Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Compassion. Show all posts
Showing posts with label Compassion. Show all posts

Monday, June 3, 2024

Morality in the Anthropocene: The Perversion of Compassion and Punishment in the Online World

Robertson, C., Shariff, A., & Van Bavel, J. J.
(2024, February 4).

Abstract

Although much of human morality evolved in an environment of small group living, almost six billion people use the internet in the modern era. We argue that the technological transformation has created an entirely new ecosystem that is often mismatched with our evolved adaptations for social living. We discuss how evolved responses to moral transgressions, such as compassion for victims of transgressions and punishment of transgressors, are disrupted by two main features of the online context. First, the scale of the internet exposes us to an unnaturally large quantity of extreme moral content, causing compassion fatigue and increasing public shaming. Second, the physical and psychological distance between moral actors online can lead to ineffective collective action and virtue signaling. We discuss practical implications of these mismatches and suggest directions for future research on morality in the internet era.

Significance Statement

Morality evolved when people lived in small, close-knit groups. Evolved responses to moral conflict, like compassion for the victim and punishment for the transgressor, had adaptive benefits. However, the internet has created a new ecosystem for human sociality changing morality in two important ways. First, the scale of the internet exposes people to unnaturally large quantities of extreme moral content. Second, people’s responses to moral transgressions are not beneficial in large, distal social groups. These mismatches can lead to compassion fatigue, ineffective collective action, public shaming, and virtue signaling.


Here is my summary:

The research discusses how the internet has transformed human morality by creating a new ecosystem that often conflicts with our evolved social adaptations. It highlights that the scale and nature of online interactions lead to compassion fatigue, public shaming, and ineffective collective action. The research emphasizes how evolved responses to moral conflicts, like compassion for victims and punishment for transgressors, are disrupted online due to the vast exposure to extreme moral content and the distance between moral actors. It delves into the evolutionary underpinnings of moral cognition, explaining how humans' innate behaviors related to social interactions have shaped morality. Furthermore, it explores how the internet exposes people to overabundance and extremity of moral content, triggering maladaptive responses like heightened outrage and hostility. The research also examines how online environments distort people's prosocial reactions to morality, leading to challenges in expressing genuine compassion, empathy, and effective third-party punishment.

Thursday, September 14, 2023

Who supports redistribution? Replicating and refining effects of compassion, malicious envy, and self-interest

Lin, C.A., & Bates, T.C.
(2023). Evolution and Human Behavior

Abstract

Debate over wealth redistribution plays a prominent role in society, but the causes of differences in support for redistribution remain contested. A recent three-person two-situation model suggests these differences are shaped by evolved motivational systems of self-interest, compassion, and dispositional envy. We conducted a close replication testing this prediction, all subjects were British, recruited from an online subject pool. Study 1 (N = 206) confirmed the roles of self-interest (β = 0.20) and compassion for others (β = 0.37), as well as a predicted null effect of procedural fairness. Dispositional envy was non-significant (β = 0.06). In study 2 (N = 304), we tested whether it was better to conceptualize envy as being two separate emotions, benign envy and malicious envy. A significant effect of malicious envy was found (β = 0.13) and no significant effect of benign envy (β = −0.06). Study 3 (N = 501) closely replicated this improved model, confirming significant effects of compassion (β = 0.40), self-interest (β = 0.21), and malicious envy (β = 0.15), accounting for one third of variance in support for redistribution. These results support the role of evolved motivational systems to explain and improve important aspects of contemporary economic redistribution.


The authors conducted three studies to test their hypotheses. In Study 1, they replicated the findings of a previous study that found that compassion, malicious envy, and self-interest all predict support for redistribution. In Study 2, they developed a new measure of envy and found that this measure also predicted support for redistribution. In Study 3, they found that left-political support was associated with higher support for redistribution.

The authors conclude that their findings support the hypothesis that compassion, malicious envy, and self-interest all play a role in shaping people's support for wealth redistribution. They suggest that future research should examine the relative importance of these three motivational systems in different contexts.

Here are some additional key points from the article:
  • The authors propose a model of wealth redistribution that is based on three motivational systems: compassion, malicious envy, and self-interest.
  • They conducted three studies to test their hypotheses.
  • The findings of the studies support the hypothesis that compassion, malicious envy, and self-interest all play a role in shaping people's support for wealth redistribution.
  • The authors suggest that future research should examine the relative importance of these three motivational systems in different contexts.

Friday, August 11, 2023

How and why people want to be more moral

Sun, J., Wilt, J. A., Meindl, et al. (2023).
Journal of Personality.
https://doi.org/10.1111/jopy.12812

Abstract

Objective

What types of moral improvements do people wish to make? Do they hope to become more good, or less bad? Do they wish to be more caring? More honest? More loyal? And why exactly do they want to become more moral? Presumably, most people want to improve their morality because this would benefit others, but is this in fact their primary motivation? Here, we begin to investigate these questions.

Method

Across two large, preregistered studies (N = 1818), participants provided open-ended descriptions of one change they could make in order to become more moral; they then reported their beliefs about and motives for this change.

Results

In both studies, people most frequently expressed desires to improve their compassion and more often framed their moral improvement goals in terms of amplifying good behaviors than curbing bad ones. The strongest predictor of moral motivation was the extent to which people believed that making the change would have positive consequences for their own well-being.

Conclusions

Together, these studies provide rich descriptive insights into how ordinary people want to be more moral, and show that they are particularly motivated to do so for their own sake.


My summary:
  • People most frequently expressed desires to improve their compassion. This suggests that people are motivated to become more moral in order to be more caring and helpful to others.
  • People more often framed their moral improvement goals in terms of amplifying good behaviors than curbing bad ones. This suggests that people are motivated to become more moral by doing more good things, rather than by simply avoiding doing bad things.
  • The strongest predictor of moral motivation was the extent to which people believed that making the change would have positive consequences for their own well-being. This suggests that people are motivated to become more moral for their own sake, as well as for the sake of others.

Monday, June 26, 2023

Characterizing empathy and compassion using computational linguistic analysis

Yaden, D. B., Giorgi, S., et al. (2023). 
Emotion. Advance online publication.

Abstract

Many scholars have proposed that feeling what we believe others are feeling—often known as “empathy”—is essential for other-regarding sentiments and plays an important role in our moral lives. Caring for and about others (without necessarily sharing their feelings)—often known as “compassion”—is also frequently discussed as a relevant force for prosocial motivation and action. Here, we explore the relationship between empathy and compassion using the methods of computational linguistics. Analyses of 2,356,916 Facebook posts suggest that individuals (N = 2,781) high in empathy use different language than those high in compassion, after accounting for shared variance between these constructs. Empathic people, controlling for compassion, often use self-focused language and write about negative feelings, social isolation, and feeling overwhelmed. Compassionate people, controlling for empathy, often use other-focused language and write about positive feelings and social connections. In addition, high empathy without compassion is related to negative health outcomes, while high compassion without empathy is related to positive health outcomes, positive lifestyle choices, and charitable giving. Such findings favor an approach to moral motivation that is grounded in compassion rather than empathy.

From the General Discussion

Linguistic topics related to compassion (without empathy) and empathy (without compassion) show clear relationships with four of the five personality factors. Topics related to compassion without empathy are marked by higher conscientiousness, extraversion, agreeableness, and emotional stability. Empathy without compassion topics are more associated with introversion and are also moderately associated with neuroticism and lower conscientiousness.  The association of low emotional stability and conscientiousness is also in line with prior research that found “distress,”a construct with important parallels to empathy, being associated with fleeing from a helping situation (Batson et al., 1987) and with lower helping(Jordan et al., 2016;Schroeder et al., 1988; Twenge et al., 2007; and others).

In sum, it appears that compassion without empathy and empathy without compassion are at least somewhat distinct and have unique predictive validity in personality, health, and prosocial behavior.  While the mechanisms through which these different relationships occur remain unknown, some previous work bears on this issue.  As mentioned, other work has found that merely focusing on others resulted in more intentions to help others (Bloom, 2017;Davis,1983;Jordan et al., 2016), which helps to explain the relationship between the more other-focused compassion and donation behavior that we observed.


In sum, high empathy without compassion is related to negative health outcomes, while high compassion without empathy is related to positive health outcomes. These findings suggest that compassion may be a more important factor for moral motivation than empathy.  Too much empathy may be overwhelming for high quality care.  Care about feelings, don't absorb the sharing of feelings.

Thursday, April 7, 2022

How to Prevent Robotic Sociopaths: A Neuroscience Approach to Artificial Ethics

Christov-Moore, L., Reggente, N.,  et al.
https://doi.org/10.31234/osf.io/6tn42

Abstract

Artificial intelligence (AI) is expanding into every niche of human life, organizing our activity, expanding our agency and interacting with us to an increasing extent. At the same time, AI’s efficiency, complexity and refinement are growing quickly. Justifiably, there is increasing concern with the immediate problem of engineering AI that is aligned with human interests.

Computational approaches to the alignment problem attempt to design AI systems to parameterize human values like harm and flourishing, and avoid overly drastic solutions, even if these are seemingly optimal. In parallel, ongoing work in service AI (caregiving, consumer care, etc.) is concerned with developing artificial empathy, teaching AI’s to decode human feelings and behavior, and evince appropriate, empathetic responses. This could be equated to cognitive empathy in humans.

We propose that in the absence of affective empathy (which allows us to share in the states of others), existing approaches to artificial empathy may fail to produce the caring, prosocial component of empathy, potentially resulting in superintelligent, sociopath-like AI. We adopt the colloquial usage of “sociopath” to signify an intelligence possessing cognitive empathy (i.e., the ability to infer and model the internal states of others), but crucially lacking harm aversion and empathic concern arising from vulnerability, embodiment, and affective empathy (which permits for shared experience). An expanding, ubiquitous intelligence that does not have a means to care about us poses a species-level risk.

It is widely acknowledged that harm aversion is a foundation of moral behavior. However, harm aversion is itself predicated on the experience of harm, within the context of the preservation of physical integrity. Following from this, we argue that a “top-down” rule-based approach to achieving caring, aligned AI may be unable to anticipate and adapt to the inevitable novel moral/logistical dilemmas faced by an expanding AI. It may be more effective to cultivate prosociality from the bottom up, baked into an embodied, vulnerable artificial intelligence with an incentive to preserve its real or simulated physical integrity. This may be achieved via optimization for incentives and contingencies inspired by the development of empathic concern in vivo. We outline the broad prerequisites of this approach and review ongoing work that is consistent with our rationale.

If successful, work of this kind could allow for AI that surpasses empathic fatigue and the idiosyncrasies, biases, and computational limits of human empathy. The scaleable complexity of AI may allow it unprecedented capability to deal proportionately and compassionately with complex, large-scale ethical dilemmas. By addressing this problem seriously in the early stages of AI’s integration with society, we might eventually produce an AI that plans and behaves with an ingrained regard for the welfare of others, aided by the scalable cognitive complexity necessary to model and solve extraordinary problems.

Thursday, November 26, 2020

Oncologist Pays for Patient's Meds: A 'Boundary' Crossed?

Nic Mulcahy
medscape.com
Originally posted 4 Nov 20

It was an act of kindness: while overseeing a patient through a round of chemotherapy, an oncology fellow at Johns Hopkins University's Kimmel Comprehensive Cancer Center in Baltimore, Maryland, paid a modest amount of money (about $10) for that patient's antiemetic medication and retrieved it from the center's pharmacy.

Co-fellow Arjun Gupta, MD, witnessed the act and shared it with the world September 23 on Twitter.

"Just observed a co-fellow pay the co-pay for a patient's post-chemo nausea meds at the pharmacy, arrange them in a pill box, and deliver them to the patient in the infusion center. So that the patient could just leave after chemo."

Healthcare professionals applauded the generosity. "Phenomenal care," tweeted Carolyn Alexander, MD, a fertility physician in Los Angeles.

It's a common occurrence, said others. "Go ask a nurse how many times they've done it. I see it happen weekly," tweeted Chelsea Mitchell, PharmD, an intensive care unit pharmacist in Memphis, Tennessee.

Lack of universal healthcare brings about these moments, claimed multiple professionals who read Gupta's anecdote. "#ThisIsDoctoring. This is also a shameful indictment of our medical system," said Mary Landrigan-Ossar, MD, an anesthesiologist at Children's Hospital, Boston, Massachusetts.

However, one observer called out something no one else had ― that paying for a patient's medication is not allowed in some facilities.

Monday, October 12, 2020

The U.S. Has an Empathy Deficit—Here’s what we can do about it.

Judith Hall and Mark Leary
Scientific American
Originally poste 17 Sept 20

Here are two excerpts:

Fixing this empathy deficit is a challenge because it is not just a matter of having good political or corporate leaders or people treating each other with good will and respect. It is, rather, because empathy is a fundamentally squishy term. Like many broad and complicated concepts, empathy can mean many things. Even the researchers who study it do not always say what they mean, or measure empathy in the same way in their studies—and they definitely do not agree on a definition. In fact, there are stark contradictions: what one researcher calls empathy is not empathy to another.

When laypeople are surveyed on how they define empathy, the range of answers is wide as well. Some people think empathy is a feeling; others focus on what a person does or says. Some think it is being good at reading someone’s nonverbal cues, while others include the mental orientation of putting oneself in someone else’s shoes. Still others see empathy as the ability or effort to imagine others’ feelings, or as just feeling “connected” or “relating” to someone. Some think it is a moral stance to be concerned about other people’s welfare and a desire to help them out. Sometimes it seems like “empathy” is just another way of saying “being a nice and decent person.” Actions, feelings, perspectives, motives, values—all of these are “empathy” according to someone.

(cut)

Whatever people think empathy is, it’s a powerful force and human beings need it. These three things might help to remedy our collective empathy deficit:

Take the time to ask those you encounter how they are feeling, and really listen. Try to put yourself in their shoes. Remember that we all tend to underestimate other people’s emotional distress, and we’re most likely to do so when those people are different from us.

Remind yourself that almost everyone is at the end of their rope these days. Many people barely have enough energy to handle their own problems, so they don’t have their normal ability to think about yours.

Monday, September 21, 2020

Changing morals: we’re more compassionate than 100 years ago, but more judgmental too

N. Haslam, M. J. McGrady, & M. A. Wheeler
The Conversation
Originally published 4 March 19

Here is an excerpt:

Differently moral

We found basic moral terms (see the black line below) became dramatically scarcer in English-language books as the 20th century unfolded – which fits the de-moralisation narrative. But an equally dramatic rebound began in about 1980, implying a striking re-moralisation.

The five moral foundations, on the other hand, show a vastly changing trajectory. The purity foundation (green line) shows the same plunge and rebound as the basic moral terms. Ideas of sacredness, piety and purity, and of sin, desecration and indecency, fell until about 1980, and rose afterwards.

The other moralities show very different pathways. Perhaps surprisingly, the egalitarian morality of fairness (blue) showed no consistent rise or fall.

In contrast, the hierarchy-based morality of authority (grey) underwent a gentle decline for the first half of the century. It then sharply rose as the gathering crisis of authority shook the Western world in the late 1960s. This morality of obedience and conformity, insubordination and rebellion, then receded equally sharply through the 1970s.

Ingroup morality (orange), reflected in the communal language of loyalty and unity, insiders and outsiders, displays the clearest upward trend through the 20th century. Discernible bumps around the two world wars point to passing elevations in the “us and them” morality of threatened communities.

Finally, harm-based morality (red) presents a complex but intriguing trend. Its prominence falls from 1900 to the 1970s, interrupted by similar wartime bumps when themes of suffering and destruction became understandably urgent. But harm rises steeply from about 1980 in the absence of a single dominating global conflict.

The info is here.

Friday, September 11, 2020

Why Being Kind Helps You, Too—Especially Now

Elizabeth Bernstein
The Wall Street Journal
Originally posted 11 August 20

Here is an excerpt:

Kindness can even change your brain, says Stephanie Preston, a psychology professor at the University of Michigan who studies the neural basis for empathy and altruism. When we’re kind, a part of the reward system called the nucleus accumbens activates—our brain responds the same way it would if we ate a piece of chocolate cake. In addition, when we see the response of the recipient of our kindness—when the person thanks us or smiles back—our brain releases oxytocin, the feel-good bonding hormone. This oxytocin boost makes the pleasure of the experience more lasting.

It feels so good that the brain craves more. “It’s an upward spiral—your brain learns it’s rewarding, so it motivates you to do it again,” Dr. Preston says.

Are certain acts of kindness better than others? Yes. If you want to reap the personal benefits, “you need to be sincere,” says Sara Konrath, a psychologist and associate professor at the Indiana University Lilly Family School of Philanthropy, where she runs a research lab that studies empathy and altruism.

It also helps to expect good results. A study published in the Journal of Positive Psychology in 2019 showed people who believed that kindness is good for them showed a greater increase in positive emotions, satisfaction with life and feelings of connection with others—as well as a greater decrease in negative emotions—than those who did not.

How can you be kind even when you may not feel like it? Make it a habit. Take stock of how you behave day to day. Are you trusting and generous? Or defensive and hostile? “Kindness is a lifestyle,” says Dr. Konrath.

Start by being kind to yourself—you’re going to burn out if you help everyone else and neglect your own needs. Remember that little acts add up: a smile, a phone call to a lonely friend, letting someone have the parking space. Understand the difference between being kind and being nice—kindness is genuinely helping or caring about someone; niceness is being polite. Don’t forget your loved ones. Kindness is not just for strangers.

The info is here.

Saturday, March 14, 2020

You’re Not Going to Kill Them With Kindness. You’ll Do Just the Opposite.

Judith Newman
The New York Times
Originally posted 8 Jan 20

It was New Year’s Eve, and my friends had just adopted a little girl, 4 years old, from China. The family was going around the table, suggesting what each thought the New Year’s resolution should be for the other. Fei Fei’s English was still shaky. When her turn came, though, she didn’t hesitate. She pointed at her new father, mother and sister in turn. “Be nice, be nice, be nice,” she said.

Fifteen years later, in this dark age for civility, a toddler’s cri de coeur resonates more than ever. In his recent remarks at the memorial service for Congressman Elijah Cummings, President Obama said, “Being a strong man includes being kind, and there’s nothing weak about kindness and compassion; nothing weak about looking out for others.” On a more pedestrian level, yesterday I walked into the Phluid Project, the NoHo gender-neutral shop where T-shirts have slogans like “Hatephobic” and “Be Your Self.” I asked the salesperson, “What is your current best seller?” She pointed to a shirt in the window imprinted with the slogan: “Be kind.”

So I’m not surprised that there’s been a little flurry of self-help books on basic human decency and what it will do for you.

Kindness is doing small acts for others without expecting anything in return. It’s the opposite of transactional, and therefore the opposite of what we’re seeing in our body politic today.

The info is here.

Sunday, July 21, 2019

The world is broken—and human kindness is the only solution

Anee Kingston
McClean's
Originally published June 19, 2019

Here is an excerpt:

The U.S. government has literally institutionalized cruelty, caging migrant children and arresting “Good Samaritans” helping ailing migrants at the Mexican border. Austerity programs, including those in Ontario, are targeting the vulnerable—the poor, children, those on the margins. The divisive, toxic political climate gave rise to the British group Compassion in Politics, founded last fall by activists and academics. “People look at British politics and see a lack of compassion in policy on refugees, immigration, housing, Brexit,” group co-founder Ma
tt Hawkins tells Maclean’s. Forty years of neo-liberal, free-market policies created widening inequities, falling incomes and a sense of desperation, he says. “There’s frustration with a political system that puts party above universal progress, majorities in Parliament over collaboration.” Support has been overwhelmingly positive, Hawkins says, including from the moral philosopher Peter Singer and Noam Chomsky; there’s interest in Australia and they’re liaising with Ardern’s office. In May, a cross-party group of British MPs called for legislation to contain a “compassion threshold.”

The loudest cries for compassion, tellingly, are heard within systems literally created to care for people. Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference, by American physician-scientists Stephen Trzeciak and Anthony Mazzarelli, published in April, is the latest book to sound the alarm about systemic inhumanity within “patient-based” medicine. The authors identify a “compassion crisis” in U.S. health care; treating patients more kindly, they argue, improves health outcomes, reduces doctor burnout and lowers costs.

Canada is in similar straits, Toronto physician Brian Goldman, author of the 2018 bestseller The Power of Kindness: Why Empathy is Essential in Everyday Life, tells Maclean’s. “We’ve designed a system that edits out empathy, that makes it almost impossible.” Something has to crack, Goldman says: “We’ve reached the limit of the myth of the superman-superwoman [doctor] who can juggle 10 things at once.”

The info is here.

Tuesday, March 26, 2019

Should doctors cry at work?

Fran Robinson
BMJ 2019;364:l690

Many doctors admit to crying at work, whether openly empathising with a patient or on their own behind closed doors. Common reasons for crying are compassion for a dying patient, identifying with a patient’s situation, or feeling overwhelmed by stress and emotion.

Probably still more doctors have done so but been unwilling to admit it for fear that it could be considered unprofessional—a sign of weakness, lack of control, or incompetence. However, it’s increasingly recognised as unhealthy for doctors to bottle up their emotions.

Unexpected tragic events
Psychiatry is a specialty in which doctors might view crying as acceptable, says Annabel Price, visiting researcher at the Department of Psychiatry, University of Cambridge, and a consultant in liaison psychiatry for older adults.

Having discussed the issue with colleagues before being interviewed for this article, she says that none of them would think less of a colleague for crying at work: “There are very few doctors who haven’t felt like crying at work now and again.”

A situation that may move psychiatrists to tears is finding that a patient they’ve been closely involved with has died by suicide. “This is often an unexpected tragic event: it’s very human to become upset, and sometimes it’s hard not to cry when you hear difficult news,” says Price.

The info is here.

Wednesday, December 26, 2018

Therapy Is No Longer a Politics-Free Zone

Peggy Drexler
The Wall Street Journal
Originally posted November November 23, 2018

Here is an excerpt:

A May 2018 survey published in the Journal of Clinical Psychology—which devoted an entire issue to how mental health professionals can understand and deal with the dramatic increase in clients feeling politics-related anxiety—found that of 604 psychotherapy patients from 50 states, only 32 percent said their therapist didn’t disclose their political beliefs, while 30 percent said their therapists divulged their views and the other 38 percent said their therapists very clearly made their beliefs known. “The old rules are pretty straightforward: Don’t talk about it,” says Dr. Steven Schlozman. a psychiatrist at Massachusetts General Hospital in Boston. “But our country right now is so about what side you’re on that almost every interaction people have these days is characterized by that.”

Full disclosure may be surprising, but it isn’t necessarily unwelcome. A 2018 poll conducted by market research firm Branded Research found that 61 percent of more than 8,000 therapy patients surveyed say it is “very” or “somewhat” important that they and their therapist share the same political values. Manhattan clinical psychologist Sarah Gundle, the co-clinical director of Octave, a “behavioral health studio” that opened in October offering individual and group therapy—including support groups for those feeling politics-related stress or anxiety—recalls a recent patient who wanted to know where she stood.

The info is here.

Tuesday, September 25, 2018

Horrific deaths, brutal treatment: Mental illness in America’s jails

Gary A. Harki
The Virginian-Pilot
Originally published August 23, 2018

Here is an excerpt:

“We are arresting people who have no idea what the laws are or the rules are because they're off their medications,” said Nashville Sheriff Daron Hall, a vice president of the National Sheriffs’ Association. “You'd never arrest someone for a heart attack, but you're comfortable arresting someone who is diagnosed mentally ill. No other country in the world is doing it this way.”

In addition to causing pain and suffering for people with mental illness, the practice is costing municipalities millions.

At least 53 percent of the deaths examined have resulted in a lawsuit. Combined, the cases have cost municipalities at least $145 million. The true cost is much higher – in many cases, lawsuits are still pending and in others the settlement amount is secret. The figures also do not take into account lawyers’ fees.

The article is here.

There are a series of articles related to mental health issues in prison.

Tuesday, September 18, 2018

Changing the way we communicate about patients

Abraar Karan
BMJ Blog
Originally posted August 29, 2018

Here is an excerpt:

There are many changes that we can make to improve how we communicate about patients. One of the easiest and most critical transformations is how we write our medical notes. One of the best doctors I ever worked with did exactly this, and is famous at the Brigham (our hospital) for doing it. He systematically starts every single note with the person’s social history. Who is this patient? It is not just a lady with abdominal pain. It is a mother of three, a retired teacher, and an active cyclist. That is the first thing we read about her, and so when I enter her room, I can’t help but see her this way rather than as a case of appendicitis.

This matters because patients deserve to be treated as people—a statement that’s so obvious it shouldn’t need to be said, but which physician behaviour doesn’t always reflect. You wouldn’t expect to know the most sensitive and vulnerable aspects of someone before even knowing their most basic background, yet we do this in medicine all the time. This is also important because in many clinical presentations, it provides critical information that helps deduce how they got sick, and why they may get sick again in the same way if we don’t restructure something essential in their life. For instance, if I didn’t know that the 22 year old opioid addict had just been kicked out of his house and is on the street without transportation to get to his suboxone clinic, I will not have truly solved what brought him to the hospital in the first place.

The info is here.

Thursday, August 30, 2018

Are We Really as Awful as We Act Online?

Agustin Fuentes
National Geographic Magazine
Originally published in August 2018

Here is an excerpt:

This process has deep evolutionary roots and gives humans what we call a shared reality. The connection between minds and experiences enables us to share space and work together effectively, more so than most other beings. It’s in part how we’ve become such a successful species.

But the “who” that constitutes “whom we meet” in this system has been changing. Today the who can include more virtual, social media friends than physical ones; more information absorbed via Twitter, Facebook, and Instagram than in physical social experiences; and more pronouncements from ad-sponsored 24-hour news outlets than from conversations with other human beings.

We live in complicated societies structured around political and economic processes that generate massive inequality and disconnection between us. This division alone leads to a plethora of prejudices and blind spots that segregate people. The ways we socially interact, especially via social media, are multiplying exactly at a time when we are increasingly divided. What may be the consequences?

Historically, we have maintained harmony by displaying compassion and geniality, and by fostering connectedness when we get together. Anonymity and the lack of face-to-face interaction on social media platforms remove a crucial part of the equation of human sociality—and that opens the door to more frequent, and severe, displays of aggression. Being an antagonizer, especially to those you don’t have to confront face-to-face, is easier now than it’s ever been. If there are no repercussions for it, that encourages the growth of aggression, incivility, and just plain meanness on social media platforms.

The information is here.

Tuesday, August 28, 2018

How Evil Happens

Noga Arikha
www.aeon.co
Originally posted July 30, 2018

Here is an excerpt:

An account of the inability to feel any emotion for such perceived enemies can take us closer to understanding what it is like to have crossed the line beyond which one can maim and kill in cold blood. Observers at the International Criminal Court (ICC) at the Hague note frequently the absence of remorse displayed by perpetrators. The clinical psychologist Françoise Sironi, who assesses perpetrators for the ICC and treats them and their victims, has directly seen what Lifton called the ‘murder of the self’ at work – notably with Kang Kek Iew, the man known as ‘Duch’, who proudly created and directed the Khmer Rouge S-21 centre for torture and extermination in Cambodia. Duch was one of those who felt absolutely no remorse. His sole identity was his role, dutifully kept up for fear of losing himself and falling into impotence. He did not comprehend what Sironi meant when she asked him: ‘What happened to your conscience?’ The very question was gibberish to him.

Along with what Fried calls this ‘catastrophic’ desensitisation to emotional cues, cognitive functions remain intact – another Syndrome E symptom. A torturer knows exactly how to hurt, in full recognition of the victim’s pain. He – usually he – has the cognitive capacity, necessary but not sufficient for empathy, to understand the victim’s experience. He just does not care about the other’s pain except instrumentally. Further, he does not care that he does not care. Finally, he does not care that caring does, in fact, matter. The emotionally inflected judgment that underlies the moral sense is gone.

The information is here.

Wednesday, July 4, 2018

Curiosity and What Equality Really Means

Atul Gawande
The New Yorker
Originally published June 2, 2018

Here is an excerpt:

We’ve divided the world into us versus them—an ever-shrinking population of good people against bad ones. But it’s not a dichotomy. People can be doers of good in many circumstances. And they can be doers of bad in others. It’s true of all of us. We are not sufficiently described by the best thing we have ever done, nor are we sufficiently described by the worst thing we have ever done. We are all of it.

Regarding people as having lives of equal worth means recognizing each as having a common core of humanity. Without being open to their humanity, it is impossible to provide good care to people—to insure, for instance, that you’ve given them enough anesthetic before doing a procedure. To see their humanity, you must put yourself in their shoes. That requires a willingness to ask people what it’s like in those shoes. It requires curiosity about others and the world beyond your boarding zone.

We are in a dangerous moment because every kind of curiosity is under attack—scientific curiosity, journalistic curiosity, artistic curiosity, cultural curiosity. This is what happens when the abiding emotions have become anger and fear. Underneath that anger and fear are often legitimate feelings of being ignored and unheard—a sense, for many, that others don’t care what it’s like in their shoes. So why offer curiosity to anyone else?

Once we lose the desire to understand—to be surprised, to listen and bear witness—we lose our humanity. Among the most important capacities that you take with you today is your curiosity. You must guard it, for curiosity is the beginning of empathy. When others say that someone is evil or crazy, or even a hero or an angel, they are usually trying to shut off curiosity. Don’t let them. We are all capable of heroic and of evil things. No one and nothing that you encounter in your life and career will be simply heroic or evil. Virtue is a capacity. It can always be lost or gained. That potential is why all of our lives are of equal worth.

The article is here.

Wednesday, March 14, 2018

Have some evangelicals embraced moral relativism?

Corey Fields
Baptist News Global
Originally posted February 16, 2018

Here is an excerpt:

The moral rot we’re seeing among white evangelicals has been hard to watch, and it did not start in 2016. Back in 2009, an article in the evangelical publication Christianity Today bemoaned a survey finding that 62 percent of white evangelicals support the use of torture. Despite a supposed pro-life stance, white evangelicals are also the most likely religious group to support war and the death penalty. Racism and sexual predation among elected officials are getting a pass if they deliver on policy. Charles Mathewes, a professor of religious studies at the University of Virginia, put it well: “For believers in a religion whose Scriptures teach compassion, we [white evangelicals] are a breathtakingly cruel bunch.”

Here’s a quote from a prominent evangelical author: “As it turns out, character does matter. You can’t run a family, let alone a country, without it. How foolish to believe that a person who lacks honesty and moral integrity is qualified to lead a nation and the world!” That was written by James Dobson of Focus on the Family. But he wasn’t talking about Donald Trump. He wrote that about Bill Clinton in 1998. Is this principle no longer in force, or does it only apply to Democrats?

As Robert P. Jones noted, the ends apparently justify the means. “White evangelicals have now fully embraced a consequentialist ethics that works backward from predetermined political ends, refashioning or even discarding principles as needed to achieve a desired outcome.” That’s moral relativism.

The article is here.

Friday, March 2, 2018

Burnout in mental health providers

Practice Research and Policy Staff
American Psychological Association Practice Organization
Originally published January 25, 2018

Burnout commonly affects individuals involved in the direct care of others, including mental health practitioners. Burnout consists of three components: emotional exhaustion, depersonalization of clients and feelings of ineffectiveness or lack of personal accomplishment (Maslach, Jackson & Lieter, 1997). Emotional exhaustion may include feeling overextended, being unable to feel compassion for clients and feeling unable to meet workplace demands. Depersonalization is the process by which providers distance themselves from clients to prevent emotional fatigue. Finally, feelings of ineffectiveness and lack of personal accomplishment occur when practitioners feel a negative sense of personal and/or career worth.

Studies estimate that anywhere between 21 percent and 61 percent of mental health practitioners experience signs of burnout (Morse et al., 2012). Burnout has been associated with workplace climate, caseload size and severity of client symptoms (Acker, 2011; Craig & Sprang, 2010; Thompson et al., 2014). In contrast, studies examining burnout prevention have found that smaller caseloads, less paperwork and more flexibility at work are associated with lower rates of burnout (Lent & Schwartz, 2012). Burnout results in negative outcomes for both practitioners and their clients. Symptoms of burnout are not solely psychological; burnout has also been linked to physical ailments such as headaches and gastrointestinal problems (Kim et al., 2011).

The following studies examine correlates and predictors of burnout in mental health care providers. The first study investigates burnout amongst practitioners working on posttraumatic stress disorder clinical teams in Veterans Affairs (VA) health care settings. The second study examines correlates of burnout in sexual minority practitioners, and the third study investigates the impact of personality on burnout. Finally, the fourth study examines factors that may prevent burnout.

The information is here.