Category Archives: Graduate School

An Account of Invisible Disability in Graduate Psychology Training

“But you look so healthy, I’m sure you’ll be fine.”

You would never know that I have a disability from just looking at me. To most people, I appear to be healthy and well-adjusted for my age. Enrolled in a doctoral clinical program, doing well in my coursework, taking on extra curricular activities – from an objective viewpoint, it is easy to assume that I lead a similar life to most people my age in my situation. Yet the very fact that things seem normal is one of the most challenging aspects to an invisible disability. Unless I go out of my way to explain it, you would likely never know that I suffer from severe tinnitus and hyperacusis, or constant ringing in the ears and extreme sensitivity to sound.

“Oh I get tinnitus sometimes, too. You should just ignore it like I do.”

Although increasingly common, issues of tinnitus and hyperacusis are not widely understood, nor is there a clear way of measuring what makes someone’s condition severe (Blasing, Goebel, Flotzinger, Berthold, & Kroner-Herwig, 2010). Unlike hearing impairment, in which the limitations of hearing are objectively measured by a hearing test, the methods for measuring tinnitus are far more subjective. Therefore, people tend to measure tinnitus severity by the amount of stress that people who encounter it experience – tinnitus generally falls into the basic categories of bothersome and non-bothersome. For the bothersome type, there are several remedies with an evidence basis, including various audiological interventions that incorporate psychoeducational counseling (Chan, 2009).

Additionally, Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Stress Reduction (MBSR) protocols have all been shown to alleviate tinnitus-related distress to varying degrees (Gans, Cole, & Greenberg, 2015; Hesser, Westin, Hayes, & Andersson, 2009). Yet once all of these have been attempted, and the person experiencing the tinnitus and hyperacusis is still not well, current available interventions have little else to offer. Having founded a support group in Palo Alto that is part of a national network and witnessing the pain and despair tinnitus can cause firsthand, I can personally attest to the widespread need for more effective treatments and interventions.

 “Sorry, but I can’t lower the music volume because the other customers want it turned up loud.”

The challenges I face with tinnitus and hyperacusis have impacted every area of my life. While providing me with a sense of mission to contribute to research and advocacy for individuals with my condition and other invisible disabilities, the path to get there has been thoroughly demanding and challenging. Simple things like riding on public transportation, food shopping, and being in noisy restaurants are all potentially painful situations for me. Urban environments are also dangerous, considering the regularity of emergency vehicle sirens, construction, car horns, loud motorcycles, and other frequent noise. At a more personal level, I have even had to tell people that their voice or laugh is too loud, and ask if they can speak more quietly when I am nearby. Frequently, my conditions become exacerbated if I do not have an opportunity to advocate for myself and explain to people the unusual nature of my sound sensitivity so that it may be accommodated.

“If the class gets too loud for you, you can just leave.”

While I am grateful to be engaged in a course of study that I am passionate about, it is a constant challenge to maintain an effective balance between self-care and productivity. Graduate level training in psychology is thoroughly demanding of a person’s physical and emotional resources, particularly considering clinical placements that may require long commutes on top of endless hours of coursework and research requirements. My condition results in frequent exhaustion and difficulty sleeping, with the symptoms often intensified resulting from stress and demands of graduate school. Excessive fatigue is common when someone experiences a disability (Olkin, 1999); by sheer requirement of rest alone, it takes more time to get the same amount of things done. In my case, many aspects of my training are limited and guided by my condition, starting from choosing a school that has parking access and adequate disability resources. Other aspects of the process are restrictive for me too, as clinical training placements involving families with small children and milieu settings with youth are frequently quite loud and therefore not compatible with my illness. Even socializing can be a challenge, as my condition is worsened from time spent in large groups of people in which many conversations are happening. I must rely on my professors, supervisors, and peers to understand and help when I need accommodations for my disability, and even when I must leave a potentially harmful situation for me.

“Oh come on, this can’t be too loud, we’re just having fun.”

Explaining this is frequently difficult. When it’s people’s lifetime experience that being in social situations is a good thing, and they display the best of intentions by wanting me to be there. It can be very hard to articulate how challenged I am by being in the places where people gather such as restaurants, parties, and bars. As such, I am left out of much social activity that I used to partake in and that used to be a resource for me – having a disability requires constant re-adaptation to life, and often in isolation from others.

Diversity factors among graduate students include all the varied forms in which disability manifests. While mobility issues obviously must be accounted for, greater awareness of other types of disabilities, including less visible, chronic disabilities such as endometriosis, Crohn’s disease, irritable bowel syndrome, brain injury, fibromyalgia, and other common conditions such as tinnitus and hyperacusis still require greater awareness among the general public. In this time when diversity is becoming an ever more present dimension of clinical proficiency, it is essential that training programs incorporate greater awareness of the potential impact of disability on people’s lives.

“Well, at least you don’t have a real disability.”

Despite the challenges my disability has put me through, it has been my experience that people truly want to help – even when they aren’t sure how. Yet sadly, often it is the case that when things become too challenging to attend to, it is a culturally consistent reaction to tend to look away. Many of the needs of people who experience limitations due to their disability may be solved by a very simple method – don’t be afraid to ask what it’s like for them, and how you may be able to help. Even just being recognized for dealing with the challenge of an invisible disability can be a huge relief.

About the Author:

Ben Greenberg is a fourth-year doctoral clinical psychology student at the American School of Professional Psychology at Argosy University, San Francisco. A former professional symphony French horn player, he played in the Colorado Symphony Orchestra, Jerusalem Symphony, Hong Kong Philharmonic, and Cairo Opera Orchestra before leaving his career due to debilitating tinnitus and hyperacusis. He is currently a grant recipient of the American Tinnitus Association for his research in the impact of sound sensitivity in tinnitus, and lives in Oakland, CA.

 

References:

Blasing, L., Goebel, G., Flotzinger, U., Berthold, A., & Kroner-Herwig, B. (2010). Hypersensitivity to sound in tinnitus patients: An analysis of a construct based on questionnaire and audiological data. International Journal of Audiology, 49(7), 518-526. doi: 10.3109/14992021003724996

Chan, Y. (2009). Tinnitus: Etiology, classification, characteristics, and treatment. Discovery Medicine, 8(42), 133-136. Retrieved from: http://www.discoverymedicine.com/Yvonne-Chan

Gans, J., Cole, M., & Greenberg, B. (2015). Sustained Benefit of Mindfulness-Based Tinnitus Stress Reduction (MBTSR) in Adults with Chronic Tinnitus: a Pilot Study. Mindfulness. doi: 10.1007/s12671-015-0403-x

Hesser, H., Westin, V., Hayes, S. C., & Andersson, G. (2009). Clients’ in-session acceptance and cognitive defusion behaviors in acceptance-based treatment of tinnitus distress. Behavior Research and Therapy, 47(6), 523-528. doi: 10.1016/j.brat.2009.02.002

Olkin, R. (1999). What psychotherapists should know about disability. New York: Guilford Press.

Graduate School in Forensic Psychology

I regularly receive office visits from students who are interested in forensic psychology as a career. Many who realize they want to continue their education in psychology past undergraduate studies quickly realize that it is not as simple as applying for college. Forensic psychology research is conducted in a number of disciplines, including clinical, cognitive, and social psychology, among others. A helpful resource in the application process is the Division 41 Guide to Graduate Programs in Forensic and Legal Psychology.

What does graduate school in clinical forensic psychology involve? I have had the opportunity to be involved in a number of research projects while in graduate school, including:

  • Papers on stigmatizing effects of psychopathy and neuroscience evidence on jury decision-making
  • The creation of an inconsistent responding scale for a psychopathy assessment measure
  • A project on identifying malingering in ADHD assessment

Outside of research, I’ve had a number of valuable experiences within my department’s clinical practica. Some experiences I’ve had include:

  • Working at the county community supervision office, conducting psychological and substance abuse evaluations for adults on probation
  • Co-teaching a weekly anger management class and providing individual therapy services for anger management
  • Conducting pre-employment psychological evaluations for local police department applicants
  • Working for a year in crisis intervention at our county detention center, conducting psychodiagnostic interviews, providing referrals to the doctor to determine the need for psychiatric medication, and providing individual therapy and crisis management

Practica experiences have taught me valuable consultation skills, as I’ve had the opportunity to work with criminal justice and health professionals at a number of community placements. I’ve also been lucky to have a supportive department with faculty who encouraged me to pursue my interests in mental health reform and advocacy. As a result, I was able to attend the SPSSI Legislative Engagement Day on Capitol Hill and advocate for research funding for the social sciences.

I would encourage anyone interested in pursuing forensic psychology to consider what career they would like to pursue and what degree is required for that career. A Ph.D. in Clinical Psychology is not appropriate for everyone interested in the career, and there are a number of opportunities available at the Master’s level. If you are interested in clinical work, be sure to research the clinical practica offered by departments you apply to. I would also encourage students interested in a Ph.D. to pursue research experiences as early as they can. My research was for the most part unrelated to forensic psychology, but these experiences demonstrated to potential graduate programs that I had an interest in research.

However, the most important advice I can provide for individuals interested in this field is to find something you are passionate about and don’t settle for any graduate program. I do not believe that I would be as happy with my graduate school experience if I was conducting research that I was less interested in or if I did not feel as comfortable in the department.

Other Resources

 

Author Bio

I am a third-year Ph.D. student in Clinical Psychology at Texas A&M University. My research includes interests in layperson perceptions of psychopathy and the implications of psychopathy and other mental health diagnoses in community and legal settings. In particular, I am interested in the possible stigmatizing effects of mental health evidence. Additionally, I am interested in emerging conceptualizations of psychopathy that place emphasis on neurobiological correlates of the disorder and the implications of this research for interventions with psychopathic individuals.

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Why Policy?

US Capitol Rotunda

U.S. Capitol Rotunda, Source: Flickr, user sidkid

“Why policy?”

I have been asked this simple, two-word question more times than any other question in the past year. Back in September, I began working as a graduate-level policy scholar for the Public Interest Government Relations office at the American Psychological Association. As this opportunity coincided with my fifth year of doctoral studies at Virginia Commonwealth University, I have often had to explain my hectic schedule upon meeting new individuals. Research and academia, most will understand, as those things fit seamlessly into the doctoral studies mold. But then comes the follow-up question: Why policy?

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How Much Do Black Lives Matter to the APA?

protestAs a student member of the APA and a psychologist in training, I’ve been disappointed in the American Psychological Association’s (APA) public response to the deaths of African American’s at the hands of police officers as well as mass shooters. While I’ve appreciated APA’s vigorous response to the Orlando tragedy, I couldn’t help but compare it to the APA’s response to the Charleston shootings. When I looked back to see if the APA offered services to the families of the victims of the Charleston shootings, or any other resources, I couldn’t find anything, not even a public statement condemning the shootings. Granted, the Charleston shooting occurred only a few weeks before the release of the Hoffman Report.  Yet preoccupation with the Hoffman Report does not explain APA’s silence, as it issued four press releases between the day of the Charleston shooting and the release of the Hoffman Report.

Moreover, the APA’s virtual silence in response to the numerous police shootings of unarmed African American men, women, and children is dumbfounding.  In an op-ed in response to Ferguson, written by former APA President Nadine Kaslow and former APA CEO Norman Anderson, the authors fall short of condemning the shooting of an unarmed black teenager and state, “[t]he judicial system will determine exactly what transpired between Michael Brown and the police officer.” Considering the historical treatment of African Americans by the judicial system, and the continued shocking disparities, their faith in the ability of the system to determine what transpired and provide a just outcome was questionable at best.  Perhaps Kaslow and Anderson’s questionable faith is representative of the APA’s position overall, and explains the silence.

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Learning the Ropes: Attending Convention for the First Time as a Graduate Student

APA Convention can be overwhelming with tens of thousands of psychologists and graduate students descending on a new city with the purpose of staying current with our work and networking! These tips will help you to plan for convention, survive (and thrive!) while attending, and debrief afterwards.

Before Convention:

  • Now is the time to register!
  • Find some other grad students to room with to save a few bucks!
  • Also, keep an eye out for any airfare specials if you will be flying to Denver.
  • Once the conference program is out, start to plan your days at Convention.
    • Start with APAGS program; it’s specifically geared towards the needs of graduate students
    • Use keywords to search the electronic program and find sessions that you’re interested in attending.
    • Plan to attend talks on your research interests, but also step outside of your comfort zone and go to a talk on a topic that you may not be exposed to in your own program.

During Convention:

  • Network! Find other psychologists and graduate students who are doing work that you are interested in. Bring business cards so that you can exchange them and keep in touch after the conference.
  • Attend APAGS events to specifically network with other graduate students.
    • The APAGS Social is always a hit! Don’t miss out!
    • APAGS also provides free food at the Food for Thought Breakfasts each morning. What a great reason to wake up early, right? This is also a great time to hear talks by amazing psychologists. Be sure to check the program for the line up!
  • Attend talks that align with your research or clinical interests, but also attend something that is new to you.
  • Get out and see Denver! As a graduate student, how often do you really get to travel? Take advantage of the opportunity to explore this cool city a bit.

After Convention:

  • Relax! You might need to take a day or two to recharge. Convention can be both exhilarating and exhausting.
  • Follow up via email or maybe even social media with the people that you met at convention.
  • Start thinking about Convention 2017! Do you want to present your work? Do you want to be an APAGS Ambassador or maybe even apply to be a member of the APAGS Convention Subcommittee?