Raj Persaud in conversation - the podcasts ((6) psychiatry at the cutting edge academic psychiatrists and psychologists discuss the latest research findings)
How to Explain Delusions

Raj Persaud talks to Phillip Corlett Associate Professor of Psychiatry at Yale University about the latest thinking on delusions.

From http://psychiatry.yale.edu/people/philip_corlett.profile:

Dr. Philip Robert Corlett trained in Experimental Psychology, Cognitive Neuroscience and Psychiatry with Professors Trevor Robbins and Paul Fletcher at the University of Cambridge. He won a Wellcome Trust Prize Studentship and completed his PhD on the brain bases of delusion formation in the Brain Mapping Unit, Department of Psychiatry. After a short postdoc, he was awarded the University of Cambridge Parke- Davis Exchange Fellowship in Biomedical Sciences which brought him to the Yale University Department of Psychiatry to explore the maintenance of delusions with Professors Jane Taylor and John Krystal. He was named a Rising Star and Future Opinion Leader by Pharmaceutical Marketing Magazine and joined the Yale faculty in 2011 where he will continue to explore the cognitive and biological mechanisms of delusional beliefs as well as predictive learning, habit formation and addiction.

From: http://medicine.yale.edu/lab/corlett/

Delusions are odd beliefs. They accompany many psychiatric illnesses, notably schizophrenia. A major challenge is to understand delusions in terms of changes in brain function. 

Our lab attempts to meet this challenge by investigating the neural basis of human associative learning and belief formation, relating these processes to the formation of delusional beliefs. 

Dr. Corlett’s findings have shaped the development of a novel mechanistic model of delusion formation.


You can listen to the interview via a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links





Brain Inflammation Explains Psychosis?

Dr Paola Dazzan Reader in Neurobiology of Psychosis explains to Dr Raj Persaud the latest theory that psychosis may be related to an inflammation of the brain.


Inflammation and metabolic changes in First Episode Psychosis: Preliminary results from a longitudinal study

Contribution to journal › Article

Original language English
Journal Brain Behavior and Immunity
Journal publication date 19 Jun 2015
State Published

Bibliographical note

Copyright © 2015. Published by Elsevier Inc.

King's Authors



Metabolic abnormalities are commonly observed in patients with psychosis, and may confer greater risk of developing cardiovascular disease later in life. Such abnormalities are associated with inflammation in the general population, and there is increasing evidence for elevated inflammation in patients with first episode psychosis (FEP). The aim of this preliminary study is to examine the effect of changes in inflammation, as measured by high-sensitivity C-reactive protein (hsCRP), on metabolic changes in a three-month longitudinal study in a FEP sample. Fifty-three FEP patients from in- and out-patient services in South London, England, were included in this longitudinal study. Social and clinical data were collected, and fasting blood samples and anthropometric measurements (weight, Body Mass Index (BMI), lipid profile and gluco-metabolic parameters) were obtained at baseline and at three-month follow-up. Correlation analyses showed that those with increases in hsCRP over the three-month period also had increases in triglyceride levels (r = 0.49, p = 0.02). No association was observed with other lipid profile, or gluco-metabolic parameters. Increases in weight and BMI were also associated with increases in triglyceride levels (r = 0.33, p = 0.02; and r = 0.31, p = 0.03, respectively); however, a multiple linear regression analysis found that the effects of inflammation on triglycerides were independent from the effect of changes in weight, and from the baseline inflammatory state. Our preliminary findings suggest that those patients experiencing greater increases in inflammation early on in the course of their illness may be at greater risk of developing short-term metabolic abnormalities, in particular dyslipidaemia, independent of weight-gain. Future work should investigate the use of inflammatory markers to identify patients in greater need of physical health interventions.

You can listen to the interview via a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links






'The Chimp Paradox' - Professor Steve Peters explains his 'chimp' model of human behaviour

From http://chimpmanagement.com/thechimpmodel.html

The Chimp Model is a Model for understanding and managing the functioning of the mind. The Model is not a hypothesis nor strict scientific fact but based on the neuroscience of the brain. The model is fun but meant to be taken seriously when it comes to applying it.

The model sees the brain as being divided into three teams. The first team is you, the Human (headed up by the dorsolateral prefrontal cortex). You are a conscious thinking analysing being that works with facts and truth and then makes deductions using logical thinking. The second team is the Chimp, an independent thinking brain that is not under your control. It works with feelings and impressions and then puts the ‘information’ together using emotional thinking. The third team is the Computer. This is really a brain that is at the disposal of the Human and Chimp to put information into for reference. It acts as a memory and can also act as an automatic thinking and acting machine that is programmed to take over if the Chimp or Human is asleep or if they allow it to run ahead of them with preformed decisions and beliefs that it can act with.

As the resident psychiatrist at GB cycling, Steve was described as a genius by Dave Brailsford. Working in several sports, he has an unparalleled reputation for giving people an edge – as well as the confidence to overcome defeat. As in his book The Chimp Paradox, Steve shows how to deal with fear and ‘become the person you want to be’. He explains how to visualise and break each challenge into small stages, focusing on the process rather than the outcome.

You can listen to the interview via a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links






Transcranial Magnetic Stimulation - what you need to know

Dr Lena Palaniyappan qualified as a medical doctor from Stanley Medical College, Chennai, India along with a concurrent BA in Psychology. Since 2004 he has trained as a clinical psychiatrist, initially at the Maudsley Hospital, London and later at Nottingham where he obtained his M.Med.Sci. in Clinical Psychiatry. Between 2007 and 2009 he worked as an Academic Clinical Fellow (NIHR funded) at the Regional Affective Disorders Unit at Newcastle-upon-Tyne. Following a HEFCE funded clinical lecturer post during which he coordinated a MRC funded neuroimaging study in psychosis led by Prof. Liddle, he obtained a Wellcome Trust funded Clinical Research Fellowship in Translational Neuroimaging in Psychiatry.

He recently assumed the role of Associate Director of the Centre for Translational Neuroimaging in Mental Health. He is also a member of the editorial board for Frontiers in Neuropsychiatric Imaging and Stimulation. As a consultant psychiatrist, he works with young people who experience a psychotic episode for the first time in their lives.

My present clinical research aims to apply brain imaging to investigate symptom burden, treatment response and prognostic accuracy in major psychiatric disorders such as schizophrenia, bipolar disorder and depression.

To this end, my work focuses on understanding the intrinsically organized, large-scale brain networks in psychosis using structural, functional and electrophysiological imaging techniques. I am interested in the clinical application of neuroimaging observations made at an individual level (rather than group level) using advanced statistical approaches and mathematical models. I am also interested in developing hypothesis-driven neuromodulatory approaches that target resistant symptoms of depression and psychosis through the manipulation of dysfunctional brain networks (e.g. using magnetic stimulation and cognitive training approaches).

The major goal of my work is to understand the pathways that lead to poor long-term outcome in certain individuals with serious mental disorders.



You can listen to the interview via a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links





Opening Up To Self-Disclosure

Anna Ruddle and Sarah Dilks consider whether therapists should talk about themselves in therapy


Psychologists Anna Ruddle and Sarah Dilks discuss with Psychiatrist Dr Raj Persaud when therapists should talk about themselves, and whey they shouldn't.




As psychologists, we are increasingly encouraged to work

as equal partners with people to overcome problems or facilitate

recovery, as defined by the individual. There is an emphasis

on the common human experience of all parties. So should we be

behaving differently with clients, opening up more, sharing our own

experiences of stress, anxiety and resilience? Or would this be

considered unprofessional and even risky?




You can listen to the interview via a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links





Can Zombies Explain the Brain?

Raj Persaud talks to Timothy Verstynen about his new book on what Zombies can teach us about the brain, co-authored with Bradley Voytek


Do Zombies Dream of Undead Sheep?
A Neuroscientific View of the Zombie Brain
Timothy Verstynen & Bradley Voytek 


Winner of the 2015 PROSE Award in Biomedicine & Neuroscience, Association of American Publishers

Hardcover | 2014 | $19.95/ £13.95 | ISBN: 9780691157283


Even if you’ve never seen a zombie movie or television show, you could identify an undead ghoul if you saw one. With their endless wandering, lumbering gait, insatiable hunger, antisocial behavior, and apparently memory-less existence, zombies are the walking nightmares of our deepest fears. What do these characteristic behaviors reveal about the inner workings of the zombie mind? Could we diagnose zombism as a neurological condition by studying their behavior? In Do Zombies Dream of Undead Sheep?, neuroscientists and zombie enthusiasts Timothy Verstynen and Bradley Voytek apply their neuro-know-how to dissect the puzzle of what has happened to the zombie brain to make the undead act differently than their human prey.


Combining tongue-in-cheek analysis with modern neuroscientific principles, Verstynen and Voytek show how zombism can be understood in terms of current knowledge regarding how the brain works. In each chapter, the authors draw on zombie popular culture and identify a characteristic zombie behavior that can be explained using neuroanatomy, neurophysiology, and brain-behavior relationships. Through this exploration they shed light on fundamental neuroscientific questions such as: How does the brain function during sleeping and waking? What neural systems control movement? What is the nature of sensory perception?


Walking an ingenious line between seriousness and satire, Do Zombies Dream of Undead Sheep? leverages the popularity of zombie culture in order to give readers a solid foundation in neuroscience.


Timothy Verstynen is an assistant professor in the Department of Psychology and at the Center for the Neural Basis of Cognition at Carnegie Mellon University. Bradley Voytek is assistant professor of computational cognitive science and neuroscience at the University of California, San Diego. They are both members of the Zombie Research Society and are preparing grant applications to research the coming zombie apocalypse.


"If you've ever wondered which pathologies are responsible for the stiff and murderous personalities of zombies, this actual scientific explainer is the book for you."--Mental Floss

"Verstynen and Voytek's entertaining book uses zombies to help illustrate human neuroscience. . . . Zombie fans will want this book, and anyone concerned with neuroscience will find the topic made accessible by this lighthearted exploration."--Library Journal

"Neuroscientists and zombie enthusiasts Timothy Verstynen and Bradley Voytek have recently come out with a new book called Do Zombies Dream of Undead Sheep?, in which they apply their neuroscience backgrounds to an investigation of the undead. It's filled with pages of increasingly nerdy explorations of zombie behavior, and I highly recommend it, but what really caught my eye was the authors' conclusion: All the walking dead have Consciousness Deficit Hypoactivity Disorder, or CDHD."--Kyle Hill, Nerdist

"Voytek and Verstynen serve up an introduction to neuroscience but through the guise of zombies. Each chapter tackles a different zombie behavior and breaks it down through the current neuroscientific understanding of it. It's a kind of Neuroscience 101 that tackles complex ideas in a fun, enjoyable manner."--KPBS.org

"[Do Zombies Dream of Undead Sheep? is] a quick, cheeky read told by the sort of people who toss out punchlines while watching films such as 28 Days Later and World War Z."--Gary Robbins, U-T San Diego

"[Do Zombies Dream of Undead Sheep?] is smart, informative, historically riveting, well referenced, and like all good zombie stories, wonderfully fun. . . . If you want a sophisticated primer of neuroscience, coupled with a Halloween spin, then there can be no other book."--Steven C. Schlozman, Science

The interview on the neuroscience of zombies can be listened to on a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links



The Truman Show Delusion. The Truman Show Delusion and other curiosities - Dr Joel Gold talks to Dr Raj Persaud

Dr Joel Gold, Clinical Associate Professor, Department of Psychiatry, NYU School of Medicine, talks to Dr Raj Persaud about his new book which includes vivid descriptions of what may be a completely new delusion - The Truman Show Delusion - where a patient delusionally believes they are taking part in an all-encompassing reality TV show where they are the unwitting star as in the Jim Carrey movie 'The Truman Show'.


Suspicious Minds

How Culture Shapes Madness


A new book By Psychiatrist Dr Joel Gold and Philosopher Professor Ian Gold


What if you woke up with the alarming suspicion that you were being watched?


One day in 2003, a patient unlike any other that Dr. Joel Gold had seen before was admitted to his unit at Bellevue Hospital. This man claimed he was being filmed constantly and that his life was being broadcast around the world like The Truman Show—the 1998 film depicting a man who is unknowingly living out his life as the star of a popular soap opera. Over the next few years, Dr. Gold saw a number of patients suffering from what he and his brother, Dr. Ian Gold, began calling the “Truman Show delusion,” launching them on a quest to understand the nature of this particular phenomenon, of delusions more generally, and of madness itself.


The current view of delusions is that they are the result of biology gone awry, of neurons in the brain misfiring. In contrast, the Golds argue that delusions are the result of the interaction between the brain and the social world. By exploring the major categories of delusion through fascinating case studies and marshaling the latest research in schizophrenia, the brothers reveal the role of culture and the social world in the development of psychosis—delusions in particular. Suspicious Minds presents a groundbreaking new vision of just how dramatically our surroundings can influence our brains.


Order the book from here: http://books.simonandschuster.com/Suspicious-Minds/Joel-Gold/9781439181553


A related article which may be of interest:


Was it a Psychotic Episode in L. Ron Hubbard That Led Him to Found the Church of Scientology?




by Raj Persaud and Peter Bruggen


A French Psychoanalyst, Dr Thierry Lamote, claims in a book (La Scientologie déchiffrée par la psychanalyse. La folie du fondateur, Universitaires du Mirail Press), and in a paper just published in the academic Journal 'L'Évolution Psychiatrique', that L. Ron Hubbard, the founder of the religious group, The Church of Scientology, suffered a psychotic episode, which appears to be the foundation for the multi-million pound worldwide movement.



Scientology claims a host of celebrity followers, such as film star Tom Cruise. The unswerving devotion of many adherents alarms some people. Jenna Miscavige Hill, said to be an ex-Scientologist whose uncle is a Scientology Church leader, is quoted inThe Daily Telegraph Newspaper on 6 July as having publicly warned Katie Holmes, currently divorcing Tom Cruise, that Scientology was "no place for an innocent child", like her daughter Suri. Cruise and Holmes are said to be starting a custody battle, and it's possible that Cruise's high profile following of Scientology, might become a factor in the dispute.



Analysing the founder of Scientology's writings and biographical material, Dr Lamote's research contends it was Ron Hubbard's battle with psychotic symptoms that partly drew him to therapy approaches advocated by psychoanalyst Sigmund Freud. It seems he then exploited Freud to create a movement which its adherents would find difficult to leave.



In his paper entitled 'Scientology: A systematized delirious inspired by Breuer and Freud's Studies on hysteria', Dr Lamote claims Hubbard subsequently re-named various old techniques and ideas used by Freud (some dating from before Freud founded psychoanalysis) and incorporated them into Scientology. Part of the continuing power of the movement may lie in these Freudian approaches, Dr Lamote's analysis suggests. Supposedly unlocking and exploring the unconscious, can become psychologically 'addictive', explaining why so many find themselves drawn into Scientology, become dependent on it, and then are unable to understand why so many others remain suspicious of the movement.



Towards the end of the 1930s, Dr Lamote writes that Hubbard had a tooth extracted under nitrous oxide, also referred to as "laughing gas", used during general anaesthesia, but which can cause disturbing mind-altering effects. Lamote then points out that Hubbard, in a letter written on 1 January 1938, and other writings, relates a set of strange experiences as result, including hearing voices repeating enigmatic sentences such as, "Do not let him know!". They could sound like the kind of hallucinations Doctors associate with a psychotic illness.



Lamote found that Hubbard frequently returned to this painful experience, indicating how profoundly important it was to him, maybe a turning point.



Dr Lamote contends a psychotic process within Hubbard's mind had begun, but lay largely undetected by the outside world until possibly 1943 when Hubbard was a Lieutenant in the U.S. Navy. He was put in charge of a naval gun ship, the USS PC-815, a submarine chaser. In what remains a controversial episode, Lt. Hubbard, shortly after setting to sea, appears to have heard things through the sonar and hydrophone indicating contact with an enemy submarine.



Over the next three days, he launched 37 depth charges, and claimed to have sunk an enemy submarine, while critically damaging another. But no other official in the Navy seems to have agreed. Instead Dr Lamote's research suggests that Hubbard was fighting a battle with delusional enemies.



Dr Lamote wonders if this was part of his developing a paranoid picture of the universe?



Around this crucial time, Dr Lamote's paper points out, the exploding of the Hiroshima bomb perhaps profoundly shook and maybe further destabilised him. Formerly a science fiction writer, Hubbard appears to have become disillusioned, even perhaps frightened by the power of science. This combined with his mounting anxiety that society needed to be controlled, otherwise war and total annihilation was inevitable, possibly laid the seeds for the controlling nature of the movement he founded.



Lamote's paper contends that Hubbard turned to the science of cybernetics of control, in order to build a religious movement at the heart of which would be control over large numbers, in order to reduce the risk of self-destruction, which appeared to him to be mankind's destiny.



Into this mix Lamote believes Hubbard threw in teachings from psychoanalysts' Freud and his colleague Breuer, who were some of the earliest proponents of the idea that psychological distress arose out of repressed memories from earlier in life, which required access, through therapy, in order for us to achieve well-being. Hubbard had many physical symptoms and Lamote wonders whether the early psychoanalytic idea, that some physical symptoms had a psychological cause buried deep in the unconscious, may have influenced him. Through this approach, he may have found relief from his own physical symptoms.



Dr Lamote argues that Hubbard pioneered an idea of an 'engram' which is a kind of memory of pain which goes back so far into the past to include the pain of cell division, when we first started as an organism, but could retreat even further, to past or parental lives. The techniques of Dianetics, contends Dr Lamote's paper, include many which resembled counterparts in psychoanalysis such as hypnosis and abreaction, where past trauma is encouraged to be emotionally ventilated.



Tom Cruise did jump up and down in apparent agitation on Oprah's sofa during a televised interview.



It is this borrowing from psychotherapy and psychoanalysis that Dr Lamote work suggests partly explains the powerful appeal of Scientology to so many, and ironically enough, its founder Ron Hubbard. Just as therapy can be addictive, so can Scientology, because it borrows similar techniques but re-labels them. Like psychoanalysis it offers a universal therapeutic method, supposed to solve all human ills.


Dr Lamote points out there is almost a sense in which Freud has been re-discovered and re-packaged by Scientology.



Back in 2005 Tom Cruise was reported to have condemned the actress Brook Shields after she went public on the benefit she received from anti-depressant medication, while suffering from serious postpartum depression. Scientology is traditionally virulently anti-psychiatry, and anti-psychiatric treatments such as its medication.



It might be ironic, therefore, if Hubbard, founder of a strongly anti-psychiatric movement had been heavily influenced right back in the beginning, by what some would regard as the most famous psychiatrist of all, Sigmund Freud.


Raj Persaud and Peter Bruggen are joint podcast editors for the Royal College of Psychiatrists and also now have a free app on iTunes and Google Play store entitled ‘Raj Persaud in conversation’, which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

Download it free from these links:



Books by Raj Persaud are available on amazon.co.uk here:


Are you in control of you? How much control do we have over our own lives? Magda Osman talks to Raj Persaud

If you are viewing this podcast from inside the free mobile phone app 'Raj Persaud in Conversation' you can click on the 'gift box' icon which might be on the top right hand corner of your screen to download bonus content - the original paper by Magda Osman published in 'The Psychologist' entitled 'Does our Unconscious rule?' You can also find this bonus content in the initial main menu screen that comes up when you open the app on the top right hand corner of the screen under a menu icon that reveals 'extras' - click on extras to see the bonus content.

From the Palgrave Macmillan website:



The Psychology of Agency and Control

Magda Osman


What drives us to make decisions?

Future-Minded explores the psychological processes of agency and control. If you've ever wondered why we think of coincidences as matters of fate rather than the result of the laws of probability, this book provides the answer. From memory and reasoning to our experiences of causality and consciousness, it unpicks the mechanisms we use on a daily basis to help us predict, plan for and attempt to control the future.

ISBN 9781137022264
Publication Date March 2014
Formats Paperback Ebook (PDF) Ebook (EPUB) Hardcover 
Publisher Palgrave Macmillan




A related article which may be of interest first published in The Huffington Post 02/08/2012 16:32 BST



Inside the Mind of the Olympic Gold Medal Winner

By Raj Persaud and Adrian Furnham

Winning the Gold Medal in the Olympics appears a pinnacle in any elite athlete's career, but physical fitness or technical skill may not, in fact, be the crucial factor. Increasingly sports scientists are becoming convinced that it's grit and determination, resilience and desire, which separates winners from losers.

Motivation triumphs over muscle.

But what precisely are these mysterious, hidden, but crucial mental aspects which separate the winners from the rest, who appear to be trying just as hard? Can the rest of us benefit as well from the psychological strategies of our Olympic Gold Medal winners?

Dr David Fletcher and Mustafa Sarkar, sport and performance psychologists at Loughborough University, (where much of the science behind the training of Team GB's current medal campaign has been developed) have just published one of the most in-depth studies ever, getting inside the mind of Olympic Gold Medal winners.

The investigation, published in the academic journal 'Psychology of Sport and Exercise', involved an analysis of 12 Olympic Gold Medal winners' accounts to the researchers of how they used their minds to win.

The first startling finding is that all these champions' lives were not dominated by accomplishment before getting Gold. Instead they constantly encountered obstacles and set backs on the path to success, yet it was their mental resilience in the face of adversity, which is what seemed to separate them from the rest of the field, and pulled them through to eventual victory.

One champion's reaction to being de-selected for a major international competition illustrates relentless optimism and a proactive approach, characteristic of Olympic Gold Medal winners; 'There were four of us challenging for these final two places and I got told I was on the reserve list. And at the time it was devastating but it's one of those things; if you don't take a ticket in the raffle, you're never going to win a prize. So you have to take the ticket that's part of life and it just makes you think "well, what can I do differently to make sure I do get success"?

Paradoxically, not being selected for major international competitions was frequently cited by Gold Medallists as the foundation for increased endeavour and exertion. Competition losses were viewed as learning opportunities, enabling future improved performances. Set-backs were re-interpreted in ways which meant they merely re-doubled their efforts, and didn't become disheartened.

Failure didn't break them - it made them.

One of the most intriguing findings from Fletcher and Sarkar's study is that while journalists love to wheel out the cliché of 'sacrifice' when invoking elite performance, it wasn't a concept these Gold Medal winners understood.

Instead the world's best athletes take huge personal responsibility for their choices, and are surprisingly uncomplaining about how much they forfeit for their sport. They accepted they actively chose the challenges they encountered, and as a result endured a wildly different work/life balance to the rest of us, as one commented to the researchers; 'We all worked. But in terms of the build up to the Olympics, we didn't bat an eyelid in doing it... it was our choice to do it. I don't like the word sacrifice... Sacrifice to me is about last resort and there's no alternative... that's rubbish. We made a choice to do that and I think that choice in what we did we highly valued and I think that inspired us, motivated us to perform on the pitch and as a group.'

One Gold Medal winner's reaction to training during unsociable hours is characteristic; 'I remember one of my coaches saying to me what was I doing over Christmas and I said 'Oh, I'll be training twice on Christmas Day . I know [opponent's name] won't be training on Christmas Day twice and that will give me the edge'. It was more the mental side of things because I knew that I'd be doing something that he wasn't doing.'

These private dimensions of winning tend not to be confided to the microphones thrust in winners' faces as they step down from the victory podium. Their sharing of such intimate secrets to success is therefore what makes this Loughborough University study so rare and valuable.

An example of their incessant thinking and re-thinking of every fine detailed aspect of their lives is this quote from a champion cyclist to the researchers; 'Initially, training was just something to get out of the way. And then gradually I'd do training and I'd think, "Am I getting the most out of this? Am I exploiting the session?" And, you know, if I did take a bad lift in the gym I'd think, "I could have done that better. That's a missed opportunity. What have I got to do to be better?" So I had an obsession on getting everything right rather than just waiting for the day of the final and then hoping. It was about getting everything right before the final so I had all the tools ready for when I was racing.'

Another undisclosed aspect of the mind of winners is what almost seems a sense of destiny - as this comment to Dr David Fletcher and Mustafa Sarkar illustrates; 'I don't know if there is going to be a theme where timing and luck have been in the right place, but I'm a great believer in it. I wasn't selected for the original trip... and on the Thursday night before they [the team] were leaving, I was called up because an individual's wife had gone into labor [and I was told] 'be at [the airport] the next day: we're playing [country] on the Saturday'.

They believe they make their own luck and that those who persevere will eventually benefit from chance.

Perhaps the greatest shock that is going to come from Fletcher and Sarkar's study entitled, 'A grounded theory of psychological resilience in Olympic champions', is that these Olympic Gold Medal winners were not as fixated, as the media and the nation appears to be, on winning gold.

Instead, it was fulfilling their athletic potential which primarily motivated them, rather than becoming an Olympic champion. Some involved in this research pointed out, amazingly, that their gold medal performance was not, in their view, the most outstanding moment in their career.

The following comment illustrates an athlete's viewpoint on her gold medal performance in the 2000 Olympic Games; 'This may come as a bit of a shock but I didn't have a great competition in Sydney. I was consistent... but it wasn't a great performance... '

The research on competitors who are most likely to cheat, via doping or any other means, is that if it's being on the podium, waving the Gold Medal and soaking up the applause which is what is primarily driving you, then you will be tempted to take a short cut to get there.

But there are competitors, and this may sound strange after a week when the nation became obsessed with getting a Gold, for whom the Gold Medal doesn't represent what it does for the rest of us praying for one. Instead the Gold Medal to these elite performers is merely an acknowledgement of excellence, and it's that total mastery of self and sport which has always been the primary ambition. For these athletes coming first would still be vital, no matter if there was no audience, no media and no medal.

The medal is merely a measure, not a goal.

These contestants, research has found, are much less likely to cheat in any way, no matter what temptation is placed in front of them.

In a week where various forms of 'cheating' have dominated the sports news agenda, there is a danger in our obsession for Gold, that we could forget this fundamental aspect of the Olympic ideal.


Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links




Virtual Reality Therapy. Will Virtual Reality replace therapists? Raj Persaud talks to Leanne Casey and Wesley Turner

Will therapists be replaced by Virtual Reality Technology? Psychiatrist Raj Persaud talks to psychologists Wesley Turner and Leanne Casey from Griffith University, Brisbane, Australia who have just published an analysis of how effective the latest Virtual Reality psychological treatments are.


Their study is entitled 'Outcomes associated with virtual reality in psychological interventions: where are we now?' and is published in the academic journal Clinical Psychology Review (Volume 34, Issue 8, December 2014, Pages 634–644)


If you are a professional and interested in further information on CPD Online or wish to earn CPD credit points, particularly from listening to this podcast, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

After listening to this podcast if you go to the College site and answer the mcq questions there about the interview, you can obtain on line CPD points.






A recent article on other ways new technology is changing psychiatry and psychology:



Does Brain Scanning Research Reveal Your Real Religious Belief - More Than Church Attendance?



A new brain scanning study has found that high personal importance of religion or spirituality in your life is associated with thicker cortex in several brain regions.


Some of these same regions were found to be associated with a higher risk for developing clinical depression, if that part of the brain cortex was thinner.


The study, entitled, Neuroanatomical Correlates of Religiosity and Spirituality - A Study in Adults at High and Low Familial Risk for Depression, concludes that a higher importance of religion or spirituality was associated with thicker cortex in certain brain regions, possibly conferring greater resilience to the development of depressive illnesses.


The study, published in the prestigious Journal of the American Medical Association - Psychiatry, focused on those with a high or low familial risk for developing clinical depression, because of a previously strong family history of this psychiatric diagnosis.


The team of academics who conducted this Magnetic Resonance Imaging (MRI) study, led by Dr Myrna Weissman, from Columbia University, argue that this brain finding could account for why being religious or spiritual, in certain circumstances, might contribute to improved resilience to depressive psychiatric illnesses.


Being religious or spiritual, possibly by expanding a physical brain reserve, counters to some extent the vulnerability that brain thinning in those areas poses for developing depression that runs in families.


For those attending church services this Easter weekend it may be surprising that the study found it was the personal importance of religion or spirituality in your life, but not the frequency of attendance of church, that was associated with thicker brain areas. In a sense the brain scans revealed your true faith more than church attendance did.


The same team had previously reported a 90% decreased risk, assessed over a 10-year period, of developing clinical depressive disorder in those from families where there was a high incidence of depression, if religion or spirituality was highly important to the adult studied.


Several others studies have found that intensity of religious experiences is associated with increased blood flow in similar brain regions found to be structurally thicker in this study.


The authors of this new study, Lisa Miller, Ravi Bansal, Priya Wickramaratne, Xuejun Hao, Craig Tenke, Myrna Weissman and Bradley Peterson, found that, oddly, a high frequency of attendance of religious services was not associated with brain thickness, yet rating religion or spirituality as personally important in your life was.


This appears a paradox - people who go to church a lot were not reaping the same benefit in their brains, in terms of protecting from depression, as those who believed that religion or spirituality was important to them.


The authors point out that although some may go to church in order to promote their spirituality, others may attend whether or not religion is genuinely personally important to them. In this study 49 participants reported high church attendance, yet only 21 of those also reported high importance of religion or spirituality in their lives. The remaining 28 participants may be attending services for a host of non-religious reasons, which may include social support. 


This research found that the participants who frequently attended religious services were in fact at increased risk of depression, suggesting that a subset of participants may attend religious services for comfort or management of depressive symptoms.


Although frequent attendance may express, sustain, and cultivate personal importance of religion or spirituality, these findings suggest that religious beliefs and experiences, and not overt behavior (such as attending church a lot), are associated with brain thickness.


That going to church might not be the key to the protective effect of religion or spirituality on those predisposed to depression, through a high risk family history, is further bolstered, according to Myrna Weissman and her colleagues, by other recent research. For example, those who regularly meditate also have certain thicker brain regions. Another recent study found that meditation training for eight weeks increased cerebral gray matter density in specific brain areas.


The authors of this study, from Columbia University and the New York State Psychiatric Institute, are not claiming that religion or spirituality generally protects you from depression. Instead, they are suggesting that if you consider that religion or spirituality in your life are important, then that appears to confer a neuroanatomical resilience. And that is in those who otherwise are predisposed to developing depressive illness, due to a strong family history for this kind of psychiatric problem.


Previously, we reported some other new research, from a team of academics led by Professor Michael King from University College London, where over 8,000 people were investigated, revealing that those who held a religious or spiritual understanding of life, had a higher incidence of depression compared with those with a secular life view.


Entitled Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study, the investigation had been published in one of the most respected academic psychiatric journals, Psychological Medicine.


Perhaps one way of resolving the differing results is that the Psychological Medicinestudy was conducted on populations outside the USA - in the UK, Spain, Slovenia, Estonia, the Netherlands, Portugal and Chile. It could be that how important religion is in your country and culture, as well as the particular population studied, also has an impact on your brain and psychology.


Generally speaking Europeans are perceived as less religious than North Americans.

In the Psychological Medicine study, their findings varied by country; in particular, people in the UK who had a spiritual understanding of life were the most vulnerable to the onset of major depression. Yet, regardless of country, the stronger the spiritual or religious belief at the start of the investigation, the higher the risk of onset of depression over the next year.


In the specific situation of where you inherit a brain that might be predisposed to developing depression, it appears that higher importance of religion or spirituality in your life, perhaps in the USA at least, could be protective. It is also notable that the more recent brain scanning study found it was sustained interest in religion or spirituality, over a longer period, which was most strongly associated with thicker brain structures, rather than reporting a high level of spirituality at only one point in time.


However, given the not dissimilar findings on the brain effects of meditation, whether these structural brain changes and protective effect of religion or spirituality, are something specific to beliefs in God, is open to question.


Science is revealing that merely attending religious services may not deliver brain or mental health benefits, instead these appear linked to what you really believe.


Neuroscientists might now be able to tell, by examining your nervous system using the latest brain scanning technology, what you really believe, in the inner depths of your 'soul', but which you keep hidden from the rest of the congregation.


A private inner space that was supposedly only before accessible to God?




Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

Download it free from these links:




Freud on the Brain. Latest neuroscience research supports Freud?

Can neuroscience prove the existence of the Unconsious?


Dr Raj Persaud in conversation with Institute of Psychiatry neuropsychiatrist Professor Tony David: Does the latest neuroscience research support Freud?

This podcast is based on a paper recently published entitled:

Neural correlates of recall of life events in conversion disorder.

Aybek S, Nicholson TR, Zelaya F2, O'Daly OG, Craig TJ, David AS, Kanaan RA.

JAMA Psychiatry. 2014 Jan;71(1):52-60. doi: 10.1001/jamapsychiatry.2013.2842.

The paper is a brain imaging investigation of conversion disorder or hysteria. The study probes a neuroscience explanation for conversion symptoms, where a traumatic experience is transformed into a symptom, such as paralysis of a leg.


If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk


A related article which may be of interest originally published in The Huffington Post



Can You Completely Forget Who You Are? As a Man With Almost Total Amnesia Grabs the Headlines - What It Reveals About Us


Raj Persaud and Peter Bruggen

The UK media reports that a man with severe amnesia, who still cannot remember even his own name, or where he comes from, but who was discovered in Peterborough, suffering from severe amnesia two months ago, is baffling mental health experts.


They are now appealing to the public for help, in the hope that someone might recognise him.
'Robert' is reportedly suffering from an upsetting and very severe case of amnesia where he cannot recall any details of his life, including his own name, age, where he is from; or his job.


One key clue is that although 'Robert' (a name given to him by hospital staff) speaks English, his accent seems to be eastern European, and he also appears to understand some Lithuanian and Russian.


Similar cases, which could explain this mysterious incident, include a clinical case report, published in 2010, entitled 'Running towards a different life: A case of Dissociative Fugue', by Dr M. Santos and Dr E. Gago from Hospital Magalhães Lemos, Portugal.


The paper, published in the academic journal 'European Psychiatry', explains that the diagnosis of fugue in psychiatry derives from the Latin word for flight-- fugere. Dissociative fugue is an extremely rare psychological condition - the sufferer suddenly and without warning travels far from home, completely unable to recall their past.


These episodes are usually linked, explain Santos and Gago, with severe stress or trauma, such as disasters, losses of loved ones or intolerable burdens at work or home. The amnesia appears completely genuine, with patients displaying no conscious understanding of the psychological reason for the flight. This is usually accompanied by muddles over personal identity and sometimes even complete assumption of a new self.


Santos and Gago report that the journeying associated with 'Dissociative Fugue' can last for several months. Some patients travel thousands of miles from home while in this state.


Another recent study entitled 'Dissociative memory impairments and immigration' also published in 'European Psychiatry' in 2010, by Dr A. Staniloiu, Dr S. Borsutzky and Dr H.J. Markowitsch, suggest there is even a possible link between this kind of psychological problem and immigration.


The authors from the University of Bielefeld, Germany, argue that stressful experiences arising during migration could precipitate these symptoms, though a delayed onset at times occurs reflecting an 'incubation' effect.


Another recent study suggests an effective treatment for 'Dissociative Fugue' which appears to have fallen out of favour recently, which might explain why it may not have been used in more current cases.


The case study entitled 'Amytal interview using intravenous lorazepam in a patient with dissociative fugue', reports a middle-aged white female picked up by emergency medical services in the USA, who could not remember her name, address, and did not know the name of the city.


Lorazepam (a sedative drug a bit like Valium) was given intravenously by the psychiatrist. Although relaxed and sleepy the patient was kept awake by asking her to restate the name of her present in-patient psychiatrist, whom she had become close to. She was led back in fantasy to the gas station where she was picked up and was requested to identify it. Once she successfully named a location from her personal history, she was led to give her name, hometown, birthday, social security number, employment, motherhood and marital status.


The investigation, published in the journal 'General Hospital Psychiatry' in 2006, reports that after she awoke the patient described past and recent sexual assaults. The recent rape was about 10 days before hospitalization. A final diagnosis of Dissociative Fugue was made, and the patient was discharged to outpatient follow-up and the Victims of Violent Crime clinic.


The authors of this paper, Dr Sunday Ilechukwu, from the Ann Arbor Health Care System and Dr Thomas Henry, then at Wayne State University, USA, argue that procedures like this provide the patient with an opportunity for the recall and review of recent emotional crisis, linkage to past trauma and provision of context to current experience.


The authors contend that the simple but critical process of naming her identity under sedation, probably helped her come to terms with the precipitating conflict.


The authors also argue care needs to be taken to minimize the risk of introducing false or distorted memories. The use of video-recorded feedback may also help consolidate gains made during the interview.


The authors conclude that the so-called 'sodium amobarbital' interviews have been in use for about 70 years and refers to the use of an older barbiturate type drug, could be brought back into modern psychiatric practice. The study suggests that such pharmacological-facilitated interviews continue to be a useful procedure with such cases, but that a safer more modern drug, such as lorazepam, can be used as an alternative.


But why should trauma lead some people to forget even who they are? Another study entitled 'A case of persistent retrograde amnesia following a dissociative fugue: Neuropsychological and neurofunctional underpinnings of loss of autobiographical memory and self-awareness', argues that, since memories can be vivid, threatening and painful, they may be removed from consciousness as a way of protecting the self-concept.


The authors, Kristina Hennig-Fast, Franziska Meister , Thomas Frodl , Anna Beraldi , Frank Padberg, Rolf Engel , Maximilian Reiser , Hans-Jürgen Möller and Thomas Meindl, brain scanned an individual suffering from these fugue like symptoms. The results highlighted the key role of visual and emotional properties of autobiographical memory in the maintenance of this kind of amnesia.



The study published in the journal 'Neuropsychologia', found reduced neural activity within the brain network producing autobiographical memory retrieval. The authors based at Ludwig-Maximilians-University, Munich, Germany, posit a protective defence mechanism caused by neuronal inhibition that serves to prevent an overflow of intensive aversive emotions.



The authors suggest that visual imagery plays a central role in the recall of autobiographical memories. Defects in the way the brain visually processes memory which might help explain puzzling phenomena such as Dissociative Fugue.



Their patient regained only three remote and strongly negative childhood memories dating from the time before the dissociative fugue. All were highly negative, vivid and fragmented episodes comparable to frozen images, e.g. of the coffin at his grandfather's funeral.



It must surely be one of the most disturbing experiences of all, not to recall anything of our past except alarming fragments. Psychiatric investigation of this kind of suffering is helping to reveal how the normal sense of personal identity is achieved. Visual aspects of memory may be more important than we previously realised. The fact that it can be lost suggests we shouldn't take it for granted.



Trying to uncover who 'Robert' really is, could also help us find ourselves.




If you are a psychiatrist, or a similar clinical professional, who is collecting Continuing Professional Development Points, after listening to this podcast and podcasts like this, it is possible to visit the Royal College of Psychiatrists CPD web site, and after completing some questions (plus registering with the site), gain CPD points on-line.


Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.