Morality as a Basic Psychological Need

Prentice, M., Jayawickreme, E., Hawkins, A.,
Hartley, A., Furr, R. M., & Fleeson, W. (2019). 
Social Psychological and Personality Science, 10(4), 449–460. https://doi.org/10.1177/1948550618772011

Abstract

We investigate the long-standing yet understudied assumption that feeling moral is a basic psychological need, perhaps like the needs to feel autonomous, competent, and related (ACR). We report an empirical “entrance exam” on whether morality should be considered a need. Specifically, we applied to morality a pioneering method from which Sheldon and colleagues provided evidence that ACR are basic psychological needs. In two studies and four samples, participants recalled events in which they felt un/satisfied, meaningful, pleasurable, at their best, and at their worst. They rated how much candidate psychological needs were satisfied during them. Morality was frequently as or more satisfied than ACR during peak events. Further, it was positively related to indices of positive functioning. These findings suggest feelings of being moral may help people identify times when life is going well. Further, they suggest that morality may be a fundamental psychological need and warrants further investigation.

Conclusion

That people have a need to feel moral is a classic psychological notion, and such a need seems integral to explaining the development and maintenance of human moral cognition and behavior.  Despite this, such a need has remained somewhat controversial for mainstream psychological science. We demonstrate that morality meets many of the criteria set out by Baumeister and Leary (1995). More broadly, we see that morality provides important information about whether people’s lives are going well. This work provides a basis for a more prominent position of the moral need in future research.

Nudging the better angels of our nature: A field experiment on morality and well-being.

Adam Waytz, & Wilhelm Hofmann
Emotion, Feb 28 , 2019, No Pagination Specified

Abstract

A field experiment examines how moral behavior, moral thoughts, and self-benefiting behavior affect daily well-being. Using experience sampling technology, we randomly grouped participants over 10 days to either behave morally, have moral thoughts, or do something positive for themselves. Participants received treatment-specific instructions in the morning of 5 days and no instructions on the other 5 control days. At each day’s end, participants completed measures that examined, among others, subjective well-being, self-perceived morality and empathy, and social isolation and closeness. Full analyses found limited evidence for treatment- versus control-day differences. However, restricting analyses to occasions on which participants complied with instructions revealed treatment- versus control-day main effects on all measures, while showing that self-perceived morality and empathy toward others particularly increased in the moral deeds and moral thoughts group. These findings suggest that moral behavior, moral thoughts, and self-benefiting behavior are all effective means of boosting well-being, but only moral deeds and, perhaps surprisingly, also moral thoughts strengthen the moral self-concept and empathy. Results from an additional study assessing laypeople’s predictions suggest that people do not fully intuit this pattern of results.

Here is part of the Discussion:

Overall, inducing moral thoughts and behaviors toward others enhanced feelings of virtuousness compared to the case for self-serving behavior. This makes sense given that people likely internalized their moral thoughts and behaviors in the two moral conditions, whereas the treat-yourself condition did not direct participants toward morality. Restricting analyses to days when people complied with treatment-specific instructions revealed significant positive effects on satisfaction for all treatments. That is, compared to receiving no instructions to behave morally, think morally, or treat oneself, receiving and complying with such instructions on treatment-specific days increased happiness and satisfaction with one’s life. Although the effect size was highest in the treat-yourself condition, improvements in satisfaction were statistically equivalent across conditions. Overall, the moral deeds condition in this compliant-only analysis revealed the broadest improvements across other measures related to well-being, whereas the treat-yourself condition was the only condition to significantly reduce exhaustion. Examining instances when participants reported behaving morally, thinking morally, or behaving self-servingly, independent of treatment, revealed comparable results for moral deeds and self-treats enhancing well-being generally, with moral thoughts enhancing most measures of well-being as well.

The research is here.

The Economic Effects of Facebook

Mosquera, Roberto,  Odunowo, Mofioluwasademi, and others
December 1, 2018.
http://dx.doi.org/10.2139/ssrn.3312462

Abstract

Social media permeates many aspects of our lives, including how we connect with others, where we get our news and how we spend our time. Yet, we know little about the economic effects for users. Using a large field experiment with over 1,765 individuals, we document the value of Facebook to users and its causal effect on news consumption and awareness, well-being and daily activities. Participants reveal how much they value one week of Facebook usage and are then randomly assigned to a validated Facebook restriction or normal use. Those who are off Facebook for a week reduce news consumption, are less likely to recognize politically-skewed news stories, report being less depressed and engage in healthier activities. One week of Facebook is worth $25, and this increases by 15% after experiencing a Facebook restriction (26% for women), reflecting information loss or that using Facebook may be addictive.

Ethical/Clinical Question: Knowing this research, is it ethical and clinically appropriate to recommend depressed patients to stop using Facebook?

Neuroexistentialism: A New Search for Meaning

Owen Flanagan and Gregg D. Caruso
The Philosopher's Magazine
Originally published November 6, 2018

Existentialisms are responses to recognisable diminishments in the self-image of persons caused by social or political rearrangements or ruptures, and they typically involve two steps: (a) admission of the anxiety and an analysis of its causes, and (b) some sort of attempt to regain a positive, less anguished, more hopeful image of persons. With regard to the first step, existentialisms typically involve a philosophical expression of the anxiety that there are no deep, satisfying answers that make sense of the human predicament and explain what makes human life meaningful, and thus that there are no secure foundations for meaning, morals, and purpose. There are three kinds of existentialisms that respond to three different kinds of grounding projects – grounding in God’s nature, in a shared vision of the collective good, or in science. The first-wave existentialism of Kierkegaard, Dostoevsky, and Nietzsche expressed anxiety about the idea that meaning and morals are made secure because of God’s omniscience and good will. The second-wave existentialism of Sartre, Camus, and de Beauvoir was a post-Holocaust response to the idea that some uplifting secular vision of the common good might serve as a foundation. Today, there is a third-wave existentialism, neuroexistentialism, which expresses the anxiety that, even as science yields the truth about human nature, it also disenchants.

Unlike the previous two waves of existentialism, neuroexistentialism is not caused by a problem with ecclesiastical authority, nor by the shock of coming face to face with the moral horror of nation state actors and their citizens. Rather, neuroexistentialism is caused by the rise of the scientific authority of the human sciences and a resultant clash between the scientific and humanistic image of persons. Neuroexistentialism is a twenty-first-century anxiety over the way contemporary neuroscience helps secure in a particularly vivid way the message of Darwin from 150 years ago: that humans are animals – not half animal, not some percentage animal, not just above the animals, but 100 percent animal. Everyday and in every way, neuroscience removes the last vestiges of an immaterial soul or self. It has no need for such posits. It also suggest that the mind is the brain and all mental processes just are (or are realised in) neural processes, that introspection is a poor instrument for revealing how the mind works, that there is no ghost in the machine or Cartesian theatre where consciousness comes together, that death is the end since when the brain ceases to function so too does consciousness, and that our sense of self may in part be an illusion.

The info is here.

Keeping Human Stories at the Center of Health Care

M. Bridget Duffy
Harvard Business Review
Originally published October 8, 2018

Here is an excerpt:

A mentor told me early in my career that only 20% of healing involves the high-tech stuff. The remaining 80%, he said, is about the relationships we build with patients, the physical environments we create, and the resources we provide that enable patients to tap into whatever they need for spiritual sustenance. The longer I work in health care, the more I realize just how right he was.

How do we get back to the 80-20 rule? By placing the well-being of patients and care teams at the top of the list for every initiative we undertake and every technology we introduce. Rather than just introducing technology with no thought as to its impact on clinicians — as happened with many rollouts of electronic medical records (EMRs) — we need to establish a way to quantifiably measure whether a new technology actually improves a clinician’s workday and ability to deliver care or simply creates hassles and inefficiency. Let’s develop an up-front “technology ROI” that measures workflow impact, inefficiency, hassle and impact on physician and nurse well-being.

The National Taskforce for Humanity in Healthcare, of which I am a founding member, is piloting a system of metrics for well-being developed by J. Bryan Sexton of Duke University Medical Center. Instead of measuring burnout or how broken health care people are, Dr. Sexton’s metrics focus on emotional thriving and emotional resilience. (The former are how strongly people agree or disagree to these statements: “I have a chance to use my strengths every day at work,” “I feel like I am thriving at my job,” “I feel like I am making a meaningful difference at my job,” and “I often have something that I am very looking forward to at my job.”

The info is here.

Delusions and Three Myths of Irrational Belief

Bortolotti L. (2018) Delusions and Three Myths of Irrational Belief.
In: Bortolotti L. (eds) Delusions in Context. Palgrave Macmillan, Cham

Abstract

This chapter addresses the contribution that the delusion literature has made to the philosophy of belief. Three conclusions will be drawn: (1) a belief does not need to be epistemically rational to be used in the interpretation of behaviour; (2) a belief does not need to be epistemically rational to have significant psychological or epistemic benefits; (3) beliefs exhibiting the features of epistemic irrationality exemplified by delusions are not infrequent, and they are not an exception in a largely rational belief system. What we learn from the delusion literature is that there are complex relationships between rationality and interpretation, rationality and success, and rationality and knowledge.

The chapter is here.

Here is a portion of the Conclusion:

Second, it is not obvious that epistemically irrational beliefs should be corrected, challenged, or regarded as a glitch in an otherwise rational belief system. The whole attitude towards such beliefs should change. We all have many epistemically irrational beliefs, and they are not always a sign that we lack credibility or we are mentally unwell. Rather, they are predictable features of human cognition (Puddifoot and Bortolotti, 2018). We are not unbiased in the way we weigh up evidence and we tend to be conservative once we have adopted a belief, making it hard for new contrary evidence to unsettle our existing convictions. Some delusions are just a vivid illustration of a general tendency that is widely shared and hard to counteract. Delusions, just like more common epistemically irrational beliefs, may be a significant obstacle to the achievements of our goals and may cause a rift between our way of seeing the world and other people’s way. That is why it is important to develop a critical attitude towards their content.

Moral enhancement and the good life

Hazem Zohny
Med Health Care and Philos (2018).
https://doi.org/10.1007/s11019-018-9868-4

Abstract

One approach to defining enhancement is in the form of bodily or mental changes that tend to improve a person’s well-being. Such a “welfarist account”, however, seems to conflict with moral enhancement: consider an intervention that improves someone’s moral motives but which ultimately diminishes their well-being. According to the welfarist account, this would not be an instance of enhancement—in fact, as I argue, it would count as a disability. This seems to pose a serious limitation for the account. Here, I elaborate on this limitation and argue that, despite it, there is a crucial role for such a welfarist account to play in our practical deliberations about moral enhancement. I do this by exploring four scenarios where a person’s motives are improved at the cost of their well-being. A framework emerges from these scenarios which can clarify disagreements about moral enhancement and help sharpen arguments for and against it.

The article is here.

Physicians aren’t ‘burning out.’ They’re suffering from moral injury

Simon G. Talbot and Wendy Dean
STAT News
Originally published July 26, 2018

Here is an excerpt:

The term “moral injury” was first used to describe soldiers’ responses to their actions in war. It represents “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.” Journalist Diane Silver describes it as “a deep soul wound that pierces a person’s identity, sense of morality, and relationship to society.”

The moral injury of health care is not the offense of killing another human in the context of war. It is being unable to provide high-quality care and healing in the context of health care.

Most physicians enter medicine following a calling rather than a career path. They go into the field with a desire to help people. Many approach it with almost religious zeal, enduring lost sleep, lost years of young adulthood, huge opportunity costs, family strain, financial instability, disregard for personal health, and a multitude of other challenges. Each hurdle offers a lesson in endurance in the service of one’s goal which, starting in the third year of medical school, is sharply focused on ensuring the best care for one’s patients. Failing to consistently meet patients’ needs has a profound impact on physician wellbeing — this is the crux of consequent moral injury.

The information is here.

Preventing Med School Suicides

Roger Sergel
MegPage Today
Originally posted May 2, 2018

Here is an excerpt:

The medical education community needs to acknowledge the stress imposed on our medical learners as they progress from students to faculty. One of the biggest obstacles is changing the culture of medicine to not only understand the key burnout drivers and pain points but to invest resources into developing strategies which reduce stress. These strategies must include the medical learner taking ownership for the role they play in their lack of well-being. In addition, medical schools and healthcare organizations must reflect on their policies/processes which do not promote wellness. In both situations, there is pointing to the other group as the one who needs to change. Both are right.

We do need to change how we deliver a quality medical education AND we need our medical learners to reflect on their personal attitudes and openness to developing their resilience muscles to manage their stress. Equally important, we need to reduce the stigma of seeking help and break down the barriers which would allow our medical learners and physicians to seek help, when needed. We need to create support services which are convenient, accessible, and utilized.

What programs does your school have to support medical students' mental health?

The information is here.

Forgiveness Therapy for the Promotion of Mental Well-Being

Sadaf Akhtar, Jane Barlow
Trauma, Violence & Abuse 2016 March 23

Abstract

Interpersonal hurts and violence against the individual have a high prevalence and are associated with a range of long-term problems in terms of psychological functioning. There is a growing body of research highlighting the role of forgiveness therapy in improving different aspects of psychological health in populations who have experienced diverse types of hurt, violence, or trauma. This article reports the findings of a systematic review and meta-analysis of the efficacy of process-based forgiveness interventions among samples of adolescents and adults who had experienced a range of sources of hurt or violence against them. Randomized controlled trials were retrieved using electronic databases and an examination of reference sections of previous reviews; each study was assessed for risk of bias. Standardized mean differences (SMDs) and confidence intervals (CIs) were used to assess treatment effects. The results suggest that forgiveness interventions are effective in reducing depression (SMD = −0.37, 95% CI [−0.68, −0.07]), anger and hostility (SMD = −0.49, 95% CI [−0.77, −0.22]), and stress and distress (SMD = −0.66, 95% CI [−0.91, −0.41]) and in promoting positive affect (SMD = −0.29, 95% CI [−0.52, −0.06]). There was also evidence of improvements in state (SMD = −0.55, 95% CI [−0.88, −0.21) and trait (SMD = −0.43, 95% CI [−0.67, −0.20]) forgiveness. The findings provide moderately strong evidence to suggest that forgiving a variety of real-life interpersonal offenses can be effective in promoting different dimensions of mental well-being. Further research is, however, needed.

The article is here.

Engineers, philosophers and sociologists release ethical design guidelines for future technology

Rafael A Calvo and Dorian Peters
The Conversation
Originally posted December 12, 2017

Here is an excerpt:

The big questions posed by our digital future sit at the intersection of technology and ethics. This is complex territory that requires input from experts in many different fields if we are to navigate it successfully.

To prepare the report, economists and sociologists researched the effect of technology on disempowered groups. Lawyers considered the future of privacy and justice. Doctors and psychologists examined impacts on physical and mental health. Philosophers unpacked hidden biases and moral questions.

The report suggests all technologies should be guided by five general principles:

• protecting human rights
• prioritising and employing established metrics for measuring wellbeing
• ensuring designers and operators of new technologies are accountable
• making processes transparent
• minimizing the risks of misuse.

Sticky questions

The report runs the spectrum from practical to more abstract concerns, touching on personal data ownership, autonomous weapons, job displacement and questions like “can decisions made by amoral systems have moral consequences?”

One section deals with a “lack of ownership or responsibility from the tech community”. It points to a divide between how the technology community sees its ethical responsibilities and the broader social concerns raised by public, legal, and professional communities.

The article is here.

The IEEE Global Initiative on Ethics of Autonomous and Intelligent Systems

Aligned Design: A Vision for Prioritizing Human Well-being with Autonomous and Intelligent Systems, Version 2. 
IEEE, 2017.

Introduction

As the use and impact of autonomous and intelligent systems (A/IS) become pervasive, we need to establish societal and policy guidelines in order for such systems to remain human-centric, serving humanity’s values and ethical principles. These systems have to behave in a way that is beneficial to people beyond reaching functional goals and addressing technical problems. This will allow for an elevated level of trust between people and technology that is needed for its fruitful, pervasive use in our daily lives.

To be able to contribute in a positive, non-dogmatic way, we, the techno-scientific communities, need to enhance our self-reflection, we need to have an open and honest debate around our imaginary, our sets of explicit or implicit values, our institutions, symbols and representations.

Eudaimonia, as elucidated by Aristotle, is a practice that defines human well-being as the highest virtue for a society. Translated roughly as “flourishing,” the benefits of eudaimonia begin by conscious contemplation, where ethical considerations help us define how we wish to live.

Whether our ethical practices are Western (Aristotelian, Kantian), Eastern (Shinto, Confucian), African (Ubuntu), or from a different tradition, by creating autonomous and intelligent systems that explicitly honor inalienable human rights and the beneficial values of their users, we can prioritize the increase of human well-being as our metric for progress in the algorithmic age. Measuring and honoring the potential of holistic economic prosperity should become more important than pursuing one-dimensional goals like productivity increase or GDP growth.

The guidelines are here.

The Wisdom in Virtue: Pursuit of Virtue Predicts Wise Reasoning About Personal Conflicts

Alex C. Huynh, Harrison Oakes, Garrett R. Shay, & Ian McGregor
Psychological Science
Article first published online: October 3, 2017

Abstract

Most people can reason relatively wisely about others’ social conflicts, but often struggle to do so about their own (i.e., Solomon’s paradox). We suggest that true wisdom should involve the ability to reason wisely about both others’ and one’s own social conflicts, and we investigated the pursuit of virtue as a construct that predicts this broader capacity for wisdom. Results across two studies support prior findings regarding Solomon’s paradox: Participants (N = 623) more strongly endorsed wise-reasoning strategies (e.g., intellectual humility, adopting an outsider’s perspective) for resolving other people’s social conflicts than for resolving their own. The pursuit of virtue (e.g., pursuing personal ideals and contributing to other people) moderated this effect of conflict type. In both studies, greater endorsement of the pursuit of virtue was associated with greater endorsement of wise-reasoning strategies for one’s own personal conflicts; as a result, participants who highly endorsed the pursuit of virtue endorsed wise-reasoning strategies at similar levels for resolving their own social conflicts and resolving other people’s social conflicts. Implications of these results and underlying mechanisms are explored and discussed.

Here is an excerpt:

We propose that the litmus test for wise character is whether one can reason wisely about one’s own social conflicts. As did the biblical King Solomon, people tend to reason more wisely about others’ social conflicts than their own (i.e., Solomon’s paradox; Grossmann & Kross, 2014, see also Mickler & Staudinger, 2008, for a discussion of personal vs. general wisdom). Personal conflicts impede wise reasoning because people are more likely to immerse themselves in their own perspective and emotions, relegating other perspectives out of awareness, and increasing certainty regarding preferred perspectives (Kross & Grossmann, 2012; McGregor, Zanna, Holmes, & Spencer, 2001). In contrast, reasoning about other people’s conflicts facilitates wise reasoning through the adoption of different viewpoints and the avoidance of sociocognitive biases (e.g., poor recognition of one’s own shortcomings—e.g., Pronin, Olivola, & Kennedy, 2008). In the present research, we investigated whether virtuous motives facilitate wisdom about one’s own conflicts, enabling one to pass the litmus test for wise character.

The article is here.

The Associations between Ethical Organizational Culture,Burnout, and Engagement: A Multilevel Study

Mari Huhtala, Asko Tolvanen, Saija Mauno, and Taru Feldt
J Bus Psychol
DOI 10.1007/s10869-014-9369-2

Abstract/Purpose

Ethical culture is a specific form of organizational culture (including values and systems that can promote ethical behavior), and as such a socially constructed phenomenon. However, no previous studies have investigated the degree to which employees’ perceptions of their organization’s ethical culture are shared within work units (departments), which was the first aim of this study. In addition, we studied the associations between ethical culture and occupational well-being (i.e., burnout and work engagement) at both the individual and work-unit levels.

Design/Methodology/Approach

The questionnaire data were gathered from 2,146 respondents with various occupations in 245 different work units in one public sector organization. Ethical organizational culture was measured with the corporate ethical virtues scale, including eight sub-dimensions.

Findings

Multilevel structural equation modeling showed that 12–27 % of the total variance regarding the dimensions of ethical culture was explained by departmental homogeneity (shared experiences). At both the within and between levels, higher perceptions of ethical culture associated with lower burnout and higher work engagement.

Implications

The results suggest that organizations should support ethical practices at the work-unit level, to enhance work engagement, and should also pay special attention to work units with a low ethical culture because these work environments can expose employees to burnout.

Originality/Value

This is one of the first studies to find evidence of an association between shared experiences of ethical culture and collective feelings of both burnout and work engagement.

A copy of the article is here.

Cultivating Moral Resilience

Cynda Rushton
American Journal of Nursing:
February 2017 - Volume 117 - Issue 2 - p S11–S15
doi: 10.1097/01.NAJ.0000512205.93596.00

Here is an excerpt:

To derive meaning from moral distress, one must first change the relationship with the suffering that it causes. Human beings have the potential to consciously decide what mindset they will bring to a given situation; they have the option to choose a path of mindful awareness and inquiry over one of helplessness and frustration. When people are mired in the “judger pit,” the tone of their conversation is punctuated by negativity, closed thinking, and judgment of themselves and others.40 Alternatively, when in an inquiring mindset, they are more inclined to remain positive—despite their distress—and are able to ask questions that may help reveal unknown or overlooked possibilities.

Shifting the focus from helplessness to resilience offers promising possibilities in designing interventions to help mitigate the effects of moral distress. Resilience—an umbrella concept that has been applied in diverse fields of study—can be psychological, physiologic, genetic, sociologic, organizational or communal, or moral. Although there is no unifying definition, resilience generally refers to the ability to recover from or healthfully adapt to challenges, stress, adversity, or trauma. One definition characterizes it as “the process of harnessing biological, psychosocial, structural, and cultural resources to sustain wellbeing.”

Psychological resilience, for example, “involves the creation of meaning in life, even life that is sometimes painful or absurd, and having the courage to live life fully despite its inherent pain and futility.”

The article is here.

Surgeon General Concerned About Physician Burnout

by Joyce Frieden
MedPage Today
Originally posted April 10, 2016

Here is an excerpt:

But in the months since he has taken office, a growing concern about emotional well-being emerged "from conversations I had with community members, and it is based on the science developed over the years that tells us emotional well-being is an important driver of health."

"People think that emotional well-being is something that happens to you -- things line up in your life, you have the right job, and your health is good, and [you are in] a happy family and in a good relationship and you're happy in your emotional life," he said. "But there's a growing body of science that tells us there are things we can do to develop our emotional well-being proactively, and that in turn can have a positive impact on our health."

Murthy noting that promoting well-being doesn't require reinventing the wheel as there are already programs focused on emotional well-being that have significant outcomes for health and education, but people just don't know about them.

The article is here.

Reforming the minimum wage: Toward a psychological perspective

Laura Smith
American Psychologist, Vol 70(6), Sep 2015, 557-565.

Abstract

The field of psychology has periodically used its professional and scholarly platform to encourage national policy reform that promotes the public interest. In this article, the movement to raise the federal minimum wage is presented as an issue meriting attention from the psychological profession. Psychological support for minimum wage reform derives from health disparities research that supports the causal linkages between poverty and diminished physical and emotional well-being. Furthermore, psychological scholarship relevant to the social exclusion of low-income people not only suggests additional benefits of financially inclusive policymaking, it also indicates some of the attitudinal barriers that could potentially hinder it. Although the national living wage debate obviously extends beyond psychological parameters, psychologists are well-positioned to evaluate and contribute to it.

The entire article is here.

Why Aristole Wants You to Be Good

By Kristjan Kristjansson
Big Ideas at Slate.com

Here is an excerpt:

Many social scientists consider this philosophical question quirky at best. The reason? An abundance of psychological evidence demonstrates the extrinsic benefits of moral choices over immoral ones, even for psychology’s Eldorado: subjective well-being. Of course, even though social scientists pride themselves on their value-neutrality, they are rarely neutral with regard to what they consider the “ungrounded grounder” of all human strivings, namely happiness, and they typically understand happiness as subjective well-being.

A case in point here is the copious literature on the benefits of the moral emotion of gratitude for subjective well-being. We now know with certainty—at least the sort of certainty to which any social scientific inquiry can aspire—that grateful people are in general happy people. Over and above that, meticulous empirical research on gratitude has shown all sorts of instrumental benefits for what social scientists call “pro-social ends.” Thus, as a moral barometer, gratitude attends affirmatively to a positive moral change in our environment; as a moral motivator, gratitude urges us to contribute to the welfare of our benefactor (or even third parties) in the future; as a moral reinforcer, gratitude makes benefactors more likely to replicate their benevolent acts at later junctures and in different contexts.

The entire article is here.

The Contribution of the Quality of Therapists' Personal Lives to the Development of the Working Alliance

By Helene A. Nissen-Lie, Odd E. Havik, Per A. Hoglend, Jon T. Monsen, and Michael Helge Ronnestad

Journal of Counseling Psychology. 2013 Aug 19

Abstract

Research suggests that the person of the psychotherapist is important for the process and outcome of psychotherapy, but little is known about the relationship between therapists' personal experiences and the quality of their therapeutic work. This study investigates 2 factors (Personal Satisfactions and Personal Burdens) reflecting therapists' quality of life that emerged from the self-reports of a large international sample of psychotherapists (N = 4,828) (Orlinsky & Rønnestad, 2004, 2005) using the Quality of Personal Life scales of the Development of Psychotherapists Common Core Questionnaire (Orlinsky et al., 1999). These factors were investigated as predictors of alliance levels and growth (using the Working Alliance Inventory) rated by both patients and therapists in a large (227 patients and 70 therapists) naturalistic outpatient psychotherapy study (Havik et al., 1995). The Personal Burdens scale was strongly and inversely related to the growth of the alliance as rated by the patients, but was unrelated to therapist-rated alliance. Conversely, the factor scale of therapists' Personal Satisfactions was clearly and positively associated with therapist-rated alliance growth, but was unrelated to the patients' ratings of the alliance. The findings suggest that the working alliance is influenced by therapists' quality of life, but in divergent ways when rated by patients or by therapists. It seems that patients are particularly sensitive to their therapists' private life experience of distress, which presumably is communicated through the therapists' in-session behaviors, whereas the therapists' judgments of alliance quality were positively biased by their own sense of personal well-being.

Introduction

The notion that the psychotherapist as an individual is important for psychotherapeutic outcomes stems in part from the well-known and frequently cited finding of meta-analyses that therapy outcome appears to be less related to the use of different therapy methods associated with established schools of therapy, and significantly related to differences between the individual psychotherapists providing the therapy (Benish, Imel, & Wampold, 2008; Blatt, Zuroff, Quinlan, & Pilkonis, 1996; Huppert et al., 2001; Kim, Wampold, & Bolt, 2006). Moreover, in efforts to identify the characteristics in therapists that promote treatment success or failure, the studies to date suggest that experience level, type of training, theoretical orientation, and so forth have limited value in distinguishing between more or less successful therapists (Beutler et al., 2004; Dunkle & Friedlander, 1996; Sandell et al., 2007; Skovholt & Jennings, 2004; Strupp & Hadley, 1977). Instead, therapists' interpersonal qualities appear to be more relevant, such as their facilitative interpersonal skills (Anderson, Ogles, Pattersen, Lambert, & Vermeersch, 2009); their ability to be affirmative, responsive, and empathic (Bohart, Elliott, Greenberg, & Watson, 2002; Najavits & Strupp, 1994); their ability to resist counteraggression when confronted with devaluation and rejections by patients (von der Lippe, Monsen, Ronnestad, & Eilertsen, 2008); and their interpersonal functioning in their personal lives (Dunkle & Friedlander, 1996; Hersoug, Hoglend, Havik, von der Lippe, & Monsen, 2009b). Hence, although therapists are professional helpers, it may be that their personal characteristics are more important than their professional qualifications in determining their therapeutic capabilities. This suggestion echoes the statements of Rosenzweig (1936), Strupp (1958), and Rogers (1957, 1961), who emphasized that studying the personal characteristics of psychotherapists is necessary in order to understand patient development in psychotherapy.

The entire article is here.

Thanks to Ken Pope for this information.

Could intranasal oxytocin be used to enhance relationships?

Research imperatives, clinical policy, and ethical considerations

By O. A. Wudarczyk, B. D. Earp, A. J. Guastella & J. Savulescu

Abstract

Purpose of review. 

Well-functioning romantic relationships are important for long-term health and well-being, but they are often difficult to sustain. This difficulty arises (in part) because of an underlying tension between our psychobiological natures, culture/environment, and modern love and relationship goals. One possible solution to this predicament is to intervene at the level of psychobiology, enhancing partners’ interpersonal connection through neurochemical modulation. This article focuses on a single, promising biobehavioral sub-system for such intervention: the attachment system, based largely upon the expression of the neuropeptide oxytocin. Could the exogenous administration of oxytocin—under the right conditions—be used to facilitate relational or marital well-being?

Recent findings.

If so, it would require considerable forethought. Recent research complicates the popular image of oxytocin as a universal social enhancer or ‘love hormone’ and shows that it may exert a variety of different effects, at different dosages, on different people, under different circumstances. Accordingly, we discuss what is known about oxytocin, including its“good” and “bad” effects on human behavior and on higher-order functional processes.

Summary.

Building upon animal-model, human preclinical, and clinical findings, we outline a proposal for the use of oxytocin in the therapeutic neuroenhancement of contemporary romantic relationships. Highlighting key targets for future research along the way, we then conclude by discussing some of the clinical and ethical considerations that would pertain to the implementation of this knowledge in applied settings.

Key Points

* Intranasal oxytocin may hold promise for the therapeutic neuroenhancement of modern relationships. Oxytocin has “good” and “bad” effects, however, that may be different for different individuals and couples depending upon a range of personal, interpersonal, and contextual factors.

* Large-scale clinical trials with adequate sample sizes, and that include both males and females, are needed to fill in a range of “gaps” in existing knowledge. Chronic administrations and ecologically valid study designs should be top research priorities.

* The imminent prospect of neurochemical modulation of interpersonal relationships should inspire the development of general ethical guidelines for the responsible use of such technology. These guidelines should emphasize autonomy, consent, and personal and interpersonal well-being.

* As is the case with any new area of biomedical research, practical, moral, and clinical-policy considerations must be addressed in tandem with any progress made on scientific and theoretical fronts.

The entire article is here.