Boosting APA's diversity

DR. LEVANT'S column ("Enhancing diversity within APA," September Monitor) touched on an issue that is close to my heart--APA's efforts in supporting diversity.

I believe APA needs a disabilities division, one that is led by those who have a disability and who can rally around the popular mantra, "Make your difference count." Members who work at living fully and thriving with their difference need to be included at the APA policy table. As a person diagnosed with and treated for schizophrenia, I believe it is important for all psychologists at APA to have the freedom and support to be open so that they are able to use all of their lived expertise.

The less than 3 percent of APA members who self-identify as having a disability begs some important questions.


The Community Consortium Inc.

Albany, N.Y.

IN HIS SEPTEMBER PRESIDENT'S column, Ronald Levant said our association must find new ways to welcome marginalized minorities. Yet APA continues to shun worldview diversity--perhaps the most important window through which it could come to a better appreciation for people of traditional values. Traditionalist views on gender, homosexuality, family and a host of other issues are currently not welcome at APA.

Two prominent former leaders of APA, Nicholas Cummings and Rogers Wright, have just released an important new critique of our profession called "Destructive Trends in Mental Health" (Routledge, 2005). The book is a must-read for anyone who is truly committed to worldview diversity. "If psychology is to soar like an eagle," the authors (both liberals) observe, "it needs both a left wing and a right wing."

They demonstrate how "diversity" has been redefined into a kind of narrow politicism, where differing worldviews are not only summarily dismissed, but the holders of such views actually punished.


Encino, Calif.

Cross-cultural psychology still too exotic

I APPLAUD DR. HENRY TOMES'S position on psychology's misunderstanding of diversity and the "social justice business" ("Diversity's unmet needs," September Monitor).

Should APA and graduate and professional education programs need to care about social justice? You bet they should. The 2000 U.S. Census should be enough argument to convince those who choose to remain blind to the rapid social changes in this country. Hurricane Katrina was a bold and scary reminder of what could happen if we choose to ignore those "social justice" issues.

Eleven years ago I wrote in my dissertation how cross-cultural psychology was "still an exotic option in universities' curricula." Unfortunately, it still rings true in 2005.


John F. Kennedy University

Psychology: Can it be a natural science?

STEVEN BRECKLER ("PSYCHOLOGY and the frontier of science," September Monitor) bemoans psychology's omission from the list of 129 milestones of scientific innovation over the past 2,600 years as compiled by the American Association for the Advancement of Science (AAAS) and speculates that it might be because "our science is still young, and perhaps some distance is required before we can fully separate the true milestones from the small incremental steps along the way."

There is another take on why psychology was slighted. Psychology hasn't kept its promise to be a natural science because it is still mired in the philosophical roots from which the natural sciences of physics, chemistry and biology long ago freed themselves and because, with some exceptions, it has moved farther from rather than closer to being an experimental laboratory science.

The cognitive revolution was a major step backward. Although its goals were laudable, its insistence on a return to mental constructs as its subject matter has stood in the way of psychology developing into a true natural science. Moreover, the almost wholesale takeover of psychology's experimental methodology by statistical inference has transformed a once promising laboratory science into one of statistical significance tests and tables. In short, mentalism and a formal research methodology stand in the way of psychology joining the ranks of the natural sciences.

The real question is whether psychology will ever get back on track. If and when it does, its achievements will one day make the AAAS list of scientific milestones. Otherwise, it will get the respect it deserves.


California State University, Los Angeles and Northridge

Demonizing plastic surgery?

I WAS BAFFLED BY THE DISCUSSION of the possible link between dissatisfaction with cosmetic-surgery procedures and suicide ("Plastic surgery: Beauty or beast?" September Monitor).

The article suggests that women who undergo breast implant surgery are up to four times more likely to commit suicide than other plastic-surgery patients of the same age because they are unhappy with their procedures, have unrealistic expectations or have personality characteristics that predispose them to suicide.

The main study cited was done by the National Cancer Institute. An important clarification missing from the article is whether or not this study specifically excluded cancer patients. If not, an alternative to the suggested hypotheses is that the women who underwent breast implant surgery were more likely than other plastic-surgery patients of the same age to have had their procedures because they had cancer. Perhaps the stress of the disease is more the "beast" here than the plastic surgery.



Too many drinks often too apparent

READING THE ARTICLE "ONE drink too many" (September Monitor), I was floored at the statement that "much of this heavy drinking goes undetected." At my small New England college, I have seen people so intoxicated by alcohol that an EMS team had to be called to treat them. I have heard students nonchalantly talk about trips to the ER after having drunk too much. After some nights, I have walked out of my dorm to see windows broken, empty cups and beer cans, hard liquor bottles strewn about, and vomit and beer spills on the pavement. For some of these scholarly partygoers, theirs truly is a drinking problem, while others are merely suffering from too much new-found freedom.

My school has tried to abate this behavior. Speakers have talked to students about the dangers of alcohol, but few students have left with the intended message. Unfortunately, many students do not care about the consequences of their drinking, but is this because they are afraid of the repercussions or because they are having too much fun "recreating"? When does this behavior evolve from simple party-going into a full-blown drinking epidemic?


Trinity College

Hartford, Conn.

Potential harm to self or others

WE APPRECIATED DR. EWING'S summary of the recent Ewing cases in California that expanded the famous Tarasoff ruling to include warnings from family members ("Tarasoff reconsidered," July/August Monitor). However, we want to emphasize that providers need to review their own state case law and statutes. For example, in Ohio, our law related to the duty to protect was amended in 1999 following a 1997 state Supreme Court decision, and information from a "knowledgeable person" now might lead to a duty to protect.

Dr. Behnke's "Ethics Rounds" column in that same issue also included a discussion of the duty to protect, but focused on how it relates to suicidality. Specifically, he highlighted some tension in conducting an ethical analysis associated with whether to intervene to protect people who are chronically suicidal. The balance between protecting clients, yet respecting their self-determination, also needs to be considered when working with terminally ill individuals making end-of-life decisions. We believe that in such situations the calculus and outcome may be different, even if a client wants to hasten her or his approaching death.

Whereas a strong intervention to prevent a person with borderline personality disorder from harming her- or himself may be warranted, it may also be the case that, after conducting a thorough assessment, allowing a dying client to take action to hasten death could be ethically and legally acceptable. All too often psychologists may misconstrue their options as obligations when working with people who are considering actions that may lead to self-harm or death.




The University of Akron