“If you were to look at me you’d see a single person…but when we look in the mirror we see us, fragmented identities living in the same body”
Carol Broad (via Caitlyn)

This episode Two Shrinks take a look at Dissociative Identity Disorder (Multiple Personality Disorder) and what it can be like living life with a fragmented sense of self. Join us for a chat about how it’s shown in media vs the diagnosable symptoms, the structure of hosts and alters and, how treatment can begin. We also squeeze in a crash course on dissociation and some recent research on distinguishing those with DID from those feigning it using a memory task. As always we wrap up with TWCA where Hunter laments the perils of daylight saving and Amy rationalises her foggy cognition when hungover

Sources:

Above quote from chapter 8 of Living with the reality of Dissociative Identity Disorders, edited by Lady Xenia Bowlby https://books.google.com.au/books/about/Living_with_the_Reality_of_Dissociative.html?id=uO9gBAAAQBAJ&redir_esc=y

United States of Tara https://www.sho.com/united-states-of-tara

Fight Club https://www.foxmovies.com/movies/fight-club

Diagnostic and statistical manual of mental disorders, 5th edition https://www.psychiatry.org/psychiatrists/practice/dsm

Case study https://journals.sagepub.com/doi/abs/10.1177/1078390317705448?journalCode=japa

Dissociation https://www.researchgate.net/publication/319914410_Dissociation_as_a_Trauma-Related_Phenomenon

An interview with Steven Porges about Polyvagal theory - fight, flight, freeze & flop http://www.hartfocus.nl/UserFiles/Nexus%20interview.pdf

Attachment, Trauma and Multiplicity https://www.crcpress.com/Attachment-Trauma-and-Multiplicity-Working-with-Dissociative-Identity/Sinason/p/book/9780415195560

Understanding and Treating Dissociative Identity Disorder https://psycnet.apa.org/record/2012-24057-000

Understanding and Treating Dissociative Identity Disorder: A Relational Approach https://psycnet.apa.org/record/2010-10294-000

Detecting DID with memory testing https://www.researchgate.net/publication/327639745_Detecting_Clinical_and_Simulated_Dissociative_Identity_Disorder_With_the_Test_of_Memory_Malingering

Measuring fragmentation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880957/

Things We Came Across:

Daylight saving and workplace injuries https://www.apa.org/pubs/journals/releases/apl9451317.pdf

Impacts of a hangover on mood and cognition https://www.researchgate.net/publication/333807036_Cognitive_performance_and_mood_after_a_normal_night_of_drinking_A_naturalistic_alcohol_hangover_study_in_a_non-student_sample

Head over to the School of Movies podcast feed to hear Amy and Hunter discuss, dissect and devour the psychological themes of control, trauma and attachment in the movie Zombieland. It is a black comedy action film about the Zombie apocalypse and is one of 2SP favs. Amy and Hunter were on the School of Movies earlier this year discussing the Pixar film Inside Out and fortunately were asked back. What better psychological topic to choose than discussing how people cope with the end of the world.

School of Movies

Podbean:

https://schoolofmovies.podbean.com/e/zombieland-1571387338/

Apple:

https://podcasts.apple.com/au/podcast/school-of-movies/id388751599?i=1000453964295

Twitter : @schoolofmovies

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 [email protected]

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/

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/

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

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 - 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

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-

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 – 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.