The Psychologist September 2013

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psychologist vol 26 no 9

september 2013

Austerity psychology Is the economy affecting how you research, teach or practice?

10 years of the Digest 630 euro congress 636 Incorporating Psychologist Appointments careers 680 ÂŁ5 or free to members of looking back 696 The British Psychological Society

swearing – language of life and death 650 anorexia and the autistic spectrum 656 no voice, no choice 660 interview with Oliver Sacks 664

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letters 618 addressing the impact of welfare change; media ethics; NLP; DSM-5; and more

THE ISSUE

news and digest 626 pre-registration reports; prisoner’s dilemma; placebo; we celebrate a decade of the Society’s free Research Digest; and much more

At the opening reception for the European Congress of Psychology in Stockholm in July (see p.636), the organisers warned that some registered delegates and speakers had been unable to attend. ‘These troubled economic times’ were cited, reinforcing a question that has bugged me for the last couple of years. It seems without doubt that economic conditions and policies are having an impact on how we live, but what about how we work as psychologists? Is the current climate affecting how we research, teach and practice?

So we asked the question, in the publication and on Twitter (@psychmag). Some of you responded (see p.644). But perhaps even more responded to say that they wouldn’t be able to respond, for fear of an adverse impact on current post or career. This is clearly worrying, and given our role as a forum for communication, discussion and controversy I can only hope that what we publish this month will serve as prompt for more open debate. If austerity is here to stay, how should psychologists respond: for the benefit of others and for the good of the profession?

Dr Jon Sutton

european congress of psychology we report from Stockholm, venue for the 13th Congress of the European Federation of Psychologists’ Associations TIMM SONNENSCHEIN/

REPORTDIGITAL.CO.UK

Austerity psychology Are ‘these troubled times’ having an impact on how you research, teach or practice psychology?

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pull-out

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Swearing – the language of life and death Richard Stephens leads us through a colourful research journey

650

Anorexia nervosa – on the autistic spectrum?

Clare Allely wonders whether the parallels might lead to novel therapy

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No voice, no choice Romana Farooq and Imran Abbas look at the challenges and benefits of doing research with ethnic minorities

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Interview: ‘I don’t feel proud of anything’ Jessie Baldwin met Oliver Sacks

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society 668 President’s column; Lifetime Achievment Award; Strategic Plan consultation; Psychology Education Award; forensic psychology awards; work–life balance; and more

reviews 688 the usual mix of books and other media reviews, including two films from the Cannes Film Festival

careers and appointments

looking back the history of educational psychology in Britain: Jane Leadbetter and Christopher Arnold review a century since Cyril Burt was appointed

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one on one

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we talk to Roy Childs about psychometrics and running a company; and Jessica Deol gives us a flavour of her work as an assistant psychologist in an acute adult neuropsychology setting

new voices 694 living with congenital heart disease: Liza Morton with the latest in our series for budding writers (see www.bps.org.uk/newvoices for more information)

…with clinical psychologist and novelist Frank Tallis

read discuss contribute at www.thepsychologist.org.uk

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NEWS

Revolutionary or stifling?

When BPS Fellow Chris Chambers and Marcus Munafo wrote to the Guardian in June calling for the introduction of study pre-registration across the life sciences, they were responding to the growing sense that something needs to be done to clean up our science.

Psychologist readers will know why.

The last few years have witnessed isolated but shocking cases of research fraud; a run of failed replications of key findings in social psychology; a survey of psychologists in which an overwhelming majority admitted indulging in questionable research practices (tinyurl.com/boynfxk); and a growing awareness of the problematic file-draw effect, whereby null results never see the light of day. These issues are not

HEALTH AND SOCIAL CARE Are you interested in health and social care and committed to public protection? The Health and Care Professions Council is currently recruiting for Council members as it moves to a smaller structure. The deadline for applications is 23 September.

I For more information, see tinyurl.com/m5esnft

Psychophysics; and restricted to psychology, Perspectives on but psychologists have Psychological Science been at the forefront of have launched initiatives to improve Registered Reports and the scientific method, similar pre-registration including Brian Nosek’s formats. launch of the Center for But now the mood Open Science, which of consensus has supports predipped with an article registration. published in the Times In their letter, Higher Education Chambers (Cardiff Supplement in July by University) and Munafo Sophie Scott, deputy (University of Bristol) director of the Institute of argued that the widespread introduction Chris Chambers – ‘the whiff Cognitive Neuroscience at UCL. She says the call for of the option of journal of revolution is in the air’ pre-registered reports publication by premust be resisted because registration – with papers judged and accepted by reviewers the format will stifle scientific freedom.

Speculative analysis of findings will be based on their methods prior to datamore difficult, she says, and reviewers collection – would help address many will be more tempted than ever to judge of the problems currently plaguing submitted research based on reputation. scientific research. Their list of 80 She adds that researchers will be tied co-signatories included some of into publication with a particular journal psychology’s leading lights – Dorothy prior to data collection, robbing them of Bishop, Jon Simons, Sergio Della Sala, the chance to choose their favoured Daniel Simons to name but a few – giving a strong impression that the wider outlet on the basis of their results.

‘If we allow to pass uncontested the community backed this plan. So far the claim that the pre-registration model is journals Cortex (where Chambers is an a gold standard,’ she wrote, ‘we will editor); Attention Perception and

New takes on prisoners’ dilemmas It’s amazing really that no one has thought to do this before.

More than 60 years after it was developed, researchers at the University of Hamburg have taken the Prisoner’s Dilemma – a classic test of cooperation and defection – into a prison and observed the performance of female inmates (Journal of Economic Behavior & Organization: tinyurl.com/ pzhnjfj).

The dilemma involves two prisoners deciding in isolation whether to confess or to accuse their partner. They are told in advance that if both confess they get one year each; if both accuse the other, they get two years each; and if one accuses and the other confesses, the accuser goes free

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while the confessor gets three years. The mutually optimal option is for both parties to confess.

At the penitentiary for women in Vechta, Germany, Menusch Khadjavi and Andreas Lange used a version of the dilemma involving coffee and tobacco rewards with 90 inmates and found that 56 per cent chose to confess (the cooperative

option). Yet when they tested female students at Hamburg University using euros as rewards, this figure was only 37 per cent. ‘Inmates are therefore able to better solve their classical dilemma situation than students,’ the researchers said, ‘on average one can expect inmates to mutually cooperate in 30 per cent of cases, while only 13 per cent of students’ pairs fully cooperate.’

The researchers also tested a sequential version of the dilemma in which first one player makes their choice, and then the second player is told of this decision and reacts accordingly. In this version, more ‘first move’ students actually went for the

cooperative option as compared with prisoners.

However, both ‘second move’ prisoners and students were equally likely to respond to a cooperative partner by reciprocating in kind.

Speculatively, the researchers said their results suggest ‘criminal behaviour does not appear to be a selfselection process by which purely self-interested individuals are more likely to commit crimes than socially oriented individuals.’ The results were unaffected by controlling for a raft of socioeconomic variables, with one odd exception. Coffee drinkers were more cooperative than non-coffee drinkers – Khadjavi and Lange have no idea why. CJ

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ROYAL SOCIETY AWARD permit the denigration of the vast majority of great research and allow a number of serious constraints to be placed on it.’

Scott is not alone in these fears.

On her lab’s website she’s published contributions from many concerned psychologists, including such luminaries as Tim Shallice, Essi Viding, Patrick Haggard, Uta Frith, and Geraint Rees, among others. ‘In neuropsychology,’ wrote Shallice, ‘pre-registration would be disastrous… One study I was involved in took five years to collect what we then pragmatically decided were enough patients (42 frontals); does one have to publish one’s hypotheses six years in advance?’

Viding expressed a concern shared by others about the means by which this issue was being debated – in the media, rather than within the scientific community. ‘Media has unsurprisingly jumped on this,’ she wrote, ‘as it makes a juicy story to allude that if scientists do not sign up for this motion, it is likely to be because they have a bunch of dodgy methods to hide.’

Haggard acknowledged preregistration may help address issues

of low power and poor methodology in psychology, but he said it was inappropriate in many other areas: ‘Pre-reg may help to provide rigorous answers to questions of important societal concern, like “Does intervention X work?”,’ he wrote. ‘But, as scientists, we also have to think outside the box.

We need ways of working which allow interventions Y and Z, which may not yet have even been thought of, to see the light of day.’

Chambers told us the concerns raised by Scott and others were understandable, ‘even if they are based on misreading or failing to read our proposal’. He added that the first preregistration submissions to Cortex are progressing smoothly and efficiently, and that he and others are currently negotiating with a large and well-known family of journals to launch Registered Reports. They are also in talks with funding agencies to incorporate the preregistration process into grants. ‘After 50 years of stagnation in scientific publishing and a research culture that has relied on questionable practices to sell science, the whiff of revolution is in the air,’ Chambers said. CJ

Lunar sleep patterns For centuries myths have swirled like clouds around the possibility that the full moon affects the human psyche. According to a new small study by researchers in Switzerland, one influence is real – at or near full moon, they found that people’s sleep is affected. Their participants slept for less time (20 minutes on average) around full moon; took five minutes longer than average to fall asleep; and they experienced a 30 per cent decrease in deep sleep, as revealed by the brain’s electrical activity (Current Biology: tinyurl.com/mngf5wn).

Crucially, these influences can’t be due to increased light at full moon because the data were collected in a sealed sleep laboratory. Also, we can safely assume no influence of experimenter effects because the data were analysed retrospectively. Christian Cajochen and his colleagues admitted, ‘We just thought of it after a drink in a local bar one evening at full moon, years after the study [and data collection] was completed.’

The results are based on two nights’ worth of sleep data collected from 17 healthy young volunteers (average age 25; nine women); and 16 healthy older volunteers (average age 65; eight women). As well as the effects on objective measures of sleep, the participants also felt they’d slept less well at or near full moon, and their melatonin levels were lower.

Cajochen and his team think their results provide tentative evidence that humans have a circalunar rhythm ‘reminiscent of other endogenous rhythms such as the circadian (daily) and circannual (seasonal) rhythms.’ CJ

read discuss contribute at www.thepsychologist.org.uk

Sarah-Jayne Blakemore at UCL has been honoured with the 2013 Rosalind Franklin Award by the Royal Society. The prize exists to support the promotion of women in science and the winner is expected to use a proportion of the attached grant of £30,000 implementing a project towards that end.

Professor Blakemore is a former winner of the British Psychological Society’s own Doctoral Award and Spearman Medal.

APA GOLD AWARD Professor Elizabeth Loftus, famed for her research into false memories, is the 2013 recipient of the American Psychological Association’s Gold Award for Life Achievement in the Science of Psychology.

The APA said: ‘Her imaginative and rigorous research has had a profound impact on the field of psychology, on scholars outside the field, and on the administration of justice around the world.’ Professor Loftus is based at the University of California, Irvine, and a member of The Psychologist’s International Panel of experts.

INTERNATIONAL NEUROETHICS SOCIETY Chartered Psychologist and Associate Fellow of the Society Professor Barbara Sahakian has been elected President of the International Neuroethics Society (INS).

The mission of the INS is ‘to promote the development and responsible application of neuroscience through interdisciplinary and international research, education, outreach and public engagement for the benefit of people of all nations, ethnicities, and cultures’. Sahakian, a professor of clinical neuropsychology at Cambridge University, will take up her post in February 2014 for a two-year term.

BEATING THE BULLIES The Beat Bullying charity group has launched the new MindFull charity and website to provide online advice and counselling support to 11- to 17-year-olds: www.mindfull.org. The initiative is supported

by Chartered Psychologist Tanya Byron.

‘Teenagers naturally look to the internet as a source of information and advice, so that’s where we need to be in order to help the hundreds of thousands of young people who are currently getting no support,’ she said.

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Dementia rates falling in the UK With a rapidly ageing population, doom-laden predictions about the inexorable rise in dementia have become all too familiar. Refreshingly, this trend was broken in July with some rare good news.

Researchers led by Fiona Matthews and representing the Medical Research Council Cognitive Function and Ageing Collaboration reported that rates of dementia were lower in a cohort assessed between 2008 and 2011, compared with a similar cohort tested between 1989 and 1994 (The Lancet: tinyurl.com/kedsmkj).

Estimates from the early More people are living to older data, based on interviews ages with better overall with over 7000 people aged functioning over 65 living in Cambridgeshire, Newcastle and had dementia in the UK at that time. Factoring in population Nottingham indicated that it changes it was predicted then was likely that 664,000 people

that this number would have risen by now to 884,000.

However, new interviews and assessments over the last few years with thousands more people in the same English regions led researchers to estimate that 670,000 people now have dementia in the UK – 214,000 fewer than expected based on the early data, and representing a decrease in prevalence from 8.3 per cent to 6.5 per cent.

The researchers speculated that factors such as improved education and cardiovascular disease prevention could have contributed to the apparent reduction in rates of dementia. In a commentary on the new findings (tinyurl.com/mtpn6s3), Sube Banerjee, the former joint lead of England’s Dementia Strategy, said the results were ‘unequivocally good news’ and testament to the effectiveness of

prevention strategies. However, he warned that the positive trend may not pass to successive generations, especially given increased rates of obesity. He also provided some perspective – ‘Even with a small decrease in incidence and prevalence, population ageing will still double the numbers with dementia worldwide in the next generation.’

In related news, a Danish study led by Kaare Christensen compared the cognitive functioning of 1584 people aged over 95 tested in 2010 with the functioning of over two thousand 93-year-olds tested in 1998, finding that the contemporary cohort were superior performers (The Lancet: tinyurl.com/l9pppq5).

This suggests ‘more people are living to older ages with better overall functioning’, the researchers said. CJ

Grappling with the placebo problem Intervention studies in psychology are afflicted by a ‘pernicious and pervasive’ problem, namely the failure to adequately control for the placebo effect. That’s according to a team led by Walter Boot at Florida State University. Writing in Perspectives on Psychological Science they lament the way psychologists frequently claim the effectiveness of interventions without ensuring that participants’ expectations for improvement are matched across the treatment and control conditions (tinyurl.com/pe9th64).

‘The lack of masked condition assignment in psychological interventions [i.e. participants know what treatment they’re receiving] is not a minor inconvenience,’ write Boot and co., ‘it is a fundamental design flaw, and experimenters have an obligation to test for the possible consequences of these design limitations.’

As a case study, Boot and his colleagues focus on claims that playing video games can give rise to a range of cognitive benefits. Typically one ‘treatment’

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they would expect greater gains in group will play an action video game such attention and multitasking compared with as Unreal Tournament while a control participants who watched the group will play a puzzle Tetris puzzle game. In contrast, game like Tetris. Greater those who saw the Tetris clips post-game improvements in were more likely to say they attention and multitasking expected gains on a story in the treatment group memory task. compared with the control In other words, group are frequently participants with and without attributed to the effect of video game experience held playing an action game. differential expectations about A problem with this the likely effects of action and interpretation is that playing puzzle games. Any observed action games may lead to differences in the effects of differential expectations of Differences could be playing these games could cognitive improvements related to expectations therefore be attributable compared with playing a rather than to content to expectations rather than puzzle game. to the content of the games themselves.

Boot and his colleagues tested this Consistent with this interpretation, the possibility by showing hundreds of naive participants’ expectations matched the and experienced participants clips from pattern of findings in the video-gaming either an action or puzzle game and then literature. Psychologists should aim to teaching them about the kinds of tests eliminate or at least measure these used to measure cognitive performance. expectancy effects, said the researchers, Participants who watched the clips from but ‘no published study has done so.’ the Unreal Tournament action game said

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FUNDING NEWS

Spirituality project The RSA in London has announced the launch of a new project out of its Social Brain Centre that will be focused on spirituality. ‘We are examining how new scientific understandings of human nature might help us reconceive the nature and value of spiritual perspectives,

practices and experiences,’ says the Centre director Jonathan Rowson on the organisation’s website.

A series of workshops and public events are planned in due course, with a final report published in 2014.

‘We do not want to collapse our deliciously difficult existential and

Boot’s team gave other examples of fields where the placebo effect is not adequately controlled – including computerised brain training; daily expressive writing; and internet therapy.

They acknowledge it can be challenging to find ways to match expectations and they highlight some methods that can help, including: using a countermand design in which participants are told to expect benefits only after a specified amount of the intervention; or using component control – different manipulations are applied together and then subtracted one at a time (this brings similarity in experience to the intervention groups and helps control expectations).

‘We are hopeful that, with better designs and better checks on placebo effects, future research will provide more compelling evidence for the effectiveness of interventions,’ the authors concluded.

In related news, researchers led by Jian Kong at Massachusetts General Hospital and Harvard Medical School have

ethical issues into psychological and sociological concepts,’ writes Rowson in an accompanying essay in the RSA’s quarterly journal. ‘The point is rather to explore the provenance of those questions and experiences with fresh intellectual resources.’ CJ

compared with pain-relieving effects of several placebo treatments on the same participants (PLoS One: tinyurl.com/opng3ve). Each volunteer had their pain sensitivity tested before and after taking placebo pills (described as Tylenol); receiving real and sham acupuncture; exposure to the cue word ‘high’ or ‘low’ (pain); and a no-treatment rest-based control condition. The treatments and assessments were spread out over several days.

Overall, pills, genuine acupuncture and the low-pain visual cue all had an analgesic effect. But crucially, there was no correlation in the size of the analgesic effect experienced by participants across placebo treatments. In other words, a person’s response in one condition did not predict their likelihood of responding in another. ‘It implies that placebo responses may not be dependent on stable individual traits,’ said Kong, ‘but rather are more a characteristic of the circumstances of individuals or a combination of both trait and state.’ CJ

read discuss contribute at www.thepsychologist.org.uk

The ESRC has launched a pilot of a new Urgency Grants Mechanism to allow them to provide funding to respond to urgent or unforeseen events where there is a strong case for immediate research. Examples of such events are the UK riots in 2011 or a natural disaster. Outline proposals must be submitted prior to making a full application.

I tinyurl.com/ljgzun9 The John Templeton Foundation has funding available under its Gods in Minds: The Science of Religious Cognition competition.

This seeks to promote the integration of existing lines of research about how people think about God and gods from the different subdisciplines of the psychological, cognitive and social sciences. Up to $250,000 is available for projects of up to 30 months duration. Online Funding Inquiry deadline: 1 October 2013.

I tinyurl.com/nnm4ox8 The EC Directorate-General for Justice is seeking proposals under the Daphne III action grants to prevent and combat violence against children, young people and women and to protect victims and groups at risk.

The priorities for this call are: Support for victims of violence; Violence linked to harmful practices; Children as victims and/or witnesses of violence in close or intimate relationships; Children as victims of bullying at school; Perpetrator interventions and victim protection measures; Prevention of violence against children, young people and women through projects targeting attitudinal and behavioural changes in the context of sexualisation; Awareness raising on violence against women. Closing date for applications: 30 October 2013.

I tinyurl.com/qzlbun7

info

A team of four psychologists led by Joe Devlin at UCL has provided a scientific answer to that perennial summer BBQ question – charcoal or gas? In blind tests with over 100 participants they found that there was no preference for beef cooked either way, although people told they were eating gas-cooked beef rated their food more highly regardless of how it had really been cooked.

The Higher Education Academy (HEA) Mike Baker Doctoral Programme provides funding for HEIs to host a PhD doctoral studentship for a project to develop pedagogical knowledge and evidence-based practice in higher education. Projects should be discipline-specific and applications relating to psychology and psychology-related theoretical grounded work are welcome.

Applications should be made by supervisors in HEIs that subscribe to the HEA. Closing date for applications: 23 September 2013.

I tinyurl.com/7zc7sok

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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DIGEST

From 2013

Smiling fighters are more likely to lose The day before mixed martial artists compete in the Ultimate Fighting Championships (UFC), they pose with each other in a staged face-off. A new study has analysed photographs taken at dozens of these pre-fight encounters and found that competitors who smile are more likely to lose the match the next day.

Michael Kraus and Teh-Way David Chen recruited four coders (blind to the aims of the study) to assess the presence of smiles, and smile intensity, in photographs taken of 152 fighters in 76 faceoffs. Fighter smiles were mostly ‘non-Duchenne’, with little or no crinkling around the eyes. Data on the fights was then obtained from official UFC statistics. The researchers wanted to test the idea that in this context, smiles are an involuntary signal of submission and lack of aggression, just as teeth baring is in the animal kingdom.

Consistent with the researchers’ predictions, fighters who smiled more intensely prior to a fight were more likely to lose, to be knocked down in the clash, to be hit more times, and to be wrestled to the ground by their opponent (statistically speaking, the effect sizes here were small to medium). On the other hand, fighters with neutral facial expressions pre-match were more likely to excel and dominate in the fight the next day, including being more likely to win by knock-out or submission.

These associations between In Journal of Cognition and Development facial expression and fighting performance held even after controlling for betting behaviour by fans, which suggests a fighter’s smile reveals information about their lack of aggression beyond what is known by experts. Moreover, the psychological meaning of a pre-match smile appeared to be specific to that fight – no associations were found between pre-match smiles and performance in later, unrelated fights. Incidentally, smaller fighters smiled more often, consistent with the study’s main thesis, but smiling was still linked with poorer fight performance after factoring out the role of size (in other words, smiling was more than just an indicator of physical inferiority).

If fighters’ smiles are a sign of weakness, there’s a chance opponents may pick up on this cue, which could boost their own performance, possibly through increased confidence or aggression.

To test the plausibility that smiles are read this way, Kraus and Chen asked 178 online, non-expert participants to rate head-shots of the same fighter either smiling or pulling a neutral expression in a pre-match face-off. As expected, smiling fighters were rated by the non-expert participants as less physically dominant, and this was explained by smiling fighters being perceived as less aggressive and hostile.

Of course, the researchers are only speculating about what's going on inside the minds of the fighters pre-match. It’s even possible that some of them smile in an attempt to convey insouciance.

If so, Kraus and Chen said ‘it is clear that this nonverbal behaviour had the opposite of the desired effect – fighters were more hostile and aggressive during the match toward their more intensely smiling opponents.’

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From 2009 Do you do voodoo?

In Perspectives on Psychological Science They are beloved by prestigious journals and the popular press, but many recent social neuroscience studies are profoundly flawed, according to a devastating critique – Voodoo Correlations in Social Neuroscience.

The studies in question have tended to claim astonishingly high correlations between localised areas of brain activity and specific psychological measures. For example, in 2003, Naomi Eisenberger at the University of California and her colleagues published a paper purporting to show that levels of self-reported rejection correlated at r = .88 (1.0 would be a perfect correlation) with levels of activity in the anterior cingulate cortex.

According to Hal Pashler and his band of methodological whistle-blowers, if Eisenberg’s study and others like it were accurate, this ‘would be a milestone in understanding of brain–behaviour linkages, full of promise for potential diagnostic and therapeutic spin-offs.’

Unfortunately, Pashler’s group argue that the findings from many of these recent studies are virtually meaningless.

The suspicions of Pashler and his colleagues – Ed Vul (lead author), Christine Harris and Piotr Winkielman – were piqued when they realised that many of the cited levels of correlation in social neuroscience were impossibly high given the respective

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10 years of the Research Digest

reliability of brain activity measures and measures of psychological factors, such as rejection. To investigate further they conducted a literature search and surveyed the authors of 54 studies claiming significant brain–behaviour correlations.

The search wasn’t exhaustive but was thought to be representative, with a slight bias towards higher-impact journals.

Pashler and his team found that 54 per cent of the studies had used a seriously biased method of analysis, a problem that probably also undermines the findings of fMRI studies in other fields of psychology.

These researchers had identified small areas of brain activity (called voxels) that varied according to the experimental condition of interest (e.g. being rejected or not), and had then focused on just those voxels that showed a correlation, higher than a given threshold, with the psychological measure of interest (e.g. feeling rejected).

Finally, they had arrived at their published brain–behaviour correlation figures by taking the average correlation from among just this select group of voxels, or in some cases just one ‘peak voxel’. Pashler’s team contend that by following this procedure, it would have been nearly impossible for the studies not to find a significant brain–behaviour correlation.

By analogy with a purely behavioural experiment, imagine the author of a new psychometric measure claiming that his new test correlated with a target psychological construct, when actually he had arrived at his significant correlation only after he had first identified and analysed just those items that showed the correlation with the target construct.

Indeed, Pashler and his collaborators speculated that the editors and reviewers of mainstream psychology journals would routinely pick up on the kind of flaws seen in imagingbased social neuroscience, but that the novelty and complexity of this new field meant such

mistakes have slipped through the net.

On a more positive note, Pashler’s team say there are ways to analyse social neuroscience data without bias and that it should be possible for many of the studies they’ve criticised to re-analyse their data. For example, one approach is to identify voxels of interest by region, before seeing if their activity levels correlate with a target psychological factor. An alternative approach is to use different sets of data to perform the different steps of analysis used previously. For example, by using one run in the scanner to identify those voxels that correlate with a psychological measure, and then using a second, independent run to assess how highly that subset of voxels correlates with the chosen measure. ‘We urge investigators whose results have been questioned here to perform such analyses and to correct the record by publishing follow-up errata that provide valid numbers,’ Pashler's team said.

Matthew Lieberman, a coauthor on Eisenberger’s social rejection study, told us that he and his colleagues have drafted a robust reply to these methodological accusations, which will be published in Perspectives on Psychological Science alongside the Pashler paper. In particular he stressed that concerns over multiple comparisons in fMRI research are not new, are not specific to social neuroscience, and that the methodological approach of the Pashler group, done correctly, would lead to similar results to those already published.

‘There are numerous errors in their handling of the data that they reanalyzed,’ he argued.

‘While trying to recreate their [most damning] Figure 5, we went through and pulled all the correlations from all the papers.

We found around 50 correlations that were clearly in the papers Pashler’s team reviewed but were not included in their analyses. Almost all of these overlooked correlations tend to work against their hypotheses.’

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From 2003 Seeing racism in the brain In Nature Neuroscience The more implicit racial bias a white person showed against black people, the more activated the cognitive/executive control regions of their brain became when they viewed photographs of black faces.

Jennifer Richeson (Dartmouth College, USA) and colleagues invited 15 white undergraduates to complete a version of the ‘implicit associations test’ (IAT; see Research in Brief, The Psychologist, 16, 429) designed to reveal underlying racial bias.

Subjects were asked to press one of two keys when certain words appeared on a computer screen. A person with racial bias would be expected to respond more quickly when the same key was paired with the words ‘good’ and ‘white’ than when paired with the words ‘good’ and ‘black’. The same participants were then invited to chat with a black interviewer for five minutes

about the college fraternity system and racial profiling.

Next they performed the Stroop test (see Research Digest Issue 5, item 6), a measure of cognitive control. Finally, within two weeks, the students underwent a brain scan while they viewed photographs of black and white faces.

The more racial bias subjects displayed during the IAT test, the poorer their subsequent performance on the Stroop test, and the more activated the executive control areas of their brain became when they viewed black faces.

The authors concluded their results suggest ‘individuals with high scores on subtle measures of racial bias may put forth additional effort to control their thoughts and behaviours in order to live up to their egalitarian, nonprejudiced values’.

This month we celebrate 10 years of the Society’s Research Digest service. Digest editor Dr Christian Jarrett has selected some of his favourite Digest items from the past decade over the coming pages.

Also look out for our 10th birthday celebrations at www.researchdigest.org.uk/blog 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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From 2008 The boy who thought 9/11 was his fault From 2006 Why do we still believe in group brainstorming?

In Neurocase

In the British Journal of Psychology

Researchers in London have documented the case of a 10year-old boy with Tourette’s syndrome and obsessive compulsive symptoms, who believed the terror attacks of 9/11 occurred because he had failed to complete one of his daily rituals.

Mary Robertson and Andrea Cavanna claim this is the firstever case reported in the literature of a person believing they were responsible for causing a major disaster of the proportion experienced in America in 2001.

The boy – described as ‘extremely pleasant and likeable’ and with good school grades – was first referred for consultation a year before 9/11 took place. As is characteristic of people with Tourette’s syndrome, the boy displayed several forms of uncontrollable tics, including excessive blinking and vocal outbursts, and he also showed obsessive tendencies and attentional problems.

Robertson next saw the boy two weeks after 9/11, at which point he was in a terrible state – ‘tortured’, as he put it, by his tics, and wracked with guilt, believing that 9/11 occurred because he had failed to walk on a particular white mark on a road.

This was just one of the many rituals the boy had developed during the course

So you need some fresh, innovative ideas. What do you do? Get a group of your best thinkers together to bounce ideas of each other? No, wrong answer. Time and again research has shown that people think of more new ideas on their own than they do in a group. The false belief that people are more creative in groups has been dubbed by psychologists the ‘illusion of group of productivity’.

But why does this illusion persist?

Bernard Nijstad and colleagues at the University of Amsterdam argue it’s because when we’re in a group, other people are talking, the pressure isn’t always on us and so we’re less aware of all the times that we fail to think of a new idea.

By contrast, when we’re working alone and we can’t think of anything, there’s no avoiding the fact that we’re failing.

To test their theory, they recruited hundreds of students and asked them, either on their own, or in differently sized groups, to think of as many ways as possible to boost tourism to Utrecht. Afterwards the students in groups reported feeling more satisfied with their performance, and feeling that they had experienced fewer failures to come up with new

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ideas, than did the students who had worked alone.

In a second study, Nijstad’s team found further support for their theory by showing that the illusion of group productivity could be undermined if different members of a group had to think of ideas for different projects. In this case, the students’ satisfaction with their performance and their sense of how much they had failed to think of new ideas, resembled the experience of students who worked alone.

The researchers said ‘We suggest that working in a group may lead to a sense of continuous activity. This may provide group members with the idea that they are productive, because they feel that the group as a whole is making progress, even if they themselves are not contributing.’

Other possible reasons for why people continue to think they work better in groups include ‘memory confusion’, the idea that after working in groups people subsequently mistake other people’s ideas for the own, and ‘social comparison’, the idea that in groups people are able to see how difficult everyone else has found it to come up with ideas too.

of the year. Others included socalled ‘dangerous touching’ rituals, including the need to feel the blade of knives to check their sharpness, and to put his hand in the steam of a kettle to check its heat.

Importantly, the researchers said the boy’s beliefs about 9/11 were distinct from the kind of delusions expressed by people with psychosis, and instead reflected an extreme form of the anxiety that people with obsessive compulsive disorder often experience when they fail to complete their rituals.

Fortunately, a mixture of drug treatments and reassurance (including explaining to the boy that his missed ritual actually occurred after 9/11, given the time difference between the USA and UK), led to him realising that he was not responsible for the attacks.

Robertson and Cavanna said this case study brings attention to the way our modern media – ‘immediate, realistic, and evocative’ – can lead to terrorist attacks and other disasters having harmful effects on vulnerable people miles away from the immediate environment of what happened.

‘Only time will reveal the many further psychosocial sequelae of 9/11, as well as the Madrid and London terrorist bombings,’ they said.

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10 years of the Research Digest

From 2005 Born already attached In the British Journal of Psychology Psychologists are becoming increasingly aware of the importance of ‘antenatal attachment’ – the bond formed between a pregnant mother and her unborn child. For example, a mother’s degree of affection for her unborn child, and the amount of time she thinks about it, can predict the quality of the mother–child relationship once the baby is born. Pier Righetti (Conegliano Hospital, Italy) and colleagues investigated whether advances in ultrasound technology that provide enhanced fetal images, would strengthen the attachment formed between parents and their unborn baby.

Fifty-six women at 19–23 weeks pregnancy, and their partners, were split into two groups. Half attended a standard 2-D ultrasound appointment, and half underwent a state-of-the-art 4-D ultrasound, which provides superior imagery of the fetus, including showing its movements in real time. Before the ultrasound, and then two weeks after it, the parents completed self-report attachment questionnaires.

The strength of the mothers’ attachment to their unborn baby increased significantly over the two-week period, probably due in part to the fetuses starting to kick more during that time. However, the quality of the ultrasound made no difference to their strength of attachment, and the fathers’ attachment didn’t increase over the two weeks regardless of the ultrasound technology.

The authors point out that the improved ultrasound could have psychological benefits not tapped by the self-report questionnaires they used; that their research should be repeated at other stages of pregnancy, and with a greater number of couples.

From 2011 How walking through a doorway increases forgetting In Quarterly Journal of Experimental Psychology Like information in a book, unfolding events are stored in human memory in successive chapters or episodes. One consequence is that information in the current episode is easier to recall than information in a previous episode. An obvious question then is how the mind divides experience up into these discrete episodes? A new study led by Gabriel Radvansky shows that the simple act of walking through a doorway creates a new memory episode, thereby making it more difficult to recall information pertaining to an experience in the room that has just been left behind.

Dozens of participants used computer keys to navigate through a virtual-reality environment presented on a TV screen. The virtual world contained 55 rooms, some large, some small. Small rooms contained one table; large rooms contained two: one at each end. When participants first encountered a table, there was an object on it that they picked up (once carried, objects could no longer be seen). At the next table, they deposited the object they were carrying at one end and picked up a new object at the other. And on the participants went. Frequent tests of memory came either on entering a new room through an open doorway, or after crossing halfway through a large room.

An object was named on-screen and the participants had to recall if it was either the object they were currently carrying or the one they had just set down.

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The key finding is that memory performance was poorer after travelling through an open doorway, compared with covering the same distance within the same room. ‘Walking through doorways serves as an event boundary, thereby initiating the updating of one’s event model [i.e. the creation of a new episode in memory]’ the researchers said.

But what if this result was only found because of the simplistic virtual-reality environment? In a second study, Radvansky and his collaborators created a real-life network of rooms with tables and objects. Participants passed through this real environment picking up and depositing objects as they went, and again their memory was tested occasionally for what they were carrying (hidden from view in a box) or had most recently deposited. The effect of doorways was replicated.

Participants were more likely to make memory errors after they’d passed through a doorway than after they’d travelled the same distance in a single room.

Another interpretation of the findings is that they have nothing to do with the boundary effect of a doorway, but more to do with the memory enhancing effect of context (the basic idea being that we find it easier to recall memories in the context that we first stored them). By this account, memory is superior when participants remain in the same room

because that room is the same place that their memory for the objects was first encoded.

Radvansky and his team tested this possibility with a virtual-reality study in which memory was probed after passing through a doorway into a second room, passing through two doorways into a third unfamiliar room, or through two doorways back to the original room – the one where they’d first encountered the relevant objects. Performance was no better when back in the original room compared with being tested in the second room, thus undermining the idea that this is all about context effects on memory. Performance was worst of all when in the third, unfamiliar room, supporting the account based on new memory episodes being created on entering each new area.

These findings show how a physical feature of the environment can trigger a new memory episode. They concur with a study published earlier this year that focused on episode markers in memories for stories. Presented with a passage of narrative text, participants later found it more difficult to remember which sentence followed a target sentence, if the two were separated by an implied temporal boundary, such as ‘a while later...’. It’s as if information within a temporal episode was bound together, whereas a memory divide was placed between information spanning two episodes.

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From 2004 Counting, the cost of a numberless language In Science Express Reports Can we think about concepts for which we have no words? Could a tribe without numbers count?

Peter Gordon (Columbia University) studied a huntergatherer tribe in the Amazon – the Piraha – who have just two numerical words, ‘hoi’ with an accent and ‘hoi’, without, signifying ‘one’ and ‘two’.

The 200 or so members of the Piraha use a ‘one-to-many’ system of counting, in which quantities above two are simply referred to as ‘many’. The tribe have no currency of their own, but barter goods instead.

In a matching task, an experimenter lined up some batteries. A member of the tribe was then required to match the number in a line of their own.

They performed well when there were two or three batteries but much less so for larger quantities.

In another task, a tribesperson watched as sweets were placed in a box whose lid had fish painted on it. When the box was hidden and then revealed together with a second box that had a different number of fish painted on its lid, the tribesperson could only identify the sweet-filled box when the number of fish to be compared between box lids was less then three; after that, performance was no better than chance.

‘These studies show that the Piraha’s impoverished counting system truly limits their ability to enumerate exact quantities when set sizes exceed two or three items’, the author said.

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From 2012 Why do children hide by covering their eyes?

In Journal of Cognition and Development A cute mistake that young children make is to think that they can hide themselves by covering or closing their eyes.

Why do they make this error?

A research team led by James Russell at the University of Cambridge has used a process of elimination to find out.

Testing children aged around three to four years, the researchers first asked them whether they could be seen if they were wearing an eye mask, and whether the researcher could see another adult, if that adult was wearing an eye mask.

Nearly all the children felt that they were hidden when they were wearing the mask, and most thought the adult wearing a mask was hidden too.

Next, Russell and his colleagues established whether children think it’s the fact that a person’s eyes are hidden from other people’s view that renders them invisible, or if they think it’s being blinded that makes you invisible. To test this, a new group of young kids were quizzed about their ability to be seen when they were wearing goggles that were completely blacked out, meaning they couldn’t see and their eyes were hidden, versus when they were wearing a different pair that were covered in mirrored film, meaning they could see, but other people couldn’t see their eyes.

This test didn’t go quite to plan because out of the 37

participating children, only seven were able to grasp the idea that they could see out, but people couldn’t see their eyes.

Of these seven, all bar one thought they were invisible regardless of which goggles they were wearing. In other words, it appears that the children’s feelings of invisibility come from the fact that their eyes are hidden, rather than from the fact that they cannot see.

Now things get a little complicated. In both studies so far, when the children thought they were invisible by virtue of their eyes being covered, they nonetheless agreed that their head and their body were visible.

They seemed to be making a distinction between their ‘self’ that was hidden, and their body, which was still visible. Taken together with the fact that it was the concealment of the eyes that seemed to be the crucial factor for feeling hidden, the researchers wondered if their invisibility beliefs were based around the idea that there must be eye contact between two people – a meeting of gazes – for them to see each other (or at least, to see their ‘selves’).

This idea received support in a further study in which more children were asked if they could be seen if a researcher looked directly at them whilst they (the child) averted their gaze; or, contrarily, if the researcher with gaze averted was visible whilst the child looked directly at him

or her. Many of the children felt they were hidden so long as they didn’t meet the gaze of the researcher; and they said the researcher was hidden if his or her gaze was averted whilst the child looked on. ‘...it would seem that children apply the principle of joint attention to the self and assume that for somebody to be perceived, experience must be shared and mutually known to be shared, as it is when two pairs of eyes meet,’ the researchers said.

Other explanations were ruled out with some puppet studies. For instance, the majority of a new group of children agreed it was reasonable for a puppet to hide by covering its eyes, which rules out the argument that children only hide this way because they are caught up in the heat of the moment.

The revelation that most young children think people can only see each other when their eyes meet raises some interesting questions for future research. For example, children with autism are known to engage in less sharing of attention with other people (following another person’s gaze), so perhaps they will be less concerned with the role of mutual gaze in working out who is visible. Another interesting avenue could be to explore the invisibility beliefs of children born blind.

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From 2010 How to form a habit In European Journal of Social Psychology Habits are those behaviours that have become automatic, triggered by a cue in the environment rather than by conscious will. Psychologists often want to assist people in breaking unhealthy habits, while helping them adopt healthy ones. Remarkably, although there are plenty of habitformation theories, before now, no one had actually studied habits systematically as they are formed.

Phillippa Lally and her team recruited 96 undergraduatess (mean age 27) and asked them to adopt a new health-related behaviour, to be repeated once a day for the next 84 days. The new behaviour had to be linked to a daily cue. Examples chosen by the participants included going for a 15-minute run before dinner; eating a piece of fruit with lunch; and doing 50 sit-ups after morning coffee. The participants also logged onto a website each day, to report whether they’d performed the behaviour on the previous day, and to fill out a self-report measure of the behaviour’s automaticity. Example items included ‘I do it automatically’, ‘I do it without thinking’ and ‘I’d find it hard not to do’.

Of the 82 participants who saw the study through to the end, the most common pattern of habit formation was for early repetitions of the chosen behaviour to produce the largest increases in its automaticity.

Over time, further increases in automaticity dwindled until a plateau was reached beyond which extra repetitions made no difference to the automaticity.

The average time to reach maximum automaticity was 66 days, although this varied greatly between participants from 18 days to a predicted 254 days (assuming the still rising rate of change in automaticity at the study end were to be continued beyond the study’s 84 days). This is much longer than most previous estimates of the time taken to acquire a new

habit – for example a 1988 book claimed a behaviour is habitual once it has been performed at least twice a month, at least 10 times. In fact, even after 84 days, half of the participants had failed to achieve a high enough automaticity score for their new behaviour to be considered a habit.

Unsurprisingly perhaps, more complex behaviours were found to take longer to become habits. Participants who had chosen an exercise behaviour took about one and a half times as long to reach their automaticity plateau compared with the participants who adopted new eating or drinking behaviours.

What about the effect of having a day off from the behaviour? Writing in 1890, William James said that a behaviour must be repeated without omission for it to become a habit. The new results found that a single missed day had little impact on later automaticity gains, suggesting James may have overestimated the effect of a missed repetition.

However, there was some evidence that too many missed repeats of the behaviour, even if spread out over time, had a cumulative effect, reducing the maximum automaticity level that was ultimately reached.

It seems the message of this research for those seeking to establish a new habit is to repeat the behaviour every day if you can, be prepared for the long haul, and don't worry excessively if you miss a day or two.

This research has a serious shortcoming, acknowledged by the researchers, which is that it depended on participants’ ability to report the automaticity of their own behaviour. Also, the amount of data made it hard to form clear conclusions about the need for consistency in building a habit. However, the study provides an exciting new approach for exploring habit formation.

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From 2007 Humans can track scents like a dog In Nature Neuroscience Bloodhounds are unlikely to be out of work just yet, but researchers have found humans can track a scent on the ground in the same way that dogs do.

While humans are traditionally considered to have a poor sense of smell compared with many of their mammalian cousins, the new finding suggests this reputation may be unfair [see also ‘The exotic sensory capabilities of humans’, December 2012].

Jess Porter and colleagues first observed that 21 out of 32 participants were able to track a 10-metre trail of chocolate essential oil through an open field using their sense of smell alone. By contrast, none of them were able to track the scent when their nostrils were taped up.

Moreover, it seems this latent ability is ripe for improvement through practice.

In a second experiment the researchers asked four participants to practise tracking scents for three hours a day, for three days. Afterwards, they were more than twice as fast at tracking a scent, and deviated less from the scent trail. Such improvements needn’t end there: ‘Our sense of smell is less keen partly because we put less demand on it’, Porter said.

‘But if people practise sniffing smells, they can get really good at it.’

Next, in a move that opponents of animal experimentation would surely approve of, the researchers used human participants to find out more about how animals track scents. They wanted to know if such tracking is done by comparing odour intensity across the two nostrils, in much the same way that sound is localised by comparing across the ears. Some have argued the nostrils are spaced to close together to be used in this way, but it’s been a difficult issue to research with even in the most well-behaved dogs objecting to their nostrils being blocked.

So 14 human participants attempted to track a scent either with one nostril taped, or with both nostrils clear.

Accuracy dropped to 36 per cent with a taped nostril (compared with 66 per cent with both nostrils clear) and speed dropped by 26 per cent. Another experiment used a special device that combined airflow so that both nostrils received the same information: this was again found to impair performance.

‘Here we find that mammals performing a scenttracking task, freely able to move their nose and sample the olfactory environment in real time, reap added benefit from sampling via their two spatially offset nostrils’, the researchers concluded.

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OPINION

Austerity psychology Are ‘these troubled times’ having an impact on how you research, teach or practise psychology? We asked, you responded, opening with the Committee of the Society’s Community Psychology Section.

It is the political task of the social scientist… continually to translate personal troubles into public issues, and public issues into the terms of their human meaning for a variety of individuals. (Wright Mills, 1959, p.187)

references

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Baker Miller, J. (1976). Towards a new psychology of women. Boston, MA: Beacon Press.

Baum, S. & Lingaard, H. (2006).

Intellectual disabilities: A systemic approach. London: Karmac Books.

British Psychological Society (2013).

Classification of behaviour and experience in relation to functional psychiatric diagnoses: Time for a paradigm shift. Division of Clinical

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ommunity psychologists are never in any doubt that austerity is a psychological issue. There may be some who are not so sure, fearing perhaps that there is a danger of crossing over onto political territory and losing objectivity in the process. Others may find the territory overly social and insufficiently psychological. The community psychology position is that psychological functioning can only be fully understood by appreciating its social context and that one important aim of psychology is to bring critical attention to the way in which distress may be compounded by blaming individuals, families and communities for problems that are in large part a consequence of the way society is arranged (Kagan et al, 2011; Orford, 2008; Walker et al., 2012).

When it comes to austerity specifically, we can point to more particular evidence linking macroeconomic conditions with individual and family health and well-being. The evidence includes: work that traces the influence of family income loss on the problem behaviour of children via the mediating link of the disorganising effects of austerity on family life during

the ‘great depression’ years in the USA (Elder & Caspi, 1988); studies of the psychological effects of unemployment and ‘under-employment’ in the UK and elsewhere, showing that lack of adequate employment is a major cause of psychological distress and ill-health (e.g.

Warr et al., 1988); and the work of Brown and colleagues (see Brown & Harris,

1978) on the role of stressful life events and difficulties in the onset of depression in women, which showed how factors such as socio-economic status in London and traditional crofting/churchgoing lifestyle in the Outer Hebrides, coupled with individual and family vulnerability factors, were important in the origins of depression. Summarising that work, Brown (1998) referred to the two everinterconnecting strands to human life – the one personal, the other social, made up of a life career of accumulating social assets, resources and status.

Many other examples could be cited in support of the argument that the psychological is social, the personal political. What is harder to understand is why psychology has lagged behind other disciplines in trying to understand these connections. Examples of the way in which other disciplines have taken the lead in this include the work of medical

Factors such as socio-economic status, coupled with individual and family vulnerability factors, are important in the origins of depression

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Brown, G.W. (1998). Loss and depressive disorders. In B.P. Dohrenwend (Ed.) Adversity, stress, and psychopathology (pp.358–370). Oxford: Oxford

University Press.

Brown, G.W. & Harris, T.O. (1978). The social origins of depression: A study of psychiatric disorder in women. London: Tavistock.

Elder, G.H. & Caspi, A. (1988). Economic stress in lives: Developmental perspectives. Journal of Social Issues, 44(4), 25–45.

Emerson E., Madden, R., Robertson, J. et al. (2009). Intellectual and physical

disability, social mobility, social inclusion and health. Lancaster: Centre for Disability Research.

Fox, M. & Priest, P. (2004). Mike Fox and the poverty tourists. Clinical Psychology, 38, 44–46.

Giddens, A. (1991). Modernity and self-identity Cambridge: Polity Press.

Jahoda, A. & Markova, I. (2004) Coping with social stigma: People with

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epidemiologists on the social gradient of health and the importance for health of psychological factors such as job control (e.g. Marmot et al, 1997); and the writings of Wilkinson and Pickett (2010) on the harmful effects of income inequality, which they attribute to psychological factors such as status insecurity. Students of psychology should be much better informed and more reflective about such work and its implications.

There are many potential consequences of the austerity programme for psychology. One is economic: scarce resources will need to be even more carefully allocated at both the policy and practice levels. Consequently, applied psychologists will not only be required to consider what works, but also at what cost (Maynard, 2012). Psychology needs to keep up with the emerging requirements associated with the austerity programme, by incorporating training in economic analysis into the research methods curriculum at undergraduate and postgraduate level.

As the most vulnerable groups (such as the elderly, the disabled and lowincome earners) are hit hardest by the austerity policies (Penny & Slay, 2012), community psychology implores psychologists to be confident in standing alongside these groups. There is the need for innovative community-level interventions that empower and involve these vulnerable groups. Applied psychology has traditionally been disproportionately focused on individuals, and if there is any opportunity arising from the austerity programme it is to move psychology towards practising at a wider systems level. Arguably, most psychology is political in the sense that it ends up being used, either overtly or covertly, with or without our agreement, to support or challenge policy. We therefore call on psychologists to become more proactive in lobbying and policy work at both a local and national government level. We would encourage our professional body to do the same.

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Kuhn, S. (1996). The structure of scientific revolutions (3rd edn). London: University of Chicago Press.

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Choose to be agents of change, not just victims ur clients face the daunting challenge of survival in an age of austerity. They are not alone. As psychologists, we also face this challenge, though we are likely to experience it in different ways.

This is the second age of austerity.

The first came after the Second World War, in a nation that was traumatised by conflict and carrying a massive national debt. The government of that time nurtured the spirit as well as the body of the people by investing in the National Health Service. How different things are these days! Under the banner of neoliberalism the NHS is privatised, services are cut and an individualistic philosophy is used to demonise those ‘scroungers and skivers’ who have the temerity to exist on benefits.

The people this punishes above all are the poor, those at the bottom of the pile in terms of social and economic status as well as power. This includes people described as learning disabled as well as others unable to sell their labour on the open market. Their income is reduced, and they are either denied services altogether, or maintained on minimal support packages that leave them desperately lonely and at risk of exploitation and harm. A dominant discourse that condemns people for impairments over which they have little or no control means that less able people become an easy target for condemnation, stigmatisation and abuse (Sin et al., 2009). The impact of these developments is seen in increased rates of disability as well as physical and psychological illhealth (Emerson et al., 2009). People’s self-perception and sense of identity is undermined on all fronts (Jahoda & Markova, 2004).

Applied psychologists find themselves caught in an uneasy position, charged with implementing the policies of austerity whilst at the same time attempting to ameliorate their harmful impact. Every clinical psychologist that

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Maynard, A. (2012). Public health and economics: A marriage of necessity.

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read discuss contribute at www.thepsychologist.org.uk

I talk to expresses their unhappiness with their work environment, both on their own behalf and on behalf of their clients.

They are working in radically restructured services, commissioned and managed by people without a clinical background.

These people, with very limited understanding of the complexities of formulation, impose cost-saving clinical decisions that are at best likely to reduce the clients’ quality of life. The working conditions of psychologists are degraded, our clinical judgement is devalued, and our ability to function compassionately and effectively is compromised. This has worrying implications not only for the individuals who need our services but also for the future of our profession.

How can we respond? And how should we respond? Most of us want and need to keep our jobs, but to do this whilst caring for ourselves and maintaining a sense of integrity. Whilst working with the new system we need to have the courage and confidence in our professional ability to continue to represent the clinical needs of our clients.

This is difficult, particularly for those of us working as lone psychologists in multiprofessional teams. We cannot do it alone. We need to find ways to strengthen our professional identity, through regular meetings with other psychologists and continued access to CPD. We also need the upper echelons of our professions to have the vision and commitment to think beyond making the new systems work.

We need them to articulate a philosophy that provides an alternative to the dominant political discourse. This means countering individualisation with social understanding; countering commodification with a belief in the inherent value of the person; and countering a belief in financial reward as a motivator with a belief in public service and altruism.

The world of values is not particularly comfortable territory for psychologists.

Our core professional identity is as

emerging consensus. Chichester: Wiley.

Penny, J. & Slay, J. (2012). Everyday insecurity: Life at the end of the welfare state. Retrieved 29 July 2013 from www.neweconomics.org/publications/ entry/Everyday-insecurity Schon, D. (1991). The reflective practitioner.

New York: Basic Books.

Shorter, E. (1992). From paralysis to fatigue: A history of psychosomatic

illness in the modern era. New York: Free Press.

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(2009). Disabled people’s experiences of targeted violence and hostility.

Manchester: Equality and Human Rights Commission.

Singh, N.N., Lancioni, G.E,, Wingon, A.S.W. et al. (2007). Mindfulness training assists individuals with moderate mental retardation to

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scientist-practitioners, and we afford primacy to facts. But we also know that science operates within a social context, reflecting society’s values in the subjects of its study, the ways in which it chooses to study them and the practices that flow from this (Kuhn, 1996). Moreover, psychologists working in learning disability, in emerging from the crucible of psychometric testing and behaviourism, have shown a willingness to nibble at the edges of the scientific paradigm. We have taken on board the idea of reflective practice (Schon, 1991); grown to respect the validity of multiple stories (see Smith, 2011); accepted the

importance of the social context of our work (Baum & Lingaard, 2006); and introduced the practice of mindfulness, which has its roots in Buddhism (Singh et al., 2007). Behaviourism itself has evolved into ‘positive behaviour support’ (British Psychological Society, 2004).

It seems that the public statements of the BPS have barely caught up with this richness of perspective and the way in which it has been driven by values at least as much as science. Now as a profession we face our biggest challenge ever. We need the BPS to reposition itself with a clear statement of philosophy that is fit for purpose in these troubled times. It is

only with such a strong professional lead that individuals, in the field of learning disability and elsewhere, will have the conviction and confidence to maintain a principled stance and thereby work effectively, whether at a clinical or a strategic level.

The tide will turn. And, as Giddens (1991) reminds us, we are not just the victims but the agents of change. If we choose to be so.

I Jenny Webb is a Consultant Clinical Psychologist jenny.webb@agencyandaccess.co.uk

A refreshing outlook

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maintain their community placements. Behaviour Modification, 31, 800–813.

Smail, D. (2005). Power, interest and psychology: Elements of a social materialist understanding of distress. Ross-on-Wye: PCCS Books.

Smith, G. (Ed.) (2011, April). Learning disability [Themed edition]. Context.

Issue 114.

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of a more scientifically based discipline, but it also acknowledged that the personal sphere is a political one and our clients are politicised. Politics shape policies, which in turn shape people’s experiences of the world, and a denial of this would be a denial of the very realities that the people who use psychological services inhabit on a daily basis.

The work of a number of psychologists and academics across the globe has been instrumental in shaping feminist theories about inequality and relationships (see Baker Miller, 1976, for an excellent introduction to relational therapies). However, most psychological research tends either to focus on people as ill (case studies of illness and individual coping with life or death issues) or to look for global factors located within the person (e.g. research into personality types or genetic correlates). Whilst this type of work is invaluable, we must also ensure that the effects of poverty and class-based issues receive the attention that they deserve in terms There is no point in theorising if it does not help of research funding. the people who access services

imbalances that keep people trapped in cycles of oppression, including (nonexhaustively) gender, wealth, class and considerations of race and (dis)ability.

Psychology as a whole is in an excellent position to take up feminist ideals as more than one of many different types of therapy – as there are many more women in psychology than men, psychology is essentially the first science subject to be ‘feminised.’ In some circles feminist psychology has been seen as purely political and therefore outside the realms

Sutherland, H. (2012). Who is bearing the cost of austerity? A comparison of 6 EU countries. In Taking the long view 2011– 2012. Colchester: Institute for Social and Economic Research.

Walby, S. & Towers, J. (2012). Measuring the impact of cuts in public expenditure on the provision of services to prevent violence against women and girls. Report for

TIMM SONNENSCHEIN/REPORTDIGITAL.CO.UK

he impact of the current economic climate in the UK is only just starting to be realised. With the increase in food banks across the country, it is becoming more difficult to deny the realities of the thousands of people who are living ‘below the breadline’. Cuts in funding to services, particularly those that provide support to victims of domestic violence (Walby & Towers, 2012) may lead to increased violence both inside and outside of the home. Working in physical health settings, there has been an increase in the number of people referred for ‘somatic complaints’ or ‘medically unexplained symptoms’ – as Shorter (1992) suggests, this may be one way that people can legitimately express their difficulties in adjusting to the current climate. People are expressing physically and psychologically the feelings of hopelessness and helplessness that come with such power imbalances. But how can psychology work with people experiencing inequality on such a scale?

Feminist approaches to psychology may hold one way of looking at the current difficulties experienced across the country. Feminist psychology moves beyond advocating equality for women, and looks towards dismantling the power

Northern Rock Foundation and Trust for London. Available via www.trustforlondon.org.uk/ publications-research Walker, C., Johnson, K. & Cunningham, L. (Eds.) (2012). Community psychology and the socio-economics of mental distress: International perspectives. London: Palgrave Macmillan.

Warr, P., Jackson, P. & Banks, M. (1988).

Unemployment and mental health: Some British studies. Journal of Social Issues, 44(4), 47–68.

Wilkinson, R. & Pickett, K. (2010). The spirit level: Why equality is better for everyone. London: Penguin.

Wright Mills, C. (1959). The sociological imagination. Oxford: Oxford University Press.

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I Sarah Chafer is a Clinical Psychologist at St Helens Hospital, Merseyside Sarah.Chafer@sthk.nhs.uk

An invitation to look outwards relation to changes to services or policy We are regularly informed by the they disagree with. Together our voices government that we are living in times of are louder and we all gain in access to ‘austerity’. The media continues to report power and resources. that there is general support amongst the Having made the case for community population for addressing the economic work, we would sound a note of caution. ‘deficit’; however, the extent to which ’Austerity’ has made partnership working there is public understanding that more difficult. Increasingly, services and ‘austerity’ is just one possible economic organisations are facing financial cuts strategy that might be utilised to address meaning that there is not as much it is less clear. We hardly need make the capacity across organisations. It is also case that measures taken in the name of increasingly common for community ‘austerity’ have placed more people at risk of poverty (Sutherland, 2012).

Austerity offers psychologists a fresh opportunity to acknowledge the social and material influences on distress. If we take up the invitation to look outwards, rather than inwards for causes of distress, we may need to look beyond our relationships with others, our families, schools and social networks and out into the more distant edges of our ‘power horizon’ (Smail, 2005) to the political and social context that is the birthplace of austerity, and the place where our We can also support groups of people who have lived interventions might be targeted. experience of homelessness There has been a recent debate in the letters page of this organisations to find themselves in magazine (April and May 2013), about competition with each other for service whether psychologists could be agents provision, which has led to fragmentation of social change. How might we do this? and self-preservation, neither of which are The Four Element model of community conducive to partnership working. psychology (Orford, 2008) offers us Though it is difficult at times, continued a framework. Psychologists can use the dialogue with partners and maintaining knowledge that they have to directly our focus on what we’re all here to do can address inequalities, for example by help overcome these constraints. facilitating access to research evidence for Psychologists’ approach of looking marginalised groups (Fox & Priest, 2004). inwards for causes of distress means that An example of this from our own practice more distal causes, like poverty, are at risk in the Homeless Mental Health Service of being obscured. We can change this by might be sharing knowledge about the looking up and out, illuminating the impact of the social context on mental distal influences on human suffering and health with sex workers through a building partnerships with communities. monthly newsletter. From the position These approaches can be mutually of accumulating this knowledge we can beneficial, friendly to the public purse, move towards joining together with and ensure people who want support are others; for example, over the years we reached before they get to crisis point and have built close relationships with local become at risk of being drawn into more groups who campaign with and provide costly, inpatient systems. services for homeless people. Once we have joined with others we can begin to take action together. For example, we might take up invitations from the City I Suzanne Elliott is a Clinical Psychologist Council to contribute to their with Leicester Homeless Mental Health consultation on proposed cuts to the Service funding of services for people who are Suzanne.Elliott@leicspart.nhs.uk homeless. We can also support groups I Colm Gallagher is a Trainee Clinical of people who have lived experience of Psychologist with Leicestershire Partnership homelessness to take direct action in Trust

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There is no point in theorising, however, if it does not help the people who access services. One way to do this is to make it clear that the reasons for people needing help are multifaceted and to place some emphasis on poverty and inequality. It is also important to try to avoid catch-all labels such as depression without explaining why the person might be depressed. For example, unemployment and bereavement are two things that may contribute to depression; however, one has more pressing implications for government policies on welfare, social care and economic growth.

Therapies following social-constructionist and narrative traditions can be seen as feminist, as they work collaboratively with people to create an understanding of their distress that is less medicalised and takes into account the multitude of social and cultural messages that people experience and that contribute to distress.

My work over the past four years (mainly in physical health settings) has come from a place of wanting to empower people to be able to recognise the difficulties that can spring from systemic inequalities, poverty and violence, whilst helping them to effectively and realistically negotiate their ways through the world. This has been done in a variety of ways, from recommending feminist texts to patients, to encouraging them to sign up for self-defence classes (and attending with them as an observer if necessary). When working with patients with ‘weight management issues’, initiatives such as Health at Every Size (HAES) allow more freedom to explore the meanings of size and weight with people rather than adhering rigidly to a model that situates the patient’s weight as a problem and ignores societal constructs of weight and shape, as well as the implications of poverty or a lack of education on making ‘bad food choices’.

From the viewpoint of a newly qualified clinical psychologist, feminist psychology offers a refreshing outlook on the current economic climate and the difficulties experienced by patients.

Attempts to help people to overcome low mood and anxiety so that they are ‘ready for work’ in an environment of high rates of unemployment does not change the economic policies and social conventions that have created this situation. As psychologists, with the ability to reflect on our practices and the practices of others, we are able to do so much more.

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My manifesto in an age of austerity grew up and trained in a rather triumphalist and peaceful New Zealand. Post–Cold War, nuclear-free, and (largely) pre-terrorism, pre-credit crunch and pre-global warming. Not for me or my friends was there a Gallipoli or a Crete. In retrospect there was little imposition made on me by power; parents, employers or the state. This has given me a somewhat optimistic and independent character. It also shaped my initial approach to psychology, as I had a strong belief both in the potential of the individual and that the barriers to achieving that potential were internal.

This view now looks both privileged and naive.

I have a memory as a small boy of playing the hero. Somewhere along the line (perhaps realising I was not that heroic) I became interested in the cowards. Not the monsters but the petty collaborators with the strings of omissions that contributed to horrors both big and small. Professional psychology pays well, and like anyone at the upper end of the income scales I have been immune from austerity. My fear is that I am blinded to and rewarded by the system that I work in such that I cannot imagine a genuinely fairer and kinder world. A darker view is that if we were genuinely revolutionary we would not be nearly as well compensated and respected as we are.

In light of all of these concerns I give you one psychologist’s reaction to austerity, my manifesto if you will. Firstly, I want to strive for a more authentic practice. These times are a reminder to genuinely listen to people’s lives, not pathologise that experience or falsely

I

What do you think?

We put out a call for contributions to this ‘Opinion special’ in the publication and on Twitter via @psychmag, but no doubt there are many who missed that and would now like to contribute. We would love to hear from you: The Psychologist is a forum for communication, discussion and controversy among all members of the Society.

So do you think there is such a thing as ‘austerity psychology’? Are these difficult economic times having an impact on how you research, teach or practice psychology? Are there positives and negatives? How can psychology, as individuals and as a profession, adapt and thrive?

E-mail your contributions to psychologist@bps.org.uk to continue the discussion via our letters pages.

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attribute cause or agency to the individual (either defective thoughts or defective genes). History, biology, society and class bind us at least as tightly as the interpretations that we make about our own experience.

Secondly, I recognise that I have power, both individual and collective. Collectively we have a professional voice, access to politicians and a science that can speak to the effects of policy and is directly relevant to the decisions of austerity. We can speak to the need for strong communities, gainful occupation, sense of equity and personal efficacy along with the shared sense of purpose that makes for healthy people and society. As a profession we can applaud decisions that contribute to this just world and speak out against those that do not.

Thirdly, I will use my individual power. I make judgements that directly influence the material My fear is that I am blinded to and rewarded by quality of people’s lives. I believe the system that I work in such that I cannot people are at their best when active, imagine a genuinely fairer and kinder world engaged and contributing within a individual recruiting additional power rich social life. I will intervene with the (legal, police or family) to protect them institutions people are involved in to help interpersonally or to face a difficult create the circumstances where an situation. This recruitment always individual person can flourish. includes an element of tackling the shame Fourthly, I will discuss the that an individual feels for being in that implications of giving a diagnosis to the situation at all. people I see. Diagnosis may be useful, but The logic for me is inescapable. The it requires something from the person. social structures within which people live, They agree to a particular construction of including austerity, support people’s the world but are allowed to appeal to distress. The demonising of the poor power for aid and forgiveness of social serves to take further power, degrade obligations. I have always been amused autonomy and is likely lead to additional that our society requires people to helplessness and distress. Therefore in the be sick to get help, where demands face of these onslaughts a psychologist for justice are ignored. Perhaps it is must support individuals to find collective safer for the majority (who are only strength, exercise autonomy and recognise lightly touched by odd mental that their need or poverty is not an phenomena, death or financial individual failing. We need a collective insecurity) or the powerful to rejection of the myths that those of us in recognise distress only if it does not power tell those who do not have power. require collective change. As the I do not know if I can do this, and the validity of individual mental health reader will recognise practical difficulties. diagnosis is fraught, it is something However, I wish to practice critically and that I will only apply with the be a good steward of the public resources patient’s permission and for their at my disposal. I hope in trying to act on benefit (British Psychological these ideas I go some way to behaving Society, 2013). justly and usefully to those who share Finally and perhaps most their stories with me. contentiously, I should be exploring the idea of collective action with my patients. I accept at an individual level people need to feel effective I James Anderson is a Clinical Psychologist and I encourage autonomy and at the William Quarrier Scottish Epilepsy assertiveness within people’s lives.

Centre Many times this has involved an james.anderson@nhs.net

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‘I have the feeling that we are in a war period’ Maria Kasmirli and Keith Frankish with a Greek perspective on austerity psychology

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faced heavier demands and tougher working Over the past few years no country in Europe conditions. The crisis has brought a huge has experienced more extreme austerity rise in depression, suicidality, anxiety than Greece. With unsustainably high levels disorders, drug abuse, domestic violence, of national debt, the country has been forced social exclusion, and other mental health to rely on loans from the ‘troika’ of the issues, and the services of medical European Commission, the European psychologists are needed more than ever, Central Bank and the International Monetary especially in the public sector, to which Fund. These lenders required the patients have increasingly turned. Yet public government to implement austerity provision has shrunk. Many institutions have measures to reduce the deficit, and the been closed, had funding withdrawn or staff consequent tax rises and spending cuts have cut. This has created long waiting lists at the sent the economy into a deep recession, now remaining institutions and left many in its sixth year. Unemployment has risen to vulnerable patients with nowhere to go: one 27.4 per cent (60 per cent among young practitioner told us that in many cases child people); hundreds of thousands of victims of domestic abuse have to be kept in businesses have closed, and there has been hospital. Meanwhile, fewer staff (from a widespread social unrest. This has been a small base) have increased workloads, while harsh climate for Greek psychologists, both suffering exhaustion and insecurity academics and clinicians. themselves. ‘Sometimes, I have the feeling Psychology has only recently established that we are in a war period,’ says Corina itself as an independent academic discipline Hatzinikolaou, a developmental psychologist in Greece (the first department was established in 1987), and psychology departments are small and vulnerable.

For the last three years, no new staff have been recruited, retiring staff have not been replaced, and even formally appointed staff have not been allowed to assume their posts. Meanwhile the Ministry of Education has admitted more students (undergraduate admissions are centrally controlled), reduced completion times, and increased the number of exam periods (turning universities into ‘mass processing exam centres’ as one academic puts it). With budget cuts, departmental mergers and closures, and competition from the private sector, many The crisis has brought a huge rise in academics feel stressed and dispirited. depression, suicidality, anxiety disorders, drug Some talk of the ‘slow death’ of small abuse, domestic violence, social exclusion and departments, such as those of other mental health issues psychology, and many younger academics at the Institute of Child Health in Athens. ‘In have left to seek posts overseas. many public health structures, psychologists Research has also been hit. University have to act quickly and attend to as many research budgets have been cut and can people as they can, not necessarily providing support only small projects, and outside the best service, but attending to the most funding is scarce (there are European Union urgent needs.’ There is a similarly bleak grants, but competition for them is fierce). picture in the private sector, where Even basic support is lacking; researchers psychologists have seen their practices often have to self-fund attendance at shrink, while having to treat patients with conferences, and institutional subscriptions more serious problems. to online academic journals have lapsed. As Yet, despite the huge stresses they are salaries have been slashed and payments under, psychologists have responded delayed, this raises the prospect that only positively to the situation. Many those with independent means will be able professionals volunteer their services, to remain active researchers. working with humanitarian organisations Psychologists working in applied settings and churches to provide counselling and (hospitals, clinics, community mental health therapy services to the poor, immigrants, centres, and educational environments) have

homeless, and addicts; and many selfemployed practitioners work with public organisations for reduced fees or none at all. Many young unemployed psychologists are involved in voluntary work – selflessly, since such activities are not considered part of their practice.

Academics have also recognised the importance of addressing the new situation.

Sofia Triliva of the University of Crete talks of an ‘ethical imperative’ to study the impact of the economic crisis on people’s lives, and has herself focused on the effects on young people and on the rise of racism, ethnocentrism and fascism, especially in schools. Maria Platsidou of the University of Macedonia notes that positive psychology is now appreciated more than ever, and that there is increased interest in topics such as subjective well-being, resilience and practical ways of helping people cope. More generally, the erosion of social structures has vividly illustrated the social dimension of psychological well-being.

As Triliva puts it, ‘The bases of the person’s insecurities and problems are social, economic, and political, so how can s/he confront these problems as a disconnected individual or entity?’

Have there been any positive aspects to the crisis? It is hard to find any, but some of those we talked to pointed to an increase sense of solidarity and social responsibility, and to the challenges of developing new research partnerships and working together for social change.

Perhaps we can mention also the opportunities for developing international collaborations. For one thing is certain: anyone interested in the effects of austerity, on individuals, society and the profession of psychology itself, can learn much from their colleagues in Greece.

I Maria Kasmirli and Keith Frankish are philosophers with strong research interests in psychology. Maria is a PhD student in the Department of Philosophy at the University of Sheffield. Keith is a Senior Visiting Research Fellow in the Department of Philosophy at the Open University and an Adjunct Professor with the Brain and Mind Programme at the University of Crete. The authors wish to thank all those who have advised them on this article, mentioning in particular Corina Hatzinikolaou, Irini Kranias, Giannis Kugiumutzakis, Zaira Papaligoura, Lili Roussou and Sofia Triliva.

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Fashion designers, manufacturers, retailers and consumers interact to produce an important global industry that employs millions of people worldwide. We buy, wear and dispose of clothes. Some design, make and sell; others collect, display, recycle and up-cycle. Our clothing affects our self-esteem and confidence as well as influencing people’s perceptions of us, and even their cognitive abilities (see Hajo & Galinsky, 2012, on enclothed cognition).

This image was taken from Fashioning the Future 2009, a global student competition recognising the next generation of fashion designers and practitioners. It’s conceived and delivered by the Centre for Sustainable Fashion at London College of Fashion (www.fashion.arts.ac.uk). The college is committed to its ‘Better Lives’ agenda, using fashion to Reference Hajo, A. & Galinsky, A.D. (2012). Enclothed cognition. Journal of Experimental Social Psychology, 48, 918–925.

drive debate and change the way we live with the aim of developing a more ethical fashion industry concerned with promoting wellbeing through fashion.

Fashion is without doubt a fascinating and important aspect of our lives. And fashion, like psychology, is inherently concerned with behaviour.

Before becoming an academic (I am now a Chartered Psychologist), I worked as a visual merchandiser, graphic designer, dress maker and portrait artist.

Now I’m developing the first ever Psychology and Fashion master’s programme, to start in 2014 at the London College of Fashion.

For more information contact me on c.mair@fashion.arts.ac.uk.

Photo by Sean Michael; designer Karina Michel; text by Carolyn Mair.

E-mail jon.sutton@bps.org.uk with your ‘Big picture’ ideas

You are what you wear?

BIG PICTURE

www.thepsychologist.org.uk

ARTICLE

Swearing – the language of life and death Richard Stephens leads us through a colourful research journey Liverpool FC manager Bill Shankly once said, ‘Some people believe football is a matter of life and death, I am very disappointed with that attitude. I can assure you it is much, much more important than that.’ The same could be said for swearing and taboo language, as this article explains. Swearing is a relatively new focus for psychology research but an apt one. From swearing in pain to swearing in foreign tongues, and several points in between, a number of investigators have begun to rise to the challenge of striving to understand the emotional power undoubtedly contained within some of the shortest of utterances in the lexicon. Here, then, is a brief introduction.

questions

Pinker S. (2007). The stuff of thought: Language as a window into human nature. New York: Viking.

Chapter 7: ‘The seven words you can’t say on television’ Jay, T. & Janschewitz, K. (2012). The science of swearing. Observer, 25(5), May/June. tinyurl.com/cw9fxnc

references

resources

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Is swearing essential, or a bad habit best kicked?

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Could you live without it?

Bowers, J.S. & Pleydell-Pearce, C.W. (2011). Swearing, euphemisms, and linguistic relativity. PLoS ONE, 6, e22341.

Bryony Shaw prompts BBC apology by swearing after Olympic windsurfing bronze (2008, 20 August). Daily Telegraph. Retrieved 18 June 2013 from tinyurl.com/cl5w3pp Dewaele, J. (2010). ‘Christ fucking shit merde!’ Language preferences for

n 2004 my second daughter was born and, aspiring to be a modern dad, I stayed with and supported my wife through the labour. After a while it became clear that things were not going according to plan. This was mainly because our daughter was trying, unsuccessfully, to come out feet first.

What followed was a very long and difficult labour for my wife, and towards the end her pain was such that she swore out loud. Indeed, she produced a rather impressive selection of expletives during each wave of agonising contractions. But as the contractions passed and the pain subsided, she became embarrassed and apologetic over having let fly in front of the nurses, midwives and doctors, only to redouble her efforts when the next wave of contractions struck. The staff, however, had clearly seen all of this before.

A midwife explained to us that swearing, four-letter words, cursing, profanity, bad language – whatever you care to call it – is a completely normal and routine part of the process of giving birth. Amid the joy at the arrival of our healthy daughter and the mental disorientation of a very difficult and emotional day, I found this fascinating.

When I eventually returned to my desk at Keele University School of Psychology I wondered why it was that people swear in response to pain. Was it a coping mechanism, an outlet for frustration, or what? I did some literature searching to find out what psychologists thought of the link between swearing and pain. To my surprise I could not find anything written on this topic, although there were some

swearing among maximally proficient multilinguals. Sociolinguistic Studies, 4, 595–614.

Dooling, R. (1996). Blue streak: Swearing, free speech and sexual harassment.

New York: Random House.

Jay, T. (1999). Why we curse: a neuropsycho-social theory of speech.

Philadelphia: John Benjamins.

Jay, T. & Janschewitz, K. (2012). The science of swearing. Observer, 25(5),

papers on the psychology of swearing more generally. Professor Timothy Jay of Massachusetts College of Liberal Arts in the States, whom I have since had the pleasure of meeting, has forged a career investigating why people swear and has written several books on the topic. His main thesis is that swearing is not, as is often argued, a sign of low intelligence and inarticulateness, but rather that swearing is emotional language. In his words: ‘Curse words do things to sentences that noncurse words cannot do’ (Jay, 1999, p.137). Indeed, Professor Jay is rather scathing at psycholinguists’ tendency to have largely ignored swearing. He says: ‘Linguistic definitions of language [that omit cursing] are ultimately invalid, although polite’ (Jay, 1999, p.11).

I spoke with colleagues. Two psychological explanations of why people might swear when in pain were put forward. The ‘disinhibition’ explanation was the idea that in the momentary stress of acute pain we enter a state of social disinhibition (a diminished concern for social propriety) and reduced self-control so that words and ideas that we would usually suppress are expressed. The other explanation was that swearing in response to pain represents ‘pain catastrophising’ behaviour. Pain catastrophising is an exaggerated negative ‘mental-set’ brought to bear during pain experience (Sullivan et al., 2001). Catastrophic thinking exaggerates the level of threat posed by a painful event and heightens the pain intensity experienced. While there was some plausibility to the idea of swearing being an expression of pain catastrophising, it also seemed illogical.

Swearing as catastrophising would serve to increase feelings of hurt and discomfort, whereas most people seek to reduce the pain they are feeling.

Our research Over the next few years my students and I worked up a laboratory procedure for assessing swearing as a response to pain.

We used the ice-water challenge (or more

May/June. Retrieved 18 June 2013 from tinyurl.com/cw9fxnc Ringman, J.M., Kwon, E., Flores, D.L. et al. (2010). The use of profanity during letter fluency tasks in frontotemporal dementia and Alzheimer disease.

Cognitive & Behavioral Neurology, 23, 159–164.

Robbins, M.L., Focella, E.S., Kasle, S. et al. (2011). Naturalistically observed swearing, emotional support, and

depressive symptoms in women coping with illness. Health Psychology, 30, 789–792.

Stephens, R. & Allsop, C. (2012). Does state aggression increase pain tolerance? Psychological Reports, 111, 311–321.

Stephens, R., Atkins, J. & Kingston, A. (2009). Swearing as a response to pain. NeuroReport, 20, 1056–1060.

Stephens, R. & Clatworthy, A. (2006).

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formally, the cold pressor paradigm) to provide a stimulus that is painful but not harmful. Participants are asked to hold their hand in ice water for as long as they can tolerate, to a maximum of five minutes. While doing this we needed them to swear and we thought it important that they used swear words of their own choosing. Initially we had them read a passage of text and they filled in blanks with either swear words or neutral words (Stephens & Clatworthy, 2006).

Later on we just asked them to provide a swear word they might use if they banged their head or hit their thumb with a hammer, and then we asked them to repeat that during the cold water immersion. The words most popularly chosen were, as you would expect, ‘fuck’ and ‘shit’.

In our first published paper (Stephens et al., 2009) we showed that people withstood the ice-water challenge for longer, rated it as less painful, and showed a greater increase in heart rate when repeating a swear word throughout the procedure, as opposed to repeating a neutral word. We theorised, based on the rise in heart rate with swearing, that participants were experiencing an emotional reaction to swearing, setting off the fight or flight response, in turn producing stress-induced analgesia.

Next, we replicated the findings for cold-water immersion time and heart rate, but additionally showed that the reduction in pain from swearing was moderated by daily swearing frequency (Stephens & Umland, 2011). Let me explain this point further. In this second study we asked

Swearing, four-letter words, cursing, profanity, bad language – whatever you care to call it – is a completely normal and routine part of the process of giving birth

Does swearing have an analgesic effect?

Poster presentation at the British Psychological Society Psychobiology Section annual conference, 18–20 September 2006, Windermere.

Stephens, R. & Umland, C. (2011).

Swearing as a response to pain – Effect of daily swearing frequency.

Journal of Pain, 12, 1274–1281.

Stone, T.E., McMillan, M. & Hazleton, M. (2010). Swearing: Its prevalence in

healthcare settings and impact on nursing practice. Journal of Psychiatric and Mental Health Nursing, 17, 528–534.

Sullivan, M.J., Thorn, B., Haythornthwaite, J.A. et al. (2001). Theoretical perspectives on the relation between catastrophizing and pain. Clinical Journal of Pain, 17, 52–64.

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people to estimate how often they swear in everyday life. The responses we got ranged from zero to 60 swear words per day.

Interestingly, the higher the daily swearing frequency the less was the benefit for pain tolerance when swearing, compared with not swearing. This suggests that people become habituated to swearing so that it has a lesser impact the more you do it.

On the strength of these findings, sensible advice is not to swear overmuch in everyday situations, so that the impact of swearing can be at its fullest when needed most!

We then aimed to investigate how an emotional response can lead to increased pain tolerance (Stephens & Allsop, 2012).

We began with the assumption that the emotion that speakers feel when they swear is aggression. Then we assessed whether increasing state aggression alters the experience of pain. In this study we had participants play a first person shooter video game which led to them reporting feeling more aggressive compared with the control condition of playing a golf video game. We went on to show that participants withstood the ice-water challenge for longer and their heart rate remained elevated after playing the first person shooter game compared with the golf game. This is consistent with our theory that swearing acts on pain perception via the emotion aggression.

So, our research shows that swearing can help people better tolerate pain, that too much swearing in everyday situations can reduce its effectiveness, and that swearing probably works by making people feel more aggressive, in turn setting off the fight or flight response. Swearing as a response to pain appears not to be an expression of pain catastrophising, because if it were, there should have been a heightened sensation of pain with swearing. The idea of swearing in response to pain as disinhibitory behaviour also seems unlikely as this predicts no alteration in pain perception, contrary to our findings. Our research instead indicates that swearing as a response to pain represents a form of pain management. While this had never been empirically demonstrated before, it seems nevertheless to have been well known anecdotally by nurses, midwives and mothers-to-be.

The media reaction to our research was unbelievable. When the first paper was published in late July 2009 my phone rang off its hook as journalists from all over the world sought to arrange interviews: with Evan Davis on The Today Programme, with Arthur Smith for The One Show and with Stephen Fry and Brian Blessed for Stephen Fry’s Planet Word.

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word ‘fuck’ is ‘pathognomonic’ for frontotemporal dementia (‘pathognomonic’ means ‘characteristic for a particular disease’). However, they acknowledge that a diagnostic tool based on this phenomenon would have limited sensitivity, since over 80 per cent of the fronto-temporal dementia patients did not produce any swear words. Swearing in this context seems to reflect disinhibition arising from the frontal-lobe impairment that is characteristic of fronto-temporal dementia. Overall, this paper presents an interesting phenomenon, but it concludes Recent swearing research that swearing can only assist with In 2010 Jean-Marc Deweale of Birkbeck, diagnosing dementia to a very limited University of London, published the extent. entertainingly titled paper ‘“Christ In the same year, Teresa Stone of fucking shit merde!” Language the School of Nursing and Midwifery preferences for swearing among in Australia’s University of Newcastle maximally proficient multilinguals’ produced a paper examining verbal (Deweale, 2010). The paper describes an aggression, including swearing, within online survey of 396 multilingual adults healthcare settings in Australia. Stone et al. who, uniquely, can choose what language (2010) surveyed 39 male and 68 female to swear in. Where preferences for nurses across paediatric, adult mental swearing in a second language were health, and child and adolescent mental observed it was for languages used health departments. One third of the socially and frequently. But, interestingly, nurses reported being sworn at by patients they overwhelmingly opt usually to swear at least weekly, and this did not differ in their first (native) language rather than according to specialism. The swear words languages acquired later on. This was perceived as most offensive were: ‘cunt’, despite similar levels of self-perceived ‘cocksucker’ and ‘motherfucker’. These proficiency and frequency of use of the papers highlight a hitherto uninvestigated acquired language. It appears the but serious problem in healthcare. emotional resonance of swearing is felt Aggressive swearing at nurses causes to be greater in the native language. distress and the nurses interviewed had Also in 2010, John Ringman and few effective strategies to deal with it. colleagues at the University College of Los Other researchers, at Bristol University, Angeles Easton Center for Alzheimer’s assessed changes in autonomic activity Disease Research produced a paper looking brought on by reading aloud swear words at whether swearing can help diagnose (Bowers & Pleydell-Pearce, 2011). Their dementia (Ringman et al., 2010). In it they main interest lay in the theoretical area of describe noticing something unusual linguistic relativity, which is the idea that during their dementia screening clinics. how we think is influenced by the form There is a neuropsychological test known of language that we use. colloquially as the ‘FAS test’ An example of this is (and more formally as the the word ‘friend’. English Controlled Oral Word “the emotional speakers can speak of Association Test). It requires resonance of swearing a friend without having to participants to generate as consider gender. However, many words as they can in is felt to be greater in Spanish speakers must one minute beginning with the native language” consider the gender of the each of the letters F, A and person concerned because the S. One patient believed to Spanish words for friend are amiga (for a have fronto-temporal dementia produced woman) and amigo (for a man). According only two words in the ‘F’ section of the to the theory of linguistic relativity, test: ‘fuck’ and ‘fart’. Given that it was still speakers of English and Spanish would not possible to diagnose specific dementias have different conceptualisations of the until autopsy, the researchers wondered idea of a friend. They examined emotional whether a tendency for dementia patients responsiveness to two different forms of to produce swear words on this task might words that nevertheless carry the same help. overall meaning. They used a very Looking back over archived data they offensive swear word (‘cunt’) and found that a number of fronto-temporal dementia patients produced the word ‘fuck’ a euphemism (‘C-word’) that captures the semantics of the word while being but no Alzheimer’s patients did. This, they expressed in a different verbal form. They said, indicates that the production of the Actually, on reflection, we were probably quite lucky in the timing of our research on swearing and pain. Maybe a few years earlier and it would still have been too much of a taboo topic to secure peer review publication. This is not so today. Indeed, it really does appear that ‘now’ is the time for researching the psychology of swearing, as demonstrated by the recent publication of a number of fascinating studies.

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also used ‘fuck’ and ‘F-word’.

Unsurprisingly they found that participants exhibited greater autonomic arousal, indicating stress, when they read aloud the swear words compared with the euphemistic forms. This, they argue, provides evidence for linguistic relativity, since the same concepts appeared to be processed differently according to the form of language employed. They also argued that swear words may access emotional centres of the brain without mediation by higher-level cognitive systems. This is an intriguing idea as it provides a neurological basis to the argument that swearing is emotional language.

Finally, we have a paper from Megan Robbins and colleagues at the University of Arizona Psychology Department (Robbins et al., 2011). The study was concerned with the implications of swearing for coping with and adjusting to illness among women with rheumatoid arthritis and breast cancer. They used what they called the Electronically Activated Recorder (EAR), a device that sampled recordings of what participants were saying for 50 seconds every 18 minutes throughout the waking day. Swearing made up 0.1 per cent of the participants overall speech, and was related to increased levels of depressive symptoms and reduced emotional support. Of course, these findings are correlational and one cannot determine whether swearing was a precursor or a consequence of the increase in depressive symptoms and the decrease in emotional support. Nevertheless, they indicate that how and when people choose to swear may have negative consequences as well as positive.

Future directions Despite a flurry of activity in recent years, research on the psychological effects of swearing is still in its infancy. Our research at Keele suggests that daily swearing frequency affects how much power swearing has – and that the power lessens with increasing amounts of everyday swearing. This raises interesting issues around how long the effects of swearing last. Our research and that of Bowers shows there is a physiological response to swearing, in terms of faster heart rate and increased skin conductivity.

The phenomenon of swearing would be better understood if it were known for what timescale these physiological changes in response to swearing persist and how long it takes to recover them once they have become depleted.

Research to answer this question is ongoing in my laboratory at Keele.

There are numerous other pressing

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an ambulance, to swear as a means of obtaining shortterm relief until medical intervention is possible.

There are interesting questions around the emotional effects of swearing. It seems likely that swearing may help people not only express their emotions but also experience them more vividly – as predicted by the principle of linguistic relativity that I mentioned earlier. It is certainly true that people swear in positive as well as negative emotional contexts. A good example of this was when A coping mechanism, an outlet for frustration, or what? windsurfer Bryony Shaw spontaneously expressed her euphoria on live daytime TV having just questions. We have shown that swearing won Olympic Bronze, proclaiming ‘I’m so can ease the acute pain of the ice-water fucking happy!’ (‘Bryony Shaw prompts challenge. What about clinical pain? It BBC apology’, 2008). would not make sense to suggest swearing At first blush swearing may seem a as a clinical tool, but it might be sound frivolous research topic for a psychologist clinical management advice for anyone to pursue. But if one considers that unable to access medical care because they psychology is the study of people, and if are in a remote location, or even awaiting

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Psychology of Sexualities Section Annual Conference

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Richard Stephens is a Senior Psychology Lecturer at Keele University r.stephens@keele.ac.uk

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one agrees that people are emotional beings (more Captain Kirk than Mr Spock), then understanding swearing, as the language of emotion, can improve our understanding of people. In his book the comedian Richard Dooling makes an excellent point when he says that the fourletter words are ‘inextricably bound up with almost everything’ (Dooling, 1996).

When I give research talks I usually end with a slide containing transcripts of the final utterances of air-crash pilots, captured on the black box flight recorder, taken from www.planecrashinfo.com/ lastwords. I use it to emphasise an important point: that swearing is the language of life and death. This surely explains the great interest in how and why people swear, and I join with others (Jay & Janschewitz, 2011) in calling out for more research on the psychology of swearing.

‘Sex, sexuality & psychological well-being’ Saturday 14 December 2013, 10.00am – 4.30pm BPS London Office, 30 Tabernacle Street, London EC2A 4UE Keynotes: The role of BDSM/fetish in sexual pleasure Dominic Davies, FBACP – Founder of Pink Therapy Sexualisation and well-being Professor Feona Attwood – Professor of Cultural Studies, Communication and Media, Middlesex University There’s more to life than sex: Why sexual people don’t get asexuality and why it matters Mark Carrigan – Department of Sociology, University of Warwick

To register, please email: possconference@gmail.com

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One-day symposium

Stories of Psychology Psychology and the Arts Tuesday 15 October 2013, 10.30am–4pm Chancellor’s Hall, Senate House, University of London Malet Street, London WC1E 7HU Dr James Kennaway (University of Newcastle) Musical mind control: The history of an idea Dr Nick Lambert (Birkbeck, University of London) The computer in the cave Dr Alexandra Lewis (University of Aberdeen) Psychology and the novel: Trauma and memory in the 19th century Dr Greg Tate (University of Surrey) John Keats’s principled feeling: Knowledge and emotion in Romantic poetry, medicine and psychology’ Professor Nicholas Wade (University of Dundee) Toying with perception: Philosophical toys and the simulation of motion in early 19th-century London CONVENOR: Dr Alan Collins (Lancaster University) Cost: £12 (£10 BPS members) including welcome refreshments and buffet lunch Registration is essential For more information and to register, go to www.bps.org.uk/stories History of Psychology Centre (t) 0116 252 9528 (e) hopc@bps.org.uk This event is supported by Senate House Library, home of the British Psychological Society’s library collection.

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INTERVIEW

‘I don’t feel proud of anything’ Jessie Baldwin, a psychology graduate from Warwick University, met Oliver Sacks – physician, best-selling author, and professor of neurology and psychiatry

unlike much of his other work, he e’s written 12 best-selling books, mentioned that many of the case studies inspired a play by Pinter, had his in this book will document the clinical story adapted into an Oscardetails of historical figures, rather than nominated film, been awarded a CBE, his own patients – such as the likes of the and holds more honorary degrees and Romantic poet Samuel Taylor Coleridge, fellowships than I can count on the Irish playwright Brian Friel and Helen fingers of both of my hands – which is Keller, a 20th-century humanitarian and why I was surprised at how humane, the first deaf-blind person to earn a gentle and warm Oliver Sacks was when degree. This excited me: Coleridge is my I met him. five-times great uncle and I was fascinated The world-renowned neurologist, to find out what Sacks knew about him. famous for his case studies detailing I could not have anticipated such an patients with neurological deficits (such answer – Coleridge, apparently, was an as the man who mistook his wife for a accidental plagiarist! He suffered from hat), visited the University of Warwick, cryptomnesia, which is when one falsely where I was a psychology student, to give thinks that someone else’s material is their a lecture on the importance of case own. In his case, he incorporated lengthy studies in medicine. I was lucky enough to catch him for half an hour to talk about passages originally written by German hallucinations, advances in neurology and philosophers into his own work, believing he had generated such ideas. Helen Keller his love of swimming. suffered from the As an 80-year-old physician, same phenomenon, Sacks is no stranger to as an 11-year-old neurophysiological impairments “One doesn’t question child, in which she himself. He has prosopagnosia, people’s experience: wrote a book of which means that his ability to one only questions their ‘delightful’ short recognise people by their faces interpretation of it” stories that she is impaired; a factor which he genuinely believed says has contributed to his had been a product of chronic shyness. He is also blind her own imagination. Unfortunately the in his right eye, due to ocular cancer, stories turned out to be extremely similar and has tinnitus, a type of auditory to ones that had been published three hallucination in which one hears a years earlier, and she faced a barrage of constant ringing or hissing sound that abuse for being a ‘plagiarist’ and a ‘liar’. may be intolerably loud. I was therefore I remarked that I had heard of this a little apprehensive about whether he phenomenon occurring in eyewitness would be able to hear all of my questions testimonies, and Sacks emphasised how and hoped I wouldn’t have to awkwardly ‘very common it is for one to have an repeat myself. Quite the opposite. Not exciting new idea but be oblivious to the only did Sacks come across as fact that it comes from somewhere or extraordinarily bright, intelligent and someone else.’ insightful, he also was very friendly, We moved on to hallucinations. leaving me wondering how it could be possible that he describes himself as being Regarding the most surprising illusions he has come across, he told me, ‘One can ‘diseased’ with shyness, social phobia or have hallucinations of their self, and see Asperger’s syndrome .

I began by asking Professor Sacks what a mirror image of themself dressed the same way, mirroring their posture – it’s he was currently working on, and he told very peculiar.’ Realising he has his own me that he was writing a book of essays experiences of hallucinations, I asked on memory, imagination and psychology’s him whether he had ever experienced greatest mystery, consciousness. However,

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such a phenomenon: ‘No, it’s something I have always hoped to experience, but never have…’, was his enthusiastic answer. ‘I also hope to experience the so-called “out-of-body” hallucinations, where one is floating somewhere “up” there and looks down to see oneself.

Normally we feel that we are so firmly “in” our own bodies, but in such an experience one feels vividly disembodied.’

‘Would that happen when a person loses proprioception?’ I enquired. ‘Yes, it seems to be due to a “scrambling up” of visual and proprioceptive experience,’ he said; ‘Which is why people with very good proprioception, like athletes and dancers, are usually resistant to such experiences. Although, hallucinations of this sort can be caused by all sorts of situations, such as a migraine or seizure, or in cases in which the brain is deprived of oxygen, such as during a cardiac arrhythmia or arrest, or after taking certain drugs.’

At this point there was a temporary pause in the interview, as Sacks took a sip from his tea and exclaimed, ‘This is remarkable tea – it seems to have needed three sweeteners! It must be an especially bitter sort of tea.’ Bemused, I laughed and waited whilst several people fussed around him, offering to go and get him another cup. Shaking his head, he explained, ‘I have a very, very sweet tooth, and I have to use sweeteners or else I put on weight.’

Back to the interview, in which he went on to enlighten me of the existence of dramatic ‘out-of-body’ and ‘near-death’ hallucinations that can stimulate nonreligious people to believe in an afterlife and become spiritual: apparently, a patient with temporal lobe seizures had experienced the phenomenon on multiple occasions, resulting in her following five different religions! He chuckled that he would be extremely interested to know how such an experience would affect a ‘hard-boiled atheist’ like himself.

Indeed, Eben Alexander, an American neurosurgeon and strict atheist, experienced an out-of-body and neardeath experience whilst in a meningitisinduced coma, and wrote a book about it, entitled Proof of Heaven: A Neurosurgeon’s Journey into the Afterlife. The book has been on the New York Times bestseller list for over five months and has caused controversy among the scientific community. Sacks told me of his objections to Alexander’s claims: ‘In the book, he insists that the brain is not necessary for experience, as his hallucinations occurred when he was in a deep coma (and therefore the brain was not really working). This suggestion, and

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to take on Luria’s approach, describing the individual at the centre of a clinical story, in his own work. Indeed, this vivid technique has been precisely what has brought his writing to life, and sparked such compassion and awe from a wide audience of readers. And did he ever meet with Luria? ‘Regretfully, no,’ he said, ‘but we corresponded over the years.’

When I asked him what advice he would give to students wanting to get involved with neurology, he exclaimed, ‘Go for it! Fifty years ago I might have warned that it will not give one anything in the way of therapeutic satisfaction, as most neurological damage is irreversible and most neurological diseases are incurable, but that is less the case now.’

What has changed to make this possible? ‘There have been discoveries at so many levels,’ he said. ‘But I think especially technical discoveries like recording from single nerve cells, recording activities in different areas of the brain in fMRI scanning, and being able to see how connected everything is in connectomes are advances which have been hugely beneficial.’

And where does he see neurology progressing in the next fifty years?

‘Hopefully we will get a better idea of consciousness’, he said; ‘though some feel that such a finding will always be infinitely far away.’ I asked whether it

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would necessarily be a bad thing if consciousness always remained a mystery.

‘That depends on whether consciousness is a “problem” which can be solved, or a “mystery” which could be infinity,’ he replied. ‘I don’t think anything is hurt by being understood, though. Blake would write about science “unweaving the rainbow” and destroying romance, but I think understanding increases one’s admiration.’

What, in Sacks’s eyes, could be the neurological basis of consciousness? ‘I don’t think there’s any small localised centre for consciousness in the brain,’ he said, ‘I think very widespread, complex processes have to occur.’

With the interview drawing to a close, I couldn’t resist asking Sacks about his passion for swimming. ‘Do you swim every day?’ I asked. He nodded, enthusiastically: ‘I am clumsy on land and very much like to be in the water. I find in a long swim I can often get into a sort of trance-like, meditative state, which is very pleasant.’

‘How many lengths do you swim?’ I challenged, wondering whether this 80-year old man would beat my standard 50 lengths a go. ‘Oh, I don’t swim lengths, only a set time every day.

My swim bag seems to weigh about a hundred tons, because it’s full of things like swim fins which I need because I have a ruptured tendon in one of my feet.’

But for Sacks, neurology is always on the brain: ‘Sometimes when I’m swimming I start writing case histories in my head, and then I have to land at intervals and write them down.’

I laughed, imagining a notepad full of fervent scribbles getting splashed by his dripping hands, and told him that I was going swimming that day. ‘As am I,’ he said, ‘I wear a green swim cap and fins – see you there.’ reading

his belief that consciousness occurs independently of the brain, outraged me!’

He added, ‘I think he rather grossly misuses his credentials as a neurosurgeon for claiming credibility. One doesn’t question people’s experience; one only questions their interpretation of it.’

The interview then moved on to discussing Sacks’s proudest achievement – to which I received a startling, but humbling response. ‘I don’t feel proud of anything’ he said, ‘The most I feel is not ashamed. If I can write anything that I’m not ashamed of, then I’m happy.’ Taken aback, I assured him that he should feel proud of his work, to which he somewhat reluctantly revealed, ‘Well, the book that came from the deepest experience is Awakenings, but the one which I like the most is The Island of the Colorblind, because it’s about travel, and exotic experiences. It has a licence which none of my medical books have.’

We then talked about Sacks’s own time as an undergraduate student of biology and physiology at Oxford sixty years ago.

The best thing about it was making new friends and experiencing new opportunities – ‘the world opening up in all sorts of ways’. After completing a Bachelor of Medicine in 1958, he chose to specialise in neurology because he passionately believed that the brain was the most interesting thing in the universe, because it essentially makes every person who they are. Although he considered both psychology and psychiatry, the opportunity to understand the physical basis of behaviour particularly appealed to him.

Undoubtedly, Sacks has been a huge inspiration to many scientists, both young and old, but who inspired him? The Russian neurologist Alexander Luria, he told me, whose work he first came across as a medical student. ‘I read an enchanting book of his called, The Mind of a Mnemonist – a mnemonist is someone with a remarkable memory – and I read 20 pages of it believing it was a novel.

Then I realised it was a case history, but the most detailed I had ever read, but one with all the beauty and drama and feeling of a novel.’ Profoundly inspired, he vowed

Books by Oliver Sacks (latest editions): Hallucinations (Picador, 2012) The Island of the Colour-Blind (Picador, 2012) The Man Who Mistook His Wife for a Hat (Picador, 2011) Awakenings (Picador, 2011) The Mind’s Eye (Picador, 2010) Musicophilia: Tales of Music and the Brain (Picador, 2007) See www.oliversacks.com

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