.

Doctor, Are You Feeling Okay?

Mental health professionals are, in general, a fairly crazy lot—at least as troubled as the general population. This may sound depressing, but, as you'll see, having crazy shrinks around is not in itself a serious problem. In fact, some experts believe that therapists who have suffered in certain ways may be the very best therapists we have.

The problem is that mental health professionals—particularly psychologists—do a poor job of monitoring their own mental health problems and those of their colleagues. In fact, the main responsibility for spotting an impaired therapist seems to fall on the patient, who presumably has his or her own problems to deal with. That's just nuts.

Therapists struggling with marital problems, alcoholism, substance abuse, depression, and so on don't function very well as therapists, so we can't just ignore their distress. And ironically, with just a few exceptions, mental health professionals have access to relatively few resources when they most need assistance. The questions, then, are these: How can clients be protected—and how can troubled therapists be helped?

Here's a theory that's not so crazy: Maybe people enter the mental health field because they have a history of psychological difficulties. Perhaps they're trying to understand or overcome their own problems, which would give us a pool of therapists who are a hit unusual to begin with. That alone could account for the image of the Crazy Shrink.

Of the many prominent psychotherapists I've interviewed in recent months, only one admitted that he had entered the profession because of personal problems. But most felt this was a common occurrence. In fact, the idea that therapy is a haven for the psychologically wounded is as old as the profession itself. Freud himself asserted that childhood loss was the underlying cause of an adult's desire to help others. And Freud's daughter, Anna, herself a prominent psychoanalyst, once said, "The most sophisticated defense mechanism I ever encountered was becoming a psychotherapist." So it's only appropriate that John Fromson, M.D., director of a Massachusetts program for impaired physicians, describes the mental health field as one in which "the odd care for the id." He chuckled as he said this, but, as Freud claimed, humor is often a mask for disturbing truths.

These impressions are confirmed by published research. An American Psychiatric Association study concluded that '"physicians with affective disorders tend to select psychiatry as a specialty." (Curiously, the authors presented this as their belief, "for a variety of reasons," without explanation.) In a 1993 study, James Guy, Ph.D., dean of the School of Psychology at Fuller Theological Seminary, compared the early childhood experiences of female psychotherapists to those of other professional women. The therapists reported higher rates of family dysfunction, parental alcoholism, sexual and physical abuse, and parental death or psychiatric hospitalization than did their professional counterparts. And a 1992 survey of male and female therapists found that more than two-thirds of the women and one-third of the men reported having experienced some form of sexual or physical abuse in early life. Freud seems to have been right about this one: The mental health professions attract people who have suffered.

Patients Can Really Ruin Your Day

So we're starting out, it seems, with a pool of well-meaning but slightly damaged practitioners. Now the real fun begins.

Check out the numbers: According to studies published in 1990 and 1991, half of all therapists are at some point threatened with physical violence by their clients, and about 40 percent are actually attacked. Try to put this in context. A special, intimate relationship exists between therapist and client. So being attacked by a client is a serious emotional blow, perhaps comparable, in some cases, to being a parent attacked by one's child. Needless to say, therapists who are assaulted get very upset. They feel more vulnerable and less competent, and sometimes the feelings of inadequacy trickle over into their personal relationships.

Let's take this a step further. Imagine working with a depressed patient every week, without fail, for several years and then getting a call saying that your patient has killed herself. How would you feel? Alas, patient suicide is another hazard of the profession. Between 20 and 30 percent of all psychotherapists experience the suicide of at least one patient, again with often devastating psychological fallout. In a 1968 hospital study, psychiatrists reported reacting to patient suicides with feelings of "guilt and self-recrimination." Others considered the suicide to be "a direct act of spite" or said it was like being "fired." Whatever the reaction, the emotional toll is great.

Virtually all mental health professionals agree that the profession is inherently hazardous. It takes superhuman strength for most people just to listen to a neighbor moan about his lousy marriage for 15 minutes. Psychologists, of course, enter the profession by choice, but you can imagine the effects of listening to clients talk about a never-ending litany of serious problems -- eight long hours a day, 50 weeks a year. "My parents hated me. Life isn't worth living. I'm a failure. I'm impotent. On the way over here, I felt like driving my car into a telephone pole. I'll never be happy. No one understands me. I don't know who I am. I hate my job. I hate my life. I hate you."

Just thinking about it makes you shudder.

It's a Rough World Out There

Patients aren't the only source of stress for psychotherapists. The world itself is pretty demanding. After all, that's why there are patients.

A number of surveys, conducted by Guy and others, reveal some worri-some statistics about therapists' lives and well-being. At least three out of four therapists have experienced major distress within the past three years, the principal cause being relationship problems. More than 60 percent may have suffered a clinically significant depression at some point in their lives, and nearly half admitted that in the weeks following a personal crisis they're unable to deliver quality care. As for psychiatrists, a 1997 study by Michael Klag, M.D., found that the divorce rate for psychiatrists who graduated from Johns Hopkins University School of Medicine between 1948 and 1964 was 51 percent—higher than that of the general population of that era, and substantially higher than the rate in any other branch of medicine.

These days, therapists face a major new source of stress: HMOs. Richard Kilburg, Ph.D., senior director of human resources at Johns Hopkins University and one of the profession's leading experts on distressed psychologists, says managed care is having a devastating effect: "Therapists are chronically anxious. It's getting harder and harder to make a living, harder to provide quality care. The paperwork requirements are enormous. You can't have a meeting of practicing psychologists today without having these issues being raised, and the pain level is rising. A number of my colleagues have been driven out of the profession altogether."

No wonder Richard Thoreson, Ph.D., of the University of Missouri, estimates that at any particular moment about 10 percent of psychotherapists are in significant distress.

Bruno Bettelheim. Paul Federn. Wilhelm Stekel. Victor Tausk. Lawrence Kohlberg. Perhaps you recognize one or two of the names. They're all prominent mental health professionals who, like Freud, committed suicide.

All too often the stresses of work and everyday life lead mental health professionals down this path. According to psychologist David Lester, Ph.D., director of the Center for the Study of Suicide, mental health professionals kill themselves at an abnormally high rate. Indeed, highly publicized reports about the suicide rate of psychiatrists led the American Psychiatric Association to create a Task Force on Suicide Prevention in the late 1970s. A study initiated by that task force, published in 1980, concluded that "psychiatrists commit suicide at rates about twice those expected [of physicians]" and that "the occurrence of suicides by psychiatrists is quite constant year-to-year, indicating a relatively stable over-supply of depressed psychiatrists." No other medical specialty yielded such a high suicide rate.

One out of every four psychologists has suicidal feelings at times, according to one survey, and as many as one in 16 may have attempted suicide. The only published data—now nearly 25 years old—on actual suicides among psychologists showed a rate of suicide for female psychologists that's three times that of the general population, although the rate among male psychologists was not higher than expected by chance.

Further studies of suicides by psychologists have been difficult to conduct, says Lester, largely because the main professional body for psychologists, the American Psychological Association APA), hasn't released any relevant data since about 1970. Why? "The APA doesn't want anyone to know that there are distressed psychologists," insists University of Iowa psychologist Peter Nathan, Ph.D., a former member of an APA committee on "troubled" psychologists.

Wait, there's more. "Mental health professionals are probably at heightened risk for not just alcoholism but [all types of] substance abuse," reports Nathan. It's not surprising: Substance abuse is one of the most common—albeit destructive—ways people deal with anxiety and depression, and, as we've seen, mental health professionals have more than their share.

Richard Thoreson's decades of research on alcoholism, in fact, stemmed from his own problems with the bottle. "I began drinking at a fairly early age," he says, "and I continued during my early academic career. My life was organized around drinking. It had a very negative impact on my family. At one point I resigned as president of an organization because I was too shaky to speak before a group. I stopped drinking in 1969, at which point I was drinking the equivalent of 16 ounces of whiskey a day."

In the 1970s, with the help of several colleagues, Thoreson founded an informal group called Psychologists Helping Psychologists, which has held open Alcoholics Anonymous meetings at the annual APA convention ever since. This unofficial, all-volunteer group has helped hundreds of psychologists over the years -- with no financial support from the APA.

"Some therapists," says James Guy, "expect to continue practicing longer than the life expectancies in actuarial tables." But with advancing age, impairment is almost inevitable. Explains Guy: "Lower back pain becomes a problem. Failing eyesight and hearing make it difficult to pick up on subtle nuances. Poor bladder control can make it difficult to sit, and fatigue becomes a big factor."

Further complicating matters is that as therapists get older, more and more of their intimacy needs and social support actually comes from their patients. "Often, most of their waking hours are spent with clients, focusing on emotionally laden material," notes Guy. "When that's the situation, it's difficult for them to think about retirement. It's even difficult for them to know when to take time off."

Many psychotherapists become, in effect, woefully addicted to their clients, with no one offering them guidance or alternatives. In general, private, independent practices—often conducted out of the therapist's home—put the therapist at greatest risk, no matter what his or her age. Thoreson adds that such practices have special appeal for therapists who don't want to be seen by colleagues the isolated practice is the ideal one for the alcoholic or drug abuser.


If therapists really have special tools for helping people, shouldn't they be able to use their techniques on themselves? After all, the late behavioral psychologist, B. F. Skinner, systematically applied behavioral principles to modify his own behavior, and he ridiculed Freud and the psychoanalysts for their inability to apply their "science" to themselves. University of Scranton psychologist John Norcross, Ph.D., and his colleagues have studied this issue extensively, with two major findings. First: "Therapists admit to as much distress and as many life problems as laypersons, but they also claim to cope better. They rely less on psychotropic medications and employ a wider range of self-change processes than laypersons."

This sounds encouraging, but Norcross's second finding makes you stop and think: "When therapists treat patients, they follow the prescriptions of their theoretical orientation. But the amazing thing is that when therapists treat themselves, they become very pragmatic." In other words, when battling their own problems, therapists dispense with the psychobabble and fall back on everyday, commonsense techniques—chats with friends, meditation, hot baths, and so on.

But aren't psychotherapists required to be in therapy at various points in their careers, so that they get specialized help from their colleagues? Not so. "People are shocked when they learn this isn't true," says Gary Schoener, Ph.D., who directs The Walk-In Counseling Center in Minneapolis, perhaps the country's first and last free psychology clinic. "Lawyers are subjected to more psychological screens than psychologists are."

Surveys do indicate that most therapists—between 65 and 80 percent—have had therapy at some point. However, except for psychoanalysts—the pricey, traditional Freudians you see more in movies than in reality—psychotherapists are virtually never required to undergo therapy, even as a part of their training.

Freud himself would be appalled by this. "Every analyst should periodically—at intervals of five years or so—submit himself to analysis," he said. Unfortunately—and ironically—many psychotherapists are reluctant to seek therapy. In a survey by Guy and James Liaboe, Ph.D., for example, therapists said they were hesitant to enter therapy "because of feelings of embarrassment or humiliation, doubts concerning the efficacy of therapy, previous negative experiences with personal therapy, and feelings of superiority that hinder their ability to identify their own need for treatment." Others are hesitant to seek therapy because of professional `complications' -- that is, they cannot find a therapist nearby whom they do not already know in another context. Or they mistakenly believe, as many patients do, that seeking therapy is a sign of failure.

"I worry," says psychologist Karen Saakvitne, Ph.D., "about the implication that the therapists who are in therapy are the ones who are impaired. They are the ones acting in their clients' best interest. I'm more worried about the therapists who don't seek help."

Maybe there's an upside to all these problems among psychologists -- if, say, a therapist needs to have experienced pain and suffering in order to relate to his or her clients' pain and suffering. This "wounded healer" concept is, I believe, woven into the fabric of the mental health profession. When I served as chair of a university psychology department, I helped evaluate candidates for our marriage and family counseling program. The admission process -- interview questions, essays, and so on -- was structured, albeit subtly, to screen out people who hadn't suffered enough. What's more, I've heard colleagues express concern about the occasional student or trainee who, through no fault of his or her own, came from an unbroken home.

Data supporting this idea, however, are hard to find. "There's no evidence whatsoever that you need a history of psychological problems in order to be a good therapist," insists John Norcross. "In some studies, in the first few sessions only, [patients see] the wounded therapist as a little more empathetic, but the effect doesn't last. Experience with pain can enhance a therapist's sensitivity, but that doesn't necessarily translate into good outcomes."

"I don't think therapists need to have had the same experiences as their clients," adds psychologist Laurie Pearlman, Ph.D. "As long as the therapist can feel those feelings, he or she can connect with clients."

On the other hand, in 1989 psychologists Pilar Poal, Ph.D., and John R. Weisz, Ph.D., found that therapists who faced serious problems in their own childhood are more effective at helping child clients talk about their problems, perhaps because of greater empathy. That study, however, is practically the only one that supports the wounded-healer hypothesis.

So you've gotten into therapy because your life is falling apart -- and now you have to keep one eye on your therapist just in case his or her life is falling apart, too? Basically, yes. Like it or not, you, the client, are probably carrying the major responsibility for spotting the signs of distress or impairment in your therapist, especially if you're seeing an independent practitioner. The current president of the California Psychological Association, Steven F. Bucky, Ph.D., puts it this way: "The truth of the matter is that unless someone complains about an impaired therapist, there is no protection for the client."

Here are some tips for protecting yourself from impaired mental health professionals, and, perhaps, in so doing, for helping them overcome their own problems. Remember, therapists are people, too.

First, it's probably safer to bring your problems to a practitioner who works in a group setting. Independent, isolated therapists are probably at greatest risk for having undetected and untreated problems of their own. On the other hand, therapists working for managed care organizations or working under the gun of insurance companies are exposed to special constraints and stressors that may limit their ability to help you.

Second, trust your gut. "If you get the feeling that there's a problem, you shouldn't deny what your instincts are telling you," says Kilburg. If, during your session, a little voice in your head begins screaming, "This guy's eyes remind me of my college roommate's when he was tripping on acid," don't be afraid to ask questions.

Indeed, any time your therapist shows clear signs of personal distress or impairment, bring your concerns to his or her attention. (Ideally, do this on the therapist's dime, after your session is over.) If you're uneasy about raising the issue with your therapist, talk to one of his or her colleagues about it. Or, consider finding a new therapist. If you think your therapist's problem is serious and has the potential to do harm, report it to the appropriate professional organization or licensing body (see below). You have legitimate cause for concern if your therapist:

shows signs of excessive fatigue, such as red eyes or sleepiness.

touches you inappropriately or tries to see you socially.

smells of alcohol, or you see liquor bottles or drug paraphernalia in the office.

has trouble seeing or hearing.

talks at length about his or her own current, unresolved problems. This is known as a "boundary violation," and it's especially worrisome, because it's often a prelude to a sexual advance. In fact, therapists who talk about their own unresolved problems are more likely to make sexual advances than those who actually touch their clients.

has trouble remembering what you told him or her last week.

is repeatedly late for sessions, cancels them, or misses them.

seems distant or distracted.

For help locating the appropriate organization or board, call the relevant national organization. For psychologists, call the American Psychological Association at (202) 336-5000 for psychiatrists, call the American Psychiatric Association at (202) 682-6000. If your therapist is a marriage and family counselor, try the American Association for Marriage and Family Therapy at (202) 452-0109, and if your therapist is a social worker, try the National Association of Social Workers at (202) 408-8600.

Contributing editor Robert Epstein's most recent books include Self-Help Without the Hype and Pure Fitness: Body Meets Mind.

Uh Oh, Now They Want Drugs

Here's something that will rock you: The 150,00-member American Psychological Association is lobbying hard to get prescription privileges for psychologists. Pilot programs are already under way, and some think that many psychologists will be able to dispense drugs to their patients within five years. So much for the distinction between psychiatrists and psychologists. A more worrisome problem, though, is: Won't prescription privileges put psychologists at greater risk for substance abuse?

Moving Repeatedly in Childhood Associated with Poorer Quality of Life Years Later

WASHINGTON – Moving to a new town or even a new neighborhood is stressful at any age, but a new study shows that frequent relocations in childhood are related to poorer well-being in adulthood, especially among people who are more introverted or neurotic.

The researchers tested the relation between the number of childhood moves and well-being in a sample of 7,108 American adults who were followed for 10 years. The findings are reported in the June issue of the Journal of Personality and Social Psychology, published by the American Psychological Association.

“We know that children who move frequently are more likely to perform poorly in school and have more behavioral problems,” said the study’s lead author, Shigehiro Oishi, PhD, of the University of Virginia. “However, the long-term effects of moving on well-being in adulthood have been overlooked by researchers.”

The study’s participants, who were between the ages of 20 and 75, were contacted as part of a nationally representative random sample survey in 1994 and 1995 and were surveyed again 10 years later. They were asked how many times they had moved as children, as well as about their psychological well-being, personality type and social relationships.

The researchers found that the more times people moved as children, the more likely they were to report lower life satisfaction and psychological well-being at the time they were surveyed, even when controlling for age, gender and education level. The research also showed that those who moved frequently as children had fewer quality social relationships as adults.

The researchers also looked to see if different personality types – extraversion, openness to experience, agreeableness, conscientiousness and neuroticism – affected frequent movers’ well-being. Among introverts, the more moves participants reported as children, the worse off they were as adults. This was in direct contrast to the findings among extraverts. “Moving a lot makes it difficult for people to maintain long-term close relationships,” said Oishi. “This might not be a serious problem for outgoing people who can make friends quickly and easily. Less outgoing people have a harder time making new friends.”

The findings showed neurotic people who moved frequently reported less life satisfaction and poorer psychological well-being than people who did not move as much and people who were not neurotic. Neuroticism was defined for this study as being moody, nervous and high strung. However, the number and quality of neurotic people’s relationships had no effect on their well-being, no matter how often they had moved as children. In the article, Oishi speculates this may be because neurotic people have more negative reactions to stressful life events in general.

The researchers also looked at mortality rates among the participants and found that people who moved often as children were more likely to die before the second wave of the study. They controlled for age, gender and race. “We can speculate that moving often creates more stress and stress has been shown to have an ill effect on people’s health,” Oishi said. “But we need more research on this link before we can conclude that moving often in childhood can, in fact, be dangerous to your health in the long-term.”

Article: “Residential Mobility, Well-Being, and Mortality" Shigehiro Oishi, PhD, University of Virginia Ulrich Schimmack, PhD, University of Toronto Mississauga Journal of Personality and Social Psychology, Vol. 98, No. 6.

Contact Dr. Shigehiro Oishi by email or by phone at 434-243-8989.

Psychological distress in university students: A comparison with general population data

Objective: While the mental health of university students is recognised internationally as an important public health issue, more epidemiological data are needed that allows benchmarking with general population data. Methods: All enrolled students from two large Australian universities were invited to complete a web-based survey. Anxiety-mood disorders were assessed using the Kessler 10. A total of 6,479 students participated in the study with sociodemographics generally consistent with the university population. Results: The estimated prevalence for mental health problems was 19.2% with 67.4% reporting subsyndromal symptoms. These rates were significantly higher than the general population. Psychological distress was associated with disability and lower academic achievement. Predictors of distress included: full-time status, financial stress, being aged between and 18 and 34 years, being female, and in a subsequent undergraduate year of their degree. Conclusions: The extremely high prevalence of mental health problems in university students provides evidence for this being an at-risk population. Implications: The results highlight the need for universal early interventions to prevent the development of severe mental illness in university students.

The Surprising Psychology of BDSM Players

Both the book and movie versions of Fifty Shades of Grey got a good deal right about erotic bondage-discipline-sado-masochism (BDSM). But Fifty Shades also got one thing horribly wrong: It depicts the dominant (dom, top) Christian Grey as the product of horrendous child abuse and implies that it propelled him into BDSM. In other words, Fifty Shades plays into the widely held belief that those involved in BDSM are psychologically damaged if not pathological.

However, the research shows that people into BDSM are psychologically healthy and no more likely to have suffered child abuse or sexual trauma than anyone else. In fact, a recent Dutch study shows that compared with the general population, in some ways BDSMers just might be psychologically healthier.

What the Books Got Right

  • Communication. Before Grey lays a hand on his sub, Anastasia Steele, they discuss in great detail how they want to play. This is quite typical—and a foundation of BDSM. Dom/sub play opens a huge realm of possibilities, and doms and subs discuss them at length, revealing their fantasies and hearing the other person’s. In fact, some BDSMers consider these discussions the most intimate element of their play.
  • Negotiation of limits. Grey presses Steele on her personal limits, the hard boundaries she can’t conceive of crossing, and the soft ones that she might cross under the right circumstances. Both players declare their limits, and pledge to respect the other’s. As a result, BDSM is play, not abuse.
  • Safe words. Grey tells Steele that if she feels at all uncomfortable at any time, she is always free to invoke their safe word (for example “red light"). Upon hearing it, doms pledge to cease all play immediately and re-negotiate the scene. Safe words mean that, ironically, the person ultimately in control of BDSM scenes is the sub.
  • Contracts. Grey hands Steele a proposed contract governing their play and they discuss it point by point. Steele agrees to some clauses, modifies others, and nixes a few. Not all BDSM players codify their negotiations in written contracts, but many do.
  • Intimacy. Steele is surprised by how intimate BDSM play feels, and how emotionally close it brings her to her lover. Aficionados say they believe that BDSM produces a depth of intimacy beyond what’s possible in ordinary (“vanilla”) sex.

Author E.L. James captures these aspects of BDSM activity quite well. Unfortunately, she’s poorly informed about its psychology.

BDSM Players Are Psychologically Healthy

For their recent survey, Dutch researchers solicited participants via the Netherlands’ largest BDSM web forum, and 902 people answered all questions (51 percent men, 49 percent women). For a control group, the researchers used Dutch women’s magazines and news media to recruit participants, and 434 people answered all questions (30 percent men, 70 percent women).

The questions probed many aspects of personality—agreeableness, attachment, conscientiousness, anxiety, introversion/extroversion, neuroticism, need for approval, comfort with interpersonal closeness, openness to new experiences, and subjective well-being. In general, doms and subs scored about the same as members of the control group, indicating that there’s nothing fundamentally unusual about those into this type of play. But BDSMers were actually somewhat less neurotic than others. They were also slightly more conscientiousness, more extroverted, and (not surprisingly) more open to new experiences. For overall well-being, doms scored higher than either subs or controls.

The researchers concluded:

“BDSM practitioners are not psychologically maladapted, but rather characterized by psychological strength and autonomy. Our data do not support the persistent assumption that BDSM is associated with inadequate developmental attachment processes because of a history of trauma or for other reasons. BDSM should be considered a form of recreation rather than the expression of psychopathological processes.”

Corroborating Evidence

The Dutch study is not the only one showing that those who enjoy BDSM are psychologically normal and healthy:

  • Australian researchers surveyed 19,370 individuals in that country and found that the 2.2 percent of men and 1.3 percent of women who participated in BDSM were psychologically healthy, and no more likely than anyone else to have been victims of childhood trauma or sexual abuse or coercion.
  • Scientists at the University of Illinois took saliva samples from 58 people before BDSM play, measuring cortisol, a key stress hormone. After a BDSM session, the researchers took new saliva samples, and found decreased cortisol levels, showing that BDSM reduced players’ emotional stress. The researchers concluded that far from being abusive, BDSM made participants feel more comfortable and “increased intimacy.”

If you’re into romance fiction, enjoy Fifty Shades of Grey—and if you find its BDSM titillating, that's fine, too. But don’t generalize Christian Grey’s history of child abuse to BDSM practitioners in general. BDSM is neither abusive nor about violence or pain. It’s just another way for consenting adults to play, and those who do are not perverted, but rather a snapshot of the general population.

Richters, J. et al “Demographic and Psychosocial Features of Participants in Bondage and Discipline, Sadomasochism, or Dominance and Submission (BDSM): Data from a National Survey,” Journal of Sexual Medicine (2008) 5:1660.


At the end of their second year as Bachelor students, Dutch psychology majors choose a specialty, such as Psychonomics, Social Psychology, or Clinical Psychology. These specialties are closely associated with different topics of psychological science and diverse professional competencies related to both research and practice. The choice of specialty may be influenced by personality and cognitive ability, but is commonly thought to depend mainly on student's interests. Research among psychology majors in the US has highlighted a clear distinction between researcher and practitioner interests (Leong and Zachar, 1991, Zachar and Leong, 1992, Zachar and Leong, 1997, Zachar and Leong, 2000). Several studies have addressed the relatively low interest in scientific issues among many psychology majors (Bishop and Bieschke, 1998, Leong et al., 2007, Tinsley et al., 1993, Vittengl et al., 2004), although psychology majors clearly differ in this regard. For instance, Martin, Gavin, Baker, and Bridgmon (2007) recently compared doctoral students at different specialties of psychology and found clear differences between these groups in scientist-practitioner interests. Also, Zachar and Leong (2000) found that psychology majors' researcher and practitioner interests were stable over a 10-year period and predictive of later professional behavior.

According to Holland, 1973, Holland, 1985, vocational interests can be seen as a personality characteristic, which can be subsumed under six types: Realistic, Investigative, Artistic, Social, Enterprising, and Conventional (RIASEC). According to Holland, both persons and professions (or fields of education) can be characterized by a profile (or three-letter-code) that indicates the dominance of the six types. The code Investigative-Artistic-Social is viewed as dominant for the profession of psychology (Camp & Chartrand, 1992). However, psychology students who follow different routes in their curriculum or who differ in research-practitioner interests may be characterized by different RIASEC profiles. While interest in research appears to be positively related to the Investigative and the Investigative-Artistic types, practitioner interests appear to be positively related to the Social type (Mallinckrodt et al., 1990, Zachar and Leong, 1992). Some RIASEC scales have been shown to be correlated with the five dominant personality factors (e.g., De Fruyt and Mervielde, 1997, Gottfredson et al., 1993) as well as with cognitive capacities (Ackerman & Heggestad, 1997). In line with these findings, Vittengl et al. (2004) found that psychology students' interest in research was positively associated with Openness to Experience and with cognitive ability. Thus, individual differences in interests, personality, and cognitive ability may be associated with specialty choice in the academic study of psychology.

The goal of this longitudinal study is to compare psychology students of different specialties in terms of interests, personality, and cognitive abilities. We studied these characteristics in two cohorts of Bachelor 1 students of Psychology at the University of Amsterdam. The students had completed successfully the first 2 years of the general curriculum and had chosen one of six major specialties at the end of the second year of the curriculum. The six specialties are best characterized by focusing on the specific routes offered in each specialty. Clinical Psychology (CP) offers routes in mental health care, somatic health care, clinical research, and clinical developmental psychology. Developmental Psychology (DP) offers routes on research in developmental psychology, general developmental psychology, and clinical developmental psychology. Psychological Methods (PM) offers general psychological methods and psychometrics. Psychonomics (PN) has two routes: physiological psychology and general psychonomics (perception and memory). Social Psychology (SP) offers routes in experimental social psychology and applied social psychology. Finally, Work and Organizational Psychology (WOP) offers three routes: personnel selection, social processes in organizations, and work and health. The student administrator did not have specific information on the enrollment in these specific routes, so we were unable to distinguish between these routes. 2

Nonetheless, the specialties differ in terms of focus on practice or research. We expected students of Psychonomics and Psychological Methods to be more research-oriented, students at Clinical Psychology and Developmental Psychology to be more oriented towards practice, and students at Work and Organizational Psychology and Social Psychology to be oriented to both research and practice. Specifically, on the basis of previous findings on the differential characteristics of psychology majors and our own assessment of the content of the specialties, we derived expectations that are expressed in terms of the relevant scales (see below) in Table 1. Moreover, we also set out to predict choice of specialty on the basis of an interest inventory. As congruence between the person's interests and the typical interest profile of his or her profession (or education) is often hypothesized to have a positive effect on performance (Holland, 1973, Holland, 1985), we also determined whether the congruence between student's interests and the interest profile of his or her chosen specialty predicted academic performance.

Why Do So Many College Students Have Anxiety Disorders?


A recent article in the New York Times reported that 60 percent of today’s college students suffer from anxiety disorders and psychological distress (Wolverton, 2019).

What has caused this dramatic escalation of anxiety in our young people? Some explanations might be early childhood trauma, a biochemical imbalance, or the stress of economic insecurity and political polarization in today’s world. And yet earlier generations managed to thrive during the Depression, World War II, Watergate, and the Vietnam War.

Research points to three changes in our culture that could be undermining the mental health of today’s college students.

1. An increase in materialistic values such as consumerism and the centrality of financial success. Research by the Cooperative Institutional Research Program at UCLA shows that college students’ number one value is now “being well off financially,” while for students in the 1960s it was “developing a meaningful philosophy of life." This increase in materialistic values appeared in the 1980s and has remained constant (Astin, 1998 Eagan, Stolzenberg, Zimmerman, Aragon, Sayson, & Rios-Aguilar, 2017). Research has associated materialistic values and extrinsic goals with anxiety, narcissism, depression, and illness (Emmons, 2003).

2. The rising cost of college. In the past, higher education was considered a public good, not a private product. Until the 1980s, it was supported by state funding and federal grants, making it affordable for nearly all students who had the aptitude and motivation to attend college. For example, in the 1960s, tuition at the University of California was $86.50 a semester it was only $35 a semester at Brooklyn College of the City University of New York. Students could support themselves and work their way through college with part-time jobs—taking charge of their lives and embracing agency and adulthood in their late teens and early 20s. Today, while two-year community colleges remain relatively affordable, the University of California’s tuition, for instance, is $13,225 a year private college tuition can be $50,000 and more. With room and board another $20,000, college has become out of reach for many of today’s young people (UCLA undergraduate admissions, 2019 Powell, 2018). Students look to their parents to pay for college, remaining economically and emotionally dependent on them, which may leave them unprepared for adult life.

3. Delayed adulthood and external locus of control. The high cost of college reinforces a pattern of developmental delay that psychologist James Arnett (2000) has called “emerging adulthood.” At an age when earlier generations were making their own decisions and exercising greater control over their lives, many college students remain, by their own admission, “kids,” relying on their parents to pay their bills, choose their majors, and even do their homework.

Raised by well-meaning “helicopter parents” who constantly control and protect their children, many young people have been denied opportunities to exercise initiative and do things for themselves. It is no wonder that many of them experience overwhelming stress when they face the challenges of college life (Egan et al, 2017).

Psychologist Jean Twenge (2000 Twenge, Zhang, & Im, 2004) has found an increase in both anxiety and external locus of control in today’s college students. In our research, my colleagues and I have found that students with controlling parents have a high degree of emotional immaturity as well as an external locus of control, believing that their lives are controlled by people and forces outside themselves (Dreher, Feldman, & Numan, 2014).

And sadly, today’s college students display a more external locus of control than 80 percent of college students in the 1960s—a disturbing finding, since external locus of control has been linked to poor physical and mental health, anxiety, and depression (Twenge, 2004 Chorpita, 2001).

Traditionally, the college years have been a time of dynamic personal growth, a time when students developed their adult identities by exploring new ideas and opportunities and exercising greater agency, responsibility, and control over their lives. Unfortunately, today materialistic values, college costs, and controlling parents are impairing this vital developmental period—and may be undermining our students’ ability to flourish.


This post is for informational purposes and should not substitute for psychotherapy with a qualified professional.

LinkedIn Image Credit: Zephyr_p/Shutterstock

Arnett, J. J. (2000). Emerging adulthood: A theory of development form the late teens through the twenties. American Psychologist, 55, 469-480.

Astin, A. W. (1998). The changing American college student: Thirty-year trends, 1966-1996. The Review of Higher Education 21(2), 115-135.

Chorpita, B. F. (2001). Control and the development of negative emotion. In. M. W. Vasey & M. R. Dadds (Eds.), The developmental psychopathology of anxiety (pp. 112-142). New York, NY: Oxford University Press.

Dreher, D.E., Feldman, D. B., & Numan, R. (2014). Controlling parents survey: Measuring the influence of parental control on personal development in college students. College Student Affairs Journal, 32, 97-111.

Eagan, K. Stolzenberg, E. B., Zimmerman, H.B., Aragon, M.C., Sayson, H. W., Rios-Aguilar, C. (2017). The American freshman: National norms 2016. Los Angeles, CA: Higher Education Research Institute.

Emmons, R. (2003). Personal goals, life meaning, and virtue: Wellsprings of a positive life. In C. L. M. Keyes & J. Haidt (Eds.) Flourishing (pp. 105-128). Washington, D.C.: American Psychological Society.

Twenge, J. M. (2000). The age of anxiety? Birth cohort change in anxiety and neuroticism, 1952-1993. Journal of Personality and Social Psychology, 79, 1007-1021.

Twenge, J.M., Zhang, & Im, C. (2004). It’s beyond my control: A cross-temporal meta-analysis of increasing externality in locus of control, 1960-2002. Personality and Social Psychology Review,8, 308-319.

UCLA Undergraduate Admissions. (2019, February 7). Fees, tuition, and estimated student budget.

Wolverton, B. (2019, February 24). The campus as counselor. The New York Times, Learning section, p. 4.


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