Wednesday, October 15, 2008
An Adventure A Day Has Kept ClinkShrink Away
Oh dear. I really have been negligent. Dinah has been working hard to carry on Shrink Rap single-handedly---and done a smart job of it too---while I've been frittering my time away hanging from rocks. But more about that later.
So here is my post. Late, short, but better than nothing.
So I've been hearing a lot lately that I may be rather crazy, or at least lacking in good judgment, for my newest hobby. Dinah has suggested that I could use it as the starting point for a blog post, and I think that's a good idea.
For the past couple months I've been off rock climbing. It's something I've always wanted to try but couldn't convince my friends to try with me. Unfortunately, for the kind of climbing I do you actually do need a friend to go with you to hold the end of the rope. And the friend has to be someone you trust completely. Given that Dinah refused, repeatedly, to hold the end of my rope it took me a while to try this hobby. Now that I've done it, I'm hooked.
So how does this relate to psychiatry? Wow, there are a lot of take-off points here. I could talk about the difference between intelligence and judgment. I could talk about issues related to trust and how you choose the people you trust. Or---and this is my preference---you could talk about risk-taking behaviors in general.
My prison patients are risk-takers. They grab opportunities to make a quick buck, get revenge, blow off steam or just blow up. The problem with my patients' risk-taking behavior is that it gets them into trouble with the law.
I rarely see pro-social risk-takers because they channel their proclivities in ways that are either beneficial for them or at least don't injure others. Pro-social risk takers are people who start businesses, explore new countries, try to set new world records or who 'boldly go where no man has gone before'. They are the adventurers and visionaries.
Why do these folks fall into one category versus the other? And what makes people risk-takers?
I think there are three things that interact here: inheritance or biology, environment (including things like socioeconomic status and resources) and individual life events or experience.
Risk-taking is a character or personality trait that exists in everyone across a continuum, like extroversion or neuroticism. People are more or less risk-taking and open to new experience. There's a biological basis for many personality traits, and risk taking does seem to be heritable. Risk-taking or sensation-seeking tendencies may co-exist with impulsivity, but not always. Non-impulsive risk-takers take the time to plan their risks---to take reasonable precautions or safety measures and to weigh out the odds (or in the case of rock-climbing, make sure the rope is anchored soundly) to maximize the chance of success. If you've grown up in a disadvantaged neighborhood where the school drinking fountains are laced with lead, you're more likely to be an impulsive risk-taker (or one of my patients). Thus, environmental factors can influence the way an inherited trait is expressed.
The third and final way is through life experience. You can imagine all the life-changing events that could influence risk-taking behavior---watching the market crash, for example, is probably putting a damper on some economic risk-taking right now. Similarly, someone who is given a diagnosis of a terminal illness might decide to uncharacteristically go on a round-the-world trip. You get the drift.
As far as my risk-taking is concerned, it's basically just for the fun of it. Thanks for bearing with me, my fellow Shrink Rappers.
And thanks for the pic.