Fast response times signal social connection in conversation

Templeton, E. M. et al.

Proceedings of the National Academy of Sciences 

Jan 2022, 119 (4) e2116915119

Abstract

Clicking is one of the most robust metaphors for social connection. But how do we know when two people "click"? We asked pairs of friends and strangers to talk with each other and rate their felt connection. For both friends and strangers, speed in response was a robust predictor of feeling connected. Conversations with faster response times felt more connected than conversations with slower response times, and within conversations, connected moments had faster response times than less-connected moments. This effect was determined primarily by partner responsivity: People felt more connected to the degree that their partner responded quickly to them rather than by how quickly they responded to their partner. The temporal scale of these effects (<250 ms) precludes conscious control, thus providing an honest signal of connection. Using a round-robin design in each of six closed networks, we show that faster responders evoked greater feelings of connection across partners. Finally, we demonstrate that this signal is used by third-party listeners as a heuristic of how well people are connected: Conversations with faster response times were perceived as more connected than the same conversations with slower response times. Together, these findings suggest that response times comprise a robust and sufficient signal of whether two minds “click.”

Significance

Social connection is critical for our mental and physical health yet assessing and measuring connection has been challenging. Here, we demonstrate that a feature intrinsic to conversation itself—the speed with which people respond to each other—is a simple, robust, and sufficient metric of social connection. Strangers and friends feel more connected when their conversation partners respond quickly. Because extremely short response times (<250 ms) preclude conscious control, they provide an honest signal that even eavesdroppers use to judge how well two people “click.”

The research is here.

The Conversational Circumplex: Identifying, Prioritizing, and Pursuing Informational and Relational Motives in Conversation

M. Yeomans, M. Schweitzer, & A. WoodBrooks

Current Opinion in Psychology

Available online 11 October 2021

Abstract

The meaning of success in conversation depends on people’s goals. Often, individuals pursue multiple goals simultaneously, such as establishing shared understanding, making a favorable impression, and persuading a conversation partner. In this article, we introduce a novel theoretical framework, the Conversational Circumplex, to classify conversational motives along two key dimensions: 1) Informational: the extent to which a speaker’s motive focuses on giving and/or receiving accurate information and 2) Relational: the extent to which a speaker’s motive focuses on building the relationship. We use the conversational circumplex to underscore the multiplicity of conversational goals that people hold, and highlight the potential for individuals to have conflicting conversational goals (both intrapersonally and interpersonally) that make successful conversation a difficult challenge.

Conclusion

In this article, we introduce a novel framework, the Conversational Circumplex, to build our understanding of conversational motives. By introducing this framework, we provide a generative foundation for future scholarship and a useful tool for conversationalists to identify their own motives, discern others’ motives, and advance their goals more effectively in conversation. The meaning of success in a conversation requires that we start by understanding what conversationalists are hoping to achieve.

Note: This has implications for psychotherapy and other helping relationships.

The information is here.

Moral Psychopharmacology Needs Moral Inquiry: The Case of Psychedelics

Langlitz N, et al. (2021) 

Front. Psychiatry, August, 12:680064

Abstract

The revival of psychedelic research coincided and more recently conjoined with psychopharmacological research on how drugs affect moral judgments and behaviors. This article makes the case for a moral psychopharmacology of psychedelics that examines whether psychedelics serve as non-specific amplifiers that enable subjects to (re-)connect with their values, or whether they promote specific moral-political orientations such as liberal and anti-authoritarian views, as recent psychopharmacological studies suggest. This question gains urgency from the fact that the return of psychedelics from counterculture and underground laboratories to mainstream science and society has been accompanied by a diversification of their users and uses. We propose bringing the pharmacological and neuroscientific literature into a conversation with historical and anthropological scholarship documenting the full spectrum of moral and political views associated with the uses of psychedelics. This paper sheds new light on the cultural plasticity of drug action and has implications for the design of psychedelic pharmacopsychotherapies. It also raises the question of whether other classes of psychoactive drugs have an equally rich moral and political life.

From the Conclusion

If moral psychopharmacology took it upon itself to develop forms of psychedelic apprenticeship for the currently sprawling medical and non-medical applications of psychedelics, it would extend pharmaceutical research and development into the extra-pharmacological realm. Such a design process needs to be informed by best practices in clinical psychology and cognate fields, but, intellectually, it cannot hide behind professional prescriptions because what counts as good and bad is precisely what is at stake here. It is an open philosophical question that has to be answered in a recursive process of psychopharmacological experimentation, clinical and ethnographic observation, historical research, and ethical reflection.

The info is here.

APF Gold Medal Award for Life Achievement in the Practice of Psychology: Samuel Knapp

American Psychologist, 76(5), 812–814. 

https://doi.org/10.1037/amp0000894

This award recognizes a distinguished career and enduring contribution to the practice of psychology. Samuel Knapp’s long, distinguished career has resulted in demonstrable effects and significant contributions to best practices in professionalism, ethics education, positive ethics, and legislative advocacy as Director of Professional Affairs for the Pennsylvania Psychological Association and as an ethics educator extraordinaire. Dr. Knapp’s work has modified the way psychologists think about professional ethics through education, from avoiding disciplinary consequences to promoting overarching ethical principles to achieve the highest standards of ethical behavior. His focus on respectful collaboration among psychologists promotes honesty through nonjudgmental conversations. His Ethics Educators Workshop and other continuing education programs have brought together psychology practitioners and faculty to focus deeply on ethics and resulted in the development of the APA Ethics Educators Award.

From the Biography section

Ethics education became especially important in Pennsylvania when the Pennsylvania State Board of Psychology mandated ethics as part of its continuing education requirement. But even before that, members of the PPA Ethics Committee and Board of Directors, saw ethics education as a vehicle to help psychologists to improve the quality of their services to their patients. Also, to the extent that ethics education can help promote good decision-making, it could also reduce the emotional burden that professional psychologists often feel when faced with difficult ethical situations. Often the continuing education programs were interactive with the secondary goals of helping psychologists to build contacts with each other and an opportunity for the presenters to promote authentic and compassion-driven approaches to teaching ethics. Yes, Sam and the other PPA Ethics educators, such as the PPA attorney Rachael Baturin, also taught the laws, ethics codes, and the risk management strategies. facts.  But these were only one component of PPA’s ethics education program. More important was the development of a cadre of psychologists/ethicists who taught most of these continuing education programs.

The full award is here.

Therapist Targeted Googling: Characteristics and Consequences for the Therapeutic Relationship

Cox, K. E., Simonds, L. M., & Moulton-Perkins, A. 

(2021).  Professional Psychology: 

Research and Practice. Advance online publication. 

https://doi.org/10.1037/pro0000405

Abstract

Therapist-targeted googling (TTG) refers to a patient searching online to find information about their therapist. The present study investigated TTG prevalence and characteristics in a sample of adult psychotherapy clients. Participants (n = 266) who had attended at least one session with a therapist completed an anonymous online survey about TTG prevalence, motivations, and perceived impact on the therapeutic relationship. Two-thirds of the sample had conducted TTG. Those participants who were having therapy privately had worked with more than one therapist, or were having sessions more often than weekly were significantly more likely to conduct TTG; this profile was particularly common among patients who were having psychodynamic psychotherapy. Motivations included wanting to see if the therapist is qualified, curiosity, missing the therapist, and wanting to know them better. Nearly a quarter who undertook TTG thought the findings impacted the therapeutic relationship but only one in five had disclosed TTG to the therapist. TTG beyond common sense consumerism can be conceptualized as a patient’s attempt to attain closeness to the therapist but may result in impacts on trust and ability to be open. Disclosures of TTG may constitute important therapeutic material. 

Impact Statement

This study suggests that there are multiple motivations for clients searching online for information about their therapist. It highlights the need for practitioners to carefully consider the information available about them online and the importance of client searching to the therapeutic relationship.

Here is the conclusion:

In this study, most participants searched for information about their therapist. Curiosity and commonsense consumerism might explain much of this activity. We argue that there is evidence that some of this might be motivated by moments of vulnerability between sessions to regain a connection with the therapist. We also suggest that the discovery of challenging information during vulnerability might represent difficulties for the patient that are not disclosed to the therapist due to feelings of guilt and shame. Further work is needed to understand TTG, the implications on the therapeutic relationship, and how therapists work with disclosures of TTG in a way that does not provoke more shame in the patient, but which also allows therapists to effectively manage therapeutic closeness and their own vulnerability.

How ecstasy and psilocybin are shaking up psychiatry

Paul Tullis

Nature.com

Originally posted 27 Jan 21

Here is an excerpt:

Psychedelic-assisted psychotherapy could provide needed options for debilitating mental-health disorders including PTSD, major depressive disorder, alcohol-use disorder, anorexia nervosa and more that kill thousands every year in the United States, and cost billions worldwide in lost productivity.

But the strategies represent a new frontier for regulators. “This is unexplored ground as far as a formally evaluated intervention for a psychiatric disorder,” says Walter Dunn, a psychiatrist at the University of California, Los Angeles, who sometimes advises the US Food and Drug Administration (FDA) on psychiatric drugs. Most drugs that treat depression and anxiety can be picked up at a neighbourhood pharmacy. These new approaches, by contrast, use a powerful substance in a therapeutic setting under the close watch of a trained psychotherapist, and regulators and treatment providers will need to grapple with how to implement that safely.

“The clinical trials that have been reported on depression have been done under highly circumscribed and controlled conditions,” says Bertha Madras, a psychobiologist at Harvard Medical School who is based at McLean Hospital in Belmont, Massachusetts. That will make interpreting results difficult. A treatment might show benefits in a trial because the experience is carefully coordinated, and everyone is well trained. Placebo controls pose another challenge because the drugs have such powerful effects.

And there are risks. In extremely rare instances, psychedelics such as psilocybin and LSD can evoke a lasting psychotic reaction, more often in people with a family history of psychosis. Those with schizophrenia, for example, are excluded from trials involving psychedelics as a result. MDMA, moreover, is an amphetamine derivative, so could come with risks for abuse.

But many researchers are excited. Several trials show dramatic results: in a study published in November 2020, for example, 71% of people who took psilocybin for major depressive disorder showed a greater than 50% reduction in symptoms after four weeks, and half of the participants entered remission1. Some follow-up studies after therapy, although small, have shown lasting benefits2,3.

The info is here.

Research on Non-verbal Signs of Lies and Deceit: A Blind Alley

T. Brennen & S. Magnussen

Front. Psychol., 14 December 2020

https://doi.org/10.3389/fpsyg.2020.613410

Introduction

Research on the detection of lies and deceit has a prominent place in the field of psychology and law with a substantial research literature published in this field of inquiry during the last five to six decades (Vrij, 2000, 2008; Vrij et al., 2019). There are good reasons for this interest in lie detection. We are all everyday liars, some of us more prolific than others, we lie in personal and professional relationships (Serota et al., 2010; Halevy et al., 2014; Serota and Levine, 2015; Verigin et al., 2019), and lying in public by politicians and other public figures has a long and continuing history (Peters, 2015). However, despite the personal problems that serious everyday lies may cause and the human tragedies political lies may cause, it is lying in court that appears to have been the principal initial motivation for the scientific interest in lie detection.

Lying in court is a threat to fair trials and the rule of law. Lying witnesses may lead to the exoneration of guilty persons or to the conviction of innocent ones. In the US it is well-documented that innocent people have been convicted because witnesses were lying in court (Garrett, 2010, 2011; www.innocenceproject.com). In evaluating the reliability and the truthfulness of a testimony, the court considers other evidence presented to the court, the known facts about the case and the testimonies by other witnesses. Inconsistency with the physical evidence or the testimonies of other witnesses might indicate that the witness is untruthful, or it may simply reflect the fact that the witness has observed, interpreted, and later remembered the critical events incorrectly—normal human errors all too well known in the eyewitness literature (Loftus, 2005; Wells and Loftus, 2013; Howe and Knott, 2015).

(as it ends)

Is the rational course simply to drop this line of research? We believe it is. The creative studies carried out during the last few decades have been important in showing that psychological folklore, the ideas we share about behavioral signals of lies and deceit are not correct. This debunking function of science is extremely important. But we have now sufficient evidence that there are no specific non-verbal behavioral signals that accompany lying or deceitful behavior. We can safely recommend that courts disregard such behavioral signals when appraising the credibility of victims, witnesses, and suspected offenders. For psychology and law researchers it may be time to move on.

Checked by reality, some QAnon supporters seek a way out

David Klepper

Associated Press

Originally posted 28 January 21

Here are two excerpts:

It's not clear exactly how many people believe some or all of the narrative, but backers of the movement were vocal in their support for Trump and helped fuel the insurrectionists who overran the U.S. Capitol this month. QAnon is also growing in popularity overseas.

Former believers interviewed by The Associated Press liken the process of leaving QAnon to kicking a drug addiction. QAnon, they say, offers simple explanations for a complicated world and creates an online community that provides escape and even friendship.

Smith's then-boyfriend introduced her to QAnon. It was all he could talk about, she said. At first she was skeptical, but she became convinced after the death of financier Jeffrey Epstein while in federal custody facing pedophilia charges. Officials debunked theories that he was murdered, but to Smith and other QAnon supporters, his suicide while facing child sex charges was too much to accept.

Soon, Smith was spending more time on fringe websites and on social media, reading and posting about the conspiracy theory. She said she fell for QAnon content that presented no evidence, no counter arguments, and yet was all too convincing.

(cut)

“This isn't about critical thinking, of having a hypothesis and using facts to support it," Cohen said of QAnon believers. “They have a need for these beliefs, and if you take that away, because the storm did not happen, they could just move the goal posts.”

Some now say Trump's loss was always part of the plan, or that he secretly remains president, or even that Joe Biden's inauguration was created using special effects or body doubles. They insist that Trump will prevail, and powerful figures in politics, business and the media will be tried and possibly executed on live television, according to recent social media posts.

“Everyone will be arrested soon. Confirmed information,” read a post viewed 130,000 times this week on Great Awakening, a popular QAnon channel on Telegram. “From the very beginning I said it would happen.”

But a different tone is emerging in the spaces created for those who have heard enough.

“Hi my name is Joe,” one man wrote on a Q recovery channel in Telegram. “And I’m a recovering QAnoner.”

The info is here.

11th Circuit blocks South FL prohibitions on 'conversion therapy' for minors as unconstitutional

Michael Moline

Florida Pheonix

Originally posted 20 Nov 20

Here is an excerpt:

“We understand and appreciate that the therapy is highly controversial. But the First Amendment has no carve-out for controversial speech. We hold that the challenged ordinances violate the First Amendment because they are content-based regulations of speech that cannot survive strict scrutiny,” Grant wrote.

Judge Beverly Martin dissented, pointing to condemnations of the practice by the American Academy of Pediatrics, the American Psychiatric Association, the American Psychological Association, the American Psychoanalytic Association, the American Academy of Child and Adolescent Psychiatry, the American School Counselor Association, the U.S. Department of Health and Human Services, and the World Health Organization.

“Today’s majority opinion puts a stop to municipal efforts to regulate ‘sexual orientation change efforts’ (commonly known as ‘conversion therapy’), which is known to be a harmful therapeutic practice,” Martin wrote.

“The majority invalidates laws enacted to curb these therapeutic practices, despite strong evidence of the harm they cause, as well as the laws’ narrow focus on licensed therapists practicing on patients who are minors. Although I am mindful of the free-speech concerns the majority expresses, I respectfully dissent from the decision to enjoin these laws.”

Matt Staver, founder and chairman of Liberty Counsel, the conservative legal organization that represented two counselors who challenged the ordinance, welcomed the ruling.

“This is a huge victory for counselors and their clients to choose the counsel of their choice free of political censorship from government ideologues. This case is the beginning of the end of similar unconstitutional counseling bans around the country,” he said in a written statement.

The info is here.

‘Disorders of consciousness’: Understanding ‘self’ might be the greatest scientific challenge of our time

Joel Frohlich

Genetic Literacy report

Originally published 18 Sept 20

Here are two excerpts:

Just as life stumped biologists 100 years ago, consciousness stumps neuroscientists today. It’s far from obvious why some brain regions are essential for consciousness and others are not. So Tononi’s approach instead considers the essential features of a conscious experience. When we have an experience, what defines it? First, each conscious experience is specific. Your experience of the colour blue is what it is, in part, because blue is not yellow. If you had never seen any colour other than blue, you would most likely have no concept or experience of colour. Likewise, if all food tasted exactly the same, taste experiences would have no meaning, and vanish. This requirement that each conscious experience must be specific is known as differentiation.

But, at the same time, consciousness is integrated. This means that, although objects in consciousness have different qualities, we never experience each quality separately. When you see a basketball whiz towards you, its colour, shape and motion are bound together into a coherent whole. During a game, you’re never aware of the ball’s orange colour independently of its round shape or its fast motion. By the same token, you don’t have separate experiences of your right and your left visual fields – they are interdependent as a whole visual scene.

Tononi identified differentiation and integration as two essential features of consciousness. And so, just as the essential features of life might lead a scientist to infer the existence of DNA, the essential features of consciousness led Tononi to infer the physical properties of a conscious system.

(cut)

Consciousness might be the last frontier of science. If IIT continues to guide us in the right direction, we’ll develop better methods of diagnosing disorders of consciousness. One day, we might even be able to turn to artificial intelligences – potential minds unlike our own – and assess whether or not they are conscious. This isn’t science fiction: many serious thinkers – including the late physicist Stephen Hawking, the technology entrepreneur Elon Musk, the computer scientist Stuart Russell at the University of California, Berkeley and the philosopher Nick Bostrom at the Future of Humanity Institute in Oxford – take recent advances in AI seriously, and are deeply concerned about the existential risk that could be posed by human- or superhuman-level AI in the future. When is unplugging an AI ethical? Whoever pulls the plug on the super AI of coming decades will want to know, however urgent their actions, whether there truly is an artificial mind slipping into darkness or just a complicated digital computer making sounds that mimic fear.

The info is here.

Psychotherapy With Suicidal Patients Part 2: An Alliance Based Intervention for Suicide

E. M. Plakun

Psychiatric Practice

January 2019 - Volume 25: Issue 1, 41-45

Abstract

This column, which is the second in a 2-part series on the challenge of treating patients struggling with suicide, reviews one psychodynamic approach to working with suicidal patients that is consistent with the elements shared across evidence-based approaches to treating suicidal patients that were the focus of the first column in this series. Alliance Based Intervention for Suicide is an approach to treating suicidal patients developed at the Austen Riggs Center that is not manualized or a stand-alone treatment, but rather it is a way of establishing and maintaining an alliance with suicidal patients that engages the issue of suicide and allows the rest of psychodynamic therapy to unfold.

(cut)

From the Conclusion

There is no magic in ABIS (Alliance Based Intervention for Suicide), and it will not work in all cases, but these principles are effective in making suicide an interpersonal issue with meaning in the relationship. This allows direct engagement of the issue of suicide in the therapeutic relationship and direct discussion of the central question of whether the patient can and will commit to the work. ABIS supports the therapist in efforts to assess whether the therapist has the will and the wherewithal to meet the patient’s anger and hate, as manifested by suicide, as fully as the therapist is prepared to meet the patient’s love and attachment. Neither side of the transference alone is adequate in work with suicidal patients.

There are no randomized trials of ABIS, but it is a way of working that has evolved at Austen Riggs over the course of a hundred years. In a study of previously suicidal patients at Riggs, at an average of 7 years after admission, 75% were free of suicidal behavior as an issue in their lives.6 These patients were considered “recovered” rather than “in remission,” using the same slope-intercept mathematical modeling as in cancer research. These findings offer encouraging support for the value of ABIS as an intervention to add to psychodynamic psychotherapy as a way to establish and maintain a viable therapeutic alliance with suicidal patients.

The article is here.

How to Combat Zoom Fatigue

Liz Fosslien and Mollie West Duffy
Harvard Business Review
Originally posted 29 April 20

If you’re finding that you’re more exhausted at the end of your workday than you used to be, you’re not alone. Over the past few weeks, mentions of “Zoom fatigue” have popped up more and more on social media, and Google searches for the same phrase have steadily increased since early March.

Why do we find video calls so draining? There are a few reasons.

In part, it’s because they force us to focus more intently on conversations in order to absorb information. Think of it this way: when you’re sitting in a conference room, you can rely on whispered side exchanges to catch you up if you get distracted or answer quick, clarifying questions. During a video call, however, it’s impossible to do this unless you use the private chat feature or awkwardly try to find a moment to unmute and ask a colleague to repeat themselves.

The problem isn’t helped by the fact that video calls make it easier than ever to lose focus. We’ve all done it: decided that, why yes, we absolutely can listen intently, check our email, text a friend, and post a smiley face on Slack within the same thirty seconds. Except, of course, we don’t end up doing much listening at all when we’re distracted. Adding fuel to the fire is many of our work-from-home situations. We’re no longer just dialing into one or two virtual meetings. We’re also continuously finding polite new ways to ask our loved ones not to disturb us, or tuning them out as they army crawl across the floor to grab their headphones off the dining table. For those who don’t have a private space to work, it is especially challenging.

Finally, “Zoom fatigue” stems from how we process information over video. On a video call the only way to show we’re paying attention is to look at the camera. But, in real life, how often do you stand within three feet of a colleague and stare at their face? Probably never. This is because having to engage in a “constant gaze” makes us uncomfortable — and tired. In person, we are able to use our peripheral vision to glance out the window or look at others in the room. On a video call, because we are all sitting in different homes, if we turn to look out the window, we worry it might seem like we’re not paying attention.

The info is here.

A Psychological Exploration of Zoom Fatigue

Jena Lee
Psychiatric Times
Originally published 27 July 20

Here is an excerpt:

This neuropathophysiology may explain other proposed reasons for Zoom fatigue. For example, if the audio delays inherent in Zoom technology are associated with more negative perceptions and distrust between people, there is likely decreased reward perceived when those people are videoconferencing with each other. Another example is direct mutual gaze. There is robust evidence on how eye contact improves connection—faster responses, more memorization of faces, and increased likeability and attractiveness. These tools of social bonding that make interactions organically rewarding are all compromised over video. On video, gaze must be directed at the camera to appear as if you are making eye contact with an observer, and during conferences with 3 or more people, it can be impossible to distinguish mutual gaze between any 2 people.

Not only are rewards lessened via these social disconnections during videoconferencing compared to in-person interactions, but there are also elevated costs in the form of cognitive effort. Much of communication is actually unconscious and nonverbal, as emotional content is rapidly processed through social cues like touch, joint attention, and body posture. These nonverbal cues are not only used to acquire information about others, but are also directly used to prepare an adaptive response and engage in reciprocal communication, all in a matter of milliseconds. However, on video, most of these cues are difficult to visualize, since the same environment is not shared (limiting joint attention) and both subtle facial expressions and full bodily gestures may not be captured. Without the help of these unconscious cues on which we have relied since infancy to socioemotionally assess each other and bond, compensatory cognitive and emotional effort is required. In addition, this increased cost competes for people’s attention with acutely elevated distractions such as multitasking, the home environment (eg, family, lack of privacy), and their mirror image on the screen. Simply put, videoconferences can be associated with low reward and high cost.

The info is here.

Inference from explanation.

Kirfel, L., Icard, T., & Gerstenberg, T.
(2020, May 22).
https://doi.org/10.31234/osf.io/x5mqc

Abstract

What do we learn from a causal explanation? Upon being told that "The fire occurred because a lit match was dropped", we learn that both of these events occurred, and that there is a causal relationship between them. However, causal explanations of the kind "E because C" typically disclose much more than what is explicitly stated. Here, we offer a communication-theoretic account of causal explanations and show specifically that explanations can provide information about the extent to which a cited cause is normal or abnormal, and about the causal structure of the situation. In Experiment 1, we demonstrate that people infer the normality of a cause from an explanation when they know the underlying causal structure. In Experiment 2, we show that people infer the causal structure from an explanation if they know the normality of the cited cause. We find these patterns both for scenarios that manipulate the statistical and prescriptive normality of events. Finally, we consider how the communicative function of explanations, as highlighted in this series of experiments, may help to elucidate the distinctive roles that normality and causal structure play in causal explanation.

Conclusion

In this paper, we investigate the communicative dimensions of explanation, revealing some of the rich and subtle inferences people draw from them. We find that people are able to infer additional information from a causal explanation beyond what was explicitly communicated, such as causal structure and normality of the causes.  Our studies show that people make these inferences in part by appeal to what they themselves would judge reasonable to say across different possible scenarios. The overall pattern of judgments and inferences brings us closer to a full understanding of how causal explanations function inhuman discourse and behavior, while also raising new questions concerning the prominent role of norms in causal judgment and the function of causal explanation more broadly.

Editor's Note: This research has significant implications for psychotherapy.

Seven Tips for Maintaining the Frame in Online Therapy

Clifford Arnold & Thomas Franklin
Psychiatric News
Originally published 25 June 20

While we are in the midst of a pandemic, teleconferencing technology can be a source of both stability and insecurity in the therapeutic relationship; on the one hand, it confers the near-miraculous ability to remain connected at a safe distance, while on the other hand it upends the basic conditions under which therapy takes place, like simply being in the same room together.

When striving for continuity in the transition from in-person to online therapy, a possible pitfall is to conserve the verbal elements of therapy and ignore the rest. This is counterproductive since the nonverbal aspects of therapy have an arguably greater impact on patients, and without them words can be ineffectual. The set of nonverbal conditions that engender trust, confidence, and security in patients and allow the words of therapy to be effective is called the therapeutic frame. The following tips are meant to help maintain the therapeutic frame during this precarious time, specifically in the transition from the office to the screen.

1. Create some distance: One way to preserve a familiar and comfortable frame is to observe personal space online as one would in the office. It would feel awkward, intrusive, and exhausting to sit four feet away from a patient and stare directly into her face for an hour straight in the office, yet we do that regularly online. Perhaps we are compensating for feeling distant in other ways or perhaps we simply can’t see or hear very well. It’s ok to back up, and some technological modifications can help (see tip #3). The extra space might allow both parties to feel less self-conscious and more at ease, less focused on maintaining a perfect affect and more on the therapy.

2. Body language matters: Here’s another reason to back off the camera a bit: Expanding the field of vision to include not just facial expressions but also upper-body language (for example, hand gestures, posture, distance modulation) has been shown to increase empathy measures, according to David T. Nguyen and John Canny in the article “More Than Face-to-Face: Empathy Effects of Video Framing.” Experiment with this. Sit back, expand the visual frame, move, and gesture as you would in person—find what feels connective and go with it. In addition to camera distance, the angle matters too; if the lens is positioned at a height lower than your eyes it may appear to your patients that you are looking down on them. Stack some books under your monitor to avoid the impression of being overbearing or aloof.

The info is here.

Empathy is both a trait and a skill. Here's how to strengthen it.

Kristen Rogers
CNN.com
Originally posted 24 June 20

Here is an excerpt:

Types of empathy

Empathy is more about looking for a common humanity, while sympathy entails feeling pity for someone's pain or suffering, Konrath said.

"Whereas empathy is the ability to perceive accurately what another person is feeling, sympathy is compassion or concern stimulated by the distress of another," Lerner said. "A common example of empathy is accurately detecting when your child is afraid and needs encouragement. A common example of sympathy is feeling sorry for someone who has lost a loved one."

(cut)

A "common mistake is to leap into sympathy before empathically understanding what another person is feeling," Lerner said. Two types of empathy can prevent that relationship blunder.

Emotional empathy, sometimes called compassion, is more intuitive and involves care and concern for others.

Cognitive empathy requires effort and more systematic thinking, so it may lead to more empathic accuracy, Lerner said.  It entails considering others' and their perspectives and imagining what it's like to be them, Konrath added.

Some work managers and colleagues, for example, have had to practice empathy for parents juggling remote work with child care and virtual learning duties, said David Anderson, senior director of national programs and outreach at the Child Mind Institute….   But since the outset of the pandemic in March, that empathy has faded — reflecting the notion that cognitive empathy does take effort.

It takes work to interpret what someone is feeling by all of his cues: facial expressions, tones of voice, posture, words and more. Then you have to connect those cues with what you know about him and the situation in order to accurately infer his feelings.

"This kind of inference is a highly complex social-cognitive task" that might involve a variation of mental processes, Lerner said.

The info is here.

Want To See Your Therapist In-Person Mid-Pandemic? Think Again

Todd Essig
Forbes.com
Originally posted 27 June 20

Here is an excerpt:

Psychotherapy is built on a promise; you bring your suffering to this private place and I will work with you to keep you safe and help you heal. That promise is changed by necessary viral precautions. First, the possibility of contact tracing weakens the promise of confidentiality. I promise to keep this private changes to a promise to keep it private unless someone gets sick and I need to contact the local health department.

Even more powerful is the fact that a mid-pandemic in-person psychotherapy promise has to include all the ways we will protect each other from very real dangers, hardly the experience of psychological safety. There will even be a promise to pretend we are safe together even when we are doing so many things to remind us we are each the source of a potentially life-altering infection.

When I imagine how my caseload would react were I to begin mid-pandemic in-person work, like I did for a recent webinar for the NYS Psychological Association, I anticipate as many people welcoming the chance to work together on a shared project of viral safety as I do imagining those who would feel devastated or burdened. But even for the first group of willing co-participants, it is important to see that such a joint project of mutual safety is not psychotherapy. No anticipated reaction included the experience of psychological safety on which effective psychotherapy rests.

Rather than feeling safe enough to address the private and dark, patients/clients will each in their own way labor under the burden of keeping themselves, their families, their therapist, other patients, and office staff safe. The vigilance required to remain safe will inevitably reduce the therapeutic benefits one might hope would develop from being back in the office.

The article is here.

What To Do If You Need to See Patients In Office?

If you are a mental health professional who continues to see (some) patients in the office because of patient needs, the following chart may be helpful.  

To protect my patients, I imagine I am a carrier, even though I have no way of knowing because our government lacks the capacity for adequate COVID-19 testing.

The therapist's dilemma: Tell the whole truth?

Jackson, D.
J. Clin. Psychol. 2020; 76: 286– 291.
https://doi.org/10.1002/jclp.22895

Abstract

Honest communication between therapist and client is foundational to good psychotherapy. However, while past research has focused on client honesty, the topic of therapist honesty remains almost entirely untouched. Our lab's research seeks to explore the role of therapist honesty, how and why therapists make decisions about when to be completely honest with clients (and when to abstain from telling the whole truth), and the perceived consequences of these decisions. This article reviews findings from our preliminary research, presents a case study of the author's honest disclosure dilemma, and discusses the role of therapeutic tact and its function in the therapeutic process.

Here is an excerpt:

Based on our preliminary research, one of the most common topics of overt dishonesty among therapists was their feelings of frustration or disappointment toward their clients. For example, a therapist working with a client with a diagnosis of avoidant personality disorder may find herself increasingly frustrated by the client’s continual resistance to discussing emotional topics or engaging in activities that would broaden his or her world. Such a client —let’s assume male—is also likely to feel preoccupied with concerns about whether the therapist “likes” him or feels as frustrated with him as he does with himself. Should this client apologize for his behavior and ask if the therapist is frustrated with him, the therapist may feel compelled to reduce the discomfort he is already experiencing by dispelling his concern: “No, it’s okay, I’m not frustrated.”

But either at this moment or at a later point in therapy, once rapport (i.e., the therapeutic alliance) has been more firmly established, a more honest answer to this question might be fruitful: “Yes, I am feeling frustrated that we haven’t been able to find ways for you to implement the changes we discuss here, outside of session. How does it feel for you to hear that I am feeling frustrated?” Or, arguably, an even more honest answer: “Yes, I am sometimes frustrated. I sometimes think we could go deeper here—I think it’d be helpful.” Or, an honest answer that is somewhat less critical of the patient and more self‐focused: “I do feel frustrated that I haven’t been able to be more helpful.” Clearly, there are many ways for a therapist to be honest and/or dishonest, and there are also gradations in whichever direction a therapist chooses.

Difficult Conversations: Navigating the Tension between Honesty and Benevolence

E. Levine, A. Roberts, & T. Cohen
PsyArXiv
Originally published 18 Jul 19

Abstract

Difficult conversations are a necessary part of everyday life. To help children, employees, and partners learn and improve, parents, managers, and significant others are frequently tasked with the unpleasant job of delivering negative news and critical feedback. Despite the long-term benefits of these conversations, communicators approach them with trepidation, in part, because they perceive them as involving intractable moral conflict between being honest and being kind. In this article, we review recent research on egocentrism, ethics, and communication to explain why communicators overestimate the degree to which honesty and benevolence conflict during difficult conversations, document the conversational missteps people make as a result of this erred perception, and propose more effective conversational strategies that honor the long-term compatibility of honesty and benevolence. This review sheds light on the psychology of moral tradeoffs in conversation, and provides practical advice on how to deliver unpleasant information in ways that improve recipients’ welfare.

From the Summary:

Difficult conversations that require the delivery of negative information from communicators to targets involve perceived moral conflict between honesty and benevolence. We suggest that communicators exaggerate this conflict. By focusing on the short-term harm and unpleasantness associated with difficult conversations, communicators fail to realize that honesty and benevolence are actually compatible in many cases. Providing honest feedback can help a target to learn and grow, thereby improving the target’s overall welfare. Rather than attempting to resolve the honesty-benevolence dilemma via communication strategies that focus narrowly on the short-term conflict between honesty and emotional harm, we recommend that communicators instead invoke communication strategies that integrate and maximize both honesty and benevolence to ensure that difficult conversations lead to long-term welfare improvements for targets. Future research should explore the traits, mindsets, and contexts that might facilitate this approach. For example, creative people may be more adept at integrative solutions to the perceived honesty-dilemma conflict, and people who are less myopic and more cognizant of the future consequences of their choices may be better at recognizing the long-term benefits of honesty.

The info is here.

This research has relevance to psychotherapy.