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< Back to the Academic Writings of Tory Hoff

Ongoing Reflections on Various Topics

Dr. Tory Hoff, Psychologist

Where to start?


Historical

It seems to me that Christ included just about everyone in his community, except the arrogant.

I perceive a parallel between some theological concepts out of the Judeo-Christian tradition and current psychological theory. For instance, the idea of original sin now has its manifestation as the psychoanalytic concept of primary narciissism. Also, the Old Testament prohibition against idolatry now appears within attachment theory. Idol worship involved what in psychological language is called a bad and unhealthy attachment with an object, one which takes the place of an attachment to an intangible being. Modern attachments to things that we make are misguided if we end up understanding ourselves in terms of the things that we make. On one hand it was useful to understand brain function in terms of the telephone system including the switchboard, and it has become useful to understand  brain function in terms of the computer software that some of us make. On the other hand, however, something is lost if our primary way of comprehending ourselves is in terms of the things we make.

The above reflections presume that during the last three thousand years of Western history, theological thought and its language have evolved into psychological thought at its language. As I indicate above, they are in some cases referring to the same phenomenon in human experience but from different perspectives. To elaborate further, private psychological experience of the kind we know today did not occur the further back in Western history we search. As others such as Julian Jaynes have noted, people were apt to experience their thoughts as due to external forces. A person  was a locale for thinking and feelings, but such experience was not necessarily attributed to oneself. For lack of better words, thinking and feeling was attributed to intangible forces or beings, sometimes conceived as being spirits. As this kind of personal experience slowly became less communal and more private, and as self reflection and self observation developed over the centuries, thinking and feeling became more attributed to oneself. This resulted in the slow emergence of  a psychological perspective. at the core of humanism.



Stephen Greenblattt presents interesting relflections. What is missing from his reflections is a sense of the developmental aspects that permeate this fundamental story. He misses a sense of the way that the writer or writers projected a sense of their own personal origins to the origins of humans. In other words, the story of Adam and Eve contains a rudimentary sense that the history of humanity has its paralllels in individual human development, one in which an age of innocence and self reflection are lost.

According to Greenblatt, it is Augustine who first gave a literal interpretation of the first chapter of Genesis. For me this brings us to the subject of the origins of "literal" interpretations of anything. Augustine was, in my estimation, like King David and perhaps Leonardo Da Vinci, hundreds of years ahead of his time, when evaluated in terms of psychological reflection. Apparently David's relationship with Jonathan is the earliest recorded friendship in Western history, in that he had a strong personal bond and comraderie with  someone outside his clan. For this to occur, he necessarily needed to transcend current mores and customs. Regarding Augustine, his historically precocious personality was most evident in his Confessions. This self reflection was much more sophisticated and elaborate than that expressed in any other documents preserved until, say, autobiographical reflections that began to appear in the 12th century. As well, Augustine, his style of self reflecdtion perhaps qualifies him as the western world's first neurotic. His precicious abilities in regards to self observation also inclined him to acquire a new kind of objectivity whereby truth was that determined by the observer.
The concept of literal truth also requires that the holder to be literate. That is, the primary of visual reading is now assumed to be the resoervoir of truth. The words contain their own interpretation and debate is thwarted because the "literal" truth is assumed to be unequivocal fact.
Those who wrote the first chapter of Genesis had no sense of words being literal. First of all, as Martin Buber emphasized in his translaltions, the further back one goes in the bibilical record, the more they are fundamentally spoken, and remembered as part of an oral tradition.. Like prayer, the oldest biblical accounts were spoken words, and only later did they evolve into written words.
In sum, the idea of lilteral interpretation is a relatively modern invention that attained full form as part of the Scientific Revolution of the 17th century.
Regarding biblical interpretation, there are two opposites that are misguided, one being the literal perspective and the other holding that the biblical account consists of stories that are more fictional and fanciful than anything reliable.  Exegetical interpretation tries to focus on what the writers of the various books on the Bible meant to communicate when they wrote what they wrote, which means understanding the context of a particular passage and imagining the tacit assumptions and beliefs of the writer.  To consider the books of the Bible to be fictional writing represents a kind of denial, a simplistic way to dismiss that which is apriori perceived to be not logical and not true. By contrast, those adhering to some kind of literal truth regarding Biblical passages are neurotically holding on to a belief and frame of reference that cannot tolerate doubt or dissent.  Ultimately it is fear based, and represents the inability to dialogue about possibilities. It lacks creativity.

That Adam and Eve started out naked parallels that all humans and born naked.  The Fall is something involving an awakening somewhat parallel to puberty.  It is misleading to consider this awakening to be some kind of teenage experience because, the modern teenager is yet another moderan invention that began to appear in the 19th century and did not really get going in North America until, say, the 1950's. Perhaps Rousseau was our first teenager, as evident in the angst conveyed in his Confessions.

Puberty does involve a break, which in previous centuries involved a transition to a new role within society, one usually involving bethrotal and then marriage, as community events.  There was no dating, and few friendships with the opposite sex, as that too is a modern invention.



Philosophical

Something Lost with the Demise of  the Classic Theory of Temperaments

The classic theory of four temperaments has its origins in medical theory of ancient Greece. The basic idea was that the human body, and for that matter everything else was a combination of four humours, which themselves were combinations of  for basic qualities, namely, hot, cold, dry, and wet. The four temperments were sanguine, melancholic, choleric, and phlegmatic.

Two basic versions circulated. One was that the sanguine temperment contained the optimal blend of  humours, whereas the other three were deviations from the ideal blend.  The dominant version was that the four tempermants were all imperfect blends. Within  the Christian community, Jesus Christ was of course thought to have had a perfect blend of humours.

This classic theory started to wane when medical science began to replace the humoural theory with modern concepts of physiology and neurophysiology.  This occurred in several stages, beginning with the Scientifiic Revolution of the 17th century and ended with the rise of neurophysiology in the 19th century.

Meanwhile, a theory of three temperaments appeared within popular culture, and a version of it became Sheldon's theory of the ectomorph, mesomorph, and endomorph.  

More recently, a theory of five tempermants, or rather five dimensions of temperaments.  They are known as the Big Five.

My purpose for presenting the above historical summary is that the theoretical framework for the Big Five is not based upon the belief that the ideal is a perfect blend of oppositive humours and temperaments. To state it differently, a blending of opposites/polarities is not a core aspect.

The point I am wanting to make is that, although there are factors in our society that value moderation, we  no longer have a theory of personality that promotes moderation or emphasizes that polar opposites cannot function together if no middle ground is found. One exception would be the Mayers-Briggs typology, though the underlying reason is that its basic categories have their origin in the classic theory of temperaments.



William James: wrote,
The truth is that in the metaphysical and religious sphere, articulate reasons are cogent for us only when our inarticulate feelings of reality ahve already been impressed in favor of the same conclusion" (Varieties, near end of Lecture 3).
James seems to be saying several things here. To me what he wrote here gets to the centre of why he was appreciated in his own times, and stilll appreciated today for his insights into the psychological side of being human.  He managed to find a place for both tangibles and intangibles.  He found room in his thinking for so called objective knowledge yet also personal knowledge and yet avoided the excesses of each when on their own.  
In my own langauge he tried to blend together observer and participatory information.  He was not a polarizing presence.  I suspect he was a more psychologically integrated person than most of us.


Clinical


In recent years, I have not read much on the subject of sleep. I could explore the books about it on my shelves, but instead I will post this email because I am curious what insights my colleagues have regarding interventions to overcome insomnia.

What I tell my clients is that it is very hard to think oneself to sleep, but that some people can, in essence, hypnotize or lull themselves to sleep by doing some kind of mental repetition. In many cases, however, what is required is that the insomniac, especially those plagued with a repetitive tune or worrisome thought, move. Any body movement, it seems to me, increases the possibility that the "tape" in one's head gets broken. This might be parallel to the observation that dreams are more likely to be forgotten ("erased") once we move, even roll over.

The "movement" that seems to most promote sleep for me is a yawn. That is, if I have been lying in bed for an hour or two, and I manage to force myself out of bed (rather than simply turning over, which does sometimes aid sleep), then my best option is to get in the shower, lean my head against the wall, and let the rather hot water beat down on my neck.  Within a few minutes, I start to yawn, maybe at first in a constricted manner but eventually I enter into a full out yawn. After I do this yawning several times, I feel ready to return to bed, which I do. Almost always I fall asleep within ten minutes.

There are of course many other "movements" that seem to help clients, eg., a certain tea or hot drink, watching tv or reading, walking a dog, etc.

But I have no recollection of yawning ever being mentioned in "How To" sleep books.

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Although I have not read the book by Paul Green, I have the following observations about the TOMM (Test of Memory Malingering, by Tom Tombaugh)

I recently finished a med/legal report for a tort claim. Again I was faced with a defence psychologist or psychiatrist concluding that my client's responses on the TOMM suggest malingering. With respect to some of my long-term clients who I know are not malingering and who for the most part are not intentionally exaggerating symptoms, this misinterpretation of the TOMM is having devastating consequences on their lives. For instance, sometimes their income benefits are cut off, and so are my services.

There are legitimate interpretations regarding why these clients did not score above the cutoff of 45 on the second administration, and in some cases scored no better than chance. The common denominator among them is some kind of cognitive deficit stemming from test anxiety, distraction, blanking out, etc.

The TOMM, in being named a test of Memory Malingering, lends itself to this misinterpretation. If it was instead named a Test Of Memory Motivation, then a more realistic and less prejudicial name is employed. But for some of my clients the TOMM is not even a test of memory motivation, that is, of the desire/willingness/energy to respond to items on a memory test with as much conscientious effort as possible.

On grounds that memory cannot be tested until a percept is actually formed and can then be retrieved, for some of my clients the TOMM becomes first of all a test of attention and concentration. In his manual Tombaugh himself indicated that he wanted to ensure that the TOMM did not become a test of attention and concentration, as he wrote on page 17 that the administrator is to do things to make sure the subject is attending to each picture.
But for my most traumatized and depersonalized clients with little self confidence, this is what the TOMM becomes... a test of concentration.

Although I am admittedly not knowledgeable about the literature reporting on research involving the TOMM, I find it difficult to believe that any research I might read would change my reality, which is that my legitimate clients who are "failing" the TOMM are doing so because of trauma- or anxiety-related difficulties. As well, it is clearly outside my reality that any clients who have been meeting with me regularly for more than a year or so and who do poorly on the TOMM are intentionally misrepresenting their abilities and somehow malingering.

These clients come back after their assessments and tell me what was happening to them during the administration of the TOMM. Generally they are not focussing on each picture at all. After a few, they start thinking about their "brain fog" and, for instance, are worrying about how they will ever get a job again, given how poorly they are doing. By contrast, in at least one instance, the psychometrist, it seems, was misinterpreting the test anxiety behaviour of the client to be a product of the effort to malinger. Our colleague, I surmise, was informed of this effort, and wrote the report accordingly... or simply signed it, whichever the case.

In my opinion one interesting variation on the standard way of administering the TOMM gives me more information regarding the lack of an initial percept of the fifty items. On the second administration, I ask a person who is obviously doing poorly to indicate after giving a response whether he or she guessed at the answer or rather felt certain that he or she gave the correct response. The more they report guessing, the more I have evidence that many of the fifty stimuli did not register in the first place.

A reading of the above might lead some listserve members to conclude that as a treating psychologist I am naive about the intentions of these clients of mine who perform poorly on the TOMM. I acknowledge a vulnerability in this area, as I tend to trust clients until proven otherwise. But I also have very honest referral sources, so do not expect to get a malingerer. and form very positive relationships with these clients. The "proof" regarding who is right, I believe, is in the results. That is, my reality sets the conditions for the client to heal, whereas the message that they are malingering stresses them further, both emotionally and financially, and interferes with their efforts to recover. But of course if some professional is already committed to the premise that this client is malingering, then seemingly no evidence can be presented to reverse this belief.

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Tory Hoff. All Rights Reserved.    Contact Dr. Tory Hoff, Psychologist at drhoff@drhoff.com