The gender psychology of fair pay and haggling

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.

I also adore having several dishes on the table

Ben Goldacre has found a so-awful-lets-hope-it’s-a-hoax article that suggests that people with Down Syndrome and people from Asia might be genetically similar, because, well, they do similar things.

Strictly speaking, of course, they’re quite right. In fact, apart from an extra 21st chromosome, most people, no matter where they come from, are genetically similar to people with Down’s.

So why are Asian people singled out in particular? Ah, because apparently, they like similar sorts of arts and crafts:

The tendencies of Down subjects to carry out recreative-reabilitative activities, such as embroidery, wicker-working ceramics, book-binding, etc., that is renowned, remind the Chinese hand-crafts, which need a notable ability, such as Chinese vases or the use of chop-sticks employed for eating by Asiatic populations.

The original grammar is left intact so you can fully appreciate the theory in all its glory.

Still not convinced? Well, there’s also the fact that both Asian people and people with Down Syndrome “adore having several dishes displayed on the table and have a propensity for food which is rich in monosodium glutamate”. Uncanny isn’t it?

The article is published in the journal Medical Hypotheses which was founded by the late Dr David Horrobin. Horrobin had a theory that schizophrenia might be linked to the metabolism of Omega-3 fatty acids, and these could be used to treat the disorder.

Initially, the idea was laughed at, although now, some limited evidence exists for its role in mental illness.

Reflecting on his experiences, Horrobin founded Medical Hypotheses, a journal where researchers could publish any ideas, no matter how far-out, to encourage creative thinking in medicine.

You could tell that Horrobin got up people’s noses, because when he died, a famously bitchy obituary was published in the British Medical Journal. So bitchy, in fact, that for the first time, an apology was printed the week after.

True to its mission, Medical Hypotheses remains the eccentric uncle of academic medicine.

The trouble with eccentric uncles though, is that sometimes they get pissed at family gatherings and embarrass themselves.

This is exactly what seems to have happened on this occasion as the article incoherently rambles about something we can’t quite make out, but we know is likely to offend if it keeps going on about it.

Luckily, one of the comments from the Bad Science post links to a much more entertaining Medical Hypotheses article:

Is there an association between the use of heeled footwear and schizophrenia?

See what you’re missing?

Link to Bad Science on embarrassing MedHyp article (with full-text).
Link to abstract of footwear / schizophrenia article.

The philosophy of love

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.

An illustrated history of lobotomy

My last place of work blocked huge swathes of the web, meaning I’m discovering I’ve missed some blog posts recently, including this wonderful Neurophilosophy article on the rise and fall of prefrontal lobotomy.

It’s a fantastic tour through the history of how the procedure was developed, popularised and abandoned.

It aptly illustrates that medical history has been driven as much by personalities as by evidence, something which has only seriously been addressed in the last half-century by systematic trials and evidence reviews, largely due to the work of Archie Cochrane.

The article does have one quirk, where it equates early antipsychotic drug chlorpromazine with ‘psychosurgery gone wrong’.

Despite some serious and unpleasant side-effects (including movement disorders, sedation, weight-gain and dizziness), there is a large amount of evidence for its effectiveness in schizophrenia, and, in fact, was the first effective treatment for psychosis.

Even ignoring the brutal nature of the procedure, lobotomy was not even proven to be a useful ‘treatment’ by anything that would be accepted as reliable evidence today.

It is, however, an important chapter in the history of neuroscience, not least for what it tells us about how individuals can have such an influence on mainstream practice.

Link to article ‘The rise & fall of the prefrontal lobotomy’.

The controversial state of ‘hands on’ sex therapy

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’.

Night Falls Fast: Jamison on understanding suicide

I’ve just finished reading Kay Redfield Jamison’s book Night Falls Fast (ISBN 0375701478), a remarkably sensitive exploration of the difficult subject of suicide.

Unlike Jamison’s better known books, An Unquiet Mind and Touched with Fire, you rarely see it in bookshops.

It’s probably her least successful book, not least, I suspect, because of the subject matter. Nevertheless, I think it’s her best and most important.

Jamison is one of the world’s leading researchers into manic depression and has the condition herself. As a result, she’s experienced periods of intense psychosis and made a near-fatal suicide attempt.

Originally, the term ‘manic depression’ was coined to describe the whole spectrum of mood disorders, but is often used these days to refer to bipolar disorder, where mood cycles between crushing depression and exuberant, or even psychotic, highs.

The name ‘bipolar’ is a bit misleading, as it suggests that mood is either high or low, when in fact it is possible to feel wired and depressed at the same time – a so-called ‘mixed state’.

These ‘mixed states’ are particularly dangerous and are perhaps one of the reasons that bipolar disorder is one of the leading causes of suicide.

It’s by no means the only cause, however, and there are a range of factors that make suicide among the top 10 causes of death in every country, and one of the three leading worldwide causes of death in the 15 to 35-year age group.

Jamison’s book is not only a comprehensive exploration of the psychology and neuroscience of suicide, but also weaves in insights from the arts and literature, as well as personal stories of suicides and their impact.

The book is emotionally difficult at times, and I often found myself having to pause and reflect mid-paragraph, but it does an admirable job of demystifying and discussing a subject that is woefully ignored in public life.

The New York Times has a brief excerpt and Jamison was interviewed about the book on the Charlie Rose show, the video of which is available online.

Link to book details.
Link to factsheet on suicide from mental health charity Mind.
Link to video of Kay Redfield Jamison interview.
Link to excerpt of Night Falls Fast.

Goodbye Fair City

I leave Dublin today after working in the Fair City since spring.

Many thanks to the psychologists I’ve worked with and learnt so much from, and the people of Dublin for their kind hospitality.

The picture is taken from Sandycove Harbour, looking out across Dun Laoghaire and Dublin Bay.

Only a few hundred yards from where this photo was taken is a tower where James Joyce stayed for several nights until his medical student housemate, Oliver Gogarty, shot at him with a gun.

The tower sets the scene for beginning of Joyce’s novel Ulysses, known for its ‘stream of consciousness’ narrative – a technique first borrowed from psychology by writer May Sinclair.

Like being struck by lightning: Musicophilia

The July 23rd edition of The New Yorker has an article by Oliver Sacks on people who suddenly experience a passion and irresistible urge to listen to music after brain injury. The article itself is only available online as a brief summary, but there’s a freely available podcast where Sacks discusses the topic in more detail.

The article has some fascinating examples of how people have, literally, been struck by the condition:

A neurologists’s notebook about Tony Cicoria, who after being struck by lightning became obsessed by piano music. In 1994, when Tony Cicoria was forty-two, and a well-regarded orthopedic surgeon, he was struck by lightning. He had an out-of-body experience. “I saw my own body on the ground. I said to myself, ‘Oh shit, I’m dead.’ …Then‚Äîslam! I was back.” Soon after, he consulted a neurologist‚Äîhe was feeling sluggish and having some difficulties with his memory. He had a thorough neurological exam, and nothing seemed amiss.

A couple of weeks later, Cicoria went back to work, and in another two weeks, his memory problems disappeared. Life had returned to normal, seemingly, when “suddenly over two or three days, there was this insatiable desire to listen to piano music.” This was completely out of keeping with anything in his past. He started to teach himself to play piano. And then, he started to hear music in his head. In the third month after being struck, Cicoria was inspired, even possessed, by music, and scarcely had time for anything else.

The article and podcast are in lieu of a new book by Sacks, entitled Musicophilia: Tales of Music and the Brain due out on October 17th.

Link to article summary.
Link to page with Oliver Sacks podcast (thanks Justin!)

SciAm special on the science of children and teens

Scientific American have just released one of their special editions of collected articles. This one is on ‘the early years’ and looks at the psychology and neuroscience of children, from infancy to the teenage years.

The SciAm specials are just collections of their previously published articles, but put in one themed issue with no adverts.

The printed edition of this new edition can be bought on newstands at the moment, or it can be bought online as a DRM-free PDF file for $4.95.

It follows on from a previous (and equally good) special issue on ‘The Child’s Mind’.

There’s a full content’s list on the issue’s webage but I’ve noticed that several of the articles are already freely available online, so have a search if you want to get a feeling for the theme.

Link to SciAm special edition on ‘The Early Years’.

Junkies and victims: addiction and the disease debate

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

2007-07-27 Spike activity

Quick links from the past week in mind and brain news:

Lifting someone’s mood makes them more likely to believe in the supernatural, reports the APA.

New Scientist reports on research presented at a conference suggesting an oxytocin spray can boost the effect of cognitive therapy treatment for anxiety disorders.

A website called We Feel Fine tracks the <a href="
“>mood of the internet.

Spatial brain circuits are used to track references during conversation, according to a new study published in Neuroreport.

How we know where our lost keys are. Scientific American investigates new findings on memory.

BBC News reports that the prescription of antidepressant drugs to children soars in the UK.

Obese girls less likely to attend college but weight and body size does not influence college attendance in boys, finds study published in Sociology of Education.

Another good obituary for cognitive therapy pioneer Albert Ellis, this time in the LA Times.

BBC News reports that a study on the health effects of mobile phone masts finds (wait for it) no link between emissions and symptoms (just like all the others).

Scientific American reports obesity more common in people with obese friends, and study finds the strength of friendship seems to be key.

The Guardian has an interesting piece on the difficulty of applying population-derived violence predictions to individuals. Original study abstract here.

New Scientist has a story on a poker playing computer that only narrowly lost to two pros.

Stephen Pinker writes in defense of dangerous ideas.

Couples’ faces grow more alike as they age

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’.

War causes trauma, death, satire

This week’s edition of satirical newspaper The Onion has a cutting ‘news’ story on both the Iraq war and psychology, highlighting the absurdity that arises from trying to quantify the bleedin’ obvious and discussing the shortcomings of the study in the press.

The story supposedly concerns a study investigating the psychological impact of the Iraq war on civillians.

“Almost all the Iraqis we interviewed said the war had ruined their lives because of the incalculable loss of friends and family,” Pryztal said. “But to be totally honest, these types of studies can be skewed rather easily by participant exaggeration.”

Psychologists and anthropologists have thus far largely discounted the study, claiming it has the same bias as a 1971 Stanford University study that concluded that many Vietnamese showed signs of psychological trauma from nearly a quarter century of continuous war in southeast Asia.

“We are, in truth, still a long way from determining if Iraqis are exhibiting actual, U.S.-grade sadness,” Mayo Clinic neuropsychologist Norman Blum said. “At present, we see no reason for the popular press to report on Iraqi emotions as if they are real.”

Pryztal said that his research group would next examine whether children in Sudan prefer playing with toys or serving as guerrilla fighters and killing innocent civilians.

The Onion has a long and proud history of satirising psychology and psychologists, inspiring stories that are often as funny as they are painful.

Link to story ‘Iraqis May Experience Sadness When Friends, Relatives Die’.

40 years on: Experiences of ‘gay conversion therapy’

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="
“>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’.

Albert Ellis has left the building

Albert Ellis, one of the co-founders of cognitive therapy, died yesterday at his home in New York. The Boston Herald has an obituary that captures some of his work and eccentric spirit.

Ellis created ‘rational emotive behavior therapy’ (REBT) that stressed a rational approach to dealing with distressing cognitive distortions – a significant break from the largely Freudian therapy he was trained in.

It was an early version of cognitive behaviour therapy (CBT), now one of the most extensively tested, empirically validated and widely used psychological treatments for mental disorder.

Ellis was a prolific writer, producing a small library of books, papers and articles, did weekly seminars for most of his life and founded the Albert Ellis Institute.

Apart from his extensive writing he was known for his boundless energy and his approach to therapy and teaching which was variously described as no nonsense / assertive / confrontational (take your pick).

He was voted sixth in Psychotherapy Networker’s list of ‘top ten’ influential therapists of all time earlier this year.

Link to Boston Herald obituary for Albert Ellis.
Link to Psychotherapy Networker on Ellis.

Epilepsy: fighting myths and saving lives

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.

* 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

* 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.