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The supreme infant We talk to Alison Gopnik about the exploratory, bright butterflies that are children, alongside a special issue about pregnancy
Incorporating Psychologist Appointments ÂŁ5 or free to members of The British Psychological Society
forum 170 news 178 careers 242 looking back 262
the maternal brain 186 a psychological plan for perinatal care 194 disadvantaged young fathers-to-be 198 taking up space – pregnancy in public 202
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Associate Editors Articles Vaughan Bell, Kate Cavanagh, Harriet Gross, Marc Jones, Rebecca Knibb, Charlie Lewis, Amina Memon, Wendy Morgan, Tom Stafford, Miles Thomas, Monica Whitty, Barry Winter Conferences Sandie Cleland, Sarah Haywood International Nigel Foreman, Asifa Majid Interviews Nigel Hunt, Lance Workman History of Psychology Julie Perks
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forum 170 excellence; home education; the internet and thinking; reductionism; and more
THE ISSUE
news, digest and media 178 communicating with ‘locked in’ patients; roots of schizophrenia; report from the Division of Occupational Psychology Annual Conference; nuggets from the Digest; and thorny issues of nature and nurture in the media
‘We are totally devoted to them when they are little and yet the most we can expect in return when they grow up is that they regard us with bemused and tolerant affection.’ So said Alison Gopnik in a Research Digest feature last year, and in this issue she has plenty more to say about the significance of babies and the caregiving relationship. Don’t miss her thoughts on childhood as a protected space to learn and imagine, parenting secrets, and taking limited care of her partner! Alongside this, we feature six articles about pregnancy covering cognitive function, risk, identity, disadvantaged fathers, space and advice, nausea and vomiting, and more. There’s the usual mix of news, views and reviews, and also some relatively rare sightings in our pages of the lesser-spotted occupational psychologist (see pp.180–1 and p.264) – more to come, I promise. Dr Jon Sutton (Managing Editor)
special issue
The maternal brain Christian Jarrett examines the evidence behind the widely held belief that pregnancy affects cognitive function
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What is ‘psychological’ about ‘normal’ pregnancy Paula Nicolson reviews issues of biology, risk, identity… and more
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A psychological plan for perinatal care Pauline Slade and Michelle Cree
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Disadvantaged young fathers-to-be Mike White on his working life
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Taking up space – pregnancy in public Harriet Gross on embodied experience
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Nausea and vomiting in pregnancy Brian Swallow on impact and treatment
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book reviews 214 intelligence testing; technology; ageing and cognition; creative writing; low mood; and building motivational interviewing skills society 220 President’s column; and two important Society articles, on accreditation through partnership, and delivering standards for tests and testing careers 242 we talk to Sara Savage, about her work with the Psychology and Religion Research Group at the University of Cambridge; and Nick Taylor on the benefits of voluntary experience; alongside the featured job, all the other latest vacancies, and how to advertise looking back 262 literature, history and biology: Peter Garrard on the uses of retrospective language analysis one on one 264 …with George Sik
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The supreme infant Alison Gopnik talks to Jon Sutton about the exploratory, bright butterflies that are children 210
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Occupational psychology and the new Jon Sutton and Christian Jarrett report from the Division of Occupational Psychology’s Annual Conference in Brighton occupational psychology consequently has a stronger influence on government policy there. He also warned that the migration of UK occupational psychology departments to become part of business schools raised challenges for its independent status. Briner followed, saying that occupational psychology is ‘churning out boring, pedantic, badly written and
irrelevant research – and that’s me trying to put it nicely’. There is no attempt to pull together and evaluate what we know and do not know about a range of important issues, he said. ‘We peddle fads rather than killing fads.’ Briner called for more ‘practice-based evidence’, and said that ‘we shouldn’t allow ourselves to be defined by technical competence’.
IN BRIEF FROM BRIGHTON I Susan Paddock of QinetiQ described how her team applied a human factors approach to the design of a new data-processing control room for a security client. 3D visualisations, user interviews, mapping of desk to equipment and desk to window distances, consideration of shift-patterns all fed into the design. The client was so impressed with the end result they’ve asked for the same approach to be applied to the rest of the building. I A diary and interview study of 29 healthcare engineers by Kevin Daniels at Loughborough University found that effective problem solving was associated with a mix of high motivation, support from others and having the autonomy to change things when necessary. Poor problem solving tended to be associated with relying on past solutions, avoidance and low motivation. I From a survey of 188 UK clergy – an under-researched group in occupational psychology – Gail Kinman of the University of Bedfordshire found that greater job involvement, past training in counselling and social support all buffered against the emotional demands of the job. A mismatch between one’s felt emotion and the emotion that must be conveyed on the job – known as ‘dissonance’ – was a particular threat. Younger clergy appeared to be at greater risk, even though they reported greater overall job satisfaction.
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More confident in the profession’s ability to put things right in organisations was Professor Mike West (Aston Business School), who said we should be training occupational psychologists to be leaders in organisations. ‘If not us, then who?’ He agreed with Briner that occupational psychologists shouldn’t just be technicians, saying that the failure of the entire capitalist system internationally has been about values, and the profession should therefore be values-based. Providing graphic illustrations of that the following day, Professor Don Ferrin returned to talk about the rise and fall of trust: ‘A great leader has to have absolute integrity in everything he or she does… said Ken Lay, founder and CEO of Enron.’ But according to Ferrin, ‘Only 51 per cent of employees have trust and confidence in senior management, and there has been a huge drop in trust in recent years. Competence, concern and character are what is needed, and if a leader has these traits there will be a strong correlation with their employees’ commitment and job satisfaction, but less so with performance.’ However, Ferrin argued that trust problems are not automatically an indictment of character, and we should remove the taboo from talking about trust. Leaders need to be much more inquisitive about how they are perceived: if your employees are reluctant to accept vulnerability in your presence, you may have a trust problem. Trust was also identified as crucial by Will Hutton (Executive Vice Chair, Work Foundation), who gave an enthralling account of just what a state we are in. He said that a 10 per cent increase in employees’ trust in management has the same effect on general levels of satisfaction as a 36 per cent increase in monetary reward. There are clear opportunities for occupational psychology, he said, in increasing control and autonomy in the workplace, developing a skills agenda, improving employee engagement and organisational development, and helping employers and employees deal with a changing relationship. This would be based on ‘flexicurity’: ease of hire and fire must be matched by high benefits and investment in active labour market programmes to equip unemployed people with the skills MIKE THOMPSON
Chairing the opening symposium of this conference, on the past, present and future of occupational psychology, Professor Fiona Patterson (City University) promised to find lots of things to be optimistic about. The speakers were not so sure, with Professor Rob Briner (Birkbeck) warning that there was nothing he liked more ‘than to give a moany, depressing rant to start a January conference’. Occupational psychologists, he said, had ‘lost our way a bit. We’re in a bit of a mess, but can we fix it?’ Professor Don Ferrin (Singapore Management University) certainly thinks occupational psychology has the tools. ‘Just think – we can measure something as intangible and ethereal as trust,’ he enthused. Yet he bemoaned the fact that 90 per cent of occupational psychology’s empirical evidence is laboratory based and cross-sectional, and we don’t have the research on the effectiveness of interventions. Academics have to start collaborating with practitioners more, and ensuring that knowledge produced is applicable cross-culturally – otherwise, in a globalised world, it becomes increasingly irrelevant. In the midst of a move back to the UK from Holland, Professor Neil Anderson flagged up some cultural differences between the two in terms of occupational psychology. There is a split between science and practice in the Dutch professional body, but Anderson’s impression is that links are better and
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they need to find work in a rapidly changing economy. The approach is well established in Denmark and has contributed to high levels of growth and employment over the last decade. Perhaps most of all, Hutton said, Britain needs a thriving ‘knowledge economy’, driven by an ‘innovation system’ that can create knowledge and disseminate it into business: a clear role for occupational psychology. The economic downturn remained on the agenda the final day, with Kamma Braham of PDI Ninth House, a ‘global leadership solutions company’, recalling how last year’s conference was all about the expected ‘doom and gloom’ of the coming year. Her own organisation responded by leaving empty roles vacant, freezing freelancers, and inviting staff to take voluntary salary reductions, though thankfully Braham said there had been no occupational psychology redundancies in the UK. Another consequence of the recession was a change in demand from clients, with more money spent on selection and assessment and less on talent programmes. ‘I’ve actually been doing more assessment work than I’ve done for the last ten years,’ Braham said, as clients wanted to make sure that the few empty posts they did have were filled successfully. An occupational psychologist in the audience whose firm works with the public sector said they had noticed how organisations were increasingly taking work in-house. Another audience member had similarly noticed that clients wanted to be upskilled so they could take work in-house. ‘It’s good short-term work but could be damaging later on,’ she said. Looking forward, Braham said there was likely to be a ‘résumé tsunami’ as job openings begin to appear. There were already hopeful signs of more demand from clients, she said, but also an increased desire to see evidence for a financial return from occupational psychology services. On that note, Braham pointed to a recent study her firm had conducted on work they’d done with American Express. This showed that the blended training programme they devised and recommended (involving classroom and online study) led to increased sales among staff, equating to a 1599 per cent return on the cost of the course.
In his keynote address, also on the topic of the recession, Dr John MahoneyPhilips, Global Head of Human Capital at UBS AG, sounded a less optimistic note. He warned that uncertainty still exists and that discretionary spending (‘that includes us’) will reduce further. ‘It’s going to be a tough time, and yet also an opportunity to become more relevant to organisations.’ How can occupational psychologists capitalise on the new economic world order? Mahoney-Philips candidly discussed various weaknesses that the profession needs to fix if it is to adapt rather than die: I Occupational psychologists often don’t know enough about their clients and their clients’ strategy, so make sure you do your research. I Get more involved in performance definition and appraisal: ‘it’s vital and core to management and engagement with staff,’ Mahoney-Philips said, ‘yet we’re not thinking about this enough.’ In particular, he added, there should be greater use of 360-degree rating scales (feedback about an employee from everyone who works with them). I Our assessment tests haven’t changed much in years, besides putting them on computer, Mahoney-Philips said. ‘We need to assess people’s competencies for dealing with future uncertainties, not their competencies that got them where they already are.’ I New forms of virtual communication are posing challenging questions about trust – this is a whole research area that could be exploited. I Bridge the practitioner/academic divide. At UBS, Mahoney-Philips has deepened links with the University of East London master’s programme and initiated a project with Kings College. Post-docs have come into the organisation to work on UBS data on staff engagement. I There’s a lack of a good independent outlet that reports occupational psychology findings in a language that’s understood by those who can use and implement it at speed. [But watch this space for news of an occupational Research Digest] I Training needs to become more vocational, perhaps requiring MSc and PhD candidates to have work experience. ‘We need real-world simulations of practitioner assignments’, Mahoney-Philips said.
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FUNDING NEWS The ESRC in agreement with ANR France, DFG Germany, and NOW Netherlands are seeking to fund the best joint research projects in social sciences. Proposals should be for integrated projects by researchers from more than one of the four participating countries. The closing date for applications is 13 April 2010. I tinyurl.com/ybsc3tt In 2010 MRC Programme Grants in Neurosciences and Mental Health have closing dates of 21 April, 29 July and 16 December. Programme Grants provide larger, long-term and renewable funding. I tinyurl.com/a39nsv The Foundation for the Scientific Study of Sexuality has a Grants-in-Aid programme that provides up to $1000 to support scientific sexuality research in areas not likely to receive support from other sources. Applications can be made at any time: grants are usually made in May and November. I tinyurl.com/ye976uj PhD studentships are available from the Alzheimer’s Society. The studentships provide support for postgraduate students, with a relevant first degree, who wish to pursue an academic career in the field of dementia. The primary objective of the research must be to contribute to the understanding of the causes of dementia, the development of cures for dementing disorders, or to advance the evidence base for effective dementia care. Studentships should be applied for by prospective supervisors. The closing date for applications is 28 May 2010. I tinyurl.com/yl2regw Funding is available for healthcare professionals to undertake research into obesity management, in either children or adults (prevention of obesity is beyond the scope of the award). The National Obesity Forum is offering a £16,000 grant in partnership with WeightWatchers. Any healthcare professional with day-to-day contact with patients can apply. Research mentorship is also offered as part of the award. The closing date for applications is 20 June 2010. I tinyurl.com/ygbkn9y
info
economic world order
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Debrief encounters Deception was a fundamental part of some of the most famous experiments in psychology, and it is still common for even the most sedate studies to involve giving participants false test feedback or misleading them about the true aims of the research. A vital element of psychological science, therefore, is to debrief participants after experimenting on them – telling them the truth about what happened and why, and listening to their feedback. Even studies that don’t deploy trickery have the potential to leave a lasting impression – consider all the tests of new interventions aimed at outcomes from improving memory to ameliorating depression. We know from past research that simply asking someone about a behaviour, such as drug taking, increases their likelihood of indulging in that behaviour. Of course, telling participants too much up front can be detrimental to the results, and fully informed consent is therefore far rarer than most researchers would care to admit. That’s why it’s so important to debrief fully afterwards. And yet, having said all this, an alarming new survey of researchers by Donald Sharpe and Cathy Faye suggests that debriefing is a neglected practice in contemporary psychology. Ironically for a science that’s supposed to be about people and behaviour, there’s also scant research on what kinds of debriefing are even effective – for example, is it enough to tell participants they were given false feedback or should they have the chance to complete a real test? Sharpe and Faye surveyed over 200 researchers who’d published during a 12month period from 2006 to 2007, either in the American Psychological Association’s flagship social psychology journal The Journal of Personality and Social Psychology or in the Journal of Traumatic Stress. Just one third of articles in the social psychology journal had mentioned debriefing and fewer than on in ten of the trauma journal articles had done so. Those mentions that were found were usually cursory, such as ‘Participants in this and all following experiments were debriefed prior to dismissal’. If the purpose of a particular study was obvious, the survey suggested most researchers considered debriefing to be unnecessary, with nearly all their focus placed instead on informed consent prior to the study. Set against this worrying picture, Sharpe and Faye make a strong case for just how vital debriefing ought to be to good-quality The September issue of Ethics and Behaviour research. Taking their lead from a provocative reports that debriefing is a neglected practice article published on this topic 30 years ago by Frederick Tesch, the pair say that effective debriefing is vital not only for the ethical reasons outlined above, but for educational and methodological functions too. Explaining to participants why and how a study was performed ought to be given far higher priority, they argue, especially when one considers how many studies are performed on psychology students. Even with non-psychology students, the exercise of carefully explaining the rationale, methodology, and perhaps even results, of a study, could help to promote the scientific cause. ‘Participants would learn about doing research, the joys and frustrations, and the excitement of discovery,’ Sharpe and Faye said. Regarding the methodological benefits of debriefing, the authors said that the process ought to be two-way, and that information garnered from participants can illuminate study findings and help improve future procedures. ‘Researchers would learn about how participants view the experimental task, what makes sense and what does not, and what the participants think it was all about,’ Sharpe and Faye said. Their paper ends with seven recommendations for how to improve the situation, including greater discussion of debriefing in the research literature; more thorough reporting of debriefing practices in journals’ methods sections; use of online overflow pages for discussing debriefing; and formalising the debriefing procedure. ‘Progress will be made when researchers recognise the importance of debriefing or when some unfortunate circumstance forces such recognition,’ the authors said.
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Natural history of the earworm In press in the British Journal of Psychology Earworms are those songs that get lodged in your cranium, playing over and over and over. There’s been surprisingly little published research on the phenomenon, and two British psychologists from the University of Reading have decided it’s time to fill the empirical void. Philip Beaman and Tim Williams surveyed just over one hundred railway travellers, students and visitors to a public garden about their earworm experiences, and they also asked 12 other participants to keep diary records for four weeks about their earworms. They found, contrary to the speculation, that earworms don’t seem to be more common in people with musical expertise. Instead, they found that it is people who judge music to be of more importance who are more likely to get a song stuck in their head. Only a minority of earworms (33 per cent in the diary study) were described by participants as unpleasant. Very few recurred in the same day and most were usually gone by the next day. Participants reported that most strategies to banish earworms, such as trying to think of another song, actually made the original earworm worse. Different participants named and shamed different earworm songs, rather than all pointing to the same offending tunes. Earworm potential appeared to be determined by amount of exposure to a tune combined with that tune’s relative simplicity and repetitiveness.
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How to brag
Hospital staff make better decisions using textual information rather than medical charts
In the January issue of Social Influence
In the January issue of Applied Cognitive Psychology No one likes a show-off. But to get ahead in this world, you’re going to need to let at least some people know what you’re capable of. Thankfully Nurit TalOr has arrived with a pair of studies that offer some insight into how to brag without coming across as big-headed. Over a hundred undergrads were presented with the script of a conversation between two people – a ‘show-off’ called Avi who boasted about his A-grade in stats exams, and his friend. Crucially, there were four versions of the conversation, with each undergrad participant reading just one version. In two versions, the friend raised the topic of the exam before he either did or did not ask Avi what grade he got; in the other two versions, Avi first raised the topic of the exam, which either did or did not provoke a question from his friend about his grade. In every version Avi ended up boasting that he got an ‘A+’. Afterwards, the students rated Avi’s character based on the version they’d read. The crux of it: context is everything when it comes to boasting. If Avi’s friend raised the topic of the exams, Avi received favourable ratings in terms of his boastfulness and likeability, regardless of whether he was actually asked what grade he got. By contrast, if Avi raised the topic of the exams, but failed to provoke a question, then his likeability suffered and he was seen as more of a boaster. Tal-Or thinks the asking of the question is all-important
because of our usually mindless approach to conversations. As a kind of mental short-cut we assume that if a conversant asks a question on a topic then they were probably the ones to have raised that topic in the first place. And once a topic has been raised, a subsequent boast is not seen as such a social sin because it’s in context. Tal-Or tested this idea with a second study, almost identical to the first, but instead of the participants rating Avi’s character, they were given a memory test on the conversation. As Tal-Or expected, when participants read the story version in which Avi’s friend asked Avi about his grades, they tended to mistakenly remember that the friend had also raised the topic in the first place, even when he hadn’t. Before you takes these tips onto the streets, there’s one major caveat worth noting. TalOr only looked at the perception of the boaster in the eyes of onlookers, not one’s actual conversation partner.
Medical graphs are prone to misinterpretation by inexperienced, distracted staff, whereas text leads to more accurate courses of action. So say Marian Van Der Meulen and colleagues, who argue that new software could automatically translate data into text-based summaries. Van Der Meulen’s team asked 35 nurses and doctors from a neonatal intensive care unit to scrutinise real data from 24 infant patients, presented via time series graphs, in the conventional manner; as textbased summaries translated from the graphs by medical experts; or as computergenerated text. Remarkably, the participating nurses and doctors chose significantly more appropriate courses of action after looking at the textual summaries written by an expert as compared with looking at the standard time-series graphs. Decisions made after looking at the computer-generated text were poorer than decisions taken after the human-
generated text but were just as accurate as decisions made from the graphs. ‘Overall, these results confirm that in a neonatal ICU, human generated descriptions of time series physiological measures are better able to support medical decisionmaking than graphs with trend lines,’ the researchers said. There’s hope that the computer-generated text can one day become as effective as the text written by a human expert. A research paper by Van Der Meulen’s team that’s in press has compared the two types of text to look for differences that could help improve the software used in this study. Such differences include the human text having a more coherent grammatical structure and narrative and a tendency to group physiological measures together. ‘[F]urther development of this technology is likely to be extremely fruitful in supporting complex real-world cognition,’ the researchers concluded.
The material in this section is taken from the Society’s Research Digest blog at www.researchdigest.org.uk/blog, and is written by its editor Dr Christian Jarrett. Visit the blog for full coverage including references and links, additional current reports, an archive, comment and more.
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The maternal brain Christian Jarrett examines the evidence behind the widely held belief that pregnancy affects cognitive function
hesitate to admit this, but in the third trimester I’m incredibly stupid.’ These were the reluctant words of feminist Guardian columnist Zoe Williams during her pregnancy in 2008. She was referring, of course, to the idea of ‘pregnesia’, ‘preghead’, ‘baby brain’, call it what you will: the widely held belief that pregnant women experience deficits in memory and cognition. An NHS pamphlet published in 2005 on 50 things would-be fathers should know, put it this way: ‘Pregnant women are a bit vague... it’s their hormones’ (tinyurl.com/lnl7ag). Does pregnancy really affect women’s
‘I
brains for the worse, or is the idea of pregnesia a sexist myth?
Muddled findings Research on the topic falls mainly in two categories: those studies that asked pregnant women whether they have any problems, and others that used objective measures. The self-report studies are strikingly consistent. Across the board, approximately two thirds of women report having some kind of memory or attention problems that they attribute to their pregnancy. For example, in a 2003 study
Ros Crawley at the University of Sunderland, and colleagues, used retrospective questionnaires and longitudinal diary sampling and found that 40 pregnant women reported their memory and attention to be significantly impaired relative to the self-reports of 24 non-pregnant women. By contrast, studies using objective tests of memory and attention during pregnancy have proven to be stubbornly inconsistent. For every study that reports an apparent deficit, there’s another that turns up a negative result. A metaanalysis by Julie Henry of the University of New South Wales in Sydney and Peter Rendell at the Australian Catholic University in Melbourne, published in 2007, helped clear some of the confusion. Of 14 studies conducted over 17 years, they concluded that it is those that placed ‘relatively high demands on effortful processing and, specifically, measures of free recall and the executive component of working memory’ that found a reliable, albeit small, deficit among pregnant women. ‘Many of the previous objective studies had small sample sizes that lacked the power to detect the relatively subtle impairment that was revealed by combining studies in the metaanalysis,’ says Rendell. ‘Some of the inconsistency in objective tests might also be methodological,’ Crawley says. ‘There’s a lot of different tasks used to measure the same cognitive functions and when people talk about the tasks that they use, sometimes one paper uses it to measure one thing and another paper uses it to measure another, so it’s quite complicated.’
Societal expectations
bibliography
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Christensen, H., Leach, L.S. & Mackinnon, A. (2010). Cognition in pregnancy and motherhood: Prospective cohort study. British Journal of Psychiatry, 196, 126–132. Corse, S. (1990). Pregnant managers and their subordinates: The effects of gender expectations on hierarchical relationships. Journal of Applied Behavioural Science, 26, 25–47. Crawley, R.A., Dennison, K. & Carter, C.
(2003). Cognition in pregnancy and the first year post-partum. Psychology and Psychotherapy, 76, 69–84. Crawley, R., Grant, S. & Hinshaw, K. (2008). Cognitive changes in pregnancy: Mild decline or society stereotype? Applied Cognitive Psychology, 22, 1142–1162. Gammell, C. (2009, 8 February). Pregnant women’s brains are not mush, says study. Telegraph. Retrieved 4 February 2010 from www.telegraph.co.uk/
The starkness of the mismatch between the consistent subjective studies and the patchy objective measures led Crawley to wonder whether pregnant women are only reporting problems because that’s what
health/healthnews/4558971/Pregnant -womens-brains-are-not-mush-saysstudy.html Henry, J.D. & Rendell, P.G. (2007). A review of the impact of pregnancy on memory function. Journal of Clinical and Experimental Neuropsychology, 29, 793–803. Keyser-Marcus, L., Stafisso-Sandoz, L.G., Gerecke, K. et al. (2001). Alterations of medial preoptic area neurons
following pregnancy and pregnancylike steroidal treatment in the rat. Brain Research Bulletin, 55, 737–745. Kinsley, C.H., Trainer, R., Stafisso-Sandoz, G. et al. (2005). Motherhood and the hormones of pregnancy modify concentrations of hippocampal neuronal dendritic spines. Hormones and Behaviour, 49, 131–142. Oatridge, A., Holdcroft, A., Saeed, N. et al. (2002). Change in brain size during
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What pregnancy does to the brain At least two human brain-imaging studies have fuelled the pregnesia myth. In 2002 Angela Oatridge and colleagues at Imperial College School of Medicine scanned the brains of a small sample of women (some of whom had pre-eclampsia) before, during and after pregnancy, and reported that brain size shrank during pregnancy and then recovered its size six months after delivery. Many journalists jumped on this, and a similar study published in 1997, as providing final irrefutable evidence for the reality of pregnesia. Other commentators, however, pointed to the woefully small sample size (just nine healthy participants) and the fact that the authors themselves admitted that the ‘mechanisms and physiological importance’ of their findings were speculative. Most of the hard facts about the physiological effects of pregnancy on the brain actually come from research on rats, where, in contrast to most human research, the evidence points to significant maternal advantages rather than deficits. One crucial maternal brain region is the medial pre-optic area (mPOA) of the hypothalamus – a structure in the temporal lobe that is involved in memory. Damage to the mPOA has been shown to inhibit maternal behaviours such as nestbuilding and the grooming of pups. Pregnancy appears to prepare this brain region for the demands of motherhood. For example, research led by Lori Keyser-Marcus at Craig Kinsley’s lab at the University of Richmond showed that pregnancy or treatment with pregnancy-related hormones led to increased dendrite density in the mPOA region (dendrites are the branches of neurons that receive incoming signals from other neurons). The same lab has also looked at dendritic spines – these are thorn-like protrusions on dendrites that improve signalling efficiency.
society expects of them. ‘Maybe there’s this societal view that women, when they’re pregnant, will have problems with memory and attention...it might be part of the overall negative view people have of women, as being at the mercy of their hormones,’ says Crawley. ‘I’m drawing parallels with the work that’s been done with premenstrual cognitive effects and menopausal effects [showing a mismatch between objective
and after pregnancy: Study in healthy women and women with preeclampsia. American Journal of Neuroradiology, 23, 19–26. Pearson, R.M., Lightmana, S.L. & Evans, J. (2009). Emotional sensitivity for motherhood: Late pregnancy is associated with enhanced accuracy to encode emotional faces. Hormones and Behaviour, 5, 557–563. Rendell, P.G. & Henry, J.D. (2008).
Kinsley’s team found that dendritic spine density was increased in the hippocampus of pregnant rats and rats treated with pregnancyrelated hormones, compared with virgin rats. Yet another study in Kinsley’s lab, led by Jennifer Wartella, studied the brains of recently pregnant rats and found signs of reduced activity in the hippocampus and amygdala regions of their brains, compared with virgin rats – a sign, the researchers said, of reduced stress reactivity in the mother rats. Crucially, all these brain changes have been linked with behavioural improvements. ‘Our rats get better at virtually everything they need to, to successfully care for their expensive genetic and metabolic investments,’ says Kinsley. ‘Foraging, predation, spatial memory all improve; stress and anxiety responsiveness decreases.’ So why is there this mismatch between the pregnancy advantages shown in rats and the deficits shown in some human studies? Kinsley thinks the answer has to do with the kinds of tasks used to test pregnant women. ‘Much of the data from human mothers has been derived from asking females to demonstrate cognitive enhancements to skills, behaviours, occupations that are largely irrelevant to the care and protection of young,’ he says. ‘Once the questions and approaches become more sophisticated in the human analogs, I believe more data will support the animal work.’ Consistent with Kinsley’s prediction, a study published late last year by Rebecca Pearson and her colleagues at the University of Bristol found evidence that late human pregnancy is associated with enhanced recognition of threatening facial expressions.
and subjective measures of cognitive performance],’ she explains. There’s certainly evidence for pregnancy-related prejudice elsewhere in the research literature. Sara Corse at the University of Pennsylvania, for example, had MBA students interact with what they thought was a manager but was really a research assistant. Students told that the ‘manager’ was pregnant subsequently gave her more negative ratings than students not fed this
Prospective-memory functioning is affected during pregnancy and postpartum. Journal of Clinical and Experimental Neuropsychology, 30, 913–919. Wartella, J., Amory, E., Lomas, L.M. et al. (2003). Single or multiple reproductive experiences attenuate neurobehavioral stress and fear responses in the female rat. Physiology and Behaviour, 79, 373–381.
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tale. Apparently the students were disappointed when the pregnant manager turned out to be authoritative rather than passive and giving. Crawley tested societal expectations about cognitive deficits and pregnancy in a paper published in 2008, with her colleagues Sophie Grant and Kim Hinshaw. Crawley’s team first showed that 13 pregnant women performed just as well as non-pregnant controls on a driving simulator task (described by the researchers as ‘a complex, cognitively demanding environment that more closely resembles an everyday activity than the laboratory tasks so far reported in the literature’), thus throwing yet more doubt on the objective reality of pregnancy-related deficits. Most importantly, though, they also quizzed dozens of pregnant and non-pregnant women and their partners about whether pregnant women typically experience cognitive deficits in pregnancy. Consistent with the idea that pregnancy-related
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cognitive deficits have become a deeprequired the women to check in with rooted cultural myth, all the participants, a PDA-style electronic device at the same not just those with experience of four time points every day. pregnancy, reported that pregnancy is Compared with non-pregnant typically associated with mild cognitive controls, the mothers-to-be performed decline. normally on the board game, but not on ‘When women are pregnant, it’s very the real-life task. ‘This wasn’t subtle at all,’ obvious, their femaleness is very obvious, says Rendell. ‘This was a very strong so maybe that triggers people to notice in effect, so maybe pregnant women have themselves and in other pregnant women trouble marshalling resources over longer when they make cognitive slips – the periods of time, or maybe they are more kind that we all make – and they attribute distracted by daily life, and challenging those slips to their pregnancy,’ Crawley tasks in that context exposes problems.’ said. Yet another possibility is that pregnancy is associated with cognitive deficits, not because of the effect of being pregnant per se, but simply because pregnancy is a major life event involving huge emotional and practical upheaval. Consistent with this, various studies have linked the cognitive deficits of pregnancy with sleep deprivation, fatigue and depression. ‘Maybe you’d find something similar if you looked at another major life event like bereavement where those factors might be contributing,’ says Crawley. Mothers-to-be performed normally on the board game, but not on the real-life task ‘But because it’s fairly plausible that pregnancy as a physiological event might The strength of this finding led Rendell have an effect on cognition – because of to wonder whether past studies have the hormonal changes – I suspect that’s underestimated the impact of pregnancy why people have looked for that more on cognition. ‘We only found an effect intently, in terms of pregnancy itself.’ over several days, so maybe past studies didn’t tap into the key problem with the A fresh clue? tasks that they used,’ he says. In 2008 Peter Rendell and Julie Henry But consistent findings remain pursued a new angle, publishing one of elusive. The very latest investigation on the first-ever tests of prospective memory the pregnesia controversy was published in pregnancy. Prospective memory is our last month in the British Journal of ability to remember to perform future Psychiatry. In a press release last year, the actions at the right time, such as making study authors claimed to have confirmed appointments or taking the dinner out of that there is, after all, no evidence that the oven. ‘When you ask people to reflect pregnancy has an adverse effect on on memory problems or what concerns women’s brains (prompting the Daily them most about memory, it is prospective Telegraph headline ‘Pregnant women’s memory that is often mentioned as being brains are not mush’). The study by important to daily life,’ Rendell says. Helen Christensen and colleagues at Rendell and Hendry tested 20 the Australian National University in pregnant women on two kinds of Canberra was unusual for the fact that prospective memory test: one was a it followed a large sample of women Monopoly-style board game that required over time. By casting a wide net, the them to remember to perform researchers were able to test 76 women hypothetical tasks over a week, such as before and during their pregnancy. ‘Our phoning the plumber or picking up the research suggests that although women – dry cleaning. The other was a real-life and their partners – think there may be a link between brain capacity and task that took place over a week and
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pregnancy and motherhood, there are certainly no permanent ones that we can find,’ Christensen said.
Does it matter? We’ve seen that whilst many women report experiencing cognitive difficulties during pregnancy, objective evidence for a link between pregnancy and cognitive decline has been inconsistent. This begs the question: does the memory deficit, if it exists, matter? Is there sufficient cause for women to worry about it? On the other hand, if there is no deficit, should we be doing more to combat what amounts to a pervasive sexist myth? Crawley says that even if there is a real deficit, it’s nothing to worry about. ‘In a previous study of mine, before I gave women the standard questionnaire comparing their cognition now to before they were pregnant, I asked them to tell me about the kinds of changes they’d noticed about themselves since they’d become pregnant. Out of 198 women, only three spontaneously mentioned cognitive changes, so I don’t think they’re very salient.’ Although no longer active in the field, Crawley’s previous findings have left her feeling that more could be done to counteract the idea that pregnancy is definitely associated with cognitive decline. ‘It’s absolutely time we exploded this myth,’ she says. A book published in 2005 by journalist Katherine Ellinson called The Mommy Brain. How Motherhood Makes Us Smarter certainly started to turn the tide, but that was in relation to the effects of being a mother, rather than pregnancy itself. But then again, there’s that new robust finding on prospective memory, so maybe we shouldn’t be too hasty in dismissing the pregnesia myth. For pregnant women who’d rather err on the safe side, Rendell has the following advice. ‘Specific strategies’, he says, ‘include creating external physical cues or imagining vivid cues that can function as alerts, for example: leave a prominent reminder note next to the lock on your office door to help you remember to take home something from work, and set a timer to remove food from the oven on time. Another specific strategy is to not delay carrying out an intended task once it has been brought to mind. Research has shown that even brief delays involving several seconds can substantially reduce the chances of the intended action being successfully carried out.’ I Dr Christian Jarrett is The Psychologist’s staff journalist. chrber@bps.org.uk
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Annual Conference 2010 The full timetable, list of poster presentations and social events can “The conference constitutes be viewed a distinguished forum online for the meeting of a multi-faceted and intellectually stimulating group of psychologists”
Don’t miss out… Last chance to register
14–16 April Holiday Inn, Stratford-upon-Avon
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What is ‘psychological’ about ‘normal’ pregnancy? Paula Nicolson reviews issues of biology, risk, identity… and more
references
resources
questions
Pregnancy means your body is out of your control, you share the ‘space’ with another, you are subject to advice from experts, friends and passers-by about how you should eat, drink, play and work; and ‘everyone’ knows your brain shrinks. What’s more you may not bond with your baby for quite a while, by which time you are exhausted from lack of sleep. So what is ‘normal’ about pregnancy?
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Is it possible to weigh the evidence to show whether the transition to motherhood is a medical ‘problem’ or a ‘natural’ experience?
Nicolson, P., Fox, R. & Heffernan, K. (in press). Constructions of pregnant and postnatal embodiment across three generations. Journal of Health Psychology. http://guidance.nice.org.uk/CG62
Bailey, L. (2001). Gender shows: Firsttime mothers and embodied selves. Gender and Society, 15(1), 110–129. Badinter, E. (1981). The myth of motherhood: An historical view of the maternal instinct. London: Souvenir Press. Breen, D. (1975). The birth of a first child: Towards an understanding of femininity. London: Social Science
mages of pregnancy and childbirth seem ever-present in the media, and information and advice to prospective parents abounds. The pregnant (and postnatal) woman has traditionally been of concern socially, morally, sexually, medically and physically to researchers, clinicians and those who surround her (Moscucci, 1993; Mullin, 2002). Yet the experience of becoming and being pregnant remains mysterious, not least because technologies have ensured that there are now several ways to conceive and give birth, whatever your relationship status, age or sexuality. So is there such a thing as a ‘normal’ pregnancy? And, if so, what have psychologists contributed towards understanding it? Women’s pregnant bodies demonstrate changes in shape, size and appetites, each of which evoke psychological implications (Houvouras, 2006; see also Harriet Gross’s article on p.202 of this issue). Consequently psychological research on pregnancy, childbirth and motherhood has focused on diverse substantive topics selecting different epistemologies, standpoints and methods.
The changing nature of pregnancy When I was born, 60 years ago, pregnancy and childbirth were hit-andmiss affairs. Oral contraceptives were things of the future. Termination of pregnancy was illegal, with many deaths or morbidities caused through ‘backstreet’ abortions. Other women with unwanted pregnancies gave their babies
Publications, Tavistock. Brockington, I.F., Aucamp, H.M. & Fraser, C. (2006). Severe disorders of the mother–infant relationship: Definitions and frequency. Archives of Women's Mental Health, 9(5), 243–251. Campbell, A. (2002). A mind of her own: The evolutionary psychology of women. Oxford: Oxford University Press. DeAngelis, T. (2008). Priming for a new
up to adoption agencies. Women who accepted the pregnancy, likely to be married, wore tent-like clothing presenting contradictory symbols of both ‘chastity’ and maternal pride. Sexuality was determinedly disengaged from the process of ‘having a baby’ and as a consequence fathers were markedly absent from the labour room. In the 1940s and early 50s women had the choice to give birth at home or in hospital. Physically healthy middle-class women were more likely to choose hospital because they could afford it and it provided opportunities for a rest. These women had a generally easier time and were more likely to give birth to a live healthy baby (wherever they chose to be ‘confined’) than those women whose lives were less privileged. Things have changed. Mothers’ expectations are now for fewer children, later in their lives and, whatever their educational status, it is likely that the majority of mothers will work outside the home at least part time. Mothers have greater control over their own fertility. Mothers are sexual beings. Mothers are concerned over their own health status and shapes. Motherhood is no longer experienced as the ultimate feminine achievement and although it is about being feminine, that does not have the same meaning for my daughter as it had for my mother (Nicolson, 2002). In the contemporary landscape pregnancy remains a medical event but there has been a subtle change from the ‘doctor knows best’ to the rhetoric of informed choice and ‘risk’. While most people greet announcements of pregnancy with cries of ‘Congratulations!’, a search of psychological literature over the past 30 years suggests an increasing focus on mental ill health, eating disorders, reexperiencing earlier sexual abuse, anxiety and depression (e.g. Nicolson, 1998). Also noted are broader health-related risks from HIV/Aids and other sexually transmitted diseases, smoking, diabetes, obesity, unwanted and unplanned pregnancies (particularly in the case of teenage
role. Monitor on Psychology, 39(8), 29–31. Deave, T., Johnson, D. & Ingram, J. (2008). Transition to parenthood: The needs of parents in pregnancy and early parenthood. BMC Pregnancy and Childbirth, 29(8), 30. doi:10.1186/1471-2393-8-30 DiQuinzio, P. (1999). The impossibility of motherhood: Feminism, individualism, and the problem of mothering.
London: Routledge. Donnison, J. (1988). Midwives and medical men: A history of the struggle for the control of childbirth. New Barnet: Historical Publications. Fox, R., Heffernan, K. & Nicolson, P. (2009). ‘I don’t think it was such an issue back then’: Changing experiences of pregnancy across two generations of women in south-east England. Gender Place and Culture,
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mothers). The potential hazards investigated by psychologists frequently embrace dual concerns for the ongoing health status of the mother and that of the newborn baby. Particular groups of women, such as teenage and older mothers and those with a history of psychiatric disorders or depression and anxiety, are frequently singled out for special attention, where concern is expressed both for them and for the baby. Pregnancy has always been physically hazardous to some extent, so the long gone days of the ‘wise women’ were not necessarily ‘good old days’. Although modern medicine and technological advances have reduced the risks of morbidity and mortality (for women and neonates/newborn infants) (Shorter, 1984) the trade-off has been that medical practitioners have exerted control over pregnancy and childbirth and power over definitions of what is ‘normal’ (Donnison, 1988; Oakley, 1980; Ussher, 2006). This is most recently evidenced by the outputs of government agencies, such as the National Institute for Health and Clinical Excellence giving advice to clinicians in the UK on antenatal care (http://bit.ly/aZGER6, 2008) and the US
16(5), 553–568. Ganley, J. (2004). Becoming a parent: The emotional journey through pregnancy and childbirth. Chichester: Wiley. Hornstein, C., Trautmann-Villalba, Hohm, P.E. et al. (2008). Maternal bond and mother–child interaction in severe postpartum psychiatric disorders: Is there a link? Archives of Women’s Mental Health, 9(5),
Food and Drug Administration, who issue advice to pregnant women. A range of foods have been identified as ‘taboo’ for pregnant women, such as soft or blue cheeses, shark or marlin, fats and sugar, nuts, caffeine and alcohol (www.eatingforpregnancy.co.uk). We found in our recent study that while young women take seriously the advice coming to them from government sources and via magazines and websites, they also pay attention to the examples set by their own mothers and grandmothers (Fox et al., 2009). Ultimately if craving for blue cheese is strong enough then pregnant women are likely to eat it regardless!
The ‘normal’ pregnant body Pregnancy [is]… a period during which normal service is suspended, when the body apparently slips its moorings and refuses to ‘obey’ in the commonplace ways (Warren & Brewis, 2004, p.221).
How do women respond to their bodies being out of their control? The literature on pregnant women’s attitudes to their bodies shows how, while pregnancy enables women to transgress the idealised female body discourse, such a construction reinforces the cultural thin ideal as the norm for women in Western culture (Johnson et al., 2004). However, there is (unsurprisingly) for many women a pride in their pregnant body, with the temporary release from the pressure of dieting. Pregnant bodies also emit embarrassing leaks from breasts and bladders, engender ‘morning’ sickness, result in discomfort, sleeplessness and pain
1434–1816. Houvouras, S. (2006). Negotiated boundaries: Conceptual locations of pregnancy and childbirth. The Qualitative Report, 11(4), 665–686. Johnson, S., Burrows, A. & Williamson, I. (2004). ‘Does my bump look big in this?’ The meaning of bodily changes for first-time mothers-tobe. Journal of Health Psychology, 9(3), 361–374.
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and the inevitable etching of experience on the body by way of enlarged veins and stretch marks. Pregnancy health-related websites advise pelvic floor exercises for stress incontinence and breast-pads for leaking breasts with the message not to worry and that this is ‘normal’ (e.g. tinyurl.com/y9p4u5m). The underlying messages, though, are that pregnancy can wreak havoc on your hormones.
The ‘normal’ pregnant brain Young women in 21st-century Britain expect and often need to work outside the home after childbirth. Mothers continue to achieve in professional life, and their actions and proven abilities hopefully close the book on the 19thand 20th-century ‘experts’ who both pathologised and regulated the female body and mind through discourses of deficiency blamed on female reproductive hormones. The onset of puberty, premenstrual syndrome, postnatal depression and psychosis, breast-feeding and the menopause in particular were all proposed as times when women were emotionally and intellectually less able than their male counterparts (Nicolson, 1998; Ussher, 1989, 2006). But does the ‘achieving mother’ mark the end of this story? Perhaps it does not. Some psychologists have ‘found that the brain shrinks a little during pregnancy… then returned to normal after delivery’ (DeAngelis, 2008, p.29). In the summer of 2009 a young woman graduated with a first class degree and later that day delivered her first baby. The newspaper report stated that she was pleased but surprised at her academic success because her brain had felt like ‘mush’. It may be that cognition and short-term memory are indeed impaired during the first trimester (Kinsley & Lambert, 2006; and see Christian Jarrett’s article on p.186 of this issue). However, reports of research on so called ‘baby brain’ (e.g. tinyurl.com/ yc54zuq) are contradictory, or very ‘subtle’, as one Australian researcher put it. Why do up to 80 per cent of pregnant women
Kinsley, C. & Lambert, K.G. (2006, January). The maternal brain. Scientific American, pp.72–79. Klaus, M. & Kennel, J. (1970). Mothers separated from their newborn infants. Paediatric Clinics of North America 17, 1015. Leifer, M. (1977). Psychological changes accompanying pregnancy and motherhood. Genetic Psychology Monographs, 95(1), 55–96.
Moscucci, O. (1993). The science of woman: Gynaecology and gender in England 1800–1929. Cambridge: Cambridge University Press. Mullin, A. (2002). Pregnant bodies, pregnant minds. Feminist Theory, 3(1), 27–44. Nicolson, P. (1992). Towards a psychology of women’s health and health care. In P. Nicolson & J.M. Ussher (Eds.) The psychology of women’s health and
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report reduced function even though there seems to be no conclusive evidence base that performance on relevant tasks is impaired? Is it because they have read the research and think it must be true and therefore applies to them? Is it because they are perfectionists and feel they are not at their best? Is their performance objectively impaired? The websites and blog debates continue to air both sides of the ‘baby brain’ question with equal passion. What is apparently conclusive though is that after giving birth performance on cognitive tasks appears to be enhanced (Kinsley & Lambert, 2006), which might account for the success of mothers in the workplace.
Bonding with the fetus and baby While it has been argued that a pregnant woman is merely a passive container for the developing fetus (Bailey, 2001) others have demonstrated that technologies such as ultrasound that provide detailed scans of the fetus in the womb enhance emotional bonding between the woman and her future baby (Zechmeister, 2001). From a Kleinian psychoanalytic perspective Raphael-Leff (1991) proposed that even without being able to see the scan of the unborn baby, the mother unconsciously actively nurtures the infant within her body. This, she suggests, equates with the way in which a mother processes the preverbal infant’s anxieties and returns them in a tolerable form to make the baby feel more secure. Thus the nurturing during pregnancy is far more than just a means of warehousing the fetus – it is the beginning of a relationship. The classic studies by Klaus and Kennel (1970) and their colleagues have demonstrated that bonding between the mother and the newborn can be encouraged by allowing them to be alone together after the birth rather than taking the baby from the mother in order for her to rest, which was the case until about 25 years ago. These results were replicated by others, which led to policy changes in
health care. Basingstoke: Macmillan. Nicolson, P. (1998). Post-natal depression: Psychology, science and the transition to motherhood. Routledge, London. Nicolson, P. (2002). Having it all? Choices for today’s superwoman. Chichester: Wiley. Oakley, A. (1980). Women confined: Towards a sociology of childbirth. Oxford: Martin Robinson. Raphael-Leff, J. (1991). The mother as
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maternity care and the knowledge that all things being equal, the more the mother and baby get to know each other, before and after the birth, the stronger their relationship over time. However, maternal affection may not be immediate, and as many as 40 per cent of first-time mothers do not feel love for the baby following birth (Robson & Kumar, 1980). How much does becoming a mother fulfil women’s More recently, scales of (implied) sole destiny? mother–infant bonding have been developed to predict postpartum disorders (Hornstein et al., 2008) and and evolutionary psychology have been the links between attachment, postpartum used to justify the notion that women’s disorders and potential child abuse brains are ‘hard wired’ to bear and rear (Brockington et al., 2006). children. But this is not the way that experts in the field interpret the evidence. Women’s true destiny? Once again the focus of evolutionary In the common view, every woman psychology and gender is about fulfils her destiny once she becomes negotiating the context of biology, a mother, finding within herself all the psychology and the social context rather required responses, as if they were than a crude determinism (Campbell, inevitable, held in reserve to await the 2002). More recently the perceived need to right moment. (Badinter, 1981, p.xx). teach parent-craft to both women and men hints more strongly that the capacity for Pregnancy and childbirth per se are the motherhood alone does not necessarily province of women alone. But how much imbue women with intrinsic skills (Deave does becoming a mother fulfil women’s et al., 2008). (implied) sole destiny? Does the capacity to bear children link in any psychological Pregnancy, motherhood way to instinctive love/attachment to the and identity baby? Academic work on motherhood as an Support for a ‘destiny fulfilment’ view emotional destiny fades out after the late has come very much from ‘popularised’ 1970s, although some of what we learnt versions of Freudian psychoanalysis that then remains important; for instance, that suggest that pregnancy, childbirth and pregnancy and motherhood are key life motherhood resolve women’s desires to transitions for women with their own do other things such as have a successful developmental stages, so that becoming professional career. However, feminist a mother increases a woman’s sense of psychologists have shown that Freud entering adulthood (Leifer, 1977) and himself did not actually argue that biology provides greater self-knowledge and sense was destiny in this way, but talked about of a place in the world (Breen, 1975). women and men as having the chance to Some feminist psychologists, myself take feminine or masculine pathways in included (Nicolson, 1992), railed against life (Sayers, 1982). Similarly sociobiology
container: Placental process and inner space. Feminism and Psychology 1(3), 393–408. Robson, K.M. & Kumar, R. (1980). Delayed onset of maternal affection after childbirth. British Journal of Psychiatry 136, 347–353. Sayers, J. (1982). Biological politics: Feminist and anti-feminist perspectives. London: Tavistock. Shorter, E. (1984). A history of women’s
bodies. Harmondsworth: Pelican. Smith, J.A. (1992). Pregnancy and the transition to motherhood. In P. Nicolson & J.M. Ussher (Eds.) The psychology of women’s health and health care. Basingstoke: Macmillan. Ussher, J.M. (1989). The psychology of the female body. London: Routledge. Ussher, J.M. (2006). Managing the monstrous feminine: Regulating the
reproductive body. London: Routledge. Warren, S. & Brewis, J. (2004). Matter over mind? Examining the experience of pregnancy. Sociology, 38(2), 219–236. Zechmeister, I. (2001). Foetal images: The power of visual technology in antenatal care and the implications for women’s reproductive freedom. Health Care Analysis, 9(4), 387–400.
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the emphasis on women as mothers for fear of equating this with the idea that women were only mothers. Smith (1992) noted that most psychological studies of pregnancy took a positivistic medical view and there was indeed more to be understood about the complex experience of ‘normal’ pregnancy as a life transition. Have we learnt anything about this in the intervening years? The reconnection that some social and health/clinical psychologists have made with psychoanalytic literature, particularly Kleinian object-relations perspectives, has brought ideas of difference to centre stage so that the emphasis is upon understanding the ambivalence of becoming a mother (DiQuinzio, 1999). This has led to a revisiting of the ‘emotional journey’, frequently in the context of self-help books, through pregnancy to motherhood acknowledging that emotions are more than responses to hormonal changes (Ganley, 2004). It was once common practice for lay and professional ‘advisers’ to suggest becoming pregnant could heal relationship problems. even though generations of researchers have shown that the stress of new parenthood is more
likely to exacerbate ongoing troubles (see for example Nicolson, 1998). Becoming pregnant can be scary alongside emotions and anxieties about the relationship with the baby’s father, fears for health, bodily changes and how to cope emotionally, physically and practically with the new baby.
Final thoughts While most women in 21st century Western societies have relatively troublefree ‘normal’ pregnancies little attention is currently paid to the psychology of these experiences from the woman’s perspective. As other articles in this issue show, pregnancy is a crucial life transition with psychological, relational and emotional risks over and above those of morbidity and mortality policed through the medicalisation agendas. How does the quality of the experience becoming a mother impact upon a woman’s psychological well-being over time? In what ways do cultural values impinge upon psychology at this time in a woman’s life? Why is the label ‘postnatal depression’ (or postpartum depression) still used as a wider and wider catch-all
category despite evidence from psychologists with expertise in women’s health and lives demonstrating its limited value? The mental well-being of mothers now appears to be less a matter of depression through social isolation and more one of depression brought about through guilt, anxiety and the stress from not feeling good enough as a mother, partner or professional. The recent example of 43-year-old Catherine Bailey, a mother of three described as ‘loving’ and a ‘top City lawyer’ found dead in the Thames, whose suicide was attributed to postnatal depression, speaks volumes. The coroner’s extrapolation that Bailey had found it hard to meet the demands of motherhood and the high standards she set herself is far more telling than any clinical label.
Paula Nicolson is Professor of Critical Social Health Psychology at Royal Holloway, University of London paula.nicolson@rhul.ac.uk
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INTERVIEW
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The supreme infant Alison Gopnik, professor of psychology at the University of California at Berkeley, talks with Jon Sutton about the exploratory, bright butterflies that are children
ou’ve described human development Y as more like reverse metamorphosis than simple growth, with babies as exploratory, bright butterflies and adults as caterpillars, inching along their narrower paths. Can you expand? The central idea is that we should think of childhood as a separate evolutionary form, adaptive in its own right, and with its own special kinds of neurological and psychological structure. In particular, the evolutionary argument is that childhood – our uniquely protracted human period of immaturity and helplessness – is designed to give us a protected space in which we can learn and imagine. As adults we put what we have learned and imagined to productive work.
reading
A recurring theme of your book is the idea that playful immersion in hypothetical worlds teaches us how to make sense of the real one. And you think this is actually what makes us human? This is one of the most interesting ideas to come out of the new formal work on computational models of development, called causal Bayes nets or probabilistic models. The great advantage of these
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www.alisongopnik.com Gopnik, A. & Schulz, L. (Eds.) (2007). Causal learning: Psychology, philosophy, computation. New York: Oxford University Press. Gopnik, A. & Schulz, L. (2004). Mechanisms of theory-formation in young children. Trends in Cognitive Science, 8, 8. Gopnik, A., Glymour, C., Sobel, D. et al. (2004). A theory of causal learning in children: Causal maps and Bayes nets. Psychological Review, 111, 1, 1–31. Gopnik, A. (2009). The philosophical baby. Farrar, Straus and Giroux. Gopnik, A. (2009). From butterfly to caterpillar: How children grow up. New Scientist, 4 August [http://bit.ly/Ml1sq]. Interview from ‘The Big Think’: http://bigthink.com/ideas/16940
It’s important to say that there is no idea here that somehow men and women do different kinds of science. But undoubtedly what you know and care about, and so what you look at, shapes the questions you ask – earthworms were around for aeons but nobody thought about actually paying attention to them till Darwin. This is particularly true for babies since there is such a large gulf between what you see when you look at babies cursorily and what you see when you know them well, although there is still more to learn from studying them scientifically. I think that as more women do psychology, and more male scientists spend time caring for babies, the significance of babies will become more widely accepted.
models is that they let us represent and construct counterfactuals – possible worlds as well as actual ones. I don’t think I appreciated how important that ability is until recently. After all, the human You come from ‘a somewhat lunatic advantage is not only that we can learn artistic intellectual family’, and one about more different environments than of your sons is a hip-hop jazz fusion any other creature but that we can musician. Is there a danger this imagine and create new environments. environment could If you look around lead you to the room you’re in overestimate the now everything in it – “there is still an impulse in centrality of the right-angled table, much of psychology to see imagination and the woven fabrics, the children as defective adults” creativity in infants? electric light – was It might be a danger, if it once just a possibility weren’t for the fact that the in somebody’s head. kids in my lab keep surprising me! We live in an imaginary world. And that Almost every time we do an experiment process of imagination begins in the I start out thinking that the kids won’t be protected pretend play of early childhood. able to hack it, and end up amazed at You often seem genuinely aggrieved how much they can do. It’s the science that the minds of babies have been that is really convincing and the science underrated and misperceived. Is just keeps coming up with more and psychology as guilty of this as other more evidence for the power of young disciplines and wider culture? minds. Well, as we parents say, ‘I’m not hurt, There seems little doubt that young just terribly, terribly disappointed’. minds are powerful, but some Psychologists like Piaget have to get the reviewers have questioned whether you credit for seeing, really for the first time in are guilty of ‘anthropomorphising’. For history, just how significant babies might example, you write that ‘even ninebe. Of course, even Piaget systematically month-olds understand some underestimated children, but then every important statistical ideas’. Are you time I do a new study I discover that I’ve confident enough in the experimental underestimated them myself. But there is techniques of psychology to disregard still an impulse in much of psychology to this possibility? see children as defective adults. For Of course, this raises interesting example, I often hear neuroscientists philosophical questions. What does it lump together children, patients and mean to ‘understand’? Does it require the animals – an evolutionary absurdity that kind of self-conscious reflective reflects an implicit assumption that adult articulation we see (sometimes) in adults? humans are somehow the psychological One of the greatest discoveries of pinnacle. cognitive science has been that the brain One of your explanations for this computes, infers, predicts and generalises underestimation is that nearly all the and we can use psychological techniques great philosophers have been men! to discover just what it is computing and Given that psychology, here in the UK inferring. And another great discovery is at least, is becoming a largely female that the relation between that discipline, perhaps children’s minds computation and our conscious adult will move to centre stage? experience of understanding and
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inference is very complicated. Even as adults we often seem to understand, predict or compute even though we don’t have a conscious ‘understanding experience’. I actually think it’s too easy to say that this sort of understanding in babies is just ‘unconscious’ or ‘implicit’ – I am fairly sure that it is associated with some vivid phenomenology and
experience. But almost certainly that experience is not like adult experience. You write that ‘All the processes of change, imagination and learning, ultimately depend on love.’ Clearly love is ideal, but don’t a lot of unloved children turn into highly imaginative individuals? Here is one of those interesting points about childhood that is easy to overlook. Even ‘bad’ parents already provide a degree of care to children that would count as profound devotion if it were offered to anyone else. They have to or the children literally wouldn’t survive. I think I take pretty good care of my highly beloved partner – but it really comes to a half-hour of cooking and a couple of hours of company each evening, after leaving him alone to take care of himself all day. A caregiver who only took that much care of a baby would be an abusive monster! So even the minimum baseline of caregiver love is already a lot – and we know that children thrive with much more than that. Moreover, studies suggest that resilient children are those who do find love somewhere, even if it isn’t the love of parents. You have noted that parenting in today’s middle-class America is unusual, because comparatively few people are
involved in the care of each child and so meditation can reproduce some of that parents are more intensely involved in childlike wonder in children. But, of it. What impact does this have? course, adult art and science and It’s not so much that parents are more meditation also require just the sort of intensely involved in care as that they are uniquely adult discipline and focus and more self-conscious about it. For most of executive control that you don’t see in history we learned how to take care of children. Real Romantic poets were rather children the way we learned most a pain because they seem to have required important skills: we watched other people about as much looking after as babies do. do it and we practised when we There’s only been about five minutes in were young. With the end of the your entire life you haven’t been around extended family and fragmented babies and children. What’s left to and mobile societies there are now discover? many people who hold a baby for Oh, it would take many lifetimes just the first time when they have a to get started. But right now what I’m baby themselves. So there is a deep working on is how caregivers play a role anxiety and a great hunger for in implicitly teaching children what they some expert technological need to know. The really enormous solution. advance of the last 10 years has been that The writer Michael Pollan we’re finally starting to understand how makes a similar point about food. its possible for children to learn so much It used to be that people simply abstract, coherent, highly structured new ate what they saw their mothers knowledge from such fragmented cook and then cooked that way evidence. I genuinely believe that the old themselves. More choices and less battles between nativism and empiricism experience turn eating into a selfhave been put to rest by the new conscious technology-driven goalcomputational work on probabilistic directed kind of work – a method models and learning algorithms. But that to get healthier. And of course, the work has also made it clear that the real irony is that being less absorbed in problem is how children decide which trying to eat healthily is actually pieces of evidence to attend to – which healthier! In the same way people feel things to learn about – and caregivers that there is some parenting secret that may play a really crucial role there. will make their baby smarter. And yet the science suggests that simply letting children explore the world in a rich way with devoted, attentive caregivers is by far the best way to get them to thrive and learn. And, a further irony, for all the intense I’ve had three of my own children and spent my focus on ‘parenting’, in fact, professional life thinking about children. And yet I still many parents are less find my relation to my children deeply puzzling. Our love supported and more stressed for children is so unlike any other human emotion. I fell and isolated than ever before.
One nagging thing…
Maybe they could learn a thing or two from children? You have said that ‘To be infantile is to be supreme’. I suspect I am so crazy about babies because I am also a capital R Romantic – I’m attracted to the sort of openended creativity that is so characteristic of babies and young children. Someone wrote that the title of Richard Holmes’ new book on Romantic poetry and science in the early 19th century could have been the title of my book too – The Age of Wonder. Often adult art and science, and even more mundane activities like travel and certain kinds of
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in love with my babies so quickly and profoundly, almost completely independently of their particular qualities. And yet 20 years later I was (more or less) happy to see them go – I had to be happy to see them go. We are totally devoted to them when they are little and yet the most we can expect in return when they grow up is that they regard us with bemused and tolerant affection. We are ambitious for them, we want them to thrive so badly. And yet we know that we have to grant them the autonomy to make their own mistakes. In no other human relation do we work so hard to accomplish such an ill-defined goal, which is precisely to create a being who will have goals that are not like ours. I This is Professor Gopnik’s contribution to last year’s Research Digest special, on ‘one nagging thing you still don’t understand about yourself’. For more from some of the world’s top psychologists, search for ‘one nagging thing’ at www.researchdigest.org.uk/blog
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Literature, history and biology Peter Garrard on the uses of retrospective language analysis
ou’re interested in language and Prescient as this criticism may seem, Alzheimer’s; why don’t you analyse however, the question still lingered: was this?’ said my wife, handing me her the composition of Jackson’s Dilemma copy of Jackson’s Dilemma – Iris Murdoch’s somehow influenced by Alzheimer’s controversial final novel. It had been a disease? The diagnosis became apparent disappointing read: turgid, insubstantial, only after the book had been published, rambling; lacking the energy and and surely even the most consistently momentum with which her earlier fiction great artists can disappoint. It has even moved. been argued that Jackson’s Dilemma is the It was 2003. John Bayley had deliberate result of an experiment in published an intimate three-volume novelistic form (Todd, 2006), or a selfmemoir of his life with Iris, and Judi conscious caricature of her previous work. Dench had portrayed, to devastating This was the Jackson’s Dilemma effect, the later stages of her dilemma, which a systematic comparison neurodegenerative illness. We not only of the book with two other Murdoch knew of the diagnosis but understood novels (1954’s Under the Net and 1978’s it as clinicians (my wife and I are both The Sea, The Sea) that I conducted neurologists), so perhaps there was an element of retrospective interpretation. Yet professional critics had delivered their damning verdicts long before Alzheimer’s was first announced: the novelist A.S. Byatt compared the book to ‘an Indian rope trick, in which all the people are intent on going up the rope into an invisible world where they have no selves and therefore there is no story and no novel’; while for Hugo Barnacle it ‘read like the work of a 13-year-old schoolgirl who doesn’t get John Bayley and Iris Murdoch out enough’.
‘Y
references
SARAH LEE
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Bernheimer, H., Birkmeyer, W. et al. (1973). Brain dopamine and the syndromes of Parkinson and Huntington. Journal of the Neurological Sciences, 20, 415–455. Garrard, P. (2009). Cognitive archaeology. Journal of Neurolinguistics, 22(3), 250–265. Garrard, P., Maloney, L. et al. (2005). The effects of very early Alzheimer’s disease on the characteristics of
writing by a renowned author. Brain, 128, 250–260. Kemper, S., Griener, L.H. et al. (2001). Language decline across the life span: Findings from the Nun Study. Psychology and Aging, 16, 227–239. MacAlpine, I. & Hunter, R. (1966). The ‘insanity’ of King George III. British Medical Journal, 1, 65–71. Ohm, T.G., Müller, H. et al. (1995). Close-meshed prevalence rates of
(Garrard et al., 2005) is now generally agreed to have resolved. The variables used (lexical diversity, lexical frequency, word length and syntactic complexity) had been extensively studied in large populations of ‘live’ Alzheimer’s patients and behaved, in the context of these works of literature, in an analogous fashion. A conscious experiment in novelistic form that mimicked so precisely the linguistic features of a disease of which the author was an unwitting sufferer, would have been not so much prescient as preternatural. Moreover, the textual effects of Alzheimer’s have since been reproduced in the works of Dutch novelist Gerard Reve (1923–2006) who also developed the disease during the final years of his life (Van Velzen & Garrard, 2008). Murdoch’s prodigious literary output included 26 novels, four plays and five volumes of philosophical writings, spread evenly over a working lifetime of more than four decades. A more extensive detailed textual survey may well prove even more interesting if it reveals the emergence at some point of a trend towards the patterns observed in Jackson’s Dilemma. This laborious undertaking will entail the acquisition of a text corpus comprising over two million words, a task which, in the hands of my research group in Southampton, is nearing completion. Retrospective textual analysis promises a uniquely illuminating approach to understanding the earliest stages of Alzheimer’s disease. Looking back at samples of language produced spontaneously before the earliest symptoms of cognitive inefficiency became apparent could potentially open a window on the elusive presymptomatic phase of dementia. It seems likely that this period extends back over years, perhaps even decades. Given the brain’s parallel structure and combinatorial complexity, many aspects of its performance are not visibly compromised by partial depletion of its functional units. It has long been recognised, for example, that significant loss of dopaminergic
different stages as a tool to uncover the rate of Alzheimer’s diseaserelated neurofibrillary changes. Neuroscience, 64(1), 209–217. Peters, T.J. & Wilkinson, D. (in press). King George III and porphyria. History of Psychiatry. Pimlott, B. (1993). Harold Wilson. London: HarperCollins. Todd, R. (2006). What is Jackson’s Dilemma? Proceedings of the third
International Iris Murdoch Conference: University of Kingston. Tomlinson, B.E., Blessed, G. & Roth, M. (1970). Observations on the brains of demented old people. Journal of the Neurological Sciences, 11, 205–242. Van Velzen, M. & Garrard, P. (2008). From hindsight to insight. Interdisciplinary Science Reviews, 33(4), 278–286.
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neurons from the nigrostriatal system in his later years. A plausible hypothesis – the midbrain may be present in patients certainly more so than any of the spate of with no clinical features of Parkinson’s lurid conspiracy theories that emerged in disease during life (Bernheimer et al., the wake of his resignation – is that these 1973). two facts are linked. Unlike Iris Murdoch, A similar ‘threshold effect’ applies to no formal neurological diagnosis attaches cognition, which may remain apparently to Lord Wilson, and his family has always undimmed in the presence of profound kept the tragedy of his late-life cognitive cortical atrophy and established decline private. Ben Pimlott’s masterly Alzheimer pathology (Tomlinson et al., biography of Wilson (Pimlott, 1993) deals 1970; Ohm et al., 1995), a phenomenon sketchily with the twilight years, perhaps that has been referred to as ‘cognitive at the request of his wife and sons. reserve’. Yet cognition is an Wilson himself, elusive concept: like ‘the in response to economy’, it represents concerns about “linguistic activity can an aggregate of multiple his health several be, and often is, interdependent indices, months before he recorded and survives its performance may be resigned said that for many years” influenced by being observed, his physician had and a small change in one declared him ‘as fit component may have as a flea’. To what important consequences for the function extent this cheerful assessment and the of the whole system. A more manageable family’s subsequent reticence reflect set of observations would result from medical awareness and social acceptance studying a single component of the of dementia can only be surmised, but the cognitive system. There are no candidates contrast with the attention paid to and more suitable for this surrogate role than allowed by Iris Murdoch and John Bayley language: language integrity depends on some fifteen years later is striking. a range of other cognitive domains and is Applying the reasoning that motivated implemented within a widely distributed the Iris Murdoch project, I wondered set of brain regions. In a diffuse disease whether Wilson’s language might provide such as Alzheimer’s, sufferers inevitably any clues to his cognitive status in the experience difficulty in both writing and months immediately preceding his speaking. Moreover, unlike indices of resignation, and set about sampling the memory, attention or problem solving, transcripts of his responses at Prime linguistic activity can be, and often is, Minister’s question time over three epochs recorded and survives for many years during which he stood at the dispatch with little or no degradation of box fielding questions from the information. Admittedly, most spoken or opposition benches. Crucially, these written language that has been recorded sessions were mostly unscripted, and for posterity comes from historically or include contributions from other artistically important figures, but one of parliamentarians. Speeches are the best-known studies of retrospective transcribed for Hansard virtually as language used stored samples of writing spoken, though distortions, stutters, produced by members of a religious and grammatical errors are typically community fifty years earlier. One of the ‘smoothed out’ in transcript. The speech most remarkable findings of the Nun samples can thus be regarded as a more Study was the demonstration that than tolerably faithful record of the language characteristics during early sentences uttered by each speaker, and adulthood impact on the likelihood of yield a body of language against which developing late life dementia (Kemper Wilson’s own could be compared. In et al., 2001). a preliminary analysis (Garrard, 2009) We have recently begun looking for I simply used the distribution of evidence of presymptomatic cognitive individual lexical items as a means decline in archives of spoken language, of comparing the similarity between using a figure from 20th-century politics Wilson’s speeches and those of all other whose words have been recorded contributors. There was a suggestion in faithfully (though not, alas, verbatim) in the statistical analysis that the difference the pages of the Official Report – better between the two samples was more known as Hansard. Readers familiar with marked during Wilson’s first (1964–70) post-war British political history will administration, than it was in the 12 recall that Harold Wilson’s decision to months leading up to his resignation. resign from office while Prime Minister A clearer picture should emerge when in April 1976 has never been satisfactorily the samples are broken down into smaller explained, and that his once prodigious time-segments (e.g. month by month). intellect suffered progressive decline in A more remote, but no less
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controversial figure from British history, about whom language analysis may yield important historical findings, is King George III (1738–1820). Thanks to a widely publicised series of articles by the psychiatrists Ida MacAlpine and Richard Hunter (1966), it has become widely accepted that King George’s bizarre behaviour was due to acute exacerbations of the inherited metabolic illness, porphyria. An exhaustive reanalysis of the historical records, however, has revealed that this claim was based on spurious and selective interpretation of contemporary medical and historical sources (Peters & Wilkinson, in press), extrapolated liberally with respect to the ancestors and descendents of George III to create the appealing myth of a ‘Royal Malady’. The many pitfalls of applying contemporary clinical concepts retrospectively need not be rehearsed here, but the debunking of the porphyria theory nonetheless leaves an obvious diagnostic deficit. The King was an assiduous correspondent, both with his family and his ministers, and a large number of his letters have been preserved and published. We plan to look for changes in the linguistic structure of the texts of these letters and hope, with reference to the writings of a ‘live’ population of patients with uni- and bipolar affective disorders, that these will provide objective grounds for invoking a primary psychiatric cause for his famously strange behaviour. Most diarists and letter writers do not find a place in political or literary history, but we believe that their linguistic legacy is potentially even more valuable. The late- life cognitive histories of countless elderly people in the United Kingdom are known in detail by their relations and friends. Among these, hundreds, perhaps thousands, will throughout their lives have written letters, diaries or professional documents. Together with the Oxford Project to Investigate Memory and Ageing (OPTIMA) we have been funded by the Medical Research Council to collect and look back at such samples in an attempt to characterise and date emerging changes. The lead-time between linguistic change and the onset of dementia will be a genuine retrospective measure of the strength of an individual’s cognitive reserve. Variations could therefore yield important insights into the biology of common neurodegenerative diseases and perhaps suggest strategies that could lead to disease onset delay. I Peter Garrard is Reader in Neurology at the University of Southampton p.garrard@soton.ac.uk
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