Discordant benevolence: How and why people help others in the face of conflicting values.

Cowan, S. K., Bruce, T. C., et al. (2022).

Science Advances, 8(7).

https://doi.org/10.1126/sciadv.abj5851

Abstract

What happens when a request for help from friends or family members invokes conflicting values? In answering this question, we integrate and extend two literatures: support provision within social networks and moral decision-making. We examine the willingness of Americans who deem abortion immoral to help a close friend or family member seeking one. Using data from the General Social Survey and 74 in-depth interviews from the National Abortion Attitudes Study, we find that a substantial minority of Americans morally opposed to abortion would enact what we call discordant benevolence: providing help when doing so conflicts with personal values. People negotiate discordant benevolence by discriminating among types of help and by exercising commiseration, exemption, or discretion. This endeavor reveals both how personal values affect social support processes and how the nature of interaction shapes outcomes of moral decision-making.

Here is my summary:

Using data from the General Social Survey and 74 in-depth interviews from the National Abortion Attitudes Study, the authors find that a substantial minority of Americans morally opposed to abortion would enact discordant benevolence. They also find that people negotiate discordant benevolence by discriminating among types of help and by exercising commiseration, exemption, or discretion.

Commiseration involves understanding and sharing the other person's perspective, even if one does not agree with it. Exemption involves excusing oneself from helping, perhaps by claiming ignorance or lack of resources. Discretion involves helping in a way that minimizes the conflict with one's own values, such as by providing emotional support or practical assistance but not financial assistance.

The authors argue that discordant benevolence is a complex phenomenon that reflects the interplay of personal values, social relationships, and moral decision-making. They conclude that discordant benevolence is a significant form of social support, even in cases where it is motivated by conflicting values.

In other words, the research suggests that people are willing to help others in need, even if it means violating their own personal values. This is because people also value social relationships and helping others. They may do this by discriminating among types of help or by exercising commiseration, exemption, or discretion.

Ethical considerations for psychotherapists participating in Alcoholics Anonymous

Kohen, Casey B.,Conlin, William E.

Practice Innovations, Vol 7(1), Mar 2022, 40-52.

Abstract

Because the demands of professional psychology can be taxing, psychotherapists are not immune to the development of mental health and substance use disorders. One estimate indicates that roughly 30% to 40% of psychologists know of a colleague with a current substance abuse problem (Good et al., 1995). Twelve-step mutual self-help groups, particularly Alcoholics Anonymous (AA), are the most widely used form of treatment for addiction in the United States. AA has empirically demonstrated effectiveness at fostering long-term treatment success and is widely accessible throughout the world. However, psychotherapist participation in AA raises a number of ethical concerns, particularly regarding the potential for extratherapy contact with clients and the development of multiple relationships. This article attempts to review the precarious ethical and practical situations that psychotherapists, either in long-term recovery or newly sober, may find themselves in during AA involvement. Moreover, this article provides suggestions for psychotherapists in AA regarding how to best adhere to both the principles of AA (i.e., the 12 steps and 12 traditions) and the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct. 

Here is an excerpt:

Recent literature regarding the use of AA or other mutual self-help groups by psychotherapists is scant, but earlier studies suggest its effectiveness. A 1986 survey of 108 members of Psychologists Helping Psychologists (a seemingly defunct support group exclusively for substance dependent doctoral-level psychologists and students) shows that of the 94% of respondents maintaining abstinence, 86% attended AA (Thoreson et al., 1986). A separate study of 70 psychologists in recovery who were members of AA revealed the majority attained sobriety outside of formal treatment or intervention programs (Skorina et al., 1990). 

Because AA appears to be a vital resource for psychotherapists struggling with substance misuse, it is important to consider how to address ethical dilemmas that one might encounter while participating in AA.

Conclusion

Psychotherapists participating in AA may, at times, find that their professional responsibility of adhering to the APA Code of Ethics hinders some aspects of their categorical involvement in AA as defined by AA’s 12 steps and 12 traditions. The psychotherapist in AA may need to adjust their personal AA “program” in comparison with the typical AA member in a manner that attempts to meet the requirements of the profession yet still provides them with enough support to maintain their professional competence. This article discusses reasonable compromises, specifically tailored to the length of the psychotherapist’s sobriety, that minimize the potential for client harm. Ultimately, if the psychotherapist is unable to find an appropriate middle-ground, where the personal needs of recovery can be met without damaging client welfare and respecting the client’s rights, the psychotherapist should refer the client elsewhere. With these recommendations, psychotherapists should feel more comfortable participating in AA (or other mutual self-help groups) while also adhering to the ethical principles of our profession.

The article is here.

Betrayal vs. Nonbetrayal Trauma: Different Effects of Social Support & Emotion Regulation on PTSD Symptom Severity

N. Kline & K.M. Palm Read

Psychological Trauma: 

Theory, Research, Practice, and Policy. 

Abstract

Objective: Betrayal Trauma Theory posits that interpersonal traumas are particularly injurious when the perpetrator is a person that the victim previously trusted and was close to. A relevant protective factor to examine is social support, which may influence PTSD symptomology through its influence on emotion regulation. The aim of the current study was to examine differences in the associations between social support, emotion regulation, and PTSD symptom severity for survivors of betrayal trauma and nonbetrayal trauma. 

Method: Two hundred and 73 trauma survivors (age: M = 25.96 years, SD = 9.42 years; 80.2% female; 63.7% White) completed the anonymous, online survey. Results: Across both groups, emotion regulation mediated the relationship between social support and PTSD symptom severity. A multiple-samples SEM analysis showed that the betrayal group evidenced a weaker relationship between social support and emotion regulation. 

Conclusions: Findings suggest that survivors of high betrayal trauma may not engage with their social support in ways that foster emotion regulation skills. Therefore, for high betrayal trauma survivors specifically, group interventions that involve the survivor and close contact(s), may be particularly beneficial in enhancing emotion regulation and decreasing PTSD symptomology.

Impact Statement

Findings suggest social support may influence the impact of trauma through improving survivors’ ability to regulate emotions. Survivors of betrayal trauma may not seek out social support to the same extent or manner as nonbetrayal trauma survivors, limiting opportunities for beneficial emotional regulation practices and support. Clinicians should consider focusing on how interpersonal processes can facilitate greater understanding, acceptance, and regulation of emotions following betrayal trauma. 

The article is here.

The dynamics of social support among suicide attempters: A smartphone-based daily diary study

Coppersmith, D.D.L.; Kleiman, E.M.; Glenn, C.R.; Millner, A.J.; Nock, M.K.
Behaviour Research and Therapy (2018)

Abstract

Decades of research suggest that social support is an important factor in predicting suicide risk and resilience. However, no studies have examined dynamic fluctuations in day-by-day levels of perceived social support. We examined such fluctuations over 28 days among a sample of 53 adults who attempted suicide in the past year (992 total observations). Variability in social support was analyzed with between-person intraclass correlations and root mean square of successive differences. Multi-level models were conducted to determine the association between social support and suicidal ideation. Results revealed that social support varies considerably from day to day with 45% of social support ratings differing by at least one standard deviation from the prior assessment. Social support is inversely associated with same-day and next-day suicidal ideation, but not with next-day suicidal ideation after adjusting for same-day suicidal ideation (i.e., not with daily changes in suicidal ideation). These results suggest that social support is a time-varying protective factor for suicidal ideation.

The research is here.

Promoting competent and flourishing life-long practice for psychologists: A communitarian perspective

Wise, E. H., & Reuman, L. (2019).
Professional Psychology: Research and Practice, 50(2), 129-135.

Abstract

Based on awareness of the challenges inherent in the practice of psychology there is a burgeoning interest in ensuring that psychologists who serve the public remain competent. These challenges include remaining current in our technical skills and maintaining sufficient personal wellness over the course of our careers. However, beyond merely maintaining competence, we encourage psychologists to envision flourishing lifelong practice that incorporates positive relationships, enhancement of meaning, and positive engagement. In this article we provide an overview of the foundational competencies related to professionalism including ethics, reflective practice, self-assessment, and self-care that underlie our ability to effectively apply technical skills in often complex and emotionally challenging relational contexts. Building on these foundational competencies that were initially defined and promulgated for academic training in health service psychology, we provide an initial framework for conceptualizing psychologist well-being and flourishing lifelong practice that incorporates tenets of applied positive psychology, values-based practice, and a communitarian-oriented approach into the following categories: fostering relationships, meaning making and value-based practice, and enhancing engagement. Finally, we propose broad strategies and specific examples intended to leverage current continuing education mandates into a broadly conceived vision of continuing professional development to support enhanced psychologist functioning for lifelong practice.

The info is here.

Don’t Nudge Me: The Limits of Behavioral Economics in Medicine

Aaron E. Carroll
The New York Times - The Upshot
Originally posted November 6, 2017

Here is an excerpt:

But those excited about the potential of behavioral economics should keep in mind the results of a recent study. It pulled out all the stops in trying to get patients who had a heart attack to be more compliant in taking their medication. (Patients’ adherence at such a time is surprisingly low, even though it makes a big difference in outcomes, so this is a major problem.)

Researchers randomly assigned more than 1,500 people to one of two groups. All had recently had heart attacks. One group received the usual care. The other received special electronic pill bottles that monitored patients’ use of medication. Those patients who took their drugs were entered into a lottery in which they had a 20 percent chance to receive $5 and a 1 percent chance to win $50 every day for a year.

That’s not all. The lottery group members could also sign up to have a friend or family member automatically be notified if they didn’t take their pills so that they could receive social support. They were given access to special social work resources. There was even a staff engagement adviser whose specific duty was providing close monitoring and feedback, and who would remind patients about the importance of adherence.

This was a kitchen-sink approach. It involved direct financial incentives, social support nudges, health care system resources and significant clinical management. It failed.

The article is here.

Facts Don’t Change People’s Minds. Here’s What Does

Ozan Varol
Helio
Originally posted September 6, 2017

Here is an excerpt:

The mind doesn’t follow the facts. Facts, as John Adams put it, are stubborn things, but our minds are even more stubborn. Doubt isn’t always resolved in the face of facts for even the most enlightened among us, however credible and convincing those facts might be.

As a result of the well-documented confirmation bias, we tend to undervalue evidence that contradicts our beliefs and overvalue evidence that confirms them. We filter out inconvenient truths and arguments on the opposing side. As a result, our opinions solidify, and it becomes increasingly harder to disrupt established patterns of thinking.

We believe in alternative facts if they support our pre-existing beliefs. Aggressively mediocre corporate executives remain in office because we interpret the evidence to confirm the accuracy of our initial hiring decision. Doctors continue to preach the ills of dietary fat despite emerging research to the contrary.

If you have any doubts about the power of the confirmation bias, think back to the last time you Googled a question. Did you meticulously read each link to get a broad objective picture? Or did you simply skim through the links looking for the page that confirms what you already believed was true? And let’s face it, you’ll always find that page, especially if you’re willing to click through to Page 12 on the Google search results.

The article is here.

An Alternative Form of Mental Health Care Gains a Foothold

By Benedict Carey
The New York Times
Originally published August 8, 2016

Here is an excerpt:

Dr. Chris Gordon, who directs a program with an approach to treating psychosis called Open Dialogue at Advocates in Framingham, Mass., calls the alternative approaches a “collaborative pathway to recovery and a paradigm shift in care.” The Open Dialogue approach involves a team of mental health specialists who visit homes and discuss the crisis with the affected person — without resorting to diagnostic labels or medication, at least in the beginning.

Some psychiatrists are wary, they say, given that medication can be life-changing for many people with mental problems, and rigorous research on these alternatives is scarce.'

The article is here.

Three Principles to REVISE People's Unethical Behavior

Ayal, S., F. Gino, R. Barkan, and D. Ariely.
Perspectives on Psychological Science
November 2015 vol. 10 no. 6 738-741

Abstract

Dishonesty and unethical behavior are widespread in the public and private sectors and cause immense annual losses. For instance, estimates of U.S. annual losses indicate $1 trillion paid in bribes, $270 billion lost due to unreported income, and $42 billion lost in retail due to shoplifting and employee theft. In this article, we draw on insights from the growing fields of moral psychology and behavioral ethics to present a three-principle framework we call REVISE. This framework classifies forces that affect dishonesty into three main categories and then redirects those forces to encourage moral behavior. The first principle, reminding, emphasizes the effectiveness of subtle cues that increase the salience of morality and decrease people’s ability to justify dishonesty. The second principle, visibility, aims to restrict anonymity, prompt peer monitoring, and elicit responsible norms. The third principle, self-engagement, increases people’s motivation to maintain a positive self-perception as a moral person and helps bridge the gap between moral values and actual behavior. The REVISE framework can guide the design of policy interventions to defeat dishonesty.

The article is here.

Social media: A network boost

Monya Baker
Nature 518 ,263-265(2015)
doi:10.1038/nj7538-263a
Published online11 February 2015

Information scientist Cassidy Sugimoto was initially sceptical that Twitter was anything more than a self-promotional time-sink. But when she noticed that her graduate students were receiving conference and co-authoring invitations through connections made on Twitter, she decided to give the social-media platform a try. An exchange that began last year as short posts, or 'tweets', relating to conference sessions led to a new contact offering to help her negotiate access to an internal data set from a large scientific society. “Because we started the conversation on Twitter, it allowed me to move the conversation into the physical world,” says Sugimoto, who studies how ideas are disseminated among scientists at Indiana University in Bloomington. “It's allowed me to open up new communities for discussions and increase the interdisciplinarity of my research.”

The entire article is here.

Very overweight teens face stigma, discrimination, and isolation

From a synopsis in the British Medical Journal

Here is an excerpt of the synopsis of the article:

In general, young people thought that individuals were responsible for their own body size. They associated excess weight with negative stereotypes of laziness, greed, and a lack of control. And they felt that being overweight made an individual less attractive and opened them up to bullying and teasing.

Young people who were already overweight tended to blame themselves for their size. And those who were classified as very overweight said they had been bullied and physically and verbally assaulted, particularly at school. They endured beatings, kickings, name-calling, deliberate and prolonged isolation by peers, and sniggering/whispering.

Some young people described coping strategies, such as seeking out support from others. But the experiences of being overweight included feeling excluded, ashamed, marked out as different, isolated, ridiculed and ritually humiliated. Everyday activities, such as shopping and socialising, were difficult.

The entire synopsis is here.

A link to the study is here.

Internet forums can have a positive influence on self-harmers, say researchers

By Jochan Embley
The Independent
Originally published October 31, 2013

Internet forums and chatrooms can have a positive influence on young people at risk from self-harm or suicide, researchers have found.

The review, which comes from researchers at Oxford University, does admit that there are also negative, potentially dangerous aspects to forums, however.

The entire story is here.

Most Professors Say They've Considered Quitting Over Work-Life Conflicts

by Audrey Williams June
The Chronicle of Higher Education
Originally published December 10, 2012


Work-life conflicts have caused roughly three out of every four assistant professors to think about leaving their institution, according to the results of a new survey.

For some assistant professors, leaving their institution isn't enough to solve their work-life problems.

Almost 45 percent of those surveyed said they could see themselves leaving academe altogether.

Meanwhile, 65 percent of full professors surveyed said that they had considered leaving their university in the last year.

<snip>

The survey found that nearly 80 percent of faculty members would consider leaving their institution in search of a more-supportive work environment.

About 60 percent would consider leaving where they now work to spend more time with their families.

About 35 percent of respondents would think about leaving to deal with elder care, while about one-fourth would consider leaving their institution because of problems related to child care.

The entire story is here.

Thanks to Ken Pope for this information.

Stressed physicians reluctant to seek support

They cite lack of time and fear of hurting their careers as reasons to avoid employee-assistance programs.

By KEVIN B. O'REILLY, amednews staff

Nearly 80% of physicians at an academic medical center said they experienced a personal crisis within the past year, yet most said they would not seek support from physician-health services or employee-assistance programs.

The 108 surgeons, anesthesiologists and emergency physicians surveyed said they experienced a wide range of stressful events, such as serious illnesses or deaths in their families and severe adverse events in their patients. But most they said they were unlikely to turn to institutional sources of support, with 40% saying they would be willing to consult physician-health services and 29% open to using employee-assistance programs. About a third of the doctors had never even heard of these services, said an Archives of Surgery study published in March.

The reason offered most frequently for not getting help was lack of time, with 90% of the physicians surveyed at Brigham and Women’s Hospital in Boston citing it. About 70% feared a lack of confidentiality, negative impact on their careers or the stigma of mental illness. Nearly half feared legal consequences or thought “using services means I am weak.”

The entire story is here.

The original abstract is here.

Suicide, Warning Signs And Issues Faced By Friends And Family

Medical News Today

A study focusing on the family and friends of people who were suicidal has highlighted the main challenges they face when trying to judge whether a person is in danger and decide what they should do about it.

The research was carried out by Dr. Christabel Owens from the Peninsula College of Medicine and Dentistry, supported by Devon NHS Partnership Trust and funded by the UK Medical Research Council. The findings are published in the British Medical Journal on 22nd October 2011 (online 19th October 2011).

(cut)

The findings of the research show that relatives and friends did not always receive clear and unambiguous warning signals from the suicidal individual, and that, even when it was obvious that something was seriously wrong, they could not always summon the courage to take action.

Family members and friends of those who may be contemplating suicide are confronted by powerful emotional blocks, particularly fear. They may be afraid of intruding into another person's emotional life or afraid of damaging a cherished relationship by 'saying the wrong thing'. The whole situation is emotionally charged, and that affects the way in which people respond.

(cut)

Dr. Owens: "It is sad that, in the course of our research, we have repeatedly come across examples of people who did go to their GP, were given a cursory risk assessment and sent home with little or no support, and subsequently killed themselves. In other cases, a relative has taken their concerns to a GP and asked for advice, and has been told that the case cannot be discussed with them for reasons of patient confidentiality and that the person must visit the GP themselves."

The entire study can be found here.

Recognising and responding to suicidal crisis within family and social networks: qualitative study

BMJ 2011; 343:d5801 doi: 10.1136/bmj.d5801 (Published 18 October 2011)

Cite this as: BMJ 2011; 343:d5801

Suicide Draws Attention to Bullying of a Gay Teen

By Anahad O'Connor
The New York Times



Five months ago, Jamey Rodemeyer, a Buffalo junior high school student, got on his webcam and created a video urging other gay teenagers to remain hopeful in the face of bullying.

The 14-year-old spoke of coming out as bisexual and enduring taunts and slurs at school. And he described, in at times desperate tones, rejection and ridicule from other teenagers.

Jamey made the video as part of the It Gets Better project, a campaign that was started last fall to give hope to bullied gay teenagers. “All you have to do is hold your head up and you’ll go far,” he said. “Just love yourself and you’re set. … It gets better.”

But for Jamey, the struggle apparently was just too much. This week his parents announced that their son was found dead, an apparent suicide. He didn’t leave a note, but his parents said he had endured “constant taunting, from the same people over and over.” They added that his school had intervened to help, and that Jamey appeared to be benefiting from counseling.

News that a bullied teenager had succumbed to the very pressures he urged others to resist came as a shock to supporters of the It Gets Better project. And it provided a sobering reminder that bullied teenagers who appear to be adjusting may still be in trouble.

Dan Savage, the advice columnist and co-founder of It Gets Better, noted on his blog on Tuesday that Jamey’s death showed that “sometimes, the damage done by hate and by haters is simply too great.”

It sounds like Jamey had help — he was seeing a therapist and a social worker and his family was supportive — but it wasn’t enough. Whatever help Jamey was getting clearly wasn’t enough to counteract the hatred and abuse that he had endured since the fifth grade, according to reports, or Jamey’s fears of having to face down a whole new set of bullies when he started high school next year.

As suicides among lesbian, gay, bisexual and transgender teenagers have gotten more attention in the past year, researchers have sought to identify the factors that play the largest role. One study published in the journal Pediatrics in May, which looked at nearly 32,000 teenagers in 34 counties across Oregon, found that gay and bisexual teenagers were significantly more likely to attempt suicide than their heterosexual peers. The risk of an attempt was 20 percent greater among gay teenagers who lacked supportive social surroundings, like schools with gay-straight alliance groups or school policies that specifically protected gay, lesbian and bisexual students.

An editorial accompanying the study said the findings pointed to the need for schools to adopt policies that create “more supportive and inclusive surroundings.”

“By encouraging more positive environments,” the report stated, “such policies could help reduce the risk of suicide attempts not only among LGB students, but also among heterosexual students.”

Watch Jamey’s It Gets Better video above.

The entire story was found here.

This story captured the attention of Lady Gaga, gay rights activist and a supporter of anti-bullying programs.  Lady Gaga dedicates a song to Jamey.