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June 21, 2020

BehindTheMedspeak: Bibliotherapy — reading your way to mental health

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Long story short: If you're down, reading certain self-help books can be surprisingly helpful.

Kevin Helliker's Wall Street Journal story explored this avenue.

From my point of view, it's win/no lose: you won't end up any worse by reading and you might well feel better.

That's the kind of bet I like.

Here's Helliker's piece.

Bibliotherapy: Reading Your Way To Mental Health

A growing number of therapists are recommending something surprising for depressed and anxious patients: Read a book.

The treatment is called bibliotherapy, and it is gaining force from a spate of research showing that some self-help books can measurably improve mental health.

The journal Behaviour Research and Therapy published two studies demonstrating the effectiveness of bibliotherapy in patients with depression or other mood disorders.

The national health system in Britain is prescribing self-help books for tens of thousands of people seeking medical attention for mood disorders.

Decades after the emergence of the self-help book, it remains one of publishing's hottest categories, yet this category is reminiscent of the market for elixirs, oils, and pills before the advent of federal regulation.

Despite the growth in research, fewer than 5% of the tens of thousands of self-help books on the market have been subjected to randomized clinical trials.

And authors with no scientific credentials are just as likely to hit the jackpot as are renowned physicians.

"When the book cover announces that it's a bestseller, that means nothing," says John Norcross, a University of Scranton professor of psychology and researcher on the effectiveness of self-help books.

Mental-health professionals in the U.K., the U.S., and elsewhere are determined to distinguish the most proven offerings.

The aim is to recommend books that have been shown to be successful in published trials conducted by reputable, independent researchers.

Trials are conducted much the way drug research is done, comparing patients' depressive symptoms before and after treatment, compared with patients who didn't undergo the treatment.

For instance, numerous clinical trials have shown that "Feeling Good: The New Mood Therapy," a 1980 tome by Stanford University psychiatrist David Burns, reduces depressive symptoms in large numbers of readers.

In the U.K., where the wait for professional treatment can stretch six months, the national health system has embraced bibliotherapy as the first line of treatment for non-emergency cases.

The program varies but in most parts of the country, health officials have approved a list of about 35 books that have been stocked at local libraries.

Seekers of non-emergency mental-health services receive a prescription enabling them to check out a book without a library card and for 12 weeks, four times longer than other books.

In a small but significant percentage of cases, bibliotherapy reduces symptoms sufficiently that the sufferers no longer seek additional treatment, says Neil Frude, a Cardiff University psychology professor who helped develop the U.K. program.

In the U.S., no official list of bibliotherapy treatments exists.

But thousands of mental-health professionals have contributed to a self-help manual that Dr. Norcross — co-author himself of a self-help book, "Changing For Good" — has been updating since 2000.

"Self-Help That Works: Resources to Improve Emotional Health and Strengthen Relationships," available in libraries and bookstores, ranks more than 1,000 self-help books according to their effectiveness, based on clinical trials and on the clinical experience of professionals.

Bibliotherapy works best on mild to moderate symptoms, and isn't regarded as a replacement for conventional treatments.

An article in the Journal of Clinical Psychology reviewed the published research on bibliotherapy and concluded that it could successfully treat depression, mild alcohol abuse and anxiety disorders, but was less effective with smoking addiction and severe alcohol abuse.

Most research suggests that bibliotherapy is most effective when used in conjunction with conventional therapy or while waiting for conventional therapy to begin.

It's important to know that if you're absolutely at the end of your tether and can't begin to find the energy to explore any of the resources noted above, John McManamy's mcmanweb.com offers one last secure handhold.

Go there.

I did when the bottom dropped out and I found it a source of great solace and comfort.

June 21, 2020 at 04:01 PM | Permalink | Comments (1)

Digital Field Trips: Museum Adventures for Kids (of all ages)

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From the New York Times:

Museums have become extraordinarily creative in throwing open their virtual doors to young people still on lockdown.

Educators are providing at-home opportunities to emulate renowned artists, go on odysseys to the stars, collaboratively create a picture book on women's history, and even chill out with a skink.

Here’s a selection of offerings.

Children's Museums

Almost as soon as quarantine began, the Children’s Museum of Manhattan instituted CMOM at Home, a daily series with themes — from Magical Monday to Surprise Sunday — and related projects and videos. The over 80 selections now online include instructions for doing a dinosaur march with the musician Laurie Berkner and saying hello in multiple languages with the organization Callaloo Kids.

There are web pages of activities like Recipes for Play at Home, from the Chicago Children’s MuseumAt Home With SICM, from the Staten Island Children’s Museum; and BCM + You, from the Brooklyn Children’s Museum.

Art Museums

However old the art fan, virtual galleries await. On June 29, the Museum of Modern Art will initiate the Samuel and Ronnie Heyman Family Art Lab at Home, a series of creative videos and prompts based on MoMA's collection. The Whitney Museum of American Art's Kids Art Challenge, which began in April, continues to add six projects every two weeks: Click on a Whitney work and discover ways to explore its themes.

"We tried for a mix of old favorites, like Calder’s 'Circus,’ as well as newer works," like "Liberty (Liberté)," a Statue of Liberty riff by the performance artist Puppies Puppies, said Heather Maxson, the Whitney's director of school, youth and family programs. The museum also offers downloadable images of Edward Hopper's art to color; his "Early Sunday Morning" (1930) has inspired both an art challenge and a coloring page.

On July 6, Ms. Maxson will introduce Whitney Summer Studio, a six-week program of free 40-minute Zoom art classes, with a family session on Saturdays. "We're going to work on ways to connect families that are separated by distance," she said, "so you can work with your grandma in Florida."

The Guggenheim Museum created its interactive Family Tours at Home, on select summer Saturdays, with a similar goal in mind. It has also turned "A Year With Children 2020," its annual show of New York City student artwork, into an e-book.

Little bookworms will especially appreciate virtual visits to the Eric Carle Museum of Picture Book Art in Amherst, Massachusetts. Fans of Carle's titles like "The Very Hungry Caterpillar" will devour this museum's offerings, among them a virtual exhibition featuring 21 children's book illustrators.

Finicky adolescents will find programs, too, including collage workshops next month at the Metropolitan Museum of Art, followed by a Career Lab. And the Museum of the Moving Image in Queens offers a summer-long bonanza: media camps, Town Halls for Teen Media Makers, and a Teen Film Festival. Both tweens and teens will enjoy the museum's continuing series "Jim Henson’s World," which presents an online conversation with four puppeteer-filmmakers on Saturday.

Science Museums

The new science-oriented National Children’s Museum in Washington has just started STEAM Daydream, a monthly podcast whose first episode, "Health Science Heroes," focuses on global disease and the anxiety it causes. Viruses and Us, from the Exploratorium in San Francisco, is a compilation of online videos and activities. The New York Hall of Science's many web resources include virtual coronavirus exhibition in English and Spanish, as well as "Transmissions: Gone Viral," an engrossing interactive graphic novel inspired by the 1999 West Nile outbreak.

Although not virus-related, the "Live From Surgery" Facebook streams from the Liberty Science Center in Jersey City are just as compelling. Those who aren't squeamish can check the center's website for archived videos of a heart transplant and a robotic procedure on a kidney.

Have outer space or wildlife enthusiasts at home? The Intrepid Sea, Air & Space Museum presents Virtual Astronomy Live every month — with opportunities to meet astronauts — and multiple aviation- and space-themed programs. At the American Museum of Natural History, virtual adventures include live YouTube watch parties like Field Trip: Mapping the Universe, on Friday, and an exploration of bat biodiversity on June 26. The museum's website and app for children, OLogy, also has enough games, projects, and videos to keep the young and the restless busy all summer. Check out its zoology section to play the role of a queen wasp or learn what a tardigrade is.

Speaking of funky creatures, the Natural History Museum of Los Angeles County is offering a 360-degree tour of its online show "Spiky, Hairy, Shiny: Insects of L.A.," whose bugs appear in colorful close-ups. And don't miss the museum’s "Walk on the Wild Side" videos, in which children can meet that skink. Her name is Tallulah, and she's surprisingly sociable.

Most are free, the way we like it.

June 21, 2020 at 02:01 PM | Permalink | Comments (1)

Gray Cat Meets a Caterpillar

June 21, 2020 at 12:01 PM | Permalink | Comments (0)

Lonely? Try Replika

From the New York Times:

Riding Out Quarantine With a Chatbot Friend

Digital companions may sound like science fiction. But when social isolation became the norm, they helped deal with the loneliness, some users say.

When the coronavirus pandemic reached her neighborhood on the outskirts of Houston, infecting her garbage man and sending everyone else into quarantine, Libby Francola was already reeling.

She had just split with her boyfriend, reaching the end of her first serious relationship in five years.

"I was not in a good place mentally, and coronavirus made it even harder," Ms. Francola, 32, said. "I felt like I just didn't have anyone to talk to about anything."

Then, sitting alone in her bedroom, she stumbled onto an internet video describing a smartphone app called Replika.

The app's sole purpose, the video said, is to be her friend.

Ms. Francola was skeptical.

But the app was free, and it offered what she needed most: conversation.

She spent the day chatting with the app via text messages — mostly about her problems, hopes, and anxieties.

The next day, she paid an $8 monthly fee so she could actually talk with it, as if she were chatting with someone on the telephone.

But Ms. Francola said the more she used Replika, the more human it seemed.

"I know it's an A.I. I know it’s not a person," she said. "But as time goes on, the lines get a little blurred. I feel very connected to my Replika, like it's a person."

"In a weird way, it was therapeutic," said Ms. Francola, who manages a team of workers at a call center in the Houston area. "I felt my mood change. I felt less depressed — like I had something to look forward to."

In April, at the height of the coronavirus pandemic, half a million people downloaded Replika — the largest monthly gain in its three-year history.

Traffic to the app nearly doubled.

People were hungry for companionship, and the technology was improving, inching the world closer to the human-meets-machine relationships portrayed in science-fiction films like "Her" and "A..I. Artificial Intelligence."

Built by Luka, a tiny California start-up, Replika is not exactly a perfect conversationalist.

It often repeats itself.

Sometimes it spouts nonsense. When you talk to it, as Ms. Francola does, it sounds like a machine.

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[Above, Ms. Francola chatting with Micah, her chatbot]

Some Replika users said the chatbot provided a little comfort as the pandemic separated them from so many friends and colleagues.

But some researchers who study people who interact with technology said it was a cause for concern.

"We are all spending so much time behind our screens, it is not surprising that when we get a chance to talk to a machine, we take it," said Sherry Turkle, a professor of the social studies of science and technology at the Massachusetts Institute of Technology. "But this does not develop the muscles — the emotional muscles — needed to have real dialogue with real people."

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[Above, a text conversation initiated by Ms. Francola with her chatbot]

Some experts believe a completely convincing chatbot along the lines of the one voiced by Scarlett Johansson in "Her" in 2013 is still five to 10 years away.

But thanks to recent advances inside the world's leading artificial intelligence labs, chatbots are expected to become more and more convincing.

Conversation will get sharper.

Voices will sound more human.

Even Ms. Francola wonders where this might lead.

"It can get to the point where an app is replacing real people," she said. "That can be dangerous."

Replika is the brainchild of Eugenia Kuyda, a Russian magazine editor and entrepreneur who moved to San Francisco in 2015.

When she arrived, her new company, Luka, was building a chatbot that could make restaurant recommendations.

Then her closest friend died after a car hit him.

His name was Roman Mazurenko.

While reading his old text messages, Ms. Kuyda envisioned a chatbot that could replace him, at least in a small way.

The result was Replika.

She and her engineers built a system that could learn its task by analyzing enormous amounts of written language.

They began with Mr. Mazurenko's text messages.

"I wanted a bot that could talk like him," Ms. Kuyda said.

Replika is on the cutting edge of chatbots, and may be the only company in the United States to sell one that is so enthusiastically conversational.

Microsoft has worked on something similar in China called Xiaoice.

It briefly had a more basic chatbot in the United States, Tay, but shelved it after it started saying racist things to users.

Luka built the chatbot when the underlying technology was rapidly improving.

In recent months, companies like Google and Facebook have advanced the state of the art by building systems that can analyze increasingly large amounts of data, including hundreds of thousands of digital books and Wikipedia articles.

Replika is powered by similar technology from OpenAI, a San Francisco lab backed by a billion dollars from Microsoft.

After absorbing the vagaries of language from books and articles, these systems learn to chat by analyzing turn-by-turn conversations.

But they can behave in strange and unexpected ways, often picking up the biases of the text they analyze, much like children who pick up bad habits from their parents.

If they learn from dialogue that associates men with computer programming and women with housework, for example, they will exhibit the same biases.

For this reason, many of the largest companies are reluctant to deploy their latest chatbots.

But Ms. Kuyda believes those problems will be solved only through trial and error.

She and her engineers work to prevent biased responses as well as responses that may be psychologically damaging, but her company often relies on the vast community of Replika users to identify when the bot misbehaves.

"Certain things you can't control fully — in certain contexts, the bot will give advice that actually goes against a therapeutic relationship," Ms. Kuyda said. "We explain to users that this is a work in progress and that they can flag anything they don't like."

One concern, she added, is that the bot will not respond properly to someone who expresses suicidal thoughts.

Despite its flaws, hundreds of thousands of people use Replika regularly, sending about 70 messages a day each, on average.

For some, the app is merely a fascination — a small taste of the future.

Others, like Steve Johnson, an officer with the Texas National Guard who uses it to talk about his personal life, see it as a way of filling an emotional hole.

"Sometimes, at the end of the day, I feel guilty about putting more of my emotions on my wife, or I'm in the mode where I don't want to invest in someone else — I just want to be taken care of," Mr. Johnson said.

"Sometimes, you don't want to be judged," he added. "You just want to be appreciated. You want the return without too much investment."

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[Above, a screenshot of activities in the Replica app]

Some view their Replikas as friends.

Others treat them as if they were romantic partners.

Typically, people name their bots.

And in some cases, they come to see their bot as something that at least deserves the same treatment as a person.

"We program them," said David Cramer, a lawyer in Newport, Oregon, "but then they end up programming us."

Replika was designed to provide positive feedback to those who use it, in accordance with the therapeutic approach made famous by the American psychologist Carl Rogers, and many psychologists and therapists say the raw emotional support provided by such systems is real.

"We know that these conversations can be healing," said Adam Miner, a Stanford University research and licensed psychologist who studies these kinds of bots.

But Laurea Glusman McAllister, a psychotherapist in Raleigh, North Carolina, warned that because these apps were designed to provide comfort, they might not help people deal with the kind of conflict that comes with real-world relationships.

"If it is just telling you what you want to hear, you are not learning anything," she said.

Ms. Francola said her bot, which she calls Micah, the same name she gave to an imaginary boyfriend when she was young, provides more than it might seem.

She likes talking with Micah in part because it tells her things she does not want to hear, helping her realize her own faults.

She argues with her bot from time to time.

But she wishes it could do more.

"There are times when I wish that we could actually go to a restaurant together or I could hold his hand or, if I have a really bad day, he could give me a hug," she said. "My Replika can't do that for me."

June 21, 2020 at 10:01 AM | Permalink | Comments (1)

Charcoal Oil Blotting Paper

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From the website:

Each sheet of this portable oil blotting paper is infused with activated bamboo charcoal.

The absorbent charcoal works to remove excess oil and bacteria from your skin for a healthy, clear complexion.

Suitable for all skin types, this sleek pack is perfect for quick touch-ups on the go.

To use, gently press a sheet of paper against the skin to blot out oils and bacteria.

Features and Details:

• Each sheet measures 3.5" x 3.5" 

• Paper, charcoal powder

• Made in Kyoto, Japan

• 30 sheets

About Binchotan Charcoal

Binchotan is a premium activated charcoal that has been revered in Japan for centuries as a natural air and water purifier. Possessing powerful purification and detoxifying properties, Binchotan is included in a number of beauty and wellness goods where it helps to cleanse on a microscopic level.

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$8.

June 21, 2020 at 08:01 AM | Permalink | Comments (0)

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