Month: July 2007

The Washington Post has an article on a recent study suggesting that the pay disparity between men and women might be explained by the fact that women don’t ask for pay rises as much as men, and it may be because they’re worried about being seen as pushy and difficult.

Crucially, the research also indicates that women’s worries are accurate, especially where men are concerned.

The study, available online as a pdf file, was led by management researcher Prof Hannah Bowles.

It asked several groups of participants to evaluate candidates who were applying for a job, either from a transcript of their interview or from video tape.

Women marked down all candidates who tried to negotiate for a higher salary in their interview. So did men, but the effect was almost twice as strong for women who asked for more money than for men who did the same.

In a second experiment, participants were asked to go through a fake interview situation themselves.

Women were much less likely than men to ask for a higher salary if they thought a man was going to make the decision. When a woman was supposedly making the decision to employ, there was no difference between the sexes.

Although it may well be true that women often hurt themselves by not trying to negotiate, this study found that women’s reluctance was based on an entirely reasonable and accurate view of how they were likely to be treated if they did. Both men and women were more likely to subtly penalize women who asked for more — the perception was that women who asked for more were “less nice”.

“What we found across all the studies is men were always less willing to work with a woman who had attempted to negotiate than with a woman who did not,” Bowles said. “They always preferred to work with a woman who stayed mum. But it made no difference to the men whether a guy had chosen to negotiate or not.”

Link to WashPost article ‘Salary, Gender and the Social Cost of Haggling’.
pdf of research paper.

ABC Radio National’s The Philosopher’s Zone just had an edition on how philosophers through the ages have made sense of that most intense of human emotions, love.

The guest on the show is philosopher Dr Linnell Secomb who’s the author of the new book Philosophy and Love from Plato to Popular Culture (ISBN 0748623671).

Secomb talks about how love has been understood by thinkers through the ages, from Socrates to Bartes, but also looks at how it has been represented in pop culture, arts and literature.

I particularly liked the discussion about the significance of love in the Frankenstein books and films:

I think what you’re raising there is this really interesting issue of how difference and sameness affects the love relation as well, and in the book I reflect on that quite a bit in different ways. But it’s the creature’s difference, his monstrosity that frightens people and undermines the possibility of love.

But I wonder also whether this sense that love works better between people who have a lot in common also undermines the possibility of the sort of adventure of discovering otherness, or discovering difference, and this is something that Nietzsche talks about and I bring Nietzsche together with the Frankenstein story because Nietzsche has really interesting little reflections on both love and friendship.

But what he seems to be indicating is that for him, a more genuine or authentic love would involve a search for the beyond, you know, beyond our own experience, so that we’d be challenged by the difference of the other. So this is something that I wanted to point out in that chapter as well.

Link to audio and transcript of TPZ on love.

Dr Petra Boynton has written a fascinating article on sex surrogacy, the controversial practice of using ‘hands on’ tutoring as part of therapy for sexual disorders.

‘Sex therapy’ is an umbrella term for a number of established psychological and behavioural treatments for sexual difficulties.

Most commonly, it involves a therapist working with a couple to discuss the problem, work out what might be going wrong, and then asking the couple to try a number of approaches to improve their relationship, communication and lovemaking.

These three approaches are key as, despite what the drug adverts might imply, many sexual problems arise from anxiety, mismatched expectations, and unhelpful learnt responses, rather than simply physical problems with the sexual organs.

This can be true for a wide range of problems, including erectile dysfunction (not being able to get or keep it up), vaginismus (where the muscles of the vagina involuntarily tighten to prevent penetration), early or absent orgasm, or loss or lack of sexual interest.

A common approach is to initially ask the couple not to have sex and simply focus on touching and intimacy (an approach known as sensate focus).

This takes the pressure off, reduces anxiety, and once the couple start feeling more connected, therapy focuses on introducing sexual activities or exercises for the couple to try at home to help deal with the remaining difficulties.

Similarly, the therapist might ask the couple to try new ways of communication, and consider how they understand their partner, both sexually and in everyday life.

You’ll notice this is very couples focussed, as is most sex therapy, potentially limiting the options for someone whose sexual problems are preventing them from getting a partner.

One option is to use a ‘sex surrogate’, someone who is employed by the sex therapist to practice sexual exercises with the patient.

It was pioneered in the UK by the now retired therapist Dr Martin Cole, who became a controversial figure in the 60s and 70s media for advocating, even at the time, quiet radical views on sexual freedom and treatment.

His clinic provided, amongst a range of other treatment and advice services, sex therapy using surrogates and even managed to get public money for his clinical work.

Surrogate therapy is rarely used in mainstream clinics these days, largely because of the difficulty of getting competent and responsible surrogates, getting suitable referrals, and dealing with the ethical dilemmas and media interest.

However, surrogate therapy is still being researched and has been found to be effective in limited trials.

For example, a study published earlier this year in the Journal of Sexual Medicine found surrogate therapy was significantly more effective than couples therapy alone in treating vaginismus.

Nevertheless, the use of surrogates in sex therapy has received very little attention from researchers, and is poorly regulated, meaning its not clear how effective involving a surrogate in therapy might be.

Petra Boynton discusses the state of modern surrogate therapy, what’s involved, and gives some advice if you’ve considered it as an option.

It’s probably worth remembering that many sexual problems can be successfully treated on the NHS where you’ll get therapy from qualified and experienced psychologists and psychotherapists who don’t use surrogates, so it’s always worth enquiring with your local services.

For private therapy, it’s always worth checking that the person is fully qualified and accredited by recognised national associations.

Link to Dr Petra Boynton ‘ Spotlight on Sex Surrogacy’.

Slate has an article by a psychologist and a psychiatrist who argue that addiction is not a ‘brain disease’, contrary to much of the recent rhetoric about drug abuse. This is one side of the debate that is driving our attempts to understand addiction.

The ‘brain disease’ concept (also known as the ‘disease model’) is one that is often thrown around in debates about mental distress or behavioural problems, but it is far from the neutral, scientific term that many of its supporters might believe.

In a sense, every problem of mind and behaviour is a ‘brain disease’, because we’ve identified it as a problem and it involves the brain, as does everything else related to thought or action.

However, a comprehensive explanation requires not only neuroscience, but also psychology and social factors to make it complete and meaningful.

Calling a mental problem a ‘brain disease’ often implies that these other factors aren’t important, and, most tellingly, suggests that the person isn’t responsible for the effects of the disorder, and, consequently, their actions.

The level of personal influence varies by condition, but, importantly, psychologists now know that the effects of all illnesses, from Alzheimer’s disease to the common cold, can be influenced by how we understand them and what we believe about our own ability to influence the effects.

There is no doubt that genetics and the development of nervous system significantly influence the risk of becoming an addict, but addiction, perhaps more than many other disorders, is amenable to personal choice, albeit to varying degrees at various stages of its course.

Theodore Dalrymple (the pen name of psychiatrist Anthony Daniels) noted in The Wall Street Journal that many people are quite able to choose to give up their addiction when sufficiently motivated and argues, in his usual provocative style, against the excess medicalisation of substance abuse:

It is not true either that addicts cannot give up without the help of an apparatus of medical and paramedical care. Thousands of American servicemen returning from Vietnam, where they had addicted themselves to heroin, gave up on their return home without any assistance whatsoever. And in China, millions of Chinese addicts gave up with only minimal help: Mao Tse-Tung’s credible offer to shoot them if they did not. There is thus no question that Mao was the greatest drug-addiction therapist in history.

However, we shouldn’t forget that there is now a large body of evidence highlighting the importance of inheriting a vulnerability to become addicted, and the most addictive drugs tend to modify exactly the bits of the brain that are involved in desire and wanting, making them less amenable to ‘will power’.

This research was recently highlighted by a Time magazine article on the neurobiology of addiction and Dr Nora Volkow’s recent radio interview on the drugs and the brain.

Both spin the ‘brain disease’ angle, and many argue that this reduces stigma. The trouble is, research has found that purely biological explanations of mental problems tend encourage stigma in the public, patients and mental health professionals.

One of the key findings of these studies is that purely biological explanations of mental disorders imply that people are less in control of their actions.

Psychological therapies are known to be effective treatments for drug addiction and one of the key components is to boost the patients ‘self-efficacy’ – that is, their belief that they can take control of their life.

We know that self-efficacy, essentially a scientific term for a sense of personal responsibility and control, is one of the most important predictors of recovery from addiction.

Genetic research has shown us that some people, through no fault of their own, have inherited an increased risk for addiction. Neurobiology has shown us that drug use modifies the brain to make resisting temptation harder.

Nevertheless, describing addiction as purely a ‘brain disease’ is neither useful nor meaningful, and may actually reduce the likelihood that someone will overcome their difficulties.

We need to understand addiction as a problem of mind, brain and society, and make sure everyone knows they play an important role in overcoming problem drug use, whether it occurs in each of us individually, or in the neighbourhood that we live in.

Anti ‘disease model’:
Link to Slate article on addiction.
Link to Theodore Dalrymple article in WSJ.

Pro ‘disease model’:
Link to Time article ‘The neurobiology of addiction’.
Link to Dr Nora Volkow radio interview

PsyBlog has picked up on a neat study from way back in ’87 that found that couples faces look more alike the longer they stay together, and the researchers suggest that empathy might play a part.

The study asked a group of participants to judge how similar pairs of photographs were. Some of the photos were taken after 25 years of marriage, some on the wedding day.

Couples were more likely to be judged as looking similar at the 25 year mark than when first married.

Couples were then asked to complete a questionnaire about how satisfied they were with their partnership. The study found that the couples who grew more alike were more likely to report being happy, share worries or concerns with each other, and perceive themselves to have similar attitudes.

The researchers suggest that empathy might play a part in the increased facial similarity.

Interestingly, now we know that more empathetic people tend to mimic other people’s facial emotional expressions more readily.

So after 25 years, the effect of more frequently copying another person’s face, might mean it would it would take on similar features.

There’s other explanations and some caveats, of course, and PsyBlog considers some of them as it looks at the study in more detail.

Link to PsyBlog on ‘Empathy Causes Facial Similarity Between Couples to Increase Over Time’.

This Saturday marks the 40th anniversary of the first major decriminalisation of male-male sexual acts in the UK. Dr Petra Boynton looks back at how the change came about and has dug up some fascinating articles on the experience of <a href="http://www.bmj.com/cgi/content/full/328/7437/427
“>patients and professionals who took part in ‘gay conversion therapy’ in the 60s and 70s.

At one time, homosexuality was considered both a criminal act and a mental disorder.

It was decriminalised in both the US and the UK before it was removed from the diagnostic manuals, and treatments to change homosexuals into heterosexuals peaked in the 1960s and early 1970s.

Two articles were published in the British Medical Journal in 2004 that highlighted the experiences of patients and professionals who were involved in ‘conversion therapy’ either voluntarily or because of a court order.

One paper describes some of the methods:

In electric shock aversion therapy, electrodes were attached to the wrist or lower leg and shocks were administered while the patient watched photographs of men and women in various stages of undress. The aim was to encourage avoidance of the shock by moving to photographs of the opposite sex. It was hoped that arousal to same sex photographs would reduce, while relief arising from shock avoidance would increase, interest in opposite sex images. Some patients reported undergoing detailed examination before treatment, while others were assessed more perfunctorily.

Patients would recline on a bed or sit in a chair in a darkened room, either alone or with the professional behind a screen. Each treatment lasted about 30 minutes, with some participants given portable electric shock boxes to use at home while they induced sexual fantasies. Patients receiving apomorphine were often admitted to hospital due to side effects of nausea and dehydration and the need for repeated doses, while those receiving electric shock aversion therapy attended as outpatients for weeks or in some cases up to two years.

Oestrogen treatment to reduce libido (two participants in the 1950s), psychoanalysis (three private participants and one NHS participant in the 1970s), and religious counselling (two participants in the 1990s) were also reported. Other forms of treatment were electroconvulsive therapy [ECT], discussion of the evils of homosexuality, desensitisation of an assumed phobia of the opposite sex, hypnosis, psychodrama, and abreaction. Dating skills were sometimes taught, and occasionally men were encouraged to find a prostitute or female friend with whom to try sexual intercourse.

The professionals interviewed in the study present mixed views, but “most doubted the treatment’s efficacy, however, and came to question whether they were acting in patients’ best interests. They began to think that treatment was underpinning questionable social values and that patients might say anything to convince them that it had worked to avoid yet more treatment or further legal repercussions.”

As we reported earlier this month, this is currently a hot topic for the American Psychological Association, who are currently re-assessing their guidelines on whether they should explicitly denounce ‘conversion therapy’.

If you want to know more about how homosexuality was de-listed as a mental illness, there’s a fantastic radio programme online which looks at how the campaign was intricately tied up with one woman’s remarkable family history.

Link to Dr Petra on 40 years of decriminalisation.
Link to BMJ article on patients’ experience of ‘conversion therapy’.
Link to BMJ article on professionals’ experience of ‘conversion therapy’.
Link to radio programme ’81 words’.

BBC News reports on a recently published study that found that myths about epilepsy and its treatment are still widely believed, possibly putting people at risk. This post will tell you how to help someone having a seizure.

The research project, led by Dr Sallie Baxendale, used the internet to survey over 4,500 people concerning their knowledge of the effects of epilepsy, and what to do if someone has a seizure.

The study found that myths about the effects are widespread, many people still believe that epilepsy commonly causes ‘foaming at the mouth’ and is strongly linked to violence, neither of which are the case.

More worringly, a third of people thought they should put something in the mouth of a person having a seizure to stop them ‘swallowing their tongue’ and two-thirds would always call an ambulance.

Never put anything in the mouth of someone having a seizure (they could choke) and you only need to call an ambulance if it’s the person’s first seizure, if the seizure has been going on for more than five minutes, if they don’t regain consciousness between seizures, or if they’re physically injured.

This is the advice from Epilepsy Action about how to help someone who is having a tonic-clonic seizure.

These are what are sometimes called ‘fits’ and used to be called ‘grand-mal’ seizures. ‘Grand mal’ literally means ‘great evil’, and so understandably, isn’t used by the medical profession, although it still is used in day-to-day language by some people not familiar with the proper name.

Tonic-Clonic seizures

The person loses consciousness, the body stiffens, then falls to the ground. This is followed by jerking movements. A blue tinge around the mouth is likely. This is due to irregular breathing. Loss of bladder and/or bowel control may occur. After a minute or two the jerking movements should stop and consciousness may slowly return.

Do…
* Protect the person from injury – (remove harmful objects from nearby)
* Cushion their head
* Look for an epilepsy identity card or identity jewellery
* Aid breathing by gently placing them in the recovery position [pictured] once the seizure has finished
* Be calmly reassuring
* Stay with the person until recovery is complete

Don’t…
* Restrain the person
* Put anything in the person’s mouth
* Try to move the person unless they are in danger
* Give the person anything to eat or drink until they are fully recovered
* Attempt to bring them round

Call for an ambulance if…
* You know it is the person’s first seizure
* The seizure continues for more than five minutes
* One tonic-clonic seizure follows another without the person regaining consciousness between seizures
* The person is injured during the seizure
* You believe the person needs urgent medical attention

Obviously, if no-one knows whether it’s the person’s first seizure and they are unable to tell you, or no-one knows when the seizure started, call an ambulance.

Also, some people who have seizures will have strong emotional reactions when they come round owing to the brain disturbance.

The person might regain consciousness and seem terrified, traumatised, confused or very anxious (not always the case, some people feel elated).

This may cause onlookers to get equally anxious and panicky. Stay calm and just reassure the person (and everyone else if necessary!), gently letting them know what’s happened.

The Epilepsy Action first aid page also has information on dealing with other types of seizure.

Take the opportunity to read through the information – the next five minutes of your life could save someone else’s.

Link to Epilepsy Action first aid information.
Link to BBC News story ‘Many ‘believe myths’ on epilepsy’.
Link to abstract of research report.