Facts and Fictions in Mental Health
Authors: Hal Arkowitz and Scott Lilienfeld
ISBN-13: 978-1118311295
ISBN-10: 1118311299
 
APA Style Citation
Arkowitz, H., & Lilienfeld, S. O. (2017). Facts and fictions in mental health. Chichester, West Sussex, UK: Wiley Blackwell.

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​Book Description
Facts and Fictions in Mental Health is comprised of a series of chapters organized by section categories that each focus on a specific myth related to mental illness, treatment, or mental health. Each chapter addresses the myth, provides examples from clinical practice, pop culture, or events in the news, followed by evidence from recent scientific inquiry on the topic. The source for most of the chapters is “Facts and Fictions” articles previously published in Scientific American Mind, although six additional entries were created for this book.
 
Each of the first seven sections corresponds roughly to a diagnostic category: Anxiety-Related Disorders, Mood Disorders, Child and Adolescent Disorders, Addictions, Personality Disorders, and Shattered Selves:  Schizophrenia and Dissociative Identity Disorder.  The remaining three sections address Popular Myths About the Brain and Behavior, Psychotherapy and Other Approaches to Change, and Other Myths. Each section opens with an engaging introduction to the broader category within psychology, followed by bite-sized chapters of three to five pages that briefly address the myth and provide the scientific evidence which dispels the myth.  Each chapter also ends with several sources for additional information on that topic.
 
The book provides an excellent tool for teachers of psychology because it addresses head-on many of the incorrect beliefs held by students surrounding issues related to mental illness. The book also addresses some of students’ most frequent questions about mental illness and treatment. There are also chapters related to other popular myths about human behavior and mental processes.

• What are the causes and most effective treatment methods for hoarding?
• Is mindfulness good medicine for anxiety and depression?
• Are bipolar disorders linked to creativity?
• Four myths about suicide, including the myth that talking about suicide increases suicidal tendencies.
• Is electroconvulsive treatment effective?
• Is there an autism epidemic?
• Do all Tourette’s patients swear?
• Are all psychopaths psychotic?
• Is schizophrenia the same or similar to dissociative identity disorder?
• Are people with dissociative identity disorder faking?
• How violent are people with mental illness?
• Are individuals either left- or right-brained?
• Is hypnosis a distinct state of consciousness?
• Are all psychotherapies equally effective?
• Why do some people resist changing when they know that doing so would improve their lives?
• What stereotypes exist in the media regarding therapy?
• Are most disorders we see in Western and European countries the same as those in the rest of the world?
• Does the presence of a full mood trigger strange behaviors?
• Is eyewitness testimony accurate?
• Is the insanity defense frequently used in criminal trials?

 
The book concludes with an interesting postscript that addresses some of the reasons behind the persistence of these myths. For example, the availability heuristic, which is a problem-solving shortcut in which we base decisions base on what is most likely to be fresh in our minds.  Arkowitz and Lilienfeld discuss how the availability heuristic contributes to the myth that divorce is almost always harmful to children.  Because it is more likely that we will hear about times when children struggle during a divorce than when they are resilient or when the change has lead to am improvement for the entire family.  The availability heuristic creates the impression children struggle after divorce because this is what they expect as the likely outcome. The research indicates that although divorce is difficult for children, long-term negative consequences are not inevitable. Another logic error post hoc causes individuals to make causal conclusions about events that might happen close in time. This has led many to believe that Autism is caused by vaccinations despite evidence from numerous, large empirical studies that have shown this link to be false. Many myths, according to the authors, persist because they are partially accurate, leading to the error of the grain-of-truth hypothesis. For example, the fact that because animals can provide temporary relief from emotional pain does not mean that animal-assisted therapy can treat the primary symptoms of serious conditions such as schizophrenia and anorexia nervosa. Finally, the authors address the problem of how information is presented and by whom can also create or perpetuate myths.  The authors discuss the problem of self-help books in chapter 39, “3,500 self-help books appear every year, but few are based on research or subjected to scientific scrutiny.”  There are also numerous psychology websites that contain misleading and inaccurate information about mental health, and mainstream media outlets can create misconceptions due to inaccurate or misleading interpretations of scientific findings. The authors also point out that individuals frequently do not read articles and rely on headlines alone for information on research studies that might be quite complex.  As a result, this can lead to misinformation about the findings of the study. For example, the headline, “Fear of Fluoride in Drinking Water,” in an article that emphasized the safety of fluoride in water spread misinformation unintentionally.
 
Facts and Fictions in Mental Health is a great tool for providing students with opportunities to dispel misconceptions and build critical thinking skills. The short chapters can be used for enrichment during units on clinical psychology, as well as cognitive psychology topics related to problem-solving and cognitive biases.
 
 
Other Related Resources
 
National Alliance on Mental Illness - NAMI
https://nami.org/Home
The NAMI organization provides numerous resources for building understanding and reducing the stigma associated with mental illness.  The website contains educational materials, information for requesting guest speakers, and advocacy opportunities. The site also has a series of effective videos that can be used to supplement instruction.
 
Time to Change – UK
https://www.time-to-change.org.uk/
Time to Change is an organization devoted to reducing stigma related to mental illness in the UK, and their website provides a variety of inspirational stories and educational materials for use in the classroom and the workplace.
 
Avoid Misleading Terminology
Fifty psychological and psychiatric terms to avoid: a list of inaccurate, misleading, misused, ambiguous, and logically confused words and phrases
https://www.frontiersin.org/articles/10.3389/fpsyg.2015.01100/full
This link is to an interesting article by author Lilienfeld and others that list and explain misleading terminology used in psychology that causes misinformation and confusion.
This article can be used as a source for a discussion related to the critical evaluation of scientific claims.  For each misleading term or phrase, the article explains why it poses a problem, provides examples of its misuse, and, if possible, provides a preferable term. Examples include a gene for, brain region “X” lights up, hard-wired, lie-detector test, truth-serum, and neural signature. Interestingly – the article addresses the problems with terminology frequently used in psychology class such as operational definition, objective personality test, and reliable and valid. The article also includes terms that are frequently misused or that are misleading overall.
 
Confusing Pairs
50 Differences That Make a Difference: A Compendium of Frequently Confused Term Pairs in Psychology
https://www.frontiersin.org/articles/10.3389/feduc.2017.00037/full
This link is to an interesting article by author Lilienfeld and others that list and explain confusing pairs of terms in psychology. 
 
Psychological Concepts and Figures
Agoraphobia
Alzheimer’s disease
Animal-assisted therapy
Anxiety and anxiety disorders
Availability heuristic
Behavioral therapy
Bipolar disorder
Client-centered therapy
Cognitive-behavioral therapy
Depression
Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Dissociative disorders
Electroconvulsive therapy
Feeding and eating disorders
Hoarding disorder
Insanity defense
Mindfulness
Mood disorders
Neurodevelopmental disorders
Obsessive-compulsive and related disorders
Personality disorders
Post hoc error
Psychotropic medications
Schizophrenia
Short-term psychodynamic therapy
Substance use and abuse disorders
Trauma- and stressor related disorders
 

​Hidden Valley Road:  Inside the Mind of an American Family
Author:  Richard Kolker
ISBN:  978-03855-43774
 
APA Style Citation
Kolker, R. (2020.) Hidden valley road. Inside the Mind of an American family.  New York, NY: Penguin Random House.
 
Buy This Book
https://www.amazon.com/Hidden-Valley-Road-Inside-American/dp/038554376X
 

​Book Description
Hidden Valley Road, named after the street the family lived on, is the tragic story of the Galvin family.  The non-fictional account follows the growing family from the time in which the young, recently married Donald and Mimi Galvin moved to Colorado Springs through the twelve children that eventually made up the Galvin family (10 boys and 2 girls).  Eventually, six of the boys would develop schizophrenia. The book addresses many facets related to mental illness, including the issues of genetic and environmental factors, the stigma around mental illness, and the difficulty in managing and finding good care for those experiencing different levels of schizophrenia.
 
Since Swiss Psychologist Eugen Bleuler initially coined the term schizophrenia, which comes from the Latin word -schizo- meaning a split in mental functioning, he had suspected that there was an underlying physical component to the disorder. The degree to which the physical components drive the illness is still one that is fascinating and much debated. Examining a family in which six of the boys developed the disease provides the opportunity to learn more about the underlying genetic components that may be associated with schizophrenia. Freud was the first but certainly not the last to place the blame of development of schizophrenia decidedly at least partially at the feet of the mother, a point not lost on Mimi as her son’s disappeared into the illness. Today, estimations are that one in one hundred individuals may experience schizophrenia at some point in their lives, but with an identical twin, chances increase to roughly 50%.  In one other famous case of schizophrenia from the 1950s, the Genain quadruplets all developed schizophrenia by age 25 and were studied by the National Institute of Mental Health.
 
Don Galvin Sr. was a professor at the Air Force Academy after having spent time in the Navy.  He had experienced in his early military career “a case of the nerves” and was hospitalized at Walter Reed hospital, this event was not much discussed in the family, and his career and family developed quickly. The eldest son Don Jr. played football, got decent grades, and wanted to follow in his father’s footsteps.  By his teenage years, however, he was smashing dishes and ruthlessly beating up his younger brothers. Mimi and Donald were frequently traveling for work and left the boys to their own devices, which could be brutal as they formed camps against one another. By sophomore year in college, Donald was experiencing full-blown psychotic episodes, believing in one case that he had murdered a professor and in another fantasizing about murdering someone at a football game.  He also killed a cat that had lived with him for a few days after it scratched him. This behavior was at first attributed to a break up with a longtime girlfriend. When he was forced to return home, he believed people were shooting at him and once removed all of the furniture from the house in a paranoid episode. Don and Mimi opted for a psychoanalytic treatment before eventually resorting to the use of Thorazine to reduce Donald’s aggressive outbursts. Because of the stigma attached to the illness, Donald Sr. and Mimi tried to manage Donald’s illness while he lived at home because admitting him to a mental institution would be to admit defeat and publicly acknowledge what was happening. With Donald Sr. frequently away for work, it was up to Mimi to manage Donald along with the ten other children still living at home, most of whom became terrified of Donald. The Thorazine caused Donald to gain weight and sleep often, but it never eliminated his delusions of having superior powers or being controlled by God. Donald eventually developed tardive dyskinesia experiencing constant jerking movement from the years on Thorazine, but he attributed it to his father, making him “stand at attention as a child.”
 
The middle group of boys threw themselves into hockey to get out of the house, and Margaret, the second youngest, was sent to live with some wealthy family friends. Mary (who now goes by Lindsay), the youngest, often locked herself in her room when home alone with her brother because she was terrified he would fly into one of his rages. 
 
Shortly after Jim, the second oldest, got married, he started hearing voices, he believed people were spying on him, and he stopped sleeping, often acting violently towards himself. He had a tumultuous marriage even prior to the diagnosis and eventually killed his wife and was sent to prison. Brian and Michael were the next to experience symptoms. Brian played in a band and had a total disregard for authority, some believed that his symptoms might have been brought on by drug use. After a weeklong stay in Denver’s psychiatric ward, he decided it was time for him to leave and he never fully accepted his diagnosis. Michael could often go for long stretches without symptoms, and it seems that although he experienced symptoms of schizophrenia, they were far less severe than his eldest brother Donald Jr. The youngest of the ten boys, Peter, was always oppositional, but after witnessing his father’s stroke in 9th grade he experienced more frequent oppositional episodes and he eventually had to be hospitalized and restrained.  Mimi now had to take care of the older boys, her husband, who was recovering from a stroke and try to find a place that was appropriate for Peter’s young age and symptoms. Peter was eventually diagnosed with acute schizophrenia with paranoid ideation.  Matt, who was another one of the hockey-playing brothers and who later fought in the Vietnam war, came to believe the government was out to get him but resisted the label of schizophrenia. He became homeless and often sold his medications for money or food but never believed that he actually had schizophrenia. He eventually went through many rounds of ECT therapy.
 
With so many cases of schizophrenia in a single family it is likely that there was some genetic factor driving the illness. It was later discovered that many of the boys who later developed the illness were molested by a priest who has been a family friend and often spent time with the boys. The lack of acknowledgment, especially with Donald Jr, may have also been an environmental factor that exacerbated the illness.  Growing up with an older brother who was schizophrenic created a chaotic and violent home environment and may also have served as environmental triggers for some of the younger boys.  
Psychologists like Irving Gottesman and James Shield began to examine the genetic influence of the disease by proposing the diathesis-stress model in which certain disorders could be predisposed for some individuals but activated by environmental factors.  In the late 1970s, Richard Wyatt found enlarged ventricles in some schizophrenic patients leading to a stronger belief in the physical attributes of the disorder. In the early 1980s, Irving Feinberg proposed that problems in neural pruning during adolescence might be the main cause of the disorder. The 1990s brought the discovery that the hippocampi in some schizophrenics were smaller than in control patients. MRI scans also found problems with activity in the frontal lobe.  Through this all, Lynn Delisi was attempting to find specific genetic markers to identify the disorders. Studying families would be the key to discovering the genetic links to the disorder.  In the 1990s, the Human Genome Project began to solve problems such as this and with $3 billion in funding.  The Galvin brothers, sisters, nieces and nephews who were willing donated their DNA to be analyzed for clues to the genetic components of the illness.  It was determined that a mutation on the C4A gene might provide some answers to the disorders. There is now the possibility of genetic testing in utero, and there may be a way to fix flaws in genes in the womb or early in life. Ironically, one of the Galvin grandchildren is working on the project that contains her family’s DNA to try to ensure that families in the future will not have to endure the chaos his own family experienced.
 
Other Related Resources
Book Trib:  Question and Answers with Robert Kolker
https://www.nytimes.com/2020/04/03/books/review/hidden-valley-road-robert-kolker.html
 
NPR:  Hidden Valley Road
Inside the Mind of an American Family
https://www.npr.org/books/titles/826844537/hidden-valley-road-inside-the-mind-of-an-american-family
 
The Gazette:  Interview with two of the Galvin Brothers
https://gazette.com/health/schizophrenic-brother-from-hidden-valley-road-struggles-to-find-long-term-care-in-colorado-springs/article_e69bec18-a4f6-11ea-b464-3fe45116d2c9.html
 
New York Time Book Review:  Good Looks ran in the Family, and so did Schizophrenia
https://www.nytimes.com/2020/04/03/books/review/hidden-valley-road-robert-kolker.html
 
Apple Podcasts:  Robert Kolker discusses Hidden Valley Road
https://podcasts.apple.com/us/podcast/robert-kolker-discusses-hidden-valley-road/id120315179?i=1000471100099
 
Psychological Figures and Concepts
Eugene Blueler
Sigmund Freud
Carl Jung
Emil Kraepelin
David Rosenthal
Thomas Szasz
 
Chlorpromazine
Clozapine
CT scans
Delusions
Diagnostic Statistical Manual for Mental Disorders (DSM)
Dopamine receptors
Hallucinations
Electroshock treatment 
Insulin shock therapy
Lithium
Lobotomies
MRI studies
Neurons
Paranoid schizophrenia
Psychopaths
Schizophrenia
Somatization disorders
Stockholm syndrome
Tardive dyskinesia
Thorazine