What do children know of their own mortality?

CC Licensed Image by Flickr user DAVID MELCHOR DIAZ. Click for source.We are born immortal, as far as we know at the time, and slowly we learn that we are going to die. For most children, death is not fully understood until after the first decade of life – a remarkable amount of time to comprehend the most basic truth of our existence.

There are poetic ways of making sense of this difficulty: perhaps an understanding of our limited time on Earth is too difficult for the fragile infant mind to handle, maybe it’s evolution’s way of instilling us with hope; but these seductive theories tend to forget that death is more complex than we often assume.

To completely understand the significance of death, researchers – mortality psychologists if you will – have identified four primary concepts we need to grasp: universality (all living things die), irreversibility (once dead, dead forever), nonfunctionality (all functions of the body stop) and causality (what causes death).

In a recent review of studies on children’s understanding of death, medics Alan Bates and Julia Kearney describe how:

Partial understanding of universality, irreversibility, and nonfunctionality usually develops between the ages of 5 and 7 years, but a more complete understanding of death concepts, including causality, is not generally seen until around age 10. Prior to understanding nonfunctionality, children may have concrete questions such as how a dead person is going to breathe underground. Less frequently studied is the concept of personal mortality, which most children have some under standing of by age 6 with more complete understanding around age 8–11.

But this is a general guide, rather than a life plan. We know that children vary a great deal in their understanding of death and they tend to acquire these concepts at different times.

Although interesting from a developmental perspective these studies also have clear, practical implications.

Most children will know someone who dies and helping children deal with these situations often involves explaining death and dying in a way they can understand while addressing any frightening misconceptions they might have. No, your grandparent hasn’t abandoned you. Don’t worry, they won’t get lonely.

But there is a starker situation which brings the emerging ability to understand mortality into very sharp relief. Children who are themselves dying.

The understanding of death by terminally ill children has been studied by a small but dedicated research community, largely motivated by the needs of child cancer services.

One of the most remarkable studies, and perhaps, one of the most remarkable studies in the whole of palliative care, was completed by the anthropologist Myra Bluebond-Langner and was published as the book The Private Worlds of Dying Children.

Bluebond-Langner spent the mid 1970’s in an American child cancer ward and began to look at what the children knew about their own terminal prognosis, how this knowledge affected social interactions, and how social interactions were conducted to manage public awareness of this knowledge.

Her findings were nothing short of stunning: although adults, parents, and medical professionals, regularly talked in a way to deliberately obscure knowledge of the child’s forthcoming death, children often knew they were dying. But despite knowing they were dying, children often talked in a way to avoid revealing their awareness of this fact to the adults around them.

Bluebond-Langner describes how this mutual pretence allowed everyone to support each other through their typical roles and interactions despite knowing that they were redundant. Adults could ask children what they wanted for Christmas, knowing that they would never see it. Children could discuss what they wanted to be when they grew up, knowing that they would never get the chance. Those same conversations, through which compassion flows in everyday life, could continue.

This form of emotional support was built on fragile foundations, however, as it depended on actively ignoring the inevitable. When cracks sometimes appeared during social situations they had to be quickly and painfully papered over.

When children’s hospices first began to appear, one of their innovations was to provide a space where emotional support did not depend on mutual pretence.

Instead, dying can be discussed with children, alongside their families, in a way that makes sense to them. Studying what children understand about death is a way of helping this take place. It is knowledge in the service of compassion.

A social vanishing

CC Licensed Photo by Flickr user Jonathan Jordan. Click for source,A fantastic eight-part podcast series called Missing has just concluded and it’s a brilliant look at the psychology and forensic science of missing people.

It’s been put together by the novelist Tim Weaver who is renowned for his crime thrillers that feature missing persons investigator David Raker.

He uses the series to investigate the phenomenon of missing people and the result is a wonderfully engrossing, diverse documentary series that talks to everyone from forensic psychiatrists, to homicide investigators, to commercial companies that help you disappear without trace.

Missing people, by their absence, turn out to reveal a lot about the tension between social structures and individual behaviour in modern society. Highly recommended.
 

Link to Missing podcast series with iTunes / direct download links.

From school shootings to everyday counter-terrorism

CC Licensed Image from Secretive Ireland. Click for source.Mother Jones has a fascinating article on how America is attempting to stop school shootings by using community detection and behavioural intervention programmes for people identified as potential killers – before a crime has ever been committed.

It is a gripping read in itself but it is also interesting because it describes an approach that is now been rolled out to millions as part of community counter-terrorism strategies across the world, which puts a psychological model of mass-violence perpetration at its core.

The Mother Jones article describes a threat assessment model for school shootings that sits at an evolutionary mid-point: first developed to protect the US President, then to preventing school shootings, and now as mass deployment domestic counter-terrorism programmes.

You can see exactly this in the UK Government’s Prevent programme (part of the wider CONTEST counter-terrorism strategy). Many people will recognise this in the UK because if you work for a public body, like a school or the health service, you will have been trained in it.

The idea behind Prevent is that workers are trained to be alert to signs of radicalisation and extremism and can pass on potential cases to a multi-disciplinary panel, made up of social workers, mental health specialists, staff members and the police, who analyse the case in more detail and get more information as it’s needed.

If they decide the person is vulnerable to becoming dangerously radicalised or violent, they refer the case on the Channel programme, which aims to manage the risk by a combination of support from social services and heightened monitoring by security services.

A central concept is that the person may be made vulnerable to extremism due to unmet needs (poor mental health, housing, lack of opportunity, poor social support, spiritual emptiness, social conflict) which may convert into real world violence when mixed with certain ideologies or beliefs about the world that they are recruited into, or persuaded by, and so violence prevention includes both a needs-based and a threat-based approach.

This approach came from work by the US Secret Service in the 1990s, who were mainly concerned with protecting key government officials, and it was a radical departure from the idea that threat management was about physical security.

They began to try and understand why people might want to attempt to kill important officials and worked on figuring out how to identify risks and intervene before violence was ever used.

The Mother Jones article also mentions the LAPD Threat Management Unit (LAPDTMU) which was formed to deal with cases of violent stalking of celebrities, and the FBI had been developing a data-driven approach since the National Center for the Analysis of Violent Crime (NCAVC) launched in 1985.

By the time the Secret Service founded the National Threat Assessment Center in 1998, the approach was well established. When the Columbine massacre occurred the following year, the same thinking was applied to school shootings.

After Columbine, reports were produced by both the FBI (pdf) and the Secret Service (pdf) which outline some of the evolution of this approach and how it applies to preventing school shootings. The Mother Jones article illustrates what this looks like, more than 15 years later, as shootings are now more common and often directly inspired by Columbine or other more recent attacks.

It’s harder to find anything written on the formal design of the UK Goverment’s Prevent and Channel programmes but the approach is clearly taken from the work in the United States.

The difference is that it has been deployed on a mass scale. Literally, millions of public workers have been trained in Prevent, and Channel programmes exist all over the country to receive and evaluate referrals.

It may be one of the largest psychological interventions ever deployed.
 

Link to Mother Jones article on preventing the next mass shooting.

The Quiet Room

This month’s British Journal of Psychiatry has a brief but fascinating article about a 1979 Marvel comic featuring and written by rock legend Alice Cooper which depicts his real-life admission to a psychiatric ward.

The comic was timed to coincide with the release of his concept album From The Inside which describes his experiences as a psychiatric patient being treated for severe alcoholism and depression.

He was there for 3 months and in the comic he depicts the patients, doctors and nurses he met during his admission. Alice has often commented in interviews that treatment in hospital and recovering from his substance misuse saved his life, when many similar artists at that time, such as Jim Morrison and Janis Joplin, were not as fortunate, succumbing to their addictions. The lead single from the album was ‘How You Gonna See Me Now’, a song describing the anxiety the singer felt coming back home to his wife after his stay in hospital and facing the stigma of being treated for his mental illness. It went on to become a well-known successful ballad. The comic can still be found in comic shops or through online auction sites.

 

Link to brief British Journal of Psychiatry article.

Hold infinity in the palms of your hand

CC Licensed image from Wikipedia. Click for imageA rare documentary about three people who have had hallucinatory and profound revelatory experiences is now available online.

Those Who Are Jesus examines the borders between revelation and psychosis and hears people recount their intense experiences while looking at how they can be understood in terms of sociology, neuropsychiatry, religion and radical mental health.

Julian believes he has been shown Jacob’s Ladder, how a universe is created and told his soul is Time itself.

Sadat says a vision of an angel said to him: “You were Jesus Christ before and you were raised to life again and you are Jesus Christ”

It’s a great non-judgemental documentary that looks at what happens when intense and idiosyncratic experience intrude on everyday life.
 

Link to Those Who Are Jesus on Vimeo.
Link to info about the documentary.

Wanted: political diversity in social psychology

A fascinating article on why social psychology needs more political diversity is due to be published in Behavioral and Brain Sciences. Sadly the full article is locked behind a paywall but the abstract gives an excellent summary of the article and the wider problem itself.

Political Diversity Will Improve Social Psychological Science.

Duarte JL, Crawford JT, Stern C, Haidt J, Jussim L, Tetlock PE.
Behav Brain Sci. 2014 Jul 18:1-54. [Epub ahead of print]

Psychologists have demonstrated the value of diversity-particularly diversity of viewpoints-for enhancing creativity, discovery, and problem solving. But one key type of viewpoint diversity is lacking in academic psychology in general and social psychology in particular: political diversity. This article reviews the available evidence and finds support for four claims:

1) Academic psychology once had considerable political diversity, but has lost nearly all of it in the last 50 years;

2) This lack of political diversity can undermine the validity of social psychological science via mechanisms such as the embedding of liberal values into research questions and methods, steering researchers away from important but politically unpalatable research topics, and producing conclusions that mischaracterize liberals and conservatives alike;

3) Increased political diversity would improve social psychological science by reducing the impact of bias mechanisms such as confirmation bias, and by empowering dissenting minorities to improve the quality of the majority’s thinking; and

4) The underrepresentation of non-liberals in social psychology is most likely due to a combination of self-selection, hostile climate, and discrimination.

We close with recommendations for increasing political diversity in social psychology.

As the article notes there is considerable evidence that social diversity is beneficial on many levels for numerous types of social groups.

This is widely believed in social science and community work except when it comes to political opinion where many believe that non-liberal views are incompatible with this type of work, when clearly they are not. This affects the field to the point where people are seemingly prepared to actively discriminate against non-liberals.

The defence of diversity matters most when you are defending the inclusion of people with whom you disagree or who make you uncomfortable. And we will all be better off as a result.
 

Link to PubMed entry for article.

Context Is the New Black

The New Yorker has one of the best articles I’ve ever read on the Stanford prison experiment – the notorious and mythologised study that probably doesn’t tell us that we ‘all have the potential to be monsters’.

It’s a study that’s often taught as one of the cornerstones of psychology and like many foundational stories, it has come to serve a purpose beyond what we can confidently conclude from it.

Was the study about our individual fallibility, or about broken institutions? Were its findings about prisons, specifically, or about life in general? What did the Stanford Prison Experiment really show?

The appeal of the experiment has a lot to do with its apparently simple setup: prisoners, guards, a fake jail, and some ground rules. But, in reality, the Stanford County Prison was a heavily manipulated environment, and the guards and prisoners acted in ways that were largely predetermined by how their roles were presented. To understand the meaning of the experiment, you have to understand that it wasn’t a blank slate; from the start, its goal was to evoke the experience of working and living in a brutal jail.

It’s a great piece that I can probably do little to add to here, so you’re best off reading it in full.
 

Link to The Real Lesson of the Stanford Prison Experiment.