47 - Munchausen’s syndrome (Factitious Disorder) - why some people fake being sick

47 - Factitious disorder, better known as Munchausen’s syndrome, is when someone fakes being sick for no apparent reason aside from the benefit of assuming the sick role. Factitious disorder imposed on another, or Munchausen’s by proxy, is when a caregiver (usually a mother) claims their child is sick, in many cases causing the child to be sick through poisoning. We take a deep dive into the literature about these disorders, discussing the extreme lengths used to pretend they are sick, including lying about symptoms, falsifying medical tests and causing illnesses in themselves. Both disorders are fascinating, rare, and result in unneeded investigations and procedures (eg. surgery). The mortality rate is high ~10% and for those who survive often are disfigured.

At about the 60 minute mark we have an extended Things We Came Across segment. We have two listener TWCA articles and ponder what makes someone cool and ask the question ‘what is art?’ (Thanks to Andy Tagg and Laura Finlayson-Short). Amy reveals the true reason psychs are called shrinks and Hunter discusses important research on gin consumption.

If you like the show then it’d be great if you could rate and review the show on apple podcasts, and if you have a pet send us a pic of it to twoshrinkspod@gmail.com

Articles:

Incidence article : https://www.hindawi.com/journals/bn/2019/3891809/

Online support groups: https://www.sciencedirect.com/science/article/abs/pii/S0165178114002613

Perpetrators of Munchausen’s by Proxy: https://www.ncbi.nlm.nih.gov/pubmed/28750264

TWCA

Cool status (thanks Dr Andy Tagg) - https://www.sciencedirect.com/science/article/pii/S0140197119301083?via%3Dihub

Gin & context - https://www.ncbi.nlm.nih.gov/pubmed/29136090

The brain on art (thanks Laura Finlayson-Short) - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330757/

Where does ‘shrink’ come from? Season 16, episode 13 of QI - https://qi.com/

46 - Dark Tetrad of personality - Psychopathy, Narcissism, Machiavellianism & Sadism

This week on Two Shrinks Pod we’re returning to the darker side of humanity and taking a look at the Dark Tetrad: psychopathy, narcissism, machiavellianism and sadism. We chat through the rationale for adding sadism into the mix and examine the ways it can play out in romantic relationships, responses to grief and online trolling. As always, we wrap up with Things We Came Across - Hunter explains judgement of people who make spelling errors and Amy makes yet another argument for why cats are awesome (i.e. how other animals are more fear and disgust inducing than them).

Hunter’s articles:

Subclinical sadism and the Dark Triad - https://econtent.hogrefe.com/doi/abs/10.1027/1614-0001/a000284
The Dark Tetrad and callous reactions to mourner grief - https://www.sciencedirect.com/science/article/pii/S0191886918304677

Amy’s articles:

Predicting short- and long-term mating orientations - https://www.ncbi.nlm.nih.gov/pubmed/29373049
Trolls just want to have fun - https://www.sciencedirect.com/science/article/pii/S0191886914000324

Things We Came Across:

Spell checker - https://www.tandfonline.com/doi/abs/10.1080/02702710500400495
Scary and revolting animals - https://digest.bps.org.uk/2019/06/25/psychologists-have-created-a-league-table-of-scary-and-revolting-creatures/

Two Shrinks on the School of Movies podcast - discussing Inside Out

Exciting news listeners - Two Shrinks recently guested on the School of Movies podcast where Amy and Hunter were asked to come on and help discuss Pixar’s masterpiece that explores the function of emotions - Inside Out. This is a movie that therapists frequently refer people to watch to help them understand emotions. School of Movies is hosted by the fabulous Alex and Sharon Shaw and they do super in-depth analysis of films (check out their Good Will Hunting episode for a great discussion of therapy and trauma). In the Inside Out episode we have a really good discussion on the function of core emotions shown in the film : Joy, Anger, Disgust, Fear and Sadness - and of course we make sure that we relate things back to therapy and therapy processes.

The episode can be found at the following places:

Podbean: https://schoolofmovies.podbean.com/e/inside-out-1561733314/

Apple podcasts: https://podcasts.apple.com/au/podcast/inside-out/id388751599?i=1000443062210

On twitter: @SchoolOfMovies

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45 - Don't stand so close to me: understanding interpersonal distance

45 - This ep we are talking about the ins and outs of interpersonal distance - that is how close you like to be to other people. Amy talks about cross-cultural differences and attachment (surprise surprise) whilst Hunter takes us on a journey of age related differences and discusses the impact of psychopathy on interpersonal distance. Spoiler: psychopaths don’t respond to your angry expression. TWCA we have a first for 2SP, a listener TWCA from Sahra O’Doherty on Pervasive Labelling Disorder, Amy talks taste perception whilst listening to music and Hunter talks about a survival analysis of the characters in Game of Thrones.

Hunter’s articles:

Age differences - https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02479/full
Psychopathy - https://journals.sagepub.com/doi/abs/10.1177/2167702618788874

Amy’s articles:

Cultural difference - https://journals.sagepub.com/doi/abs/10.1177/0022022117698039
Attachment - https://www.ncbi.nlm.nih.gov/pubmed/15513270

TWCA:

Pervasive labeling - https://gsep.pepperdine.edu/content/faculty/pld.pdf
Game of thrones - https://www.ncbi.nlm.nih.gov/pubmed/30535868
Sourness and music - https://www.ncbi.nlm.nih.gov/pubmed/27311296

44 - Men's responses to a miscarriage or still-birth - with Kate Obst

44 - How do men respond to pregnancy loss? What is their experience? What supports do they need? And is it different to how women respond? This episode Hunter interviews Kate Obst whilst at that APS Health Psychology conference in Adelaide in April 2019 and she talks about men’s responses to a miscarriage or still-birth. This will be of interest to anyone (not just men) who is interested in grief and how we respond to the loss of a baby. Kate was awarded the prestigious Westpac Future Leaders Scholarship in 2018 and at the conference presented on her honours research. She is currently completing a combined PhD/Master degree where she is continuing to research this topic. In this interview Kate discusses her research findings and highlights the variability in response to pregnancy loss, the barriers men face to accessing support and some possible paths to improve the response of the health system for grieving parents.

The interview was recorded on location at the conference in what turned out to be a room that was a little noisy - there is a slight hum in the background - but it shouldn’t detract from the content of the episode.

Some relevant links:

Heartfelt foundation (photography for grieving families): https://www.heartfelt.org.au/

Sands Australia (miscarriage, stillbirth and neonatal death support) 24 hour support line: 1300 072 637

Sands men's support line appointments: https://www.sands.org.au/male-parent-supporters

Bears of Hope 24 hour grief support line: 1300 11 HOPE

Red Nose grief and loss 24 hour support line: 1300 308 307

Miracle Babies 24 hour NurtureLine for families with a baby currently in the NICU/SCN: 1300 622 243

Pillars of Strength (Australian-first organisation supporting bereaved dads to stillbirth, neonatal death and infant loss): http://pillarsofstrength.com.au/

Pink Elephants Support - they focus on infertility and miscarriage specifically. They are also rolling out a service called Fertility in the Workplace, encouraging organisations to better support staff RTW post loss. They also offer peer support.  https://pinkelephantssupport.com/

For psychologists looking to do CPD there is a conference coming up in Melbourne in October 2019. Hosted by the centre for perinatal psychology. https://www.centreforperinatalpsychology.com.au/perinatal-loss-conference/?fbclid=IwAR33xyaalPdw535qvcbz994JBJexZ0NJX79qZTPaGmd3lcwHaTqYje4kUs0

Kate’s research:

Australian men's experiences of support following pregnancy loss: A qualitative study https://www.midwiferyjournal.com/article/S0266-6138(18)30343-7/fulltext

Australian heterosexual women’s experiences of healthcare provision following a pregnancy loss https://www.sciencedirect.com/science/article/pii/S1871519217301142?via%3Dihub

Media articles about Kate’s research and supporting scholarship: 

https://rubyconnection.com.au/insights/social-responsibility/pregnancy-loss-understanding-the-whole-familys-grief.aspx

https://familyincluded.com/category/pregnancy-loss/

Research profile : https://researchers.adelaide.edu.au/profile/kate.obst

Hunter on location at the APS Health Psych conference (in the noisy IT room) with Kate Obst

Hunter on location at the APS Health Psych conference (in the noisy IT room) with Kate Obst

43 - Self-forgiveness as a therapeutic strategy - with Dr Grant Dewar

43 - This week Hunter brings you an interview whilst on location at the Health Psychology conference in Adelaide. He interviews Dr Grant Dewar who use self-forgiveness as a therapeutic strategy in particular using it to lessen the impacts of adverse traumatic events that have occurred earlier in our lives. His approach has its roots in ACT (acceptance and commitment therapy) and is easy to understand. Grant has conducted a number of studies into this approach and uses it in his clinical practice. This should be of interest to therapists and also to people who are struggling with the effects that trauma and other negative experiences.

Research:

https://www.adelaide.edu.au/directory/grant.dewar#

Other links:

http://www.vitallivingpsychologyservices.com

https://www.facebook.com/Grant.M.Dewar

https://www.facebook.com/vitallivingpsychology/

Tim Gordon on youtube:

https://www.youtube.com/playlist?list=PL-QVJ0oJH-XNvMb9wOjRZZ7OHsxB-yKC-

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42 - What makes us laugh? The psychology of humour

This week, Two Shrinks tackle humour. Hunter and Amy agree with toddlers that wearing underpants on your head is indeed hilarious, snort over funny words and discuss the role of feedback in enjoyment of cartoons. We also chat about the role of humour in therapy - where can it help and when does it go too far? As always, we wrap up with things we came across. Hunter justifies his recent earworm and reads a perfectly ‘p’ preoccupied proposal to the APA before Amy finishes up with the tragedy of rabbit auricular amputation.

Hunter’s articles:

What makes some words funny?

Humour and psychotherapy


Amy’s articles:

Toddler humour production

Facial feedback and enjoyment in children with autism

TWCA:

Positive and negative earworms

Auricular amputations in rabbits

A perfectionistic proposal to the APA

41 - Harry Potter & the Pathological Personalities

41 – Ever wondered what Voldermort’s attachment style is? Does Bellatrix Le Strange meet criteria for Borderline Personality Disorder? What about Snape? Is his behaviour schizoid, obsessive or best explained by complex grief?

If you are a fan of Harry Potter then this is the Two Shrinks Pod episode for you. In this episode Amy and Hunter go through each of the ten personality disorders discussed in the personality disorder series last year and discuss which characters from J.K. Rowling’s Harry Potter books could have personality disorders. They also discuss possible differential diagnoses and ponder the use of words starting with P in the DSM-5 diagnostic categories. For a bit of fun Hunter gives Amy the Two Shrinks equivalent of her O.W.L.s, quizzing her on her Harry Potter knowledge at the end of each personality cluster.

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40 - You can't ask a psychologist that

40 - Are you psychologising me right now? Do you think about me when I’m not here? Can I be the only one that sees you next time? Do you think I’m crazy? Why would I come and see if you if you’ve never had this problem? My kid has the problem so why are you telling me I need to change? How do you cope with everything I tell you? Should I leave my partner/job? Where do you live and can I touch your hair?

Yep - these are some of the questions psychologists get every day - so we decided to run through these and talk about how we respond to them and why. This is the ep for anyone who is super curious about psychologists and why we act the way we do - it should also be good for other psychologists to know they aren’t crazy and their experiences are normal (also see question four). For this episode we got Liz Daff (from the forensic episode) to join us in this discussion to give us an additional perspective on these questions.

We finish off with “Pods We Came Across” - pods we’ve been listening to this year.

Liz: Malcolm Gladwell’s Revisionist History http://revisionisthistory.com/

Hunter: Trumpcast with the wonderful Virginia Heffernan http://www.slate.com/articles/podcasts/trumpcast.html

Amy: Susan Calman’s Mrs Brightside - https://www.bbc.co.uk/programmes/p0683q6p/episodes/downloads

39 - Improving the performance of professional athletes. Sports psychology and mental conditioning with Michael Inglis

39 - Ever wondered how athletes improve their mental game and stop cracking under pressure? Or would you like to know how you could improve your own performance in sport (or anything else)? Then this is the episode for you. Hunter chats to Michael Inglis, sports psychologist and co-founder of The Mind Room https://themindroom.com.au/ about a mental conditioning program he runs for athletes. Michael has worked with professional athletes from many different sports including AFL, rugby, soccer and cycling and has a wealth of experience. The episode wraps with a food orientated Things We Came Across discussion of being “hangry” and orthorexia.

TWCA:

Feeling Hangry : https://www.ncbi.nlm.nih.gov/pubmed/29888934

Orthorexia : https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia

38 - Social Stigma and Welfare with Dr Timothy Schofield

For the final interview of psychology week, Amy talks to Dr Timothy Schofield, research fellow at Melbourne University. They chat about Tim’s research into the stigma associated with welfare benefits, what makes a group vulnerable to stigma and the challenges of a research career. We wrap up with a Things We Came Across that soothes Amy’s doubts and riles up Tim with references to embodied cognition.

TWCA:

Bitter preference and psychopathy - https://www.ncbi.nlm.nih.gov/pubmed/26431683

37 - Neuroscience of Social Anxiety - with Laura Finlayson-Short

In our next interview for psychology week, Amy chats with Laura, a PhD candidate who’s researching the parts of our brains that are active in social anxiety. We talk about what happens when we think about ourselves and others at the same time, how they might be skewed in social anxiety and what it’s like being a PhD candidate.

36 - Psychological treatment of chronic pain - with Dr Kathleen Leach

36 - for the second psychology week 2018 interview Hunter talks to Dr Kathleen Leach about chronic pain and the role psychologists play in the treatment and management of chronic pain. Kathleen has extensive experience working with patients who have chronic pain. Our usual experience of pain is that pain means damage but this is not the case in chronic pain which is different to acute pain. Some of the topics covered include the risk factors for developing chronic pain as well as why the best practice treatment of chronic pain is done with team of a physiotherapist, occupational therapist and psychologist, in additional to medical staff. Kathleen talks about some of the psychological approaches to help patients improve quality of life and management of their pain, such as countering unhelpful boom/bust cycles.

Things we came across

Teaspoons : https://www.bmj.com/content/331/7531/1498

35 - How to get better sleep - with Dr Lyndel Shand

35 - Want to know how to get better sleep? Then have a listen to this episode which is our first in the series of interviews for psychology week 2018. Hunter talks to Dr Lyndel Shand on how to get better sleep, they talk the ins and outs of sleep hygiene, why it is important to understand sleep cycles and stages of sleep if you are to improve sleep. As sleep problems can mean different things to different people they then talk through several cases examples exploring how psychologists (and you can) resolve sleeping issues. Topics include struggling to get to sleep, struggling to get back to sleep after waking, not going to bed, and hyper-somnia.

Hunter and Lyndel finish up with segment Things We Came Across, discussing the important topics of whether knuckle cracking does give arthritis, and the correlates of binge watching television.

Things We Came Across

Hunter: https://www.ncbi.nlm.nih.gov/pubmed/9588755

Lyndel: Binge watching research https://www.ncbi.nlm.nih.gov/pubmed/27106091

Psychology Week 2018 - Preview

Psychology Week 2018 and 2SP is having a podathon! We have conducted four interviews and we will release one each day this week.

Topics:

  • How to get better sleep - with Dr Lyndel Shand. Hunter and Lyndel talk about understanding sleep cycles and then discuss several case examples (trouble getting to sleep, trouble getting back to sleep etc) to illustrate different problems and how psychologists work to overcome them

  • Psychological treatment of chronic pain - with Dr Kathleen Leach - Hunter interviews Kathleen who has extensive experience working with people with chronic pain. They discuss the role of psychology in the treatment of chronic pain and how psychologists work in to improve the lives of chronic pain patients.

  • Neuroscience of Social Anxiety - with Laura Finlayson-Short - Amy has a great chat with Laura, who is a psychology PhD candidate about what our brains do when we are socially anxious, and discuss what it is like being a PhD candidate.

  • Understanding Stigma - with Dr Timothy Schofield - Amy talks to Tim who is a research fellow about his work on understanding stigma towards the self and others (eg. towards those on welfare payments), and have a candid discussion about what it is like working as an academic.

For each we also got our guests to join in on the Things We Came Across section - with interesting results.

Stay tuned.

34 - Obsessive Compulsive Personality Disorder - Ordered, Controlled, Anally Retentive

Know someone who likes to have things neat and tidy, sticks rigidly to the rules and appears tightly wound? This week we’re talking about the characteristics of Obsessive Compulsive Personality Disorder. In the last of our personality disorders series, we cover diagnosis, theory and treatment of this PD. We attempt to avoid self-diagnosis (Hunter), outwardly reject prior misdiagnosis (Amy) and barely refrain from diagnosing the entire psychology profession with OCPD. Wrapping up the show, Hunter talks about medical journal articles from the 1800s and Amy ponders if she’s got what it takes to survive an apocalypse.

Resources
Personality Disorders in Modern Life, 2nd Edn. Millon & colleagues
Diagnostic and Statistical Manual of Mental Disorders, 5th Edn (DSM-5)

Things we came across

Hunter:
Maladies of the 1800s : https://www.ncbi.nlm.nih.gov/pubmed/?term=%22Edinb%20Med%20Surg%20J%22%5Bjour%5D

Amy:
Alie Ward’s Ologies : https://itunes.apple.com/au/podcast/somnology-sleep-part-2-with-dr-w-chris-winter/id1278815517?i=1000422378279&mt=2

Are survivalists malevolent? https://www.sciencedirect.com/science/article/pii/S0191886918301223

33 - Dependent Personality Disorder - "Please look after me"

Pod 33 - The penultimate episode of our personality disorder series takes a look at Dependent Personality Disorder - when someone has an excessive need to be taken care of, is submissive, clingy and fears separation. Whilst it is a rare PD (<1%) all of us have dependent elements and Amy and Hunter also compare it to some of the other personality disorders discussed in the previous pods. There is, as usual, good discussion about different theories to explain this disorder (hear Hunter get frustrated about psycho-dynamic theories) and finishes up with talking about how to do therapy to address the problems of this disorder. For TWCA Hunter spends a moment talking about Dr Christine Blasey Ford and her research, then pivots to discussing what your resume photo really tells others, whilst Amy succumbs to more research about the tv show Survivor (hey we have a brand and we are sticking to it).

Dependent Personality Disorder

https://en.wikipedia.org/wiki/Dependent_personality_disorder

Personality Disorders in Modern Life, 2nd Edn. Millon & colleagues (copies of pdfs of this can be found for free online if you know where to look)
Diagnostic and Statistical Manual of Mental Disorders, 5th Edn (DSM-5)

Things We Came Across

(Hunter) Dr Ford https://en.wikipedia.org/wiki/Christine_Blasey_Ford
Resume photos: https://www.sciencedirect.com/science/article/pii/S0191886916309023

(Amy) Survivor - chapter “Do you know who your friends are? An analysis of voting patterns and alliances in the reality tv show Survivor in : https://books.google.com.au/books/about/Reality_Television.html?id=mFVHXwAACAAJ&source=kp_book_description&redir_esc=y

32 - Avoidant Personality Disorder - Sensitive, Vigilant and Socially Anxious

This week, Two Shrinks is leaving behind cluster B personality disorders and launching into cluster C, taking a long look at Avoidant Personality Disorder. We’ll chat about the people who seem shy, quiet and invisible, hanging out on the the fringes of social interactions. Continuing our PD series, we’ll take you through diagnosis, theories and treatment. As always, we wrap up with things we came across - Hunter discloses he has been binging on a Survivor podcast (Oz survivor). and ponders the effects of watching reality tv on aggression? Then they discloses Are Amy’s phantom vibrations normal?


Join us next time for Dependent PD!

Avoidant PD material from:
Personality Disorders in Modern Life, 2nd Edn. Millon & colleagues
Diagnostic and Statistical Manual of Mental Disorders, 5th Edn (DSM-5)

Things we came across:

Oz Survivor podcast - http://australiansurvivor.libsyn.com/website
Post-reality tv watching aggression - http://psycnet.apa.org/record/2014-33476-001
Phantom vibrations - https://www.sciencedirect.com/science/article/pii/S0747563212000799

31 - Forensic psychology with Liz Daff : working in prisons, working with anti-social personality disorder and psychopathy.

31 - Finishing up our mini-series on Anti-Social Personality Disorder and psychopaths we thought we’d talk to our colleague Liz Daff about working as a forensic psychologist. That is, a psychologist who works in prisons or forensic settings with people convicted of crimes or about to go to trial. This interview was so interesting and gripping. It is for anyone fascinated by crime shows (Midsomers Murders anyone?) or wondered what it’d be like to work with someone convicted of a serious crime. Liz is completing her clinical and forensic training through Swinburne University and gives a great description of some of the challenges working in this area.

We of course finish of with ‘Things we came across’ which Liz joins us for, with a discussion on the lack of evidence base for parachutes, Amy talks about anti social personality disorder and Survivor (the tv show), Hunter meanwhile talks about the psychological processes behind why his honey, lemon, cloves and ginger drink helps with head colds (ie. the placebo effect).

Links:

Survivor (Amy) : https://www.tandfonline.com/doi/abs/10.1080/15205436.2011.567346

Parachutes (Liz) : https://www.bmj.com/content/327/7429/1459

Placebo effect (Hunter) : https://www.sciencedirect.com/science/article/pii/S0191886917304191

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30 - More about psychopaths. Children with psychopathic traits, successful people who have psychopathic traits, & treatment of psychopathy

This episode we decided to continue on from pod 29 and chat more about psychopathy. Amy takes us through a discussion of how psychopathy does and does not manifest itself in children and adolescent. Spoiler – it does and doesn’t.


Hunter then talks (at length) about ‘successful’ or non-incarcerated psychopaths, think nasty politicians, corporate CEO, that kind of thing. 

At about 47 minutes we jump to a discussion about treatment of psychopaths and anti-social personality disorder which is really interesting.

For TWCA Hunter ponders the number of Subway stores by country and talks about white-coat hypertension, whilst Amy finds comfort in knowing chimps fake laugh to improve social standing.

References:

The Handbook of Psychopathy – Christopher J. Patrick (Ed).
Psychopathy in children - http://psycnet.apa.org/record/2006-01001-020

Succcessful psychopaths - http://psycnet.apa.org/record/2006-01001-023

 

TWCA

Subway stores: https://www.subway.com/en-US/ExploreOurWorld

White coat hypertension and personality: https://www.ncbi.nlm.nih.gov/pubmed/25186529

Aping expressions : https://www.ncbi.nlm.nih.gov/pubmed/21355640