The Psychologist, July 2013 by The Psychologist

the

psychologist vol 26 no 7

july 2013

Working as an expert witness We meet Gisli Gudjonsson and others in the legal system

Incorporating Psychologist Appointments ÂŁ5 or free to members of The British Psychological Society

letters 466 news 478 looking back 496 careers 522

psychology in the operating theatre 498 HIV in the UK 504 big picture: what is uniquely human? centre digital piracy and the moral compass 538

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letters 466 diagnosis debate – attack or thoughtful critique?; from silence to a public voice; retired psychologists; self-dosing and the e-cigarette; NLP; and more news and digest avatar therapy; MyConnectome; charitable giving; new Little Albert theory; registered reports; a review of a one-day conference on scientific research with psychedelic drugs; and the latest nuggets from the Society’s free Research Digest service

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Expert witness work – time to step up to the plate David Crighton introduces a special feature Interview: A thirst to learn the truth Jon Sutton talks to Gisli Gudjonsson CBE Day in the life: Working as an expert witness We hear from four psychologists about their interactions with the legal system Looking back: Psychologists in the witness box Graham Davies and Gisli Gudjonsson

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Psychology in the operating theatre Michael Wang, Catherine Deeprose, Jackie Andrade and Ian F. Russell ask what anaesthesia can tell us about consciousness, learning and memory

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HIV in the UK Poul Rohleder, Tomás Campbell, Audrey Matthews and Jenny Petrak consider the ongoing challenges

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society 510 ten things you didn’t know about new Society President Richard Mallows; welfare fund; Psychologist bath; Psychology4Graduates; and more careers and appointments

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we meet Ciarán O’Keeffe, ‘the parapsychologist’, and two counselling psychologists working with children, young people and families

july 2013

THE ISSUE This is my first contribution to The Psychologist, but as incoming Society President I will have the opportunity through the President’s columns for a few more. My personal vision for the British Psychological Society is to securely position the Society as the learned Society for psychology and to be more outward looking in the world. The Society is busy working on its next strategic plan and this is the chance for all members to contribute. I have long been a fan of The Psychologist because you never know when an item will catch your imagination, be professionally supportive or inspirational for teaching. I have often followed up items in The Psychologist directly with the authors, most recently over the ‘Scottish Referendum Question’. A few years ago I responded to an article about ‘altruism’ as I contemplated retirement and involvement with the BPS. This issue of The Psychologist contains a special feature on expert witness work following in the tradition of The Psychologist being unafraid of challenging issues. Dr Richard Mallows Society President 2013/14

reviews 530 Chelsea Flower Show; Man of Steel; TED talks; The Human Swarm; secular Sunday service; reader recommends; and more in our broader ‘Reviews’ section new voices 538 digital piracy and the moral compass: Steven Brown with the latest in our series for budding writers (see www.bps.org.uk/newvoices) one on one

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…with Jacqueline Akhurst

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LETTERS

Distortions and maps of wonderland

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Given the importance they attach to evidence, it is surprising that Essi Viding and Uta Frith (Letters, June) should use the words ‘attacking the DSM-5’, implying both aggression and lack of justification, for what is in fact a thoughtful, evidencebased statement by the Division of Clinical Psychology (DCP) on psychiatric classification. In criticising the statement and subsequent ‘pronouncements in the media’, Viding and Frith present the current situation in mental health as one led by evidence, in which researchers and clinicians take due account of both environmental and biological factors in understanding ‘the symptoms that mark mental illness’. This is far from the case. For the last 30 or 40 years, research and practice in this area has been dominated by approaches which privilege genes and biology, depict emotional and behavioural problems as akin to physical illnesses, and systematically de-emphasise the potential causal role of people’s social and personal contexts. This is in spite of a poor evidence base for all three of these

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stances. This situation itself has a social context, which may help explain both its persistence and the strength of feeling often evoked by attempts at change (Boyle, 2011; Cromby et al., 2013; Pilgrim, 2007). And contrary to Viding and Frith’s claims, the DCP argument is not based on a ‘false dichotomy between genes and environment’. It does position itself for a reconceptualisation of the role of biology and against a model that sees mental, emotional and behavioural difficulties as symptomatic of biologically based illness. It also argues for due acknowledgement of the vast amount of evidence that many of these difficulties are meaningful responses to often extremely challenging life circumstances. Finally, Viding and Frith imply that those who claim a causal link between child abuse and

Professors Viding and Frith (Letters, June 2013) excoriate critics of DSM-5 who, they say, ‘are in danger of muddying mental health issues by ignoring… biology’. They write approvingly of Simon Wessely’s Observer article (12 May 2013) and endorse his claim that ‘a classification system is like a map. And just as any map is provisional, ready to be changed as the landscape changes, so is classification.’ Let me outline how history illustrates the value of this metaphor of mapping the mind.

In 1952, when the first Definitely Scientific Map (let’s call it ‘DSM-1’) was published, only 106 cartographic entities were in the atlas. A good index of the success of the cartographers of the mind is the phenomenal productivity of their subsequent explorations – new islands, continents, rivers, mountain ranges, swamps, and so on, were added, and although many old ones were thrown out they achieved an average rate of increase over the next 42 years of close to one every eight weeks: DSMap-4 (1994) showed 365 entities.

These pages are central to The Psychologist’s role as a forum for discussion and debate, and we welcome your contributions.

Send e-mails marked ‘Letter for publication’ to psychologist@bps.org.uk; or write to the Leicester office.

‘schizophrenia’ are ‘not slowed down by a need for an evidence base, but instead irresponsibly make unsubstantiated and alarmist pronouncements’. This is completely unjustified. There is good evidence, some of it cited in the DCP statement, that the links between child abuse and psychosis are likely to be causal, and such claims are not made lightly. This evidence may be difficult for many to hear and unfortunately, Viding and Frith’s ad hominem response, rather than one engaging with the evidence, is not untypical. I hope the DCP statement will encourage truly informed debate on these issues to the benefit of researchers,

How had they achieved this fecundity? Untiring effort was the answer. Year in, year out their exploration vessels sailed the seven (7.34 ± 1.56) seas, proudly flying the Cartographers’ flag, a banner inscribed ‘BP’. (Crew members gave different answers when asked what the letters stood for: ‘Big Pharma’, said some,

Letters over 500 words are less likely to be published. The editor reserves the right to edit or publish extracts from letters. Letters to the editor are not normally acknowledged, and space does

‘Big-time Psychiatry,’ said others, but the groups worked together as one big happy family regardless). It was not always smooth sailing. For example, when explorers sent descriptions of the landscape to the head office of the Cartographers of the Mind Association (CoMA) for official rulings, one might

not permit the publication of every letter received. However, see www.thepsychologist.org.uk to contribute to our discussion forum (members only).

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clinicians and, above all, service users themselves. Professor Mary Boyle University of East London References Boyle, M. (2011). Making the world go away, and how psychology and psychiatry benefit. In Rapley, M., Moncrieff, J. & Dillon, J. (Eds.) De-medicalising misery. London: Palgrave Macmillan. Cromby, J., Harper, D. & Reavey, P. (2013). Psychology, mental health and distress. London: Palgrave Macmillan. Pilgrim, D. (2007). The survival of psychiatric diagnosis. Social Science & Medicine, 65, 536–547.

We welcome contributions to the debate that has been raised by the DCP Position Statement on Classification, which can be read in full at http://dcp.bps.org.uk/dcp/ the_dcp/news/dcp-position-statement-onclassification.cfm The statement is not about DSM specifically but about conceptual systems ‘based on a “disease” model’. This would include ICD. Nor do we see it as an ‘attack’ but as a thoughtful critique based on a two-year process of reviewing the evidence and consulting within all the DCP Faculties, where it has widespread support. It is difficult to convey a complex

be told that a tenant was on Mount Skitzos while a second tenant in the same building was on the Isle of Catatonia, a third on Lake Normalia. But none of this impeded the enlightened help BP could provide to the inhabitants – the holds of the vessels of exploration were brimming with curative chemicals that were equally effective everywhere on the Map. There were of course sceptics, people who thought, for example, that it might be more effective to build warm buildings in (bi?) polar regions instead of filling inhabitants with chemicals that made them complain less about the cold. As a gesture of goodwill (and to try to rid themselves of the distractions of repetitive complaints), exploration vessels started to carry small amounts of

argument through the media. We regret that some of the reporting has badged this as a psychiatry versus psychology battle. We have been working hard to counter this. The statement itself makes it absolutely clear that, to quote: ‘This position should not be read as a denial of the role of biology in mediating and enabling all forms of human experience, behaviour and distress… It recognises the complexity of the relationship between social, psychological and biological factors’ (p.2). We are unhappy with responses that, quite wrongly, represent us as presenting ‘a false dichotomy between genes and environment’ and hope that all members of the Society will take the opportunity to correct such misinterpretations. Nevertheless, our position, supported by a great deal of evidence, is that it is neither accurate nor helpful to conceptualise the experiences that may lead to a functional psychiatric diagnosis within a ‘disease’ model, in which biological causal factors such as genes or biochemistry are hypothesised to be the primary causal ones. We do not do this for other responses to life events – for example, bereavement – and by analogy, our argument is that the increasing amount of evidence for the causal role of all kinds

building material, pumps to drain swamps, and so on. CoMA itself even professed to subscribe to a Bio-PsychoSocial model of disorder: their banners accordingly now read ‘BPS’ not ‘BP’. (This new image has perhaps brought to light a little-researched version of the Stockholm syndrome, with scientists who are not members of the BP team taking up cudgels on the team’s behalf). Sceptics even argued that the metaphor itself is flawed. Geographic cartographers, they say, draw representations of things we are reasonably sure exist independently of the maps drawn of them: mountains, islands, and so on, they disingenuously claim, are real. DS Maps of mental disorders, they say, are different. They are not representations of realities:

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of traumas and life circumstances in psychiatric breakdown makes it implausible to do so in many of these cases as well. The DCP is, in conjunction with the BPS Media Centre, monitoring the media coverage closely and working to correct any distortions of our message. The point is well made that we need to explore the possibility of alternative clustering systems, and internationally there are a number of groups engaged in this task. The DCP has funded its own project to outline the principles of an approach that identifies common patterns of responses, both psychological and biological, to life events and social circumstances, and that might supplement and support the use of individual formulation. Clearly, the existing classification system will be with us for some time. However, the DCP believes that it is vitally important to ‘achieve greater openness and transparency about the uses and limitations of the current system’ and ‘to open up dialogue with partner organisations, service users and carers, voluntary agencies and other professional bodies in order to find agreed ways forward’ (p.4). Richard Pemberton Chair, BPS Division of Clinical Psychology

the entities they purport to describe are constructions of the minds of Cartographers of the Mind. They are Maps of Wonderland. Professor Justin Joffe London N2

The American critic H.L. Mencken once remarked, ‘For every subtle and complicated question, there is a perfectly simple and straightforward answer, which is wrong’. The question of how to respond to psychological distress is subtle and complicated. The answer that has dominated recent Western thinking, namely that there exist mental illnesses and that these are illnesses like any other, has the virtue of being simple and straightforward. But it may also be wrong – or at least, partial, misleading and, in some cases, actively unhelpful.

The DCP’s recent statement is to be commended for not trying to replace one ‘simple, straightforward and wrong’ answer with another. The document acknowledges the subtle and complicated nature of the issues. Contrary to what some commentators have suggested, it does not pit clinical psychology against psychiatry or deny the role of biology – indeed, it states explicitly that what is required is ‘multi-factorial and contextual approach, which incorporates social, psychological and biological factors’. It highlights problems with the current system of classification, but does not object to classification per se. It offers no off-the-shelf alternative, calling instead for wide-ranging dialogue to develop new approaches. Even the document’s most striking

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suggestion, a move away from the system of diagnosis described by the DSM-5, is hardly radical. Similar arguments have recently been made by influential and mainstream groups such as Mental Health Europe (see tinyurl.com/bqdgos9) and the US National Institute for Mental Health (see tinyurl.com/cl5ekbc). That such a measured and non-polemical statement

should provoke howls of outrage perhaps tells us something about the tenuous foundations of the medical model. If proponents had the confidence of their convictions they would have nothing to fear from – indeed would welcome – critical interrogation. By contrast, those who raise problems with diagnosis, or with the concept of mental illness as such, are accused of ‘anti psychiatry

prejudice’ and of having no interest in relieving suffering (see tinyurl.com/no88tpb). Most baffling of all is the response that criticising diagnosis is somehow antiscientific – particularly absurd when, as the DCP statement makes clear, many of the difficulties of the DSM arise from a failure to follow the scientific method. Although the DCP statement makes no new

arguments, it performs a valuable service by bringing vital critiques of the medical model of mental illness to wider public attention. Personally, I am proud to see the BPS finding its voice and raising subtle and complex questions. Dr Sam Thompson Institute for Psychology, Health and Society University of Liverpool

Methodological shortcomings of biological research I read with interest Essi Viding and Uta Frith’s response to the DCP’s recent statement concerning DSM-5. They write that the DCP representatives are ‘in danger of muddying mental health issues by ignoring the biology’ and that ‘their present stance will fail to deliver help for those who suffer from mental health problems’. I thought this was a curious response, given the outright failure of behaviour genetics research over several decades to benefit service users in any way whatsoever. This failure to deliver anything of use to those on the

NOTICEBOARD I Clinical and counselling psychologists are invited to participate in an international research study on the relationship between core beliefs, stress and burnout. This study will help us to develop resilience training to strengthen coping skills amongst psychologists. To access the survey, please go to tinyurl.com/kkbfnfo. This study has been approved by the University of South Australia’s Human Research Ethics Committee. Susan Simpson susan.simpson@unisa.edu.au I As part of PhD studies at the University of Greenwich I am seeking personal accounts by therapists of anomalous experiences in, or in connection with, counselling/psychotherapy. Participation in this study would ask you to complete an online questionnaire. If you would like further information on the nature and purpose of this research, please go to tinyurl.com/q5qjtsr Paul Atkinson ar57@gre.ac.uk

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sharp end should not be considered surprising given that the case for a genetic basis for the behaviours and experiences which are categorised as serious mental illness has been vastly over-stated. A recurrent feature in this work has been the poor reliability of diagnostic categories, absence of biological markers and an automatic interpretation that data from twin and family studies favour a genetic interpretation when in actuality the greater genetic similarity of MZ twins compared to DZ twins is confounded by their greater shared environment. It is simply not the case that the equal environments assumption can be so blithely ignored or that the use of structural equation modelling as a research tool can circumvent the problems. It is well known – or at least ought to be – that in any multivariate model where there are two potential predictors of an outcome of interest and these are strongly related (as is the case for genetic similarity and degree of shared environment in twin studies) the one which is measured with greater precision will seem to be the more strongly related with the outcome than is actually the case (Davy Smith & Phillips, 1996; Phillips & Davy Smith, 1991). Twin studies incorrectly interpreted have led researchers to expect huge genetic effects that have simply not materialised in molecular genetics research. The recent ‘breakthroughs’ proposing a common genetic pathways in five psychiatric disorders for example (Cross-Disorder Group of the Psychiatric Genomics Consortium, 2013) is but one example. The authors were only able to explain between 1 and 2 per cent of the variance in any of the target disorders (ADHD, ASD, bipolar disorder, major depressive disorder, and schizophrenia)

with the expressed possibility that their results could have been inflated by diagnostic overlap. Given the sample size they used (over 30,000) the findings may have no clinical significance whatsoever. Their preference for biological theorising made clear, Viding and Frith, with a rhetorical wave of the hand, then refer to ‘unsubstantiated and alarmist pronouncements about child abuse causing schizophrenia’. That child sexual abuse is a risk factor for almost all forms of ‘psychopathology’ (including schizophrenia) is not unsubstantiated but is in fact well attested by a large body of research (e.g. Roberts et al., 2004). Viding and Frith are of course correct to point out that current interventions (both medical and psychological) are far from effective, but that situation is not likely to improve until the poor track record and methodological shortcomings of biological research in mental health is acknowledged. Ron Roberts Kingston University References Cross-Disorder Group of the Psychiatric Genomics Consortium (2013). Identification of risk loci with shared effects on five major psychiatric disorders: A genome-wide analysis. Lancet, 381, 1371–1379. Davey Smith, G. & Phillips, A.N. (1996). Inflation in epidemiology: ‘The proof and measurement of association between two things’ revisited. British Medical Journal, 312, 1659–1661. Phillips, A.N. & Davey Smith, G. (1991). How independent are ‘independent’ effects? Relative risk estimation when correlated exposures are measured imprecisely. Journal of Clinical Epidemiology, 44(11), 1223–1231. Roberts, R., O’Connor, T.G., Dunn, J. et al. (2004). The effects of child sexual abuse in later family life: Mental health, parenting and adjustment of offspring. Child Abuse & Neglect, 28(5), 525–545.

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Stepping from the shadow We are writing to commend the immediate and comprehensive use of the DCP statement on formulation to all of our colleagues. It has appeared at the very time when the shortcomings of psychiatric diagnosis have been exposed in the critical international response to the publication of DSM-5 by the American Psychiatric Association. Our current context then provides the profession of clinical psychology with a unique historical opportunity to adopt a clear position of scientific humanism. DSM and other forms of psychiatric nosology are incompatible with a psychological approach to helping people with their problems, which should be both humane and scientific. Our approach to helping others should be based on identifying specific problems (defined As 210 clinical psychologists and mental health professionals, we support the DCP’s call for a paradigm shift in how we think about mental distress and the need to move away from psychiatric diagnosis. We are pleased by the media coverage and the debate this has stimulated in the wider public. It is essential that diverse voices are heard and that rather than considering individuals as receptacles of disorders, deficits and distortions, we make sense of distress in more helpful and evidence-based ways. We need to focus far more on people’s lives, experiences

by clients themselves but, for obvious practical purposes reflecting a common lexicon) and working with them to develop individual and context-bound formulations. These would include the unique events in a person’s life past and present, the meanings they invest in, or attribute to, those events and strengths to build upon that he or she has exhibited to date in coping with challenges in their life. David Pilgrim Professor of Health and Social Policy Peter Kinderman Professor of Clinical Psychology Richard Bentall Professor of Clinical Psychology University of Liverpool

and social contexts and to consider how people embody and are shaped by the world around them. We note that organisations such as the Hearing Voices Network and Mental Health Europe, which represent the service-user perspective, have recently challenged the diagnostic and professional expert-driven status quo, and we believe that clinical psychology needs to support and work with these groups. We

Following the publication of the DCP’s Position Statement on Diagnosis, which we have already endorsed, the Psychosis and Complex Mental Health Faculty is keen to work on bringing about the changes in practice and conceptualisation that it envisages in our services. Most of us in the Faculty work closely with colleagues in other professions in a team context, so that collaboration, both with them and with service users and carers, is a priority. We are seeking to further this agenda at the Faculty conference and AGM to be held on 20 November at the

need to step out from the shadow of biological reductionism and consider the multifaceted nature of what it is to be human and to be part of the world around us. We wish to support the DCP and the growing number of service users, carers, professionals and organisations who are questioning the dominant paradigm. This is a very important step for the profession and one that is long overdue. Dr Mel Wiseman Wellingborough and 209 other signatories (For the full list see the html version in ‘Letters’ at www.thepsychologist.org.uk)

BPS London office under the heading ‘Developing the narrative – Creating a shared paradigm shift towards a holistic view of mental health’. This should further the process of moving beyond restrictive, illness-based conceptualisations in partnership with the other groups and professions concerned with complex mental health, in line with the second recommendation at the end of the position statement. Isabel Clarke Chair of the PCMH Faculty of the DCP on behalf of the Faculty Committee

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The recently published Francis Report calls for a change in the culture of the NHS, repositioning the patient at the centre of care and enshrining values of responsibility and accountability in everyday practice (among 290 recommendations). The stars aligned with the publication of DSM-5 and the DCP’s position statement ‘Time for a paradigm shift’; this seemed like a timely way to generate debate, about the influence of diagnostic categories on constructions of distress and thus mental health care provision. The response to the DCP statement from some quarters has left me stunned and greatly concerned for the profession. It makes me think of Menzies-Lyth’s (1960) work on socially structured defence mechanisms in the face of anxiety. Some of the defences proposed include atomisation of tasks and the ceding of responsibility to higher-ranking staff. This potentially entrenches hierarchies and negates questioning dominant narratives in services. Bringing this back to the here and now, it seems there is a real danger that a great many healthcare professionals work in systems that do not encourage questioning. This is self-evident following Francis and possibly not confined to the NHS services of Mid Staffordshire. The Francis Report calls for a new culture of patient care, which surely includes a fresh examination of the paradigms that support this care. This poses a series of questions for commissioners, providers, and practitioners. Do we want healthcare professions not to question? Will this lead to greater responsibility and accountability? Can we put patients’ needs in the centre of our practice without critically examining our models, the evidence we draw on, and the language we use to define others’ distress? If we don’t critically reflect on what we do, whose needs are we serving? For those that have come out strongly against the DCP position statement I think its positive that a genuine debate might at last happen. And, reflecting on the work of Žižek (2008), can I ask you one last question – in entering the debate in this way have you taken the right step, but the wrong direction? Ima Nusm Trainee clinical psychologist University of East London References Menzies Lyth, I. (1960). Social systems as a defence against anxiety. An empirical study of the nursing service of a general hospital. Human Relations, 13, 95–121. Žižek, S. (2008). In defence of lost causes. London: Verso.

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Are we competent to recognise our incompetence? It is fashionable to seek to connect disparate things, and in response to three parts of The Psychologist, June 2013, I offer these thoughts. I want to connect editor Jon Sutton’s quote from Bertrand Russell (‘One of the painful things about our time is that those who feel certainty are stupid, and those with any imagination and understanding are filled with doubt and indecision’) and the letters on the DSM vs. DCP conflicts with the letter about Farrelly’s Provocative Therapy. My challenge to DSM people and DCP people is this: you are incompetent, you have clearly failed to make progress with people’s mental health in general and should rethink your position. If you cannot outline a positive way forward then you should all go home. Examples of failure? Well, an obesity crisis is surely self-harm on a massive scale and almost total failure to create a response to genocidal climate change (killing off a future generation is genocide in my book) shows total disregard for priorities let alone anything else. My own view of why you are incompetent, that you fail to accept a paradigm of multiplicity – that a persona which might have a biological response system should be switched to a persona which will respond to an environmental response (and vice versa is an option of course: see Rita Carter, Ornstein and even William James) – is not actually relevant. What is relevant

is that whatever paradigms you are adopting (and most times you fail to declare them) they are failing and after 90 years of trying you should give up. For those who think I am singling out clinical I am happy to challenge educational psychology (which paradoxically is regulated through the medical model) that you should also all give up and go home because the school system is not much better if at all from 50 years ago. Likewise, in forensic you fail to make any inroads into prisoner rehabilitation and for organisational psychologists, you are dismal failures when it comes to having any success with governments current and past (as the audit trail shows they aren’t even getting the maths right, though maybe that is the fault of the educational psychologists) and even more so with company executives and leadership, management and teamwork, where your pay should yield a better return than the worst recession in decades – why haven’t you run over the cliffs like lemmings do? (Or don’t to be accurate.) So, let’s own up to our incompetence at recognising our incompetence, give up what we are trying to do and failing, and do something else, help save the planet maybe (but not as psychologists, please). Graham Rawlinson Chichester

Public protection – a moral maze In today’s media-focused culture, moral judgements about other people’s behaviour are made every second. Most people would probably agree that health and care professionals are given unique trust by the public. However, there is less clarity around the expectations that go with this trust, and the consequences for breaches of trust. Consider the following: A health professional is arrested for shoplifting. Does this have an impact on his fitness to practise? A health professional has been charged with drink-driving after attending a party whilst off duty. She drank four or five glasses of wine – and has not shown a history of alcohol abuse. Does this impact on her ability to do her job? The Health and Care Professions Council wanted to explore this complex area in relation to public understanding of ‘protection’, and what health and care regulators should be doing as the gatekeepers of professional standards. We commissioned a study, to which 270 people contributed, including members of the public, those from patient and service user groups, professionals, educators and employers (read the report at www.hcpcuk.org/publications/research).

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Participants were asked to share their experiences of care, and explore different scenarios like the ones above. The majority saw the first scenario as more serious in relation to fitness to practice. This was because it signified a deliberate, premeditated act, whereas in the second, participants thought it might not impact on a professional’s ability to do their job. A comprehensive understanding of the individual circumstances would usually be required to make a judgement about fitness to practise. This case-by-case consideration of the evidence, taking account of the context in which actions occur, reflects the HCPC’s approach to all fitness to practise referrals. Maintaining public safety is paramount. Clearly, a drink-driving conviction is a serious breach of the rules. However, it would likely have greater implications for a professional if they were on duty at the time or travelling to or from work, if it were a repeat offence or if the professional showed no insight into the impact of drink-driving on safety. There was agreement amongst the participants that repeated behaviour or practice that did not meet standards, a premeditated decision to do something known to be illegal or other dishonest behaviour should trigger an investigation by the regulator. They also agreed that,

where actions had consequences for patients or service users, the professional’s fitness to practise should be investigated. In the aftermath of the Francis Report, we are looking closely at this research and its lessons. There are lines that can be drawn, where the majority would agree there are implications for both public safety and public confidence. HCPC standards exist as a framework, a Highway Code, designed to guide. But context is a hugely important factor when making judgements about other people’s actions, and informed judgements are almost always about understanding the context. What professionals – and regulators – must do is maintain high levels of selfawareness and moral questioning, which militate against making bad choices, but can never totally eliminate them. I hope that this report will be discussed by patient and service-user groups and professionals. The need to engage in this debate about ethics and behaviour grows ever more urgent as more and more reports of poor care and overstretched staff emerge. The future of health and care professional practice depends as much upon our individual response to ethical obligations as it does on our technical competence. Anna van der Gaag Chair, Health & Care Professions Council

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From silence to a public voice ? ange h c l cia for so s t s i bby be lo

th house their r child is ei om in bedro whilst thlong-term h exists tly in a ment. T ce curren-care pla with he foster ‘s contact ential child er and pot ith her moth ication w to be ly if reun er is like if the moth y affected ired t greatl er is requ mun h m ot m her co port out of cial sup and her so blished mo is esta r accom d le smal e the chil wher le to be acn unab st this is Whil in depth for andividual on in t referre clien hlight to higumber the n suf to stand chan ed plannestion o qu h the ts could it w us ogis sychol chol bly RS ANDE

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I was moved (both in the emotional sense and the ‘moved to actions’ sense) by Jade Weston and Nic Horley’s letter (‘Can we be lobbyists for social change?’, April 2013). It reminded me of the position of the Just Therapy group (Waldegrave et al., 2003) that states that for those in the helping professions to witness the stories of hardship and how social injustices impact on the well-being of those who consult with us and to remain silent is an immoral act. It made me question why I, and my profession, have been too silent about the real and potential impacts of the current changes to health care and the welfare system on the lives of those who consult with us. The anonymous letter in The Psychologist, May 2013 (‘Lobbying for social change’) makes the important point though that we should not idealise or romanticise poverty or other disadvantages. Unfortunately the moral high ground has never belonged to any one socio-economic group. Those from poorer backgrounds who have been so inclined have found ways to abuse the benefit system, just as some from financially more privileged positions have found ways to abuse the tax system. In my view though this is not a moral question for the individual on whether we

s our at ct th ges d chan ing are gomost t and ety. ci of so nical believe , we ly moral for ocate ts. This clien and d ngageelfare ial w make and tomental e detri We wer t s. n ir live in a rece urtherhat

are ‘good’ and deserving human beings (however we might want to define what that means) and thus entitled to a decent quality of life and decent services. Rather, it is a moral question for society. The welfare state holds that all are entitled to good education, good health care and a humane standard of living whatever your social circumstances. The current changes, from my perspective, change this and lead to a position where those from deprived backgrounds can find themselves unable to maintain a basic quality of life and where they no longer have access the an equal standard of healthcare provision.

RETIRED… BUT STILL A PSYCHOLOGIST As a retired independent practitioner, I am delighted that independent practitioners will hopefully now have a voice – it would have meant a lot to those practitioners like me who felt themselves marginalised. [The Society’s Trustees have supported a proposal to establish a Special Group for Independent Practitioners; the next step is the vote of the membership to establish it.] Now, following on from letters to The Psychologist (Peter Topham, February; Harry Gray April; Janie Penn-Berwell, May), might be a good time to establish a special interest network for retired psychologists. As Penn-Berwell indicated, leaving a lifelong profession is a form of bereavement. As an occupational psychologist I found it relatively easy to identify a workable alternative career path (copy writing) but I’m still a psychologist – sort of incognito. I think retired psychologists have lots to offer each other, the BPS and the public. By establishing a relevant group, the BPS could offer those approaching retirement good reasons for remaining active members after they’ve filed their Practising Certificates under ‘Miscellaneous’. Eleanor Lancaster Bangor, N. Wales

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In my view it is the duty of psychologists and others who witness the direct impact of changes to the benefit system and National Health Service on the lives of those who consult with us to make these impacts visible to our professional community and to society. I was so impressed by the strong stand the DCP and BPS have taken in response to the DSM-5, highlighting the problems associated with an individualised understanding of human distress and emphasising the importance of fully acknowledging and responding to the social contexts for that distress. Maybe these challenging times are activating us as a profession to have a stronger and more political public voice and to become influential lobbyists for social change. In the meantime, Weston and Horley’s letter makes it difficult for us as individual psychologists not to consider what position and action we each wish to take. Lizette Nolte Clinical Psychologist University of Hertfordshire Reference Waldegrave, C., Tamasese, K., Tuhaka, F. & Campbell, W. (2003). Just therapy – a journey: A collection of papers from the Just Therapy team, New Zealand. Adelaide: Dulwich.

Self-dosing and the e-cigarette It would seem from the comprehensive review of smoking addiction in the May issue of The Psychologist by Lynne Dawkins that despite years of research there is still no real progress in helping smokers to quit. One significant factor in the maintenance of the habit, however, is not discussed in the article, namely the way in which smokers can automatically adjust their nicotine input to some ‘optimum’ level according to the perceived level of stress. It is over 40 years ago that Heather Ashton and myself first demonstrated this behaviour in human

participants (Ashton &Watson, 1970). Our study was prompted by earlier research which suggested that a smoker has ‘literally fingertip control of how much nicotine he takes into his mouth’ (Armitage et al., 1968). Our study demonstrated that the effects of nicotine depend largely upon the dose and rate of self-administration by smoking and that critically the rate of self-administration is controlled more by the puff rate than by the depth of inhalation of each puff. During a complex motorperceptual task smokers of cigarettes with high-retention filters took more frequent

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puffs obtaining nearly the same amount of nicotine as smokers of cigarettes with lowretention filters during the tasks; and in the following resting period low-nicotine cigarette smokers took more frequent puffs than those smoking high-nicotine cigarettes (participants were unaware of the different filters). The results suggested that the smokers were striving for a nicotine-alerting effect whilst engaged in the task. Both groups of smokers also showed a significant increase in puff rate during the resting period after the tasks, and the amount of nicotine obtained per unit of time also rose during this period. This suggested that the subjects may have been attempting to obtain a ‘tranquilising’ effect of a higher dose of nicotine. All participants showed a

slightly higher nicotine abstraction rate during the most stressful task. It was concluded that the rate of self-administration is controlled more by the puff rate than by the duration or depth of each puff. Armitage et al. (1975) substantiated these findings using arterial nicotine concentrations as a measure of nicotine levels and concluded that smokers adjusted their way of smoking in order to achieve a desirable psychological effect – small frequent doses of nicotine produce effects associated with central stimulation (desynchronisation of electrocorticogram and increased cortical acetlycholine release) whilst larger doses given less frequently may cause depressant effects (decrease in cortical activity and acetylcholine). More

recent research, such as that by Corrigal et al. (1994), has also implicated the role of dopamine release by the activation of the nicotinic acetylcholine receptors in the brain, which we suspected at the time but were unable to measure. Although sensory and learned behavioural aspects of smoking a cigarette may have some influence on the maintenance of the habit, it would seem that with reference to the studies described above that for the electronic cigarette to be effective it must replicate the ‘finger-tip control’ the smoker has in varying their nicotine intake by altering their puff rate to achieve a desired pharmacologically mediated psychological effect. If it does not allow this self-dosing then the e-cigarette may be no more successful than the campaign

some years ago to encourage all smokers to change to lowyield nicotine cigarettes. Don Watson Faculty of Health and Life Sciences University of Northumbria References Armitage, A.K., Dollery, C.T., George, C.F. et al. (1975). Absorption and metabolism of nicotine from cigarettes. British Medical Journal, 4, 313–316. Armitage, A.K., Hall, G.H. & Morrison, C.F. (1968). Pharmacological basis for the tobacco smoking habit. Nature, 217, 331–334. Ashton, H. & Watson, D.W. (1970). Puffing frequency and nicotine intake in cigarette smokers. British Medical Journal, 3, 679–681. Corrigal, W.A., Coen, K.M. & Adamson, K.L. (1994). Self-administered nicotine activates the mesolimbic dopamine system through the ventral tegmental area. Brain Research, 653, 278–284.

All-or-nothing thinking about NLP All-or-nothing thinking is often regarded as inferior to the more considered thinking of the analytical mind as it is usually triggered by strong emotion, and I am surprised how often I find this type of thinking associated with those three letters NLP (neuro-linguistic programming). In my experience the polarisation that occurs is the result of a lack of understanding and education in psychologists. The predictions in the 1980s that NLP was just another fad to come out of the Human Potential movement that will blow itself out has not eventuated and it is now stronger than ever. I know a Google search is not the most scientific way to conduct research, however on 8 April 2013 I typed in ‘NLP’ and I got 72.5 million hits. This is substantially more than the most popular branch of psychology, clinical psychology, which trailed behind with 51.3 million, and my own discipline occupational psychology with only 11.6 million. Professor Rob Briner conducted a similar piece of research and Googled ‘chartered occupational psychologist’ associated with a number of other terms. He found NLP (84,900 hits) compared with say coaching (31,700 hits) or Belbin (674 hits) (Briner 2012). Even though

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Briner acknowledges these numbers are not reliable it does beg the question why should Chartered Psychologists wish to be even remotely associated with something which for some of their colleagues is the devil’s spawn? Yes there is unethical practice in NLP, yes there are numerous exaggerated claims; however this is one end of the curve; at the other end there is good, ethical and responsible practice. Often it seems psychologists make generalisations from the undesirable extreme across the whole field. On the other hand NLP practitioners deride what psychology has to offer in terms of conceptual clarity and hypothesis testing. A typical example comes from Jon Sutton’s (2012) comments in The Psychologist where he describes NLP as an easy target in the context of a ‘series of pops’. In examining the source material I read: ‘Meanwhile, the field (or cult) of “neurolinguistic programming” (NLP) sells techniques not only of selfovercoming but of domination over others’ (see tinyurl.com/8jkndqc). Tosey et al. (2009) make it quite clear in their academic review, NLP it is not a cult and the description of NLP above is frankly insulting to anyone who takes the field seriously. I often ask psychologists:

Have you read about the recent applications of NLP in the field of psychotherapy (Wake et al., 2013) or coaching psychology? (Grimley 2013)? Do you know since 2008 ANLP have hosted NLP research conferences at UK universities? And are you aware there is good-quality research out there (see, for example, tinyurl.com/nlpconf) that supports NLP?. If psychologists do take time to source and read this type of material they might be able to more professionally and ethically comment on a field that has been popular since the early 1970s. Bruce Grimley Achieving Lives Coaching St Ives, Cambridgeshire References Briner, R.B. (2012). Does coaching work and does anyone really care? OP Matters, No 16, pp.4–12. Grimley. B. (2013). The theory and practice of NLP coaching: A psychological approach. London: Sage. Sutton, J. (2012). Never mind the neurobollocks. The Psychologist, 25, 813. Tosey, P. & Mathison, J. (2009). Neuro-linguistic programming: A critical appreciation for managers and developers. Basingstoke: Palgrave Macmillan. Wake, L., Gray, R.M. & Bourke, F.S. (2013). The clinical effectivenesss of neurolinguistic programming: A critical appraisal. London: Routledge.

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Choice in controlling relationships I am a barrister and former solicitor in the field of human rights, with experience in domestic violence and human trafficking cases. I hope to draw attention to the anomaly that is consent to controlling relationships, and should value your readers’ views/comments on the issue. My concern is that the appearance of choice in such dynamics may not be choice at all, but a symptom of deception. This would help to explain both why victims remain in controlling relationships, and how their partners get away with subordinating them to their will. A prerequisite to choice is knowledge of what one is choosing. Take the customer who is unwittingly sold an imitation Rolex. She does not choose the fake watch any more than she chooses to be deceived; she believes it is something different. And, logically, the same applies to a person who is deceived as to her partner’s identity: she cannot choose to be with that person as such. Critically, then, an individual’s belief that she is making a choice is no guarantee that she is. And, whilst that is primarily a matter for her, it seems negligent to ignore the possibility that she is deceived as to what – or indeed who – is on offer. As the 20th-century philosopher Simone Weil (1952) observed: ‘Liberty, taking the word in its concrete sense, consists in the ability to choose’ (p.12). It follows that an individual who does not choose is not free. In assuming that she is, Whose choice? therefore, we risk reinforcing her confinement. Of course, in theory, an individual may choose to relinquish choice altogether, by submitting herself to another’s will. Yet, as such, it would be her last choice, annulled the instant it was made. And, to that extent, the scenario is unimaginable, as to remain in active submission would require further/ongoing choice. In practice and in law, even people in ostensibly controlling relationships have been found to demonstrate their capacity to make independent choices, an indication that they are not, ultimately, controlled. For example, on sentencing Mairead Philpott to 17 years in April, Mrs Justice Thirlwall recognised that her husband had treated her as a ‘skivvy or a slave’, but emphasised that in repeatedly refusing him a divorce, she had

‘made a choice that was not his choice’. But – stepping back – if a person believes that her relationship is consensual, then is she not likely to demonstrate that belief by appearing to make independent choices, whether or not she actually is? The point is that we should expect a victim of deception to believe that she is not deceived. But whether her choice is real or illusory, will depend on whether she is deceived as to what it is she is allegedly choosing. The fake Rolex of controlling relationships is, it seems, ‘fake support’. Its peddlers present as guardian angels, unconditionally supportive of their victims’ entitlement to a better life (with them, of course…). Inevitably, however, tangible signs of control start to emerge: the victim’s emotional and/or geographical isolation from her loved ones, for instance, servile behaviour towards her ‘partner’, etc. Yet, any critical doubt on the controllee’s part as to the nature of her situation is overridden, it seems, by her desire to believe the deceiver’s fanciful message. Indeed, as clinical psychiatrist Arthur Deikman (1994) astutely observed, ‘wanting to believe is perhaps the most powerful dynamic in initiating and sustaining cult-like behaviour’ (p.137). ‘Guardian angels’ target those most likely to want to believe their message of hope: the vulnerable person in need of help; the disillusioned romanticist; the idealist, etc. They pop up in the courts and in the press from time to time. Yet, by the time they do, it is usually too late for their victims. Worse still, those same victims are often labelled as accomplices to their fate. They are not, are they? Or does a slave choose her master? Tom Gaisford London N7 References Deikman, A.J. (1994). The wrong way home: Uncovering the patterns of cult behavior in American society. Boston, MA: Beacon Press. Weil, S. (1952). The need for roots. London: Routledge & Kegan Paul.

Working with media agendas With reference to the psychologists working with the media article ‘Psychology on the back seat?’ (June, 2013), I would like to offer my own reflections on this experience. It is without doubt exciting, and a bit of a giggle, to be asked to make a contribution to the media, and easier to be swept up in that

excitement. Let’s face it, most people would love the opportunity to be on the telly. We dress this up with thoughts of: ‘what a brilliant opportunity to promote psychology’, ‘…to promote the service/department’, ‘a chance to demonstrate to the public the value of psychological perspectives in understanding the human condition’, ‘at last!

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Recognition!’, and ‘I’ll be needing a new suit’. In my case I’ve made radio and television appearances to promote the Veterans Community Mental Health Service, on behalf of Tees Esk & Wear Valleys NHS Foundation Trust. The key learning point for me is that the media always have an agenda! Whether dealing with

a director, producer or journalist, they will have already decided what direction they want the programme to go in, what they want from you, and how they want to present you, their contributor. They make no secret of this, and if you ask them they will tell you. Where conflict begins is when the contributor is unaware of the programme’s

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agenda, and is seeking to follow their own agenda. So, while my agenda might be to promote the service, and the psychological perspective of veterans mental health issues. The media agenda might be that there are not enough services for veterans, and isn’t it a pity? As the producers of the programme have the editorial control, their agenda will always take prominence. So, that insightful monologue I gave succinctly relating the observed phenomenon to psychological theory, and formulating a solution, ends up on the cutting-room floor. So, how to move forward? Talk to the producers, the directors, the presenters, the journalists, ask them how they are presenting the situation, and what perspective they are looking for from you the contributor. Assuming you are ethically comfortable with the programme agenda, then the

and withdraw that consent?; Will there be follow-up care for any service users /vulnerable people involved in the programme?; How will my involvement benefit the participants, listeners, viewers, myself, and my profession?; Should I do it, what does my

challenge is to acknowledge that agenda, and incorporate yours into it, ideally in collaboration with the producers. Of course, if you are not comfortable with their agenda, or the programme, then you should talk to the producer about your concerns and not get involved until they are resolved. As a last resort you can approach the industry regulator. If you can facilitate the media and your own agenda, then you succeed in promoting psychology, and sharing psychological knowledge. A checklist of questions: What is the programme about?; Why do they want my input?; What is the programme agenda?; Is the programme ethically sound?; Will the participants benefit from taking part in it?; If there are vulnerable people involved, are there adequate safeguarding structures in place?; Are the participants able to give informed consent,

I am writing in response to Sarah Rose’s letter published in the June 2013 edition of The Psychologist entitled ‘Clinical psychology heartache’. My aim is to emphasise the necessity of greater support and provision of opportunities for graduate psychologists. To illustrate the need for this, I feel it would be beneficial to share my own experiences, which I think are likely to be representative of many others’ trials, tribulations and utter

CRIME, JUSTICE, LAW, INTERVENTIONS

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july 2013

letters

I was able to secure a post as a psychological assistant in Her Majesty’s Prison Service. The irony of this is that after all of my hard work, this job had no requirement for degree-level education. However, I had a real interest in forensic psychology, and so perceived this to be a great opportunity. The post started really well, and I absolutely loved the role. However, after one year of being in the post and receiving excellent appraisals during that time, I received a global e-mail Support? from an Area Psychologist which included devastating news. New changes were being introduced which meant that completion of an accredited MSc would

support worker, and also gained voluntary work experience in Her Majesty’s Prison Service shortly after graduation. Despite appearing to be well prepared for a future psychology career, I encountered rejection after rejection when submitting job applications after graduation. When I sought feedback from prospective employers, I kept getting the reply that I did not have sufficient or specific enough experience to be considered at the application stage. In fact, one prospective employer said to me: ‘Unless you have direct experience in working with patients who have neurological disorders, don’t bother to apply.’ This brought the question to mind of how I was supposed to gain the experience I needed. Eventually after months of enduring the misery of repeated rejections for the same unchanging reasons,

I across

I down

8 9 10 12 13 14 15 17 20 22 24 25 26 27 28

Lesson given with drug shot – this should lift the spirits (6,7) Psychologist’s first consideration having left gem (5) Appears to have heart that’s edible (3) Position of control in personality psychology? (5) Celebrated boisterously – scheduled about one (9) Liking for smack (5) Newspaper in charge of living matter (7) Itinerant man one doc treated (7) Part-decorated internally in 1920s style (3,4) Function for each school group (7) Action taken against something during dream phase (2,3) I’d try to get around composition of unpleasant tasks (5,4) Longs to drop number for a very long time (5) Afterthought I added in Greek letter (3) Rider moving large number west in less damp conditions (5) Nineteen moles somehow very at home (2,4,7)

Zero assessment for declaiming (7) 3 Suddenly together (3,2,4) 4 Most of realm I caught based on practical experience (7) 5 Seed-spilling Biblical character put on continuously (2,3,2 ) 6 & 8 down Dual nature of Yugoslav character? (5,11) 7 Struck and worked out without hesitation (7) 8 See 6 down 11 Marches keep disturbing one who’s 2 down (11) 16 Suffering short modern lines with passenger vehicle overturned (9) 18 Coach takes monarch to see landscape (7) 19 One giving name to complex work about English princess (7) 20 One-sided description of instinct in psychoanalytic theory (7) 21 Dark blue appears neat on boy (7) 23 Craftsman, parent and child (5)

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now be a requirement to apply for Forensic Psychologist in Training posts (FPiT), and that the Prison Service would no longer fund this course. I was given an ultimatum in the email: either apply for upcoming FPiT posts anyway, knowing that I may be rejected at any time as soon as the changes came in, or decide not to apply. I researched opportunities to complete the MSc but was unable to raise the funds to do this, due to considerable financial commitments. I applied for the FPiT posts anyway, but was rejected due to lacking experience of specialist risk assessments that other candidates gained as a result of working with a higher-risk population. I was devastated; once again, I’d been rejected. I kept telling myself that surely the standard of my degree would set me apart, but in fact, it was never even considered. My next steps were to source opportunities in clinical psychology, but I faced many further rejections despite reframing my forensic experience within the context of clinical formulation and intervention. I often missed out on the chance to even apply for vacancies in the clinical field, as jobs would often open and close during the same or next working day, and I did not have internet access at work in order to apply. I also found a distinct pattern of Clinical Assistant Psychologist posts being of a temporary and/or part-time nature, or in some cases completely honorary, which entirely ruled out a chance of me applying for the role. I left university feeling like I had a talent for psychology; something which my grades strongly imply. I was often given positive feedback about my critical thinking and original and novel approaches to assignments;

and I genuinely feel that I had a lot to offer the discipline. I must admit that I’m exhausted, frustrated, uninspired and utterly demoralised at the prospect of further pursuing a career in psychology. What I now have to manage is the intense guilt and sense of failure I feel at myself for not succeeding in this discipline. I’m not sure if or when I will ever be able to let this go. I will always tell myself that there is something more I should have done, even if right now, I genuinely cannot see what more I can do. I have not written this letter as an opportunity to complain, but rather as a firm and resounding request for the BPS as a professional body to work in collaboration with public, private sector and voluntary organisations in order to offer support to graduates in obtaining relevant work experience. Additionally, to review the entry criteria for professional training in psychology so that this more fairly measures aptitude and the potential to contribute to psychology, as opposed to the unrealistic requirement for graduates to have secured elusive and unobtainable posts. The above is essential if applied psychology is to avoid becoming an elitist discipline, dominated by those who have the resources to pursue academic training and shortterm, ad hoc work experience placements. I feel that I have been undervalued and let down by the discipline and it is my understanding that many other graduates feel the same. Consequently, psychology runs the risk of losing many novel critical thinkers, clinicians and theorists of the future with the emergence of an elitist discipline. Is this the future we want for psychology? Lisa Molloy Wiltshire

Editor’s note: Society representatives have been invited to respond in a subsequent issue.

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Avatar therapy Psychiatrists have documented promising results using a new form of ‘avatar therapy’ for patients diagnosed with schizophrenia who hear voices (British Journal of Psychiatry: see tinyurl.com/n85oapy). Julian Leff at Royal Free and University College Medical School and his colleagues used existing and novel software to work with the patients to create a computerised embodiment – an ‘avatar’ – of the voice that troubles them most. During seven weekly therapy sessions, each patient (in a sample of 16 men and 10 women) sat opposite their chosen avatar, which was displayed on a computer screen. The avatar’s words were spoken by the therapist located in another room. The male therapist’s voice was altered by software to sound like the patient’s hallucinated inner voice, whether male or female. As the therapist spoke, the avatar’s lips were also synched so it seemed as if the avatar were speaking. Each patient was gradually encouraged to stand up to their avatar, and over the sessions, the avatar became less abusive and instead more helpful and supportive. After conversing with their avatar over the course of therapy, the patients came to find their heard voices less distressing, and experienced them less often (the effect size was 0.8 – usually considered large). In three cases, the patients’ voices stopped altogether, including in one patient who’d heard the

voice of the devil for 16 years. These gains were maintained or even improved upon three months after therapy. Suicidality was also reduced after the therapy, and depression was lower three months after therapy compared with pre-therapy. ‘Reductions of this degree are clinically important considering that the patients’ hallucinations had failed to respond to many years of the most effective anti-psychotic A selection of the avatars – patients were gradually drugs available,’ the encouraged to stand up to them researchers said. from their voices, which the researchers The results are based on 14 patients say may help the patients realise the who started the avatar therapy straight source of the voices was their own mind. away, with their gains compared against The research is exploratory and a control group of 12 who began with Leff’s team acknowledged the limitations treatment as usual (anti-psychotic in their work. Above all, the nature of medication managed by a psychiatrist). the control group means we can’t know Eight members of the control group later whether the benefits of the avatar underwent the avatar therapy and therapy were due to the specific showed similar benefits. techniques involved or simply to the Leff and his team think the process increased attention and care. Also, the validates the patients’ experiences and therapy isn’t suitable for all patients. they can take risks with the avatar and Five patients dropped out of the initial learn to do the same with their therapy condition, and four of the persecutory voices. The researchers also control group chose not to receive avatar gave the patients a digital recording of therapy. The same therapist also the therapy sessions that they could conducted all the sessions so it’s not yet listen to at any time. Furthermore, the clear whether others can be trained. therapist used the therapy to draw Future research is planned to address attention to the links between the these points. CJ patients’ low self-esteem and the abuse

POSTCARDS FROM THE EDGES A creative project by United Response, is online now at www.postcardsfromtheedges.org.uk. Beth Bridewell, a psychology graduate working as Web Assistant for United Response, a national charity that supports people with mental and physical disabilities, told us that the project ‘offers a blank space for expression to anyone affected by disability or mental health problems. It invites people to tell their stories and help the broader public get to know and understand them better.’ The website is the hub of the project, allowing people to create postcards online and upload them instantly, as well as upload premade postcards. ‘In late 2013 four art galleries across the country will host Postcards from the Edges exhibitions, displaying the wide variety and range of postcards we have received,’ Bridewell said, ‘from drawings to poems and collages; on topics ranging from benefit cuts to beloved pets and shopping lists.’ JS

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New Little Albert identity theory Canadian researchers have cast doubt on claims that Little Albert – the infant studied infamously by behaviourist John Watson – was the neurologically impaired, short-lived boy Douglas Merritte (see News, February 2012, and ‘Looking back’, May 2011). Presenting at the International Society for the History of the Behavioral and Social Sciences held in Texas in June, Russell Powell at Grant MacEwan University and his colleagues said they’d identified another individual – William Albert Barger (1919–2007) – who is more likely to have been Little Albert. Like Merritte, this person was also the son of a foster mother at Johns Hopkins Hospital and would have been the right age at the time of Watson and Rayner’s classic 1920s research. Powell’s group also claim that Mr Barger would likely have gone by the name of Albert Barger at that time, which fits with Watson and Rayner’s referring to their boy as ‘Albert B’. CJ

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Doing their BIT for charity Staff at HMRC in Southend were sent ‘winter greeting’ e-mails last December containing a message from a colleague who donates to charity, plus information on how they could start donating too. The intervention was part of a trial documented in the latest publication from the government’s Behavioural Insight Team – Applying Behavioural Insights to Charitable Giving (pdf at tinyurl.com/kmrqfxz). According to the report, the UK is already a generous country. Collectively we gave nearly £12 billion to charity in 2011, and there are around 150,000 active charities here. However, the report authors Michael Sanders, David Halpern and Owain Service say that four key psychological insights could increase charitable giving even further – making giving easy; attracting attention; focusing on the social aspect of giving; and paying attention to timing. The HMRC trial illustrates the power of social influence. Researchers found that simply including a picture of the charitable colleague in the e-mails more than doubled the number of recipients who signed up to donate, from 2.9 to 6.4

per cent. The trial also revealed which factors were irrelevant. It made no difference to recipients’ generosity whether the colleague was of the same gender or from the same neighbourhood. Other trials documented in the report involved collaborations with the Zurich Community Trust, the Home Retail Group (the owner of Argos and Homebase), Cooperative Legal Services and Deutsche Bank. This last study involved employees being asked, via an e-mail from the CEO, to donate a day of their salary to charity. The base rate of signup was 5 per cent. This rose to 11 per cent if staff were also greeted that morning by charity volunteers giving out sweets. It rose to 12 per cent if the CEO e-mail included a personal greeting (‘Dear David’ rather than ‘Dear colleague’). The combination of sweets and a personal e-mail tripled rates of giving to 17 per cent. ‘Overall, Deutsche Bank staff gave more than £500,000 to charity on a single day,’ the report states. ‘What this trial shows is that, if all staff had received the personalised e-mail and sweets, the bank would have raised more than £1million.’ CJ

MyConnectome A neuroscientist at the University of Texas at Austin is more than half way through an ambitious programme of selfexperimentation that involves scanning his own brain three times a week. Two of Russ Poldrack’s scans are of his ‘resting state’ activity, designed to reveal functional networks. The other scan is either functional fMRI, structural MRI or diffusion tensor imaging, which reveals the

brain’s white matter tracts. The MyConnectome project also requires weekly analysis of Poldrack’s blood and twice daily monitoring of his mood, diet, exercise and other activities. Poldrack’s research is an extension of the Human Connectome Project, which is looking at functional and structural connectivity at a single moment in time in the brains of hundreds of participants (see News,

read discuss contribute at www.thepsychologist.org.uk

July 2012). First findings from MyConnectome are expected early in 2014. ‘It is almost certainly the most ambitious study of a single living person’s brain ever attempted,’ says the project website at www.myconnectome.org. ‘The data will provide new insights into the dynamics of brain activity and their relationship to bodily metabolism and psychological function.’ CJ

CARDIFF WINS MAJOR NEUROSCIENCE FUNDING The Wellcome Trust has awarded £5.25 million to a team at Cardiff University’s Neuroscience and Mental Health Research Institute to conduct multidisciplinary research into the genetic and neural bases of mental illness. Programme leader Professor Mike Owen said part of the research will involve looking at how previously identified genetic risk factors affect brain function and behaviour. I www.cardiff.ac.uk/research/neuroscience

APA DIVISION 9 PRESIDENT Chartered psychologist and BPS Fellow Professor Dominic Abrams has been elected President of APA Division 9, the Society for the Psychological Study of Social Issues (SPSSI) for 2013 to 2014 – the first psychologist outside North America to hold the position in the organisation’s 76-year history. Abrams is Director of the Centre for the Study of Group Processes at the University of Kent and was joint winner of the 2009 BPS President’s Award for Distinguished Contributions to Psychological Knowledge.

TAKE ONE BOOK A DAY AFTER MEALS… A self-help book prescription service has launched across England. Known as Reading Well Books on Prescription, the programme was developed by the Reading Agency and the Society of Chief Librarians and is supported by the BPS. Thirty approved titles including Mind over Mood: Change How You Feel by Changing the Way You Think will now be available in libraries for recommendation to suitable patients by GPs or mental health professionals.

BLOG AWARD Psychologist Pete Etchells, based at the School of Experimental Psychology at the University of Bristol, has won the award for ‘Best blog post about peer-reviewed research’ in the inaugural Science Seeker blog awards. The post on his Counterbalanced blog (tinyurl.com/mdhnwrq) critiqued press coverage of a trial looking at the effects of exercise on depression. A post from the BPS Research Digest blog was a finalist in the psychology category of the awards (tinyurl.com/9nogkqv). CJ

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Knocking at the doors of perception Jon Sutton reports from a discussion on scientific research with psychedelic drugs, at Imperial College London …our normal waking consciousness, rational consciousness as we call it, is but one special type of consciousness, whilst all about it, parted from it by the filmiest of screens, there lie potential forms of consciousness entirely different. We may go through life without suspecting their existence; but apply the requisite stimulus, and at a touch they are there in all their completeness, definite types of mentality which probably somewhere have their field of application and adaptation. No account of the universe in its totality can be final which leaves these other forms of consciousness quite discarded. William James, 1902

‘There are so many old friends in the audience,’ began Professor David Nutt. ‘I would like the enemies to stand up now. By the end, there almost certainly will be some.’ Professor Nutt’s combative mood was understandable: his piece in Nature Reviews Neuroscience on the effects of drug laws on neuroscience research and treatment innovation had been published that morning (see tinyurl.com/pjquuyt), and he had high hopes for this one-day event as a means of enticing mainstream scientists through the doors of perception into psychedelic drug research. With the ‘prophet of psychopharmacology’ Aldous Huxley a regular supportive presence on screen (Nutt was taught by his stepbrother), Nutt argued that science has missed a trick or two since LSD was banned in 1964. Two of the most important discoveries of our time – Francis Crick on the double helix structure of DNA and Kary Mullis on the polymerase chain reaction that allowed DNA sequencing – were reputed to have been made under the influence. Nutt is with Einstein when he says that ‘no problem can be solved from the same level of consciousness that created it’, and Stan Grof when he says ‘psychedelics, used responsibly and with proper caution, would be for psychiatry what the microscope is for biology and medicine or the telescope is for astronomy’. For Nutt, rather publicly dismissed as Chairman of the government’s Advisory Council on the Misuse of Drugs in 2009, the Schedule 1 drug laws are the worst

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censorship of research since the Catholic Church banned all books advocating the Copernican system of planetary motion in 1616. ‘We create the drug laws and then they control us’ he said, or in Huxley’s words: ‘All gods are homemade, and it is we who pull their strings, and so give them the power to pull ours’. It wasn’t always this way. In the 1950s and 1960s, clinical interest in LSD was producing promising results: effect sizes

Knocking – but we can’t come in?

in treating alcoholism that were greater than all other therapies, pioneering work on depression and anxiety in cancer. Nutt says the push to ban LSD came from the CIA, and that not all were convinced. Bobby Kennedy questioned the US Drug Enforcement Administration, saying, ‘if [clinical LSD projects] were worthwhile six months ago, why aren’t they worthwhile now?’ Nutt and his colleagues at Imperial College believe they are, and they regularly pick their way through regulations and ethics committees in order to conduct research on how these drugs work, the role of 5-HT2A receptors in brain function, and the potential applications. These receptors, part of the serotonin family, are highly localised in the part of the brain that’s the most evolutionarily recent, and the complexity of the interaction between inhibitory and excitatory neurons clearly fascinates Nutt and his colleagues. Finding an unexpected decrease in cerebral blood flow after the administration of psilocybin, a naturally occurring psychedelic compound produced by more

than 200 species of mushrooms, Nutt said: ‘A few times in my career I’ve seen things as completely paradoxical as this and you know they must be right, because there’s no bias’. A follow-up with magnetoencephalography (MEG) proved it was an effect on layer V pyramidal neurons, ‘the first time in humans we’ve been able to show an effect of a particular neural subclass on human experience’. Yet journals turned the findings away as too specialised for their readers. You get the feeling Nutt gets used to rejection: the UK support group for cluster headaches – described as ‘worse than childbirth’ by some sufferers – refused to countenance research with mushrooms or LSD because they’re illegal, and Nutt doesn’t know whether he can use a non-psychedelic version – 2 Bromo-LSD – because no one knows whether it’s legal or not! Most frustratingly, Nutt says, ‘drug laws have stopped people even thinking there are questions to be asked’. Or again, in the words of Huxley: ‘By simply not mentioning certain subjects… totalitarian propagandists have influenced opinion much more effectively than they could have by the most eloquent denunciations.’ Next up, Dr Robin Carhart-Harris gave us a quick tour of fMRI and MEG studies with psilocybin. Its components are strikingly similar to serotonin, and Carhart-Harris pointed to parallels with both the effects of meditation and treatments for depression, which also suppress activity in the medial prefrontal cortex. Pioneering psychologist William James viewed his own depression as ‘a positive and active anguish’, and to Carhart-Harris it is significant that psilocybin leads to a localised decrease in functional connectivity in the brain’s so-called ‘default mode network’. This usually works in tandem with the attention network, but the normal ‘Yin and Yang’ relationship seems to collapse under psilocybin. Carhart-Harris says this may map onto some aspects of the phenomenology of the experience, for example when people report ‘I only existed as a concept, as an idea’. This

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not just how the contours of hallucinations are produced, but the colour, depth and motion. These ‘stage 1’ hallucinations occur in the primary visual cortex, show topological correspondence to the primary visual field, and mirror exactly those patterns generated in the visual cortex when it becomes unstable. Beyond that, hallucinations become more cognitive and conceptual, involving memory and context. ‘You’re on your own there,’ says Cowan, ‘I just do the math.’ Finally, Dr Charles Grob (UCLA) reported a pilot study for psilocybinassisted psychotherapy in end-stage cancer. Grob feels that LSD allows you to really ‘hit that deep existential level’, noting that the best treatment outcomes when the drug is used in alcoholism are in those who have ‘psychospiritual level experiences’. As William James said, perhaps the best treatment for dipsomania is religio-mania. In Grob’s study, 12 subjects with advanced-stage cancer used a moderate dose of psilocybin and demonstrated significant reductions in anxiety and depression several months later. Grob closed proceedings with an impassioned plea. ‘This area is ripe for development, it’s been neglected for half a century. It’s time to leave the 60s behind us – to quote the Moody Blues, Timothy Leary is dead. We need to speak the truth and do so in an open manner. Be tenacious. Do your research impeccably. Keep moving the field forward.’ To end with another quote, from the poet William Blake: ‘If the doors of perception were cleansed every thing would appear to man as it is, Infinite. For man has closed himself up, till he sees all things thro’ narrow chinks of his cavern.’ I’m glad these researchers are knocking at those doors: will regulators let them in? I Look out for a special issue of The Psychologist on hallucinogens

Registered reports Numerous psychologists are among more than 70 signatories to an open letter in the Guardian calling for a new approach to publishing across the life sciences – the registered report (tinyurl.com/kta8qle). Already instigated by BPS Fellow Dr Chris Chambers at the journal Cortex, the idea is that registered reports are reviewed prior to data collection and accepted ‘in principle’ based on soundness of the study question and methods. Publication is then virtually guaranteed regardless of the actual results. ‘[P]reregistration overcomes the publication bias that blocks negative findings from the literature,’ wrote Chambers and his co-correspondents. ‘And by conducting peer review both before and after a study is completed, questionable practices to increase “publishability” are greatly reduced.’ Not everyone welcomed the proposal. Professor Sophie Scott at UCL tweeted: ‘we run the risk of throwing baby, bath, towels, shampoo, soap, razors, exfoliators flannels & all the toys out with the bathwater.’ CJ

read discuss contribute at www.thepsychologist.org.uk

FUNDING NEWS The Wellcome Trust’s Society and Ethics programme seeks to support research that explores the social and ethical aspects of biomedical research. Several of the Wellcome Trust’s grants can be applied for under this programme including the New Investigator Awards and Senior Investigator Awards. Both have a closing date for application of 19 July 2013. Small grants of up to £5000 can be applied for at any time. I tinyurl.com/ktmer4c The International Social Science Council is inviting outstanding early career social and other scientists to become World Social Science Fellows, and to participate in a World Social Science Seminar on Risk Interpretation and Action: Decision-making under conditions of uncertainty. Following the earthquakes in New Zealand and other recent disasters the key issue under discussion will be the ways in which people interpret risks and how they respond based on these interpretations. The seminar will be held in New Zealand in December 2013. The closing date for the submission of applications is 15 July 2013. I tinyurl.com/ou2tyuc The Dunhill Medical Trust offers grants for research that focuses on: I the care of older people, including rehabilitation and palliative care I the causes and treatments of disease, disability and frailty related to ageing. The grants give are normally of between £10K to £500K and are given for smallerscale projects that may not attract funding from the major research councils. Applications can be made at any time. I tinyurl.com/c4nyrhm The National Institute on Drug Abuse (USA) has announced a call for research into Prescription Drug Abuse (R01). Prescription drug abuse is a major public health concern, and the NIDA is seeking to support basic preclinical and clinical research, epidemiology and prevention research, and treatment and health systems research. Details of the research questions they wish to explore are given on the website. The next closing date for applications is 5 October and the funding stream will be open until January 2016. I tinyurl.com/a6m5cqs

info

‘disintegration of ego boundaries’ is specifically correlated with a decrease in alpha waves post psilocybin, i.e. the oscillatory activity of the brain. CarhartHarris points to similar patterns in early psychosis and the ‘at-risk’ mental state, and he put forward a model of ‘entropy’ and disorder in the brain that is mediated by 5-HT2A receptors. These ideas found support from the next speaker, Dr Enzo Tagliazucchi (Frankfurt). Again we saw the localised reduction in blood flow and fMRI signal after drug intake, with the signals oscillating around the decreased mean. Are these fluctuations meaningful? Tagliazucchi looked at the relationship between structural and functional connections: parts of the brain that are physically connected aren’t always connected in terms of what they do, but it appears that after psilocybin the links between functions in the brain more closely resembles the underlying anatomy. Following an array of short presentations from researchers working with psychedelics at Imperial, Bristol, Oxford and Barcelona, Professor Jack Cowan (University of Chicago) took the audience on a mind-bending trip from cave art to the architecture of the visual cortex. Based on a lifetime’s work dealing with intrinsic noise in neural networks mathematically, Cowan attempted to show how geometric visual hallucinations are produced. Press hard on your eyeballs for a ‘pseudo-hallucination’, an entopic image that Cowan argues is directly correlated with the structure of the visual cortex. Seeing a hallucination as dynamic, with an instability reflecting an instability in its conditions of origin, has big implications. Take cave art, which many feel produced modern forms of religion. Was its often hallucinogenic form inspired by being in deep caves with flickering light? Cowan says he now has a theory for

For more, see www.bps.org.uk/funds Funding bodies should e-mail news to Elizabeth Beech on elibee@bps.org.uk for possible inclusion

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The mindbus technique for resisting chocolate If someone gave you a bag of 14 chocolates to carry around for five days, would you be able to resist eating them and any other chocolate? That was the challenge faced by 135 undergrads in a new study that compared the effectiveness of two different ‘mindfulness’ resistance techniques. Kim Jenkins and Katy Tapper taught 45 of their participants ‘cognitive defusion’, the essence being that ‘you are not your thoughts’. The students were told to imagine that they are the driver of a mindbus and any difficult thoughts about chocolate are to be seen as awkward passengers. The students chose a specific method for dealing with these difficult thoughts/passengers and practised it for five minutes – either describing them, letting them know who is in charge, making them talk with a different accent, or singing what they are saying. Another group of students were taught an acceptance technique known as ‘urge surfing’. They were instructed to ride the wave of their chocolate cravings, rather than to sink them or give in to them. A final group of students acted as controls and were taught a relaxation technique. As well as trying to resist the bag of chocolates, the students in all conditions were asked to avoid eating any other chocolate as far as possible, and to keep a diary of any chocolate they did eat over the five days. The key finding is that the mindbus group ate fewer chocolates from their bag as compared with students in the control group. By contrast, the urge surfing group ate just as many of their chocolates as the controls. Diary records showed the differences between groups in their other chocolate consumption were not statistically significant, although there was a trend for the mindbus group to eat less (13g vs. 52g in the urge surfing group and 44g in the control condition). Another way of describing the results is to say that 27 per cent of the mindbus group ate some chocolate over the five-day period, compared with 45 per cent of the urge surfers and 45 per cent of controls. A habits questionnaire suggested the mindbus technique was more effective because it reduced the students’ mindless, automatic consumption of chocolate more than the other interventions. Jenkins and Tapper said their results show the mindbus In the British Journal of Health Psychology ‘cognitive defusion’ technique is a ‘promising brief intervention strategy’ for boosting self-control over an extended time period. The serious chocaholics among you may not be so convinced. Although the students were recruited on the basis that they wanted to reduce their chocolate consumption, they appeared to show saintly levels of abstinence. On average, even the control group participants ate just 0.69 chocolates from their bag over the five-day period (compared with an average of 0.02 chocolates in the mindbus condition; 0.27 in the urge surfing condition). The controls’ other chocolate consumption amounted to the equivalent of little more than four individual chocolates over five days. You’ve got to wonder – how serious were these participants about chocolate and just how tasty were the chocolates in that bag?* Another thing – the researchers included a measure of ‘behavioural rebound’. After the students returned to the lab on day five, they were presented with a bowl of chocolates and invited to eat as many as they liked. The groups didn’t differ in the amount of chocolates they consumed, which the researchers interpreted as a good sign – after all, the mindbus group hadn’t compensated for their restricted intake during the week. But hang on, they also showed no evidence of greater resistance to the chocolate. Sounds to me like the passengers had taken over the bus. * Co-author Katy Tapper got in touch on Twitter to tell us: ‘The chocolates were very tempting Cadbury’s Celebrations!’

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Engaging lecturers can breed overconfidence In the May issue of Psychonomic Bulletin and Review Eloquent and engaging scientific communicators in the mould of physicist Brian Cox make learning seem fun and easy. So much so that a new study says they risk breeding overconfidence. When a presenter is seen to handle complicated information effortlessly, students sense wrongly that they too have acquired a firm grasp of the material. Shana Carpenter and her colleagues showed 42 undergraduate students a oneminute video of a science lecture about calico cats. Half of them saw a version in which the female lecturer was confident, eloquent, made eye-contact and gestured with her hands. The other students saw a version in which the same lecturer communicated the same facts, but did so in a fumbling style, frequently checking her notes, making little eye contact and few gestures. After watching the video, the students rated how well they thought they’d do on a test of its content 10 minutes later. The students who’d seen the smooth lecturer thought they would do much better than did the students who saw the awkward lecturer, consistent with the idea that a fluent speaker breeds confidence. In fact, the two groups of students fared equally well in the test. In the case of the students in the fluent lecturer condition, this wasn’t as good as they’d

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Scanning a brain that believes it is dead In Cortex predicted. Their greater confidence was misplaced. A second study was similar – 70 students watched either a fluent or fumbling lecturer, but this time the students had a chance afterwards to spend as long as they wanted reviewing the script. On average, both groups of students devoted the same amount of time (perhaps out of habit). But only among the students who’d watched the fumbling lecturer was there a link between time spent on the script and subsequent performance on the test. This suggests only they used the time with the script to fill in blanks in their knowledge. ‘Learning from someone else – whether it is a teacher, a peer, a tutor, or a parent – may create a kind of “social metacognition”,’ the researchers said, ‘in which judgments are made based on the fluency with which someone else seems to be processing information. The question students should ask themselves is not whether it seemed clear when someone else explained it. The question is, “can I explain it clearly?”’ An obvious limitation of the study is the brevity of the science lecture and the fact it was on video. It remains to be seen whether this result would replicate in a more realistic situation after a longer lecture. Also, in real life, there may be costs to a fumbling lecture style that weren’t picked up in this study, such as students mind wandering and skipping class.

What is going on in the brain of someone who has the deluded belief that they are brain dead? A team of researchers led by neuropsychologist Vanessa Charland-Varville at CHU SartTilman Hospital and the University of Liege has attempted to find out by scanning the brain of a depressed patient who held this very belief. The researchers used a positron emission tomography (PET) scanner, which is the first time this scanning technology has been used on a patient with this kind of delusion – known as Cotard’s syndrome after the French neurologist Jules Cotard. The 48-year-old patient had developed Cotard’s after attempting to take his own life by electrocution. Eight months later he arrived at his general practitioner complaining that his brain was dead, and that he therefore no longer needed to eat or sleep. He acknowledged that he still had a mind, but (in the words of the researchers) he said he was ‘condemned to a kind of half-life, with a dead brain in a living body’. The researchers used the PET scanner to monitor levels of metabolic activity across the patient’s brain as he rested. Compared with 39 healthy, agematched controls, he showed substantially reduced activity across a swathe of frontal and temporal brain regions incorporating many key parts of what’s known as the ‘default mode network’. This is a hub of brain regions that shows increased activity when people’s brains are at rest, disengaged

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from the outside world. It’s been proposed that activity in this network is crucial for our sense of self. ‘Our data suggest that the profound disturbance of thought and experience, revealed by Cotard’s delusion, reflects a profound disturbance in the brain regions responsible for “core consciousness” and our abiding sense of self,’ the researchers concluded. Unfortunately the study has a number of serious limitations beyond the fact that it is of course a single-case study. It’s unclear whether the patient’s distinctive brain activity was due to Cotard’s, depression or his intense drug regimen to treat the depression, although the researchers counter that such an extreme reduction in brain metabolism is not normally seen in patients with depression or on those drugs. Another issue is with the lack of detail on the scanning procedure. It’s not clear for how

long the patient and controls were scanned, nor what they were instructed to do in the scanner. For example, did they have their eyes open or closed? What did they think about? But perhaps most problematic is the issue of how to interpret the findings. Does the patient have Cotard’s delusion because of his abnormal brain activity, or does he have that unusual pattern of brain activity because of his deluded beliefs? Relevant here, but not mentioned by the researchers, are studies showing that trained meditators also show reduced activity in the default mode network. This provides a graphic illustration of the limits to a purely biological approach to mental disorder. It seems diminished activity in the default mode network can be associated both with feelings of being brain dead or feelings of tranquil oneness with the world, it depends on who is doing the feeling.

The material in this section is taken from the Society’s Research Digest blog at www.researchdigest.org.uk/blog, and is written by its editor Dr Christian Jarrett. Visit the blog for full coverage including references and links, additional current reports, an archive, comment and more. Subscribe by RSS or e-mail at www.researchdigest.org.uk/blog Become a fan at www.facebook.com/researchdigest Follow the Digest editor at www.twitter.com/researchdigest

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Expert witness work – time to step up to the plate David Crighton introduces a special feature

questions

Is there an alternative to adversarial expert testimony?

resources

The UK and many other societies operate under the rule of law, meaning simply that various forms of, often highly formal, decision making are present. Psychology as a profession and psychologists as individuals have a potentially key role in assisting such decision making and doing so in the interests of justice. The early history of psychology is replete with examples of such contributions, and in the absence of this various types of injustice may follow. It is therefore a reasonable expectation that high-quality and evidence-based opinion will be available to inform legal decision making. Yet this is also an area that provokes personal and professional anxiety. The scrutiny, often public, of beliefs, practice and the basis for these may be uncomfortable. There are, though, clear benefits for psychology as a discipline and for individual psychologists in contributing more actively to such work. Such scrutiny may serve to drive up professional standards and active participation in legal decision making may drive the social and political contribution of psychology as a discipline.

tinyurl.com/expertwit – BPS expert witness guidelines Civil Rules and Practice Directions: www.justice.gov.uk/courts/procedurerules/civil/rules/pd_part35#pagetop Clifford, B.R. (2010). Expert testimony. In G.J.Towl & D.A. Crighton (Eds.) Forensic psychology. Oxford: BPS Blackwell.

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How can expert witnesses best communicate with juries?

he role of an expert witness is not the exclusive province of any one area or branch of psychology; the need for expert advice and guidance may indeed involve a wide range of psychological research and practice. Yet it is fair to say that many psychologists are anxious about becoming involved in this area, so much so that some may avoid such activities. The reasons why researchers and practitioners might not want to provide expert testimony to the courts, tribunals and other quasi-judicial bodies may appear self-evident. Less obvious are the reasons why psychologists should become more involved. The role of the expert witness involves the point where recognised forms of specialist knowledge meet the systems that society uses to render decisions about issues that are felt to be important. Broadly, the rendering of fair judgements in this way is a key aspect of what we term ‘justice’. It includes issues such as crime, child custody and efforts to compensate individuals for being wronged. Psychologists and the discipline of psychology can and do contribute significantly to such processes. In doing so we can make the decisions reached more just. This is not an opportunity to be missed. Yet it is probably a fair criticism to say that psychology as a discipline and psychologists as a group of professionals have not fulfilled our early promise with regard to giving expert witness testimony. There is, however, evidence to suggest something of a renaissance in this area. This is vividly illustrated by the examples of expert witness work covered in this issue. Here the discipline of psychology has been central to improving the resolution of some of the most difficult questions we may face as a society. The social importance attached to these decisions is reflected in the way that these decision-making processes are delivered: everything about the Supreme Courts in London and Edinburgh are designed to signal this, and the status is mirrored to a greater or lesser extent throughout the varied systems of legal decision making. Given the breadth of expertise that may be of benefit to the legal system, it is

not sensible or indeed practical to set out specific training routes. Some specialist knowledge may only apply to one or two cases a year. Other forms of knowledge may be of routine value in many thousands of cases. Largely for this reason legal systems have tended to reserve the capacity to call the most appropriate experts, regardless of their training or background experience. Yet there are a number of key practice areas that cut across all areas and need to be addressed. The first of these is the issue of motivation. At the outset it is worth being clear about why we undertake such work. For most psychologists, as for most lawyers, the focus will be a commitment to serving the best interests of ‘justice’. Of reaching the fairest decision possible. Of balancing competing interests and needs as well as we can. It clearly parallels the professional commitment to serving the best interests of patients or clients. But it is distinct and broader, in that it generally requires considerations that go beyond the individual or indeed organisational interests to a much broader consideration of the interests of society. Indeed, the requirements of an expert witness differ significantly from the day-today work of most psychologists, and you must make sure you understand what is required. The first duty of the psychologist as an expert witness is to give a fair and accurate presentation of their specialist knowledge. Lawyers are, quite properly, there to advocate for their client. They have a professional duty to do their best for their client, within whatever system of rules they are working. As an expert, a psychologist is very definitely not there to do this, and in fact must not act as an advocate. This may be challenging at times. In settings such as the family courts the issues may be highly contentious, emotionally charged and involve difficult issues like the risk of abuse. In other cases it may appear that individuals have been the victim of callous employers or statebased abuses. Yet such examples serve to stress the importance of continuously seeking to maintain a degree of professional detachment. The role of a psychologist as an expert witness is to describe and explain the relevant specialist evidence in a fair and balanced manner. Be well prepared. This risks stating the obvious, but it remains the case that psychologists can and do attend as expert witness in the absence of adequate preparation. Being adequately prepared covers the entire process of acting as an expert witness. It starts with the initial instructions to undertake such work through to any post-case queries that may arise. The term ‘instructions’ refers to an

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initial brief to undertake work. Typically this will be from an individualâ&#x20AC;&#x2122;s legal representative or from a court or tribunal directly, setting out what they want from the psychologist. This may include specific questions to be addressed or may be more broadly framed. It should also generally include the arrangements for funding the work and when payment is likely to be made. This is an important opportunity to address any areas that are unclear and to decide whether you are in fact the appropriate expert to give advice. Having accepted instructions, preparation involves conducting an appropriate level of research and/or assessment work. It is equally inappropriate to accept an instruction to act as an expert on the basis of undertaking an inadequate or an excessive level of work. This forms the basis of preparing on an open, honest and professionally ethical basis. In preparation one should draw on an appropriate range

JAMES GROVER

ethical duties to comply with such instructions. Most courts and tribunals rely heavily on written reports, and this is a trend that has increased over recent years. Providing a well-written and accurate report is therefore central to good preparation. Any report needs to strike a balance between giving sufficient information and avoiding over-disclosure or excessive detail. This is perhaps best illustrated in relation to psychometric and structured clinical assessments, but it also extends more broadly. In seeking an expert report a doctoral dissertation is not required, but a summary that can be readily understood by an intelligent lay reader is. Give your views in a measured and professional manner. The aspect of expert testimony which generally concerns psychologists most is the provision of oral testimony. This is perhaps not a surprise. There is little in the general training of psychologists that is designed to prepare them for this. The role and methods of oral explanation, communication and disputation remains central to the training of lawyers. There are differences across higher-education institutions, but in general such aspects of teaching and training have, at least until recently, seen a progressive decline. Many if not most psychologists will be more comfortable in a laboratory or clinic, than settings which involve giving and defending views orally. Those involved in the courts and tribunals will generally be aware of this and make allowances. Expert witnesses are not expected to perform at the levels required of legal representatives. What is expected of expert witnesses is that they address any instructions given. They will also be expected to respect the process, know their area of expertise, the detail of their report and be able to answer relevant questions thoughtfully. In giving testimony, psychologists will be expected to give a full and honest account of their area of expertise and their conclusions. Do not change your opinion too readily. In most walks of life we can change our views without difficulty. Part of the scientific process involves the progressive refinement of ideas in the light of emerging evidence. To paraphrase the famous economist John Maynard Keynes, when the evidence changes my opinion

Expert psychological evidence can be key

of materials and should actively seek additional information and clarification where you need it. Seeking corroborative evidence can be particularly important in a number of cases. It is increasingly common for courts or tribunals to issue specific instructions in the area of expert testimony, and this is also a key area of preparation. Such instructions may set limits to the testimony or, where two or more experts are involved, may require that they confer to reduce the areas of disagreement to a minimum. Such instructions serve a number of functions, and these may include efforts to contain the stresses on participants and the costs involved in the process. Psychologists providing expert testimony have legal and

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changes. Here though, changes are not casual but depend on the credible evidence rather than a simple wish to agree or defer to perceived power and authority. In the expert witness role casually changing your view will rarely if ever be well received. It is expected that in preparing a report the opinions formed will be adequately based and will therefore be robustly held. Where new evidence emerges which requires a change of view, then a high degree of formality is expected and required. Typically this involves advising the instructing party at the earliest opportunity. So you need to be clear about what you think and why you think it. This could be considered under the area of good preparation, but is so central that it probably warrants separate consideration. Legal representatives will seek to examine and cross-examine expert testimony. This forms a key part of their professional expertise. From a witness perspective though this will generally involve a focus on the logical basis of what is stated and the evidence that underpins it. This can be seen as serving two purposes. Firstly, it seeks to make even the most difficult specialist areas intelligible to nonspecialists. Secondly, it makes it difficult to hide weaknesses in an argument behind technical language, concepts and jargon. In common with other areas of specialist knowledge it is common in psychology not to continually think about fundamental assumptions. Paradoxically this is something that may become more pronounced with greater experience and training, where the assumptions become less consciously attended to. Thinking through and giving an honest account of such assumptions is likely to make oral testimony much more straightforward. If in doubt ask the lawyers about procedural issues. There is perhaps a tendency for those new to expert testimony to be overly focused on the procedure and â&#x20AC;&#x2DC;theatreâ&#x20AC;&#x2122; of the process. Much of this may appear arcane, and in some settings much would still be familiar to Shakespeare and Newton. It is worth being clear at the outset that few psychologists have expertise in law or legal procedure and that this is not expected. If in doubt, you should not be afraid to ask for guidance. I hope that this special feature provides some of that guidance and information on where to find out more, while whetting your appetite for expert witness work. I David Crighton is Chair of the British Psychological Society Expert Witness Advisory Group david.crighton@dur.ac.uk

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INTERVIEW

A thirst to learn the truth Jon Sutton talks to Gisli Gudjonsson CBE about false confessions and expert witness work

s a young detective with the Reykjavik Criminal Investigation Department, you once spent two days sifting through a rubbish dump looking for a murder weapon to verify a confession. Has your search for the truth been a lifelong quest? Yes, it certainly has and it continues to be so. My work with the Reykjavik Criminal Investigation Department was the inspiration that laid the foundation for my interest in forensic psychology and false confessions. It is fortunate that I had this unique experience and I’ve have been able to utilise it throughout my career as a forensic psychologist.

foundation for the release of the Guildford Four and Birmingham Six. You’ve worked on some of the highest profile cases – e.g. the Guildford Four, Birmingham Six, Barry George, Derek Bentley. But do you have any idea how prevalent false confessions are? It is difficult to provide specific rates, because this depends on so many different factors, including base rate of guilt of people interrogated, the age and education of the person interrogated, interrogative and legal practices, and cultural and regional variations. What we do know is that cases of false confession based on DNA exoneration are only the

countries with the highest rate being in Iceland, about 67 per cent, and substantially lower in other countries in Europe, about 44 per cent. In addition young people, those still in mandatory education, have less frequently been arrested and questioned by police than the older students, about 10 per cent versus 20 per cent, but their rate of reported false confession per interrogation is considerably higher, demonstrating the particular vulnerabilities during questioning among younger persons. And it’s not just an issue for people with intellectual disabilities? No, it’s not just a question of learning disabilities; in fact most miscarriage of justice cases and our own research show that sometimes normal people give false confessions to crimes such as murder. You don’t have to be learning disabled or mentally disordered to give a false confession to police. Given the right circumstances, next time it could be you! So don’t be complacent about the risk of false confessions.

Do you remember the first false confession you received yourself? Whilst working as a detective I inadvertently elicited a false confession from a man who accepted the You moved to the UK, allegation of a theft whilst learnt English and having no real memory of went on to become a committing the offence. Professor of Forensic Further investigation revealed Psychology and the that he was innocent but had world expert on false accepted the allegation confessions. But when because he did not trust his you started in the own memory during police area, did people doubt questioning. This case, and that such a thing even others I worked on in existed? England with James When I started MacKeith, led us to develop researching false the concept of the memory confessions in the early distrust syndrome, which is 1980s there was great now embedded in the scepticism among scientific literature. psychologists, Inadvertently eliciting a false psychiatrists and confession and believing in its lawyers that false veracity at the time, was a real confessions occurred eye-opener and has made me with sufficient aware of the dangers of taking frequency to merit Professor Gisli Gudjonsson (right) searches for a murder weapon on the veracity of confessions for attention. It was a an Icelandic rubbish dump granted. It also demonstrated struggle to persuade the ‘tip of the iceberg’. False confessions are the power of belief. If you believe or are judiciary that false confessions do occur. easier to elicit than people think. Since persuaded you have committed a crime of I worked closely with a psychiatrist, 2004 I have been working with colleagues which you’re innocent, you may admit it Dr James MacKeith, and we soon learned at Reykjavik University conducting large without having any memory of it. This that ‘changing minds changes lives’. epidemiological surveys among students ‘false belief’ may last many months, or We began to educate colleagues and the in Iceland and other countries in Europe. even years. legal profession about psychological We’ve now collected data on over 70,000 vulnerabilities and the risk of false young persons and their experience with Your work has led directly to numerous confession, whether elicited by police police. This research shows that the base changes in police interviewing and the or offered voluntarily. This educational rate of guilt varies greatly across different detention process – what changes are component to our work laid the

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you most proud of? What has been most significant has been the change in attitudes among the British judiciary, police officers and colleagues, which was fundamental to all the other changes. The resistance and hostility I experienced in the 1980s is no longer apparent and was overcome by education and improved awareness. I am proud to have had the opportunity of being part of a criminal justice system that has responded to the need to review and improve practice. The Birgitte Tengs case I worked on in Norway in 1998 shows how other countries have also shown the capacity to make changes following a case of miscarriage of justice. Now that your work has had that impact, is it ‘case closed’, job done? No, there is much more work to be done. For example, our current research at an English police station shows that even with the increase in mental health staff at police stations following the Bradley recommendations for reform, vulnerable detainees are no better identified now and provided with an appropriate adult than they were when we conducted similar research over 20 years ago. We need to find a way of translating knowledge into practice. This is fundamental to change. Presumably some countries have adopted your research more readily than others? When I think of the Reid technique of interrogation, which seems such a staple of TV cop dramas, it must be hard for the individuals who have been so immersed in that culture to change. In contrast to the PEACE model, which was developed in the early 1990s in England after collaborative work of police officers, psychologists, academics, lawyers, the ‘Reid technique’ encourages interviewers to use deception and psychological manipulation to break down resistance of suspects where the interrogator assumes them to be guilty. The problem is that interrogators are not as good as they think they are at detecting who is lying and who is telling the truth, and therefore often misclassify them as suspects. This increases the risk of false confession. The recent exoneration of Darrel Parker in Nebraska raises questions about the Reid technique. It was the author of the Reid technique, John Reid, who had in 1956 obtained the false confession from Mr Parker. Mr Parker was a college graduate with no criminal background, so they can’t blame his false confession on learning disability. The guilt-presumptive and confrontational processes inherent in the

Reid technique should be replaced by the PEACE model or a similar noncoercive technique. Such a reform will be strongly resisted by American police authorities, because the Reid technique has a deeprooted history and its prescriptive nature and apparent effectiveness in breaking down resistance make it attractive. Authorities in the United States have been less responsive than those in the UK in addressing issues associated with the negative aspects of deceptive police interview techniques and in actively doing something to reduce the likelihood of miscarriage of justice resulting from police-induced false confession. As far as police interviewing is concerned, the main challenge for the future is to develop transparent and accountable interview techniques that maximise the number of noncoerced true confessions while minimising the rate of false confessions. Have other scientific advances, such as DNA evidence and CCTV footage, rendered confessions less important and therefore false confessions less of an issue? There have been over 300 DNA exonerations in the USA since the late 1980s and of those over 20 per cent involve a false confession or a false plea, but in spite of these changes there appears to have been little appetite in the USA to address the issue of false confessions. This has been different in England. There have been few DNA exonerations in the UK, but DNA has been found to support my evidence. The Cardiff Three case is one example. The convictions of all three defendants were quashed by the Court of Appeal in 1992 on the basis of oppressive interviewing. In 2003 the real murderer, Jeffrey Gafoor, pleaded guilty to murder and was given a mandatory life sentence after being identified by DNA evidence. I have had other similar experiences. This has been rewarding. I am not aware of a case where my evidence of unreliability was later contradicted by DNA evidence. Unfortunately, DNA evidence is only available in a small number of cases and therefore in a great majority of cases does not overcome the issue of false confessions. The position regarding CCTV footage is less well known. Good DNA and CCTV evidence is likely to encourage suspects to give a genuine confession (i.e. increase the likelihood of confession) and in some case it will help to exonerate the wrongly convicted. You’ve actually saved lives, by stopping executions. You must be incredibly

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proud of that, but do you ever worry you have freed the guilty? What makes me the proudest is that I continue to feel the thirst to learn and improve my knowledge base and the quality of my work. Each case is a huge learning experience, indeed it is an opportunity to learn from our success and failures, and combined with extensive research this has made me the expert I am in the area of confessions. The work on confessions focuses on the ‘reliability’ and safety of the confession, based on all the available relevant evidence, including the psychological evaluation. It is usually unwise to focus on guilt or innocence; this is an issue for the court, not for the expert witness. No, I don’t worry about freeing the guilty – my evidence only forms a part of the picture, and in some cases it is the most crucial evidence. Where is that thirst to learn taking you now? I’m very excited about the work we have been doing, and are currently doing, into the vulnerabilities of people with attention deficit hyperactivity disorder. There is growing evidence that ADHD symptoms are related to offending, susceptibility to giving false confessions during police questioning, ineffective coping with the trial process, and disruptive behaviour in prison. I work closely with Dr Susan Young, who is the leading expert in the UK into ADHD and offending, and Professor Jon Fridrik Sigurdsson and other colleagues in Iceland. We are currently conducting two studies, one in Inverness and one in Iceland among prisoners, which should help in identifying the specific pathways of ADHD suffers into offending. ‘Semi-retirement’ is going well then?! Semi-retirement has been busier than I had anticipated! I’d like to turn to expert witness work now. What distinguishes an ‘expert’ witness from an ordinary witness? The main difference between an ‘expert’ witness and an ordinary witness is that the former is allowed to give an opinion. Ordinary witnesses are only allowed to give factual evidence and have to keep their opinion to themselves. In addition, expert witnesses can, with the permission of the court, sit in court and listen to other witnesses give evidence prior to their own, including that of other expert witnesses and a defendant. So it’s quite a powerful, responsible position? It’s a privileged and a responsible position

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to be in and should be taken seriously. The duty is to the court, not to the client or the lawyer commissioning the report. At all times act with integrity. Who decides whether you are qualified to act as an expert witness? It is up to the judge to determine the relevance and the reliability of the expert’s proposed evidence. In England the reliability of a particular expert’s testimony is rarely challenged, but in countries like America there are more strident criteria used, referred to as a ‘Daubert’ analysis. The issue is not just the qualifications of the expert, but also the science and methodology behind his or her evidence. Do you find the process intimidating? Yes it is an intimidating experience. In the early days I often experienced a great deal of hostility from prosecutors and judges when testifying, but the courts are now more accepting of psychological evidence. With experience, testifying becomes less intimidating.

Suddenly I asked Barry if he would mind my hypnotising him to restore his sight. He agreed and it worked! The trial could now commence. What a sense of relief. When working on cases you need to be really innovative and quick in your thinking. It’s not always easy to know what the latest evidence in an area of psychology is, or how reliable it might be. How do you ensure that evidence is good enough? Expert witnesses have to keep up to date with their field and expertise. They also have to ensure that they use the most appropriate and upto-date psychological tests and do not interpret the findings in isolation to other relevant material. The internet has made it easier to keep up to date with the literature.

Say it’s the day before you’re due to appear as an expert witness. What are your top tips? The top tip is to prepare well for your testimony. There is no substitute for good Professor Gisli Gudjonsson preparation. In Institute of Psychiatry addition, use each case gisli.gudjonsson@kcl.ac.uk as a learning experience and try to continually improve the quality of your work. Learn both from your successes and mistakes. If you Is there a danger of straying from your discover an error in your report don’t area of expertise? How do you guard cover it up. Declare it to the court at the against that? beginning of your testimony. My practice has been to stay within my own area of expertise and competence, There are risks inherent in serving as and when necessary seek advice and an expert witness, and in some ways supervision. In the case of Barry George, you’re putting your reputation and I was the first psychologist to interview career on the line. So why do you do it? and test him. My assessment suggested When testifying in court you are leaving that he might have neuropsychological yourself open to public scrutiny and any problems, and I recommended a qualified mistakes and criticisms can be very neuropsychologist, Dr Susan Young, and unpleasant. In the early years, I did a neuropsychiatrist, Professor Michael sometimes ask myself ‘So why do it?’ Kopelman. The three of us worked on the I saw it as an opportunity to make a real case as an effective team. I love working contribution to psychology and court on cases with colleagues rather than on proceedings. My ambition was to further my own, it is much more fun and there is the development of forensic psychology added strength in team work. During the having been inspired during my clinical first trial, Barry George suddenly lost his training by the late Professor Lionel eyesight during legal arguments, and the Haward, the father of British forensic three of us were asked by the trial judge psychology. It has been challenging but to bring his sight back, otherwise the trial enormously rewarding. It is an experience could not continue. We had two hours to that I would not like to have missed. achieve this and nothing seemed to work.

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Nobody I have talked to about expert witness work seems to mention money! Is it lucrative, and is that a motivation? Money has never been the main issue for me. My court work has been combined with my clinical and academic work. I don’t take on a case because it pays well. I take on a case when I think I can really make a contribution. Presumably now that the Society is no longer the regulator, there is an opportunity to shift the emphasis around expert witness work to that of support and CPD? In my experience it is not always easy, because some experts are very defensive about their reports and testimony, even when of poor quality. Court work is no place for arrogance or complacency. Our aim should be to provide the best-quality work possible and not to be so naive as to think that we know it all and need no feedback, guidance and supervision. The process is by its very nature adversarial, so how do you deal with the situation where you are, for example, openly criticising another psychologist? Any criticism of other expert witnesses should not be personal or disrespectful; it should only focus on the problems and limitations identified in the other expert’s testimony. How might you increase resilience in those undertaking expert witness work? Good training and knowledge base, practice and experience, learning from previous and current cases, and appropriate supervision are the key factors in improving resilience. Does expert witness work have the potential to reach all corners of the discipline, or will your area continue to dominate? I think that expert witness work will broaden to other areas of psychology beside clinical and forensic psychology. But these two areas will dominate, because they are fundamental to many pre-trial, trial and sentencing issues. Clinical training is the best foundation for forensic work, followed by specialised forensic training and experience. Lots of issues in court relate to mental health issues rather than offending per se. Clinical and forensic qualifications don’t make you a good expert witness. These are basic qualifications and specialised training courses, CPD and appropriate supervision are also essential.

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491

DAY IN THE LIFE

Working as an expert witness We hear from four psychologists about their interactions with the legal system

* Case details in all four authors’ contributions to this article are composites of actual cases or have been otherwise anonymised.

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I arrive at the young offenders prison with a sigh of relief but then panic as I cannot find my driving licence card – the essential ID to get in. I know the staff in the medical wing, I am a regular visitor so I wonder whether I can swing it, despite the security notices all around the entrance reminding all of the ID requirements. I take my Cambridge University student card (photo ID) and my BPS 2013 card and hope this might JAMES GROVER

wake on the day of the assessment thinking already about going to the prison to assess a 15-year-old boy accused of murder.* Young people who are facing trial for such serious crimes have often lived through more conflict in their short lives than I have in mine. I already have an idea of the circumstances of the alleged crime, according to both the papers from the prosecution and the defence solicitors, but now I go to find out for myself. Today I am assessing this child at the request of the defence, who have learned he has a history of ‘special needs’ when still attending school, although he stopped attending over two years ago. At this stage it makes little difference who has made the request for the assessment because I am to form my own opinion – one of the key duties of an expert witness to any court. I have a rushed breakfast but then remember to stop long enough to meditate, clear my head and begin the day with a fresh view of the world. I find this mindfulness-based practice helps me to be even more aware of my own responses and those whom I am to assess. I take the papers and the assessment materials with me and head for the train. Every time I wish my bag could be lighter as I haul it from car to train to tube to train to taxi. In the taxi to the prison I am given one of those speeches by the taxi driver once he knows I am going to interview someone: ‘They should all be shut away and left to rot... they don’t deserve to be out in society... life is too easy in prison.’ Today I choose to say nothing and keep my focus on the assessment ahead. When I leave the taxi I feel I should say something like ‘If it were your son/brother…’. I used to believe these views were rare but now I brace myself for such onslaughts whenever I say where I am going and why.

be enough – it is, although they looked at me a bit oddly. I always knew that one day the BPS membership card would come in handy! I go through security, which I now take for granted, but is a bit daunting. Think airport security but with a guaranteed pat down along with an occasional dog sniffing at you. I have learned to carry in nothing I do not absolutely need to avoid delays at security. Finally I am taken to the medical wing where I am given a room, and the young man comes to join me. He is a slightly built 15-year-old black British youth with a mix of worldly wise and child about him. I spend time taking care to explain why I am there, that he has a choice about taking part, even though in reality it will go against him if he does not. This is one of those times when my awareness of the ethical dilemmas in expert witness work makes me uncomfortable. Psychologists

enter into the legal system at their peril. We spend hours together, at first getting to know each other. I always feel the first few minutes are the vital ones, when we are both sizing each other up. ‘Establishing rapport’ is the official name, but for this young man it is a matter of deciding whether he can speak, who in this system of prison warders, solicitors and ‘shrinks’ he can trust enough to talk about his family and his life before prison. At YOI Feltham I already feel more relaxed than at other prisons because the room is quiet, I know we won’t be interrupted and I have time. At other prisons I can find myself in rooms where everyone can see in, or even in a visitors hall with 50+ other inmates and families. Being assertive is certainly a skill – but the last time this occurred I ended up politely sitting on the floor, making it clear I was not leaving until the room previously promised was made available. I have always been a fan of peaceful protest! The afternoon goes quickly. I feel sad for him, for his victim, for both families and all the people affected by this case. As I travel home again I reflect on the details of the crime itself, the assessment and wonder what the psychometric scores might reveal to add to this picture. I feel both sadness and frustration that so many opportunities to make a difference have been missed. I arrive home and pick up messages and e-mails. One is about a court hearing (a different case) set for the end of the week. No one seems sure whether I am going to be needed or which day. I start to stress out on how I am going to juggle this with other my therapeutic work. I am also warned this case is getting nasty. In the past I have had my degrees and chartered status questioned, my history of feminist writing and erotica writing for couples suggested as a bias in favour of women, rather than questioned on the assessment or opinion formed. I remind myself my role is to provide information and psychoeducation to the court, not to persuade them of someone’s guilt or innocence. Thank goodness I don’t have that responsibility. If I did, I couldn’t do this work. I Susan van Scoyoc is a Chartered Psychologist, registered with HCPC as a counselling and health psychologist, a member of the UK Register of Expert Witnesses and a senior member of the Register of Psychologists Specialising in Psychotherapy. She sits on a number of BPS committees and offers teaching on being an expert witness via the BPS Learning Centre.

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have undertaken specialist psychological expert witness work for more than 20 years; recent semiretirement now means I am able to devote a day to do this at a more leisurely pace. Like many colleagues, I originally started this kind of work by accident, became known as a source of reports and am now asked to undertake a variety of different kinds of investigation. I am therefore an ‘expert’ by virtue of clinical and medicolegal experience, qualifications and appointment as a Consultant Clinical Psychologist, the ability to write a report a court can understand, and a publication history. The latter is optional. It is for the courts to decide who is an expert and,

although it is now less frequent, I still come across ‘expert’ reports written by authors, including psychologists, who have strayed from their areas of training and competence, and occasionally by people with no recognisable qualification at all. A typical ‘expert’ day will initially involve travelling to a private clinic where I rent a room for an appointment with a client, arranged after a request from a solicitor or intermediary firm. On this day it is a lady who has been involved in a rather nasty car accident, causing significant physical injuries. She has mentioned in a medical assessment that she has been having nightmares, and is

find out if there were any other stresses and strains occurring in her life after the accident. Many clients will question why such a full assessment is made, and I have to explain the need ‘the court’ has for a robust opinion. My second client has been involved in a serious work accident in which two fingers

help him desensitise ‘himself’ to both work and social fears. I plan to see him again in six months to see how he is faring. These two interviews involve me listening carefully to the client’s story and experience and also asking appropriate questions to clarify their history before and after the adverse event. I need to be able to listen, talk and write notes simultaneously and make sure the client feels I am sympathetic and understanding. When I am finished, I take part in a telephone conference with a barrister and lawyer (based 100 miles away) to discuss a similar report completed 12 months ago. I am being asked to clarify and explain why I came to the particular opinion I did. The barrister’s ‘agenda’ of the discussion is to maximise the level of ‘psychological damage’ identified – my agenda is to ensure ‘the court’ or ‘ten reasonable psychologists’ would come to the same or similar opinion that I have, given the available evidence. Not difficult, in this instance – but can be a problem if I’m put under pressure to alter my view. I entered clinical psychology and later the medical-legal field to be both sympathetic and helpful to people but also for the intellectual challenges. Leaving the clinic today, I feel I have had both these experiences and the day has gone well. JAMES GROVER

oday is Wednesday. This means a short train journey from Cheltenham to Bath, and a quick coffee as I walk to my clinic in a leafy part of Bath city centre. A cheery welcome from the friendly reception staff and a clean, tidy office space all helps to start the day well. I will be seeing two clients to prepare psychological reports on their reaction to recent accidents they have been in. For one, I have been asked by the solicitors representing them and for one, it is the insurers of the person or company that caused the accident who have instructed me. However, in each case it is ‘the court’ to whom my independent opinion is directed. In other words, I must arrive at a balanced, reliable and sensible overview of the psychological impact that occurred in each case. One of my two clients has been in a motorway car accident where a lorry suddenly pulled out without seeing her and a potentially lifethreatening crash occurred. Apart from her physical injuries, she reported problems sleeping, a fear of driving and being a passenger, and difficulties coping with work, including the actual journey to and from her workplace. While being very sympathetic to this understandably very frightening experience, I need gently to put this in context of how she had been coping before the accident and also

reluctant to drive. Her lawyers have therefore requested a specialist report. She arrives on time, driven by her daughter, and brings as requested a number of completed psychometric tests sent to her previously. What follows is a standard clinical interview leading to a formulation, prognosis, and recommendation for treatment. Like many victims of road accidents she is prey to conditioned symptoms of anxiety and avoidance, and may well be helped by some cognitive-behavioural therapy. In my report I sup with the devil and refer to DSM criteria; courts love diagnoses and precision, and one has to use terms with which they are familiar.

were partially amputated when he was working on a machine. As a result he has become phobic (afraid, avoidant) of both machining at work, which has implications for his job security, and of going into social situations in which he tends to hide his damaged hand from others. There is nothing of relevance in his history apart from this very nasty accident. In this case, I recommend some CBT therapy session to

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I Hugh Koch is a Chartered Psychologist and personal injury expert enquiries@hughkochassociates.com

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(personal injury) and criminal work, the downward pressure on costs will continue; however, previous attempts to ‘bundle up’ this kind of work, and have NHS Trusts, for instance, do it on the cheap, have not succeeded. Mylle, J. & Maes, M. (2004). Partial posttraumatic stress disorder revisited. Journal of Affective Disorders, 78(1), 37–48.

compared with the likely size of the compensation award. Current ‘straws in the wind’? For PI

I Adrian Skinner is a Chartered Psychologist in the NHS and private practice, and has formerly served as Chair of the Division of Clinical Psychology and as a member of the Board of Directors of the BPS adrian@adrianskinner.co.uk

n many high-value claims for personal injury, arising from road traffic accidents, clinical negligence, and accidents at work, it is often the case that a significant head of damage arises from loss of earnings capacity. The court then may require expert evidence on the quantification of occupational disability. The basic methodology involves on the one hand assessing the potential career and future earnings, until retirement, as a fully fit uninjured individual, whilst on the other hand assessing the impact of their injuries and disability on their future working capacity following the accident. The following three case studies illustrate some of the issues involved. The first case involves a serving Royal Air Force NCO in his mid-twenties injured in an accident. He was discharged from the RAF on medical grounds, described as suffering from various cognitive and motor impairments. Both of these caused problems in his post-accident RAF work placements, and he had been moved from one placement to another due to his inability to perform to the required standard. After extensive rehabilitation he was regarded as unfit for military service, and unfit to be transferred to another trade. There was convincing evidence that before the injury he had had good prospects for promotion in the RAF. Unfortunately all that is now gone. He returned home and undertook retraining in graphic design, but was unable to cope with the pressures of a degree programme.

He now has no ambitions to take up any further study, and he feels somewhat demoralised by what he perceives as a failure. It is clear that his self-confidence has taken a blow, as he was initially convinced that he could cope with degreelevel academic study. Further vocational rehabilitation will be extremely difficult. Another case serves to illustrate some of the psychological issues arising. Knocked down as a cyclist in her late fifties the claimant sustained multiple injuries to the hips and legs, with psychological sequelae (mild PTSD and depression). This claimant had an impressive portfolio and contacts in the advertising industry. It was her evidence that at the time of the accident she was about to relaunch herself on the advertising world and pick up on her creative career. My own expert opinion was influenced by the context of this career. The claimant had worked in the USA for many years until she was badly injured in a skiing accident. She returned to the UK, and there are records of her receiving ongoing treatment not only for her physical injuries but also for psychiatric problems. For a period of seven years prior to the cycling accident she had not been continuously in work, having held only a few short-term jobs, none of which was in advertising. Most people who develop their careers do so from a position of strength, i.e. in employment. In the advertising industry this will be even more so, as it is a very competitive industry. Thus, I was not convinced that there was a serious chance of the claimant at the age she was

JAMES GROVER

As with many clients, this lady suffers some, but not all, of the symptoms of post-traumatic stress disorder. In this situation I tend to use the term ‘Partial PTSD’; whilst not a formal DSM category it is widely used (Mylle & Maes, 2004), and I have not been challenged as to its use thus far. At the end of the assessment I explain my formulation to the client. It is not the function of such an assessment to be therapeutic, but it often is. I tell her that her anxieties are common in RTA victims, the natural history is for them to decay, and that this can be hastened by treatment. I explain that she is no more likely to have an accident than she was before; it is her personal estimate of the danger that has been knocked askew. She has, like most victims, not been offered treatment by her GP, so we discuss options such as private treatment and how it might be arranged. She leaves with her daughter, happier than when she arrived. During the reading of notes, assessment and writing the report, I keep note of the time spent, a lesson learned from my legal colleagues. Although many reports are produced to an agreed fee, it is important in other cases to keep an eye on the chargeable time spent. In the afternoon I have a ‘Meeting of Experts’. This is a specific procedure under Part 35 of the Civil Procedure Rules, devised under the ‘Woolf Reforms’ to encourage experts instructed by claimant and defence to meet prior to any trial to try and resolve differences or at least highlight the points of disagreement. I meet my fellow psychologist (although these meeting can be crossdisciplinary) over a pot of tea to discuss the cognitive status of a client who has suffered a head injury. I have concluded that their abilities have been affected and the injury was probably the cause; my fellow psychologist feels that these discrepancies were more likely than not present before the accident. Since we are both familiar with the statistics the central point of disagreement emerges quickly – how likely is it that her difficulties pre-dated the accident. We agree to disagree and decide that I should write up our meeting and send it to my colleague for her approval. We will then both sign it and send it to both sets of lawyers. We agree informally that there will probably still be settlement in view of the prohibitive cost of proceedings

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resuming her career after such a break, and with a somewhat difficult recent medical history. Needless to say my opposition expert thought quite the opposite, that the claimant was about to re-establish a previously successful career, and eventually we agreed to differ. Like all court-approved experts doing personal injury work we are guided by the Civil Procedure Rules, under which in the majority of cases one has to identify areas of agreement and disagreement (with reasons why) with an opposition expert. This can occasionally lead to ferocious arguments, very often about the honesty, motivation and career potential of the claimant. In addition to interview and test material (e.g. occupational aptitude tests and job preference inventories) one might be supplied with medical records, educational records, employment files and surveillance evidence. Over the years I have become cautious about believing everything one is told at interview! A third case involved a claimant, aged 39 at the time of the accident, sustaining extensive severe physical and psychological injuries. At the time of the accident she was a finance manager with

a firm supplying horticultural products. She was earning a six-figure salary and bonus package. About a year or two after the time of the accident, she was expecting to be appointed to a seat on the board and to be earning significantly more in salary and benefits. Given her experience and career development up to this point I did not think it unrealistic for her to have realised this expectation. Further, the claimant considered that she would have worked at that senior level for 12–15 years or so, say to age 55, followed by a five-year winding down period, when she would probably have been a consultant to the company or to other businesses, either on a part-time employed basis or through her own small consultancy. I formed the opinion that in a role of consultant she could have earned £50,000 pa pre-tax, but net of business expenses. Now, the medical evidence was that she will remain at a significant disadvantage for employment in the future, and suffers ongoing cognitive disability and mood disorders arising from the accident. She was terminated from her pre-accident employment due to loss of capability, and subsequently lost

another position under similar circumstances. She now works with another firm in a much less senior position on a much lower salary than she was earning before the accident She describes it as a struggle, involving quite a bit of travelling round the UK and absence from home. There have been false starts in this return to work, and the events as they unfolded provided a real-life account of the claimant’s problems in re-adjusting to high-level work demands. It was clear that she could not cope with the highlevel decision making required before the accident. Her residual level of employment probably represented her limit, although there may still have been an ongoing risk to the security of this employment with the new employer. These case studies hopefully give a flavour of some of diverse professional challenges facing an occupational psychologist working in the litigation world. I Dr Michael H. Banks is an HCPC Registered Occupational and Health Psychologist drmichaelbanks@btinternet.com

Postdoctoral Conference Bursary Scheme This Research Board bursary scheme supports the work of postdoctoral researchers and lecturers. Conference bursaries are available to support UK psychology postdoctoral researchers and lecturers to attend any academic conference, either in the UK or internationally, relevant to the applicants work. Each bursary consists of up to £150 (UK) or £300 (international) to contribute towards the costs of registration and travel to attend the full conference.

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There are two rounds of the scheme each year, with submission deadlines on 1 April and 1 October. Get your applications in now for the October deadline. For the full criteria and an application form please contact Carl Bourton at the Society’s office carl.bourton@bps.org.uk Note: For the purposes of the bursary scheme, a postdoctoral research/lecturer is defined as a person who is employed at a UK HEI and is within three years of the completion of their doctoral research degree (i.e. PhD) in psychology.

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Psychologists in the witness box Graham M. Davies and Gisli H. Gudjonsson run through a brief history

references

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Bartol, C.R. &Bartol, A.M. (1987). History of forensic psychology. In L.B. Weiner and A.K. Hess (Eds.) Handbook of forensic psychology (pp.3–21). New York: Wiley. Binet, A. (1900). La suggestibilité. Paris: Schleicher frères. Cattell, J.M. (1895). Measurements of the accuracy of recollection. Science, 2, 761–766. Davies, G.M. (2003). Psychology in the

Suggestibilité (1900). Binet demonstrated the impact of leading questions on children’s responding and was the first to distinguish between false answers based purely on social pressures and cognitive changes in children’s underlying memory. Although qualified as a lawyer, Binet was never permitted to testify in the French courts. By contrast, the Belgian psychologist, Julien Varendonck (1879–1924), testified on the findings of his own research on children’s suggestibility in a murder trial in 1911, where children’s evidence was critical to the prosecution case. In contrast to Binet’s nuanced approach, Varendonck’s research confounded social and cognitive suggestibility, but it contributed to the defendant being found not guilty (Davies, 2003). Germany, too, embraced the new Psychologie der Aussage (the psychology of verbal reports) led by William Stern (1871–1938), who started the first scientific journal devoted to testimony research (Lamiell, 2010). A close working relationship between psychology and the law exists in Germany: since The status of ‘recovered memories’ spilled over from 1955, the Supreme Court has the lecture theatre into the courtroom, leading to required psychologists to ‘battles of experts’

courtroom: In the footsteps of Varendonck. In L. Kools, G., Vervaeke, M,. Vanderhallen & Goethals, J. (Eds.) De waarheid en niets dan de waarheid (pp.2–17). Leuven: die Keure. Elliott, R. (1993). Expert testimony about eyewitness identification: A critique. Law and Human Behavior, 17, 423–437. Gudjonsson, G.H. (2003). The psychology of interrogations and confessions: A handbook. Chichester: Wiley.

Gudjonsson, G.H. (2008). Psychologists as expert witnesses: The 2007 BPS Survey. Forensic Update, 92, 23–29. Gudjonsson, G.H. (2010). Invited article. Psychological vulnerabilities during police interviews. Why are they important? Legal and Criminological Psychology, 15, 161–175. Gudjonsson, G.H. (2012). False confessions and correcting injustices. New England Law Review, 46, 689–709.

Gudjonsson, G.H., & Haward, L.R.C. (1998). Forensic psychology: A guide to practice. London: Routledge Hale, M. (1980) Human science and social order: Hugo Münsterberg and the origins of applied psychology. Philadelphia: Temple University Press. Haward, L.R.C. (1965). Hearsay and psychological reports. Bulletin of the British Psychological Society, 18, 21–26.

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he provision of expert testimony by psychologists in legal proceedings can be traced back to the very beginnings of experimental psychology and its founder Wilhelm Wundt and his students. In 1896 Baron Albert von Schrenck-Notzing (1862–1929), a German psychiatrist who had trained with Wundt, gave evidence in a sensational trial involving the murder of three women. Drawing on his research on suggestion, the Baron argued that the witnesses could be suffering from what he termed ‘retroactive memory falsification’: confusing the vivid accounts they had read in the newspapers with what they had actually seen (Bartol & Bartol, 1987). For the first time, but certainly not the last, the court rejected his evidence and found the defendant guilty. Subsequently, Schrenck-Notzing abandoned expert testimony for psychical research, although the phenomenon to which he drew attention is well-known to today’s forensic psychologists as ‘post-event misinformation’ (Loftus, 2005). Another of Wundt’s pupils, the American James M. Cattell (1860–1944) was among the first to demonstrate the unreliability of memory for events from the recent past and the tenuous link between witness confidence and accuracy (Cattell, 1895). Cattell’s findings excited the interest of the French psychologist Alfred Binet (1857–1911) who conducted a series of systematic investigations into suggestibility in children, which he summarised in his monograph La

conduct a preliminary assessment of all child abuse complainants in contested cases, including an analysis of the content of their testimony – ‘statement validity assessment’ – and to give evidence on their findings to the court (Vrij, 2008). In the United States, another of Wundt’s protégés, Hugo Münsterberg (1863–1916), wrote the first book published in English on psychology and law, entitled On the Witness Stand (Münsterberg, 1908). Apart from eyewitness accuracy, the book discussed the role of psychology in the detection of deception; false confessions; the impact of leading questions in court and the development of effective interviewing procedures for witnesses. The book was a popular success, but its bombastic tone alienated lawyers (dismissed as

looking back

‘obdurate’). Münsterberg ’s own attempts to give expert testimony in the American courts were unsuccessful, and with his death much of the research interest in psychology and law in the USA died with him (Hale, 1980). Interest only revived when cognitive psychology became the dominant paradigm in the 1970s, with its emphasis upon a greater engagement with ‘realworld’ issues. Research such as that conducted by Elizabeth Loftus and Robert Buckhout (1935–1990) highlighted again the vulnerabilities of witness testimony and this time, some US courts were prepared to listen (Loftus. 1986). Psychologists began to testify for the defence in high-profile cases that hinged on disputed identifications or witness testimony, though the degree to which it was legitimate to extrapolate from laboratory findings to the realities of criminal investigations remained controversial (Elliot, 1993; McCloskey & Egeth, 1983). In the 1990s the dispute between psychologists over the status of ‘recovered memories’ spilled over from the lecture theatre into the courtroom, leading to ‘battles of experts’. In the Franklin murder trial in 1990, Loftus for the defence faced psychiatrist Lenore Terr for the prosecution. The prosecution’s case was that Franklin’s daughter had witnessed her father murdering a school friend nearly 30 years previously, but had only recently recovered the memory. Terr argued that such recovered memories were commonplace in therapeutic work, while Loftus argued that old memories become less, rather than more reliable over time and that there was no scientific evidence to support the concept of repressed memories. The jury found Franklin guilty, but the verdict was later reversed on appeal (MacLean, 1993). For many years, the opportunities for British psychologists to testify as experts in court were constrained by the legal rule that only medically qualified persons could testify on matters to do with the mental functioning of witnesses or

Lamiell, J.T. (2010). William Stern (1871– 1938): A brief introduction to his life and works. Berlin: Pabst Science. Loftus, E.F. (1986). Ten years in the life of an expert witness. Law and Human Behavior, 10, 241–263. Loftus, E.F. (2005) Planting misinformation in the human mind. Learning and Memory, 12, 361–366. MacLean, H.N. (1993). Once upon a time: A true story of memory, murder, and the

defendants. In reality, the findings of clinical and educational psychologists were regularly incorporated into expert medical reports, but psychologists were not permitted to give evidence in their own right (Gudjonsson & Haward, 1998). A campaign to recognise the status of psychologists in law, led by Lionel R.C. Haward (1920–1998), was eventually successful, on the grounds that the exclusion of psychologists testifying about their own findings violated the hearsay and ‘Best Evidence’ rules (Haward, 1965). Haward went on to regularly testify in a range of high-profile cases, including that of the multiple murderer Donald Neilson (1976) and the Oz obscenity trials (1971). In the Confait case in 1972 the English legal system had been shaken by a miscarriage of justice based on false confessions, another topic originally highlighted by Münsterberg. This case led to the setting up of the Royal Commission on Criminal Procedure and the introduction in 1986 of the Police and Criminal Evidence Act, which resulted in mandatory electronic recording of police interviews and the use of ‘appropriate adults’ for juveniles and mentally vulnerable suspects. Following further miscarriages of justice, notably the Guildford Four and the Birmingham Six, the Royal Commission on Criminal Justice was set up in 1991. A number of research projects were commissioned, including one investigating the psychological vulnerabilities of persons detained for police interviews (Gudjonsson, 2003). Expert psychological evidence relating to confession evidence was first accepted in the Court of Appeal in 1991, and since that time it has been accepted and influential in a number of other high-profile appeal cases, with the main reason for overturning the conviction being evidence of psychological vulnerabilities (Gudjonsson, 2010). Expert psychological and psychiatric evidence is more readily admitted in the UK courts than the US courts, and the

law. New York: HarperCollins. McCloskey, M. & Egeth, H.E. (1983). Eyewitness identification: What can a psychologist tell a jury? American Psychologist, 38, 550–563. Münsterberg, H. (1908). On the witness stand. New York: Doubleday, Page & Company. Vrij, A. (2008). Detecting lies and deceit: Pitfalls and opportunities. Chichester: Wiley.

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focus in the UK is on fairness and reliability, rather than voluntariness and coercion (Gudjonsson, 2012). Importantly, a detailed analysis of real-life cases, including DNA exonerations, has furthered the scientific understanding of the key pathways into false confession and wrongful convictions and the kinds of remedies that are needed internationally (Gudjonsson, 2012). The remedies recommended include improved police interview training, mandatory electronic recording of all suspect interviews, and improved identification of psychological vulnerabilities and safeguards. A survey among British psychologists (Gudjonsson, 2008) illustrated the wide variety of topics on which psychologists prepared reports for the criminal and civil courts, including personal injury, child custody disputes, fitness to plead and stand trial, disputed confessions, reliability of witness statements, and recommendations about disposal (including treatment). In civil cases, the great majority of cases were settled out of court, whereas in criminal cases, tribunals and family proceedings often required the psychologist to give oral evidence. The UK courts called upon a variety of different specialisms within psychology, including forensic, educational and occupational psychologists, but clinical psychologists formed the largest single group of expert witnesses. In conclusion, expert testimony by psychologists in court has come a long way since the days of Schrenck-Notzing. However, many of the same issues that preoccupied the pioneers still persist. Tensions continue between lawyers and psychologists as to what is ‘specialist knowledge’ and what is ‘common sense’, for which no expert input is required. Recently, the English courts, unlike the USA, have reaffirmed their general opposition to the admission of expert testimony on eyewitness matters, on the grounds that the vagaries of memory are something familiar to all jurors (see R v. Anderson [2012] EWCA Crim 1785). It is up to the new generation of forensic researchers to produce more robust and reliable findings which demonstrates the value of their science to law and justice.

I Graham M. Davies is at the School of Psychology, University of Leicester gmd@le.ac.uk I Gisli H. Gudjonsson is at the Institute of Psychiatry, London

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changes in sensation, cognition and memory rather than a sudden switch from awake to asleep. In this article, we address some key questions about anaesthesia and what it can tell us about the mind.

Psychology in the operating theatre Michael Wang, Catherine Deeprose, Jackie Andrade and Ian F. Russell ask what general anaesthesia can tell us about consciousness, learning and memory I gratefully look forward to oblivion, but I must be sure of it. Taylor Caldwell

questions

The aim of anaesthesia is to provide a temporary state of oblivion, from which a patient will awake without memory for surgery. Unfortunately, we will show here that absence of memory for surgery does not guarantee that oblivion was successfully achieved. The operating theatre has become a laboratory for psychologists to investigate the boundaries of consciousness, learning and memory.

What mechanisms might underlie the phenomenon of intraoperative consciousness followed by postoperative amnesia?

resources

Deeprose, C. & Andrade, J. (2006). Is priming during anesthesia unconscious? Consciousness and Cognition, 15(1), 1–23. – Reviews the anaesthesia and memory literature from a psychological perspective

references

What is meant by implicit emotional memory?

American Society of Anesthesiologists Task Force on Intraoperative Awareness (2006). Practice advisory for intraoperative awareness and brain function monitoring. Anesthesiology, 104(4), 847–864. Andrade, J. (1994). Is learning during anesthesia implicit? Behavioral and Brain Sciences, 17(3), 395–396. Andrade, J. (1996). Investigations of hypesthesia: Using anesthetics to

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n 1965, Dr Bernard Levinson, a practising psychiatrist and former anaesthetist, dosed 10 dental patients with thiopentone, nitrous oxide and ether in order to perform an unusual experiment. Mid-way through the operation, he staged a mock crisis in which he exclaimed, ‘Stop the operation. I don’t like the patient’s colour. His/her lips are much too blue. I’m going to give a little more oxygen.’ Thereafter, surgery continued and all patients were reported to have made an uneventful recovery. However, under hypnosis one month later, four of the patients repeated verbatim Levinson’s statement, and another four had some recall for intraoperative events. This study is in many ways methodologically flawed: for example, Levinson conducted both the mock crisis and the hypnosis. However, the startling findings provided a starting point for research into psychological aspects of anaesthesia. This research really took off when psychologists provided appropriate tools and frameworks for researching implicit memory (Andrade & Deeprose, 2006; Deeprose & Andrade, 2006). At that point, the operating theatre became a laboratory in which to investigate the boundaries of consciousness, learning and memory. The main message from this research is that the boundaries are blurred, with loss of consciousness involving gradual

explore relationships between consciousness, learning, and memory. Consciousness and Cognition, 5, 562–580. Andrade, J. & Deeprose, C. (2006). A starting point for consciousness research: Reply to Thomas Schmidt. Consciousness and Cognition, 15(1), 28–30. doi:10.1016/j.concog.2006.02.004 Andrade, J., Deeprose, C. & Barker, I.

What does general anaesthesia involve? We often talk about sending patients ‘off to sleep’, but sleep is not an accurate analogy for anaesthesia. EEG studies demonstrate that general anaesthesia does not have the same electroencephalic signature, architecture or sleep stages of natural somnolence (Schwartz, 2010). Unlike sleep, unconsciousness resulting from anaesthesia is a state created through artificial means, and, by definition, there is an absence of response to very strong stimulation. Generally it is held that there are three common aims of general anaesthesia: I analgesia (loss of sensation, to prevent physiological shock); I hypnosis (unconsciousness or oblivion); and I muscle paralysis (to allow for surgical access). Often at least three different drugs are responsible for these components, and thus they are relatively independent. It is possible to be given sufficient muscle relaxant to produce effective paralysis, with insufficient hypnotic, leaving the patient conscious but unable to move. A further complication is that the effect of the hypnotic component of the anaesthetic cocktail, that is the anaesthetic proper, is determined by the balance between the dose of anaesthetic and the level of surgical stimulation and psychological arousal. Just as you may have difficulty sleeping in a noisy environment, so you will need more anaesthetic to keep you unconscious during an invasive surgical procedure than during a more minor superficial procedure. As a patient, your state of consciousness or unconsciousness exists on a continuum of ‘depth of anaesthesia’ between fully awake

(2008). Awareness and memory function during paediatric anaesthesia. British Journal of Anaesthesia, 100(3), 389–396. doi:10.1093/Bja/Aem378 Bargh, J.A., Chen, M. & Burrows, L. (1996). Automaticity of social behaviour. Journal of Personality and Social Psychology, 71, 230–244. Byers, G.F. & Muir, J.G. (1997). Detecting wakefulness in anaesthetised

children. Canadian Journal of Anesthesia, 44, 486–488. doi:10.1007/bf03011935 Davidson, A.J., Huang, G.H., Czarnecki, C. et al. (2005). Awareness during anesthesia in children: A prospective cohort study. Anesthesia and Analgesia, 100, 653–661. Deeprose, C. & Andrade, J. (2006). Is priming during anesthesia unconscious? Consciousness and

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and fully unconscious. Where you are on this continuum will vary during an operation, and a difficulty for the anaesthetist is to determine how close you are to moving into the ‘wakeful’ end of the continuum before it is time for you to do so. The reader at this point may wonder why the anaesthetist does not just continually give an overdose of anaesthetic, and often they do, but there are dangers here of increased medical morbidity and (rarely) mortality. The idea of a continuum of consciousness is supported by studies of the effects of sedative or sub-anaesthetic doses of anaesthetic drugs. These studies have found a progressive, sequential but dissociative loss of sensation. Hearing is commonly the last sense to be affected and electrophysiological studies have shown that limited sense of hearing can continue despite even deep anaesthesia (Koelsch et al., 2006). Importantly, long-term encoding

Cognition, 15(1), 1–23. doi:10.1016/j.concog.2005.05.003 Deeprose, C., Andrade, J., Harrison, D. & Edwards, N. (2005). Unconscious auditory priming during surgery with propofol and nitrous oxide anaesthesia: a replication. British Journal of Anaesthesia, 94(1), 57–62. doi:10.1093/Bja/Aeh289 Deeprose, C., Andrade, J., Varma, S. & Edwards, N. (2004). Unconscious

of memories is impaired before language and working memory functions (Andrade, 1994, 1996).

What’s the risk of consciousness during general anaesthesia? Consciousness during anaesthesia has traditionally been measured retrospectively, in terms of patients’ recollections of surgery. The standard definition of awareness during anaesthesia refers to a situation where a patient has ‘woken up’ during surgery and recalls doing so when they come round after their operation. Achieving awareness by this definition requires that the period of consciousness is complete enough, in terms of the extent to which sensory and cognitive functions are regained, and long enough to be encoded in memory sufficiently to be recalled and verbalised at a later time. It also requires that

learning during surgery with propofol anaesthesia. British Journal of Anaesthesia, 92(2), 171–177. doi:10.1093/Bja/Aeh054 Ghoneim, M. (2010). The trauma of awareness: History, clinical features, risk factors, and cost. Anesthesia & Analgesia, 110, 666–667 Harris, J.L., Bargh, J.A., & Brownell, K.D. (2009). Priming effects of television food advertising on eating behavior.

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memory encoding is not compromised by the amnestic effects of anaesthetic drugs. Often these memories of surgery are quite fragile and only become apparent once more vivid memories of the hospital visit have faded. The best studies of anaesthetic awareness therefore interview patients at several time intervals following surgery, to maximise the chance of capturing a faint memory of intra-operative events. These studies of retrospective explicit recall indicate a risk of about around one in every 600 operations for adults (Sebel et al., 2004) and around one in 100 operations for children (Davidson et al., 2005). These incidence rates clearly present a concern given that approximately 2.9 million anaesthetics are conducted in the UK each year (Woodall & Cook, 2011). Moreover, these statistics exclude operations where there is high risk of awareness. Risk of awareness increases if blood circulation is compromised (e.g. during heart bypass or trauma with blood loss), or if the dose of anaesthetic must be minimised (e.g. to avoid anaesthetising the baby during Caesarean section). Studies using post-operative interviewing may underestimate the true incidence of consciousness during anaesthesia. This is because explicit memory, as assessed using retrospective recall, does not necessarily correlate with consciousness at the time of learning: there can be full consciousness with explicit memory, full consciousness with no explicit memory but with implicit memory, unconsciousness with no explicit memory but with implicit memory, or unconsciousness with no explicit or detectable implicit memory. Many lowdose anaesthesia studies have demonstrated that anaesthetic drugs commonly obliterate explicit recall, giving rise to amnesia, despite the fact that the patient was conscious and communicative during the period the drugs were active (see review by Andrade, 1996). This is particularly common in the case of conscious sedation during unpleasant investigative procedures such as endoscopy, when a benzodiazepine such

Health Psychology, 28, 404–413. Ijerman, H. & Semin, G.R. (2007). The thermometer of social relations: Mapping social proximity on temperature. Psychological Science, 20, 1214–1220. Kerssens, K., Gaither, J. & Sebel, P. (2009). Preserved memory function during bispectral index–guided anesthesia with sevoflurane for major orthopedic surgery. Anesthesiology, 111, 518–524.

Koelsch, S., Heinke, W., Sammler, D. & Olthoff, B. (2006). Auditory processing during deep propofol sedation and recovery from unconsciousness. Clinical Neurophysiology, 117, 1746–1759. Lebovits, A.H., Twersky, T. & McEwan, B. (1999). Intraoperative therapeutic suggestions in day-case surgery. British Journal of Anaesthesia, 82, 861–866.

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as midazolam is injected intravenously. Many people have complete amnesia for such procedures and imagine they have been unconscious when clearly they have not (Woodruff & Wang, 2004). It is possible to be wakeful during general anaesthesia and have no postoperative recall for this episode.

How can we assess depth of consciousness? The major focus of research on assessing depth of anaesthesia has been EEG measures of brain function. There is evidence that these measures can help reduce awareness during anaesthesia (Myles et al., 2004), but at best they provide a probabilistic indication of a patient’s state of consciousness. In other words, they tell us that the majority of patients will be unconscious at a particular EEG index reading. But what if the patient is actually at the tail of the normal distribution? A direct measure of consciousness during anaesthesia would tell us if a patient was awake right now. Such a measure could help prevent the worst awareness cases. Much, if not most of major surgery in the Western world involves the use of muscle relaxants, which cause whole-body paralysis. If you are unfortunate enough to become ‘wakeful’ in the presence of such drugs, you will be incapable of any movement. Anaesthetic awareness patients tell of strenuous and desperate attempts to signal to theatre staff their predicament, without success. Moreover, most anaesthetists believe, and are indeed taught, that they can detect consciousness in the presence of muscle relaxants because of changes in heart rate, blood pressure, tear secretion and sweating. However, there is now abundant empirical evidence that this is simply untrue (Moerman et al., 1993). Despite comments from eminent/learned bodies that ‘Intraoperative

Leslie, K., Chan, M.T.V., Myles, P.S. et al. (2010). Posttraumatic stress disorder in aware patients from the B-Aware trial. Anesthesia & Analgesia, 110, 823–828. Levinson, B.W. (1965). States of awareness during general anaesthesia. British Journal of Anaesthesia, 37, 544–546. Macleod, A.D. & Maycock, E. (1992). Awareness during anaesthesia and

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awareness cannot be measured during the intraoperative phase of general anesthesia’ (American Society of Anesthesiologists Task Force on Intraoperative Awareness, 2006), the isolated forearm technique provides a simple yet highly effective method for determining consciousness during anaesthesia (Russell, 1993; Russell & Wang, 1997, 2001). Before muscle relaxants are administered, a tourniquet is applied to one arm using a cuff, ensuring the patient is capable of moving the hand during surgery despite the presence of muscle relaxant in the rest of the body. The patient is then asked to ‘squeeze their fingers’ by the anaesthetist at regular intervals. In early studies of the isolated forearm technique, Russell (1989) found that 44 per cent of patients receiving a once commonly used anaesthetic could respond sensibly to command at some point during the operation. However, on recovery almost all patients had complete amnesia for the surgical period. The incidence for awareness in children measured directly using the isolated forearm technique is approximately 1 per cent (Andrade et al., 2008), similar to the rate estimated by retrospective recall. During particularly stimulating procedures such as intubation or when anaesthesia is very light, the incidence can be much

post traumatic stress disorder. Anaesthesia and Intensive Care, 20(3), 378–382. Messina, A.G., Wang, M., Ward, M.J. et al. (in press). The effectiveness of anaesthetic interventions for prevention of wakefulness and awareness during and after surgery. Cochrane Database of Systematic Reviews. Moerman, N., Bonke, B. & Oostings, J.

higher (Byers & Muir, 1997). The incidence of consciousness in adults receiving modern anaesthetics is currently unknown, but is likely to vary significantly according to the specific anaesthetic technique used and surgical procedure. Early studies suggest the true incidence could be considerably higher than the incidence estimated by recall measures (Messina et al., in press), though the discrepancy between the child and adult data is not yet understood. The isolated forearm technique is not used routinely in clinical practice, and in our experience, clinicians are either not aware of the technique or resistant to adopting it. Electrophysiological measures are also not routinely used in Europe, as there is little evidence that they reduce the risk of awareness in low- or medium-risk cases. Rather than attempting to assess the level of consciousness of individual patients, efforts to reduce awareness have focused on reducing human error.

Can we form memories during unconsciousness? Although consciousness at the time of learning does not necessarily result in explicit recall, another form of memory may persist. Implicit memory is the enhanced processing, or ‘priming’ of information, such as improved ability to identify previously presented words embedded in white noise or to recognise or generate a word from its beginning or ‘stem’. Priming memory may occur during moments of undetected consciousness, but also occurs during adequate and even deep anaesthesia – at least as defined using an EEG measure and routine patient observation (Deeprose & Andrade, 2006). Thus research by Jackie Andrade and Catherine Deeprose has shown that, on recovery, patients are more likely to complete word stems with target words if they have heard those words during surgery (Deeprose et al., 2004). If patients had been paralysed, then the anaesthetist as well as the EEG monitor may have missed signs of

(1993). Awareness and recall during general anaesthesia – Facts and feelings. Anesthesiology, 79, 454–464. Myles, P.S., Leslie, K., McNeil, J. et al. (2004). Bispectral index monitoring to prevent awareness during anaesthesia: The B-Aware randomised controlled trial. The Lancet, 9423, 1757–1763. Nilsson, U., Rawal, N., Uneståhl, L.E., et al (2001). Improved recovery after

music and therapeutic suggestions during general anaesthesia. Acta Anaesthesiologica Scandinavica, 45, 812–817. Russell, I.F. (1989). Conscious awareness during general anesthesia. Baillieres Clinical Anaesthesiology, 3, 511–532. Russell, I.F. (1993). Midazolam-alfentanil: An anesthetic? An investigation using the isolated forearm technique. British Journal of Anaesthesia, 70,

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consciousness (Russell, 2008a, 2008b). However, patients were not paralysed, and so were free to move and communicate had they woken during surgery. None did, consistent with the conclusion that priming took place during adequate anaesthesia (Deeprose et al., 2005; Deeprose, et al., 2004; see also Kerssens et al., 2009).

What are the implications for well-being?

On the opposite side of the coin, there is some limited evidence that the formation of implicit memory during surgery may be used to benefit patients through priming positive expectations, such as ‘you will make a good recovery’ (Lebovits et al., 1999; Nilsson et al., 2001). However, it has not yet been demonstrated that the processing of this conceptual type of information can take place during adequate anaesthesia, and early positive findings in this field may reflect unintended consciousness during anaesthesia, which was not detected by anaesthetists or consciously recalled by patients on recovery.

The psychological effects of explicit memory for consciousness during anaesthesia may be persistent and debilitating, including re-experiencing of the traumatic event, avoidance and The impact of psychology on hyperarousal consistent with posttraumatic stress disorder (Ghoneim, anaesthetic practice 2010; Leslie et al., 2010). But implicit Given the above considerations, memory may also impact on psychology has much to contribute to the psychological well-being. There is an evaluation of what constitutes ‘adequate intriguing literature in which patients anaesthesia’. Unintended anaesthetic have developed psychopathology awareness appears to be much more following surgery for which they have widespread than many imagine, and no memory and which, on the face of it, evidence suggests that as many as 50 per appeared to be unproblematic at the time cent of people who experience this may (see review by Wang, go on to develop serious 2010). However, psychological problems subsequent investigation such as PTSD (Macleod “unintended anaesthetic of anaesthetic records & Maycock, 1992). Many awareness appears to be has often suggested anaesthetic awareness much more widespread inadequate anaesthesia, sufferers make no than many imagine” likely resulting in complaint, perhaps implicit memory for the because of phobic avoidance surgery. It is well of medical personnel or because established that implicit memory can they don’t wish to make trouble for have a significant impact on behaviour hospital services. Presently two of us (JA, (e.g. Harris et al., 2009; Ijerman & Semin, MW) are members of a joint Royal 2007). For example, experimental work College of Anaesthetists and Association has shown that being ‘primed’ by an of Anaesthetists of Great Britain and elderly stereotype results in healthy adults Ireland committee that is auditing cases walking away from the laboratory more of awareness from the whole of the NHS slowly (Bargh et al., 1996). The influence in the UK and in healthcare services in of implicit memory on post-operative Ireland (National Audit Project 5 – recovery has important implications if the www.NAP5.org). Any reader treating implicit memory may exacerbate existing a recently reported case of awareness anxieties, or includes strong emotional should notify the project content, such as an unfavourable (nap5@nap5.com). One of us (MW) prognosis discussed by medical staff has contributed to the development of during the surgery. a forthcoming NICE report on the use of

42–46. Russell, I.F. (2008a). BIS-guided isoflurane/relaxant anaesthesia monitored with the isolated forearm technique. British Journal of Anaesthesia, 100(6), 875P–876P. Russell, I.F. (2008b). BIS-guided TCI propofol/remifentanil anaesthesia monitored with the isolated forearm technique. British Journal of Anaesthesia, 100(6), 876P.

Russell, I.F. & Wang, M. (1997). Absence of memory for intraoperative information during surgery under adequate general anaesthesia. British Journal of Anaesthesia, 78, 3–9. Russell, I.F. & Wang, M. (2001). Absence of memory for intra-operative information during surgery with total intravenous anaesthesia. British Journal of Anaesthesia, 86, 196–202. Schwartz, R.S. (2010). General

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EEG monitors to detect consciousness and a Cochrane Review on the prevention of unintended anaesthetic awareness (Messina et al., in press).

Conclusion The research we have reviewed illustrates a point well known to psychologists – that being conscious and being able to remember being conscious are not the same thing. It raises some important questions for psychology. The effects of implicit memory on behaviour have been extensively researched, but effects on psychological well-being are not well understood. Similarly, although we know a lot about explicit and implicit memory, there remain questions about how conscious we need to be, and which brain processes need to operate, to encode memories of different sorts of stimuli. Finally, this interdisciplinary research shows the usefulness of cognitive psychology for providing a framework for understanding and tackling clinical problems. Michael Wang is Professor of Clinical Psychology, School of Psychology, University of Leicester mw125@leicester.ac.uk

I Catherine Deeprose

is Lecturer in Psychology, School of Psychology, Plymouth University catherine.deeprose@plymouth.ac.uk I Jackie Andrade

is Professor of Psychology, School of Psychology, Plymouth University jackie.andrade@plymouth.ac.uk I Ian F. Russell

is Consultant Anaesthetist, Hull Royal Infirmary I.F.Russell@hull.ac.uk

anesthesia, sleep, and coma. New England Journal of Medicine, 363, 2638–2650. Sebel, P.S., Bowdle, T.A., Ghoneim, M.M. et al. (2004). The incidence of awareness during anesthesia. Anesthesia and Analgesia, 99, 833–839. Wang, M. (2010). Implicit memory, anaesthesia and sedation. In G.W. Davies, D. (Ed.) Current issues in applied memory research (pp.165–

184). London: Psychology Press. Woodall, N. & Cook, T. (2011). National census of airway management techniques used for anaesthesia in the UK. British Journal of Anaesthesia, 106(2), 266–271. Woodruff, G. & Wang, M. (2004). An investigation of implicit emotional memory and midazolam amnesia following colonoscopy. British Journal of Anaesthesia, 93, 488.

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Research. Digested.

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ARTICLE

HIV in the UK Poul Rohleder, Tomás Campbell, Audrey Matthews and Jenny Petrak consider the ongoing challenges

question

What challenges do psychologists face in delivering services to people living with HIV in the UK?

resources

Gutmann, M. & Fullem, A. (2009). Mental health and HIV/AIDS. Arlington, VA: USAID/AIDSTAR-One. www.bps.org.uk/standards-psychologicalsupport-adults-living-hiv

references

British Psychological Society, British HIV Association & Medical Foundation for AIDS & Sexual Health (2011) Standards for psychological support for adults living with HIV. London: MedFASH. Cook, J.A., Grey, D., Burke, J. et al. (2004). Depressive symptoms and AIDS-related mortality among a multisite cohort of HIV-positive women. American Journal of Public

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here may be some of you that are thinking that HIV is not a big issue here in the UK; that the much-feared plague of death that people were expecting in the very early 1980s did not happen, and that everything is pretty much under medical control. While on the surface this may seem true, this obscures the many considerable challenges that people living with HIV in the UK continue to face. It was evident from the very early days of the discovery of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) that they were associated with considerable psychological, social and political challenges. Since the start of the HIV epidemic, the disease was associated with groups of people already stigmatised, even denigrated, by society. Susan Sontag (1991), writing about the metaphors associated with HIV and AIDS, observed how these were often associated with notions of sin and punishment. Before HIV was identified, the syndrome later known as AIDS was first referred to as the ‘gay cancer’ or gay-related immune deficiency (GRID). It was constructed as the ‘gay plague’ come to punish the immorality of ‘gays’ as well as prostitutes and drug addicts. We have certainly come a long way since then (see ‘Milestones’). There is a greater level of knowledge and understanding about HIV, its transmission and prevention, and improved care and treatments. With improved medical treatments, HIV has become, for many, a chronic, manageable illness, rather than the death sentence that it was seen to be. While some people may still think of

Over the past 30 years of the HIV epidemic, many advances have been made in HIV treatment and care, and HIV is now considered to be a chronic medical condition rather than the fatal illness it once was. People living with HIV are able to live longer, healthier lives. However, stigma remains a significant problem. The stigma of HIV also intersects with other traits, behaviours and identities that are considered undesirable. This article takes a brief look at some of the more significant issues here in the UK, focusing specifically on stigma and its impact on mental health. Research has shown that mental health is an important component in HIV care, and greater attention to this is needed, at this time of great economic uncertainty. HIV requires a multidisciplinary response, and psychologists from a variety of subdisciplines have much to contribute.

Health, 94(7), 1133–1140. Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Harmondsworth: Penguin. Health Protection Agency (2012). HIV in the United Kingdom: 2012 Report. London: Health Protection Agency. Hogwood, J., Campbell, T. & Butler, S. (2012). I wish I could tell you but I can’t: Adolescents with perinatally acquired HIV and their dilemmas

HIV as a ‘gay disease’, HIV and AIDS has gradually come to be decoupled from men who have sex with men (‘gay AIDS’). However, while the HIV epidemic grew exponentially in poorer regions of the world, particularly in sub-Saharan Africa, HIV and AIDS has come to be associated with Africa (‘African AIDS’). The HIV epidemic is perhaps the biggest global public health crisis facing us today, particularly in sub-Saharan Africa, with 34 million HIV-positive individuals worldwide at the end of 2011 (UNAIDS, 2012). After three decades of the HIV epidemic and advances in medical treatment and care, we may think that all is OK, certainly here in the UK. While statistically the HIV epidemic in the UK is small, it is still a significant problem, and, unfortunately, has continued to grow. At the end of 2011, approximately 96,000 people were living with HIV in the UK, of whom an estimated 24 per cent were not aware of their infection (Health Protection Agency, 2012). Challenges certainly remain: biological, psychological and social. Challenges to which psychologists can make a valuable contribution towards facing.

Stigma – continuing the othering HIV continues to be a highly stigmatised disease. Goffman (1963) provided a seminal conceptualisation of healthrelated stigma in which he considered it to be ‘an attribute that is deeply discrediting’ (p.13) and one which creates, what he termed, a ‘spoiled identity’. The mechanism for this process is a societal one by which difference (that which is undesirable) is identified and located in an individual or group. While there has been considerable investment in addressing the medical and behavioural aspects of HIV prevention, stigma prevention efforts are on the most part not as much of a priority. Because stigma may operate at the level of the individual and also at organisational and societal levels and may be affected by different cultural or national settings, it has been

around self-disclosure. Clinical Child Psychology & Psychiatry 18(1), 44–60. doi:10.1177/1359104511433195 Lampe, F., Speakman, A., Phillips, A., Sherr, L. et al. (2012). Depression and virological status among UK HIV outpatients. Paper presented at the British HIV Association conference, London, 18–20 April 2012. National AIDS Trust (2008). The myth of HIV health tourism. London: Author.

National AIDS Trust (2011). HIV: Public knowledge and attitudes, 2010. London: Author. Parker, R. & Aggleton, P. (2003). HIV and AIDS-related stigma and discrimination. Social Science & Medicine, 57(1), 13–24. Sengupta, S., Banks, B., Jonas, D. et al. (2011). HIV interventions to reduce HIV/AIDS stigma. AIDS & Behavior, 15(6), 1075–1087.

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with gay men, an already stigmatised group. In recent years, there has been a gradual shift to associating HIV with 1981 USA reports first AIDS cases in gay men Africa, and, in the UK, 1983 HIV virus identified African men and women. 1987 UK government ‘Don’t Die of Ignorance’ campaign According to official 1988 World AIDS Day established statistics, there has been an 1991 Freddie Mercury dies of AIDS-related illness increase in HIV prevalence 1992 First combination therapies introduced acquired through 1995 AIDS diagnoses in the UK exceed 10,000 and >25,000 ‘heterosexual’ living with HIV transmission. Research 1997 Deaths amongst PLWHA fall with introduction of antisuggests that the majority retroviral therapy (ART) of HIV infections in the 2000 Routine antenatal HIV testing introduced across UK UK that were acquired 2000 >30 million PLWHA worldwide through heterosexual sex 2001 First criminal trial for reckless transmission of HIV held were probably acquired in in Scotland African countries, 2002 Global fund is established to boost response to HIV, TB particularly the highand malaria worldwide prevalence countries of 2010 US HIV travel ban ends sub-Saharan Africa (Sinka 2011 HIV ‘treatment as prevention’ hailed as major breakthrough et al., 2003). The reporting of ethnicity in such healthcare system. Thus many members statistics is controversial, and may lead to of the general public might think that HIVeasy stereotyping. Social discourses prevail positive migrants arrive in the UK knowing about ‘health tourism’: the notion that their status, and with the intention of certain migrants are understood as coming accessing free health care. However, these to the UK in order to access free health myths of HIV-related ‘health tourism’ are care, and in so doing, abusing the British not supported by data, which suggests that the majority of migrants only learnt of their HIV status some time after arriving in the UK (National AIDS Trust, 2008). Furthermore, HIV anti-retroviral medication may have side-effects that result in physical stigmas. One such sideeffect is lipodystrophy, where there are changes in body fat. An individual may lose body fat, such as in the face, leading to a gaunt appearance. An individual may also gain body fat in certain areas, such as in the neck and shoulders. This results in visible stigmata for individuals, and is a considerable body-image concern for people living with HIV. Much of the stigma research to date has focused on changing negative attitudes towards people living with HIV or AIDS (PLWHA), and HIV-positive adults’ perceptions of stigma and its impact on their physical and psychological wellIgnorance = Fear, 1989. HIV continues to be a highly stigmatised disease difficult to measure the extent and impact of stigma, both on individuals living with HIV and wider healthcare and societal structures (Sengupta et al., 2011). Parker and Aggleton (2003) further argue that stigma is not a static process but rather one that is constantly changing and is fundamentally underpinned by power. In this conceptualisation power can be economic, social or political, but the purpose of stigma is to enhance and reinforce social inequality and to marginalise those who are identified as different and undesirable. The effects of stigma may also be a layered experience. This idea refers to HIV being particularly prevalent in certain groups or associated with sexual behaviours or drug-using behaviours, all of which are already stigmatised. In this way HIV stigma also becomes attached to other ‘traits or behaviours that are undesirable’ (Swendeman et al., 2006, p.502). This interaction of HIV and personal characteristics that may already have stigma attached to them provides a context in which the importance of the individual factors become blurred and stigma is experienced at many levels. From the start HIV has been associated

Milestones

Sherr, L., Clucas, C., Harding, R. et al. (2011). HIV and depression – A systematic review of interventions. Psychology, Health & Medicine, 16(5), 493–527. Sinka, K., Mortimer, J., Evans, B. & Morgan, D. (2003). Impact of the HIV epidemic in sub-Saharan Africa on the pattern of HIV in the UK. AIDS, 17, 1683–1690. Sontag, S. (1991). Illness as metaphor and

AIDS and its metaphors. London: Penguin. Swendeman, D., Rotherham–Borus, M.J., Comulada, S. et al. (2006). Predictors of HIV-related stigma among young people living with HIV. Health Psychology, 25(4), 501–509. UNAIDS (Joint United Nations Programme on HIV/AIDS) (2012). Global Report: UNAIDS Report on the Global AIDS Epidemic – 2012.

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Geneva: UNAIDS. Weatherburn, P., Keogh, P., Dodds, C. et al. (2007). The growing challenge: A strategic review of HIV social care, support and information services across the UK. London: Sigma Research. Williams, E. & Catalan, J. (2009). The changing profile of mental health problems in people with HIV. Psychological Medicine, 8(6), 216–222.

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CATHY CRAWFORD AND PUPILS FROM

DRUMMOND COMMUNITY HIGH SCHOOL (WWW.HIVALWAYSHEAR.ORG)

Working with people living with HIV I began my qualified career as a clinical psychologist in a Sexual Health and HIV Service in Scotland in early 2009, having worked with a variety of longterm conditions prior to and throughout my extended doctoral training. I was reassured by colleagues that I had many transferable skills (e.g. biopsychosocial assessment, formulation, working with health beliefs, adherence issues, individual and systemic responses to a diagnosis, etc.) to put to good use in my first post and that the progressive nature of the specialist field I was launching my career in would keep me enthused for some time. After four and a half years, these words still hold true and my diverse role continues to captivate me daily. Referrals include adults and older adults who are HIV positive from a multitude of backgrounds and cultures. Presenting difficulties (often unrelated to HIV) cover such a broad spectrum of issues that formulation is a truly fascinating process. Many patients have a mental health history (sometimes unrecognised) and experiences of social discrimination long pre-dating their HIV diagnosis, whilst the emotional struggle of other patients can be a very new experience. Individual therapy

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may focus on issues such as adjustment to HIV, adherence to anti-retroviral therapy, disclosure and stigma worries, sexual health and sexual-risk-taking concerns. However, at times, the focus instead relates to difficulties such as anxiety, depression, selfesteem, substance misuse and/or trauma, just as in any other mental health setting. Having helped to deliver various selfmanagement groups for patients with other long-term conditions in the past, I had not quite anticipated the complexities that setting up group work in an HIV service might entail, given disclosure concerns for many who remain intensely private about their condition. Another hugely fulfilling part of my role is consultancy with colleagues. This can involve sharing the key, relevant themes of a formulation and the context of an individual’s HIV diagnosis with those most involved in their care or, when appropriate, consulting with the wider healthcare system to inform patient understanding and management. Being based and embedded within the service with easy access to colleagues certainly facilitates this important part of my job. In addition, I work closely with colleagues from a variety of voluntary sector agencies that provide invaluable

services, such as advocacy, employment advice and peer support to many of our patients. It has been really interesting coming into an area where science is progressing at speed and the meaning of a diagnosis has so quickly changed from one of a terminal illness to a longterm condition with a more or less normal life expectancy. Although the rapid developments from HIV research have undoubtedly benefited the lives of HIV patients hugely, it has been striking to observe some of the trickier issues that have accompanied such changes. Long-term survivors of HIV, who were diagnosed before antiretroviral treatment was available, have shared with me how difficult it has been for them to adjust to the changing nature of care offered. Having previously received intensive support from well-resourced services set up in response to the HIV epidemic, progress in treating the condition coupled with the current economic climate has meant that such concentrated input is now generally deemed unnecessary and no longer possible. For some of these patients, this new, more time-limited, self-management approach can therefore be extremely difficult to engage with. Interestingly, some healthcare providers working in the field

since the earlier days of HIV have also found this a difficult transition. The changing economic climate, resulting in a dramatic overhaul of the benefits system, has also had other knock-on effects on my work, and benefits worries are increasingly a topic high on my patients’ agendas. Many HIV patients, who were previously led to expect financial support for years (and sometimes for life), are now being ushered to work. Whilst in countless cases, employment seems to be in patients’ best interests, it is unsurprisingly an exceptionally daunting prospect for those who have not worked for years during which the employment landscape has changed dramatically. My experiences to date have shown me firsthand the value of a close working relationship with my medical colleagues as part of effective HIV treatment. When patients’ mental health issues are identified and effectively treated, their ability to adhere better to their anti-retroviral medication, reduce their high-risk behaviours and/or engage fully with society again can be remarkable. It is these kinds of improvements in patients’ quality of life that attracted me to our profession and this specialty in the first place. Dr Audrey Matthews

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being. Interventions have sought to change negative perceptions of people with HIV through mass media campaigns, education about transmission and enactment of laws to prevent discrimination. However, UKbased research suggests HIV-stigma is stubbornly resistant to change. The National AIDS Trust reported that in their 2010 survey of 1944 adults, 64 per cent of respondents agreed that there is still a lot of HIV stigma in the UK (NAT, 2011). While there is some evidence that psychosocial interventions may reduce stigmatising attitudes and behaviours towards PLWHA (Sengupta et al., 2011), surprisingly little is known about the efficacy of such interventions in demonstrating a public health benefit (such as increasing access to testing and treatment, improved mental and physical health outcomes or increased social support for PLWHA). Psychological interventions to address or counter the negative effects of stigma amongst PLWHA are even rarer and suggest that this is an area in which psychologists have expertise, given the extensive literature about interventions to help other populations (e.g. people with intellectual disabilities, those with psychosis) cope more effectively with others’ prejudices and negative attitudes toward them.

Living with a ‘spoiled’ identity There is increasing acceptance that HIV stigma has complex and mostly negative effects on people living with HIV. Stigma can be a barrier to accessing HIV testing and HIV-related health care, and may result in poorer social support and poorer mental health in people living with HIV. Additionally, fear of disclosure of status to others may affect adherence to antiretroviral therapy (ART). From the start of the epidemic, mental health problems have been associated with HIV and AIDS. Mental health problems were traditionally understood as associated with the various risk factors (e.g. drug use) for HIV infection. It was also recognised that receiving a diagnosis was psychologically traumatic, in that there were severe consequences of having HIV, including the resulting denigration and exclusion from a broader society. AIDSassociated dementia was also a significant problem for patients with AIDS in the early days. With the arrival of anti-retroviral treatment, the profile of mental health problems associated with HIV has shifted to those associated with living with chronic illnesses (Williams & Catalan, 2009). Organic problems associated with AIDS have declined as fewer people progress on to AIDS, and other mental

disorders such as depression and anxiety have increased. In our clinical work with people living with HIV (see ‘Working with people living with HIV’), stigma remains a central concern for HIV-positive individuals. Fear of rejection and actual rejection leave many feelings isolated and lonely. A further central concern for many is the damage to their sexual identity and sex lives. Many of the clients we see may want to have sex, but find it very difficult to find opportunities with potential sexual partners. They have either experienced rejection from potential partners, or fear rejection if they disclose their HIV status. This is a particularly salient concern for adolescents living with HIV transitioning into adulthood (Hogwood et al., 2012). Some people living with HIV also struggle with feelings of shame, as a consequence of having become infected with HIV, which many in their family and social environment may continue to view as ‘punishment’ for immorality. As a consequence, receiving an HIV diagnosis, and living with HIV, has a number of adverse psychological and social consequences. Recent reviews of the international literature suggest that HIV-positive individuals have higher rates of depression, anxiety and suicidality than HIV-negative individuals (e.g. Sherr et al., 2011).

No HIV health without mental health Mental health has an impact on HIVprevention efforts for people living with HIV/AIDS. People living with HIV as a chronic illness on ART live longer and healthier lives, but may require support with regard to their long-term psychosocial needs and maintaining safer sexual behaviours. Studies have shown that where an individual has HIV and a co-occurring mental illness, their physical health suffers (Cook et al., 2004). Depression has also been shown to be a major barrier to HIV medication adherence (Lampe et al., 2012). Thus, meeting the mental health needs of people living with HIV has increasingly been recognised as a necessary component of HIV treatment and care. Recently, the British Psychological Society, together with the British HIV Association and the Medical Foundation for AIDS & Sexual Health have published Standards for Psychological Support for Adults Living with HIV (2011), which highlights the importance of identifying psychological difficulties among people living with HIV and providing interventions to promote mental health

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and well-being. The specific standards are: I Standard 1: Promotion of mental health

and psychological well-being I Standard 2: Comprehensive

psychological support services I Standard 3: Engagement of people living

with HIV I Standard 4: Support at time of diagnosis I Standard 5: Identifying psychological

support needs I Standard 6: Competence to provide

psychological support I Standard 7: Coordination of

psychological support I Standard 8: Evidence-based practice

This comes at a time of considerable uncertainty around HIV care in the NHS. There have been recent discussions in the UK about mainstreaming healthcare services for HIV, which has been critiqued as offering less specialised care to deal with the complex needs of persons with HIV (Weatherburn et al., 2007). Many symptoms of depression may resemble those of chronic HIV infection, and so may not be recognised by healthcare workers and GPs who may not be trained to detect mental health issues. The NHS is also witnessing significant budget cuts in these current times of austerity, which impact on the delivery of HIV prevention, care and treatment, including psychology. However, the HIV epidemic continues to be far from over, and its psychological impact also continues to be particularly felt in terms of concerns such as stigmatisation and depression. In the current climate, it is important that we do not lose the impetus of three decades of developing, promoting and delivering biopsychosocial models of care in HIV. Poul Rohleder is a Principal Lecturer at Anglia Ruskin University and, until recently, a Clinical Psychologist at Addenbrooke’s Hospital Poul.Rohleder@anglia.ac.uk I Tomás Campbell

is Consultant Clinical Psychologist and Head of Clinical Health Psychology, Newham Psychological Services Tomas.Campbell@eastlondon.nhs.uk I Jenny Petrak

is Consultant Clinical Psychologist (Locum), Department of Sexual Health, Homerton University Hospital I Audrey Matthews

is a Chartered Psychologist at the Chalmers Centre, Edinburgh Audrey.Matthews@nhslothian.scot.nhs.uk

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SOCIETY

President’s column Richard Mallows

President Dr Richard Mallows

Contact Richard Mallows via the Society’s Leicester office, or e-mail: thepresident@bps.org.uk

President Elect Professor Dorothy Miell Vice President Dr Peter Banister Honorary General Secretary Professor Pam Maras Honorary Treasurer Professor Ray Miller Chair, Membership Standards Board Dr Mark Forshaw Chair, Psychology Education Board Dr Catriona Morrison Chair, Research Board Professor Judi Ellis Chair, Professional Practice Board David Murphy 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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someone I did not know. When I asked Tony y track to this column starts with an Gale why he had done this, he said that he inspirational teacher. Like many in my thought I might stir things up a bit. I think it is generation, my first subject was not nevertheless a demonstration that in this sense psychology. In my case it was chemistry. As a at least the BPS can be a democratic body. teacher in a secondary modern school in the late A previous President, Gerry Mulhern, raised 1960s life was not easy. I had been introduced issues about to aspects of developmental democracy and the psychology whilst training, BPS. To increase but I thought there must be participation I would more to support the day to encourage members day work. I was lured by to register online in the reputation of a local order to vote evening class in psychology. electronically. The enthusiasm was I have long been pervasive and I was hooked. an enthusiastic The teacher was David supporter of The Legge. Psychologist, but David is of course well I expect each new known to those in the BPS President wonders as a former President and if anyone is going to Head of Office and he is read their column. still making an important Gerry Mulhern’s contribution to the Society. opening comment In his class I learnt to was that this column develop a degree of is eccentrically tolerance for ambiguity, placed. I think it still which I hope I passed on to is. I believe it should my students in subsequent A track with many junctions appear at the start of The decades. I also hope it will Psychologist together with be helpful in my current members’ letters. This role. would reduce in a symbolic fashion the distance The next step was another evening between the President/Board of Trustees and institution Birkbeck College, University of those for whom we are working. London. Apart from the excellent teaching, By the time this column has appeared I will Birkbeck helps develop perseverance, resilience have carried out my first official engagement as and broad shoulders, all useful career assets. President at the Wessex Branch AGM, some After Birkbeck the threat of being sent on three days after assuming office. I hope to visit secondment for six months to Ceausescu’s as many networks as I can during what will be Romania to teach computing sent me scurrying a shortened year of office due to the AGM being for employment closer to home. I arrived in restored to its better place at the Annual York expecting to stay for five years. I like the comment in a recent obituary in The Psychologist Conference. I look forward to my term in office and about an educational psychologist who, when would like to thank my predecessor Peter asked if he was still in Walsall, said that yes he Banister, who has handed on the BPS in good was in Walsall, but not ‘still’. That cheered me shape. I hope that likewise I will do the same up after 40 years in York. for my successor Dorothy Miell. It would have Over those years I have had an on-off been difficult in my institution to take the time relationship in terms of being an active to be President, but I have been fortunate to be participant with the BPS. For the last five able to retire from full-time work. I hope that years I have been Honorary Treasurer, having my experience, particularly contact with young previously been involved at a postgraduate people throughout my career and my active level, Branch, Section and Council level and participation in the BPS will help me to as a trustee. I became a Trustee having been understand issues facing the membership. proposed at a Representative Council by

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Ten things you didn’t know about the new President Richard Mallows

Qualifications In my final year as a Head of Department I went on an intensive evening class for two evenings a week for a year. When asked to guess the subject, my students suggested it ought to be IT, given my skills, but was more probably a language – French. At the end of the year I was very proud to receive my City and Guilds Certificate in Bricklaying.

Sartorial eccentricity I wear sandals all year round regardless of the weather. In the late 1980s I had the chance of a six-month sabbatical and I wanted to work with occupational psychologist Cary Cooper, whom I knew by reputation. I heard he would be at the annual CIPD Conference in Harrogate. I was coerced into shoes for this potential meeting. As I searched the conference venue I began to feel queasy, not helped by seeing peculiar yellow bits on the vivid green carpet everywhere I went. By the time I found Cary I was very lop-sided and had realised that the sole of my elderly but unworn shoe had split and spilled its contents. That meeting completely changed the direction of my research and teaching interests for the remainder of my career.

mid-1990s was astounded by what he described as empathy avoidance in two of his colleagues, whilst a case study on a mature student’s severely epileptic son resulted in continued funding by the local authority. One of the most revealing was being left-handed in the army.

Favourite ‘psychology’ book The book which inspired me to study psychology was a slim volume, Group Performance by James Davis published in 1969. I took it with me to my first Social Psychology Section annual conference at Durham where I was to give my first paper. I duly obtained his autograph. Twenty years later at the section’s annual conference at Sussex University Davis was again a speaker. Having had no contact in the interim, he told me that he remembered me because on his return to the USA he had been able to tell his children that there was at least one person who liked his book. He even remembered what I was wearing!

Music and film Although having an eclectic musical taste, one of my favourite composers is Vivaldi. There is an emotional synergy between the Vivaldi pieces used by François Truffaut and his film L’Enfant Sauvage. Although I continued to illustrate my lecture about Victor of Aveyron with coloured photographs taken at pertinent locations in France, the student’s threshold for black and white films diminished rather sadly over time. I suspect some also prefer the metal band Gojira’s version to Vivaldi.

Foreign affairs

I have family relations in both the Falkland Islands and Argentina. During the conflict my aunt in Buenos Aires accommodated the BBC correspondent, much to the Retirement leaves new President consternation of other family members. up in the air Puffer-nut Closer to home, following a summer holiday, This description I heard recently sounds much when my teenage son said he did not want to friendlier than train spotter. I have always been interested in steam go to France again, we returned home to find we were able to shake trains, although not in the same league as rivet counters. I am hands with him inside without opening the front door. Our first building a model railway based on the Southern Region circa what thoughts were that this must have been the ultimate teenage party. we call era 5 1957–1966. This project, basically a giant problemWe moved out. The house was pulled down and rebuilt on a tensolving exercise in miniature, is on hold not being compatible with metre deep concrete foundation. my BPS commitments.

All over the place My first memory is being in Bombay shortly after India’s independence, where I saw and experienced completely out of the ordinary events for an English infant. I have travelled to every continent and over a third of the world’s 230 countries. If I had to choose a representative souvenir it would be a rug made by a Muslim and bought in Peshawar, Pakistan. The rug contains red crosses in recognition of help that the maker received from the Red Cross. I find that symbolic and optimistic. Whilst in Peshawar I looked out of a classroom window expecting to see children in the playground but instead found myself looking at a tented city of one million Afghan refugees – a literal eye opener.

“xx”

Teaching Throughout my teaching career whether in secondary school, private business or in HE I have been an advocate of the small-scale research project, but the area investigated had to come from the student. Some second-year undergraduate work-based projects led directly to jobs, others indicated surprising gaps in research data. One survey of the disabled in York culminated in very significant changes in access to the city for this group. A part-time nurse in the

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Classics I own what is politely called a classic caravan. It is now 43 years old and it has travelled over 100,000 miles. It has a door on either side which is my excuse for taking it on the continent, as far as Gibraltar in one direction and Santa Maria di Leuca in another, any direction that is south. Fuel costs have rather restricted its current range (no contest with cheapo airlines) so the next trip is probably Land’s End.

Retirement One of the joys of retirement is it is easy to say ‘Yes’, although caution should be exercised. I have found myself doing a number of things for the first time. What I thought was going to be a forest walk in northern Argentina turned out to be abseiling down a waterfall at Iguassu Falls and zip wiring from one tree to another in the tall forest canopy (see photo). I do not like heights! Having been trained as a small child in the tropics that all animals were rabid, I now find myself each year looking after a friend’s small farm on the coast in Wales whilst they have a holiday. The sixty sheep, dogs, cats, goats, chickens, ducks, rabbits, guinea pigs and AGA all have to be kept alive until their return. And then there is my garden…

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WELFARE FUND The history of the Fund ‘While the Society’s Royal Charter encourages its charitable activity in supporting psychology, it does little to support psychologists’ (opening statement to the notice that application had been made to the Charity Commissioners for registration as a charity). This lacuna having been recognised, the BPS Welfare Fund was duly established in 1993. An inaugural meeting was held on 14 December with five Trustees in attendance and Professor Rob Farr was elected Chair. In 1999 he resigned due to ill health, and in the absence of any other candidate I became Chair. In 2006 the Society Trustees decided to replace the Fund Trustees, six were recruited and appointed and an inaugural meeting took place on 28 September 2006. From the outset of my time as Chair it became clear that the Fund’s resources were woefully limited. Relying on voluntary and spontaneous donations from members, the most ever at the Fund’s disposal was £2016, at one time the balance was down to £10, and grants to deserving applicants fell far short of what was needed. In September 2000 an advertisement appeared in The Psychologist appealing to members to contribute something, either as an annual or as a one-off contribution. This did, eventually, result in more money being available, and since 2004 the yearly balance has varied between £10,009 and £18,110. So after considerable fluctuations the Fund has been in a much healthier state and has been able to make more generous and appropriate payments to those in need.

Applicants Many applicants have had physical or mental disabilities, either themselves or in the family, and many, the majority female, have been single parents. A number have lost their jobs, some of these having been embroiled in disputes with employers. For many their problems have resulted in their being burdened by unmanageable debts.

Beneficiaries Between 2005 and 2011 a total of 41 people have been helped by the fund, averaging about six a year. Average grants were about £750, the largest given being £2000. To summarise, the Fund has, to some extent at least, fulfilled the purpose for which it was established, that of offering help to any psychologist in need, not just Society members. That help, although always welcomed and appreciated, has virtually always been less than what was truly needed. It is to be hoped that more of the Society’s more fortunate members will feel able to support the Fund. Even a minuscule amount – £1 annually from every member – would enable substantial, realistic support to be provided to those who at the time need it. Anyone looking for help from the Fund should apply to Russell Hobbs at the Society’s headquarters. Those who would like to contribute should add the amount to be offered to their yearly subscription, or, if a one-off donation, send it to Russell Hobbs. Grateful thanks to the Trustees (Professor Ann Clark, Professor Pat Howlin, Professor Marie Johnston, Roger Miles, Professor Barbara Tizard, and Dr Peter Wright) whose tireless and invaluable work has enabled the Fund to function at its maximum capacity.

Janet Carr

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Research assistantships The Society’s Undergraduate Research Assistantship Scheme provides up to 12 researchers with the opportunity to provide an undergraduate with ‘hands-on’ experience of research during the summer vacation, to gain an insight into scientific research and to encourage them to consider an academic career. The project must provide real benefits to the student and give them tangible training and career development support. The Undergraduate Research Assistantship Scheme is a prestigious award that marks out a student as a future researcher and potential academic. It is hoped that the senior researcher, to whom the award is made, will develop the RA’s potential and interest in research. Students will be provided with the opportunity to engage in a defined research project for six to eight weeks of their summer vacation. This will enable them to not only gain insight into scientific research as a career, but importantly, will also give their CV a distinctive edge. Supervisors will be able to conduct a specific research project during the summer vacation, but it also presents an opportunity to demonstrate a commitment to science and education by supporting the research assistant. It is intended to help identify potential PhD students as well as providing early mentoring experience for existing PhD students, postdocs, etc. The 12 winners of the 2013 award are: 1. Dr Kate Bennett at the University of Liverpool with Marianne Erskine-Shaw for the project ‘Does intoxication influence environmental effects on drinking behaviour?’ 2. Dr Victoria Bourne at Royal Holloway with Domicele Jonauskaite for the project ‘Exploring the neuropsychological processing of emotion and mood in mothers during and after pregnancy: A longitudinal study’. 3. Dr Lucy Cragg at the University of Nottingham with Sarah Maddison for the project ‘The development of cognitive control in the social domain’. 4. Dr Katherine Berry at the University of Manchester with Isabelle Butcher for the project ‘The impact of a ward based intervention on violence and aggression in people with psychosis: a case note review’. 5. Professor Susan Wilkinson at Loughborough University with Kathrina Connabeer for the project ‘Anger, conflict and disagreements in calls to a child protection helpline’. 6. Katie Slocombe at the University of York with Lauren Hogan for the project ‘Is it just apes that ape? An investigation of social learning in parrots’. 7. Mhairi Bowde & Viv Brunsden at Nottingham Trent University with Holly Walton for the project ‘An exploration of place identity, memory and well-being in individuals with Alzheimer ‘s disease’. 8. Dr Margaret Martin at the University of Glasgow with Rusne Kuliesiute for the project ‘Sleepless in Scotland: How do patterns of sleep disruption interact with mood and paranoia?’ 9. Dr Richard Stephens at Keele University with Amy Zile for the project ‘Swearing as emotional language’. 10. Dr Niall Galbraith at the University of Wolverhampton with Jodie Betham for the project ‘Adolescents’ misconceptions of psychology and the relationship with help-seeking’. 11. Dr Nadja Heym at the University of Nottingham with Sarah

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A bath full of ideas and theories The Psychologist celebrates its 25th anniversary this year (see the January issue). To mark this with a strong presence at the Society’s Annual Conference in Harrogate in April, Managing Editor Dr Jon Sutton commissioned two artists to create a special Psychologist bath. Debora D’Auria (Head of Psychology at Southend High School for Girls) and James Townsend had already produced a psychology bath (see tinyurl.com/psychmagbath), layered with pages from textbooks and with a shower tap that played audio of lectures. For the Annual Conference, they produced an entirely new tub layered with covers, images and articles taken from back issues of The Psychologist. Rather than playing audio, the shower head was adapted to record the thoughts of those who sat in the bath. D’Auria said: ‘Archimedes is said to have exclaimed “Eureka!” in the bathtub. This is a bath full of ideas and theories. I wanted people to stop and pause for just a moment, to think about The Psychologist, psychology more broadly, and perhaps even their own psychology.’ The audio from the event is now available at www.thepsychologistbath.org.uk. Dr Jon Sutton says: ‘Once you get past a few minutes of me droning on, there’s some really interesting stuff about the last 25 years and what The Psychologist means to people. And you really can’t miss sports psychologist Dave Shaw singing an especially adapted Bobby Darin classic!’ Many thanks to all those who took the plunge, and who are continuing the conversation on Twitter, following @psychmag

James Townsend and Debora D’Auria

and using #psychmag25 to reflect on the past 25 years of psychology, The Psychologist and what the next 25 might hold. At the end of this anniversary year, we will be looking for a good home for the Psychologist bath. You could add a glass top to make an excellent coffee table, make use of the recording facility to gather data, or even use it as a bath! All offers considered – get in touch with Jon on jon.sutton@bps.org.uk to let us know how you would make use of it.

EFPA changes editorial direction The European Psychologist, which is the official organ of the European Federation of Psychologists’ Associations and supported by other organisations of psychology in Europe (including the British Psychological Society), is changing. Managing Editor Kristen Lavallee told us: ‘First, we are changing the editorial direction of the journal. Starting this year, EP will be publishing almost exclusively integrative and review articles (rather than single empirical studies). It is intended to be a showcase for cutting-edge research across Europe. Second, we have a new

section called EFPA News and Views. Part of this section will include quarterly updates from EFPA member societies from across Europe. Veronika Polisenska (v.polisen@gmail.com) has organised a network of national news correspondents from each country, who will regularly contribute updates on legal, policy and other matters from individual countries in order to better connect the member societies to each other. If you or anyone you know from the UK would like to contribute to this section, please get in touch with Veronika or your local news correspondent. Finally, Hogrefe has

Olin for the project ‘Individual differences in reinforcement sensitivity as underlying mechanism in decision-making and risk-taking behaviour in children’. 12. Dr Myra Cooper at the University of Oxford with Alexandra Pike for the project ‘The influence of a single dose of fluoxetine on anger processing in healthy volunteers’. To be eligible to receive a Research Assistantship award, students must be completing a Society-accredited undergraduate degree (or equivalent) in psychology, considering research as a career,

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updated the look of the website and the journal cover. Hogrefe offers an open access option to all authors (http://hogrefe.com/openmind). Further, plans are in the works to have translations available of published abstracts in order to increase accessibility.’ The first issue with the new style content and new layout is available free at www.hogrefe.com/periodicals/europeanpsychologist and Hogrefe is offering one year of free access to The European Psychologist for all participants in this month’s European Congress of Psychology in Stockholm.

expecting to achieve a 2.1 or a first class degree and be finishing the penultimate year of their degree and due to start their final year following the completion of the project. In addition, the supervisor must be employed in a UK Higher Education Institution, the same one as the selected student, and be at least a Graduate Member of the British Psychological Society. The next round will open in late November and close in early March 2014. More details, including application and full criteria will be available nearer the time.

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New professional indemnity requirements The Department of Health in England recently consulted, on behalf of the four UK Health Departments, on draft legislation that would see the introduction of indemnity arrangements as a condition of registration for health professionals. In order to be registered with their respective regulator, professionals would be expected to have indemnity arrangements in place. This requirement is as a result of the need for the UK government to transpose an EU Directive into domestic law and needs to be in place by Friday 25 October 2013, subject to the legislative timetable. The Health and Care Professions Council (HCPC) responded to the Department of Health consultation and you can read their response at tinyurl.com/pombse4 The HCPC anticipates that the majority of their registrants ‘will already be able to meet these requirements as they will be indemnified either through their employer, a professional body, directly with an insurer or a combination of these’. They emphasise, however, that it is important that professionals understand their responsibility to have appropriate arrangements in place. Until Friday 2 August, the HCPC will be inviting comment on the proposals via online tool, by e-mail or in writing. Details will be posted at www.hcpc-uk.org/aboutus/consultations. I The Society offers reduced rates for professional indemnity via Towergate and Howdens

Update Service On 17 June the government’s Disclosure and Barring Service (DBS) launched a new service, called the Update Service. Individuals can choose to subscribe to the Update Service for an annual fee of £13, or free for volunteers. Their DBS certificate will be kept up to date so that they can take it with them from role to role within the same workforce. As a result millions of employees and volunteers will no longer have to apply for a new criminal record check each time they apply for a job. If an individual has subscribed to the Update Service their employer will be able to go online, with the

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PSYCHOLOGY4GRADUATES Registration is now open for the Society’s first ever Psychology4Graduates event, to be held at the Regent’s College Conference Centre on 14 November 2013. If you are you going to graduate from an undergraduate degree soon, or have in the last few years and are considering studying psychology at postgraduate level, this event is for you! Psychology4Graduates highlights the career opportunities available to you as a psychology graduate, with a focus on the routes to becoming a Chartered Psychologist. Talks from psychologists will let you hear about their careers and get an insight into what postgraduate study in psychology involves. In the interactive break sessions, you will have an exclusive opportunity to meet and mingle with established psychologists from all of the applied areas – a unique chance for you to get your questions answered in a friendly, relaxed environment. A detailed programme will be published soon but the event promises to be educational, informative and entertaining and will hopefully leave you feeling inspired and well informed about your future career in psychology. Delegate rates are discounted for members and places are limited so visit www.bps.org.uk/p4g2013 for more information and to register your place today.

SOCIETY NOTICES individual’s consent, and carry out a free, instant check to find out if the information released on the DBS certificate is current and up to date. The Society’s membership team provides standard and enhanced CRB checks for Society members who are living in England, Wales and Scotland. I See tinyurl.com/ot6wgba for more information

Postdoctoral Conference Bursary Scheme – Call for applications See p.495 BPS Annual Conference 2014, Birmingham See p.i BPS conferences and events See p.516 2013 CPD workshops See p.517 Leaving a legacy See p.535 Transpersonal Psychology Section Conference, Scarborough, 20–22 September 2013 See p.537

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Final Day Syndrome: reflections on presenting at the Annual Conference As a presenter at this year’s BPS Annual Conference, I was dismayed when I perused the timetable and saw that I had been allocated to present on the final day of the conference (Thursday 11 April). I have called this the ‘Final Day Syndrome’. There is nothing worse than spending the first couple of days watching others present their research, paranoid that my own presentation isn’t quite up to scratch! Also, watching difficult questions being fired at presenters can be alarming if not for the superb ways in which most presenters manage to answer these tricky enquiries. Indeed, it is the first time at a conference I have not been presenting in the first oral session of the programme. Previous years, I had been first to present after the opening keynote, which was great for three reasons. First, I wasn’t able to over-think it; that is, having not seen other presentations I couldn’t question my own. Second, I was able to relax thereafter and enjoy the conference without secondguessing my presentation and having to contend with pre-presentation anxiety for two days! Third, I could harness the excitement of being at a huge conference to present in an energetic manner, hopefully to the benefit of the presentation. So this year was different. But surprisingly (to me), presenting on the last day instead of the first was a blessing in disguise. I felt really relaxed and ready when I presented, which in part was probably because my colleague Matthew Slater had presented superbly on the previous day, and I was able to bask in some of his glory. I’m pretty sure he didn’t mind(!). Another contributing factor to my relative calm was how well the conference was organised, cramming enough into the programme to make it thoroughly worthwhile, while providing enough breaks so that I could network and meet researchers whose work I admire. For example, as a sport psychologist I was delighted to get to talk to Dr Paul McCarthy from Glasgow Caledonian University, whose poster on ‘re-evaluating the stigma of consulting a sports psychologist’ struck a chord with me and no doubt every other sport psychologist at the conference; and Dr Mark Allen from London South Bank

University, who has conducted some great research in an area I am interested in (challenge and threat states). I was also able to talk with Dr Andrew Manley who not only convened the fascinating ‘Interpersonal perception in sport and exercise contexts’ symposium, but also chaired the session in which I presented,

helping create an interesting and forumlike session where presenters and audience members were able to engage in discussion concerning all of the presentations. First, we had Kerry Schofield from forePSYte presenting ‘Is God necessary? A comparison of the psychological functions of religion and empiricism’, a fascinating discussion-type presentation which made me ask questions about mine and others’ beliefs. Next up was me. I talked about my research looking at how we can promote challenge states (adaptive psychophysiological reactions) in participants about to climb a climbing wall. As ever, I enjoyed the experience, and I was elated that the video of me climbing the wall (used as a stressor in my study) worked on the big screen! We then got an insight into the darker workings of the human mind with Loren Abell from the University of Central Lancashire talking about her research on ‘Machiavellianism, competition and selfdisclosure in friendship dyads.’ This was aptly followed by Gordon R.T. Wright from Birkbeck, University of London, who presented ‘The Dark Triad’s reputation for

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deceptive ability is a lie’. Both Loren’s and Gordon’s presentations were an intriguing insight into the behaviours and thought processes of individuals with traits that are misunderstood if not underresearched. I was very lucky to have presented in such an interesting and thought-provoking session. Overall, one of the biggest lessons I learned from this year’s conference was that the presentation I had arrived with was a work in progress, and through watching and experiencing others’ presentations I was able to alter not only my presentation slides, but also my presentation approach. I had the opportunity to be inspired by other presenters, and learn important lessons about presentation style. I felt more relaxed, less rushed, and more able to present in a balanced way. That is, having seen evidence of some of the amazing and groundbreaking research happening in the UK and around the world presented modestly, I realised that my research attempts to answer a small question, in a small area of research. Therefore, I didn’t feel that need to ‘oversell’ my work. I was able to present the research and more importantly respond to questions in a non-defensive manner. Maybe the Final Day Syndrome is not so bad at all. In fact, I hope to present on the final day next year! Dr Martin James Turner, Staffordshire University I Bursaries for Annual Conference are provided by the Society’s Research Board and are available to postgraduate students who are members of the Society and are presenting at the conference. Bursaries cover the attendance fee (excluding travel and accommodation). Successful applicants are requested to write a post-conference report. The application process opens each year in November in line with the conference programme timetable being published. Full details will be posted on the conference website at www.bps.org.uk/ac2014.

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Organised by BPS Conferences 2013

BPS conferences are committed to ensuring value for money, careful budgeting and sustainability

CONFERENCE

DATE

VENUE

WEBSITE

Psychology of Women Section

10–12 July

Cumberland Lodge, Windsor

www.bps.org.uk/pows2013

Division of Counselling Psychology

12–13 July

The Angel Hotel, Cardiff

www.bps.org.uk/dcop2013

Social Psychology Section

28–30 August

University of Exeter

www.bps.org.uk/social2013

Reading University

www.bps.org.uk/cogdev2013

2014

Joint Cognitive and Developmental Psychology 4–6 September Qualitative Methods in Psychology

4–6 September

Huddersfield University

www.bps.org.uk/qmip2013

Division of Health Psychology Faculty for Children, Young People and Their Familes

11–13 September

www.bps.org.uk/dhp2013

24–26 September

Holiday Inn, Brighton Mercure Bristol Holland House Hotel and Spa

Psychology 4 Graduates

14 November

Regents College, London

www.bps.org.uk/p4g2013

Psychology 4 Students (North)

21 November

Mecrure Hotel Sheffield

www.bps.org.uk/p4s

Psychology 4 Students (South)

4 December

Kensington Town Hall

www.bps.org.uk/p4s

Division of Clinical Psychology

4–6 December

The Royal York Hotel,York

www.bps.org.uk/dcp2013

Division of Sport & Exercise

16–17 December

Midland Hotel, Manchester

www.bps.org.uk/dsep2013

CONFERENCE Division of Occupational Psychology Annual Conference

DATE 8–10 January 7–9 May

VENUE The Grand, Brighton ICC, Birmingham

WEBSITE www.bps.org.uk/dop2014 www.bps.org.uk/ac2014

www.bps.org.uk/cyp2013

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2013 CPD Workshops Professional development opportunities from your learned Society The psychology of loneliness and belonging in school (DECP)

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Working with personality disordered offender clients in mainstream prison environments (DFP)

17 September

KidsWIN: Using a human givens approach to support children and young people’s mental health (DECP)

18 September

Tapping into the heart of leadership for counselling psychologists (DCoP)

20 September

Working therapeutically with children Part 1 (DCoP)

26 September

MBCT: Clinical applications for anxiety and depression (DCoP)

27 September

Vulnerable and challenging – What works in changing student behaviour (DECP)

1 October

Expert Witness: Presenting evidence in court (Level 3)

8 October

Working with individuals, families and couples facing childhood illness and death: A systemic and narrative based approach (DCP C&YP)

11 October

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14 October

Working with dementia and strokes

16 October

Supervision skills training: Workshop 2 – Enhancing supervision skills

18 October

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21 October

Expert Witness: The use of psychometric assessments for court (Level 4)

22 October

Complex trauma, structural dissociation and the body

25 October

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28 October

Working therapeutically with children Part 2 (DCoP)

31 October

How to improve your skills in client work: Learning to set and use an agenda and learning to set goals to improve therapeutic outcomes

1 November

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WHAT QUESTIONS DOES PSYCHOANALYSIS RAISE FOR THE NATURE OF SCIENCE? The Conference will contain a presentation by Tom Burns of his recent book on the nature of psychiatry Our Necessary Shadow (Allen Lane, June 2013); wide-ranging discussions of the relevance of the notions of paradigm and research programmes in the structure of science; and reference to the current discussions on the pertinence of DSM5.

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CAREERS

‘I’ve never made plans… I just follow my interests’ Ian Florance meets Ciarán O’Keeffe, aka ‘the parapsychologist’

recognised Ciarán O’Keeffe from his website photograph as he entered a coffee shop in Marlow, Bucks. We settled down and I mentioned that I was surprised by his website’s address: www.theparapsychologist.com. He smiled. ‘I suppose if you use that word to describe what you do, people often look at you strangely and change the subject.’ But Ciarán is more than a parapsychologist. We discussed his investigative psychology training and research, his clinical experience, the influence of a childhood interest in ghost stories and approaching

jobs online

www.psychapp.co.uk is now open to all. Advertisers can now reach beyond the prime audience of Society members that they reach in print, to include the many other suitably qualified individuals online. Society members have the added benefit of being able to sign up for suitable e-mail and RSS alerts, and we are looking to add more

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phenomena sceptically but not cynically. It’s not possible to cover everywhere Ciarán has lived and the different jobs he’s done but, to begin at the beginning… ‘I was born in Norwich to a Swiss mother and an Irish father. I lived in Norfolk, Somerset and then High Wycombe.’ Why did you do your undergraduate studies in Washington? ‘Well, I’d been a classical pianist since the age of four. My interest in music and performing is a continuing one. I did Maths, Physics and Music at A-level and became interested in sound recording. I applied to a number of UK colleges but ended up attending a Liberal Arts course at a small Maryland Liberal Arts College, double majoring in Music and Psychology.’ Why the focus on psychology? ‘I was interested in the psychology of performance, though I knew that I didn’t really have what it took to make my living as a musical performer. My other enduring fascination is parapsychology.’ How did that interest start? ‘I grew up reading ghost and horror stories, at a time when people like Clive Barker, Peter Straub and Stephen King were bestselling authors, but I also delved into earlier Gothic writers like Poe and Lovecraft. There was also an upsurge in films and TV based round the supernatural at the time – Arthur C. Clarke’s Mysterious

Worlds and the Ghostbusters films.’ Ciarán wanted his undergraduate dissertation to deal with his interest in parapsychology, but his tutors felt that was outside their area of expertise, and in the end his supervisor came from the Institute of Parapsychology (now the Rhine Research Center). In the US Ciarán had been encouraged to get experience in some sort of clinical setting. ‘One summer I worked in a psychiatric unit at Amersham Hospital. When I came back to the UK in 1994 after my degree, I became very interested in nursing. I worked in psychiatric nursing at Lewisham, Hither Green and Wycombe General. I had been thinking about doing a PhD and I was considering my next academic step and qualification in the background. I taught English in Spain for a while and it was there that I finally decided to “go for it”. I applied for master’s and got on the Investigative Psychology course at Liverpool.’ Ciarán tells me how investigative psychology originally focused on offender profiling but then developed a more systematic, scientific basis for all psychological inputs into criminal work, including investigation processes and legal aspects. ‘For instance it looks at how police make decisions or draw inferences from information. David Canter was running the Centre for Investigative Psychology at Liverpool when I was there.’ Ciarán describes getting involved in a lot of research during the course, ‘into areas such as the geo-spatial behaviour of serial killers, the psychology of fraud and the role of hypnotism in the legal system. But I was known as having this “weird interest” in parapsychology, the “Fox Mulder” of the unit. I started to research the language of psychics and mediums.’ That seems a big jump from his course. ‘Not really, I was struck by similarities between the language psychics use and that used by profilers. They’re both emotionally loaded and ambiguous yet beguiling. My master’s thesis looked at psychic detectives and their narratives.’

member-only benefits as the site develops over the coming years. Please let the Managing Editor know what features you would appreciate, on jon.sutton@bps.org.uk. Please help us to spread the word. Recruiters can post online from just £750, and at no extra cost when placing an ad in print. For more information, see p.526.

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careers

Before talking about his later career I wanted to ask Ciarán some more general questions about his interests. How does he typify what he does? ‘I’m an applied psychologist with an interest in a number of areas ranging from those covered by forensic psychology to parapsychology.’ As we touched on at the beginning, it must be difficult to get your interest in parapsychology taken seriously. ‘Yes, the word causes people to recoil. Some people say “It’s full of frauds and fakes, why bother?” Others assume you’re a “true believer”, maybe even a practitioner. But if you look at the academic history of parapsychology you’ll come up with a definition of the area which is something like the scientific study of the paranormal. I’m a sceptic. I shouldn’t need to say that, because I’m a scientist and that’s what scientists are. They question; they test claims. Let’s say someone has what appears to be a hallucination in a reputedly haunted house. Do we ignore it because to most people it seems obvious what’s happening? In fact plenty of “respectable” studies address the phenomenon of hallucinations since they might begin to explain why an illness happens, how you can treat it, what causes hallucinations. You might find out something about the way visual and cognitive systems work. You might even find out a particular instance wasn’t a hallucination at all. I’m a sceptic not a cynic, though people in the media often assume I’m cynical.’ Ciarán points out that he uses a particular methodology to investigate these phenomena ‘but there are cases, for obvious reasons, that are difficult to investigate in the laboratory. You have to go into the field to study the effects of the emotion and fear that participants feel when presented with phenomena they find impossible to explain or have learnt to react to in a certain way. My methodology is stringent but, since parapsychology draws in a rich variety of professionals – from historians and linguists to physicists and sociologists – you tend to be exposed to varied ways of approaching an issue. Increased acceptability of qualitative methods of research has helped here.’ At the end of his master’s course, Ciarán cooperated with Professor Laurence Alison to organise a one-day conference discussing the similarities between psychic detectives and profilers. James Randi, the magician and highprofile sceptic, gave the keynote and Richard Wiseman, Professor of the Public Understanding of Psychology at the University of Hertfordshire also spoke. ‘Richard had also done a study of psychic

detectives. He suggested I do a PhD which extended the study of language used across all parapsychological practitioners. I got about 50 per cent of my funding from a big sceptics society in the USA.’ Ciarán first got involved with the media during his master’s course, ‘but even more so during my PhD. I helped out with Richard’s laughter lab. In fact I announced the result of the research project to find the world’s funniest joke to the world’s media. I was dressed up as a chicken at the time!’ While doing his PhD, Ciarán also kept up his interest in music by doing research into infrasound, sound below the cusp of human hearing, investigating it in the context of two concerts at the Purcell Room, Royal Festival Hall (see also ‘Big picture’, November 2011: tinyurl.com/d3e8cdw). ‘After my PhD I lectured in criminal psychology and parapsychology at Liverpool Hope University and also spent some time working in France. I still have an unpaid research associate position at the Université de Toulouse, but I’m now employed at Buckinghamshire New University.’ I ask Ciarán how easy it is to get funding for research into areas like miracles, possession, mediumship and exorcism. ‘There are a number of organisations devoted to sceptically examining these phenomena who are prepared to fund them in a very small way. Writing popular books generates some money, and appearing on TV programmes such as Living TV’s Most Haunted and Jane Goldman Investigates provides further funding that I can put in.’ The latter income stream can be controversial. ‘Yes, I was involved in quite a firestorm when I was reported as questioning the veracity of a particular popular medium. I had to stress that I find out the facts, report them and let readers and, in certain cases, viewers decide. But media work has also helped grow my research participant pool.’ Some psychologists are very suspicious of working with the media. ‘You do get misrepresented at times but you don’t have to be taken over by it. It can be just one part of what you do and can have huge benefits for your work and for the institution you’re working in.’ Given his openly sceptical attitude I wondered why people who claim to have paranormal powers still agree to work with him. ‘For some it’s a way of finding out about whatever ability they think they have. For others it’s a badge of credibility to have been examined by a scientist, whatever the outcome. They

seek and advertise at www.psychapp.co.uk

tweet the event straight away.’ Presumably there’s also a fundamental ethical challenge for you in a lot of what you do. ‘Yes but again I try to take a scientific approach. There are some things that happen every day which you know are damaging to others and where you have to intervene. But take the case of someone who is claiming to get messages from a person’s dead spouse. Is that harmful? We assume it is, but we really don’t know. We need to research the effects. Of course if it’s deliberate fraud there’s no denying it is harmful and deceptive, but we’re also dealing with someone’s belief in mediumship and the afterlife. You can see a parallel with various religions. Yes, religious beliefs could be used to exploit the vulnerable, but some research suggest that such beliefs genuinely help certain people in specific ways.’ Ciarán also gets involved in field reviews of haunting experiences. ‘I come across cases where amateurs have gone in to a house and announced “You’ve got an evil spirit here”. At its most extreme this could trigger untreated psychosis. I’ve actually drafted some ethical guidelines for investigations into haunting.’ This issue of untrained people who can do real damage is obviously important to Ciarán. ‘There are about a hundred parapsychologists trained to an acceptable level. It’s a small field.’ And what are Ciarán’s plans? ‘I’ve never really made plans. Who knows what’s round the corner? I’ve always followed my interests, and seen where they’ve got me. I still keep my toes dipped in music. I’m very much entrenched in the investigative psychology and parapsychology areas, and I expect I’ll remain there. In many ways there’s more acceptance of the areas I work in than there was 10 years ago.’ This takes me back to why I wanted to interview Ciarán in the first place. One of the ways psychology has impinged more on the public consciousness is through figures like Derren Brown; and Hilary Mantel, the Booker Prize-winning novelist, has written on parapsychology (one of her novels is a penetrating study of a medium). Most recently, I’d seen an episode of the TV series Lewis depicting psychological students investigating the claims of mediums (with murderous consequences, given the programme). When I told friends I was interviewing a parapsychologist they expressed real interest. When I summarised Ciarán’s very reasoned account of what he does they were fascinated and surprised. Ciarán’s work reflects wider, contemporary interest in the work of psychologists.

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Counselling psychologists working with children, young people and families Counselling psychologists are increasingly taking up positions in the NHS and charitable sector working with children, young people and families. Counselling psychologist Dr Ioanna Petropoulou shares her experience of working within a charitable organisation and Deborah Kemp, a trainee counselling psychologist, tells us about her role within a Child and Adolescent Mental Health Service (CAMHS). worked for the Domestic Violence Intervention Project’s children’s therapy service at Stephen’s Place Children’s Centre, between the years 2011 and 2012. DVIP was founded in 1991 as a charity which offers a specialist service to individuals affected by domestic violence. Within five different teams, DVIP offers: risk assessments, specialist interventions for perpetrators of domestic violence and associated support services for women (additional services for the Arabicspeaking communities), supervised contact services, parenting assessments, therapy for children affected by domestic violence and specialist interventions for young perpetrators and their families/partners. My main responsibilities as a counselling psychologist at SPCC included offering therapy to children affected by domestic violence (DV), as well as conducting assessments and follow-up meetings with their mothers, and offering supervision to trainees. However, often my responsibilities extended much further than the typical clinical role of a counselling psychologist. The vast majority of carers bringing their children for therapy at SPCC were female survivors of domestic violence, perpetrated against them by their male expartners. These women were often in the middle of court proceedings and sought guidance in order to deal with practical issues, such as contact with the perpetrator and safeguarding. When there was no assigned social worker or DV support worker for the family, it became part of my role to offer the relevant guidance and to signpost mothers to the appropriate services. In addition, mothers

size fits all’ approach. Within were often this service, I worked from affected by their a child-centred/play-therapy own traumatic framework with strong experiences of psychodynamic DV and were thus underpinnings. This referred to other framework takes into professionals for consideration the conscious psychological and unconscious power and support. This control dynamics of DV. Play included referrals allows the child to enter a for parenting space in which he/she can courses, DV process inner conflicts and awareness approach relationships with courses and significant others, from a individual or psychologically safer distance family therapy. (Bromfield, 2003). Above all, Finally, several Dr Ioanna Petropoulou, the aim of therapy was to consultations with Counselling Psychologist, facilitate the child’s trust and mothers were Domestic Violence Intervention the formation of a robust arranged in order Project (DVIP), Stephen’s Place therapeutic relationship. This to offer guidance Children’s Centre (SPCC) is particularly vital when on parenting skills working with children exposed to DV, and to discuss any other issues that whose sense of trust and safety towards came up during their child’s therapy. adults has been damaged. Regular contact with other This was one of the most challenging professionals, such as school teachers, but, at the same time, fulfilling and social workers and GPs, was also an exciting experiences of my career as important part of the work at SPCC. a counselling psychologist. When the Very often during the course of therapy, dynamics of DV are re-enacted within disclosures were made by either the child the therapy room, the therapist may often or the mother, and child protection issues be left with the same emotions of needed to be dealt with immediately. powerlessness and despair that the child Therefore, close collaboration with social felt when he/she was exposed to an allservices was vital in order to keep the powerful, violent parent. Supervision and child and the family safe. support from colleagues played a great From a therapeutic point of view, the role in helping me to hold those tensions complexity of working with trauma and and to be able to offer a safe and abuse requires a more holistic/integrative containing therapeutic space to children. approach from the therapist that responds By the end of my work at SPCC, I was to each individual child’s needs. This is deeply moved by the changes that I saw particularly relevant to counselling psychology’s critical stance towards a ‘one- in these children and their carers.

If you would like to advertise a vacancy please contact : Giorgio Romano, 020 7880 7556, giorgio.romano@redactive.co.uk

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Deborah Kemp, final-year trainee counselling psychologist placement, Newham Child and Family Consultation Service (CFCS), Child and Adolescent Mental Health Services (CAMHS)

My work placement as a trainee counselling psychologist at Newham CFCS was part of a counselling service for adolescents that was an adjunct to the Family Therapy Team. I was encouraged to bring all of my therapeutic knowledge and skills to the table. This included my experience of working within child placements that were primarily play therapy-focused and drew from personcentred and psychodynamic theories. I also drew from my cognitive-behavioural therapy and integrative adult-work experience. I needed to be able to adapt my approach to working with adolescents, bearing in mind their level of cognitive understanding and the developmental concerns of the age group such as peer relationships and identity formation. At Newham I benefited from working within a multicultural environment and being part of a large family therapy team. Along with learning how to integrate more of a systemic and narrative focus into my work through supervision, I was able to take part in a family therapy training team and to form part of a reflecting team (Anderson, 1987) working with families. There were also opportunities for me to undertake initial assessments and to co-work with other therapists during family therapy sessions. There was a strong multidisciplinary and inter-agency feel to the work at Newham CFCS. The system surrounding each case was carefully explored and riskassessed. There was an emphasis upon effective communication with families and agencies supporting the young people and families and a focus upon informationsharing and accountability. Through this experience I developed

a greater appreciation of the need for flexibility within services working with children, young people and families. It seemed to be helpful to look at a range of options and to decide whether families were suited to family therapy interventions, or whether supportive counselling work for individuals, alongside family therapy or separate from family therapy was most beneficial. I found that holding and supporting families within the Family Therapy Team provided a multifaceted overview of the needs of each member of the family within the family context, in comparison to the perspective gained from viewing individuals in isolation.

Conclusion Counselling psychologists offer a unique contribution to therapeutic work with children, young people and families. This incorporates a flexible, adaptable and child-centred approach to therapeutic work. Counselling psychologists recognise that the unique, subjective experience of the individual is paramount and that wellbeing is fostered through the development of a therapeutic relationship. This approach, alongside a pluralistic stance, enables counselling psychologists to manage and respond to the multiple perspectives inherent in the work, as attention to communication, networking and collaboration is so fundamental for affecting change and supporting children, young people and families.

Clinical Psychologist London Competitive salary

Positive Behaviour Support Co-Ordinator South East ÂŁ18,430 PA

Clinical Neuropsychologist South East Competitive part-time salary

References Anderson, T. (1987). The reflecting team: Dialogue and meta-dialogue in clinical work. Family Process, 26, 415â&#x20AC;&#x201C;428. Bromfield, R. (2003). Psychoanalytic play therapy. In C. Schaefer (Ed.) Foundations of play therapy (pp.1â&#x20AC;&#x201C;13). New York: Wiley.

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The British Psychological Society Reach 48,000 readers as part of the publication for psychologists - a large, prime, well-qualified audience. Advertising is also now available on the Society’s award-winning Research Digest blog at www.researchdigest.org.uk/blog. There are also other online options, including the ‘featured job’ at www.psychapp.co.uk. All recruiters in the print edition of The Psychologist get their vacancy posted online at www.psychapp.co.uk at no extra cost. Members can then search by job type and geographical area, and then view full details online or via RSS feeds and e-mail alerts.

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Child and Adolescent Mental Health Service Outreach Service, Guernsey

Clinical Psychologist

Outside back cover 40% extra: Inside back cover 25% extra.

Guernsey G uernns nse seyy

Salary scale: up to £63,393 pa We require a Clinical Psychologist to provide a psychology service to young people and their families and act as team leader within the CAMHS outreach service. This service is part of an integrated team within specialist services. The post holder will provide direct therapeutic input to young people and their families as well as providing specialist clinical advice, supervision, and consultation to other professionals and will participate in the planning of the outreach service in liaison with senior managers. Applicants will have a postgraduate qualiﬁcation in Clinical Psychology with British Psychological Society accreditation as a chartered clinical psychologist / HCPC accreditation n as a clinical psychologist. Yo ou will have post-qualiﬁcation experience working with children and families as well as experience of working within multidisciplinary teams and carrying out liaison and consultation work. We are committed to your professional development and actively support participants in learning and development opportunities in Guernsey and the UK.

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We provide regular supervision, sion, team meetings and an annual appraisal. The post carries a 15 year licence and an attractive relocation p package. For more information about bout the post please contact Dr Penny Thompson, Head ad of CAMHS CAM or Dr James Murray y, Head of o Psycholo tel: 01481 701441. Closing Date: 21 July 2013 Please be advised that this post can be applied for via our new online application service at www.gov v..gg/jobs where you will also ﬁnd further information about the post. The E-Recruitment Team e can be contacted on 01481 747394.

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vol 26 no 7

july 2013

Managing Consultant, Talent and Assessment Competitive salary plus bonus and benefits London/South (home based) We’re looking for a highly skilled and experienced talent and assessment expert to design, develop and deliver solutions for existing and new clients, and make a signiﬁcant contribution to growing our reputation and revenue in the areas of talent assessment, talent development and talent strategy. This is a key role within Cirrus and a tremendous opportunity for an experienced consultant to join our fast-growing, successful organisation and to create innovative, large-scale solutions for blue-chip clients. You’ll be someone who can lead major client programmes, contribute to ambitious revenue targets and push boundaries to deliver high quality solutions at pace. A genuine thought leader, you’ll be bold, innovative and different, up-to-date with the latest research and developments in the senior executive and talent assessment arena. You’ll be commercially astute and well connected, with an ability to grasp corporate

Send your CV to jobs@cirrus-connect.com Find out more about the role and Cirrus visit cirrus-connect.com or call 01625 425 460

goals and HR strategy, understand commercial imperatives, and translate these into effective, profitable solutions. You’ll combine consultancy design, delivery and assessment experience with the ability to advise on talent strategy in line with organisational goals. Successful applicants will have a first degree with an HR or behavioural science specialism, and a business-related post-graduate qualification such as an MBA would be a bonus. Previous experience of a similar role within a consultancy specialising in talent assessment is essential.

We are also recruiting for a Project Manager, to ﬁnd out more visit cirrus-connect.com/careers

Job Title: Managing Consultant, Talent and Assessment Employer: Cirrus The design of Cirrus’s website reflects a creative, fast-growing company offering, as a home page, a set of 10 engaging, highly designed screens mapping out a consultancy journey. Rob Davies, Partner at the company, explains the organisation’s focus. ‘We’re a consultancy that capitalises on critical connections, creating leadership and brand engagement experiences that build reputation and deliver results. We believe that effective leadership generates much greater engagement with employees and customers, connections that are inextricably linked. Our approach drives greater commitment and improved performance.’ Cirrus was formed in 2010 and has grown quickly since. ‘Our core business is working with major organisations to develop leaders and engage employees with brand values; we also have strong digital capability as well as a creative team, which develops effective internal and external communications for clients. The company acquired talent and assessment specialists, Xancam, to strengthen its talent and assessment expertise alongside Cirrus’s existing leadership and engagement abilities. And that’s where this role fits in.’ I asked Rob what is attractive about this role and what opportunities it brings. ‘It’s a very exciting role, we want someone to come in and bring senior talent expertise into the business – to trailblaze. He or she will sell talent and assessment interventions to existing Cirrus clients and have an opportunity to work with leading companies, including M&S, Monarch Airlines, eBay, Arcadia and EE. We’re also seeking to generate revenue streams from new clients which will lead to further contribution to Cirrus successes.’ Will this person be driven purely by sales targets? ‘The role isn’t just about business development. We have a robust sales approach at Cirrus; being a good team player is essential to the role. We do want someone who’s comfortable in a business environment and in talking in a commercially pragmatic way: someone who can use their expertise to match solutions to clients’ commercial and business priorities. That’s why we’re looking for someone with a solid grounding in behavioural science, who already has real expertise in talent and assessment, but why some sort of business-related qualification would be an advantage.’ Presumably you’d prefer someone with relevant experience. ‘That’s essential. He or she must hit the ground running. They must be used to managing in-house consultants and external associates to deliver projects. And we have expansion plans involving a growth in consultant numbers so this is a great opportunity for someone to grow with the job.’

seek and advertise at www.psychapp.co.uk

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ABA TUTOR/LSA REQUIRED SOUTH LONDON.

Tutor required to work with a friendly 15 year old girl who goes to a normal mainstream school. Experience desirable but not essential as training will be provided. The successful applicant must enjoy children, be patient, and willing to learn a new educational method. Hours required: LSA at School on 2 WEEK DAYS, 8.25am to 6pm Home session on SUNDAY, 9am to 1pm Salary:

Commensurate with experience.

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Post 1

Clinical Psychologist (Essex) Salary dependent on experience, Hours negotiable Following successful appointment in Norfolk earlier this year Autism Anglia are looking for suitably experienced Clinical Psychologists with an understanding of the autistic spectrum to join our Therapy Team based in Colchester. We have one permanent, whole time equivalent post and we are happy to make these hours up by appointing a full time or two part time positions depending on interest. The initial focus will be on contributing to MDT assessments though there will be scope to develop other specialisms as the role develops. This is an exciting opportunity to join the organisation at a time of growth and expansion. Successful candidates will be registered with the HCPC.

Post 2

Assistant Psychologist (Norfolk) Salary ÂŁ17,700, FT To check the latest jobs please go to

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We are also looking to appoint a new Assistant Psychologist to work with our team in Norfolk under regular supervision. This is a full time, 12 month fixed term post based in Dereham. Closing date: 28th July 2013 (Please note we may stop taking applications for Post 2 prior to the closing date if we receive large numbers of forms). For Job Description and Application Pack please contact:

Dereham Office on 01362 853753. Please state on your form which post you are applying for and how many hours you would like to work. to advertise please contact: Giorgio Romano, 020 7880 7556, giorgio.romano@redactive.co.uk

See website www.autism-anglia.org.uk

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“It was when I was given the tools to manage my behaviour and make better choices.”

MY TURNING POINT

Reducing reoffending and creating safer communities – we are helping to achieve both at HMP Ashﬁeld near Bristol, a re-roled Category C prison for male adult sex offenders. Working in partnership with Serco and Catch22, we will be providing psychological interventions to offenders during their time in prison.

Forensic Psychologist (Area Operations Manager) c. £55,000

HMP Ashﬁeld, Bristol

This role calls for a powerful blend of clinical, managerial and organisational skills. Leading our Interventions Team and providing regular clinical and line management supervision, we’ll rely on you to lead the team to meet performance targets and manage the budget effectively, as well as operate at a more strategic level and promote effective partnership working. With a Doctorate in Forensic Psychology or equivalent and relevant experience within a secure prison environment, you’ll need in-depth knowledge of OBPs. For the right candidate we can offer ﬂexible hours and relocation assistance. To ﬁnd out more visit: turning-point.co.uk/workforus

Job Title: Forensic Psychologist (Area Operations Manager) Employer: Turning Point Nerys Anthony, Head of Justice and Performance at Turning Point, is excited about this job. ‘It’s a new project in which we partner with Serco and Catch22 to manage offending behaviour programmes at HMP Ashfield near Bristol. Ashfield is being re-roled to an adult male category C sex offender prison for 400 low- and medium-risk prisoners.’ Turning Point is a social enterprise which celebrates its 50th anniversary next year. It addresses a range of health and social care issues including mental health, learning disability, substance misuse, offending and employment. ‘We have expertise in supporting people with complex needs. I work in the substance misuse and offending sector within the organisation, but our interventions don’t just address drug or alcohol issues – we take a holistic approach to the whole person.’ Nerys stresses that ‘this is a genuine strategic leadership role. The Forensic Psychologist will liaise closely with the Interventions Manager, a forensic psychologist working towards chartership, who will undertake much of the operational management. The Forensic Psychologist will need to nurture and develop a varied and growing team. He or she will also be responsible for risk assessment, clinical governance, best practice and service standards. Budget control and meeting contractual performance targets are critical. We want someone who will keep up to date with latest thinking and use this knowledge to improve our services. Communicating with different audiences is also a core skill in the role since he or she will work with all our partners and advise varied individuals, groups and committees.’ I asked Nerys what sort of qualifications and experience a successful candidate would possess. ‘A doctorate in forensic psychology or equivalent is essential, as is up-to-date registration as a Forensic Psychologist. We’re looking for someone who can hit the ground running, with experience of leading an interventions team working with sex offenders within a secure prison environment. They must understand offender behaviour programmes and, in particular, sex offender treatment programmes. The role might suit somebody who’s done a similar job in a public setting but wants a new challenge.’ This is a pioneering role which has real development possibilities. ‘Turning Point operate from a number of prisons, for example HMP Thameside, but this is the first time we will be delivering sex offender treatment programmes in a prison environment. It’s a model for future projects. Its also a growing project as we’re expecting our targets and service team to grow.’ Nerys concludes: ‘We’ll look after the person’s CPD and if it’s important we’ll discuss flexible hours and a job share. But in return for support we’re looking for someone who can create and lead a major new project.’

seek and advertise at www.psychapp.co.uk

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REVIEWS

Participation in the garden The Chelsea Flower Show is not a typical venue for The Psychologist, so it was particularly interesting that at this year's centenary event psychologists were involved in a show garden. Not always obvious, given the predominance of plants and design, but psychology in collaboration with others. The 'Digital Capabilities' social media garden was created by myself and colleagues in Social Computing and Architecture at the University of Lincoln, and Harfleet the garden designers. The concept of the garden arose from a combination of my research interests in the psychology of people and their gardens and Shaun Lawson’s interests in people’s interactions through social media. Key to the garden design was to challenge typically passive engagement with flower show gardens by introducing interactivity and movement. The garden plot was small (6m x 3m) by Chelsea standards and was divided diagonally into two halves: an outer space filled with familiar plants in a cottagey style and an inner space filled with unusual tropical and subtropical planting. These were separated by the ‘Twitter wall’ made Chelsea Flower Show 2013 up of 20 motor-actuated panels Royal Horticultural Society controlled by a single raspberry pi computer, which accessed Twitter to determine volume of tweets around any given topic (e.g. #RHSChelsea; garden) and opened or closed the panel to reveal/conceal elements of the inner garden. In this sense, the garden’s behaviour was determined by the audience on Twitter, both on site and remotely. Also, tweets directed to the garden received a picture from the inner space. In the context of Chelsea this garden was certainly a novelty and provoked enthusiastic comments from the throngs of visitors, many of whom had seen the garden on TV and made it a specific destination. Even those professing little interest in social media were captivated by the ‘mesmerising’ movement of the panels, the planting and the concept of representing digital interaction in this way. The concept was a bit tricky to convey and required some explanation (‘no it’s not a greenhouse!’), mixing real and virtual interaction with the garden. It was a beautiful and exciting installation and won a Gold Medal. Encouragingly, other gardens had a psychology theme: 'Digital Capabilities' backed onto the 'Mindfulness Garden', another Gold Medallist, which attracted big crowds. Elsewhere in the show, an Exeter University psychologist was demonstrating healthy offices and the 'Get Well Soon' Artisan garden celebrated the ways that gardens and plants benefit health. Who knows what will be showing next year; maybe worth putting RHSChelsea 2014 in the diary? I Reviewed by Harriet Gross who is a Professor of Psychology at the University of Lincoln

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‘Avatar therapy’ Health Check BBC World Service The BBC World Service’s Health Check (http://bit.ly/Hcheck) provides a weekly round-up of topical health issues. In a recent episode (29 May), Health Check’s Lorna Stewart investigated a fascinating new technique being used in the psychological treatment of voice hearing in psychosis, ‘avatar therapy’ (see also ‘News’, p.478). This therapy, being developed by Professor Julian Leff at University College London, aims to help people develop a new relationship with their voices, and to Professor Leff’s astonishment, for three of the 16 participants in his trial, appears to have helped them lose their voices altogether. Talking to Health Check, Professor Leff explained that avatar therapy is ‘intended to enable the patient to take control of something that otherwise is uncontrollable’. With the help of computer software, the voice-hearer is able to create a physical likeness, an avatar, for their voice. No longer do they have to engage with an invisible, repetitive and often non-responsive entity. Furthermore, because the voice-hearer creates their own avatar, they know it can’t harm them. The client sits in one room, while the therapist sits in another room, observing the situation and controlling the avatar via a computer interface. At the beginning of therapy, the avatar matches the person’s voice in its persecutory content; however, over the course of several sessions the therapist encourages the client to stand up to the avatar. The avatar gradually changes, accepting the misery that it has caused and becoming supportive. In addition to those patients whose voices went away, for others the voices became quieter and less bothersome, while the patients developed strategies to

A challenge Time /No Time: The Paradox of Poetry and Physics Seán Haldane In Time/No Time clinical neuropsychologist and poet Seán Haldane [see interview in The Psychologist, January 2011] takes the reader on a dizzying ride through the fields of cosmology, quantum physics, neurophysiology and poetry. The book is written with the ostensible purpose of encouraging poets and scientists to be more open to one another’s ideas, and the basis for this is a challenge to conventional wisdom about a subject intimately bound up with all these disciplines, namely time. It is a brave venture, but the book proves more challenging than convincing for a number of reasons. For one thing, great reliance is placed upon personal anecdote, as Mr Haldane builds much of his case for ‘the non-existence of objective time’ on chains of coincidence he has observed in his own life. These may be impressive, but clearly there is room for a certain selectivity here: life has a lot of non-coincidences too. Nor does the book convince that at the primary creative level poets and scientists can really interact in any significant way. Their enterprises are qualitatively different, and both sides will rightly be wary of a

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deal with the voices. The study also reported a reduction in depression that occurred after the therapy stopped, as well as a reduction in suicidal thoughts and behaviour. One of the trial’s participants spoke to the programme; Claire (pseudonym) had experienced persecutory voices for 10 years, and neither medication nor three years of psychotherapy helped significantly with the voices. Following avatar therapy, in addition to a reduction in her voice hearing, Claire reported having greater self-esteem, stopping self-harming and socialising more than before. From my perspective as a clinical psychologist, the study (http://bit.ly/avatarth) is a great example of the innovative, evidence-based and empowering approaches being developed for the treatment of psychosis. Working with people’s beliefs about their voices, helping them overcome feelings of helplessness and giving them a sense of power over their voices is a key intervention in modern CBT for psychosis. The avatar system, although it needs more study, appears to provide a powerful tool for working with voices. More broadly, it’s fantastic to see a topic relating to psychosis being covered in a sensitive and intelligent manner in the media, as well as to see a new therapeutic technique described so clearly. I did, however, feel that the article was a little rushed and in particular, in its interview with Claire, that it failed to provide a sense of how it felt to participate in the avatar therapy. The rationale for the therapy could have been explained in more detail, but then I always feel that such topics deserve a little more space. Perhaps Claudia Hammond’s new BBC series The Truth About Mental Illness, which is airing now, will deliver that space. I Reviewed by Fergus Kane who is a newly qualified clinical psychologist working in psychosis

sciolistic appropriation of knowledge not truly their own. Sir Peter Medawar observes that for the scientist, science is what goes on at the rest point of the mind. And what goes on at the rest point of the poet’s mind is poetry, but I am doubtful that the poet’s chaotic shifting landscape of the personal, lit by wandering shafts of insight and analogy, has much in common with the ordered impersonal investigations of science. As for the ‘true nature’ of time, the blithe assertion that past and future are illusions and there are only ‘endless nows’ is all very well, but that’s just not the way the temporal cookie appears to crumble, and whatever quantum physics may have to say on the matter poets have for centuries been united in a common perception of time: it exists and it’s a bastard. In the words of Philip Larkin, ‘Truly, though our element is time,/We are not suited to the long perspectives/Open at each instant of our lives./They link us to our losses’. Or as W.B. Yeats still more succinctly puts it, ‘Man is in love, and loves what vanishes./What more is there to say?’ From the point view of understanding time, quite a lot, if this book is to be believed; from the point of view of experiencing it, rather less. I Parmenides Books; 2013; Pb £11.99 Reviewed by David Sutton who is a poet (and the editor's Dad!)

Rediscovering ‘forgotten’ research A History of Psycholinguistics: The pre-Chomskyan Era William J.M. Levelt The traditional view of the history of psychology is one that started with structuralism and functionalism, followed by the counter movements of Gestalt psychology and behaviourism. It is now becoming clear, however, that this view is wrong and grew out of the American introductory books of psychology (e.g. Brysbaert & Rastle, 2013). The origins of psychology are much older than 1879 (when Wundt started his laboratory of experimental psychology) and the first studies in psychology were much less based on introspection than is generally assumed. Levelt’s book is a beautiful illustration of just how rich research in scientific psychology was in the second half of the 19th century and how much has been forgotten. The book starts with the observation that in current writings ‘[i]t is a widely shared opinion that the new discipline of psycholinguistics emerged during the 1950s [when Chomsky published his scathing criticism of Skinner’s behaviourist book Verbal Behavior and presented his own alternative]’. The remainder of Levelt’s book is a detailed refutation of this shared opinion. In 600 pages Levelt shows how the psychology of language has a history going back into the 18th century, based on four pillars: (1) Historical research into the genealogy of languages, (2) Medical research into the consequences of brain damage, (3) Educational research on the development of language in young children, and (4) Experimental research on word processing in adults. These four lines of research were reviewed and integrated in a much underestimated book of Wilhelm Wundt Die Sprache (‘Language’) (1900)

read discuss contribute at www.thepsychologist.org.uk

but became lost as a result of two world wars in Europe, which completely annihilated language research, and the lack of access to (and interest in) the publications in American experimental psychology. As a result, when cognitive language research started to take off in the 1950s, it looked as if it was brand new, whereas in reality quite some insights were a recapitulation of previously well-known theories. Along the lines Levelt unearths the true, 19th-century, origins of word association studies, the cohort model of spoken word processing, the evidence that sign language is a fully developed language on par with spoken language, the serial model of word reading, the importance of the first letter in visual word recognition, the characteristics of speech errors, the first theories sentence parsing and phonemes, and the motor theory of speech perception. Levelt’s book is too informative and detailed for undergraduate studies, but it should be on the shelves of all their lecturers, as an example of just how much has been forgotten and rediscovered in the history of psychology. It should also be read by everyone interested in language research. They will not only discover the true origins of their pet theories, but will also have several evenings of pure delight while reading the book. Brysbaert, M. & Rastle, K. (2013). Historical and conceptual issues in psychology (2nd edn). Harlow: Pearson Education.

I Oxford University Press; 2013; Hb £60.00 Reviewed by Marc Brysbaert who is Professor of Psychology at Ghent University (Belgium) and Swansea University

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Tasty TED talks Love, no matter what Andrew Solomon We all lead busy lives, in this era of information overload. Our days can feel like one doomed attempt after another to tackle what’s on our plate, to juggle all our staple roles, let alone finding the time to try new flavours. One of the most frustrating things about that, in my view, is that even when people kindly break things down into nice bite-sized chunks for your consumption, it’s still hard to squeeze it in. I’ve experienced that in my role with The Psychologist itself, and our Research Digest. If I had a pound for every time somebody said they just don’t get round to reading them… and I can sympathise, because I find myself in the same position with resources as excellent as the online TED talks (see www.ted.com). TED is a non-profit organisation devoted to Ideas Worth Spreading. It started out (in 1984) as a conference bringing together people from three worlds: Technology, Entertainment, Design. Since then its scope has become ever broader, and its short online talks are an important part of that

Secular Sunday service The Sunday Assembly York Hall, Bethnall Green This month I went to the Sunday Assembly. Describing itself as a ‘godless congregation’, this is essentially a church service for atheists. The hour and half comprised singing (pop songs, mostly to do with love), a guest speaker, a reading, some time of quiet reflection (in lieu of prayer) a description of some charity work and a couple of comedic yet heartfelt addresses by the

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(with more than a billion views). Every day they pop up in my e-mail inbox or on my phone app, and every day I think ‘when I’m retired I’ll watch one of those every morning’. Today I made the time, and spent half an hour watching Andrew Solomon – a writer on politics, culture and psychology – talk about the line between unconditional love and unconditional acceptance (see tinyurl.com/kulld2l). What is it like to raise a child who's different from you in some fundamental way (like a prodigy, or a differently abled kid, or a criminal)? Solomon shares what he learned from talking to dozens of parents, including those of Dylan Klebold, one of the perpetrators of the Columbine massacre. I was struck by Solomon’s realisation that ‘all of us who have children love the children we have, with their flaws. If some glorious angel suddenly descended through my living room ceiling and offered to take away the children I have and give me other, better children – more polite, funnier, nicer, smarter – I would cling to the children I have and pray away that atrocious spectacle.’ TED talks are fairly consistent, in that it’s rare to watch one and think ‘that idea wasn’t worth spreading’. Our own discipline is well represented, with speakers including

organisers Sanderson Jones and Pippa Evans (who are also comedians). The theme of this Sunday’s assembly was happiness, and Richard Layard – programme director of the Centre for Economic Performance at the London School of Economics and the architect of the Improving Access to Psychological Therapies initiative – was a great choice of speaker, given his influence on governmental policies on psychological wellbeing. Unfortunately the sound balance needed work so it was hard to hear the first half of what Layard had to say, but what I did

Sarah-Jayne Blakemore, Dan Gilbert, Alison Gopnik and Martin Seligman. Whether or not TED genuinely disseminates science to new and diverse audiences is a matter for debate: a recent paper (see tinyurl.com/pft76nn) commented that ‘it is altogether possible that those who watched and “liked” these videos were often themselves academics’. The researchers also found that giving a TED presentation appeared to have no impact on the number of citations subsequently received by an academic. But no matter. As the TED website says, most regular TED Talk listeners ‘would tell you the experience has impacted how they think and what they do’, so that’s the real outcome. ‘Ideas reshape minds and change the way people act’, and ‘more than 10,000 people in more than 100 countries are spending a substantial number of hours ensuring that TED is not just talk, but has on-the-ground impact.’ We should cherish a ‘global community welcoming people from every discipline and culture who seek a deeper understanding of the world’, and ensure we find the odd half hour for its tasty treats. I Reviewed by Jon Sutton who is Managing Editor of The Psychologist

hear spoke to known psychological benefits of being kind to others, and of attending church, which fits with the Sunday Assembly’s ethos. He explained some of the research into these benefits in a clear and accessible way, and was received well. Overall there are still a few things for the Assembly to iron out: mainly getting the speaker easily seen and heard: this difficulty might have been a consequence of a recent review in Time Out, resulting in a doubling of their numbers this month (there were apparently about 600 people in the audience). There was a touch too much singing from my point of view too, with the same unfortunate tendency that church services have of pitching the songs in a key which is both too low and too high. But choral singing has been linked to happiness too, so maybe this was more than an aping of a church service and in fact another tactical happiness-boosting technique.

Overall the Assembly is an interesting idea, with charismatic leaders and the potential to be a really stimulating event. It reminded me a bit of the principles of Alain De Botton’s ‘School of Life’ (see my interview with him in the May issue), in that it targets people who like to think about how they live their lives without necessarily doing this through the lens of a religion. Unlike talks at other places, this is free to attend (though you can give a donation if you like). It had the flavour of a community rather than a commercial venture. I’ll definitely be back in a couple of months to see how it’s evolving. The Sunday Assembly is on the first Sunday of every month. Check out their website here: http://sundayassembly.com I Reviewed by Lucy Maddox who is Associate Editor for Reviews and a clinical psychologist in the NHS. Her blog is at http://psychologymagpie. wordpress.com

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reviews

Rigorous academic discussion Psychology and Crime (2nd edn) Clive R. Hollin This is Clive Hollins’s update of his review of research in criminological psychology, incorporating developments in the field since the first edition in 1989. This version contains 12 chapters, which divide into three general parts. The first part covers some relevant basic concepts from law, criminology and psychology. The second part looks at some specific criminal acts (arson, violent and sexual crime) and the relationship between mental disorder and crime. The third part discusses the investigation, punishment and prevention of crime from a number of perspectives. The main strength of the book is its comprehensive coverage of relevant literature, mainly from forensic/criminological psychology but also from other domains. Its scope is quite impressive: one chapter, for example, draws from developmental psychology to consider the development of criminal behaviour across the lifespan, while another deals with workforce issues in law enforcement such as officer selection, training, and stress management. As well as reviewing relevant theories and findings across the topics covered, Hollin highlights methodological issues such as the evaluation of crime reduction interventions. For a bit of light(ish) relief, some

chapters also list media references to the subject matter, such as TV shows. In case you were wondering, yes, these do include Cracker. However, despite (or maybe because of) the book’s depth and scope, I did find some of the chapters difficult to follow as the arrangement of topic headings within them was not very intuitive. The first three chapters in particular seemed to include some repetition of topics and to go back-and-forth between them, so the reader can afford to be selective in how much of these chapters he or she reads. Incidentally, there will be a companion website with supplementary material that may be helpful to those studying the book. My overall impression is that Psychology and Crime would serve well as a general textbook in criminological psychology. It contains a wealth of information and will be of value to anyone seeking a rigorous academic discussion of the psychological issues associated with crime.

Act of bravery

Superman – heroic morality

Deadweight: A Case Study Concerning Mental Illness Nicholas Boyd Crutchley

I Routledge; 2012; Pb £34.99 Reviewed by Denham Phipps who is a Research Fellow, University of Manchester

Man of Steel Zack Snyder (Director)

Following a self-described breakdown, Crutchley’s life was suddenly and somewhat permanently contracted by the force of serious mental illness (a schizophrenic diagnosis and its common concomitants, mood disorder, suicidality, hallucinations, etc.). The author promotes the book as a ‘novelised case study’ of mental illness. Another way to view it is a novelised memoir of mental illness; Sybil meets C.S. Lewis’s less widely known Space Trilogy series. It is a difficult read. This is not because the story is uninteresting or poorly written. Instead, Crutchley preserves the authentic dialogue of mental illness, which in its organic state looks and reads a bit like poor science fiction (and which the cover illustration does little to challenge), a taxing narrative for the ‘normal’ mind. To the rational mind, the recounting of a protracted episode of paranoid delusion can be so absurd as to seem fictional, and to that end the story works as a novel but without the present-time voice of the narrator, it is hard to hold on to the intention of the book, which is to humanise the severely mentally ill to professionals, caregivers and the general public. Still, Crutchley is to be commended for his act of bravery, the book is a raw accounting of serious mental illness, without the pretension of academia or the heavy editing of pop-science.

As a reinvention of Superman for movie-watchers who loved Christopher Nolan’s Batman trilogy, Man of Steel is likely to be a success. Tonally and visually dark, it presents a young and inexperienced Superman forced to confront his genetic legacy: renegade Kryptonians who see Kal-El as a way to revive their lost people. Henry Cavill and Amy Adams do fine jobs in the roles of Clark Kent/Superman and Lois Lane, but the standouts are Russell Crowe as Jor-El and Michael Shannon as General Zod, who steal every scene in which they appear. Many of the standard superhero themes are present, such as the relationship between power and responsibility, as well as the public’s fear of the powerful (a hot topic in today’s comics as well). Relations between father and son play a significant role, especially between Clark and Jonathan Kent, which climax in a pivotal scene in the middle of the film. The tension between Superman’s Kryptonian and human loyalties are mentioned, but because most of the movie takes place before Clark moves to Metropolis, we don’t see much of the issues of dual identities and ‘Who am I, Clark or Superman?’ In my opinion, the most interesting issues with the film rest with the moral choices Superman makes. Despite his powers, Superman faces moral conflicts and tragic dilemmas like the rest of us, and the way he resolves them is yet another way he expresses his heroism – and one of the ways we can emulate Superman. But some of the choices he makes in the movie are controversial, and may question some viewers’ ideas of what heroism entails and demands. That said, examples of traditional heroism are not hard to find in Man of Steel, and are not limited to Superman himself. Jonathan Kent, Lois Lane, and Perry White all pitched in as they could, showing that you don’t need super-strength or heat-vision to put your own well-being aside to help others. Ultimately, this is the most important point any superhero movie can make. While Man of Steel may not satisfy everyone’s idea of heroic morality, it is sure to prompt discussion about such issues while providing an exciting and emotional thrill-ride at the cinema.

I Self-published; 2013; eBook £2.49 Reviewed by Stephanie Dinnen-Reini who is at Yale School of Medicine, West Haven, CT

I Reviewed by Mark D. White who is chair of the Department of Political Science, Economics, and Philosophy at the College of Staten Island in New York City and editor of Superman and Philosophy (Wiley, 2013)

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Dipping into death matters Death Matters: Transforming Our Fear of Death Sally Petch Sally Petch writes in Death Matters that she wishes to ‘help us to accept and feel more comfortable with our own journey towards death’. Aiming for accessibility, she adopts a conversational style reminiscent of a cookery writer and a format to encourage ‘dipping-in’. She covers losses from redundancy to a child dying, and ranges from asking readers to question why they dye their hair to suggesting that a cardboard coffin is lovely for a child. Perhaps because of the breadth of subjects, the approach jarred me. While losses have different meanings for people, at best the book skims the surface of the complexity of emotions surrounding death and at worst seems glib. As a bereavement volunteer, I seek out materials that empower people to talk about dying and death openly such as the website www.dyingmatters.org. This slight book would not, I feel, help most people in that process. I Matador; 2013; Pb £8.99 Reviewed by Lucy Fiddick who is an assistant psychology practitioner in LIFT (the IAPT service in Bristol) and Bereavement volunteer for CRUSE

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The Buddha and the Borderline Kiera Van Gelder ‘The difference between being told “There’s no reason to feel that way” and “I can understand how you feel that way” is the difference between taunting a rabid squirrel and giving it a tranquilizer’ Kiera Van Gelder Kiera’s account of her journey is forthright, honest, insightful and with more than a hint of humour. She comes across as very knowledgeable about her diagnosis as well as being well read in terms of therapies and psychological perspectives. Kiera details her passage through services, therapies, relationships, life transitions and finally Buddhism where the mindfulness teachings of DBT are underpinned. Kiera discusses the controversy and stigma surrounding her diagnosis and her perception of the professionals and

Left me cold The Human Swarm Channel 4 Jimmy ‘Jamie Oliver’s mate’ Doherty is off the farm and following every other Tom, Robert and Michael into fronting popular science documentaries. He’s an engaging enough presence but unfortunately this was a title and a presenter in search of a programme. ‘We humans think and move like members of the herd in more ways than we realise,’ Doherty began. For the remainder he said ‘like a human swarm’ every now and then, but that didn’t make it true. The premise was that changes in the weather, and specifically temperature, can makes us act ‘not as individuals but as a collective mass, a human swarm’. For example, we buy more porridge when it’s cold. Dr Mark Hetherington, described as an environmental psychologist, was on hand to explain the role of the hypothalamus in making us want to take on more food when the temperature drops. Interestingly, although we crave hot food, even a salad would do. And these days

treatments made available. She also portrays her experience of intimacy with others with candour and wisdom. This book developed my understanding as a DBT therapist of how patients might experience the therapy that my service delivers; a valuable appreciation of their multifaceted internal world as a result of Kiera’s expert perspective. Far from solely being a fascinating personal account of borderline personality disorder (recommended to friends and family of sufferers), this is an exceptional reference text for clinicians working in the area. For me, this book engendered empathy for the raw pain and confusion endured by my patients as well as the strength and bravery that they show in tackling life’s obstacles like no other text. I Recommended by Keren Smith who is a clinical psychologist at Maudsley Hospital. Do you have a favourite book, film or album that has you have found of value in your personal or professional life? Contact Lucy Maddox on maddox.lucy@gmail.com

we only get cold for short periods, and then we take on lots of extra calories and go and sit in a warm office. A host of other effects were covered. There are 200 extra heart attacks for every one degree drop in temperature, as blood gets more viscous and is pushed into the body. Use of online dating sites goes up. There was also some underplayed stuff about the 2.5 billion GB of data we produce a day, leaving a trail of information that can be used by companies and governments. For example, a ‘sick weather’ website collects information from social networking sites on the use of flu-related words, and one day the NHS could make use of this live flow of data to predict the spread of illnesses – a virus forecast. But generally the programme got a bit ‘aren’t supermarkets brilliant?’, with lots of assertions that ‘because we respond together, just like a swarm, the supermarkets can predict with certainty that there will be a sharp rise in demand for warming winter food’. I was left none the wiser as to whether that behaviour is in any way like a human swarm… perhaps we’re more like shambolic

zombies, directed by Starbucks and Sainsbury’s, than the collective hive mind of the bee. I Reviewed by Jon Sutton who is Managing Editor of The Psychologist

contribute

reader recommends

reviews

Sample titles just in: Brainwashed: The Seductive Appeal of Mindless Neuroscience Sally Satel & Scott Lilienfeld The Human Spark: The Science of Human Development Jerome Kagan Permanent Present Tense Suzanne Corkin For a full list of books available for review and information on reviewing for The Psychologist, see www.bps.org.uk/books Send books for potential review to The Psychologist, 48 Princess Road East, Leicester LE1 7DR To review anything else, contact the Editor on jon.sutton@bps.org.uk

vol 26 no 7

july 2013

Piaget, Rawlings, Spearman, and Myers all left something to Psychology …

What will you leave?

A lasting contribution The British Psychological Society is the representative body for psychology and psychologists in the UK. Formed in 1901, it now has approximately 45,000 members. By its Royal Charter, the Society is charged with national responsibility for the development, promotion and application of pure and applied psychology for the public good, and with promoting the efficiency and usefulness of Society members by maintaining a high standard of professional education and knowledge. With your help the Society works to: ■ To encourage the development of psychology as a scientific discipline and an applied profession; ■ To raise standards of training and practice in the application of psychology; ■ To raise public awareness of psychology and increase the influence of psychological practice in society. By including us in your will you can help ensure the future of your discipline in the years to come by continuing to support the Society. For more information on how to leave a legacy please contact Russell Hobbs, Finance Director at russell.hobbs@bps.org.uk or call him on 0116 252 9540.

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Doctorate in Counselling Psychology and and Psychotherapy by Professional Studies (DCPsych) A Joint Programme with Middlesex University This five year part-time programme is accredited by the British Psychological Society (BPS) for the training of Chartered Psychologists and approved by the Health and Care Professions Council (HCPC) for he training of Counselling Psychologists. The programme is also accredited by the UK Council for Psychotherapy (UKCP) for the training of Integrative Psychotherapists. The programme is based on a practitioner research philosophy and presents an innovative design that seeks to integrate research and practice at doctoral level. It is open to psychology graduates who possess the Graduate Basis for Chartered Membership (GBC) as specified by the BPS.

Applicants need to believe that they have the capabilities to make a significant contribution to practice based knowledge in the psychological therapies. The course offers an integrative programme of study in the theory and practice of psychological therapy and covers both clinical and research training. It is offered over ten 3-day weekend modules during each academic year, thus allowing students to combine their broader life commitments with the demands of further study. Applications are invited for the 2013 academic session. The application process includes attendance at an Introductory Workshop and at a Group Assessment interview.

For further information please contact: Anna Kopec, DCPsych Co-ordinator on 0208 579 2505 or at anna.kopec@metanoia.ac.uk Metanoia Institute, 13 North Common Road, Ealing, London W5 2QB

www.metanoia.ac.uk Registered Charity 1050175

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vol 26 no 7

july 2013

PROFESSIONAL TRAINING OPPORTUNITIES

Take your career forward with our postgraduate training opportunities in psychology.

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Professional Doctorate in Health Psychology BPS accredited Provides Stage 2 Professional Training in Health Psychology, which gives eligibility for Chartered Psychologist status and for registration with the HCPC as a Health Psychologist. Study two years full-time or four years part-time Individual CPD modules available for candidates on the BPS route to Stage 2 Professional Training in Health Psychology.

Graduate Diploma in Psychology Conversion course for non-psychology graduates Equivalent of an accredited honours degree in psychology.

Confers Graduate Basis for Chartership (GBC) with the BPS.

Transpersonal Psychology Section 17th Annual Conference

Transformation and the Transpersonal 20–22 September 2013 Cober Hill Conference Centre Cloughton, Scarborough

Psychotherapeutic Counselling MSc, PgD, PgC, Professional Certiﬁcate and Diploma Professional counsellor training from certiﬁcate to MSc with opportunities for for graduates and nongraduates. The course contact hours may, at BACP’s discretion, be counted towards meeting part of criterion 4 of the BACP Counsellor/Psychotherapist Accreditation scheme. Candidates for accreditation must note that they will also have to meet all other criteria. For further information: t: 01782 294400 e: enquiries@staffs.ac.uk www.staffs.ac.uk/psychology

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Keynote speakers Professor Yochanan Altman London Metropolitan University

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Tim Wheater Wheater Sound Academy

Call for papers – deadline Friday 12 July 2013 For further details please visit

www.transpersonalpsychology.org.uk. Bookings can be made via the website or by e-mailing Dr Ho Law (ho.law@empsy.com)

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NEW VOICES

Digital piracy and the moral compass Steven Brown with the latest in our series for budding writers (see www.bps.org.uk/newvoices for more information)

he digital revolution has left a lingering mark on society which has far-reaching cultural, commercial and legal implications. Naturally, it has inspired a wealth of research from a variety of disciplines into different aspects of this multifaceted research area. I will consider one such trend in the literature: the morality of digital pirates, those who illegally copy and sometimes sell digital information. Two questions account for the bulk of music piracy research into predictive factors and deterrents: Who are the pirates? How can they be stopped? A variety of individual differences have been discovered, including demographics with the profile of pirates typically (but not universally) being young males. Piracy has also been noted as consistent with the theory of planned behaviour, not an impulsive act like most criminal activities (see d’Astous et al., 2005, for example, where having swapped music in the past exerts a strong influence on one’s intention to do so again). Additionally, attitudes are a significant predictor of piracy engagement (Taylor et al., 2009), where individuals holding an optimism bias engage in piracy as they believe themselves to be at lower risk than other populations (Nandedkar & Midha, 2012). Such findings may draw attention from health psychologists as informing suitable deterrent strategies. However, traditional approaches have focused on punitive measures, continuing to fail in making any real impact on piracy

references

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Al-Rafee, S. & Rouibah, K. (2009). The fight against digital piracy: An experiment. Telematics and Informatics, 27, 283–292. Bandura, A. (1991). Social cognitive theory of moral thought and action. In W.M. Kurtines & J.L. Gewirtz (Eds.) Handbook of moral behaviour and development: Vol. 1. Theory (pp. 45–103). Hillsdale, NJ: Erlbaum. Batson, C.D., Thompson, E.R. & Chen, H. (2002). Moral hypocrisy. Journal of

behaviours. Anti-piracy campaigns have largely failed to address the phenomenon of widespread engagement in music piracy, with Wikstrom (2011) suggesting that: ‘perhaps the single most enduring effect of these initiatives has been a negative impact on the reputation of the music industry’ (p.155). The UK government has expressed concern over the ‘morally unsustainable’ nature of piracy. Complications over piracy as theft (rather than copyright infringement) aside, there is difficulty in persuading pirates that their actions are wrong as those messages principally come from either government or industry. The recent expenses scandal in the UK is likely to impede any convincing arguments over ‘morally questionable’ behaviour from the government, and increased awareness over the exploitative practices of the music industry will similarly prove to weaken their efforts. Are the government aiming their cannons at the wrong target? The research is inconclusive. While no link between moral reasoning and piracy has been found (see Jacobs et al., 2012, for example), associations demonstrating pirates as less ethical have also been found (Gupta et al., 2004). No research has depicted pirates as morally superior. Kini et al. (2004) observed significant differences in the moral intensity of US students and Thai students, arguing that Thai students’ comparatively low moral reasoning may account for their higher rates of software piracy.

Personality and Social Psychology, 83(2), 330–339. Brown, S.C. & MacDonald, R.A.R. (in press). Predictive factors of music piracy. Musicae Scientae. Chiou, J., Huang, G. & Lee, H. (2005). The antecedents of music piracy attitudes and intentions. Journal of Business Ethics, 57(2), 161–174. Copes, H. (2003). Societal attachments, offending frequency, and techniques

Related to ethics is religion, with AlRafee and Rouibah (2009) conducting an experiment emphasising different aspects of piracy in developing Arabic and Middle Eastern countries. Here, ‘intention to pirate’ scores dropped significantly after receiving information depicting piracy as immoral from a religious point of view. Does it therefore follow that moral arguments could be used as a deterrent? Chiou et al. (2005) suggest that a moral focus could be the best approach to tackling the issue, not confusing legal messages or invasive technological advancements. Sound in principle, this suggestion does not take into account the sources of such messages (see above) or what Albert Bandura (1991) calls ‘moral disengagement’. As Batson et al. (2002) concluded, ‘what may look like motivation to appear moral (moral integrity) often is not. It is instead motivation to appear moral yet, if possible, avoid the cost of actually being moral’ (p.339). How might pirates appear moral to themselves? A theory from Sykes and Matza (1957), on how criminal behaviour can be justified prior to the behaviour itself, has relevance. These techniques include (a) the denial of responsibility, (b) the denial of injury, (c) the denial of a victim, (d) a condemnation of condemners, and (e) an appeal to higher loyalties. Use of these techniques allows criminals to convince themselves that their behaviour is acceptable, regardless of laws or norms that conflict with such behaviours. Drawing both from interviews and ethnographic observation of forum data, Holt and Copes (2010) noted that the most common neutralisation technique employed by pirates was denial of injury, where pirates appeased their behaviours by illustrating the little harm their piracy behaviours cause, remarking on how it in fact helps musicians. This finding was corroborated by Hinduja (2012) and Moore and McMullan (2009), whose sample additionally indicated support for at least one of six neutralisation techniques.

of neutralization. Deviant Behavior, 24(2), 101–127. d’Astous, A., Colbert, F. & Montpetit, D. (2005). Music piracy on the web. Journal of Consumer Policy, 28, 289–310. Flores, A. & James, C. (2012). Morality and ethics behind the screen. New Media Society. doi:10.1177/1461444812462842 Gupta, P.B., Gould, S.J. & Pola, B. (2004). ‘To pirate or not to pirate’: A

comparative study of the ethical versus other influences on the consumer’s software acquisition-mode decision. Journal of Business Ethics, 55, 255–274. Hinduja, S. (2012). General strain, selfcontrol, and music piracy. International Journal of Cyber Criminology, 6(1), 951–967. Holt,T.J. & Copes, H. (2010). Transferring subcultural knowledge on-line: Practices and beliefs of persistent

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we value music, behaving in less altruistic While support for the theory is ways than before. This shift has been present elsewhere (Siponen et al., 2012, largely facilitated by the perceived for example), perhaps the most anonymity of the internet, disinhibiting convincing conclusions to be drawn on behaviours. Holt and Copes (2010) the topic come from Yu’s (2012) mixedspeculate that ‘as more deviant groups methods approach. This collectively develop online communities, it is possible exposed techniques of neutralisation as that involvement in deviant behavior may accounting for almost 75 per cent of the spread to larger populations of nonvariation on viewing piracy as justifiable. deviants’ (p.650). These changes are Whilst findings demonstrated that piracy is partly influenced by lower moral judgments, this was found to stem from not perceiving piracy as a serious crime. Pirates were not found to be morally inferior overall (when considering other crimes). Yu explains: ‘This corresponds to the theory of neutralisation in that the theory argues that criminals are not totally immoral’ (p.374). For techniques of neutralisation and rationalisation to be truly applicable, it is first necessary for the individual to believe that there is something wrong with their behaviour (Copes, 2003). A qualitative study from Flores Pirates know their behaviours are immoral, but and James (2012) suggests they don’t care do, with one participant saying: ‘I know what I’m doing is inherently psychological and, as such, wrong, but until there are more strict only psychologists can readily research laws, I just don’t really think about it’ them using scientific methodologies, (p.8). Pirates know their behaviours are informed by theoretical lines of inquiry. immoral, but don’t care. Conventional deterrent approaches Observing unethical thinking amongst have largely centred on technological and 98 per cent of their sample (even those legislative changes, with substantial who were labelled strong moral and evidence demonstrating that pirates adapt ethical thinkers), Flores and James (2012) well to such changes. Sinha and Mandel ultimately conclude that the relative (2008) observed that negative incentives anonymity of the internet is likely to (undesirable outcomes of piracy) are facilitate self-serving behaviours online, a strong deterrent for certain consumers including piracy, so it becomes important but can actually increase the propensity to make the wider implications of actions to pirate for others. Conversely, positive more salient. This may also reduce the incentives (such as improved neutralisation technique most functionality) were observed to prominently noted amongst the studies significantly reduce the tendency to pirate explored above – the denial of injury. amongst the entire sample studied. This Underneath all the fancy new highlights not only a potential root cause business models are real changes in how

digital pirates. Deviant Behavior, 31(7), 625–654. Jacobs, R.S., Heuvelman, A., Tan, M. & Peters, O. (2012). Digital movie piracy. Computers in Human Behavior, 28, 958–967. Kini, R.B., Ramakrishna, H.V. & Vijayaraman, B.S. (2004). Shaping of moral intensity regarding software piracy. Journal of Business Ethics, 49(1), 91–104.

Moore, R. & McMullan, E.C. (2009). Neutralizations and rationalizations of digital piracy. International Journal of Cyber Criminology, 3(1), 441–451. Nandedkar, A. & Midha, V. (2012). It won't happen to me: optimism bias in music piracy. Computers in Human Behavior, 28(1), 41–48. Nuttall, P., Arnold, S., Carless, L. et al. (2011). Understanding music consumption through a tribal lens.

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of the continued failure of conventional anti-piracy strategies, but that good alternatives to piracy are worth investing in and may prove the best anti-piracy strategy of all. While research suggests piracy itself may be immoral, this appears to be context-specific. Pirates are not otherwise immoral individuals. Most importantly, it doesn’t matter; at least not in terms of formulating anti-piracy strategies. In my view, they simply won’t work. As ever, more research is needed. Over 10 years of study on music piracy appears to have made very little impact in practical terms. More has to be done beyond the research itself to ensure its validity in the real world. Studies vary considerably in both their theoretical and methodological approaches where in terms of validity, more rigorous research methods must also be employed. A substantial volume of research on piracy involves non-empirical work using various forms of (economic) modelling and self-report methodology from student samples. I myself have created original scales to measure piracy attitudes (a predictor of engagement) – see Brown and MacDonald (in press). By not using the loaded word ‘piracy’ I can minimise social desirability. I have similarly conducted qualitative and ethnographic research, all in the hope of gaining accurate and reliable data on piracy. With a dearth of qualitative research on the topic, those studies which have employed such methodologies have been invaluable (Nuttall et al., 2011). Perceived as a victimless crime, pirates’ willingness to disclose their behaviours should be seized upon by researchers.

Journal of Retail and Consumer Services, 18, 152–159. Siponen, M., Vance, A. & Williams, R. (2012). New insights into the problem of software piracy. Information and Management, 49, 334–341. Sinha, R.K. & Mandel, N. (2008). Preventing Digital Music Piracy. Journal of Marketing, 72(1), 1-15. Sykes, G. & Matza, D. (1957). Techniques of neutralization: A theory of

Steven Caldwell Brown is at Glasgow Caledonian University steven.brown@gcu.ac.uk www.musicpiracyresearch blog.blogspot.co.uk

delinquency. American Sociological Review 22, 664–670. Taylor, S., Ishida, C. & Wallace, D. (2009). Intention to engage in digital piracy. Journal of Service Research, 11, 246–262. Wikstrom, P. (2011). The music industry. Cambridge: Polity Press. Yu, S. (2012). College students’ justification for digital piracy. Journal of Mixed Methods Research, 6, 364–378.

539

ONE ON ONE

…with Jacqueline Akhurst Principal Lecturer at York St John University

resource

One inspiration From early on, Urie Bronfenbrenner’s (1977) writings about ecological systems theory were of fundamental importance to me. These ideas immediately resonated with my experiences of working as a schoolteacher with learners who experienced difficulties, and the model became very important as a tool for teaching psychology in postapartheid South Africa.

marginalised youth and immigrants in London and East Anglia. Following the principles of community psychology enables connections to be made with these groups of people, who would not often seek assistance or gain access to traditional psychological services.

One challenge you think community psychology faces We established the BPS Community Psychology Section in 2010, just as the financial crunch was having

One book that you think all psychologists One moment that changed should read the course of your career I think the 1978 When, as a secondary school translation of Lev geography teacher, the head Vygotsky’s Mind in teacher asked me to take on Society is of vital the role of school counsellor importance, because (at the time I was completing of its emphasis on my honours in psychology the interaction and studying a module in Jacqueline Akhurst between cultural/ counselling psychology by j.akhurst@yorksj.ac.uk historical influences correspondence). and individuals. We dramatic effects on local are immersed in rich language One important application authority services and the and social interactions from of community psychology NHS. Our challenge therefore, birth, and I believe these are There are some very good is to establish our credibility fundamental to our examples of community and find ways of working in development. psychologists working with partnership with others, when a number of the programmes with which our work would www.pnarchive.org/cardsort2/cardsort_psychology have had a natural affinity ‘I developed this online card sort whilst working at the Higher (e.g. Sure Start) have faced Education Academy Psychology Network. It’s for undergraduate dramatic cuts in funding. psychology students to develop their employability awareness.’

540

Articles on stuff and things, hearing voices, social support following stroke, and much more... I Send your comments about The Psychologist to the editor, Dr Jon Sutton, on jon.sutton@bps.org.uk, +44 116 252 9573 or to the Leicester office address I To advertise Display: ben.nelmes@redactive.co.uk, +44 (0)20 7880 6244 Jobs and www.psychapp.co.uk: giorgio.romano@redactive.co.uk, +44 (0)20 7880 7556

contribute

coming soon

One nugget of advice for

aspiring psychologists Don’t be put off by the naysayers and the daunting path towards becoming a psychologist. Strive to build a portfolio of skills and experiences, especially in voluntary and third sector organisations, and find ways to explore and ‘give away’ your knowledge of the rich evidence base being built in many areas of psychology, wherever you find yourself working. One treasured possession I have owned my own motorcycle since my teens, and my latest is a Triumph 800 Tiger, which my husband and I look forward to using next summer to tour parts of Europe! One hero from psychology past or present At present I am particularly drawn to the integrationist work of Dan Siegel, and his approach to ‘interpersonal neurobiology’. One way HE teaching could become more community driven A growing number of undergraduate programmes are working with various forms of community-based learning, as part of a work placement system. These could be ‘long and thin’ over the course of a semester, or more concentrated over a three- to four- week period in early summer. Such initiatives give students invaluable experiences of applying psychology in ‘real-life’ situations, and can impact on their career thinking. More answers online at www.thepsychologist.org.uk

Think you can do better? Want to see your area of psychology represented more? See the inside front cover for how you can contribute and reach 50,000 colleagues into the bargain, or just e-mail your suggestions to jon.sutton@bps.org.uk

vol 26 no 7

july 2013

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Annual Conference 2014 Confirmed Keynotes Professor Sir Simon Wessely Professor of Psychological Medicine at King’s College London and Civilian Consultant Advisor in Psychiatry to the British Army Ben Shephard Historian, Author and Television Producer Professor Marinus H. van IJzendoorn Centre for Child & Family Studies, Leiden University Susan van Scoyoc Private Practice and Counselling and Health Psychologist Professor John Aggleton Professor of Cognitive Neuroscience, Cardiff University

7-9 May 2014 International Conference Centre, Birmingham ‘big picture’ pull-out www.thepsychologist.org.uk

BIG PICTURE

What is uniquely human? Photo by Eiko Fried. Send your ‘Big picture’ ideas to jon.sutton@bps.org.uk

psychologists – is trying to figure out what is uniquely human by studying cognition, theory of mind, emotion, and communication in human and nonhuman primates,’ he tells us. ‘The photograph reflects on

potential differences, but also the many similarities between us and our closest relatives – and depicts the fundamental barrier that makes it so tremendously difficult to understand the mental states of others.’

www.thepsychologist.org.uk

A little boy looks into a mirror, and at the same time into the remote past. What is uniquely human? What sets us apart from our closest relatives, the great apes? A concept of the self maybe? The vast range of emotions we can experience, or the astounding cognitive capacities we are equipped with? The photographer, Eiko Fried, is a PhD candidate at the Cluster Languages of Emotion at Freie Universität Berlin. ‘The focus of the labgroup I am situated in – mostly primatologists and

Your psychologist Your choice

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vol 26 no 7

july 2013