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Unlocking the social cure A special feature on the new psychology of health
www.thepsychologist.org.uk
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the psychologist
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contact The British Psychological Society 48 Princess Road East Leicester LE1 7DR 0116 254 9568 mail@bps.org.uk www.bps.org.uk the psychologist and research digest www.thepsychologist.org.uk www.bps.org.uk/digest www.jobsinpsychology.co.uk psychologist@bps.org.uk Twitter: @psychmag Download our iOS/Android apps advertising Reach 50,000+ psychologists at very reasonable rates. CPL, 1 Cambridge Technopark Newmarket Road Cambridge CB5 8PB recruitment Kai Theriault 01223 378051 kai.theriault@cpl.co.uk display Michael Niskin 01223 378 045 michael.niskin@cpl.co.uk april 2018 issue 47,139 dispatched design concept Darren Westlake www.TUink.co.uk cover Taken from the cover of The New Psychology of Health, courtesy of Routledge printed by Warners Midlands plc on 100 per cent recycled paper issn 0952-8229 (print) 2398-1598 (online) © Copyright for all published material is held by the British Psychological Society unless specifically stated otherwise. As the Society is a party to the Copyright Licensing Agency (CLA) agreement, articles in The Psychologist may be copied by libraries and other organisations under the terms of their own CLA licences (www.cla.co.uk). Permission must be obtained for any other use beyond fair dealing authorised by copyright legislation. For further information about copyright and obtaining permissions, e-mail permissions@bps.org.uk.
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Unlocking the social cure A special feature on the new psychology of health
www.thepsychologist.org.uk
The Psychologist is the magazine of The British Psychological Society It provides a forum for communication, discussion and controversy among all members of the Society, and aims to fulfil the main object of the Royal Charter, ‘to promote the advancement and diffusion of a knowledge of psychology pure and applied’
The Psychologist needs you! We rely on your submissions throughout the publication, and in return we help you to get your message across to a large and diverse audience. For details of all the available options, plus our policies and what to do if you feel these have not been followed, see www.thepsychologist.org.uk/contribute The main message, though, is simply to engage with us. Contact the editor Dr Jon Sutton on jon.sutton@bps.org.uk, tweet us on @psychmag or call /write to us at the Society’s Leicester office.
Managing Editor Jon Sutton Assistant Editor Peter Dillon-Hooper Production Mike Thompson Journalist Ella Rhodes Editorial Assistant Debbie Gordon Research Digest Christian Jarrett (editor), Alex Fradera, Emma Young
Associate Editors Articles Michael Burnett, Paul Curran, Harriet Gross, Rebecca Knibb, Adrian Needs, Paul Redford, Sophie Scott, Mark Wetherell, Jill Wilkinson Conferences Alana James History of Psychology Alison Torn Interviews Gail Kinman Culture Kate Johnstone, Sally Marlow Books Emily Hutchinson, Rebecca Stack Voices in Psychology Madeleine Pownall International panel Vaughan Bell, Uta Frith, Alex Haslam, Elizabeth Loftus, Asifa Majid Psychologist and Digest Editorial Advisory Committee Catherine Loveday (Chair), Phil Banyard, Emma Beard, Harriet Gross, Kimberley Hill, Rowena Hill, Peter Olusoga, Richard Stephens, Miles Thomas
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84 Culture
I manage my eldest son’s football team. I’ve taken them from under-8s to under-14s, and the challenges in my working life pale into insignificance against what the average weekend throws up. There are perhaps times when membership of this particular social group feels like a curse. I fantasise about pulling them through to under18s, and then never setting foot in the club again. But our special on ‘the new psychology of health’ (p.28) suggests I shouldn’t be too hasty. Sure, groups can be negative if they are disadvantaged, stigmatised, if they don’t value you or if they make unhealthy choices. But psychologists are unlocking the ‘social cure’ afforded by groups, in a fine example of bridging the gap between research and practice, to influence public policy. And they’ve made me realise that when it’s time to shed my ‘Birstall United Juniors FC’ identity, I should at least consider taking up bowls. As ever, lots more in this issue, including a welcome to new CEO Sarb Bajwa.
88 A to Z What have we got for Q?
Dr Jon Sutton Managing Editor @psychmag
24 Lean in – but how? Michelle Ryan and Teri Kirby on a phenomenon they consider both under- and overrated 02 Letters Worboys case; digital data; and more
08 Obituaries 12 News Cambridge Analytica; and more 22 One on one with Sarb Bajwa, new Society CEO
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28 Unlocking the social cure S. Alexander Haslam introduces a special collection with his ‘Lists for Life’
54 ‘Individuals are active agents in their own environments’ We meet Essi Viding
32 Reversing the social curse Jolanda Jetten
62 Careers We hear from Lauren Bishop, and Simon Whalley
36 Addiction and the importance of belonging Genevieve Dingle
72 Jobs in psychology Featured job, latest vacancies
40 How groups beat depression Tegan Cruwys
76 Books Including five words that matter to psychology
44 Scaffolding a stronger society Catherine Haslam concludes, with how we are moving beyond social prescribing
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Shadowy puppet masters or snake oil salesmen? T
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he month of March saw blanket media coverage of the Facebook/Cambridge Analytica scandal, with CEO Mark Zuckerberg eventually breaking his silence to acknowledge that the policies that allowed a misuse of data were ‘a breach of trust between Facebook and the people who share their data with us and expect us to protect it’. Robinson Meyer, writing for The Atlantic, helpfully summed up the complex scandal: ‘In June 2014, a [psychology] researcher named Aleksandr Kogan developed a personality-quiz app for Facebook. It was heavily influenced by a similar personality-quiz app made by the Psychometrics Centre, a Cambridge University laboratory where Kogan worked. About 270,000 people installed Kogan’s app on their Facebook account. But as with any Facebook developer at the time, Kogan could access data about those users or their friends. And when Kogan’s app asked for that data, it saved that information into a private database instead of immediately deleting it. Kogan provided that private database, containing information about 50 million Facebook users, to the voter-profiling company Cambridge Analytica. Cambridge Analytica used it to make 30 million “psychographic” profiles about voters.’ Cambridge Analytica has significant ties to some of
President Donald Trump’s most prominent supporters and advisers, and reportedly used its ‘psychographic’ tools to make targeted online ad buys for the Brexit ‘Leave’ campaign, the 2016 presidential campaign of Ted Cruz, and the 2016 Trump campaign. During the Brexit referendum, Cambridge Analytica received a £625,000 payment from a pro-Brexit campaign organisation, potentially violating referendum spending rules. This isn’t the first time Facebook has been at the centre of a furore over the use of its data for psychological purposes. In our August 2014 issue we reported on the ethics of their own study of ‘emotional contagion’, in which the site manipulated its users’ news feeds over a week to assess whether being shown fewer positive or negative stories from friends would affect the emotions of individuals. And The Guardian actually broke the Cambridge Analytica story back in 2015. There are clearly numerous ethical and legal issues around such uses of our personal data online. But there’s also interesting discussion around whether any of this actually works. Is this a story about shadowy psychologists pulling the strings on a global stage? Of psychologists with real research tools increasingly hooking up with the social media titans who have the means to use them for leverage in life-changing ways?
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the psychologist may 2018 news Or simply a case of a psychologist providing data to a company who then use it to overpromise and under-deliver?
What’s special about ‘psychographic profiles’?
As Sasha Issenberg reported for Bloomberg in 2015, ‘Cambridge Analytica’s trophy product is “psychographic profiles” of every potential voter in the U.S. interwoven with more conventional political data. The emphasis on psychology helps to differentiate the Brits from other companies that specialized in “microtargeting,” a catchall term typically used to describe any analysis that uses statistical modeling to predict voter intent at the individual level. Such models predicting an individual’s attitudes or behavior are typically situational – many voters’ likelihood of casting a ballot dropped off significantly from 2012 to 2014, after all, and their odds of supporting a Republican might change if the choice shifted from Mitt Romney to Scott Brown. [Cambridge Analytica CEO] Nix offered to layer atop those predictions of political behavior an assessment of innate attributes like extroversion that were unlikely to change with the electoral calendar.’ Many are sceptical that such an approach actually works. Eitan Hersh, who wrote the 2015 book Hacking the Electorate, said that ‘Every claim about psychographics etc. made by or about the firm is BS… “Let’s start with fb data, use it to predict personalities, then use that to predict political views, and then use that to figure out messages and messengers and just the right time of a campaign to make a lasting persuasive impact” ...sounds like a failed PhD prospectus to me.’ New York Times reporter Kenneth Vogel tweeted: ‘BIGGEST SECRET ABOUT CAMBRIDGE ANALYTICA: It was (& is) an overpriced service that delivered little value to the TRUMP campaign, & the other campaigns & PACs that retained it – most of which hired the firm because it was seen as a prerequisite for receiving $$$ from [important Republican donor family] the MERCERS.’ In a Wired piece titled ‘The noisy fallacies of psychographic targeting’, Antonio Garcia Martinez wrote ‘the aspiring psychograficist (if that’s even a thing) is now making two predictive leaps to arrive at a voter target: guessing about individual political inclinations based on rather metaphysical properties like “conscientiousness”; and predicting what sort of Facebook user behaviors are also common among people with that same psychological quality. It’s two noisy predictors chained together, which is why psychographics have never been used much for Facebook ads targeting, though people have tried.’ Indeed, he notes that ‘Most ad insiders express skepticism about Cambridge Analytica’s claims of having influenced the election, and stress the real-world difficulty of changing anyone’s mind about anything with mere Facebook ads, least of all deeply ingrained political views.’ Others (including the historian Heidi Tworek) have written that fears of manipulation by new media are as old as mass media themselves, and ‘we’re back to the old new vision of crowd psychology and mass psychosis
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popularized by Gustave Le Bon in 1895’. Brendan Nyhan, a Professor of Government at Dartmouth College, pointed to a recent meta-analysis of numerous different forms of campaign persuasion, including in-person canvassing and mail, finding that their average effect in general elections is zero. Yet there is recent research (led by Sandra Matz) showing the effectiveness of these techniques in purchasing behaviour. With politics seemingly becoming more populist by the day, perhaps it’s just a matter of time before our voting behaviour is swayed in the same way. And some have argued that we’re looking for effects in the wrong place. Tom Stafford (University of Sheffield) said ‘My view is that persuasion effects are probably the wrong place to look… mobilisation effects (or the dark pattern alternative – influencing people not to vote) are probably where the action is.’
The tip of the iceberg?
One thing is for sure: the Cambridge Analytica scandal may end up being only the first of countless similar cases. Facebook has allowed third-party app developers to access private user data since 2007. How many of them cached the data and made their own private databases? Where is that data now, and how might it be used? Some psychologists we spoke to are concerned about this, and surprised the case isn’t making more waves within the discipline. Stafford told us: ‘When news of this broke in 2015, UK psychology was mostly silent: in marked contrast to many other scandals. Perhaps we weren’t au fait with the new frontiers in ethics that big data/social media are opening up. If that’s the case, we need to get up to speed… not only are many academics deeply involved in business, but social science research is itself perhaps moving to tech firms, which have the data and resources to do things that academics would like to do.’ Joseph Devlin (University College London) agreed. ‘I’m baffled about why the Cambridge Analytica affair didn’t even seem to penetrate most people’s awareness, especially among professional psychology researchers in the UK. It was, after all, “one of us” who seemed to have perpetrated this data collection, and he was based at one of the top universities in the world’ (although the University of Cambridge have now issued a statement distancing themselves from Kogan’s work). Yet some key figures have voiced their concerns. Michal Kosinski, psychologist, data scientist and now Professor at Stanford University, worked with Kogan and was reportedly the first academic approached by Cambridge Analytica. His internal emails from May 2014 suggest he described Kogan’s approach to the research as ‘highly unethical’ and warned that ‘this situation is really disturbing to the culture of our department and destroys the good name of the university’. In an interview with us last year, Kosinski had said: ‘I will stick to teaching and researching at Stanford – consultancy doesn’t interest me much.’ In that interview, he also voiced his concerns over the potential for Facebook to manipulate democracy: ‘The big problem is that in the past, editorial policy was obvious. You could see if you were looking at a left-leaning
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or right-leaning paper… Now, a guy in the back-room, an engineer, can tweak a tiny thing that will affect the online environment for 1.6 billion people and no one would know. If Facebook decided to be liberal-leaning, nobody would even know because everyone sees a different thing. It’s creating different results for billions of people so it’s sort of difficult to measure, even for the owner of Facebook. No single person can claim to know how it works.’ For his part, Dr Kogan has said: ‘The events of the past week have been a total shell shock, and my view is that I’m being basically used as a scapegoat by both Facebook and Cambridge Analytica when…we thought we were doing something that was really normal.’ Maybe there’s the rub… that as more psychologists become involved with commercial companies and the internet’s big hitters, they will continue to encounter grey areas
around what is ‘normal’, ethically and legally speaking. We’re becoming ingrained in ‘an expansionary economic logic that insists on inspecting ever more of our thoughts, feelings and relationships’ (in the words of William Davies in the London Review of Books). And if the data becomes more detailed and the tools more powerful, psychologists may find themselves – wittingly or unwittingly – having a growing yet partly invisible influence on the world we live in. js This is a complex, evolving story… visit the online version for the latest developments, and numerous hyperlinks to sources. You can also find our January 2016 interview with Professor John Rust, Director of the Psychometrics Centre at the University of Cambridge, whose emails with Kogan are amongst the revelations.
Trainees’ experiences of personal therapy
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Many training programmes for psychotherapists and counsellors include a mandatory personal therapy component – as well as learning about psychotherapeutic theories and techniques, and practising being a therapist, trainees must also spend time in therapy themselves, in the role of a client. Indeed, the British Psychological Society’s own Division of Counselling Psychology stipulates that counselling psychology trainees must undertake personal therapy as part of obtaining their qualification. What is it like for trainees to complete their own mandatory therapy? A new meta-synthesis in Counselling and Psychotherapy Research is the first to combine all previously published qualitative findings addressing this question. The trainees’ accounts suggest that the practice offers many benefits, but that it also has ‘hindering effects’ that raise ‘serious ethical considerations’. David Murphy and his colleagues at the University of Nottingham conducted a systematic review of the literature and found 16 relevant qualitative studies up to 2016, involving 139 psychologists, counsellors and psychotherapists in training who had undertaken compulsory personal psychotherapy as part of their course requirements. Most the studies involved interviews with the trainees about their
experiences; the others were based on trainees’ written accounts. Murphy and his team identified six themes in the trainees’ descriptions. Some were positive. The trainees talked about how therapy had helped their personal and professional development, for example raising their selfawareness, emotional resilience and confidence in their skills. Personal psychotherapy also offered them a powerful form of experiential learning in which they got to see for themselves how concepts like transference play out in therapy, and they obviously experienced what it is like to be a client. They also learned about ‘reflexivity’ – how to reflect on themselves and the way their own ‘self material’ contributes to the dynamics of therapy. Another positive theme was therapeutic gains – some trainees saw their personal therapy as a form of ‘explicit stress management’; they said it helped them work through issues from their past; and also helped them to become their authentic selves and to accept their strengths and weaknesses. The remaining themes were more concerning. Many trainees spoke of the stress and anguish that the therapy caused them, and the way it affected their personal relationships. In some cases this left them feeling unable to cope with their client work
(in which they were the therapist). Another theme summarised the burden that trainees felt that the mandatory therapy imposed on them, in terms of time and expense, and the pressure of being assessed and of their lost autonomy. Finally, the researchers said some trainees talked about how their therapist was unprofessional, yet it was difficult to change them; that they felt coerced into therapy and that the mandatory nature of it prevented them from truly opening up – in fact there was a sense of some trainees simply jumping through hoops in a functional way to complete their course requirement. Murphy and his team end their paper calling on regulatory and training institutions to consider the issues raised by their findings. Although the ‘hindering factors’ they identified raise serious ethical issues, they believe that it may be possible to address them. ‘We envisage that programmes that attend to the points raised in this study will provide the best learning opportunities, compared with courses that do not regularly critically reflect upon, assess, and evaluate mandatory psychotherapy within the course.’ Dr Christian Jarrett for the Research Digest www.bps.org.uk/digest Read the article: tinyurl.com/ yat9cdb3
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Flowers, apologies, food or sex? Getty Images
You and your partner have had a tiff. Of all the things they could do to try to make up with you, what would be the most effective? A group of evolutionary psychologists recently put this question to 164 young adults. They presented them with 21 categories of reconciliatory behaviour, including giving a gift, cooking a meal and communicating better (derived from an earlier survey of 74 other young adults about ways to make up). Men and women agreed that the most effective reconciliatory behaviour of all is communicating (for instance, by talking or texting). To varying degrees, both sexes also rated apologising, forgiving, spending time together and compromising as among the things their partner could do that would most likely heal wounds. But some behaviours men thought would be more effective for making up than women, and these
were their partner performing nice gestures (such as chores, favours and compliments), and offering sex or sexual favours. On the other hand, women thought their partner apologising or crying would be more a more effective way for their partner to make up than did the men. Joel Wade at Bucknell University and his colleagues said these differences are in line with the predictions of evolutionary psychology, namely that thanks to sex differences in mating strategies shaped through our deep ancestral past, men are generally more concerned about opportunities
for sex whereas women are more concerned about emotional commitment. The findings also complement past research, in the same vein, that’s found that men are more likely to end a relationship if their partner is sexually unavailable, while women are more likely to end the relationship if their partner is emotionally distant. ‘Evolutionary theory predicts a number of sex differences in mate selection, mate retention, and mate expulsion,’ the researchers wrote in Evolutionary Psychological Science. ‘The present research expands this literature by documenting systematic differences in which actions men and women perceive as most effective in promoting conflict reconciliation within romantic relationships.’ Dr Christian Jarrett for the Research Digest www.bps.org.uk/digest Read the article: tinyurl.com/ yayf4sp4
Tea-drinking for creativity
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that the effect is simply due to relaxation – so why not sit back and enjoy a brew with your next brainstorm. Dr Alex Fradera for www.bps.org.uk/digest Read the article: tinyurl.com/y7or2tbj
Joseph Albert Hainey
A study in the journal Food Quality and Preference [see tinyurl.com/y7or2tbj] suggests that tea-drinking benefits divergent thinking, a key element of creativity that’s associated with generating ideas or identifying patterns. The researchers from Peking University greeted their initial 50 student participants with a cup of either hot water or black tea, before asking them to use children’s building blocks to make the most attractive design they could. Independent raters, blind to the study purpose and condition, rated the tea-drinkers designs as more creative, in terms of factors like aesthetic appeal, innovativeness and grandness. In a second study, 40 more participants proposed names for a ramen noodle shop, and judges considered the names produced by tea-drinkers to be more innovative (but no more playful). Tea-drinking has already been tied to enhanced convergent thinking – coming up with the single correct answer to a problem – but the researchers claim theirs is the first study to find a relationship with more open, explorative thinking. The reasons for the effect aren’t clear: no significant improvement in arousal or positive mood was observed in the tea drinkers, nor did the participants prepare tea themselves, a ritual that some have speculated could help shift mindset. It’s possible
News online: Find more news at www.thepsychologist.org.uk/reports, including: a preview of psychology at the Hay Festival; Rebecca Fellows reporting from the Division of Clinical Psychology Prequalification Group conference; and more. For much more of the latest peer-reviewed research, digested, see www.bps.org.uk/digest (or download the free Research Digest app). Do you have a potential news story? Email us on psychologist@bps.org.uk or tweet @psychmag.
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Research digest
A Swedish study has used parent interviews to gauge changing levels of ADHD-related symptoms over a 10year period among nine-year-olds. While official diagnosis rates of ADHD increased five-fold during the study, levels of clinical-level symptoms had not changed, suggesting shifts in awareness and medical opinion may be responsible for the apparent increase in ADHD prevalence. Journal of Child Psychology and Psychiatry Researchers have proposed an alternative approach to emotion regulation that does not require in-themoment cognitive effort. They showed that prompting people to engage in ‘situation selection’ – deliberately choosing activities and situations that are likely to make them feel more positive – led them to experience more positive emotion, and this was especially true for people who said they usually struggled to regulate their emotions. Cognition and Emotion Psychologists have explored the kinds of songs that we like listening to on repeat and found they fell into three main categories: happy/energetic; calm and relaxed; and bittersweet. The last category was listened to the most perhaps because they were the most likely to produce deep connections, and participants felt they could replay more of them in their heads. Psychology of Music By Dr Christian Jarrett. These studies were covered, along with a new one every week day, by him, Dr Alex Fradera and Emma Young on our Research Digest blog at www.bps.org.uk/digest 16
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Birkbeck, University of London is building the world’s first ‘ToddlerLab,’ where scientists will monitor the behaviour and brain activity of children aged 18 months to three years. It will be part of the college’s Centre for Brain and Cognitive Development (CBCD), where the ‘BabyLab’ is currently based. The CBCD’s BabyLab has been investigating the psychological processes in infants’ brains for the past 20 years, and they have uncovered major insights into child development. The BabyLab scientists have previously identified the earliest marker of autism in babies, found important links between Down’s syndrome and Alzheimer’s disease and found that screen time affects the sleeping patterns of babies as young as six months, among other world-leading research projects. The ToddlerLab will enable researchers to extend their learnings from babies to toddlers. It will be equipped with wireless motion trackers, ‘hairnet’ sensors to record brain activity and a ‘nap lab’ to monitor the effects of sleep on brain activity. Professor Denis Mareschal, Director of the CBCD said: ‘There’s a real black hole in our understanding of the development of toddlers’ brains. Toddlers are active and dynamic. Unlike babies, they can’t sit on their parents’ laps and keep still. What they want to do is play and explore and meet other friends. The new ToddlerLab will provide us with an exciting facility for toddlers to roam around, interact with peers and behave as they would in the normal world, but all the while wearing specialist equipment that allows us to measure their brain activity.’ Birkbeck is currently crowdfunding to provide this equipment. One cutting-edge piece
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Using hypothetical scenarios, psychologists have found that those people more willing to speak up and confront antisocial behaviour, such as spitting or littering, tend to be more extravert, confident, persistent and good at regulating their emotions. They also feel socially accepted, and they are happy to take on social responsibility – such as voting and paying their taxes. British Journal of Social Psychology
Learning about toddlers’ brain development
of technology the ToddlerLab will include is the CAVE: an audiovisual, immersive, virtual-reality, environment. This can transport toddlers to different surroundings to see how they react to different scenarios and stimuli. Professor Mareschal continued: ‘Seeing how children react to different environments is very important because many toddlers will only be detected as having disorders when they go to school and they have to interact with their peers. Having lots of other children around brings out the difficulties these children have in engaging what others are thinking and how to respond to them. ‘It’s important to identify these disorders as early as possible because this means that we can start to intervene. We can help the child by putting them in a programme that may help alleviate their symptoms, or by helping their parents to identify a problem and giving them strategies for coping with any difficulties that their children will have, as well as learning new ways of interacting with their children that may circumvent the problems.’ To contribute to Birkbeck’s crowdfunding campaign for the ToddlerLab’s equipment, go to birkbeck.hubbub.net
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the psychologist may 2018 news
Fostering the next generation of researchers The British Psychological Society recently held its second Psychology Research Day at Senate House in London. Aimed at improving research skills and methods, the day featured a programme of useful talks for postgraduate students and early-career researchers, covering topics such as getting published, securing academic jobs, and blogging. Psychology publisher for Wiley, Rebecca Harkin, gave some useful tips for publishing with impact. She pointed out the way impact is now measured, using metrics not only from the number of citations a person’s work gets but also how far afield research has spread online, has changed how authors should approach their writing. One of the best ways to write to achieve impact is to consider one’s narrative, and Harkin suggested splitting work into subheadings to make it easier to read and digest. In the digital world it is also worth considering how easily your paper may be found online. To ensure search engines pick up on your research it is useful to have a title that features keywords, preferably within the first 65 characters – as these are used by most search engines – and also to include those keywords within an abstract. Harkin pointed to recent controversy over using impact factors, or the average annual number of citations a journal has; she argued these are only useful up to a point, revealing little about individual pieces of research. Altmetrics have been developed as a response to this – they track when a certain paper is reported on in newspapers, on social media, in reference management software such as Mendeley and in government documents, giving a better idea of how much impact a paper has really had. Rejection in academia is not unusual, to say the least, and Dr David Ellis (Lancaster University) gave some hints on how to avoid this when securing a first academic job. He said while a person’s number of publications was important, there are many other factors to consider. Being a good academic citizen, and good person, will assure any job interview panel you are happy to work within a research team rather than just for individual gain. Ellis encouraged PhD students to update their CVs regularly, even including applications for grants that have been rejected. He said if the idea for a grant was interesting an interview panel would acknowledge this even if it was unsuccessful. Applying for an academic job will usually also require competency questions, a cover letter, interview, presentation and a research plan – which usually outlines your plans for the next five years. Ellis pointed out that it is well worth planning for competency questions and presentations, even though many consider them something of an afterthought. Dr Christian Jarrett, Editor of the British Psychological Society’s Research Digest, spoke of the merits, and potential pitfalls, of blogging about research. Jarrett started his blogging career around 17 years ago
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with contributions to MindHacks before the Research Digest launched. Blogging, he said, helps academics overcome the ‘curse of knowledge’ whereby they can assume others share the same level of background knowledge when writing about a topic. Jarrett said that writing about one’s work in plain English for the general public presents a completely different challenge to academic writing. Academics are faced with an increasing expectation to share their work, and blog posts about studies can lead to greater exposure in the mainstream media. He pointed to The Conversation and The Mental Elf as good platforms for academics to blog about their work. Blogging also provides a way to clarify or defend one’s research with critiques of studies increasingly taking place in the online world. The exposure blogging offers, however, comes with some dangers. Jarrett specifically pointed to occasional backlash from readers who rarely choose their words carefully – people behave very differently online, he said. The Research Day, jointly organised with Senate House Library, also featured oneon-one clinics with librarians, technicians and postgraduate students on a wide range of topics including how to challenge gender Rebecca Harkin inequality within research careers, using qualitative research methods, research ethics and conducting literature reviews. er
Threat to qualitative research The British Psychological Society has expressed concerned over the adoption of a revised editorial policy by some journals (including the Journal of Child and Family Studies and the British Medical Journal) to stop accepting submissions of qualitative research. Professor Daryl O’Connor (Chair, Research Board) and Professor Andy Tolmie (Chair, Editorial Advisory Group) said: ‘We are particularly concerned at the claims that such studies are “low priority”, “unlikely to be highly cited”, “lacking practical value”, or “not of interest to our readers”. Qualitative research is now widely recognised as an important aspect of scientific work. Whilst some research may be considered as “lacking practical value” or of “low quality”, the same argument can be made for research utilising other methodological approaches and techniques, and are not issues that are restricted to qualitative research alone. There is a risk that editorial decisions of this nature will begin to shape the discipline, instead of the discipline being shaped by the activity of the broader community of researchers.’
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Winning ways From multi-talented technicians and students placed at the heart of restorative justice to academics with decades of experience – the British Psychological Society’s award-winners have some fascinating stories. Ella Rhodes spoke to them. Read more at tinyurl.com/bpswinways
Gill Allen
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Dr Gill Allen, who leads the Criminological and Forensic Psychology BSc (Hons) Programme at the University of Bolton, was inspired by her own practical experience with the prison service, youth offending teams and mental health services in giving students truly handson experience. The course, which has been given the Society’s Education and Public Engagement Board’s 2017 Award for Innovation in Psychology Programmes, sees students working on restorative justice panels and teaching young children about crime. In 2015 she and her colleagues signed a memorandum of understanding with Greater Manchester Police, which has led to students forming a restorative justice panel to help both victims and offenders work together following minor crimes. The students, who are fully trained, carry out risk assessments and set up conferences between both parties – a project that has piqued the interest of local schools. Allen said the students had worked on a range of offences, including violence and the inappropriate use of mobile phones. ‘Recently we’ve also diversified our referral system and we’re not just taking referrals from the police – a number of schools across the Bolton area know about our service and are putting referrals in. It can be bullying or more minor aggression, but the school may not want to deal with it though exclusion and it’s more about supporting individuals to make positive changes.’ Course students are also involved with Project Chameleon – a 10-week course in which the BSc students teach 10-year-old school pupils about crime, alcohol, self-defence, drugs and their effects, as well as the ‘ladder of aggression’ and how situations may escalate. Allen said it was fantastic to receive the award and to receive recognition from a prestigious panel: ‘In July last year we had the best outcomes ever for a cohort on the course with the most first class and 2:1 degrees we’ve seen. There was something really special on their graduation day as it was the first cohort I’d seen through all three years, and hearing their feedback on the course and the wide range of job opportunities which opened up to them thanks to the placements and their experiences was a real highlight.’ Speaking to me from his pleasantly cluttered lab, surrounded by every imaginable piece of psychological testing equipment, the winner of this year’s Technical Support in Psychology Research Award, Barrie Usherwood, said he was humbled by the honour of this
joint BPS/Association of Technicians in Psychology (ATSiP) award. An electronic engineer, Usherwood has previously worked in the automotive and food-processing sectors, as well as developing telemetry technology before moving to Lancaster University 10 years ago. Usherwood’s day-to-day work is exceptionally varied and involves helping psychologists use lab equipment, advising on the appropriate equipment for particular research aims and developing specialist software and hardware solutions. ‘I found out that I’d been nominated for the award a while ago and forgot all about it. When I got the email I was humbled, shocked, proud, a whole mixture of things. Working in this department I’ve been given so much scope to work on a huge variety of projects, the lab has become an extension of me really.’ Sam Royle, a Psychology Technician at the University of Salford, won this year’s BPS/ATSiP Technical Support in Psychological Teaching Award. As well as having a fulltime job, Royle is also in the midst of completing a PhD and is currently Secretary for ATSiP. He told me that there had been a drive in recent years by the Science Council to increase the recognition, visibility, career development and sustainability of technicians. Royle has been part of this drive thanks to his role in ATSiP, he explained: ‘We will need another 70,000 technicians per year for the next decade – that’s a huge number, and none of those people are yet being trained. The initiative is about making sure technicians are appreciated for what they do and are given the opportunity to develop in the same way our academics and students develop.’ Dr Trevor Powell, a clinical psychologist and neuropsychologist with 35 years’ experience, has won the Professional Practice Board’s Lifetime Achievement Award. Powell has spent most of his career working in adult mental health and neuropsychology and is the clinical lead and manager of the Berkshire-wide neuropsychology service. Powell has also been Chair of the brain injury charity Headway Thames Valley for 30 years. After a degree in psychology and sociology Powell worked as a nursing assistant on an adolescent unit in Macclesfield and eventually went into a clinical psychology doctorate course at Surrey University. He became interested in helping people with brain injuries after being accosted by a patient’s mother: ‘One of my patients was a young man who’d had a head injury, and I met him and his mother when I was a schoolboy psychologist. His mother was a very charismatic New Zealander, and she told me they were having a meeting about services with people with brain injury and asked if I’d come. I had to leave halfway through and whispered in her ear to let me know if there was anything I could
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the psychologist may 2018 news do to help. She gave me a call the next morning asking me to be Chairman of the charity they were founding, Headway – I asked what a chairman did and she assured me we’d make it up as we went along! That was 30 years ago, when people with head injuries were a neglected population who fell through the cracks between mental health, physical disability and learning disability; there wasn’t much for them in those days but there’s a lot more now.’ Thanks to his work in neuropsychology Powell has also been involved in medico-legal cases involving brain injuries. He told me about one involving mercury poisoning: ‘I went to South Africa and interviewed Zulu people who had worked in a mercury processing plant The company had employed Zulu people and just gave them a pair of wellies and overalls to work around mercury, which is highly neurotoxic, ignoring health and safety rules. Some of them had died and a number had significant brain injury, resulting in the company being taken to court. Powell has also written six books, including The Mental Health Handbook – a collection of photocopiable free handouts for use in psychological therapy and Head Injury, A Practical Guide, which gives advice on coping after head injury and was adopted by Headway. More recently Powell has helped expand the Berkshire neuropsychology service to include diagnostic assessment and support for adults with neurodevelopmental difficulties such as autism/Asperger’s syndrome and ADHD. As a result of this work, he has carried out some research and written a book entitled: Recognising Asperger’s Syndrome: a Practical Guide to Adult Diagnosis and Beyond. Colleagues and friends Dr Claire Hallas and Sasha Cain have been jointly named the winners of the Professional Practice Board’s Practitioner of the Year Award 2017. Both work as applied health practitioner psychologists and, after working in the NHS for more than 10 years each, set up their business SCCH Consulting in 2012. SCCH provides specialist training for practitioner health psychologists and other health professionals as well as developing psychological interventions for organisations, evaluating services and advising organisations on integrating evidence-based assessment, formulation and interventions into their work. Hallas and Cain met while working on the BPS Division of Health Psychology (DHP) Committee. As the only NHS practitioners on the committee at that time, they acted as a voice for applied health psychologists and helped to develop health psychology stage 2 training to include writing specific competencies for individual psychological intervention work. SCCH has also been commissioned to carry out some interesting projects, including the development of an online intervention to help people who have asthma and are experiencing problems in taking their preventer medication. During their time working on the DHP committee Cain and Hallas realised there were many applied practitioner health psychologists around the UK often working in isolation from colleagues and in areas of healthcare not necessarily linked to psychology departments. They
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set up a LinkedIn network for these colleagues and later ran two annual half-day networking events to bring them together, this eventually evolved into an annual one-day conference held in 2017 and 2018. Cain told me many health psychologists in these roles felt lacking in support and supervision, and many do not have a clear pathway for career progression. She added: ‘People told us that they really wanted to hear what other health psychologists were doing in practice, because in our profession more often than not we are working out in all sorts of applied settings often not within psychology departments and are quite isolated from other health Sam Royle psychologists.’ The Professional Practice Board’s Award for Distinguished Contributions to Psychology in Practice 2017 winner is Dr Emmanuelle Peters who co-founded the Psychological Interventions Clinic for Outpatients with Psychosis (PICuP) Clinic with Professor Elizabeth Kuipers. The clinic, based at the Maudsley Hospital in London, is one of the few entirely psychology-led services for psychosis in the UK, providing cognitive behavioural therapy for psychosis including comorbid PTSD and bipolar disorder, and family interventions. Peters is a clinical academic and is Clinical Director of PICuP, which started its life as a research trial. She fought hard for PICuP to become fully funded as a specialist NHS service following the success of the trial. In a time of savage austerity cuts, Peters said, keeping financially afloat was a huge challenge. However, she added, after 15 years with PICuP there had been some enormous highlights, and she pointed to hearing the good news stories of service users who had particularly good outcomes. ‘Some service users have actually published deeply moving articles about their experience of therapy, for example Dolly Sen’s article “What stays unsaid in therapeutic relationships” published in Psychosis last year.’ Peters said she felt running PICuP was the most important and meaningful thing she did in her working life: ‘I am extraordinarily Emmanuelle Peters proud of the work we do and of all the people who work there, many of whom worked with me as trainees and came back to stay. They are the most talented, devoted group of clinical psychologists you could ever hope for – it is a privilege to lead a team with such deep commitment to helping people with psychosis and a sense of shared values.’
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‘Principles define you as a person’
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Jon Sutton
Sarb Bajwa, the British Psychological Society’s new Chief Executive
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the psychologist may 2018 one on one or six days, and it differs from the Gregorian calendar so that it really is seven or eight years behind our calendar. One ‘encounter’ with psychology I received some coaching as part of a promotion in a previous role… though I was at first resistant to the idea, I very quickly realised that it was the best training I have ever undertaken. It has stayed with me to this day. One priority for the British Psychological Society Ensuring we deliver what our members want. That sounds like a rather generic answer but there’s a lot of work that needs to take place for us as an organisation to understand members’ priorities and needs, translate this into a vision, focus on our priorities and then deliver. One album Pink Floyd’s Dark Side of the Moon. A close runner-up would be anything by the Velvet Underground. Clearly, my musical tastes are stuck in the past.
One reason I wanted the job Well, I understand membership organisations and enjoy working with communities of experts, translating that into new products and services and then helping them to tell their story to a wider audience. So, I think I have some skills I can offer. Culturally, it seemed the right fit for my own values and outlook. The size of the job is demanding, and I enjoy the challenge this brings. Finally, I enjoy taking organisations and people on a journey, painting a vision of the future and how we’re going to get there. The Society’s already started to take the first few steps on that road. One guiding principle of leadership I don’t think you can have one set of principles for your personal life and one for your professional life. Principles define you as a person. One of my principles is around integrity – being and behaving honestly. It is the basis for all relationships and for me the foundation of trust. One place Many places evoke memories at different stages of my life. I am fascinated by the past and probably should have read History or Classics at university. So from this perspective Istanbul and Rome stand out. Both wonderful cities and at their peak the centre of empires. Of course, running an empire demands the exercise of power and so in a modern context I also love Washington. My most rewarding place in terms of my career is probably when I was working in Ethiopia. A wonderful, beautiful and fascinating country. For those old enough to remember, Ethiopia probably evokes memories of famine and Bob Geldof. However, it is a stunning country with a civilisation that stretches back to the Egyptians, gorgeous landscapes with major rivers, highlands, rolling savannahs and two rainy seasons a year, a cultural mix of Arab and African influences and a strong orthodox Christian faith. It really is stepping back in time as it operates on a different timescale, so you have 12 months of 30 days and one month of five
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One favourite dish I love food. I can narrow it down to particularly enjoying anything that comes from around the Mediterranean basin. In a tribute to childhood though, the odd fish finger sandwich always hits the spot. One inspiration My mother. A wonderful lady who is kind, open, bright and articulate and has made me the person I am today. From a historical perspective I have always been fascinated by Augustus, the first Roman Emperor, who clearly was a bit of a PR genius. From an intellectual perspective I think that the work done by Amartya Sen on the interaction and linkage of civil and political with economic, social and cultural rights is fascinating and ground-breaking. One book I seem to go through phases in my reading habits. So, when I was 19, I was transfixed by the Beat movement so Jack Kerouac was an idol. Moving through genres of literature there is Bulgakiv for magical realism; Dostoevsky for the Russian soul; Don Delillo, John Updike and Saul Bellow for the modern American masterpiece; and Chinua Achebe is unbeatable for colonial literature. One superpower For someone who loves history, clearly the ability to travel through time would be invaluable. One thing about yourself you still don’t understand In my head I imagine myself to be about 5’10” tall when in reality I am almost 6’3”. This misalignment means that I am, especially when tired, clumsy… my limbs seem to extend far further than I think they can! One joke The past, present and future walk into a bar… It was tense. One piece of advice for someone starting a new job Talk to everyone and get to understand the business as quickly as you can.
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Lean in – but how? Michelle K. Ryan and Teri A. Kirby on why ‘Lean In’ is both an underrated and overrated phenomenon
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f you’ve perused an airport bookshop in the past five years, or attended a women’s leadership course, you will be well aware of the Lean In phenomenon. The phrase was popularised by Facebook Chief Operating Officer Sheryl Sandberg, first in a TED Talk (2010) and then in her bestselling book (2013; co-written with Nell Scovell). Sheryl Sandberg’s message with Lean In is a fighting call to women in response to persistent workplace gender inequality. She urges us to face discrimination front-on – to overcome the ‘internal obstacles’ that hold us back from success, to ‘lean in’ to our careers, to ‘take a seat at the table’, and exhibit the ‘will to lead’. On a popular spin-off website (https://leanin. org) there are top tips, books to purchase and a series of empowering memes – ‘If you’re offered a seat on a rocket you don’t ask what seat. You just get on’, and ‘Don’t wait for an epiphany. Go on a treasure hunt. Find opportunity’. We will argue that the Lean In phenomenon is, at the same time, both underrated and overrated. Underrated as a clear and convincing documentation of the continuing barriers that women face in the workplace, but overrated in terms of solutions for overcoming these barriers.
Barreto, M., Ryan, M.K. & Schmitt, M. (Eds.) (2009). The glass ceiling in the 21st century: Understanding barriers to gender equality. APA Division 35 Book Series. Eckes, T. (1994). Explorations in gender cognition: Content and structure of female and male subtypes. Social Cognition, 12, 37–60. Rudman, L.A. & Glick, P. (2001). Prescriptive gender stereotypes and backlash toward agentic women. Journal of Social Issues, 57, 743–762. Sandberg, S. (2010). Why we have too few women leaders. tinyurl.com/mldvylf Sandberg, S. (with Scovell, N.) (2013). Lean in: Women, work, and the will to lead. New York: Alfred A. Knopf. Swim, J.K., Mallett, R., Russo-Devosa, Y. & Stangor, C. (2005). Judgments of sexism: A comparison of the subtlety of sexism measures and sources of variability in judgments of sexism. Psychology of Women Quarterly, 29, 406–411.
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What is underrated The Lean In phenomenon runs the risk of being written off as a popular self-help book from a high-profile, successful woman. But the book does an excellent job of documenting the barriers that women continue to face in the workplace and the very different experiences women have compared with their male colleagues. Using clear anecdotes and examples, it provides a comprehensive review of the blatant discrimination and stereotypes that impact upon women, but also elucidates how subtle messages about gender roles can create pressure for women to behave in line with these exact stereotypes.
The clarity of this documentation is crucial for tackling workplace inequality. Many instances of gender discrimination or inequality are ambiguous and subtle (e.g. Barreto et al., 2009), and research tells us that instances of discrimination are often difficult to identify as such (e.g. Swim et al., 2005). The Lean In phenomenon renders subtle discrimination easier to identify – if you will, it makes the ‘glass’ in the glass ceiling (or indeed the glass cliff) more opaque. It allows women to recognise their shared experience of inequality, and importantly, by encouraging the establishment of Lean In support circles, provides a mechanism by which women can commiserate and assist one another in addressing inequality. What is overrated There is no doubt that Lean In provides an excellent description of the barriers faced by women as a group and, importantly, it kick starts a discussion about workplace inequality. Where we think it falls short is in the solutions that it offers to address this inequality. For all its empowerment and fighting talk, we feel that Lean In’s core message is that we should fix women – taking a seat at the table that is laid for men, getting on the rocketship designed by men for men. In short, it calls for women to adjust themselves to fit in within a very masculine environment. Despite acknowledging the external barriers to gender equality, the book instead proposes solutions to fix the internal barriers women apparently erect themselves. For example, the book suggests that it is women’s chronic lack of confidence that prevents them from taking a seat at the table. However, this narrative neglects the fact that external barriers are precisely what lead women to question themselves in the first place. We argue that internal and external barriers must be seen and treated as being inextricably linked. Tackling internal barriers in isolation of external barriers is unlikely to be productive for a number of reasons. It is like describing a swimming hole full of dangerous creatures – crocodiles, water snakes, leeches (pardon the metaphor here) – and then saying that people should just brace themselves, take the risk, and dive in, with little regard for what they will encounter when they do so. Both blatant and subtle societal messages discourage assertiveness and ambition in women. So while empowering women to step up to that
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rocketship may increase their motivation and desire to put themselves forward, it does little to prepare them for, or address, the very real consequences they will face when they push against these norms. Think of Hillary Clinton or any number of other powerful women who have been described as an old battle-axe, merely for being assertive – behaviour that is mundane for powerful men is perceived as threatening when enacted by a woman. Given the social repercussions women face for ‘leaning in’ (Rudman & Glick, 2001), the book’s solutions may be setting many women up to fail (unless they’re one of the magical unicorns who can manage to be assertive without being too threatening). Moreover, Lean In is a message of individual mobility – trying to equip individual women to adapt to the existing system by adopting the values and strategies endorsed by it. While this strategy may work for individual women, and often those women who are privileged in terms of their intersecting identities (white, highly educated, straight women), it does
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little to change the system itself. In this way, women as a group are unlikely to benefit from such an approach. The success of a token few is also unlikely to change stereotypes about gender or about leadership. The small number of successful women are likely to be subtyped (e.g. Eckes, 1994). Even if women manage to ‘lean Dr Teri A. in’ effectively, their conformity Kirby is at the with masculine workplace norms University of reinforces the perception that being Exeter assertive and decisive is the only T.Kirby@exeter. reasonable model of leadership ac.uk in the workplace. It does nothing to challenge outdated ideas about what qualities define good leadership. We suggest that alternative solutions are needed, solutions that are empowering for women as a collective, rather than for women as individuals. Instead of suggesting that women adjust to the workplace, we suggest that workplaces need to change to become more hospitable places for women. If we want sustainable change – we must challenge the status quo, not adapt to it or replicate it. Professor Michelle K. Ryan is at the University of Exeter M.Ryan@exeter. ac.uk
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Unlocking the social cure S. Alexander Haslam introduces a special collection with his ‘Lists for Life’: what will kill you and what will make you stronger? Over the past 50 years a huge body of evidence, dating back to Tajfel’s famous minimal group studies, has built up support for the idea that social identity – a sense of ‘us-ness’ – is central to the dynamics of intergroup relations. But in the last decade a new body of work has built up around the idea that social identity is also critical for health: it’s the basis for a sense of connection and an associated sense of meaning, support, purpose and agency. This special collection features five researchers who have spearheaded this so-called ‘social cure’ research. As the former President of the Academy of Royal Medical Colleges, Dame Sue Bailey, said in the foreword to their new book The New Psychology of Health, this is a revolution we should all want to be part of. 28
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n 2009 Umberto Eco, the Italian semiologist and novelist, observed in an interview with Der Spiegel that lists are the origin of culture: they serve ‘to make infinity comprehensible’. More provocatively, he went on to note that because they allow us to engage with things that are limitless and boundless (such as knowledge), lists give us the capacity to deal with the one aspect of our lives that is most discouragingly limiting: death. So, in blunt terms, he argues that ‘humans beings make lists because we don’t want to die’. This point is interesting in itself, but it also raises the question of what types of lists people create when they are explicitly interested in staving off death. Giving some credence to Eco’s observations, it is clear that people – not least researchers and policy makers – invest an enormous amount of energy and effort in creating and circulating such lists. Two years ago the Chief Medical Officer in Queensland, the Australian state I now call home, invested a considerable sum of money in the production and dissemination of a glossy pamphlet entitled ‘Simple steps to better health’. This contained a list of nine behaviours that Queenslanders could engage in to stay healthy and prolong their lives. It included such things as staying physically active, having a healthy diet, saying no to tobacco, and being sun safe all year round. Its content would be recognisable to any reader of The Psychologist. Indeed, it corresponds very closely to the list (see box) compiled by the Chief Medical Officer in England in 1999 (although understandably, this makes no mention of the dangers of year-round sunshine). Advice of this form is eminently sensible and clearly well grounded in medical science. It’s familiar, and most of us have, at least to some extent, taken it on board. Testament to this, in a study that we recently conducted with a large community sample of people from the US and UK we found that their judgements of the degree to which various health behaviours (e.g. not smoking, exercising, having a good diet) increased life expectancy corresponded quite closely to the results of studies that have quantified this (Haslam et al., 2018). More specifically, there was a strong positive
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The Chief Medical Officer’s Ten Tips for Better Health 1. Don’t smoke. If you can, stop. If you can’t, cut down. 2. Follow a balanced diet with plenty of fruit and vegetables. 3. Keep physically active. 4. Manage stress by, for example, talking things through and making time to relax. 5. If you drink alcohol, do so in moderation. 6. Cover up in the sun, and protect children from sunburn. 7. Practise safer sex. 8. Take up cancerscreening opportunities. 9. Be safe on the roads: Follow the Highway Code. 10. Learn the First Aid ABC: airways, breathing, circulation.
correlation between people’s subjective estimates of how important key health behaviours were for life expectancy and their actual contribution, as revealed in an influential 2010 meta-analysis of 148 relevant studies by Julianne Holt-Lunstad and her colleagues. As lists go, then, these are ones that are both credible and given wide credence. What traditional lists leave out Familiar as lists like these are, they have a very particular focus: health behaviours that are well studied and well understood by medical researchers. In the process, they leave out causes of death that fall outside the traditional purview of medical science. There are two key classes of these causes. The first encompasses a range of social determinants of health such as poverty, unemployment and poor housing. As Jolanda Jetten explores in her article in this collection, when one takes stock of these causes
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of ill health, this leads people to construct lists that look very different from the one above. A second class relates to issues of social connection and social isolation. These are interesting for at least two reasons. The first and most basic is that it turns out that they are at least as important for health as the most important health behaviours that are identified in traditional lists. Going back to Holt-Lunstad and colleagues’ meta-analysis, we find that social support and social integration make a contribution to life expectancy that exceeds that of all of the traditional factors (such as smoking, alcohol consumption, exercise, air pollution, etc.). But it gets really interesting when we add in the data from our community sample: we find that the importance of these social factors is not well appreciated by the general public. Indeed, our respondents judged social support and social integration to be two of the three least important predictors of life expectancy. So whereas members of the community were quite good at judging the benefits of various health behaviours,
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they were spectacularly bad at recognising the benefits of these social factors. One reason for this, of course, is that they never appear on the lists that Chief Medical Officers send them, or that they see in doctors’ surgeries.
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A new psychology of health Of course, though, the fact that lists produced by Chief Medical Officers do not refer to the importance of social integration for health is not the only reason why people overlook this. Indeed, this can be seen to be symptomatic of a bigger problem, which is that the reasons why social connectedness is so important for health are not well understood, especially within medical science. Moreover, partly as a result of this, social disconnection is a problem that proves hard to tackle practically. Once we have understood that smoking causes cancer, the intervention is easy: stop. Once we have understood that exercise reduces the risk of heart disease, the intervention is easy: start. (Although, for reasons we discuss further below, it turns out that these behaviours are not quite so easy to change as one might think.) Yet how does one start to become socially integrated? And how does one stop becoming socially disconnected? These are thorny questions, and, moreover, they are not ones that psychologists have found it easy to answer. Part of the reason for this, we suggest, is that the way our discipline has traditionally oriented to matters of health (and much else besides) is by seeking to understand the psychology of individuals as individuals, when to tackle challenges of social isolation we need instead to understand how people function as group members. As the title of our new book suggests, this requires us to develop a ‘new psychology Key sources of health’. At the core of this new psychology is a recognition that people’s sense of self – and the Haslam, C., Jetten, J., Cruwys, T., perceptions and actions that flow Dingle, G. & Haslam, S.A. (2018). The new psychology of health: Unlocking the from it – is often dictated at least as social cure. Abingdon: Routledge. much by their group memberships Haslam, S.A., McMahon, C., Cruwys, and an associated internalised T. et al. (2018). Social cure, what social sense of social identity (a sense of cure? The propensity to underestimate ‘we-ness’) as it is by their personal the importance of social factors for identity as individuals (a sense of health. Social Science and Medicine, 198, 14–21. ‘I-ness’). Holt-Lunstad, J., Smith, T.B. & Layton, But why does this matter J.B. (2010). Social relationships and for health? A core reason is that mortality risk: A meta-analytic review. humans are social animals who PLoS Medicine, 7, 2–20. live, and have evolved to live, in Oyserman, D., Fryberg. S.A. & Yoder, N. social groups. Accordingly, like (2007). Identity-based motivation and health. Journal of Personality and Social hunger and thirst, physical and Psychology, 93, 1011–1027. psychological isolation are inimical Turner, J.C. (1982). Towards a cognitive to our make-up and design. In this redefinition of the social group. In H. regard, the fundamental significance Tajfel (Ed.) Social identity and intergroup of social identity is that, as John relations (pp.15–40). Cambridge: Turner (1982) first observed, it is Cambridge University Press. what makes group behaviour possible.
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Ten social identity tips for better health 1. If you feel socially isolated try to join a group. 2. If you can, join more groups. 3. Try to hold on to positive group memberships, especially if you are going through a challenging time. 4. If you lose membership in an important group, seek out a new one. 5. Invest in groups that are important to you and in groups by which you are valued. 6. Be wary of groups that make unhealthy choices. 7. Get support from your groups, but also give support to others in your groups. 8. Recognise that it can sometimes be healthy to try to leave disadvantaged and stigmatised groups, while at other times it can also be healthy to stay. 9. Challenge the stigma and disadvantage that produce health inequality. 10. If you experience health problems seek professional help — ideally from a source with which you identify.
Because this is such a pivotal point, it’s worth pausing for a moment to flesh it out with an example, albeit a rather trivial one. Imagine that you wanted to engage in a relatively simple form of group behaviour: as part of a community-based social club. What, psychologically, would allow you to do this? As Turner argued, the answer hinges on your having the capacity to define yourself, and hence to behave, as a club member. That is, rather than simply seeing yourself and other club members as individuals (i.e. in terms of personal identities as Alex, Bill, Cath, etc.), in order to engage in meaningful club activities you need to be able to see yourself and fellow team members as exemplars of the same social category (in terms of your shared social identity as ‘us Club members’). Amongst other things, then, your sense of yourself (technically, your self-categorisation) as a club member would mean you would be friendly to other club members and would go out of your way to help them (e.g. by giving them a lift to club meetings, doing their shopping if they are unwell). And of course, this same selfcategorisation process means they would do the same for you, and that, when they did, you would appreciate their efforts (rather than see them as patronising, say). At the same time, the fact that this sense of shared identity is context-sensitive and negotiated would mean that if the club merged with another club, you might treat its members in the same way too. Importantly, this internalisation of social identity
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predicted by the groups they are provides the essential platform for members of and identify with. As a range of attitudinal, perceptual ‘For me, the Tegan Cruwys shows, depression and behavioural phenomena. penny dropped can be understood to be a function These include a sense of similarity, about the of a person’s (changing) group commonality and connectedness importance of memberships that lead them to (i.e. a sense that members of your social identity experience social identity loss. And group are in some sense alike and for health finally, as Catherine Haslam shows, ‘in the same boat’ as you) and the when I was just as the loss of meaningful group ability to influence and coordinate working with Steve Reicher life is a harbinger of psychological the thinking and behaviour of on the BBC Prison Study in difficulty, so too efforts to (re)build those ingroup members (but 2001. As the Prisoners’ sense group-based social connection not outgroup members – which, of shared identity increased, constitute a royal road to recovery incidentally, explains why a lot their mental health improved from the scourge of social isolation. health advice falls on deaf ears; markedly; but as the Guards see Oyserman et al., 2007). lost their sense of identityIn this relatively mundane based connection, they became A new list for life example we can see not only that stressed, depressed, paranoid In many ways, our contributions to social identity underpins group and dysfunctional. Since then, this issue only scratch the surface behaviour, but also that it is this I’ve become attuned to the of the large and growing body of that allows us to access whatever ways in which workplaces can work that is informed by the social benefits a particular group activity resemble these two distinct identity approach to health – work affords. Accordingly, if it is the case sets of outcomes – and to to which a large and growing body that being in a club is good for the profound mental health of researchers around the world you and your health (and there is consequences of leadership have contributed. Thus, as well plenty of evidence that it is), then it that either builds or destroys as work on social disadvantage, is also the case that social identity this sense of “us-ness”.’ addiction, depression and is a gateway to these benefits. intervention, The New Psychology More particularly, it is the fact that of Health also addresses issues of group members see themselves S. Alexander Haslam is in the stress, trauma, ageing, pain, eating (i.e. self-categorise) as being ‘in the School of Psychology, University behaviour, chronic mental health same club’ (in terms of a shared of Queensland, Australia and long-term physical health. social identity) that allows them a.haslam@uq.edu.au Importantly, this work not only to work together in meaningful documents the ways in which ways: to contribute to collective social identities can adversely affect health, but also the achievements, and to support each other effectively in fundamental role they play in securing positive health the face of adversity (Haslam et al., 2018). Moreover, the more that group members define themselves in this outcomes. But returning to the issue with which we started, way – that is, the higher their social identification – the how might we distil these ideas into health advice that more true this is. speaks to the alternative realities that Holt-Lunstad More generally, this example also allows us to and her colleagues capture, but that traditional see that social identity is a fundamental basis for a guidance overlooks? Our list (see box) is a way of range of psychological states that are critical to health drawing together some of the key lessons that can and wellbeing. Amongst other things, this is because be learned from social identity research, and thereby feeling that we are ‘part of a group’ engenders a sense of trust and support, a sense of self-esteem, control and capturing important determinants of life and death that agency, and a sense of purpose, direction and meaning. traditional approaches to health fail to embrace. As with medical lists, the advice here is not always This also has material consequences in shaping the easy to heed. It is hard to join groups when you move way we interact with other people: whether we love to a new city, or work around the clock. It is hard to them, whether we lead them, whether we help them. avoid groups that make unhealthy choices when these In the most general sense, then, we can say that social are the only groups you know and have access to. identity is what allows us to fulfil our potential as The idea of challenging discrimination is often more human beings. appealing than the task of actually doing something. These are points that are fleshed out in the other Most particularly, though, these are things that it contributions in this issue. As Jolanda Jetten shows is particularly hard for people to do on their own. It in her article, people’s perceptions of, and responses is here, then, that groups really come to the fore and to, disadvantage are fundamentally shaped by their where we can bring the skills and insights of social, standing within a group, and the relationship between clinical, health and organisational psychologists to bear their group and others. As Genevieve Dingle shows, with particular potency. whether or not people smoke or misuse other It’s time to unlock the social cure: read on… substances – and whether or not they stop – is heavily
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Reversing the social curse Jolanda Jetten on when groups are disadvantaged and stigmatised
Consider for a moment the social groups you belong to. Focus in particular on the groups that are central in your life. What role do you think these play in your health?
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hink of your work groups, your extended family, your soccer team, a film or book club or your local community group. Consider more generally other groups that are central to the way you define yourself: your gender, nationality, ethnicity or religion. Some of the groups you belong to may be highly regarded by others. For instance, your work team may have high status within your organisation because it consistently outperforms all other teams. However, other groups that you belong to may be ranked much lower in the social pecking order (e.g. you may live in a relatively run-down neighbourhood). Other groups you belong to may not only have low status, but may face outright prejudice and discrimination in society (e.g. groups based on a sexual orientation, ethnicity or religion). While it is not hard to understand that people feel better when they belong to a group that is esteemed and has high status in society, it may come as more of a surprise to learn just how much the status of our groups affects our mental and physical health. There is now a wealth of sociological and epidemiological studies showing the profound role that social status and disadvantage play in determining health outcomes. As just one illustration of the magnitude of these effects, in his 2015 book The Health Gap, Michael Marmot observes that in the poorest (i.e. lower-status) parts of Tottenham, the life expectancy for men is 17 years lower than it is for men living only a dozen tube stops away in affluent Kensington and Chelsea. In Glasgow, the life-expectancy gaps for men between 1998 and 2002 were even more pronounced. So while in upmarket Lenzie a man was expected to live to 82 years of age, in the poor parts of Calton, just seven miles away, it was only 54. Testament to the fact that this gap is at least partly affected by the effectiveness of social policy, in Glasgow by 2015 this difference had been reduced from 28 years to around 20 years. Nevertheless, the stark differences here (which are replicated around the world), underscore the point that health has powerful social determinants. Thus, as a tonguein-cheek counterpoint to traditional recipes for health of the form summarised in the first list that Alex Haslam presents in the previous article, Dennis Raphael (2000) has presented an alternative list of health tips (see box) – this speaks to the fact that health flows at least as much from collective (dis)advantage as it does from personal-level factors. Similar negative health effects are observed when people are exposed to stigma and discrimination. To clarify the nature of these effects, in 2014 Michael Schmitt and colleagues conducted a comprehensive meta-analysis of 328 studies that examined the relationship between discrimination and mental health outcomes. This revealed a highly reliable, moderately sized correlation (r = -.23 between perceived discrimination and mental health, such that the experience of discrimination is associated with less positive and more negative mental health outcomes (e.g. lower self-esteem and life satisfaction, but higher depression, anxiety and psychological distress).
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Not the whole story When it comes to explaining why disadvantage and discrimination are associated with poor health, there is, of course, one simple explanation. This is that people who have low status and face material deprivation may simply not have the means to maintain a healthy lifestyle. Their budget does not run to such things as healthy food and fitness clubs. Likewise, those who face stigma may stay away from health professionals who they fear will not provide them with the same level of care as they give individuals from more advantaged groups. Yet while these explanation are certainly true, it is also clear that they are not the whole story when it comes to understanding the health gaps between rich and poor and between advantaged and disadvantaged individuals. We need to understand more clearly the processes through which status and stigma affect our health. In the case of social status, to understand why the status of a person’s groups affects their health, we need to take account of the fact that individuals are in important ways defined by the social groups to Key sources which they belong. It follows that when a person’s group has high Best, D., Loudon, L., Powell, D. et status, this reflects positively on al. (2013). Identifying and recruiting them, but that when a group has recovery champions. Journal of Groups in lower rank this puts them in Addiction & Recovery, 8, 169–184. a negative light. Haslam, C., Jetten, J., Cruwys, T., et al (2018). The new psychology of health: The impact of group Unlocking the social cure. Abingdon: memberships on our wellbeing is Routledge. especially pronounced if individuals McNamara, N., Stevenson, C. & identify highly with that group Muldoon, O.T. (2013). Community so that it is internalised as an identity as resource and context. important part of the self (Turner European Journal of Social Psychology, 43, 393–403. et al., 1987). If a soccer team is Marmot, M. (2015). The health gap: The relegated, for example, it is its challenge of an unequal world. London: die-hard fans who suffer most. Bloomsbury. More seriously, this is why people Postmes, T. & Branscombe, N.R. who identify with their work often (2002). Influence of long-term find retirement both difficult and racial environmental composition on subjective well-being in African painful. When they no longer have Americans. Journal of Personality and their work, something of their self Social Psychology, 83, 735–751. is lost too. Raphael, D. (2000). Health inequities Some clinical evidence that in the United States. Journal of Public supports this reasoning is provided Health Policy, 21, 394–427. by a 2010 study that Fabio Sani Sani, F., Magrin, M.E., Scrignaro, M. & McCollum, R. (2010). Ingroup and his colleagues conducted with identification mediates the effects of two populations: prison guards subjective ingroup status on mental in Italy and families in Scotland. health. British Journal of Social In both populations, respondents’ Psychology, 49, 883–893. sense that the groups they were Schmitt, M.T., Branscombe, N.R., members of had relatively high Postmes, T. & Garcia, A. (2014). The consequences of perceived status was associated with greater discrimination for psychological psychological health in terms well-being. Psychological Bulletin, 140, of lower perceived stress, lower 921–948. depression, and greater satisfaction Turner, J.C., Hogg, M.A., Oakes, P.J. et with life. Importantly too, in both al. (1987). Rediscovering the social group. cases, this effect was explained by Oxford: Blackwell. stronger identification with groups
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Alternative tips for better health 1. Don’t be poor. If you can, stop. If you can’t, try not to be poor for long. 2. Don’t live in a deprived area. If you do, move. 3. Don’t be disabled or have a disabled child. 4. Don’t work in a stressful, low-paid manual job. 5. Don’t live in damp, low-quality housing or be homeless. 6. Be able to afford to pay for social activities and annual holidays. 7. Don’t be a lone parent. 8. Claim all the benefits to which you are entitled. 9. Be able to afford your own car. 10. Use education to improve your socioeconomic position. Source: Townsend Centre for International Poverty Research (cited by Raphael, 2000, p.403)
that were seen to be of higher status. A similar explanation helps to understand why being the victim of discrimination has negative health effects. Stigma typically involves discrimination and exclusion on the basis of group membership. So when that group membership is an important aspect of one’s self (i.e. one’s social identity), discrimination not only means that ‘my group’ is excluded, but also that, by definition, ‘I’ am excluded and not welcome. In short, if your group really matters to you, then group-based discrimination becomes personal. And that both hurts emotionally and damages the self. The search for positive identity Despite the importance of status and stigma for health and wellbeing, it is also clear that members of disadvantaged groups are not necessarily condemned to have poorer health outcomes than their higherstatus and stigma-free counterparts. In particular, this is because even though defining oneself as a member of a socially disadvantaged group will tend to compromise self-esteem – and hence have negative consequences for wellbeing – the first instinct of those who have low status or who are stigmatised is not to resign themselves to their dismal fate. Instead, they continue to search for a positive identity. What is more, while disadvantaged and stigmatised group memberships often harm health, the same group memberships are often also instrumental in countering those threats to health. In other words, the same social identities that are experienced as a ‘social curse’ can also be a major source of ‘social cure’. This is rather ironic because it implies that for those who are members of a disadvantaged or stigmatised group,
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their group membership is both a cause of negative health effects and ‘I became the key to helping them overcome interested those negative effects. in social How does this work? More identities and particularly, isn’t it the case that health when leaving a disadvantaged and we did a large stigmatised group is the most research proves to be critical to health and obvious way to avoid negative project examining students’ wellbeing. As other articles in this wellbeing outcomes? Well, it turns transition to university. issue explain, these resources centre out that the answer to this second Following a cohort of new on the experience of support, question is often ‘no’ – those who students to the University of belonging, control and meaning leave disadvantaged groups do Exeter, we found that while (see Haslam et al., 2018). not always secure better wellbeing some students flourished after outcomes than those who stay. As their move, others struggled, evidence of this, a 2002 study from and they reported elevated An addendum Tom Postmes and Nyla Branscombe depression levels. The crucial Returning to the list of tips for found that black Americans who variable in explaining students’ health that we presented at the engaged in individual mobility by wellbeing was whether they top of this article, we can see that moving to white neighbourhoods had taken on the new identity while it has integrity as it stands, and seeking employment in white as a university student – those it could also be augmented. Yes, it areas often had poorer health who identified more strongly is true that health and wellbeing outcomes than those who had adjusted more quickly and felt are products of poverty and stayed. This can be explained by much better.’ disadvantage as well as of stigma the fact that those who continued and discrimination. However, the to live and work in black solution may not be to simply communities reported receiving Jolanda Jetten is in the School abandon these groups in the way more social support and being more of Psychology at the University of that this list suggests. Indeed, accepted by their neighbours (i.e. Queensland as the list itself implies, even if other African Americans), whereas J.Jetten@psy.uq.edu.au you wanted to follow the tips those who moved often felt rejected this is not always easy. For most both by the communities they had people becoming a lone parent, living in a low-quality moved into and those they had left. housing, or working in a low-paid manual job is not a Here too there is also good evidence that the more lifestyle choice but a fact of life. people identify with a disadvantaged or stigmatised Yet even in cases when one is stuck in a identity, the better their health and wellbeing. This was disadvantaged or stigmatised group, all is not lost. the conclusion reached by researchers who conducted Health and wellbeing can still be preserved, protected a household survey study with people living in disadvantaged areas of Limerick in Ireland (McNamara and even enhanced. Ironically too, this is best achieved et al., 2013). This found that those who identified most not by turning away from groups (as many of the recommendations on Raphael’s list suggest), but by strongly with the disadvantaged community reported turning towards them. Seek out others who face similar higher wellbeing. Further analysis showed that this was explained by the greater sense of collective efficacy forms of disadvantage and stigma, build a community, provide social support to others and receive support among those who identified more strongly with the from them in return. For example, join a single mum community. High-identifiers’ better wellbeing was support group (such as www.singlemothersunited. thus explained by their belief that they were coping org/about-us) or take part in recovery walks for collectively with the challenges that their community people who have overcome addiction (see Best et al., as a whole was facing. 2013). It is, then, by building shared social identity Surprisingly perhaps, group identification also that negatives can become positives and that stigma proves to be protective of health even when the can become strength. For this reason, we suggest group in question is the target of discrimination that at least one more recommendation should be and prejudice. In particular, a vast literature now added to the list: ‘If recommendations 1 to 10 fail or shows that people are more likely to be able to cope are not possible, consider turning to others who are successfully with stigma when they can band together disabled, poor, sole parents, living in your community, with other members of their group and collectively address their difficulties, rather than dealing with them or working in the same low-paid manual job as you do, and work as a group to challenge the shared on their own. This is because it is only when they injustices you face.’ It’s not easy, and not a magic bullet; act in terms of shared social identity that individuals but taking on board this lesson from social identity are able to draw upon the psychological resources research may be the most curative strategy of all. that group membership uniquely provides and this
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Addiction and the importance of belonging Genevieve Dingle takes a social identity route in and out of substance use Substance-using groups and identities may not be healthy and positive forces in our life, but people value them. Mapping such networks, and ensuring they are replaced, may be the key to behaviour change in addiction.
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n 1990 I arrived in London for a ‘gap year’, staying with some friends-of-friends for a few weeks while looking for a job and somewhere more permanent to live. I was young, far from my family and friends, and in those days before the advent of social media it was a lonely time. Everyone in the house smoked heavily. It was a shared ritual and a way of belonging. Soon – despite my knowledge of the health hazards – I became a smoker too. At clubs and parties that year, I would gather with ‘the smokers’, who always seemed to me to be the group having the most fun. I moved out of the shared house quickly but continued smoking – it took the place of a friend and something to do during a time of transition where I felt I didn’t belong. After returning home and back to friends, work and study, my smoking became something of a burden. There were no smokers in my family and I tried to hide it from my parents and colleagues who would no doubt have disapproved. Australian anti-smoking policies made smokers a stigmatised population. We paid increasingly heavy taxes on cigarettes and were forced to stand in smoking zones further and further away from our places of work and leisure. I noticed at parties that ‘the smokers’ group dwindled and instead of being the ones having the most fun, the smokers appeared to be the outcasts. Ironically, the smoking that had started as a way of belonging had become a barrier to connecting with family and friends. Eventually the day came when I realised that I was no longer one of ‘the smokers’ and I gave it up. Social identity pathways through addiction Looked at through a social identity lens, my move to London brought about the loss of connection with several important social groups (family, friends, work). The identities that I drew from them (daughter, sister, buddy, scientist) became less salient. By taking up smoking, I gained an identity and a sense of belonging with a group of young people in the house. I conformed to the normative behaviours and attitudes of that ingroup (which included heavy smoking and drinking). I held positive group stereotypes of smokers – they were the ones having fun and living for the moment. However, after I returned home to my usual social networks and identities, my smoker identity was incompatible with the group norms of most of these valued groups. By the time I quit, losing my smoker identity was not difficult since I was a member of various other groups in which non-smoking was the norm. More recently, as a psychologist researching addiction, I wanted to know whether the need for belonging that had motivated me to start and later to quit smoking was apparent for other people who were addicted to alcohol and a range of other drugs. Together with colleagues Tegan Cruwys and Dan Frings in a 2015 study, we analysed interview transcripts from 21 adults in residential treatment for alcohol and other drug
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Recovery Initiation initial exposure to recovery groups;; attraction to and gradual engagement with new recovery group time Figure 1. Social identity model of recovery (SIMOR), adapted from Best et al., 2015 Figure 9.8. interviews provided evidence for two problems. These distinct social identity-related pathways into and out of addiction. The first was an identity gain pathway in which substance use and addiction gave otherwise isolated people a new social identity and sense of belonging (similar to my own smoking experience). However, other participants described how their previously positive social groups and identities (e.g. as a student, parent, worker) were lost when their addiction took hold – in ways that pointed to the existence of an identity loss pathway. For many, this loss was profound, such as marriage breakdown, loss of employment and loss of custody of their children. For this latter group, being a drinker or drug user was a negative identity with negative group stereotypes. Clearly, these pathways represent quite different social experiences for these two subgroups of people, yet both are motivated by the need to belong. It is also the case that when they come out of recovery the two groups tend to have quite different trajectories. For those on the identity gain pathway, recovery tends to be about forging new aspirational identities to replace their former substance-using identity, while for those on the loss pathway it is often also about picking up the pieces and reconnecting with previously positive groups. If people simply move away from their using groups and don’t join any new groups, they are vulnerable to relapse and social isolation.
Moving away from substance using groups In the past 10 years, a growing body of research has helped to explain the role that belonging and identification with social groups play in determining
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active participation in recovery group;; salience of recovery-focused identity growth
our health and wellbeing. According to a social identity framework, people who are going through a period of transition tend to fare better if they maintain membership in multiple social groups and if they join new meaningful groups that are compatible with pre-existing identities. This is certainly the case for people going through life transitions such as retirement, moving from school into university, becoming a mother for the first time, or recovering from serious illness (see Haslam et al., 2018, for reviews). However, the story is more complicated when it comes to addiction. In this case, moving away from heavy substance-using social groups is a predictor of treatment success, because it allows people to see themselves less in terms of their addiction. It also makes them less vulnerable to social influence from groups in which heavy substance use is the norm. This process of social identity change is one that we and other colleagues have mapped out in the social identity model of recovery (see Figure 1). This conceptualises recovery from addiction as a process of social identity change, in which the balance of countervailing group forces changes over time. On the one hand, identification with, and hence the influence of, substance-using groups decreases; on the other, the acquisition of non-user identities provides alternative (healthier) sources of identification and influence. Illustrative of these processes in action, Sarah Buckingham and her colleagues studied 61 AA and NA members recovering from addiction in the UK. Their study, published in 2013, reported that the extent to which participants held a negative view of their addiction identity and a comparatively positive view
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of their recovery identity was related to lower relapse rates and ‘I am a clinical reduced substance use. In a second and music study of 81 ex-smokers, preference psychologist for a recovery identity over a who became smoker identity was related to interested in higher self-efficacy, and this in turn the importance treatment in one of five therapeutic predicted lower likelihood that a of social communities in Australia as person would start smoking again. identities for health through part of the Social Networks and In a similar study of adults work which examined their role Recovery project (Best et al., 2016; entering a drug and alcohol in recovery from mental illness Dingle et al., 2018). At entry to therapeutic community (TC) and addictive behaviours.’ treatment, participants’ substance in Queensland, colleagues and user identities were very salient, I measured how much people rated 5.2 to 5.6 out of 7 on a endorsed their identification with Genevieve Dingle commonly used measure of social substance using peers; with others is in the School of Psychology, identification. Again, though, in recovery (at the TC); and with University of Queensland after spending six months in the other non-users, dingle@psy.uq.edu.au TC, participants tended to see at fortnightly themselves more in terms of a intervals during Key sources recovery identity and less as a substance user. And, treatment. We found that those after accounting for demographic factors and addiction residents whose identification with Beckwith, M., Best, D., Dingle, G.A. severity, the difference between these identities at the TC increased within the first et al. (2015). Predictors of flexibility in six months accounted for 8 per cent of the variance few weeks in treatment and whose social identity among people entering in treatment retention, 27 per cent of the variance identification with their substancea therapeutic community for substance in commitment to sobriety and 36 per cent of the using groups reduced stayed longer abuse. Alcoholism Treatment Quarterly, variance in wellbeing. in treatment (Beckwith et al., 2015). 33(1), 93–104. This is important, because retention Best, D., Beckwith, M., Haslam, C. et al. (2015). Overcoming alcohol and other is an early indicator of positive drug addiction as a process of social A social approach to addiction outcomes. We found that 64 per identity transition: The social identity Various group and identity-related factors drive cent of the sample stayed the same model of recovery (SIMOR). Addiction addiction and need to be understood and harnessed in or increased their recovery-identity Research & Theory, 24, 111–123. treatment and recovery. Clinicians in alcohol and other ratings over the first month at the Best, D., Haslam, C., Staiger, P. drug-treatment services know that many people who same time that 76 per cent of the et al. (2016). Social Networks and Recovery (SONAR): Characteristics of seek treatment have tried to stop taking substances, sample decreased in user-identity a longitudinal outcome study in five often on multiple occasions, and then relapsed. This strength over the first month in therapeutic communities in Australia. particularly tends to happen at the time when people the TC. Speaking to the importance Therapeutic Communities, 37(3), 131–139. leave treatment and return to homes and communities of these patterns for long-term Buckingham, S.A., Frings, D. & Albery, where heavy substance use is the norm. outcomes, we followed up 60 of I.P. (2013). Group membership and In this context, it seems that behaviour change the original 132 participants around social identity in addiction recovery. Psychology of Addictive Behaviors, 27, and change in beliefs about substance use are most seven months after they left the 1132–1140. likely to be maintained when they are accompanied TC and found that the extent to Dingle, G.A., Cruwys, T. & Frings, D. by social group and network changes that are aligned which they endorsed a recovery (2015). Social identities as pathways with and support non-problematic use. Our need for identity over a substance-user into and out of addiction. Frontiers of belonging is strong: we cannot expect people to lose identity was a strong predictor of Psychology, 6, 1795. valued substance-using social groups and identities substance use and wellbeing at Dingle, G., Haslam, C., Best, D. et al. (2018). Social identity differentiation unless we help them to replace these with other the follow-up point (Dingle, Stark predicts treatment commitment and valued groups and identities. For some this means et al., 2015). Moreover, this was retention in therapeutic communities. reconnecting with their former positive groups and true even after accounting for age, Unpublished manuscript, University of gender and substance-use severity at identities (e.g. family member, friend, colleague, team Queensland. player) – while for others, it means joining mutual treatment entry. Among those with Dingle, G., Stark, C., Cruwys, T. & Best, support groups (e.g. AA, NA, and SMART recovery) better recovery trajectories, then, D. (2015). Breaking good: Breaking or therapeutic communities in which a recovery ties with social groups may be good it appears that recovery identity for recovery from substance misuse. identity can become a ‘transitional identity’ between becomes internalised and stronger British Journal of Social Psychology, 54(2), the user and the non-user identities. Whatever (more salient) relative to the user 236–254. direction the road to recovery takes, though, our sense identity. Haslam, C., Jetten, J., Cruwys, T., et is that social identities are always a major part of the This research has recently been al (2018). The new psychology of health: terrain. Accordingly, much is to be gained by mapping replicated and extended in work Unlocking the social cure. Abingdon: this terrain and helping people traverse its most Routledge. that my colleagues and I have problematic features. conducted with 307 adults entering
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Food:
Disorder or Wellbeing Friday 26 October 2018 8.45am till 4.30pm BPS London Office, Tabernacle Street
Speakers and Facilitators Dr John Adlam Dr Aikaterini Katerina Fotopoulous Psychotherapy Section Student members – Free
Dr Louise Langman Dr Matthew Pugh Dr Marie Reid
Dr Geraldine Shipton Professor Valeria Ugazio
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This event is organised by Psychotherapy Section and administered by KC Jones conference&events Limited.
https://www.kc-jones.co.uk/psychotherapy2018
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How groups beat depression Tegan Cruwys considers the evidence that identifying with others is a sustainable route to wellbeing Too many people know the suffering of depression firsthand. Approximately one in five experience it at some stage in their life – the figure is even higher in areas afflicted by disaster, trauma or poverty. It would be a lucky person indeed who avoids seeing depression in either themselves or the people they love. So why have we got no better at reducing its prevalence or impact? Is it time for a new approach?
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ost people are well aware of the key signs of clinical depression: notably, the experience of profound sadness, a loss of enjoyment and interest, changes in energy levels and appetite, and a sense of guilt or hopelessness about the future. Depression has received more research attention than most other mental health issues, and thankfully we have two forms of treatment
People who were depressed tended to report belonging to far fewer social groups than the rest of the population
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that work: psychological therapy and antidepressant medication. But here is the bad news: over the last 30 years, existing treatments have not reduced either the prevalence of depression or the disability caused by it (Baxter et al., 2014). As we will see, this is probably a reflection of issues related to access, compliance and relapse. First, access to evidence-based treatments tends to be difficult, with only a small minority of people around the world able to get seen by a mental health professional who can offer antidepressants (most commonly a selective serotonin reuptake inhibitor, or SSRI) or psychological therapy (most commonly cognitive behavioural therapy, or CBT). These tend to be people who are financially better off, and who live in urban areas of wealthy nations (Simon et al., 2004). This is why UK initiatives like Improving Access to Psychological Therapies (IAPT) are so important: they make a big difference in getting evidence-based treatment to more people who need it. Second, even people who have access to highquality care don’t necessarily follow treatment recommendations. Some studies have found that less than half of those prescribed antidepressants take them as directed – often because of problematic side-effects such as weight gain, emotional numbing or sexual dysfunction. Moreover, even though many people prefer psychological therapy, the stigma of seeing a therapist can often stop people from following through on a referral. Third, and perhaps of most concern, even among people who do manage to complete these ‘gold standard’ treatments, relapse is high. One of the highest-quality trials on depression treatment, comparing CBT and SSRIs, found that among people who received both, almost a third had relapsed only 18 months later (Shea et al., 1992). This high level of relapse is one of the reasons why depression remains a leading cause of disability worldwide. More than 80 per cent of people with depression relapse at some point in their lives, and the average person who has had one episode of depression can expect four or five more across their life, each of about six months in duration (Judd, 1997). Taken together, this evidence suggests that we need new approaches to treating depression that are low-cost and non-stigmatising, and that protect people across the lifespan (and not only during periods of acute symptoms). A growing body of evidence suggests that social connectedness is a good place to start looking for these new solutions. The first study that we conducted to explore the link between social connectedness and depression, published in 2013, included over 4000 adults living in England who were aged over 50 and who were tracked over six years. We compared people with severe depression with those who had fewer if any symptoms of depression. Consistent with a lot of existing research, the first finding here was that people who were depressed tended to report belonging to far
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fewer social groups than the rest of the population. We then looked at how these group memberships changed over the next two years. What we found was that people who joined more groups in this time – regardless of how many they belonged to at baseline – were less likely to be depressed four and six years later. Interestingly too, these effects were much stronger among those with a history of depression. Putting this in concrete terms, if a person with depression at baseline joined three groups across the next two years, they reduced their risk of relapse another four years later by as much as 63 per cent. Any way you look at it, this is a striking result. It suggested we were onto something meaningful and important that other researchers had overlooked. So is it that social isolation causes depression, as we might interpret from the above results, or the other way around? In fact, many health professionals who treat people with depression are trained to expect the latter, and see social isolation as a consequence of depression. To get a handle on this, we conducted a follow-up study, examining both the effect of social isolation on psychological distress over time and the effect of psychological distress on social isolation over time (Saeri et al., 2018). Following a sample of over 21,000 New Zealand adults across four years, we compared the size and significance of these longitudinal relationships. As one might expect, we found that the effect worked both ways. However, the effect of social isolation on psychological distress over time was about three times stronger than the converse. What this suggests is that social isolation both leads to, and follows from, depression. But it also tells us that in most cases, people become socially isolated before, not after, they become depressed. While this evidence is compelling, in psychological science nothing is more compelling than experimental evidence – and so this was the methodology we applied in our next study (Cruwys et al., 2015). For this we invited 88 young adults into the laboratory and assigned them to one of three conditions: to write about one group membership that was important to them, three group memberships, or to just skip this part of the study (the equivalent of writing about no groups). Participants then completed a problemsolving test, but what we did not tell them was that these were unsolvable problems. After 10 minutes all participants were individually given feedback that they had scored 0 on the test. What we were most interested in, though, was how participants interpreted this failure. Compared with the participants who had been thinking about one or three of their social groups, participants in the no groups condition were significantly more likely to interpret their failure in a way that was internal, global and stable: ‘I failed because I’m stupid’ (rather than, say, because the test was too hard or the time too short). This kind of interpretation is known as a depressive attribution style, and it is a recognised marker of depression.
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approach to depression, we found These participants were also that the more strongly people more likely to report negative ‘As a clinical identified with the social group that affect following their failure psychologist, they had joined, the greater the experience. All in all, then, this it has felt improvement in their depression experiment suggests that merely to me like a symptoms over time – dropping thinking about the social groups disconnect below the diagnostic cut-off only we belong to can make us more that most of in the ‘high social identifiers’. Put resilient in the face of life stress, our training another way, even among people and less likely to respond with focuses on dysfunction undergoing evidence-based CBT unhelpful interpretations and within people (e.g. social for depression, benefits were more negative emotions that, if repeated skills deficits or maladaptive likely to accrue to those people over time, may well culminate in schemas), when the vast who identified with others in their depression. majority of people seek help therapy group. What is true in the lab, with things in their social however, isn’t always true in worlds (e.g. workplace bullying, practice. It is also true that not all relationship breakdown or Next steps groups are the same. Certainly, we trauma). In my research I seek In sum, an increasing body of can all think of times we have been to address this disconnect, and evidence suggests that social involved in group activities that give practitioners the concrete, isolation (a lack or loss of social have felt like a chore, and where it evidence-based tools to identities) is not only associated is hard to imagine a benefit to our work with their clients’ social with depression, but is causally mental health. worlds.’ implicated in its development, Indeed, the maintenance and effective social identity Key sources treatment. This is exciting, not just approach Tegan Cruwys is in the School because it breaks new theoretical says that just of Psychology, University of Baxter, A.J., Scott, K.M., Ferrari, A.J. et ground, but also because it helps ‘showing up’ at Queensland al. (2014). Challenging the myth of an us to address the need for new a social group T.Cruwys@uq.edu.au ‘epidemic’ of common mental disorders. directions in depression treatment. activity is not Depression and Anxiety, 31, 506–516. As an approach to treatment, enough to make Cruwys, T., Dingle, G.A., Haslam, C. et al. (2013). Social group memberships social group connectedness suffers few of the issues a difference. It is only when those protect against future depression, related to access, compliance and relapse. Social groups are incorporated into our alleviate depression symptoms and groups are an affordable intervention because they self-concept, thereby becoming prevent depression relapse. Social can reach many people in need at one time, and are social identities, that they enable Science and Medicine, 98, 179–186. not the exclusive purview of highly trained mental health benefits. Our next study, Cruwys, T., Haslam, S.A., Dingle, G.A., health professionals. Moreover, compliance tends then, aimed to test the role of et al. (2014). Feeling connected again. Journal of Affective Disorders, 159, not to be a barrier to social group connectedness, as social identification as the ‘active 139–146. the ‘side-effects’ are not typically aversive, and with ingredient’ in groups that combats Cruwys, T., South, E.I., Greenaway, K.H. this approach it is also possible to avoid the stigma depression. Furthermore, this & Haslam, S.A. (2015). Social identity that can be associated with traditional diagnosis and study looked to translate the above reduces depression by fostering positive therapy. Finally, being involved in social groups is open findings into practice by exploring attributions. Social Psychological and to people across their lives; thus this approach holds how social identity principles Personality Science, 6, 65–74. Judd, L.L. (1997). The clinical course of promise not only for people with acute depression could be applied in clinical and unipolar major depressive disorders. symptoms, but also as a protection against its onset community settings (Cruwys et al., Archives of General Psychiatry, 54, and relapse. 2014). 989–991. An important next step for this research is to For this purpose we followed Saeri, A.K., Cruwys, T., Barlow, F.K. translate these various lines of evidence into useful, two samples across a period of et al. (2018). Social connectedness concrete interventions that increase social group several months: first, a group of improves public mental health. Australian and New Zealand Journal of connectedness. This is an issue that Catherine Haslam 91 outpatients with depression Psychiatry, 52(4), 365-374. addresses in the next article in this issue. The key or anxiety disorders who joined Shea, M.T., Elkin, I., Imber, S.D. et al. point to reinforce here, though, is that groups have a therapy group to receive CBT. (1992). Course of depressive symptoms an important role to play in helping beat depression Second, a group of 52 disadvantaged over follow-up. Archives of General because they have an important role to play in its people, the majority of whom had Psychiatry, 49, 782–787. development. Understanding this provides a platform complex mental health issues, Simon, G.E., Fleck, M., Lucas, R. & not just for better insight into the condition but also Bushnell, D.M. (2004). Prevalence and who joined a recreational group predictors of depression treatment in for a more sustainable approach to treatment. Indeed, facilitated by social workers. What an international primary care study. because groups are probably the most natural and we found, as expected, was that American Journal of Psychiatry, 161, effective vehicle for self-development that humans depression symptoms decreased 1626–1634. have devised, this may feel less like treatment and over time in both groups. However, more just like life at its best. and consistent with a social identity
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The School of Psychology is offering Postgraduate programmes in: Health Psychology (MSc) Distance Learning – BPS accredited (contact: Dr Liz Simpson, eea.simpson@ulster.ac.uk)
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Scaffolding a stronger society Catherine Haslam on moving beyond social prescribing, by applying Groups 4 Health to unlock the social cure In January the UK government decided to appoint the first minister for loneliness in the UK. For the party who gave us ‘there’s no such thing as society’, this represents a major, overdue shift in thinking. It forces us to look closely at the social processes and structures that are integral to the wellbeing of societies and to apply ourselves to the challenging task of working to do something meaningful to tackle what is widely recognised as a ‘wicked’ social problem.
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ocial isolation touches all our lives and knows no bounds. It affects the young and old, the rich and poor, and those who are in good and ill health. It also places huge pressures on health services – estimates suggest that around 10 per cent of adults suffer from its debilitating consequences, and that GPs spend around 20 per cent of their time dealing with non-health problems with two thirds of their clients raising issues of social isolation (Caper & Plunkett, 2015). With its new policy focus, the UK government has said it aims to ‘develop a wider strategy on the issue, gather more evidence, and provide funding for community groups to start activities to connect people’. A strategy of this form is clearly welcome, but it needs to do more than recognise the value of the various social activities (e.g. arts, sporting and voluntary groups) that are already supported by a large number of charities as part of a wider social prescribing movement. These activities are important, and they have a very positive impact; but, on its own, social prescribing is unlikely to solve the problem of social isolation. A key reason for this is that while social prescribing rightly recognises a lack of social connection as the cause of a great many physical and mental health complaints, merely telling people to go out and make more social connections is unlikely to help them do so. Indeed, many (perhaps most) people who are socially isolated do not wish to be, and they already understand that it is a problem. What they lack is the social scaffolding that supports and empowers them to (re)build sustainable and meaningful connections with others independently (Williams et al., in press). What form, then, might this social scaffolding take, and how can psychologists best act as social scaffolders? On the basis of a large body of research that has been conducted over the course of the last decade, our answer to these questions has recently culminated in the development of a new programme, Groups 4 Health (G4H). This is a structured intervention that puts insights from the social identity approach to health into practice in ways that help to unlock ‘the social cure’. Groups 4 Health The experience of social isolation and disconnection is common across a range of health conditions and contexts. It is a consequence, for example, of social disadvantage, mental health difficulties, addiction, pain, brain injury, trauma and ageing. At a time when people need them the most, social isolation robs them of the resources that flow from belonging to social groups. This is because social group belonging – and the sense of internalised social identity that this provides – has been shown to be a key source of self-esteem, feelings of control, access to social support, and a sense of purpose and meaning. As we see it then, social identity capital is
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Figure 1. Example of a paper-and-pencil social identity map (from Haslam et al., 2018)
Figure 2. Example of an electronic social identity map (from Haslam et al., 2018)
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create a visual representation the key outcome that interventions of the social groups in their lives. to tackle social isolation need to ‘I first began Examples of these maps are deliver. to recognise provided in Figures 1 and 2. These With this in mind, Groups 4 the importance reveal the number and types of Health aims to increase such capital of groups for groups that a person belongs to, by building group-based social ties people’s health the groups that are important to in the context of an in-vivo group when I was them (denoted by larger boxes), experience, so that the programme working as a their experience of these groups itself serves as a classroom through neuropsychologist in a hospital (e.g. how much support they offer which to tackle the issues it seeks rehabilitation department. and how positive people feel about to address (Haslam et al., 2016). What became very clear to them, indicated with numbers), and The programme is informed by the me was that, regardless of also the relationships between these social identity model of identity their specific condition, people groups (with the lines between change (SIMIC) and works on two who had more fulfilling group groups indicating how compatible pathways that are implicated in lives tended to have far better they are). positive health outcomes following recovery trajectories.’ In our previous research major life changes associated with these various features of the maps such things as illness, trauma have been found to be powerful or retirement. One of these Catherine Haslam predictors of health and wellbeing pathways centres on the process is in the School of Psychology, (Cruwys et al., 2016). In particular, of social identity continuity (i.e. University of Queensland people who are healthier and more maintaining pre-existing group c.haslam@uq.edu.au resilient tend to have maps in memberships) and the other on which there are (a) more important the process of social identity gain groups, (b) more groups associated with positive (acquiring new group memberships). The key point experience, and (c) more compatible groups. As well here is that when life throws up challenges, a sense as allowing people to reflect on their social world in of social identification with others is one of the main the present, these maps provide a useful platform for things that helps us to weather them. Sometimes this thinking about how this world might change over identification is associated with groups that we have time and be enriched in the future. In particular, in been members of for a long time (e.g. our family), but the Sourcing and Scaffolding sessions participants sometimes it is associated with groups that we have are helped to identify groups that they would like to only just joined (in particular, as a consequence of our make more important, and groups shared experience, e.g. as trauma that they would like to add to survivors). In all of this, the more “when life throws up their maps. These goals are then groups a person has, the more the focus of skill and strategy likely they will weather the storm. challenges, a sense of development within the modules, The G4H programme is social identification with and in the final (Sustaining) structured around five modules: others is one of the main module participants recreate their • Schooling: Raising awareness of maps to see how successful they the value of groups for health things that helps us to have been. and of ways to harness this. weather them” At present, there are around • Scoping: Developing social maps a dozen intervention studies that to identify existing connections provide support for individual and areas for social growth. elements of the G4H programme. Amongst other • Sourcing: Training skills to maintain and utilise things, these speak to the importance of helping people existing networks and reconnect with valued to hold on to their membership of groups that matter groups. to them, and, if they can’t, of helping them build new • Scaffolding: Using the group as a platform for ones. Moreover, these benefits have been observed new social connections and to train effective in the context of a range of life transitions including engagement. starting university, recovering from injury, having • Sustaining: Reinforcing key messages and a child and retiring. They have also been observed troubleshooting (held one month later as a booster under conditions of challenge and adversity that might session). present when a person is living with depression or coping with stress. Each of these modules centres on group tasks and There is also growing evidence of the effectiveness activities that are supported by a facilitator and also of G4H as an integrated package. In particular, this by a participant resource book. Among these activities, one that provides the foundation for much of the work comes from two studies involving adults experiencing social isolation and psychological distress. The first is social identity mapping. This activity is the focus of recruited 81 adults and found that G4H was associated the Scoping session and its purpose is to help people
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Why do we need Groups 4 Health? Given the number of approaches and interventions that have been used to treat social disconnection, one might reasonably ask why we need another. The answer is that despite the weight of evidence showing that social groups have a disproportionate bearing on health outcomes, existing programmes do not prioritise these as active ingredients in treatment (see Haslam et al., 2018; Jetten et al., 2012). This shortcoming cannot be addressed simply by delivering interventions in groups, or by tacking a group component on to what are primarily individual-focused therapies. To target the group as a core ingredient of intervention we need a framework that speaks directly to the ways in which social groups determine health outcomes and to the role that social identification plays in this. In addition, any applied framework needs to recognise the capacity for groups to function both as a cure and, if inappropriately managed, a curse. In this regard, there are two key features that differentiate the social identity approach from other approaches to managing health and social disconnection. First, its emphasis on the importance of groups and, second, its emphasis on the importance of a person’s identification with those groups. The combined upshot of these means that, as a cure for social isolation, it is not the case that any old group will do. Social prescribing that is oblivious to this point may not succeed and may even backfire. This is because it is only those groups that give our lives meaning, purpose and value that have the power to
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with marked improvement in depression, social anxiety, and loneliness both after the programme and then six months later (Haslam et al., 2016). In the second, 82 adults either received G4H or were placed on a wait list based on random assignment. This found that feelings of loneliness and depression declined in both conditions, but that this drop was greater among those who received G4H. For those receiving the programme, 83 per cent showed an improvement in loneliness and 71 per cent an improvement in depression. Interestingly too, GP visits increased significantly for those in the control group but not for those who took part in G4H (Haslam et al., 2018). This has particular relevance given that one of the key goals of the new minister for loneliness is to reduce the burden that loneliness places on health services, including GPs. More research is needed, not least to compare the effectiveness of G4H with that of other active treatments, such as cognitive behavioural therapy and social prescribing (involving referral to community case workers and navigators to link people with non-clinical local services). Nevertheless, findings to date provide grounds to be optimistic about the programme’s value as a means of building social identity capital among those who are suffering from social disconnection.
GP visits increased significantly for those in the control group but not for those who took part in G4H
support and sustain social connectedness. These are the groups that matter to us, that we identify with, and that become central to who we are (e.g. ‘we Australians’, ‘we psychologists’, ‘we Leicester City supporters’). These two features thus provide the basis for the two fundamental predictions that the social identity approach makes about the role that groups play in health and wellbeing: 1) Because it is the basis for meaningful group life, social identity is central to both good and ill health; and 2) A person will generally experience the health-related benefits or costs of a given group only to the extent that they identify with that group. Understanding which groups are a source of social cure – those that promote a sense of belonging, positive health behaviours, and boost self-esteem – and how they might be harnessed to support health and wellbeing is therefore the key starting point for the G4H programme. This knowledge is then backed up with strategies and skills designed to help people (re)build strong group-based ties with others. By providing the means for those who are socially disconnected to (re)gain control of their social lives through the (re)discovery of group-based agency, this framework has the capacity to take social prescribing to the next level.
Key sources Seize the opportunity The appointment of a minister for loneliness is a critical step in the process of prioritising the large-scale problems posed by social isolation. But, as psychologists, we need to seize this opportunity to ensure that people reap the full benefit of social prescribing. In particular, we need to ensure that efforts to promote social participation provide a scaffold that ultimately helps people to manage their own social worlds independently. In this regard, the chief benefit of G4H is that it is a democratising intervention, seeking to unlock the curative power of social groups and associated social identities in accessible and effective ways.
Caper, K. & Plunkett, J. (2015). A very general practice. London: Citizens Advice. Cruwys, T., Steffens, N.K., Haslam, S.A. et al. (2016). Social identity mapping (SIM). British Journal of Social Psychology, 55, 613–642. Haslam, C., Cruwys, T., Haslam, S.A. et al. (2016). Groups 4 Health. Journal of Affective Disorders, 194, 188–195. Haslam, C., Jetten, J., Cruwys, T. et al. (2018). The new psychology of health: Unlocking the social cure. Abingdon: Routledge. Jetten, J., Haslam, C. & Haslam, S.A. (Eds.) (2012). The social cure. Hove: Psychology Press. Williams, R., Bailey, S. & Bhui, K. (in press). Social scaffolding. London: Royal College of Psychiatrists.
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Essi Viding ‘Individuals are active agents in their own environments’ Our editor Jon Sutton meets Essi Viding (University College London)
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You study children with ‘callous and unemotional’ traits. What are they actually like to work with – it must be hard to connect? I think these children are a lot easier to engage in research than they are to work with in a school setting,
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or to parent. They can be perfectly charming. You can have a session where you just wouldn’t know that you are meeting a child who presents with challenging behaviour. They come and take part in research on volunteer basis. This means that the child
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has already made a choice that they want to give time to our project. I think they’re also slightly curious about brains. They often get to have a little outing in London when they take part, or if we test at schools they get to come out of a lesson to meet people they don’t normally see and do something that is relatively interesting and different. So we’re not there to deal with these children’s day-to-day behavioural difficulties, and because we don’t have an ongoing relationship with these children, there is no point in them trying to manipulate us in a one-off testing session. That’s not to say we don’t experience testing sessions that are challenging, but the challenging behaviours typically relate to co-occurring ADHD features. I saw a boy a couple of weeks ago who had severe ADHD, but who was not on medication. He managed to stay relatively still in the scanner, but that was such an effort that he was crawling under the furniture for the rest of the testing session. So we filled questionnaires together, two questions at the time, and then jumped up and down together, then did two more questions… I got my exercise for that day in the process, but we also got data that we needed and his mum sent an email afterwards saying that the boy felt that for once somebody ‘got’ his ADHD. You’re in quite a privileged position then, because you’re not there constraining, controlling, going on at them about conduct. You’re just interested in them. That’s very true. We only get a very short window of time with these children when we do research, and I know from talking with practitioners and parents that managing a really difficult child can feel overwhelming and hopeless. Yet there are very few children I have met, even the really difficult ones, where I didn’t feel that there could be some hope if there just were the right interventions and resources to support them. We know that children with ‘callous-unemotional’ traits benefit from traditional interventions, but their behaviour is often so severe that additional techniques and resources are needed. People often wonder whether it is possible to improve these children’s ability to empathise with other people. This is a reasonable question, but I’m not sure that we can necessarily engender empathy, or at least empathy as felt by most other people. But I do think that for pretty much all the children I have seen, if there were the right resources, you could modify their behaviour to be more prosocial. The milliondollar question is how to best do this. Given what we know about how children with ‘callous-unemotional’ traits see the world around them, my hunch is that you may need to socialise them using very different methods than what you would use for a typical child or adolescent. We normally rely on empathy induction, sanctions and social rewards – such as praise and positive emotional expressions – to motivate prosocial behaviour. Evidence indicates that children with ‘callous-unemotional’ traits are less responsive in these domains. This means that we may need to
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motivate good behaviour by appealing to instrumental benefits for ‘number one’. I often think that the biggest challenge we have in developing new treatments is to get the adults on board in using alternative socialisation strategies, which in many cases will feel really ‘grating’. We have such a strong sense of what is morally right and what sort of behaviour ought to have consequences. If behaviours are truly reprehensible, you feel like the person engaging in them should get their comeuppance. Discipline can be tough enough with your own children! Yes, and if I think about my own children, one of the things that keeps you going as a parent is that you get something back. Even though they’ve just vomited on you at 3am, or they have the most ridiculous tantrum, what keeps you going is that they hug you, tell you that they love you, want to please you. Not at every moment of the day, but on the whole. Now imagine that instead you have a child who does not just have the odd tantrum, but who you catch doing nasty things to others, lying to you, blaming others, rarely showing empathy and remorse. Further imagine that this child does not often say or do nice things for you, or if they do it’s only to get what they want – how long can a parent keep going with that? So I often get contacted by parents who are in a complete burnout and have run out of tools to manage their child’s behaviour. In order to get the interactions between these parents and their children on the right track, you will most likely need intensive professional help. If these children are like that, what is the glimmer of hope you’re seeing? That you can get them to look after number one in a way that is acceptable to society. We may have to come to terms with the fact that not everyone is as empathetic and loving as their peers, but actually it’s in everyone’s interest that they don’t go around actively exploiting and being aggressive to other people. When you have seen adults like that, do you see the same glimmer of hope in them, or are we talking about a window of opportunity that closes? I think I’m too optimistic to think that it’s ever fully closed, but if you have someone with a criminal history it will be very hard to rehabilitate them to mainstream society. Usually at that point they have years of not being in gainful employment, not having the education they need for that, years of having established certain habits and patterns of behaviour… often they have been able to attract quite a bit of resources with their antisocial behaviour, whether that be sex or power or financial rewards. How are you going to motivate that person, when what you can offer them if they stay
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on the straight and narrow is an unskilled job which doesn’t give them status, doesn’t give them much money, and probably as a repercussion doesn’t increase their chances of having much sex either? That’s hard. A part of your approach is to conduct genetically informative studies. We know that chaotic, violent backgrounds are going to be bad for children. So if you find that some children who develop callous and unemotional traits are particularly vulnerable to the impact of that type of environment, does that really make any difference? We should be putting resources into ensuring those types of environments aren’t created in the first place. Yes, but actually we have less good evidence that those environments are causal for the antisocial behaviour of children who have the callous and emotional presentation. In the children who have low levels of callous and unemotional traits, there is a clear dose– response relationship between the level of harsh parenting and their conduct problems. For the children high in callous and unemotional traits, the association between harsh parenting and conduct problems is less clear. And a 2009 twin design study of ours suggests that what modest association there may be seems to be an epiphenomenon of genetic risk in the family. That doesn’t of course negate your point… clearly we want to be as efficient as possible in preventing abuse and maltreatment, that’s just a moral obligation. But there are children from very dysfunctional families who don’t develop callous and unemotional traits or conduct problems, and there are those who come from ostensibly very healthy family environments and they still turn out that way. So biology is not destiny. It’s not, but it gives you a window within which you will likely function. Related to this, I’m very interested in how individuals are active agents in their own environments. We tend to view environmental risk factors as totally independent of the individuals they happen to. In certain cases, for example extreme abuse, that’s more than likely the case. But there are a number of social and environmental risk factors that are not independent of the person. Better understanding genetic risk, how that impacts the starting state of a neural system and how that develops over time, can help us understand environment, for example whether a person is more likely to evoke a particular reaction or choose certain environments. This can, in turn, help us think about how we might best nudge an individual onto a different path – for example what are the things which motivate that person that might be more adaptive?
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If you’re saying the high callous and unemotional children are tending not to be so impacted by the harsh parenting environment, that doesn’t necessarily push you down the route of a more neurobiological intervention?
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Absolutely not. People often view genetically informative research suspiciously and worry about researchers wanting to push medications or gene therapy. I actually think that the strength of genetically informative research is in what it can tell us about environment. I think it’s inevitable but unfortunate that we focus so much on risk factors. Sadly, risk factors are often things that we can’t fully control, and it is not easy to demonstrate the causal mechanisms by which risk factors act – if they are causal at all! Genetically informative study designs can be helpful in understanding whether risk factors are causal and can prevent wasting of resources on interventions that are not likely to succeed. But I actually think the strongest contribution that such research can make is to the systematic study of positive influences, and which ones can nudge somebody to a more prosocial outcome. For example, there’s a nice adoption study that shows that chances of developing of callous-unemotional traits can be reduced by warm and consistent parenting – even in children who at biological risk of developing such traits. But do you think some parents might prefer those biological solutions? If you give parents a choice of giving a hug before bed or an experimental drug that affects amygdala activation, which do they choose? I think most of them would go for the hug. It’s very rare to meet a parent who doesn’t truly love their child. A parent may be really short of tools as to how to bring up the child, they may lack an effective way of building their child’s self-esteem and making the child feel loved, but I almost never get the sense that a parent doesn’t care about their child. It can be helpful for the parent to think about individual differences that are rooted in biology, and this may help them have more realistic expectations regarding what their child can do and where their child will need help and support. So rather than expecting their child to be exactly like little Timmy who’s just lovely, brings the teacher an apple and never puts a foot wrong, they might think, ‘OK, it’s challenging for this child but we can get them on a different track and part of that has to do with me, and I might have these challenges myself… maybe I can now accept a bit of help, if I’m not just viewed as this bad parent who’s failing because I don’t care’. How do you go about putting them on a different track then? If they’re callous and unemotional, is it those aspects you’re directly working on? Well, there’s very little intrinsic motivation for these children, or adults, to empathise with others. If you have high levels of anxiety, you feel lousy. It’s just not nice to feel worried all the time. If you have high levels of callous and unemotional traits, you’re fine! You’re not feeling bad. Most of us experience the affective arousal that comes with the empathy response to other people’s distress as highly negative. If you don’t have
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that negative arousal response, why would you be motivated to seek it out in your everyday life? I am not sure that individuals with callous-unemotional traits would reliably do that.
child and asked to be a little bit more flexible about how I worked, the response from David Shanks, my then Head of Division, was along the lines of ‘I don’t care if you write your papers on the moon, as long as you write them’.
I do want to return to that hypothesis space… I can imagine if I was a parent, and you say, ‘We’ve Part of the award is that you have to design a project, identified this cognitive difference, in your child, and to promote women in science. a group of children like your child, and this is what Yes, it’s an honour to get the award but the project rolls out of that, and what we might need to do with is the cooler bit! My project is to select a group of them and with you.’ But then you say almost as an science ambassadors from GCSE-age children, in afterthought, ‘Oh and by the way obviously this is collaboration with schools from more deprived in part genetic and has neuroscientific correlates in boroughs in London. We’re going to ask teachers terms of brain activation, because everything does’… to nominate girls from a variety of backgrounds it just seems to me that the problem space has been traditionally under-represented in science, and the girls constrained by the understanding of the mechanism will then tell us why they would be interested in this without getting the genetic side of it involved at all. role. The selected girls will participate in a two-day I think it depends what you are then going to do with workshop with lectures, practicals and transferable the information about genetic skills training, such as training on influences. If you’re going to start interview and presentation skills. genotyping all these children and Such skills often act as gatekeepers “there should be grant think that’s somehow going to for study and workplace entry. The funding for early-career give you something magic – well girls will also be interviewed about that’s clearly not the case at the their experience, before and after, researchers which lasts moment. But if you think that will write some blogs and will get up to eight years and genetic vulnerability may constrain to interview scientists. We’ll also can be transferred particular neurodevelopmental generate a web resource, which outcomes and may also impact schools around the country can use across institutions” the environmental conditions, to find out about careers in science. then that information could The hope is that it will showcase help you think about the child’s science as a viable career for girls development and what they might respond to in from diverse backgrounds, and offer practical tools a different way. You might also feel less like you are that may increase their chances of getting into science failing as a parent, and more like you have a better careers. understanding of the source of challenges for yourself and your child. You may need special help to deal Not all academics I meet seem that happy with with a child with particular characteristics and you the state of things, but you seem to plough on. may also be more readily aware of sharing some of the Oh, I think there are things that need to change in difficulties that the child suffers from yourself. academia, there’s too much emphasis on grant income and the number of publications, too little emphasis on Talking of environments, of growth… you recently slow science and deep thinking. I see a lot of junior won the Rosalind Franklin Award, a great honour academics thinking about how they can game the recognising you as a female scientist. There’s an system to get money, rather than focusing on what’s incredible group of UCL women, exceptionally the interesting research question. And I cannot blame smart, very supportive, but with an interesting them, given the current job market and focus on the edge… do you think you’ve grown together in your financial ‘bottom line’. And diversity is a big issue… careers, mentored each other? I’ve tried to persuade some incredibly promising Obviously the first person that comes to mind in this undergraduate students from BAME backgrounds to context is Uta Frith. I do think that Uta is not just a stay on and do a PhD, but they often feel that they mentor, she actively ‘sponsors’ people. But I think UCL want careers with a stable income. If you don’t come also has an atmosphere that is quite forward-thinking, from a background where your parents can support in terms of women in science and other issues – UCL you financially should there be a gap in your income, has always been radical. It was the first university in then it is entirely rational to view PhD and postdoc as the UK that was set up to be entirely secular. There is a very risky career route. I think there should be grant no chapel on the campus. There’s always been a huge funding for early-career researchers that lasts up to emphasis on academic freedom. I think this attracts eight years and can be transferred across institutions a certain kind of man and a certain kind of woman. if the researcher makes good progress. This might My Heads of Division since I have been here have incentivise people from less well-off backgrounds to both been men, but men who have been very active stay in science. Currently we are not able to retain in promoting women in science. When I had my first these students, and this is a huge loss to psychology.
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Bridging the gap between theory and practice Tony Wainwright on the book that is the cornerstone of this edition
The New Psychology of Health Catherine Haslam, Jolanda Jetten, Tegan Cruwys, Genevieve A. Dingle & S. Alexander Haslam Routledge; Pb £24.99
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his issue of The Psychologist has five articles on social identity and health. These provide an overview of the social identity approach advanced within The New Psychology of Health. This can be thought of as a practical handbook for researchers and applied psychologists who are looking for a clear account of the way in which social psychology can be made relevant to health and wellbeing. The particular brand of social psychology that the book promotes is concerned with the importance of social groups for our health. Research in this fascinating field goes back to classic studies that demonstrated how perceptions and behaviour are structured by our group memberships – even when those groups have no prior meaning (Tajfel et al., 1971). In recent times, studies on very young infants have found strong ingroup preferences, again based on very small distinctions, such as which sorts of crisps the infants prefer (see e.g. (Pun et al, 2017). So, the importance of our connection to others is undeniable. We are clearly social creatures. For some, though, a frustration has been how to apply this work in clinical practice and in health settings more generally. An opening case for the capacity of The New Psychology of Health to deal with this theory–practice gap was made in The Social Cure published six years ago
(Jetten et al., 2012). This set out the research evidence for the effect of membership in social groups on health, and explored the various ways in which this knowledge could be mobilised in practice. That book was divided into five sections each addressing a particular theme: health and wellbeing; stigma and coping; stress and trauma; recovery and rehabilitation; and theory, practice and policy. The New Psychology of Health progresses each of these themes in substantive and persuasive ways. The opening chapter in this comprehensive text makes the case for the importance of the social groups to which we belong for health and the equal importance of our identification with these groups. It discusses the different contemporary approaches to understanding health (biomedical, psychological and social) and provides a well-argued case that the social identity approach has something important to offer that is highly relevant to both impact and delivery. After this introductory chapter, the book is essentially divided into two parts. The first part covers the arguments for this approach in dealing with many of the same themes as in The Social Cure, but in a more accessible manner, with examples that bring each theme to life. The second part covers areas of clinical practice (trauma,
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the psychologist may 2018 books ageing, depression, addiction, eating behaviour, acquired head injury, pain and chronic mental and physical health conditions) and explores how the social identity approach can be utilised in these different areas – again using helpful examples and case studies. The final chapter describes the Groups4Health programme and its effectiveness. All the chapters have a similar format, with the main body of the text covering the core theme and concluding with key points for practice and resources. As the authors point out, applying this knowledge is not so easy. In the same way that simply telling someone to stop smoking won’t necessarily help them to do so, telling people to join a group (lots of groups if possible) is also unlikely to work. Nevertheless, I am old enough to remember how long it took to convince people that smoking was harmful and to deal with the vested interests concerned. We may be in a similar situation concerning social approaches to health and wellbeing, as the recognition of its importance, both in keeping us well or making us unwell is a first step to doing something about it. Again, though, there are strong vested interests that disrupt this important message (see e.g. Gøtzsche, 2013). For researchers and those in the healthcare business, the book’s appendices are a further source of useful material. The first appendix is a set of hypotheses derived from the social identity approach to health. As the book shows, these have been subjected to, and supported by, a variety of tests in both experimental and field settings. These are invaluable as they allow a very specific focus on, for example, the type of group with which you identify and the potential outcome for your health and wellbeing. The other resource is a series of assessment tools that can be used to characterise groups and group identification. In summary, this book is a potential game-changer in how we conceptualise our interventions, and I thoroughly recommend it. It is a relatively easy read and provides clear guidance on the application of wellresearched theory. It packs an important, fresh and timely message and should be an invaluable resource for psychologists in training, those who provide training, and for researchers, policy makers and a lay readership who simply want a better understanding of important issues at the heart of health. Tony Wainwright is in the Psychology Department at the University of Exeter References Gøtzsche, P. (2013). Deadly medicines and organised crime: How Big Pharma has corrupted healthcare. London/New York: Radcliffe. Jetten, J., Haslam, C. & Haslam, S.A. (2012). The social cure: Identity, health and well-being. Hove/New York: Psychology Press. Pun, A., Ferera, M., Diesendruck, G. et al. (2017). Foundations of infants’ social group evaluations. Developmental Science [Advance online publication]. doi:10.1111/desc.12586 Tajfel, H., Billig, M.G., Bundy, R.P. & Flament, C. (1971). Social categorization and intergroup behaviour. European Journal of Social Psychology, 1(2), 149–178.
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Elastic – Flexible Thinking in a Constantly Changing World Leonard Mlodinow Allen Lane; Hb £16.99
Neophilia and schizotypy ‘I am an art addict.’ My friend proceeded to follow up that uncompromising statement with an explanation: ‘I was hiking in Patagonia, and, although surrounded by an incredible display of natural beauty, my brain wanted to see a work of art. I always need new stimuli.’ He was revealing a personal truth to me that he found bewildering. In his compelling latest book, Elastic, Mlodinow offers some sophisticated explanations for my friend’s conundrum. Mlodinow argues that our brains have developed to reward engagement with the arts with a pleasure response. Creative and original thinking are fundamental to helping us to respond to change and unpredictability. It is neurochemically satisfying for us to solve problems, making innovation and evolution part of our genetic make-up. Analytical thinking, which emerges from our executive functions, is neither suitable nor sufficient when we are confronted by wholly new situations. In these cases, Mlodinow contends, we have to rely upon a non-linear, divergent way of thinking. Every day we are required to process a 300-page book’s worth of information. Mlodinow believes that we will only be able to cope with the shifting realities around us by being increasingly ‘elastic-minded’. The defining traits of this elasticity are neophilia and schizotypy: a love of novelty, the quick generation of unusual ideas and being able to integrate opposing concepts. Through an engaging narrative replete with witty anecdotes, Mlodinow summarises the latest neuropsychological studies that bear out his central thesis. These investigations extol the versatility of our cognitive resources, looking at their impact on society’s development, when interconnected with emotional networks. Mlodinow’s book is a must-read for anyone remotely interested in how we can adapt to the rapid pace of life in the 21st century. My friend certainly appreciated it – he’s taken to referring to himself as a ‘neophiliac innovator’! Reviewed by Dr Lucia Giombini, Specialist Clinical Psychologist, King’s College London; Elysium Healthcare; The Child and Family Practice, London (UK)
Extracts online: We’ve collected many of our ‘online exclusive’ book extracts at https://thepsychologist. bps.org.uk/further-reading
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Five words that matter to psychology Tim Lomas (University of East London) with some highlights from his new books Translating Happiness and The Happiness Dictionary The field of psychology is founded upon concepts – from ‘memory’ and ‘perception’ to ‘depression’ and ‘wellbeing’. Its central task is to define these, tease apart their dynamics, and assess how they manifest in people’s lives. Given that, a significant thought arises: the field is inextricably shaped by the language in which it is conducted. This mainly means English, the dominant language of journals and conferences. As a result, the concepts that comprise the field – its nomological network – are generally those that happen to exist in English. But what of concepts that lack an exact equivalent in our own tongue? Do they reveal phenomena which have been overlooked or underappreciated in psychology? I have been collecting such words, and specifically ones relating to wellbeing (being a researcher in positive psychology). The result is an evolving ‘positive lexicography’, as I explore in two new books – Translating Happiness, an academic analysis published by the MIT Press, and The Happiness Dictionary, a general interest exploration of key words published by Piatkus. Here, I consider five words that have been assimilated into English and helped to shape the field, or that are beginning to make their mark. You can find five more in the online version of this piece. My hope is that these and other terms, perhaps words I am yet to learn myself, will prove to be useful in a lexicography which enriches our understanding of the mind. Ego Let’s begin with one of the most well known yet also unusual examples, ego. The Latin word for I has been thoroughly assimilated into the psychological lexicon, and indeed English more broadly. Freud himself used German terms for his tripartite theory of the ego, id and superego, namely Ich (‘I’ in German), Es (‘it’), and Über-Ich (‘over-I’) respectively. However, his translator, James Strachey, turned to Latin, perhaps aiming to confer greater scientific legitimacy upon the theory. As a result, ego has become a richly complex term, laden with meaning
and significance, when there had been no English equivalent. Gestalt From one perspective, English is a German dialect, brought to our shores in the fifth century ce by conquering Germanic tribes. It has continued to furnish us with loanwords, many of which then take on special meanings in psychology. A prime example is Gestalt. Originally this just meant ‘form’ or ‘shape’. But then, in the 19th century, it was deployed by Christian von Ehrenfels to describe the overall configuration of something. It moreover came to imply that the whole is ‘other’ – and possibly ‘greater’ – than the sum of its parts. He gave the example of a melody: this is not merely a succession of individual notes, but an entity unto itself. Since then, the term has proved influential, leading to Gestalt theories and processes in disciplines ranging from perception to psychotherapy. Sati This Pāli term for skilful attentiveness is the basis for the construct of mindfulness, which has achieved near ubiquity over recent years. But should we stick to the original term? Critics have argued that ‘mindfulness’ does not fully capture the spirit of sati, being rather cerebral, and lacking its warm, compassionate affective qualities. Moreover, the term mindfulness is often operationalised and harnessed in a secular way, ‘decontextualised’ from its original Buddhist roots. As a result, it is frequently denuded of the ethical and spiritual undertones that gave sati such depth and power. In that respect, in its English rendering, as Kabat-Zinn himself has pointed out, there is a risk of valuable ideas and lessons getting lost in translation. Sisu This word has a special significance for me, being the catalyst for the lexicography itself. It was after I stumbled across a presentation on sisu by Emilia Lahti that I decided to start my collection of words. Lahti suggested that although sisu shares conceptual similarity with
terms like resilience and grit, it is not synonymous. Rather, it conveys a form of extraordinary inner determination and courage, particularly in the face of extreme adversity and/or challenges which appear to exceed our capacities. Crucially though – for the purposes of my project – while it is celebrated as a nation-defining resource that has enabled Finland and its people to survive and thrive in the face of adversity, Lahti argues that sisu does not only belong to Finns, even if they had the foresight to create the term. It’s a human quality we may all ideally tap into. Indeed, her work is aimed at helping people to do just that. As such, it exemplifies the potential that may be waiting to be tapped in the myriad other words found in the lexicography. Ikigai Users of social media may have seen an intriguing petal-like image pop up in their timeline. It has four overlapping circles, arranged in a cross formation like a complex Venn diagram. These circles represent, respectively, ‘what you love’, ‘what the world needs’, ‘what you can be paid for’, and ‘what you are good at’. Their intersections signify: your mission (you love it, and it’s needed); your vocation (it’s needed, and pays); your profession (you’re paid, and good at it); and your passion (you’re good at it and love it). At the very centre, the bullseye, is a Japanese word: ikigai. Explained as having a ‘reason to live’, the term has come to attention through the work of people like Dan Buettner, with his work on ‘blue zones’. These are places whose inhabitants enjoy healthier and longer lives than peers elsewhere, including Okinawa in Japan. Buettner suggests that longevity in these places is due to a combination of factors, including a mostly vegetarian diet, moderate regular physical activity, and… ikigai. This quality is specifically recognised and celebrated in Japan, hence its inclusion in the figure. However, Buettner contends that ikigai is common across all blue zones, even if the inhabitants do not have a specific word for it. In that sense, maybe we could all do with searching for more ikigai in our lives.
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Eat Up! Ruby Tandoh Profile Books; Hb £12.99
The psychology of food, digested Ruby Tandoh loves food. She loves it so much that her first two cookery books weren’t enough to get the message across, and now her latest edition Eat Up! is devoted purely to the art of loving what you eat. Discussing everything from trendy pea-shoot smoothies, to Come Dine with Me, to the beauty of a Cadbury Creme Egg, this book is punctuated with anecdotes of food, love, psychology, and everything that meets in between. Eat Up! is a celebration of seemingly mundane food. It is not a ‘food book’ in the sense that it has pages filled with shiny photographs of dressed rocket salads and crushed avocado on toast. Instead, it spends winding pages discussing playful, warming dishes like Toffee
Apple Rock Cakes (‘if you can love these… you can sure as hell love your own wonderful body’) and Potato Curry. As someone who squeals with excitement at the ping of my oven timer, I instantly loved this book. However, whilst I always liked the idea of dedicating a book to the art of food, I was pleasantly surprised at the amount of psychology within the narrative. Carefully slotted in amongst the bite-size recipes and foody anecdotes lie some rather trenchant observations, all with psychological backing. Tandoh casts a critical eye over so-called ‘wellness culture’, fad diets, and fat-ism and, importantly, acknowledges that hunger and
appetite are both physical and psychological: ‘we may start a bowl of pasta to satisfy a hunger, and finish it to satisfy our senses’. She unpicks the ‘muddled, moral multitudes’ food ethics, and explores the social and political minefield that is ‘nutrition’. In a world that is equally concerned with both obesity and body image, Eat Up! digests all the psychological complexities surrounding our relationship with what we eat. Reviewed by Madeleine Pownall, who is an undergraduate at the University of Lincoln and Associate Editor: VIP Programme. She blogs at http:// thoughtbubblesblog.co.uk
Truth, lies and statistics [of] accepting the absence of evidence as signifying the In this engaging and illuminating book the authors evidence of absence’. attempt to understand the psychology behind why The authors advance some guiding people ignore scientific evidence in order principles based on their findings. Quite to believe in alternative possibilities. Denying to the Grave: often one can presume that irrational The obvious example is that of climate Why We Ignore the Facts beliefs are based on having a poor change, where there is a reasonably large That Will Save Us education, but the authors are very clear group of people, who deny the scientific Sara E. Gorman that a good education is no barrier to a evidence that human interaction with the & Jack M. Gorman poor belief system. Being human means environment is having a negative effect Oxford University Press; that people are more susceptible to on the planet’s climate. As a previous Hb £22.99 emotion than to statistics. The authors resident of Australia this reviewer recalls suggest that charismatic leaders are the ex-PM of Australia, Tony Abbot, a usually very good at the appealing to the proud sceptic of many things, stating that former, hence many people can be duped by the charm ‘climate change is a lot of crap’. The authors highlight the of a persuasive speaker. Finally, people can have trouble apparent stupidity of intelligence in that there is a ‘direct changing their minds once their beliefs are in place. relationship between intelligence and not vaccinating This can mean that despite evidence showing a contrary children’. position many people prefer to stick to their original The book offers key principles to adhere to, as well thinking for a considerable time, presumably until the as solutions to help people understand the issues around weight of evidence becomes overwhelming. the absence of facts in science. After all, there are very few absolutes in science, especially that of medicine, but Reviewed by Christopher Boyle PhD, Associate Professor there are statistics and probability. The authors argue in Educational Psychology, Graduate School of Education, that therein lies one of the issues: many people are not University of Exeter educated in the nature of science in that absolute facts do not exist. There are many variables, which can be confusing, and obfuscation can be easily practised if so required. As many scientists use hypothesis testing to put forward findings, which cannot be regarded as being unconditionally correct, the authors state that ‘many Reviews online: Find more book reviews at people can be uncomfortable with this’. A solution put www.thepsychologist.org.uk/reviews, including: forward is that members of the science media should be Catherine Loveday’s review of Inventing Ourselves: better trained to present information in such a way as to The Secret Life of the Teenage Brain by Sarah-Jayne ward against the ‘mistake in some science journalism Blakemore.
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The chimp brain takes over Anna Waters encounters Great Apes at the Arcola Theatre
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atrick Marmion’s adaptation of Will Self’s 1997 novel Great Apes is a funny, gripping and unnervingly original reflection on humanity’s place in the evolutionary chain. After a wild night of drinking and drugs, Turner Prizewinning artist Simon Dykes wakes up to find that his world has changed beyond recognition. His girlfriend, Sarah, has turned into a chimpanzee. And to his horror, so has everyone else. Immediately rushed to Charing Cross Hospital, Simon is taken into the care of charismatic radical psychiatrist Dr Zack Busner and treated for being under the psychotic delusion that he’s human. The play starts with fast-paced, loud and dramatic scenes, setting the tone for the rest of the play. Sarah
Beaton’s minimalistic stage design, with scenes switching from pulsating nightclub to hospital psychiatric ward in seconds, is impressive. Dan Balfour’s excellent sound design is a prominent feature of the play and helps to heighten the feeling of uncertainty and fear in a world ruled by chimpanzees. I was interested to see how the chimpanzees would be brought to life, and the play achieves this triumphantly through harem pants, short crutches and bowed legs. One of the highlights of the staging is the incredible chimpanzee vocals, with the actors crying out in panthoots. This characterisation is thanks to contribution from movement director Jonnie Riordan and chimpanzee
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Dr Anna Waters is Lead Psychologist for Performing Arts, at Chimp Management Ltd
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…divorced by first light? do not take advantage of this perfect With its third UK series just match, granted to them by Science broadcast, the premise of Channel 4’s Itself… well, that’s their fault. Married at First Sight is that science By the end of Series 3, science can successfully pair people in has married off eight of its ‘perfect’ marriage. The hook is that selected UK matches – but without any participants agree to marry science’s obvious successes. How could match ‘blind’ – meeting for the first this be? Did the perfectly matched time at the altar. couples not try hard The science enough? underpinning the tv This explanation matching, which Married at First Sight seems very unlikely, featured quite Channel 4 unless the broadcast prominently in Series footage is misleading. 1, is shadowy in A much simpler Series 3. The buoyant alternative is that science’s talk of personality types, oxytocin, measures of personality types and attachment theory, DNA and Jason’s genetic predispositions, although symmetrical face (apparently, presented with much fanfare, indicating that he has ‘strong genes’) are incapable of producing the is gone. Also gone, and perhaps just as well, is Series 1’s rather snooty condescension towards online dating agencies. Three couples are selected for marriage, all goodlooking, white and articulate, representing the best matches from two thousand potential pairings. With science using sophisticated data that scientists only its choicest 0.15 per cent, the scorned online rivals might justifiably need to judge marital compatibility. Big-noting about DNA samples and complain. The worst marriage ‘oxytocin hits’ sounds impressive but agency in the world can do better just makes science look ridiculous than 0.15 per cent. when Richard, with his pet dog, ends The weddings take place (minus up marrying Harriet, who can’t bear one couple that has withdrawn) and dogs. the newlyweds throw themselves As entertainment, Married at First into married life. They desperately Sight is fun. As science, its greatest want marriage to work; Channel 4’s contribution is in demonstrating, producers desperately want them albeit unintentionally, the immense to have sex and admit it on camera. difficulties that behavioural scientists But instead, the newlyweds are face when they try to predict any discovering ‘lack of chemistry’ and specific behaviour or feelings in things they don’t like. Weren’t these the incompatibilities that science was specific individuals in specific situations. supposed to eliminate? The scientists’ answer is shifty. Reviewed by Dr Chris Timms, who is Science only provides the basis for a an independent writer perfect relationship. If participants Getty Images
physicality and vocalisation consultant Peter Elliott (amazing job title!). The play balances humour with serious questions, all of which seems particularly pertinent in today’s society. Removing the barriers of society and allowing the chimps to be in charge, the play offers debate on areas around mental health, sexuality, gender hierarchies, gender bending, the NHS, and psychiatry. The production offers the audience a fresh perspective and a chance to reflect and question some of our social customs, boundaries and rules. Oscar Pearce makes a great debut as a director, and I was particularly impressed with the cast of seven actors, who cover nearly 20 parts. Ruth Lass stands out as the alpha male psychiatrist chimp Dr Zack Busner. It’s a great choice to cast an actress in this role, and the decision serves to highlight how farcical all the male posturing and gender hierarchies are. As well as being able to pant-hoot like a real chimp, and ferociously bite a colleague who dares challenged him/her on the arm, Lass brings a nurturing caring quality to the role. This is highlighted at the end of Act I in Dr Busner’s kitchen, when Zack and Simon share some sloes and the latter begins asking questions about his new environment – you can sense a real bond forming between doctor and patient. During this part of the play, Simon is staying at Dr Busner’s home. Watching this as a psychologist, I felt uncomfortable – it prompted me to think about patient and practitioner boundaries. Indeed, during the evening I found myself frequently reflecting on the way we practise as psychologists. I work with Professor Steve Peters and use his Chimp Model in my sessions with clients. The Chimp Model greatly simplifies the neuroscience and explains how the mind can be seen as having three teams, each with their own agenda and way of working. The Human (you) is mainly based in the frontal lobe, associated with logical thinking and working with facts and truth. The Chimp, mainly based in the limbic system, is an independent emotional thinking machine that works with feelings and impressions. There is also the Computer, spread throughout the brain, which is a storage area for programmed thoughts and behaviours. Great Apes gives an opportunity for us to see what it could be like if the emotional thinking part of our brains (our Chimps) were allowed to take over and rule society. I did wonder whether it would have been more powerful to explore the differences that a society ruled by chimpanzees might bring, rather than the similarities (the chimps discuss issues in a rational way, drive cars and become famed psychiatrists). My friend and I were left feeling that whilst the play was captivating, impressive and thought-provoking, it lacked a little depth and feeling. Perhaps it attempts to touch too many different areas. But overall, I would highly recommend going to see the production.
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film A Love That Never Dies Beyond Goodbye Media
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A most sensitive and profound portrayal On rare occasions a work of art is produced that inspires an audience to recognise that human beings belong to one great family. This film made by Jane Harris and Jimmy Edmonds does exactly that as it examines the grief felt by a group of American families who have lost a child, usually a teenager who has died violently in a road accident or, as in one case, by the accidental shooting of a gun owned by the family. Jane and Jimmy meet these families as they cross the USA on a road trip the couple make in honour of their late son Joshua. It is generally accepted that the loss of a child is indeed the worst thing that can happen to a family: as one of the interviewed parents says, ‘It’s just about the messiest process you can go through.’ It has an unbearable ‘nightmare quality’ that the family wants to retreat from back to a time when their child was alive. The film brilliantly captures this feeling right at the start when it shows metaphorically and momentarily vehicles and people moving in reverse through a township. The film, by two Brits, turns out to be a brilliant road movie in the best American tradition; it is, above all, an inspiring love story, which gives us a most sensitive and profound portrayal of family bereavement. It connects with all of us whether we want it or not, and audiences will come away having shared in many emotions – both positive and negative – that are felt by bereaved families. The film reveals how to talk about family bereavement: they will learn that a mother’s grief can seem ‘sacred’; that parents want ‘to embrace their feelings’ not run away from them; and that their emotions are ‘natural’ and not to be ashamed of. At times a bereaved family can have a ‘real good laugh’ as well as
Reviews online: Find more reviews at www.thepsychologist.org.uk/reviews, including: Mark Guyers meets Matthew Murphy (‘Murph’), lead singer of the Liverpool band The Wombats, to talk about psychological influences on his songwriting, and musicians’ mental health.
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shed ‘real good tears’. Above all, an audience will learn that, unlike losing a parent, losing a child means you have ‘lost their future’, and that’s what makes the death of a child so unacceptable. The film also makes the point that the human spirit can shine through even the darkest moments: one we remember can be described as Shakespearian when a family decides to shed their child’s ashes over a cliff edge only for those ashes to be blown by the wind back into their faces. There is also anger in this film when Jimmy Edmonds attacks the media’s simplistic reliance upon the term ‘closure’, which, to the bereaved, is a nonsense because they do not want to forget, they do not want to ‘close the door’ to ‘leave behind’. Closure is something that other people, outsiders, want so that they can avoid embarrassment. Jane Harris and Jimmy Edmonds are experienced film makers who, as bereaved parents themselves, have combined the inspiration of their own tragic loss of an adorable and
beautiful son with their professional expertise. They have woven together a road movie that tells several stories of family loss and love, striking pictures of the American landscape, and their own autobiographical story of the loss of their son Joshua. All done with seamless editing, highly skilled camera work, and extraordinarily sensitive questioning. On this last point we’d like to say how much we admired Jane’s interviewing style: measured, sensitive, tactful – a quality of beauty about it! Yes, it needs saying that Jimmy and Jane’s rapt attention to the stories of the bereaved families brought out the best in everybody connected with this film. Reviewed by Barbara and Michael Wilson (whose daughter, Sarah, died in a white water rafting accident in Peru: she was never found) Find information on screenings and watch a trailer at https:// alovethatneverdiesfilm.com
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the psychologist may 2018 culture
Left wondering why… you’ll say (as a BBC 2 viewer) when Dan’s Each programme in this five-part series backstory is revealed and Brett’s modern focuses on two people identified as likely manliness unfolds. ‘Tut’ you’ll go to benefit from some special help when you hear some of the advice during a challenging time in their tv given and by whom! I feel that I now lives. In the first programme, Dan The Secret have a much deeper appreciation of receives help in the run-up to his Helpers both terms when used in the phrase wedding to Suzy, and Brett is helped BBC Two ‘guilty pleasure’. in the days after he and his wife Jess Much of the viewing pleasure bring home their newborn twins. came from the abundant charm and The website accompanying the show dignity of the two men allegedly receiving for some reason makes it clear that the help. They are nice people with noble people receiving help are ‘Brits’. intentions in ‘everyman’ situations. It would The help comes via an earpiece from be hard for any humane viewer not to want a panel of (non-British!) ‘wise strangers’ or things to go well for them. They certainly ‘sages’. In the first programme, these are win over the sages’ hearts. One expert in ‘an Irish nun, a traditional healer and her particular became a lot more sympathetic friend from South Africa, a couple of retired in all senses as she gradually transformed cops from New York, two Italian mamas and from slightly suspect ‘Transmitter of a Norwegian health guru’. Wisdom’ to genuine well-wisher. I feared the show would be utterly It was difficult to fully commit to predictable and derivative, rely on and the invitation for a group hug of warm perpetuate lazy stereotypes, encourage wonderfulness, though. Partly this was narcissistic judgmentalism, be jam-packed a trust issue. Friends and family of those with artifice presented as reality, and try to helped had been given a cover story to mawkishly manipulate viewers’ emotions. explain the cameras and what-not, but it Fears that proved not entirely groundless. wasn’t entirely clear precisely what they The series definitely fits the genre of what had been told or whether they had been might be called ‘Bless and Tut TV’. ‘Bless’
given any particular instructions. At times, the actions and reactions around the central characters were clearly spontaneous, genuine and emotionally affecting. At other times, they were weird and provoked suspicion, such as when Brett the avowed atheist stumbled part-way through intoning a Christian blessing over his children, to Jess’s amused bewilderment. It is interesting to speculate why this series has five episodes of two stories each rather than ten shorter episodes with a single ‘cleaner’ story apiece. Time will tell but my suspicion is that the programme’s formula will quickly become too apparent and its beneficial effects will wear off with repeated doses. Brett and Dan both seemed to appreciate and to genuinely benefit from the input they received from the Goggleboxlike voices in their heads, but maybe this was partly because they themselves are such nice people. In their position, I suspect that I would have felt like I was in an episode of Black Mirror and would have spent much of my time trying not to scream. Reviewed by Tom Farsides, University of Sussex
Autism – differences and difficulties As an autistic academic and parent to an autistic son, I usually approach media representations of autistic people with some trepidation. This programme was no exception, having followed on from a survey entitled ‘How autistic are you?’. The programme was, however, refreshingly presented by two young autistic campaigners, and followed two adults in their 30s through diagnostic assessments and a range of cognitive experiments. Whilst the programme contained some contested and tired interpretations and explanations for the actions of autistic people, such as the ‘theory of mind’ hypothesis alluded to in one of the activities used, it also contained some more interesting psychological tests. There were contributions from Anna Remington and colleagues from University College London on perceptual load, as well as an experiment regarding the difficulties autistic people can have when plans and focus are diverted. The narrative therefore fluctuated between the established ‘experts’, often depicting a purely clinical-deficit model of autism, and autistic people and upcoming academics using a more respectful language of difference. The content with regard to how autism is defined and diagnosed was somewhat limited. A graphic indicating autistic traits as a constellation was used, yet not fully explained, potentially leaving the viewer with a confused or simplistic understanding. This was counteracted,
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though, by the undoubted highlight – the number of autistic voices talking about their own lived experiences, including an amusing comment regarding Simon BaronCohen’s theory of the ‘extreme male brain’. The narrative assumed that the ‘lost generation’ would be ‘suffering through life’ without diagnosis, and that diagnosis was a key to self-understanding and the explanation of difficulties faced. Key to this message was the emphasis on the traditional under-diagnosis of autistic women. It was remarked upon that not enough research had been done in this area, and that social masking could be a major reason for this disparity. Yet the programme did not explore the gendered cultural context of diagnostic practice in great depth, nor postdiagnostic support. The programme will also no doubt anger those who would like better representation of those on the autism spectrum classed as having intellectual disabilities. This aspect of lived experience hardly featured. Although identifying some of the potential difficulties autistic people face in navigating social life, the programme failed to examine the inter-subjective and socially situated nature of many of the issues raised.
tv Are You Autistic? Channel 4
Reviewed by Dr Damian Milton, Lecturer in Intellectual and Developmental Disabilities at the Tizard Centre, University of Kent
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AZ the
Karla Novak
psychologist to
Q ...is for Quality of Life
Suggested by Lisa Thorpe, PhD student at the University of Chester @l_thorpe8 ‘The choices we make today affect our quality of life as we get older. The population over the age of 65 is rising and so are reports of feeling isolated and lonely. Whether it’s listening to music or participating in a club, it is important that the benefits of activities and how they influence our quality of life longterm are reported.’
Living with chronic conditions or severe allergies in youth can clearly have a major impact on quality of life. In articles by Line Caes and Abbie Jordan (February 2017), and Kathryn Evans and Khadj Rouf (May 2014), we heard about these issues and how studying them requires mixed methods and attention to the voices of young people.
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In her March 2016 ‘New voices’, Evelyn Barron considered quality of life in our ageing population, asking, ‘Is healthy ageing a long life, a disease-free
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coming soon… is our capacity to influence policy overrated?; plus all our usual news, views, reviews, interviews, and much more...
life, a good quality of life or the ability to remain independent in later life?’ In our first ‘Viewpoints’ piece in April 2012 we heard about how ‘the wellbeing of a caregiver goes hand in hand with quality of life of the care recipient’. A study (reported on our Research Digest) of the effects of the ‘cool challenge’ – a 30-day event in the Netherlands that involved more than 3000 people taking daily showers that ran cold for at least the last 30 seconds – found positive effects on quality of life! Some psychologists call trying to define quality of life a ‘wild goose chase’ (see tinyurl.com/y9v8jzjf).
A to Z Tweet your suggestions for any letter to @psychmag using the hashtag #PsychAtoZ or email the editor on jon.sutton@ bps.org.uk Entries so far are collated at https:// thepsychologist. bps.org.uk/ psychology-z
contribute… reach 50,000 colleagues, with something to suit all. See www.thepsychologist.org.uk/ contribute or talk to the editor, Dr Jon Sutton, jon.sutton@bps.org.uk, +44 116 252 9573 comment… email the editor, the Leicester office, or tweet @psychmag to advertise… reach a large and professional audience at bargain rates: see details on inside front cover
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Find out more online at www.bps.org.uk
President Nicola Gale President Elect Professor Kate Bullen Honorary General Secretary Dr Carole Allan Honorary Treasurer Professor Ray Miller Chair, Membership and Standards Board Dr Mark Forshaw Chair, Education and Public Engagement Board Professor Carol McGuinness Chair, Research Board Professor Daryl O’Connor Chair, Professional Practice Board Alison Clarke Chief Executive Sarb Bajwa Director of Policy and Communications Kathryn Scott Director of Corporate Services Mike Laffan Director of Standards and Qualifications Andrea Finkel-Gates Director of Member Services Annjanette Wells (Acting)
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CPD workshops 2018 See p.10 Division of Forensic Psychology Annual Conference Gateshead, 19–21 June 2018 See p.20 Qualifications Committee Supervision Conference Huddersfield, 25 July 2018 See p.26 Qualifications Committee Trainee Conference Huddersfield, 26 July 2018 See p.26 Psychotherapy Section Conference ‘Food: Disorder or Wellbeing’ London, 26 October 2018 See p.39 BPS conferences and events See p.51 Psychology of Education Section Annual Conference Oxford, 14–15 September 2018 See p.51 Social Psychology Section Annual Conference Keele, 28–30 August 2018 See p.71
Professional Practice Board Prescribing Rights for Psychologists Task & Finish Group Chair and Members See advert p.60 Contact Emma Smith emma.smith@bps.org.uk Closing date 4 June 2018
Director of Finance Russell Hobbs The Society has offices in Belfast, Cardiff, Glasgow and London, as well as the main office in Leicester. All enquiries should be addressed to the Leicester office (see inside front cover for address).
The British Psychological Society was founded in 1901, and incorporated by Royal Charter in 1965. Its object is ‘to promote the advancement and diffusion of a knowledge of psychology pure and applied and especially to promote the efficiency and usefulness of Members of the Society by setting up a high standard of professional education and knowledge’. Extract from The Charter
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