Financial Therapy

(WSJ Illustration)

When I was going to business school 50 years ago, I admired the select few who were in the JD/MBA program. They had to be accepted separately to both the law school and business school--each of which was tough to get into--and devote four years to complete their studies.

But I'm not impressed by this latest dual credential, the financial therapist: [bold added]

The goal of financial therapists ultimately is to help people make good financial decisions, typically by raising their clients’ awareness of how their emotions and unconscious beliefs have affected their sometimes messy experiences with money...

Financial therapists tend to come from mental-health and financial-planning disciplines, and there are signs that their ranks are rising: The Financial Therapy Association has 430 members, up from 225 in 2015. Still, according to the group, fewer than 100 financial therapists have completed its certification process, introduced in 2019. You can be an association member without being certified by it...

Still, there are possible pitfalls when hiring a financial therapist. One major drawback: Anyone can claim they are qualified to practice financial therapy.

No government agency regulates the young profession. Candidates for certification by the Financial Therapy Association must take online courses designed by the association covering financial and therapeutic techniques, counsel clients for 250 hours and pass a 100-question test. But you can call yourself a financial therapist and not be certified by the association.

Meanwhile, the cost of financial therapy varies widely—from $125 to $350 an hour, [Financial Therapy Association President Ashley] Agnew estimates. Insurance rarely covers the tab.

Because of recent well-publicized policy mistakes, "experts" have lost the deference that their credentials used to afford them. However, credentialing and licensing do have their place in verifying that a person has a certain level of knowledge to practice often-complex professions.

The fact that there are zero certification requirements in "financial therapy" will result inevitably in scandal, defalcation, and possibly worse outcomes for clients. I wish it weren't true, but sad experience teaches otherwise.

Life's Purpose: A Psychiatrist Has the Answer

I'm always interested in hearing what people have to say about life's purpose (while noting that a sizeable number who are overwhelmingly atheist assert that life has no purpose).

Yale Associate Professor of Psychiatry Samuel Wilkinson thinks he has found the answer based on his studies of evolutionary biology and cognitive psychology.

In an interview with Yale News, Wilkinson discusses what inspired his fascination with understanding life’s purpose, how nature instills in humans a “dual potential,” and the evolutionary forces that spur us to be our more altruistic selves.

“When you combine the concept that we are free to choose with the dual potential of human nature, to me this strongly implies that life is a test,” said Wilkinson, who is also director of the Yale Depression Research Program. “The purpose of life is to choose between the good and evil impulses inherent within us.

“This seems to be written into our DNA.”

...I totally acknowledge we have a capacity for selfishness, but in other ways we also have a deep capacity for altruism. In a way that was unexpected to me, evolution has shaped us such that we are pulled in different directions. This is a core example of how nature has left us conflicted, what in the book I call the “dual potential” of human nature.

Prof. Wilkinson has a scientific explanation for the selfish and altruistic duality of human behavior--it's built into our DNA. But I'm still at a loss to see why one is necessarily better than the other, or why life is a "test" to see whether we will choose altruism. Who is the Grader?

Science is excellent at explaining why things work, but it's so far been lacking in determining answers to basic questions, for example, if I died today did my life have value? By the way, by what criteria does one determine that value?

Or maybe I had value because I left children behind. So that's it: propagate the species? If so, individual rats and cockroaches do more for their species than I did for mine. And so on and so forth.

For now I'll search for answers in the writings of philosophers and theologians rather than psychiatrists. One good things about Prof. Wilkinson's attempt is that it prompted me to get cracking on reading Paul Tillich and Teilhard de Chardin while there's still time to do so.

Often Wrong But Never in Doubt

(Marijuana map from governing. com)

In addition to taxes and regulations stunting sales, there may be another reason for business projections falling short where marijuana has been legalized: the public doesn't trust the enthusiasts who say it's no worse and may even be less harmful than alcohol.

Headline: Marijuana Is More Dangerous Than You Think. Coincident with the rise of marijuana use has been an increase in the incidence of psychosis and paranoia, though we must be careful to state that marijuana has not been proven to be the reason because correlation is not necessarily causation. [bold added]

And last September, a large survey found a rise in serious mental illness in the U.S. too. In 2017, 7.5% of young adults met the criteria for serious mental illness, double the rate in 2008.

None of these studies prove that rising cannabis use has caused population-wide increases in psychosis or other mental illness, although they do offer suggestive evidence of a link. What is clear is that, in individual cases, marijuana can cause psychosis, and psychosis is a high risk factor for violence. What’s more, much of that violence occurs when psychotic people are using drugs. As long as people with schizophrenia are avoiding recreational drugs, they are only moderately more likely to become violent than healthy people. But when they use drugs, their risk of violence skyrockets. The drug they are most likely to use is cannabis.

The most obvious way that cannabis fuels violence in psychotic people is through its tendency to cause paranoia. Even marijuana advocates acknowledge that the drug can cause paranoia; the risk is so obvious that users joke about it, and dispensaries advertise certain strains as less likely to do so. But for people with psychotic disorders, paranoia can fuel extreme violence. A 2007 paper in the Medical Journal of Australia looked at 88 defendants who had committed homicide during psychotic episodes. It found that most of the killers believed they were in danger from the victim, and almost two-thirds reported misusing cannabis—more than alcohol and amphetamines combined.

What about predictions that legalization would reduce violent crime?

The first four states to legalize marijuana for recreational use were Colorado and Washington in 2014 and Alaska and Oregon in 2015. Combined, those four states had about 450 murders and 30,300 aggravated assaults in 2013. In 2017, they had almost 620 murders and 38,000 aggravated assaults—an increase far greater than the national average.

The broad effects of legalization---public health and mental illness, criminal justice, economic activity, taxation--will take years to make themselves known.

But it's called a social experiment for a reason. We can guess at but don't know the results in advance. Possible harmful effects are already appearing. A little humility is called for, especially in the advocates, but I'm not expecting to see it.

No, It Doesn't Make You Look Fat

Of course, if you had to pick truth vs lies, we know
which one is better (National Autism Resources)

People with autism-spectrum disorder (ASD) [bold added]

indeed have a hard time being untruthful.

This is caused, [Duke professor Murali Doraiswamy) added, by the trouble they have with what specialists in the field call “theory of mind”—that is, the basic ability to put ourselves in somebody else’s shoes and empathize with their perspective. Most of us are able to ask ourselves, “How would that person feel if I told them that their haircut is unflattering or that they smell?” Many young people with Asperger’s don’t tend to think this way, so they often don’t develop the habit of telling white lies for reasons of politeness. They don’t learn to dial down unnecessarily hurtful truths to spare another person’s feelings.

We know a number of ASD children and adults, and they do find it difficult to lie. (The more socially adept change the subject or keep silent.) However, it's been our experience that it's not their excessive truthfulness that gets them into trouble but their physical reactions---not necessarily violent---in social situations.

It's no wonder that ASD kids 1) Like computers, video games, and other screen-based media, yet 2) Stay away from social forms of the technology.

A Nettlesome Problem

For male prisoners with a history of violent behavior the catalyst frequently is perceived disrespect, which leads to shame, which in turn triggers violence. Writer Jonathan Asser "used to struggle with his extreme rage until he learned to master it – and discovered a skill for calming violent prisoners." [bold added]

With the exception of psychotic prisoners being treated through the healthcare department, every violent incident I have ever come across in prison could be traced back to shame and the feeling of being disrespected. Conventional programmes working outside the heat of the moment studiously avoid the crucial shame trigger. I worked with it every day. I came up with the name Shame/Violence Intervention (SVI) to describe my approach.

Many prisoners are able to give the "correct" answer when a staff psychologist poses a hypothetical question, such as "what if you see a man talking to your girlfriend?" In SVI therapy Jonathan Asser publicly embarrasses the prisoners and trains them how to recognize and control their responses.

His approach is difficult, slow, expensive (in terms of trained therapists' time) and successful. Unfortunately, it's not easily scalable and demonstrates why breaking the cycle of violence is such a nettlesome problem.

[Update - 3/9/14: Jonathan Asser's screenplay, Starred Up, was nominated for eight British Independent Film awards.]

Mental Illness Definitions: Take Another Look

After 13 years of deliberation, the American Psychiatric Association has made significant changes to its definitions of various conditions in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Examples:

Hoarders: For the first time, hoarding disorder will be included as a diagnosis, meaning those who can't get rid of ephemera can now seek reimbursement for therapy

The Bereaved: The previous DSM said those in mourning don't necessarily qualify for depression therapy or medication. DSM-5 eliminates that exclusion.

Interestingly, what didn't make the list as a disorder was parental alienation syndrome (PAN) - "the difficulty kids feel after parents divorce". If it turns out that his parents' divorce was a contributing factor to Adam Lanza's commission of mass murder, look for enormous pressure to add PAN to the list.

Parents would want mental-health professionals to perform, and insurance companies to pay for, the screening of the many thousands of children of divorce in the hope that a future massacre will be prevented, and it will be very difficult to dismiss these concerns. © 2012 Stephen Yuen
[Update - 12/22: "We don't hear about the effects of fatherlessness, especially on young men. We don't hear that the most reliable predictor of crime is neither poverty nor race but growing up fatherless. We don't hear that a large majority of violent criminals were fatherless."]

[Update - 6/14/13: The WSJ writes about the DSM-5's inclusion of caffeine intoxication and withdrawal "when they impair a person's ability to function in daily life." However, the DSM-5 website has less alarming phraseology:

DSM-5 will not include caffeine use disorder, although research shows that as little as two to three cups of coffee can trigger a withdrawal effect marked by tiredness or sleepiness. There is sufficient evidence to support this as a condition, however it is not yet clear to what extent it is a clinically significant disorder. To encourage further research on the impact of this condition, caffeine use disorder is included in Section III of DSM-5.