Being hospitalized for any reason is never a fun time, but there are some instances where it can be a harrowing experience. This is especially true for psychiatric patients, who are already in a crisis even before being plunged into the hospital atmosphere, which can overwhelm them. This disconnect between patients and hospital staff has long been an issue. Today’s guest shares some insights on her work to improve this relationship.
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About Our Guest
John M. Grohol, Psy.D. is the founder & CEO of PsychCentral.com, a mental health and human behavior/technology expert, co-author of Self-Help That Works (Oxford University Press, 2013), the author of The Insider’s Guide to Mental Health Resources Online, and is a published researcher. He sits on the scientific board of the journal, Computers in Human Behavior and was previously on the editorial boards of CyberPsychology, Behavior, and Social Networking and the Journal of Medical Internet Research. He is a founding board member and current treasurer of the Society for Participatory Medicine, and sits on the board of the International Foundation for Research and Education on Depression. He currently oversees PsychCentral.com, the world’s leading mental health resource offering information and support groups to over seven million people each month.
FACT OR FICTION SHOW TRANSCRIPT
Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
Narrator 1: Welcome to the Psych Central show, where each episode presents an in-depth look at issues from the field of psychology and mental health – with host Gabe Howard and co-host Vincent M. Wales.
Gabe Howard: Hello everyone and welcome to this episode of the Psych Central Show podcast. My name is Gabe Howard and Vin is gone. We don’t know where he is. He’s been missing for… I’m just kidding. He’s just off on this episode because we have Dr. John Grohol as everybody knows Dr. John is the owner of Psych Central the editor in chief. The founder found that it was 22 years ago, John?
Dr. John Grohol: 95.
Gabe Howard: So in 1995 I was in high school.
Dr. John Grohol: Do the math. I don’t think that’s 22.
Gabe Howard: I don’t know. I do know that I was in high school and you were starting this Web site and all these years later you get stuck with me. So that’s pretty cool.
Dr. John Grohol: I wouldn’t say stuck but yeah. Awesome.
Gabe Howard: Well while Vince is off gallivanting around America John and I thought it would be really cool to have a conversation surrounding the mental health information that we consume on the Internet. John is is an expert in Internet media just because he’s been around so long as the owner of Psych Central. He of course also reviews all of the stuff that’s on his Web site to make sure that it’s scientifically accurate to try to give readers information that they need to know the difference between personal experience which is what I write about and research based experiences what John writes about and we’ll just everything in between. So John I don’t know that I need to welcome you to your own show but welcome to my show.
Dr. John Grohol: But I appreciate being here. Thank you.
Gabe Howard: You’re welcome. Hey it has your name on it. I mean it’s the Psych Central show with Gabe and Vince and we kicked Vince off for you. So now I’m just kidding.
Dr. John Grohol: Great to be here.
Gabe Howard: John, you write from a scientific standpoint and that has some basic rules that the lived experience standpoint which is based almost entirely on opinion doesn’t have. Can you give us some of the criteria that you use when writing an article to make sure that you are factually accurate and not misleading the general public?
Dr. John Grohol: Yeah absolutely. So one of the things I do before I write an article is I look at the research and see what psychological research what research has been done what studies have been done with science has kind of gelled around in terms of the common wisdom and a an opinion that is shared by most of the researchers in that area with all scientific research. There is always the opportunity for there to be an outlier two in the data but in most of the research it’s pretty clear that there is a consensus and when there isn’t a consensus I’m happy to say that as well. So I go into the literature and I do a lot of research lookups kind of like Google and Google has a version of that it’s called Google Scholar that anybody can use the databases I check are a little bit more journal specific and are more readily available to university students and professors and things like that. And then I turn all of that research gobbledygook and statistics into something that is readable by the general public because usually as a love specialized knowledge that the reason people go to graduate school for.
Gabe Howard: So if somebody did a study right now John that tried to determine if a new drug was working and they had 500 participants the end result of that study would be how many pages?
Dr. John Grohol: Between six and 12 generally speaking.
Gabe Howard: Really?
Dr. John Grohol: Yeah.
Gabe Howard: I always thought studies were gigantic.
Dr. John Grohol: Well the bigger the study and the more complex the study usually the larger the write up of the study in the published journal. But most common studies are done on under 100 people which are most studies in psychiatry and psychology can be written up and in six to twelve pages. The challenge is again researchers are writing for each other. They’re not writing for the general public. And so there is a lot of opportunity there to misunderstand and misconstrue the results.
Gabe Howard: One of the things that I that I always hear is that science proved science proved science proved science doesn’t prove anything right. Science looks at something and figures out that this is true with the knowledge that we have that we have today. You know for example it’s not uncommon for science to also disprove something that somebody thinks that that science already proved in the example that I always uses eggs you know depending on which era of history eggs are either completely healthy for you or eggs are the worst thing that you can consume and as we find new data and we understand more about nutrition there’s sort of like warring research on it.
Dr. John Grohol: Yes there is and research is even more nuanced than what you’ve just said it actually doesn’t prove or disprove anything. What is. Actually does it say the chances of this being true are so much greater than it not being true given the data that we’ve looked at. There are so many different ways that you can manipulate the data though and that’s what most people don’t understand because they aren’t researchers right. So you look at the data and you can’t just read the study for face value you have to dig into what kind of population did the researchers use to conduct their study what was the subject poll. How was the subject poll chosen was a randomized. So there’s so many different variables that go into making really good high quality research vs.. And this research wasn’t that good but it managed to get itself published in The Journal. Which leads to another point which is that there’s a wide variety of quality of journals.
Gabe Howard: To put a pin in the quality of journals for a moment. There’s a really great example that I love from the 80s where a burger chain we won’t name them so that we don’t get sued conducted a study to figure out if they had the best sandwich and what they did is they asked all the people that went to the restaurant do you prefer sandwich a or sandwich b a sandwich being the one that they sold sandwich B B and the one that there’s a competitor sold. But as you said their data wasn’t randomized they were asking people that had come to their restaurant.
Dr. John Grohol: Yeah.
Gabe Howard: So clearly they said hey you know we love your sandwich the best. And they were like look you know nine out of 10 people prefer our sandwich. But like you said that was a true statement with their study. They weren’t lying but if you evaluated the research better you’d be like Yeah this is no you didn’t find a random poll.
Dr. John Grohol: Sure. And that’s exactly the point for marketing for an advertising campaign for a marketing campaign. That kind of research is done all the time and it’s perfectly acceptable. But when you’re talking about treatments for mental disorder treatments for cancer things of that nature the stakes obviously get are much higher. And so you definitely want the research to be of a higher quality in order for people to make conclusive statements about what treatments should we use and what kind of dosing how long things of that nature.
Gabe Howard: One of the things that you said is that there’s a wide variety of quality of journals. Now I don’t think anybody surprised by that there’s a wide variety of quality of everything. But are there journals out there that that the, I’m trying not to say the doctor community, but are there journals out there that are really just designed to mislead the public? I mean they’re just they’re just essentially maybe somewhat fraudulent?
Dr. John Grohol: I don’t know the journal gets into the business to mislead the public although with the advent of fake news and things of that nature certainly that is going to become a greater concern. What it does happen though more frequently is we have journals that are set up in order to make a profit that they’re designed to be money making machines for the Journal publisher and with the advent of pay for play basically where an author researcher can pay a journal to accept an article in reality they’re actually kind of paying the journal to publish the article. Technically the Journal is doing some sort of review of the articles but for anywhere from two to five thousand dollars I can pretty much guarantee that I can get an article published in some really low quality journals and it just takes a few weeks and the money. So that’s the increasing problem in academia. And the only clear answer the only clear response to that problem is to be familiar with the reputation of each journal. And because there are literally thousands of journals out there that can be very challenging.
Gabe Howard: And another problem that we have John is that not everybody is reading a study synopsis from Dr. John Grohol some of them are just picking them up from the local newspaper from a Web site that they like and the study is literally being interpreted just by a layperson. And that opens up all kinds of mistakes.
Dr. John Grohol: Sometimes the process fails us. And because there are a lot of secondary gains being made through across the spectrum of the journal publishing industry for instance most researchers work for a university. And the way that they increase their credentials among in the university area and amongst their peers is by being published and by being published quite frequently the more the better. And you don’t get published by publishing negative results. You don’t get published by saying I didn’t find anything in the data so that means that not only do you have to get published but then you have to get recognized because there are something like a thousand articles journal articles peer reviewed journal articles being published each and every day. And that may be a gross understatement of the number of our. Published every day. So you need to stand out from the crowd. You can’t just do that by saying blah blah blah in your boring research speak. You have to get a headline grabbing the title and everything related to that. So it’s a whole media blitz that basically your university does on your behalf which starts in the pressroom and each university has its own newsroom news staff that write up news releases based upon your latest research. And while they’re usually pretty good they usually take their cue from the researchers themselves. So the researchers say our data show that you know X causes Y then the newsroom just repeats I claim. Now of course in most cases researchers can’t show a causal relationship. That’s a very specific kind of study that you have to do and most research in psychology is correlation. X increased or decreased and then Y increased or decreased based upon that. And then they draw some conclusions around that. However that’s not a causal relationship and a lot of times something gets lost in translation between the researchers and newsroom and suddenly we now know that something bad causes something else bad.
Gabe Howard: We’re going to step away to hear from our sponsor and we’ll be right back.
Narrator 2: This episode is sponsored by BetterHelp.com, secure, convenient and affordable online counselling. All counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face-to-face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. BetterHelp.com/PsychCentral.
Gabe Howard: We’re back talking with Dr. John Grohol. One of the things that you’ve mentioned a couple of times during this episode as peer reviewed it has to be peer reviewed. Can you explain what peer reviewed is? Because when I write something nobody reviews it but me and you’re saying that studies need to be peer reviewed.
Dr. John Grohol: So everybody understands it most things they get published in a book or in a newspaper or on a big Web sites like CNN or Washington Post they go through a review process with an editor an editor reads the article before the public does and helps improve it helps ensure that it’s stating facts and that if it’s quoting people that they’re quoted accurately and things of that nature in academia with research papers we have something called peer review which is a very similar process except that people are reviewing the research studies to see if the science makes sense the data makes sense that they write statistical tools were used to analyze the data. Those peer reviewers are actually other researchers who do the peer review process as a volunteer activity as a part of what they do in academia. They don’t get paid by any one which is a very weird anomaly in the whole publishing process. They do peer review because it’s expected of them as a part of their academic appointment. I’ve done a fair amount of peer review myself over the years. It’s it takes a while. I mean if you do it well and you do it accurately to review a study and make sure that everything makes sense and what happens is after you’ve gone through the study which can take an hour or two you give comments back to the editors. You let the editors of the journal know hey these are the issues I have with the study and then the authors have to come back and respond to those questions that the reviewers have about the study and make sure that the responses make sense or edit the study to address the concerns of the reviewers. Every study has between two and three sometimes even four reviewers.
Gabe Howard: We know that there’s a lot of misinformation. You just need to log into your favorite social media to hear people talking about all kinds of things that you know aren’t based in scientific fact are based in fact aren’t based in reality. There’s just a ton of misinformation out there. Would you agree with that?
Dr. John Grohol: Yeah I think the research I’m familiar with. Yes there is some misinformation out there but Google does a pretty good job of shielding us from the worst of the worst unless you specifically are using keywords to go looking for that misinformation. So in general Google does a pretty good job of helping filter out health and mental health misinformation but doesn’t stop us from being exposed to it on social media platforms like Facebook Twitter Instagram etc.
Gabe Howard: How can the public protect themselves? I mean one of the ways it sounds like is to use Google are. I just found out about Google Scholar literally at the beginning of this episode. Obviously use reputable sites like Psych Central but other than that how can how can just a lay person that you know literally a guy like Gabe. I don’t have a doctorate. I didn’t go to any go to grad school. How can I make sure that I’m getting good information? Because it sounds like Google Scholar isn’t the place for me because I’m not going to even understand the big words.
Dr. John Grohol: You know when I have a health question I always go to the reputable big name sites to get a general overview of what it is. I have a question about so I’m looking on the same brand websites I’m looking at government resources that the federal government produces. Now the only problem with government resources I’ve discovered over the past two, two and a half decades of doing this is that they don’t tend to update their resources nearly as frequently as people who are in the business of providing up to date health and mental health information. So with that in mind when you look at a government resource about information about treatment of depression and treatment of bipolar disorder things of that nature you have to be aware that sometimes that information may be a few years out of date. Things don’t change all that much in in mental health treatment. They do change more with general health kinds of concerns. I stay away from personal accounts and people’s individual stories when I’m just trying to get the foundation of understanding what it is I’m dealing with or a loved one is dealing with I may be interested in those personal accounts later on as I feel like I have a better understanding a solid footing to understand the condition but that’s where I think a lot of the misinformation sometimes comes from because people talk from their own personal experience which is fantastic. It’s really valuable cannot say that enough however a person’s personal experience may not generalize to you and your needs and your specific treatment because of the condition comes to you in a different way. You have different symptoms you are experiencing the condition in a different manner than that other person.
Gabe Howard: First off I want to thank you for allowing the lived experience that the personal experience on Psych Central and I know how much value you see in it. So somebody you know maybe not familiar with Psych Central or Dr. John Grohol might think that that you’re kind of pushing down the personal experience and I know personally because that’s all I have. I write about my lived experience. So thank you for understanding the value in that. And also thank you for helping on the site to put it in its place.
Dr. John Grohol: That’s how I got started in doing this is that I was in a group a support group for people who were grappling with depression and I saw the value of people sharing their experiences and it helped me too at the time and it was very important. So I’ve always taken that to heart and taken it with me in my own journey to help when people need to understand what a mental health concern entails that includes learning about different people’s personal experiences with that disorder it’s so important.
Gabe Howard: As longtime listeners of the show know, I do a lot of speaking and writing about living with bipolar disorder and one of the things that I always try to say is if you’ve never met anybody with bipolar disorder you now have a better understanding because you’ve met me but it still means you’ve only met one person with bipolar disorder. We’re not all the same. And one of the number one questions that I get asked is What’s your medication what medication do you take. And they want to take that medication write it down and like give it to the person that they’re worried about and this is one of the reasons that I never share my medication because I see the danger in that. I appreciate that you love the lived experience and I think it’s also important to say that you know lived experience has its place and it has its value. You’ve got to read it sort of with a critical eye and make sure that you understand the difference between that person’s opinion and that person’s fact. Would you say that the same is true, I mean our doctors always write out our doctor’s ever misleading us. I mean like how did we get supplements for example?
Dr. John Grohol: Well yeah. So doctors are also trying to make a living right. And sometimes some of them I would argue a small minority of them go down a path of products and services that they’re trying to supplement their income with. And I don’t find them very compelling and the evidence certainly is very rarely compelling and the research on things like supplements and whatnot. And unfortunately there’s really no way you know there’s no database of bad doctors. There’s no database of shysters and other people who are looking to take advantage of people who are vulnerable and I think in mental health more than any where you have a lot of people who are vulnerable and open to a quick cure idea or hey just read this brochure book The. That’s ten bucks an hour. and might have some value to people. Don’t get me wrong. I think if you get value from a book and a self-help book certainly or even supplements to some extent you know fine. But understand that some of that value especially with supplements is probably coming from placebo effect.
Gabe Howard: And can you explain what placebo effect is John?
Dr. John Grohol: Placebo effect is when researchers are studying a new medicine and they’re trying to understand hey is the medicine what’s causing improvement in treatment in those symptoms. Or is it just the fact that we’re paying this person more attention that we’re giving them a pill and just the idea of hey I’m getting this pill and it has some sort of active ingredient that’s going to help my symptoms that that in itself is a very powerful persuasive suggestion. And so medical researchers say hey you know one way to help balance out the impact of people getting a pill one with active treatment is to give another group of people a pill that’s just a sugar pill. It doesn’t have any active ingredients. And that way they’re both groups are getting the same amount of attention from the researchers. They’re both feel like they’re taking a pill and it’s going to help them. And because of that they can now study you know whether that whether it’s the actual active ingredient in the pill that’s causing the reduction symptoms or whether it’s something else. So we use that. Researchers use that term placebo effect to describe benefits that people might enjoy from any kind of treatment that hasn’t been scientifically proven. So the supplement for instance you know you might feel like oh I take the supplement everyday and improves my mood. That’s great. More power to you but it may not be because of an active ingredient in that supplement. It just may be the act of you taking that pill.
Gabe Howard: And also especially in mental health. Let’s talk about depression for example you know depression is that you know that feeling of loneliness that that darkness you don’t have anybody you’re now involved in a study you go someplace you know maybe once a week people are talking to you you’re calling you’re on the phone more people are visiting you can see how that and that alone forget about medication just now somebody is invested in your life could cause an uptick and then of course even in mental health it’s an ebb and flow. You know maybe the reason that you’re feeling better is because your natural cycle of moods is just up during the two weeks that the study is happening. So they want to make sure that they don’t assign those to the new pill or they could get bad results and the final thing is the researchers usually don’t know which one is the active ingredient in which one is placebo correct. So they’re interacting literally exactly the same. And that’s called a double blind study. Right?
Dr. John Grohol: Correct.
Gabe Howard: Hey see, I know something.
Dr. John Grohol: You do know something.
Gabe Howard: John it is always awesome to hang out with you. Do you have any closing thoughts for our audience?
Dr. John Grohol: One of the things I guess I would like to emphasize before we close our eyes just because someone has a doctorate after their name or an M.D. or something that doesn’t mean that they’re necessarily an expert or going to lead you down a path of the best treatment available for you. Maybe they will but at the end of the day you need to understand and find treatments that work best for you. There are so many different types of treatments for so many different disorders that we don’t we don’t have a algorithm to say this is the medication that’s going to work for you at this dosing level of this many times a day. We haven’t gotten there yet. And are that this type of psychotherapy treatment is the most effective for you for this condition. So you need to be skeptical of people and you need to embrace the whole trial and error process of mental disorder treatment. It’s not ideal but it is where we are today. And when you read something online look for verification look for backup of a claim being made. So if you come to one Web site and they say oh taking Vitamin C is completely changed my depressive symptoms look for other Web sites that are reputable their name brand to verify that kind of information. Don’t just take one person’s word for or just because someone posted something to your Facebook news feed or you know your Instagram feed that suddenly oh wow you know vitamin C cures depression. Be skeptical when you especially when it comes to health and mental health information. And the more outrageous the claim the more likely it is not to be true or the more outrageous the claim the less likely it is to be true.
Gabe Howard: I know that a lot of people out there feel that they can’t question their doctors and you believe in participatory medicine. In fact you helped found the Society for Participatory Medicine. And that doesn’t mean that the doctor tells you what to do or that you tell the doctor what to do. It means that the patient and the doctor work together to design the treatments that work best for. For both. You know I like that society but I as somebody living with bipolar disorder I like that because my medical team has to get the information for me. They can’t do a blood test. They have to listen to Gabe and design it and then when I leave I have to follow it. It’s not like surgery where they’re just knocking me out and doing whatever they want I. I have to be involved.
Dr. John Grohol: So absolutely treatment should be a partnership between the professional who’s providing the treatment and the patient or a client and it needs to be as much as possible an equal partnership that you’re developing a treatment plan cooperatively together and that you decide on what are the goals of treatment what are the outcomes? When can we decide that treatment should be over? Because we’ve or I’ve reached my goals as a patient so I think all of those things are super important and definitely result in people more engaged in treatment and enjoying probably better outcomes from treatment.
Gabe Howard: John it is always cool hanging out with you. Thanks for playing in our sandbox.
Dr. John Grohol: Always a pleasure to stop by.
Gabe Howard: All right and thank you everyone for tuning in and remember you can get one week of free convenient affordable private online counselling anytime anywhere simply by visiting BetterHelp.com/PsychCentral. We’ll see everybody next week.
Narrator 1: Thank you for listening to the Psych Central Show. Please rate, review, and subscribe on iTunes or wherever you found this podcast. We encourage you to share our show on social media and with friends and family. Previous episodes can be found at PsychCentral.com/show. PsychCentral.com is the internet’s oldest and largest independent mental health website. Psych Central is overseen by Dr. John Grohol, a mental health expert and one of the pioneering leaders in online mental health. Our host, Gabe Howard, is an award-winning writer and speaker who travels nationally. You can find more information on Gabe at GabeHoward.com. Our co-host, Vincent M. Wales, is a trained suicide prevention crisis counselor and author of several award-winning speculative fiction novels. You can learn more about Vincent at VincentMWales.com. If you have feedback about the show, please email talkback@psychcentral.com.
About The Psych Central Show Podcast Hosts
Gabe Howard is an award-winning writer and speaker who lives with bipolar and anxiety disorders. He is also one of the co-hosts of the popular show, A Bipolar, a Schizophrenic, and a Podcast. As a speaker, he travels nationally and is available to make your event stand out. To work with Gabe, please visit his website, gabehoward.com.
Vincent M. Wales is a former suicide prevention counselor who lives with persistent depressive disorder. He is also the author of several award-winning novels and creator of the costumed hero, Dynamistress. Visit his websites at www.vincentmwales.com and www.dynamistress.com.
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