4th update: 4 July 2009
The Graves Model - and its Spiral Dynamics 'build' - lie at the heart of Integrated
SocioPsychology, The following is a plea to psychiatrists, clinical psychologists,
mental health workers and those involved in research into various areas of Psychopathology
to examine rigorously the work of Clare W Graves (1970, 1971/2002, 1978/2005) with
a view to its implications for mental health conditions.
There are literally millions of people whose suffering could be alleviated if we
understood more of the psychological processes underlying it.
There are a multiplicity of reasons why the work of Clare W Graves (1970, 1971/2002,
1978/2005) needs to be taken up much more comprehensively by the academic communities
and investigated rigorously for its validity. (Which will result in a much higher
profile and wider acceptance of the model.)
One of these reasons, I propose, is the Graves Model's applicability to mental health.
Strangely enough, for all the many champions of Graves' work and the Spiral Dynamics
'build' developed by Don Beck & Chris Cowan (1996), little has been said about the
relationship between Graves' Spiral of motivational systems (vMEMES) and psychological
disorders.
Although my plea is for research into the Graves Model related to all forms of mental
illness, in this article I will be focusing primarily on 'Clinical Depression'.
There are thousands of research projects to be undertaken and hundreds of books to
be written to apply the arguments I will put forward not only to Depression but many
other forms of psychological disorder. However, the limitations of space and time
- plus, to some extent, my own expertise - mean we shall restrict ourselves primarily
to Depression in this piece.
So...can vMEMES cause Clinical Depression (aka Unipolar Disorder or Major Depression)?
Since vMEMES are the neurological systems which motivate us according to the Life
Conditions we experience in both our internal and external Environments, the answer
per se has to be ‘No’. However, by putting together certain pieces of evidence, it
is possible to see how certain vMEMES in certain conditions could predispose some
of us to Depression.
Just to be clear what we mean by Clinical Depression, it's pertinent to refer to
the symptoms described in the 'Diagnostic & Statistical Manual of Mental Disorders'
(DSM) of the American Psychiatric Association, the leading psychiatric classification
system in the world. It lists the following:-
- Emotional symptoms: sad, depressed mood; loss of pleasure in usual activities
- Motivational symptoms: changes in activity level; passivity; loss of interest and
energy
- Somatic symptoms: difficulties in sleeping (insomnia) or increased sleeping (hypersomnia);
weight loss or gain; tiredness
- Cognitive symptoms: negative self-concept; hopelessness; pessimism; lack of self-esteem;
self-blame and self-reproach; problems with concentration or the ability to think
clearly; recurring thoughts of suicide or death
According to DSM, 5 of the listed symptoms must be present almost every day for a
minimum of 2 weeks for the condition to be classified as Major Depression. However,
there are reported numerous problems with diagnosis, as commentators such as Andrew
Solomon (2002) have been at pains to stress. Reports of misdiagnosis are not exactly
uncommon. Guilt, irritability, aches and pains and, in women, changes in menstrual
patterns are non-DSM symptoms associated with Depression by many clinicians. Clearly,
there needs to be some flexibility in interpretation of the symptoms and their severity;
but DSM does give us a starting point for identifying the condition under discussion.
Generally these days the principal approach to psychological illness - as well as
many physiological illnesses - is to view such conditions as the result of a Diathesis-Stress
interaction. 'Diathesis' is the predisposition to develop the condition. 'Stress'
means environmental and/or behavioural factors which trigger the onset of the condition.
The concept of a genetic predisposition to certain physiological illnesses such as
heart disease and cancer has been accepted in the medical professions for a number
of decades, with interventions being made through such domains as diet and exercise
to minimise the likelihood of the environmental triggers for the onset of the illness
being fired.
The Diathesis-Stress model was first applied to psychological disorders by Joseph
Zubin & Bonnie Spring (1977) in attempting to understand how Schizophrenia develops.
The Diathesis can lie in abnormalities in brain structure and/or too high or too
low levels of neurotransmitters such as dopamine, GABA, serotonin and noradrenaline;
as we shall see, for women, in particular, fluctuations in hormones can have devastating
effects on mood. And there is increasing evidence that, in many cases, the predisposition
is genetic in nature. A Stress factor could be lifestyle - eg: cannabis use has become
increasingly identified with the development of Schizophrenia - see the Blog: ‘Time
to turn against Cannabis!’ - or a specific event - eg: the sudden death of your partner/spouse.
How much the onset of a condition will be due to Diathesis and how much to Stress
will depend on the particular psychological disorder and in any case will vary widely
from individual case to individual case. Certainly some individuals seem to experience
the onset of a condition purely from Stress factors; while having a Diathesis for
a condition, in most cases, by no means dooms someone to develop that condition.
It is reasonable to assume that vMEMES are part of the complex Diathesis-Stress interactions.
Since the crux of the Graves Model is the interaction between the internal coping
mechanism (vMEME) and the Life Conditions (what's going on) in the Environment (internal
or external), it fits the Diathesis-Stress frame rather well.
Biological Diatheses
Major/Clinical Depression tends to be termed either Endogenous - ie: it comes from
within; so it is primarily due to the Diathesis factor - or Reactive - ie: the condition
is the response to stressing environmental factors.
However, Major Depression tends to come up with the lowest concordance rates of the
psychotic illnesses. For example, M G Allen’s widely-respected 1976 study found concordance
rates of monozygotic (from the same egg) twins suffering from Major Depression mostly
to be around 40%. By contrast he found Major Depression's very ugly cousin, Manic
Depressive Psychosis (aka Bipolar Disorder), to have a monozygotic twin concordance
rate of 72%. In other words, if one identical twin develops Manic Depression, according
to Allen, there's a statistical probability of 72% the other will develop it. With
Major Depression, the other twin becoming similarly depressed is more of a significant
possibility than a probability - down to 40%.
So the Diathesis effect in Major Depression is important - particularly for those
who suffer from purely Endogenous Depression! - but the ability to cope with the
stressing factors is perhaps more important in the majority of cases. That ability
to cope results from a mix of endogenous, motivational and learned factors.
There is undoubtedly a genetic element in many instances of Depression. Recent research
by Alexander Neumeister, Dennis Charney & Wayne Drevets (2004) from the US National
Institute of Mental Health suggests that tryptophan depletion unmasks an inborn trait
– the essential amino acid trytophan being the chemical precursor for the generation
of serotonin. Lowered serotonin levels, which have been associated with Major Depression
for many years, affect emotion-regulating circuitry involving the anterior cingulate
cortex, thalamus, ventral striatum and orbitofrontal cortex. Essentially this means
that some people are unable to extract enough trytophan from what they digest to
form sufficient serotonin to keep these neural networks functioning effectively.
Since monoamine oxidase (MAO) enzymes in the brain break down serotonin, there is
a need to build up new supplies regularly of this neurotransmitter. People who have
difficulty naturally in processing trytophan, therefore, are at a major disadvantage.
Keeping with the notion that MAOs break down serotonin, there is, unfortunately for
a number of women, a gender bias in the way Depression often works. The levels of
the hormone oestregen decrease (as progesterone increases) as a part of the menstrual
cycle. High levels of oestregen help inhibit this breakdown or 'reuptake' of serotonin.
(Monoamine oxidase inhibitors (MAOIs), such as Rivvol, and serotonin specific reuptake
inhibitors (SSRIs), like Prozac, are used as anti-depressant drugs because they have
the same effect.) When oestregen levels drop in the approach to menses, MAOs are
less inhibited in their breakdown of serotonin - and this is thought to be a key
contributing factor to PreMenstrual Syndrome (PMS) and the depressed mood of many
women during their periods.
Lowered oestregen levels and, thereby, lowered serotonin levels may well be a principal
contributing factor as to why twice as many women as men are diagnosed with Depression
in the Western world. It may also help explain why more women are 'chocoholics' with
a preference for milk chocolate. Tryotophan is abundant in milk; and milk is used
plentifully in the production of milk chocolate. Effectively: eat milk chocolate
and boost your serotonin levels!
While approximately 75% of women experience some degree of PMS on a regular basis,
by no means do all of them experience depressive symptoms to the levels required
for a DSM diagnosis of Depression. So there must be other factors involved - biological,
behavioural or environmental.
The great Anglo-German psychologist Hans J Eysenck (1967) certainly saw parts of
the brain as determining natural temperament.On his Dimensions of Temperament model,
people high in Introversion (due to overstimulation of the cortex by the ascending
reticular activating system) and high in Neuroticism (as a result of a very reactive
amygdala) will be Melancholic personalities. Such people will tend to easily become
anxious, moody pessimistic and unhappy. Clearly a natural Diathesis!
So, obviously then, there are people with the endogenous potential to become depressed;
and it would appear women are most at risk. Thankfully most people will need some
form of stress factor for Depression to take hold.
But what have these biological Diatheses got to do with Graves and Spiral Dynamics?,
you may ask. One way to answer that is by using the 4Q/8L (2000) framework Don Beck
developed from the All Quadrants/All Levels concepts (1995) of Ken Wilber .
The Upper Quadrants in this schematic represent 'I'. The Lower Quadrants represent
the external world - including ‘We’ - in which 'I' operates. The Upper Right represents
the functioning of the biological mechanisms which manifest themselves as what we
call 'mind' in the Upper Left. Thus, the vMEMES of the Upper Left, which enable us
to cope with the external world of the Lower Quadrants, are dependent on the effective
functioning of the biological mechanisms of the Upper Left.
So biological malfunctioning - preferences, even - in the Upper Right will affect
our ability to develop coping systems (vMEMES) in the Upper Left. And that could
make us very vulnerable indeed!
4Q/8L immediately demonstrates how complex the Diathesis-Stress relationship is -
the Upper Right impacting upon the Upper Left’s ability to cope with life - the Lower
Quadrants. Robert Dilts’ Neurological Levels (1990) construct provides us with a
model for how changes at the levels of Identity and Values & Beliefs should drive
changes in Skills & Knowledge and Behaviour as the Environment (internal and/or external)
changes - Life Conditions. If change in the Life Conditions requires a vMEMETIC shift
in response and the individual cannot make that shift because of biological restrictions/preferences
in the Upper Right Quadrant, almost by definition they will be unable to cope with
their Life Conditions.
Not being able to cope causes stress and anxiety and, if prolonged, can lead to Depression.
A frequent cry of the 'Depressed' is: “I can't cope!”
Cognitive Diatheses
So, having established that biologically-determined Diatheses can influence both
our vulnerability to psychological disorders such as Depression and the capacity
to develop vMEMES as coping mechanisms, is it possible for there to be cognitive
Diatheses?
The answer is - unfortunately, in one sense at least - a resounding ‘Yes’.
The negative version of the Cognitive Triad - developed by Aaron T Beck et al (1979)
from the work of Lyn Abramson, Martin Seligman & John Teasdale (1978) and pictured
below - depicts thinking patterns that create a Diathesis (predisposition) to Depression
- all that’s needed is the Stress trigger.
For a number of years now those who study Neuro-Liguistic Programming (NLP) have
looked at the effects unhealthy or limiting beliefs about yourself have in contributing
to anxiety and Depression by reducing your self-efficacy. This is Albert Bandura's
(1977) term for belief in one's ability to acquire and use (the neurological level
of) Skills & Knowledge – which leads us back to coping or not and the potential for
Depression that not being able to cope can create.
