The Psychologist, March 2011

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psychologist vol 24 no 3

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The value of pets for human health Deborah Wells with a menagerie of surprising research

Incorporating Psychologist Appointments £5 or free to members of The British Psychological Society

letters 154 news 162 careers 216 looking back 226

falling on deaf ears 178 are you being outsourced? 182 responding to ‘parent abuse’ 186 interview with Kerry Chamberlain 190

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The British Psychological Society Contact The British Psychological Society St Andrews House 48 Princess Road East Leicester LE1 7DR tel 0116 254 9568 fax 0116 227 1314

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Associate Editors Articles Vaughan Bell, Kate Cavanagh, Harriet Gross, Marc Jones, Rebecca Knibb, Charlie Lewis, Wendy Morgan, Tom Stafford, Miles Thomas, Monica Whitty, Barry Winter Conferences Sarah Haywood International Nigel Foreman, Asifa Majid Interviews Nigel Hunt, Lance Workman History of Psychology Julie Perks

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letters national well-being; psychology myths; gender; your deadly sins; and more

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news and digest 162 cuts begin to bite; Sure Start; ECT; reports from the Division of Occupational Psychology conference; and nuggets from the Society’s Research Digest media the history and future of mind control, with Kirsten V. Smith

PETS AS THERAPY

The value of pets for health Deborah Wells has a menagerie of surprising and controversial research on animal antics

172 MARK SMITH

178 182

Falling on deaf ears Geoffrey D. Munro examines when people believe psychology is not science

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Are you being outsourced?

Stephanie J. Morgan looks at how psychology can aid our understanding of work fragmentation

182

Responding to the problem of ‘parent abuse’ Amanda Holt asks whether there is a role for psychology

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The psychological transformer Kerry Chamberlain talks to Lance Workman about the academic evolution of his work

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book reviews 192 narratives in human science; challenging religion; creativity in the classroom; and more society

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taking a stance in the President’s column; online archive; QMIP Section awards; and more

march 2011

THE ISSUE I edited this month’s cover article around the time my kids were badgering me to get a dog (or doggedly requesting a badger…

I wasn’t really listening). On p.172, Deborah Wells certainly makes a case that ‘pets are good for us’.

Did you know, for example, that dog owners are eight times more likely to be alive one year after a heart attack than non-dog owners?

Not so good if you own a cat though.

The piece also features my favourite ever line from a Psychologist article: ‘More recently, Hunt et al. (1992) found that a woman sitting in a park received significantly more social approaches from passers-by whenever she was accompanied by a rabbit or turtle, than when she sat alone with a television set or blowing bubbles.’

Also this month, the third of our ‘Big picture’ centre spread pull-outs.

Richard Wiseman’s work stars in our own version of the X-Files: we hope it will appeal to all those psychology sceptics out there.

Professor Wiseman will be speaking at the Society’s ‘Psychology 4 All’ public engagement event in London this month: for information and to book see tinyurl.com/psych4all.

Dr Jon Sutton

careers and psychologist appointments

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how psychology sang to Jake Farr; the things Jillian Sullivan wished she had known at the beginning of her PhD; all the latest jobs looking back the strange history of tropical neurasthenia, by Anna Greenwood

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one on one …with Ruth Mann

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BIG PICTURE

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Richard Wiseman is the UK’s most popular psychologist, with books topping the bestseller charts, over 10 million views on his YouTube channel and more than 60,000 followers on Twitter. A former professional magician, he has spent the past 20 years investigating the psychology of the paranormal. His new book, Paranormality, tackles the psychology of seemingly supernatural phenomena.

‘Take, for example, our ability to unconsciously see faces and figures in meaningless stimuli’, Professor Wiseman says. ‘This strange phenomena, known as pareidolia, is a fundamental quirk of the human perceptual system and fools us into seeing a face on Mars, the man in the Moon; Jesus in the Crystal Palace FC turf, Mother Teresa in a cinnamon bun, or, as shown here, a UFO in lenticular clouds’ (for more examples, see tinyurl.com/5dbwfe).

If it all seems trivial, consider that someone paid $28,000 for the Virgin Mary on a piece of toast!

A similar phenomenon is at work when people claim to hear satanic messages in songs being played backwards, such as Led Zeppelin’s ‘Stairway to Heaven’ (have a listen Paranormality, with Richard Wiseman. Photo at tinyurl.com/48trcqm).

Library. If your work lends itself to a striking i Wiseman is also the Professor of Public Understanding of Psychology at the University of make a difference in people’s Hertfordshire, and it is a role he takes very seriously. He will be speaking at the Society’s ‘Psychology 4 All’ event I ‘Psychology 4 All’ is a one-d on 26 March, and he says: ‘It is great to tell the public psychology and demonstrate about the findings from academic research and help to relevance. To book, see tinyu

Why we see wh

I WANT TO BELIEVE…

…but th

what isn’t there hoto by Magrath/Folsom/Science Photo king image, e-mail jon.sutton@bps.org.uk ople’s lives.’ one-day event to promote trate its scientific basis and tinyurl.com/psych4all.

the evidence is an illusion

www.thepsychologist.org.uk

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DIGEST

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TV dinner problem Besides how hungry we feel, all sorts of other factors also affect how much we eat, including portion size and social convention. Another factor is memory for how much we’ve already eaten. The much-studied amnesic HM readily sat down to eat a second meal having just finished one, presumably because he’d forgotten he’d already eaten. Now Dolly Mittal and her team have shown that snacking while watching TV, as opposed to snacking while not watching TV, can lead us (well, women at least) to eat more later on, partly because the effect of the TV is to affect our memory for how much we snacked on earlier.

Thirty-two non-dieting women of unexceptional weight spent 20 minutes in the morning consuming as much snack food as they could, including chocolate balls, crisps and coke/orange squash. Half of them did this while watching Friends or Seinfeld, the others while sitting quietly. There was no difference in the amount of snack food the two groups consumed. Approximately an hour later, the women sat down to eat a lunch of sandwiches, biscuits, crackers and dip. The key finding is that the women who’d earlier snacked while watching TV ate significantly more of this later meal, than did the women who’d earlier snacked without TV. What’s more, the TV group were also less accurate at recalling how much they snacked on in the morning.

The implication seems to be that watching TV while snacking affects our memory for how much we’ve snacked on, thereby leading us to eat more later on.

A follow-up study was similar to the first except the researchers investigated the effects of different types of TV show – boring TV (a lawn bowling contest – apologies to bowling In Applied Cognitive Psychology fans), sad TV (a scene from the film Dead Poets Society), and funny TV (a Friends episode).

The main finding from the first experiment was replicated as regards snacking whilst watching TV leading to more eating later on, but the specific type of TV show made no difference.

An anomaly in the results is that TV versus no TV had a larger effect on the amount eaten later on compared with its effect on recall memory. This suggests that TV has some other effect besides impairing memory for snack consumption, or else it affects memory in more ways that just impairing recall.

Another issue is that the effect has so far only been demonstrated for women. When a pilot study was attempted with men, Mittal’s team explained, they ‘treated the experiment as an opportunity to consume as much food as possible, so the design may not be optimal for this group’. ‘[O]ur data suggest that TV probably exerts some as yet unspecified effect on participants’ ability to recall earlier bouts of food consumption, leading to over-consumption on a later TV free test meal,’ the researchers said. ‘As TV viewing is associated with eating in so many different ways, and as overconsumption of food is a major problem in most industrialised nations, it would seem important to study exactly how this occurs.’

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Behind the scenes of life In the December issue of Personality and Social Psychology Bulletin Have you ever had the feeling that everyone else seems so sorted, so at ease? According to Alexander Jordan and colleagues, most of us have such a tendency to underestimate other people’s experience of negative emotion.

In turn the researchers think this skewed perception perpetuates a collective delusion in which we all strive to present an unrealistically happy front because we think that’s the norm.

Jordan’s team began their investigation by asking 63 undergrads to describe recent negative and positive emotional experiences they’d had. As expected, the negative examples (e.g. had an argument; was rejected by a boy/girl), more than the positive examples (e.g. attended a fun party; had a great meal), tended to occur in private and to provoke emotions that the students had attempted to suppress.

The most frequently cited of these experiences were then put to a separate set of 80 students whose task was to say how many times in the last two weeks they had lived through something similar, and to estimate how often their peers had. The students consistently underestimated their peers’ experience of negative events (by an average of 17 per cent) whilst slightly overestimating their peers’ experience of positive situations (by 5.6 per cent).

What about close friends – surely we have a more accurate sense of their emotional lives?

A third study was based on emotional weekly blogs kept by over 200 students, which they used to rate their experience of various positive and negative emotions over the course of a term. Each blog student then nominated a close friend or romantic partner who had to estimate the range of emotions the blogger had experienced that term. Consistent with the study’s main message, close friends and partners tended to underestimate the bloggers’ experiences of negative emotions and to overestimate their experiences of positive emotions. A deeper analysis suggested the underestimation of negative emotion was partly mediated by the bloggers’ deliberate suppression of their negative emotions.

A final study showed that students with a greater tendency to underestimate their peers’ negative emotions also tended to feel more lonely, less satisfied with life and to ruminate more, thus suggesting that underestimating others’ misery could be harmful to our own well-being. Of course the researchers acknowledge that the causal direction could run the other way (i.e. being lonely and discontented could predispose us to think everyone else is happier than they are), or both ways.

An enduring mystery is why we continue to underestimate other people’s misery whilst knowing full well that most of our own negative experiences happen in private, and that we frequently put on a brave, happy

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digest

Stressful meeting? Have a coffee, if you’re female In the December issue of the Journal of Applied Social Psychology face when socialising. Why don’t we reason that other people do the same? Jordan and his colleagues point to ‘the fundamental attribution error’ – people downplay the role of the situation when assessing other people’s behaviour compared with their own.

This research could perhaps help explain the popularity of tragic art, be that in drama, music or books. ‘In fictional tragedy, people are given the opportunity to witness “the terrible things in life” that are ordinarily “played out behind the scenes”’, the researchers said (quoting Chekhov), ‘which may help to depathologise people’s own negative emotional experiences.’

If a meeting becomes stressful, does it help, or make things worse, if team members drink lots of coffee? A study by Lindsay St. Claire and colleagues that set out to answer this question has uncovered an unexpected sex difference. For two men collaborating or negotiating under stressful circumstances, caffeine consumption was bad news, undermining their performance and confidence.

By contrast, for pairs of women, drinking caffeine often had a beneficial effect on these same factors. The researchers can’t be sure, but they think the differential effect of caffeine on men and women may have to do with the fact that women tend to

respond to stress in a collaborative, mutually protective style (known as ‘tend and befriend’) whereas men usually exhibit a fight or flight response.

The study involved 64 male and female participants (coffee drinkers at the University of Bristol with an average age of 22) completing various construction puzzles, negotiation and collaborative memory tasks in same-sex pairs. They did this after drinking decaffeinated coffee, which either had or hadn’t been spiked covertly with caffeine (the equivalent of about three cups’ worth of coffee). Stress was elevated for some of the pairs by telling them they would shortly

The material in this section is taken from the Society’s Research Digest blog at www.researchdigest.org.uk/blog.

The Research Digest is proud to announce the birth of an offspring title – the Occupational Digest. The Occupational Digest is a new blog and e-mail produced by the British Psychological Society, reporting on psychology in the workplace. Building on the successes of the main Digest, it is funded by the Division of Occupational Psychology and aims to reach occupational psychology practitioners together with a wider audience who care about putting psychology to work, including HR professionals, managers, and anyone with an interest in the field. It is edited by Chartered Psychologist Dr Alex Fradera.

Subscribe by RSS or e-mail at www.occdigest.org.uk Follow the Occupational Digest editor at www.twitter.com/occdigest

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have to give a public presentation, and by warning them that their participation fee would be performancedependent.

How large were the caffeine effects? The men’s memory performance under stressful conditions with caffeine was described by the researchers as ‘greatly impaired’ whereas caffeine didn’t affect women in the same situation. For the construction puzzles, caffeine under high-stress conditions led men to take an average of 20 seconds longer (compared with no caffeine) whereas it led women to solve the puzzles 100 seconds faster.

A shortcoming, acknowledged by the researchers, was that there were overall few effects of stress on the participants’ performance, no doubt in part because they’d been told they could bail out any time they liked (although none of them did). Further research is clearly need to replicate the findings and explore the possible underlying mechanisms. Such work is urgent, the researchers concluded, ‘because many…meetings, including those at which military and other decisions of great import are made, are likely to be maledominated. Our research suggests that men’s effectiveness is particularly likely to be compromised.

Because caffeine is the most widely consumed drug in the world, it follows that the global implications are potentially staggering.’

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MEDIA

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The history and future of mind control Kirsten V. Smith on The Brain: A Secret History he December edition of The T Psychologist celebrated 150 years of experimental psychology and was devoted

contribute

to the pioneers that first investigated the mind–body connection. On 6 January BBC4 hosted the first in a series of three programmes dedicated to the darker side of experimental psychology.

The Brain: A Secret History, presented

by Dr Michael Mosely, probed the ways in which scientists have endeavoured to manipulate thoughts and behaviours. It was only a matter of minutes before the shocking extent to which early pioneers had gone to advance science was illustrated. I am sure that most of us are aware of Ivan Pavlov and his canine experiments that were the basis for classical conditioning and learning theory – pair the sound and the food and eventually the dog will salivate to the sound alone. Less well known is the salivary fistulas implanted into the cheeks of children to demonstrate the same conditioned response seen in dogs. The footage of a young boy with a metal pipe attached to a glass test tube, collecting saliva, protruding from his face prompted a gasp of horror and a quick rallying of my house-mates to see if any of them had heard of such experiments... Nope, no mention of this in A-level psychology.

A subsequent PsycINFO search followed by a Google search resulted in no reference to Pavlov’s children, either by him in his early work or by others in their dissemination of his findings. Given the vilification of Watson and Rayner (1920) for their infamous ‘Little Albert’ experiment I was surprised that Pavlov’s ethical misdemeanours have gone largely unnoticed.

Not short on shock factor, the programme then introduced the viewer to the work of Dr William Sargant, a British psychiatrist, whose clinical work was based on Pavlov’s early experiments. The

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The Media page is coordinated by the Society’s Media and Press Committee, with the aim of

rationale was fairly simple. By forcing the human brain into a state of ‘break-down’ all conditioned responses, behaviours, and thoughts would be subsequently lost therefore allowing ‘disturbed’ individuals to form new ‘healthy’ brain connections.

Sargant used a combination of druginduced comas (sometimes lasting as long as three months), copious amounts of medication, and electric shock therapy to break these pre-existing neural connections and ‘wipe the slate clean’.

Treatments were often administered without the patients’ knowledge or consent, and Sargant described the protocol of administering other treatments while the patients slept as ‘an exciting beginning in psychiatry’ by which a patients’ resistance and refusal could be bypassed.

These uncomfortable segments of scientific history were thankfully balanced out by showcasing some current innovative research investigating manipulation of the mind. Professor David Nutt presented his work looking at the neurological effects and clinical implications of the active ingredient for magic mushrooms – psilocybin.

I spoke to Professor Nutt and he described how, contrary to what had been expected, psilocybin actually dampened down neural activity in the brain and particularly the thalamus, the posterior cingulate cortex, and the anterior cingulate cortex (ACC). These three regions of the brain are key structures in a brain system known as the default mode network (DMN). The DMN displays increased activation when there is no sensory interruption from the outside

promoting and discussing psychology in the media. If you would like to contribute, please contact the ‘Media’

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world. Increased DMN activity can be seen when we are daydreaming, remembering an event from the past or planning an event in the future, and is thought to underpin our sense of self.

The posterior cingulate cortex is thought to be responsible for coordinating input from different sensations and awareness of the body. A common experience resulting from psilocybin is a disconnect between the sense of self and the body. Professor Nutt hypothesised that these psychedelic and pleasurable effects may be a result of a dampening down of DMN. This work is now being linked to clinical populations as a way of understanding thought patterns in depression. Common clinical observations in depression include a ‘rigidity in thinking’ or a ‘stuck mindset’.

Professor Nutt conceptualises this ‘treadmill of negative thinking’ as being driven by an overactivation in parts of the ACC. Previous research has found that depressed people find it very difficult to access any positive memories.

Professor Nutt and his team are testing the idea that the ACC may be a potential mediator in the emotional feedback accessed when exploring memories.

His team have demonstrated that through the use of psilocybin depressed patients experience an increase in emotional pleasure when accessing autobiographical memories.

‘We thought that if we could turn down the ACC then we could allow people to access a normal emotional response and get back into the right frame of mind.’

He hypothesised that this may only need to be done a couple of times within a psychotherapy setting to demonstrate an effect.

The long-term effects of this have yet to be demonstrated, however this research may shed some light on the concept of a biological basis for a ‘stuck mindset’ and how this impacts on recovery.

Whilst the discipline of psychopharmacology is in its infancy more is being discovered about the utility of combining psychological models of mental health problems with advances in pharmacological understanding. Let us hope that in 50 years this process of discovery can be disseminated without prompting gasps of horror.

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Earlybird rates expire 8 March Don’t miss out!

Keynotes Marie Johnston David Farrington Neil Macrae

4–6 May Marriott Hotel Glasgow Keynotes Elizabeth Loftus Uta Frith Annette Karmiloff-Smith

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ARTICLE

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The value of pets for human health Deborah Wells has a menagerie of surprising and controversial research on animal antics

T

questions

A wide range of potions, pills and other therapies are prescribed every day in a bid to remedy the vast array of physical and mental disorders afflicting the British public. Many of these treatments come with a range of unpleasant, not to mention, costly, side-effects.

But could the solution be simpler than this? Might our pets, for example, offer a slightly less bitter pill to swallow? This article explores the evidence for animals being able to promote human wellbeing, and examines whether or not they have a role to play in modern health care.

Should AAT schemes be introduced to prisons in the UK? Could AAT be detrimental to animal welfare?

references

resources

What are the drawbacks of using animals as ‘therapists’?

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Society for Companion Animal Studies: www.scas.org.uk Pets As Therapy: www.petsastherapy.org Animal Behaviour Centre: tinyurl.com/3xsdtpp Fine, A. (2006). Handbook of animalassisted therapy. London: Academic Press.

Allen, K.M, Blascovich, J. & Mendes, W.B. (2002). Cardiovascular reactivity and the presence of pets, friends and spouses. Psychosomatic Medicine, 64, 727–739.

Allen, K.M., Blascovich, J., Tomaka, J. & Kelsey, R.M. (1991). Presence of human friends and pet dogs as moderators of autonomic responses to stress in women. Journal of Personality and Social Psychology, 61,

he notion that ‘pets are good for us’ is by no means a new one. As early as the 18th century William Tuke, a Quaker philanthropist who ran an asylum for people with severe mental disorders, indicated that his patients gained health benefits from being around animals. The courtyards of the asylum were thus stocked with an array of rabbits, seagulls, hawks and poultry in the hope of encouraging ‘benevolent feelings’, greater responsibility and self-control. Animals became increasingly common features of English mental asylums throughout the 19th century. Indeed, it was recommended by the British Charity Commissioners that sheep, hares, monkeys and other domestic animals should be added to these institutions in a bid to create a less hostile, and more attractive, environment. The value of animals for physical health was also noted in these earlier years, with Florence Nightingale, in her Notes on Nursing (1880), indicating that people confined to the same room because of medical problems gained pleasure from the presence of a bird.

These early observations have been followed in more recent years by experimental work designed to explore the effect of animals on human health and well-being (see Wells, 2009). Much of this research has explored the influence of animals on physical health in humans.

Although not without its criticisms, this work has yielded largely positive results.

For example, in one of the most widely cited studies in this area, Friedmann and colleagues (1980) found that dog owners

582–589.

Anderson, W.P., Reid, C.M. & Jennings, G.L. (1992). Pet ownership and risk factors for cardiovascular disease.

Medical Journal of Australia, 157, 298–301.

Bauman, A.E., Russell, S.J., Furber, S.E. & Dobson, A.J. (2001). The epidemiology of dog walking. Medical Journal of Australia, 175, 632–634.

Baxter, D.N. (1984). The deleterious

were 8.6 times more likely to still be alive one year after a heart attack than non-dog owners. Cat owners, by contrast, were actually more likely to have died one year on from a coronary than their non-catowning counterparts. More recently, Anderson and associates (1992) found that pet owners were at a significantly lower risk of developing coronary heart disease than non-owners, while Serpell (1991) found that the acquisition of a dog or cat was associated with a significant reduction in the frequency of minor physical ailments (e.g. coughs, dizziness, hayfever) one month on from obtaining the animal.

Some authors have examined the short-term physical health benefits of animals, exploring, for instance, whether being in the presence of, or looking directly at, an animal can buffer people from potentially stressful situations. In one

Ownership of a pet dog or cat can ameliorate the

effects of dogs on human health.

Community Medicine, 6, 29–36.

Baxter, D.N. & Leck, I. (1984). The deleterious effects of dogs on human health: 2. Canine zoonoses.

Community Medicine, 6, 185–187.

Beck, A.M. & Katcher, A.H. (1984). A new look at pet-facilitated psychotherapy.

Journal of the American Veterinary Medical Association, 184, 414–421.

Brown, S.G. & Rhodes, R.E. (2006).

Relationships among dog ownership and leisure-time walking in western Canadian adults. American Journal of Preventative Medicine, 30, 131–136.

Bustad, L.K. (1990). Prison programs involving animals. In L.K. Bustad (Ed.) Compassion, our last great hope (pp.72–73). Renton, WA: Delta Society.

DeSchriver, M.M. & Riddick, C.C. (1990).

Effects of watching aquariums on

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value of pets

of the earliest studies of this kind, Katcher and colleagues (1983) reported lower blood pressure responses to the stressor of reading aloud when participants were allowed to watch fish swimming in a tank, than whenever the same people were exposed to an aquarium devoid of animals or stared at a blank wall. In various studies the presence of a dog in an experimental room has been shown to result in transient decreases in heart rate and/or blood pressure responses to stressors, including reading aloud (Friedmann et al., 1983), mental arithmetic (Allen et al., 1991) and a cold pressor test (Allen et al., 2002).

Although the results of these studies are hard to generalise beyond the experimental setting, they nonetheless shed useful light on some of the mechanisms by which animals might be able to improve our long-term health.

PAUL BOX/REPORTDIGITAL.CO.UK

While most authors have concentrated on the health merits of ‘live’ animals, recent work has shown that videotapes of animals may serve as a potential alternative in stressful situations. DeSchriver and Riddick (1990), for example, reported decreases in the physiological stress responses of elderly people exposed to a videotape of fish swimming in an aquarium. More recently, Wells (2005) found that moving images of fish, birds and monkeys buffered participants from the stressor of reading aloud significantly more than exposure to video recordings of people or blank television screens. It was concluded that this mode of presentation may offer advantages where the use of live animals is not feasible or desirable.

Companion animals may not only be able to facilitate certain aspects of physical health in humans, they may also contribute towards the long-term psychological well-being of people.

Research has shown that ownership of a pet dog or cat can ameliorate the effects of potentially stressful life-events (e.g. bereavement, divorce), reduce levels of anxiety, loneliness and depression (Folse et al., 1994; Garrity et al., 1989) and enhance feelings of autonomy, competence and self-esteem (Beck & Katcherm 1984; Kidd & Kidd, 1985; Levinson, 1972; Robin & ten Bensel, 1985).

Animal-assisted therapy

effects of potentially stressful life-events

elders’ stress. Anthrozoös, 4, 44–48.

Folse, E.B., Minder, C.C., Aycock, M.J. & Santana, R.T. (1994). Animal-assisted therapy and depression in adult college students. Anthrozoös, 7, 188–194.

Friedmann, E., Katcher, A.H., Lynch, J.J. & Thomas, S.A. (1980). Animal companions and one year survival of patients after discharge from a coronary care unit. Public Health

Recognition of the fact that animals, and in particular dogs, may be able to bolster our psychological well-being has resulted in their wide-spread use in therapeutic settings. Interest in this area started in the

Reports, 95, 307–312.

Friedmann, E., Katcher, A.H., Thomas, S.A. et al. (1983). Social interaction and blood pressure. Journal of Nervous and Mental Disease, 171, 461–465.

Friedmann, E. & Thomas, S.A. (1995). Pet ownership, social support, and one year survival after acute myocardial infarction in the Cardiac Arrhythmia Suppression Trial (CAST). American

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1960s, when Boris Levinson, a child psychologist, noted that his patients developed a rapport with his dog, and were more inclined to respond positively to therapy in its presence. Levinson (1962) surmised that the animal served as a social ‘catalyst’, opening up a channel for the discussion of subconscious worries and fears. Levinson’s early theories have since been supported by a wealth of scientific studies exploring the role of ‘animal-assisted therapy’ (AAT) in hospitals, nursing homes and other settings. Schemes vary considerably according to the type of animal employed (see later), the mode of treatment delivery and the population of interest under scrutiny, but most share as their goal an attempt to improve the physical, mental, social and/or cognitive functioning of a patient.

Many AAT schemes have been targeted at people residing in nursing homes, hospitals or other healthcare facilities, and studies exploring their efficacy have yielded promising results. For example, Kawamura and colleagues (2007) found that elderly people in a residential nursing home showed significant improvements in their mental functioning over a one year period of twice-monthly visits from assistance dogs. Richeson (2003) similarly found significant decreases in agitated behaviours amongst older adults with dementia following AAT intervention for three weeks. Around the same time, Nathans-Barel and associates (2005) discovered a significant improvement in hedonic tone, the use of leisure time and a trend towards enhanced motivation in 10 chronic schizophrenia patients exposed to 10 weekly interactive sessions of AAT. Together, these studies show a vast range of physical and psychological benefits arising from animal-assisted intervention schemes. Indeed, a recent meta-analysis of AAT concluded that the intervention has a moderate effect on improving a range of outcomes, including behavioural problems, medical difficulties and emotional dysfunction (Nimer & Lundahl, 2007).

Although AAT might be particularly

Journal of Cardiology, 76, 1213–1217.

Garrity, T.F., Stallones, L., Marx, M.B. & Johnson, T.P. (1989). Pet ownership and attachment as supportive factors in the health of the elderly.

Anthrozoös, 3, 35–44.

Hart, L.A. (2006). Community context and psychosocial benefits of animal companionship. In A. Fine (Ed.) Handbook of animal-assisted therapy (pp.73–94). London: Academic Press.

Headey, B. (1998). Health benefits and health cost savings due to pets.

Social Indicators Research, 47, 233–243.

Hunt, S.J., Hart, L.A. & Gomulkiewicz, R. (1992). Role of small animals in social interactions between strangers. Journal of Social Psychology, 132, 245–256.

Jessen, J., Cardiello, F. & Baun, M.M. (1996). Avian companionship in

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advantageous for people with recognised physical or mental disorders, its utility as a therapeutic tool for people residing in prisons and other types of correctional facility has started to attract attention. Like those living in other institutional settings, prison inmates can suffer from a wide variety of psychological disturbances, whether it be loneliness, denied responsibility or low self-worth. Animal-based therapy schemes have therefore been introduced to penal institutions in the United States, in a bid both to enhance psychological well-being and to rehabilitate previous offenders. While schemes differ slightly between sites, most of them require participants to look after the animal in their care, and in many cases train it for a specific purpose (e.g. as an assistance dog).

In most circumstances animals are acquired from rescue shelters, where they may be facing prolonged stays, or euthanasia.

Research exploring the efficacy of animals employed in this context is relatively limited, though promising in its results. Studies of the Oregon-based scheme Project POOCH, for example, have shown that incarcerated male juveniles display a greater degree of honesty, empathy, nurturance and social growth following the introduction of abandoned and abused dogs (Merriam-Arduini, 2000).

Women in a correctional centre have also been shown to demonstrate increased selfesteem following participation in an inhouse dog training programme (Bustad, 1990). Although the long-term impact of such schemes is unknown, greater levels of respect for authority have been recorded; one step, closer, it could be argued, to rehabilitation and successful reintegration into society.

The UK has been much slower than the US in using AAT in prisons, although the positive results arising from the research in this area suggests that it may

alleviation of depression, loneliness, and low morale or older adults in skilled rehabilitation units.

Psychological Reports, 78, 339–348.

Katcher, A.H. (1981). Interactions between people and their pets: Form and function. In B. Fogle (Ed.) Interrelationships between people and pets (pp.41–67). Springfield, IL: Charles C. Thomas.

Katcher, A.H., Friedmann, E., Beck, A.M.

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only be a matter of time before similar schemes are introduced to British penal institutions.

How do animals enhance human health?

The evidence in support of animals promoting human well-being, whilst not entirely conclusive, is fairly convincing.

One big question still remains, however; namely, how do they do this? A number of mechanisms may be at play (for review, see Wells, 2009). For example, some benefits may arise from the mere provision of companionship. It appears that the presence of another living being can help to reduce loneliness and feelings of isolation (e.g. Headey, 1998; Jessen et al., 1996). Pets may thus be particularly advantageous for people living alone (Zasloff & Kidd, 1994). The ‘needy’ behaviours exhibited by pets, in particular dogs and cats, may also help to enhance the well-being of their owners. Their greeting rituals, naturally affectionate disposition, loyalty and widely perceived ability to ‘love’ unconditionally may all

& Lynch, J.J. (1983). Talking, looking, and blood pressure. In A.H. Katcher & A.M. Beck (Eds.) New perspectives on our lives with companion animals (pp.351–359). Philadelphia: University of Pennsylvania Press.

Kawamura, N., Niiyama, M. & Niiyama, H. (2007). Long-term evaluation of animal-assisted therapy for institutionalized elderly people.

Psychogeriatrics, 7, 8–13.

serve to promote feelings of self-worth and self-esteem.

Mental health may also be facilitated by pets through the facilitation of social contacts with other people. Several studies have shown that walking with a dog results in a significantly higher number of chance conversations with complete strangers than walking alone (e.g.

McNicholas & Collis, 2000). Younger dogs, with their large foreheads, big eyes, short limbs and clumsy movements (all good examples of ‘supernormal’ stimuli), and those with a reputed ‘good’ temperament (e.g. Labrador retrievers) tend to act as stronger social lubricants than older animals or those that have received more negative public attention, such as Rottweilers (Wells, 2004). The socialising role of dogs is perhaps most apparent for people with disabilities.

Studies have repeatedly shown that the presence of a service dog encourages more approaches and positive acknowledgements from both friends and strangers (for review, see Hart, 2006). In this context, the dog has the ability to serve a normalising role, enhancing the

Kidd, A.H. & Kidd, R.M. (1985). Children’s attitudes toward their pets.

Psychological Reports, 57, 15–31.

Levinson, B.M. (1962). The dog as cotherapist. Mental Hygiene, 46, 59–65.

Levinson, B.M. (1972). Pets and human development. Springfield, IL: Charles C. Thomas.

Marino, L. & Lilienfeld, S.O. (2007).

Dolphin-assisted therapy: More flawed data and more flawed

conclusions. Anthrozoös, 20, 239–249.

McNicholas, J. & Collis, G.M. (1998).

Could Type A (coronary-prone) personality explain the association between pet ownership and health?

In C.C. Wilson & D.C. Turner (Eds.) Companion animals in human health (pp.173–186). Thousand Oaks, CA: Sage.

McNicholas, J. & Collis, G.M. (2000).

Dogs as catalysts for social

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self-esteem and confidence of people who might otherwise feel overlooked or alienated.

Although dogs probably have the greatest potential to serve as social facilitators, in light of the fact they are taken out for walks, other species can also encourage interactions between people.

As early as 1975, Mugford and M’Comisky provided two groups of elderly people with either a begonia or a budgerigar to look after.

Three years later, it was discovered that the people required to care for the bird had more friends, visitors and links with their community than those provided with a plant. While not statistically significant, the researchers also discovered fewer deaths among the budgie owners. More recently, Hunt et al. (1992) found that a woman sitting in a park received significantly more social approaches from passers-by whenever she was accompanied by a rabbit or turtle, than when she sat alone with a television set or blowing bubbles.

As touched upon briefly earlier, it is also possible that animals may promote our health by serving as ‘stress busters’.

The action of stroking an animal, particularly a familiar one, has repeatedly been shown to result in transient decreases in blood pressure and/or heart rate (e.g.

Katcher, 1981; Shiloh et al., 2003; Wilson, 1991). The mere presence of a companion animal can also offer short-term health benefits, helping to lower autonomic responses to conditions of moderate stress (see earlier). Allen and others (2002), for example, recently reported that the presence of a pet dog or cat resulted in lower heart rate and blood pressure responses relative to the presence of a friend or spouse, in people exposed to the psychological stressor of mental arithmetic, and the physical stressor of a cold pressor test. It must be assumed that

interactions. British Journal of Psychology, 91, 61–70.

Merriam-Arduini, S. (2000). Evaluation of an experimental program designed to have a positive effect on adjudicated violent, incarcerated male juveniles age 12–25 in the state of Oregon.

Unpublished PhD thesis, Pepperdine University.

Mugford, R.A. & M’Comisky, J.G. (1975).

Some recent work on the

the animal in this context serves as a buffer or distraction to the stressful situation.

Health advantages, particularly longterm ones, may be also gained from pets indirectly, perhaps through the increase in exercise that typically accompanies the ownership of an animal (Bauman et al., 2001; Brown & Rhodes, 2006; Serpell, 1991). This mode of action would certainly explain why dogs, which need to taken out for regular walks, seem to be more advantageous for our health than companion animals such as cats that lead more owner-independent lifestyles (e.g.

Rajeck, 1997; Serpell, 1991).

The mechanisms underlying the ability of companion animals to improve human health are complex and further research is needed before firm conclusions can be drawn. The possibility that there is a noncausal association (i.e. no correlation) between animals and human health must also be acknowledged. It is possible, for instance, that people who choose to keep a pet also possess personality traits more likely to dispose them to enhanced health and well-being (McNicholas & Collis, 1998).

Dogs, cats and other beasts It is often questioned what type of animal is best for our health. Although this might depend to some extent on who is asked (e.g. dog lover vs. cat lover), the domestic dog is certainly the most commonly used type of therapeutic animal (see Wells, 2007), and in this respect could be argued to offer the greatest health advantages. ‘Man’s best friend’ is domesticated, easily housetrained, serves as a remarkably strong social catalyst and can be readily shaped to help people with a wide variety of disabilities, including hearing, visual and mobility impairments. This species is also likely to enhance human health through a number of different routes (e.g. stroking, the provision of companionship, social lubrication, exercise, etc.), perhaps increasing its chances of success.

More recently, studies have pointed to

psychotherapeutic value of cage birds for old people. In R.S. Anderson (Ed.) Pet animals and society (pp.54–65). London: Bailliere Tindall.

Nathans-Barel, I., Feldman, P., Berger, B. et al. (2005). Animal assisted therapy ameliorates anhedonia in schizophrenia patients. Psychotherapy and Psychosomatics, 74, 31–35.

Nimer, J. & Lundahl, B. (2007). Animalassisted therapy: A meta analysis.

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the potential of dogs to help in the detection of certain types of underlying disease. Whilst not without its criticisms, research has shown that some dogs have an innate ability to detect cancer, oncoming seizures and even hypoglycaemia (see Wells et al., 2008).

How they perform this feat is still unclear, although a variety of cues, including visual and olfactory signals, have been proposed.

Using this knowledge, organisations such as Dogs4Diabetics (USA) and Support Dogs (UK) have started to train dogs to serve as an alert system for people with conditions such as epilepsy and diabetes.

The animals are trained to monitor their owners for outwards signs of imminent seizures or hypoglycaemic episodes and exhibit ‘alert’ behaviour designed to attract attention, allowing the person to take appropriate action before the effects of the problem become disabling.

Cats have received less attention on the therapeutic front than their canine counterparts, and the research conducted using this species has not always produced positive results, or for that matter been without its methodological problems. For example, early work, although criticised for its failure to take other potential causal factors into account, found that cat owners were more likely to have died one year following a heart attack than non-cat owners; dogs owners, by contrast, were significantly more likely to have survived the attack (Friedmann & Thomas, 1995).

Cat owners have also been found to be more likely to have to return to hospital with further heart-related problems or angina than non-pet owners (Rajeck, 1997), although the author’s use of multiple statistical comparisons and failure to consider illness severity must be borne in mind here.

The news may not be as bad for cat owners as this early work suggests.

Qureshi and colleagues (2008) found that cat owners have a 30 per cent lower risk of death from heart attack than individuals who do not own a cat. Whilst this result is not necessarily proof of a causal link, and again, other potential contributing factors

Anthrozoös, 20, 225–238.

Parslow, R.A, Jorm, A.F., Christensen, B. et al. (2005). Pet ownership and health in older adults. Gerontology, 51, 40–47.

Pluijm, S.M.F., Smit, J.H., Tromp, E.A.M. et al. (2006). A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling. Osteoporosis International, 17, 417–425.

Qureshi, A.L., Suri, M.F.K., Ezzeddine, M.A. et al. (2008). Cats as domestic pets reduce the risk of cardiovascular diseases. Proceedings of the 33rd International Stroke Conference, New Orleans, 19–21 February.

Rajeck, L.S. (1997). Pets and human health. Unpublished PhD thesis.

University of Cambridge.

Richeson, N.E. (2003). Effects of animal-

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(e.g. owner personality and lifestyle) were overlooked in the analysis, it does strengthen the case for a possible association between cat ownership and well-being, with stress reduction (perhaps through stroking, or simply being in the presence of the animal) most likely serving a key mediating role.

Dogs and cats, whilst the most common pets, are not the only ones that can offer health benefits. Horses, for example, have been employed since the 1960s to enhance the motor skills and sensory processing of adults and children with a wide variety of conditions, ranging from Down’s Animals should not be overlooked as an alternative, syndrome to cerebral or complementary, form of therapy palsy. Equine-assisted therapy, or ‘hippotherapy’, as it is more widely bottlenose variety) in captive or semiknown, is now relatively commonplace, captive conditions. The scheme is particularly in Europe, although robust normally reserved for people with specific studies designed to assess its efficacy are types of problem, including disturbed few and far between, rendering it difficult motor patterns, learning difficulties and to comment on its overall utility. Studies autism. designed to explore the route by which Despite its now widespread such animals might enhance people’s occurrence, published research on the health are equally lacking, although it efficacy of DAT and the mechanism/s by might be assumed that the increments which it exerts its effects, is surprisingly in short-term mood enhancement that sparse, and results are fraught with typically accompany pastimes like controversy. Most of the studies published horseriding may be at play. report positive benefits of DAT including, Dolphins have also attracted attention for example, improved attention span, in relation to the health benefits they can language skills and motivation, and bestow upon people. Dolphin-assisted reduced short-term anxiety. Recent critical therapy (DAT) began in the 1970s and reviews of the literature, however, point to has since expanded into an enormously flawed methodologies in most, if not all, of lucrative industry, with organisations the studies undertaken (e.g. Marino & running the scheme around the globe.

Lilienfeld, 2007). This, coupled with DAT allows people the opportunity to reports of poor regulation over the DAT swim with dolphins (usually of the

assisted therapy on agitated behaviors and social interactions of older adults with dementia. American Journal of Alzheimers Disease and Other Dementia, 18, 353–358.

Robin, M. & ten Bensel, R. (1985). Pets and the socialization of children.

Marriage and Family Review, 8, 63–78.

Serpell, J.A. (1991). Beneficial effects of pet ownership on some aspects of human health and behaviour. Journal

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of the Royal Society of Medicine, 84, 717–720.

Shiloh, S., Sorek, G. & Terkel, J. (2003).

Reduction of state-anxiety by petting animals in a controlled laboratory experiment. Anxiety, Stress, and Coping, 16, 387–395.

Wells, D.L. (2004). The facilitation of social interactions by domestic dogs.

Anthrozoös, 17, 340–352.

Wells, D.L. (2005). The effect of

industry, and potential welfare risks for both the people swimming with dolphins and the animals themselves, raises serious ethical questions over the future of this particular animal-assisted therapy scheme.

Conclusion Whilst the evidence for a direct causal association between animals and human health is still not conclusive, the literature is largely supportive of the long-held belief that ‘pets are good for us’, contributing to both our physical and mental well-being. Unfortunately, not all of the research carried out in this area has been without criticism (for review, see Wells, 2009). The lack of longitudinal designs and standardised measures that assess diverse areas of physical and cognitive functioning makes it difficult to draw finite conclusions, and further work in this sphere is certainly needed. It must be pointed out that research exploring the relationship between pets and human health has not always produced positive results (e.g. Parslow et al., 2005; Pluijm et al., 2006). Moreover, animals have the potential to pose enormous threat to human health, spreading disease, inducing allergies, inflicting bites and triggering psychological trauma (e.g.

Baxter, 1984; Baxter & Leck, 1984).

Pets should certainly not be regarded as a perfect pill for treating ill health.

Nonetheless, employed in the correct manner, and targeted at the appropriate user group, animals have the potential to contribute significantly to our well-being and quality of lives, and, as such, should not be overlooked as an alternative, or complementary, form of therapy in modern-day healthcare practices.

videotapes of animals on cardiovascular responses to stress.

Stress and Health, 21, 209–213.

Wells, D.L. (2007). Domestic dogs and human health. British Journal of Health Psychology, 12, 145–156.

Wells, D.L. (2009). The effects of animals on human health and well-being.

Journal of Social Issues, 65, 523–543.

Wells, D.L., Lawson, S.W. & Siriwardena, N. (2008). Canine responses to

Deborah Wells is Senior Lecturer in Psychology at Queen’s University, Belfast d.wells@qub.ac.uk

hypoglycaemia in patients with Type 1 diabetes. Journal of Alternative and Complementary Medicine, 14, 1235–1241.

Wilson, C. (1991). The pet as an anxiolytic intervention. Journal of Nervous and Mental Disease, 179, 482–489.

Zasloff, R.L. & Kidd, A.H. (1994).

Loneliness and pet ownership among single women. Psychological Reports, 75, 747–752.

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The strange history of tropical neurasthenia Anna Greenwood on a relatively short-lived colonial affliction

O

further reading

ne of the most interesting things about the history of medicine is that certain diagnoses have fallen out of favour. Conditions formerly deemed problematic such as hysteria (in both preand post-Freudian incarnations), fugue (demonstrated via a person’s repeated unplanned travel or wandering), chlorosis (or ‘green sickness’, frequently observed as a condition of young languid virgins), and sexual inversion (homosexuality) are now largely regarded as historical curiosities: at best misunderstood by the 19th-century doctors that studied them.

While some conditions, such as sexual inversion, are no longer classed as illnesses at all, others have become recategorised during the 20th century and realigned towards modern psychological understandings. Where we formerly had the melancholic, some might argue we have now substituted the depressive; the neurotic could now be described as suffering from a form of obsessive-compulsive behaviour, and the nymphomaniac would now attend a sex addiction clinic.

Perhaps the most famous of these disappearing historical conditions is neurasthenia, which was a psychosomatic disorder made popular in the 1860s by George Beard in America and imported to the UK during the 1880s. Beard’s articulation of ‘American nervousness’ was an explication of the white, middle-class breakdown that he perceived to be occurring in epidemic proportions during the 1860s. This problem Beard attributed primarily to the stresses of an increasingly

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Allbutt, C. (1895). Nervous diseases and modern life. Contemporary Review, 67, 210–231.

Anderson, W. (1997). The trespass speaks: White masculinity and colonial breakdown. American Historical Review, 102, 1343–1370.

Crozier, A. (2009). What was tropical about tropical neurasthenia? Journal for the History of Medicine and Allied Sciences, 64, 518–548.

industrialised and mechanised urban life; typified by the ‘whirl of the railway, the pelting of telegrams, the strife of business, the hunger for riches, the lust of vulgar minds for coarse and instant pleasures’ (Allbutt, 1895, p.214).

The symptoms of neurasthenia varied, but included: fatigue, ennui, listlessness, hypochondria, depression, headache, backache, stomach-ache, irritability, loss of appetite, constipation (or diarrhoea), insomnia (or excessive sleep), poor eyesight or auditory disturbances, cardiovascular malfunctions, and sexual symptoms. Because of the broad range of possible symptoms, neurasthenia was widely acknowledged as notoriously hard to diagnose: it could be both anything and nothing.

Although not exactly a positive diagnosis, neurasthenia was a relatively civilised affliction of the middle and upper classes, and sufferers could expect to live without institutional confinement. People were afflicted with different degrees of severity, with some plagued with it throughout their lives and others recovering in a matter of weeks. Overall, as a condition that carried fewer stigmas than lunacy, the prognosis for sufferers tended to be good. Although neurasthenia has now disappeared as a diagnostic category in modern medicine, there is some debate over whether neurasthenics have simply become reassigned in contemporary diagnostics as victims of what we would now identify as chronic fatigue syndrome.

Kennedy, D. (2006). Diagnosing the colonial dilemma. In D. Kennedy & D. Ghosh (Eds.) Decentering empire (pp.157–181). Hyderabad: Orient Longman.

McKinnon, M. (1934–5). Medical aspects of white settlement in Kenya. East African Medical Journal, 11, 376–394.

Woodruff, C.E. (1905). The effects of tropical light on white men. New York: Rebman.

Closely related to neurasthenia, but much less well known and now entirely disappeared from view, was its colonial brother – tropical neurasthenia. Similar in many ways to ‘home-grown’ neurasthenia, tropical neurasthenia was something that white (mostly male) colonists suffered from specifically due to the environmental stresses of their tropical colonial lives. Like classic conceptions of neurasthenia based in the Western world, tropical neurasthenia was not psychosis or madness, but was rather an ennui or loss of edge brought about by the strains of tropical life, and could cover a gamut of renegade, bizarre, or even genuinely neurotic, behaviours of Caucasians in the tropical outposts. Although tropical neurasthenia saw the height of its popularity between 1905 and 1920, it did not completely disappear from colonial medical discourses until the beginning of the Second World War; proving it to be remarkably more durable than the Western-based version of neurasthenia from which it stemmed and had gone out of fashion in the UK and America by the end of the First World War. Furthermore, although it was difficult to identify – having a wide range of symptoms and manifestations – tropical neurasthenia was surprisingly commonly diagnosed. So frequently in fact, that a 1913 statistical table published in the British Medical Journal, actually named it as the chief reason (over malaria, cholera and dysentery) for Europeans to be invalided while serving overseas in British tropical possessions. Despite this relatively high profile as a health problem of Empire, tropical neurasthenia has largely been forgotten, perhaps as part of a wider trend of forgetting the more uncomfortable parts of colonial history.

Above and beyond everything else, tropical neurasthenia was a ‘whites only’ condition, solely suffered by those who were deemed sensitive, cultured and ‘civilised’. It is hardly surprising then that such inherent support of outdated ideas of white racial superiority have naturally made it a rather embarrassing historical relic.

Tropical neurasthenia provides an interesting case study of how a disease category can mutate as it changes geographical contexts. When neurasthenic symptoms were located in Europeans living in, or travelling to, the tropical world they were reformulated to suit the particular exigencies of the colonial situation. For example (and unsurprisingly given the British climate), the tropical variant of neurasthenia identified the deleterious effects of the sun as the most important causative

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factor in creating nerve damage and sapping vital energies. Similarly predictably, racial differences too played a more prominent role in defining sufferers in the colonies. Interestingly, whereas Western conceptions of neurasthenia pinpointed it as a reaction to the strains and stresses of continued contact with fast-paced modern life, in the colonies tropical neurasthenia was conceived as the manifestation of an individual’s separation from civilisation and modernity. Advice on the avoidance of tropical neurasthenia therefore typically centered on maintaining civilised standards and intellectual pursuits typical of one’s home milieu and social standing, for example, attending lectures, concerts, plays and debates as often as was practically possible. This type of remedial action – almost cultural therapy – for sufferers of tropical neurasthenia was supplementary to the usual advice on recuperation for neurasthenics in the UK, which typically focused upon rest, diet and exercise. These subtle reformulations of the disease category to suit the colonial context are revealing of specifically colonial anxieties and also show how medical diagnoses can become not only adapted over time, but also over space.

Perhaps the main difference between the tropical and nontropical formulations of nervousness was the way the tropical variant neatly dovetailed with already entrenched concerns about the inability of Europeans to ‘acclimatise’ to the tropical heat. Since the earliest foreign settlements there had been debates over the suitability for Europeans to live in foreign climes, especially those with extreme temperatures, unfamiliar physical geographies and foreign diseases, such as Africa or India. By the final decade of the 19th century, however, the acquisition of a large number of African territories made the health conquest of the tropics all the more pressing; correspondingly, debates filled the medical press over the white man’s prospects for long-term settlement abroad.

Advances made within tropical medicine were often cited as a sign that the tropics could be managed without deleterious medical consequences. But interestingly, despite this optimism in medical advances, modern medical theory was not able to entirely allay fears over the way the climate may detrimentally interfere with the central nervous system of the European.

Given this contemporary preoccupation with the viability of European settlement in the tropics, it is easy to understand the enthusiastic reception Major Charles Woodruff’s medical description of neurasthenia specific to hot places received when it was published in 1905. Woodruff’s theory was originally developed as an explanation for the neurasthenic symptoms experienced by American colonisers in the Philippines, which they had occupied in 1898, but the term soon made its way over the Atlantic, where it was enthusiastically taken up as an extension of debates about the suitability of the tropics for white settlement. It was embraced with such enthusiasm that by 1913 tropical neurasthenia even formed

the topic of the presidential address at the annual meeting of the Society of Tropical Medicine and Hygiene.

For the most part, variations between the colonial and the home model of neurasthenia were in emphasis rather than kind. Just as in the home context, tropical neurasthenia offered a respectable label for symptoms for the listless or deviant behaviours of middle- and upperclass white men and, just as at home, it was a diagnosis with considerable social and cultural usefulness. The chief difference in sociopolitical utility, however, was the way that tropical neurasthenia was used as a diagnostic marker of white civility, as opposed to black madness. When indigenes acted in ways deemed deviant, they were typically locked up by the colonial state in asylums; when whites did the same, similar or worse, they were often diagnosed as sufferers from tropical neurasthenia and were quickly repatriated under this only slightly stigmatising label.

In short, the tropical diagnosis was an expedient for furthering the colonial

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political agenda and allaying colonial racial anxieties. Fears of tropical neurasthenia guided the recruitment of personnel to Empire, helped colonial governments to weed out unsuitable characters, and gave colonials themselves a respectable exit route from colonial life.

Tropical nervous diagnoses were used as a means of policing the colonisers and trying to control and homogenise behaviours to a model of acceptability.

Tropical neurasthenia explained all sorts of aberrant behaviours and ‘regrettable incidents between natives and Europeans’, from ‘sudden acts of violence’ to ‘acts of criminal folly’ (McKinnon, 1934–5, p.389.) Suggested solutions included taking up both a hobby and a (European) wife in the remote colonial location to distract the mind and make sure that some civilised home comforts still existed in remote outposts.

Yet, despite the threat to manliness and colonial authority that the diagnosis pointed towards, tropical neurasthenia was still a relatively socially acceptable diagnosis that did not contain the negative connotations of real insanity and displaced the blame for the problem away from the sufferer and on to the environment.

Furthermore, it was a means of stressing white civility, by constructing the work of Empire (and by implication the job of trying to rule and administer the indigenes) as a particularly stressful task.

This short history of tropical neurasthenia shows just how historically and culturally contingent the medical classification of behaviour can be.

Although tropical neurasthenia was in many ways a diagnosis entirely typical of late Victorian and early Edwardian medicine, it was also reconfigured in such a way as to support the colonial enterprise. So tropical neurasthenia embodied slight – yet significant – differences from classic neurasthenia, ones that particularly stressed the excessive heat and sunlight and cast the problem as, if not exactly a badge of honour, certainly less stigmatising that its home-grown equivalent. Despite the threat to manly reputation and colonial image that a nervous diagnosis could point towards, tropical neurasthenia nevertheless provided an useful means of categorising European neuroses at a safe critical distance from indigenous mental health problems.

I Anna Greenwood is at the University of Nottingham, Ningbo, China annagreenwood1@gmail.com

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