In response to "Fixitol"
I was delighted to see the November Monitor on Psychology article and accompanying videos conveying that psychotherapy is a viable intervention for depression and anxiety. Yet, I thought the clever mocking of medication with a fictitious drug called "Fixitol" does not serve patients or our profession well. Some medications, some psychotherapies and other classes of intervention (e.g., lifestyle changes such as exercise) are effective for depression. Before mocking medication, we might get our own house in better order. For example, the article essentially says psychotherapy works (article title) with depression and anxiety. This requires qualification. For example, most psychotherapies in use clinically have not been evaluated empirically; among the therapies that have been evaluated empirically, only a few have been studied and shown to be effective for depression, and any consumer of treatment ought to find out what those are. In my opinion, our first commitment in any clinical context is to individual patients and patient care more generally. That commitment might lead us to promote what can be done for depression and anxiety that has any evidence in its favor or is the best practice at this time. Some of what can be done is psychologically based and we ought to be proud of that; I am. Yet, some of what can be done comes from other quarters (disciplines, professions), and we serve patients and ourselves well by promoting well-being (mental and physical health), whether or not that involves a psychological intervention.
Alan E. Kazdin, PhD
APA past president
Editor's note: The video Dr. Kazdin refers to was designed to educate consumers about options for mental health treatment. The video script intentionally states that medications are an appropriate choice for some patients. Our purpose was not to bash medications or medical practice, but to highlight the option of psychological interventions vis-à-vis medication for adults with mild to moderate depression and anxiety. It is important that psychology communicate this information, in part, as a counterbalance to the huge amount of drug advertisements consumers see on a daily basis.
John Watson and morality
There may be no evidence that John B. Watson monitored his sexual activities with his research assistant Rosalie Rayner, as described in the article "Notes on a scandal" in the October Monitor. However, there is well-documented evidence that his moral standards in regard to sexuality were questionable at best. In a little noted part of the article that he and Rayner wrote describing their work with Little Albert, whom they conditioned to fear a white rat, they reported plans to decondition him that were never carried out because he was removed from the foundling home. Among the methods they would have tried was the following: "trying to ‘recondition' by showing objects calling out fear responses (visual) and simultaneously stimulating the erogenous zones (tactual). We should try first the lips, then the nipples and as a final resort the sex organs." (See Watson and Rayner's 1920 article, "Conditioned emotional reactions," in the Journal of Experimental Psychology.)
In Watson's readiness to sexually abuse this infant we see not only his own moral lapses, but those of the scientific community who published their report and accepted this as normal behavior.
Laura Levine, PhD
Central Connecticut State University
An ounce of prevention is worth a pound of cure
In response to "Preparing for the ‘silver tsunami'" (October Monitor), if the "silver tsunami" persists as expected, then within 15 years Alzheimer's prevalence will reach epidemic levels in the United States. The threat of this happening should motivate psychologists to take action toward Alzheimer's prevention by encouraging people to change their risky behaviors. As the article suggests, this epidemic will create opportunities for psychologists in the future, and it can also be expected that Alzheimer's research will have positive outcomes on development of innovative treatments for the disease over the next several decades. However, the initial focus needs to be on prevention, and psychologists should have an active role in that. They should be involved in outreach and behavioral intervention programs that address disadvantaged populations and focus on managing risk factors, such as obesity, smoking, depression, and mental and physical inactivity. Alzheimer's disease has an extensive developmental history, therefore it is understood that improvement in these areas helps minimize its incidence. This country needs the assistance of psychologists to be better advocates in preventing and managing the disease in order to minimize the detrimental effects this "silver tsunami" could have on the health-care system as a whole.
The November article "Living history" should have reported that Olivia Hooker, PhD, joined the U.S. Coast Guard in 1945.