A trauma trigger is a psychological stimulus that prompts involuntary recall of a previous traumatic experience.
The stimulus itself need not be frightening or traumatic and may be only indirectly or superficially reminiscent of an earlier traumatic incident, such as a scent or a piece of clothing. Triggers can be subtle and difficult to anticipate. A trauma trigger may also be called a trauma stimulus, a trauma stressor or a trauma reminder.
The process of connecting a traumatic experience to a trauma trigger is called traumatic coupling. When trauma is “triggered”, the involuntary response goes far beyond feeling uncomfortable and can feel overwhelming and uncontrollable, such as a panic attack or a strong impulse to flee to a safe place. Avoiding a trauma trigger, and therefore the potentially extreme reaction it provokes, is a common behavioural symptom of posttraumatic stress disorder (PTSD), a treatable and usually temporary condition in which people sometimes experience overwhelming emotional or physical symptoms when something reminds them of, or “triggers” the memory of, a traumatic event. Long-term avoidance of triggers increases the likelihood that the affected person will develop a disabling level of PTSD. Identifying and addressing trauma triggers is an important part of treating PTSD.
A trigger warning is a message presented to an audience about the contents of a piece of media, to warn them that it contains potentially distressing content.
Brief History
Trauma triggers have been recognised by medical professionals since the 19th century.
Triggers
The trigger can be anything that provokes fear or distressing memories in the affected person, and which the affected person associates with a traumatic experience. Some common triggers are:
A particular smell: Such as freshly mown grass, the fragrance of an aftershave product, or perfume. The sense of smell, olfaction, has been claimed as more closely connected to traumatic reminders than other sensory experience, given the proximity of the olfactory bulb to the limbic system..
A particular taste: Such as the food eaten during or shortly before a traumatic experience.
A particular sound: Such as a helicopter or a song.
A particular texture.
Certain times of day: For example, sunset or sunrise.
Certain times of year or specific dates: For example, autumn weather that resembles the affected person’s experience of the weather during the September 11 attacks, or the anniversary of a traumatic experience.
Sights (real, photo, film or video): For examples, a fallen tree or a light shining at a particular angle.
Places: For example, a bathroom, or all bathrooms.
A person: Especially a person who was present during a traumatic event or resembles someone involved in that event in some respect.
An argument.
A sensation on the skin: Such as the feeling of a wristwatch resembling the feeling of handcuffs, or sexual touching for victims of sexual assault.
The position of the body.
Physical pain.
Emotions – such as feeling overwhelmed, vulnerable, or not in control.
A particular situation – for example, being in a crowded place.
The trigger is usually personal and specific. However, it need not be closely related to the actual experience. For example, after the Gulf War, some Israelis experienced the sound of an accelerating motorbike as a trigger, which they associated with the sound of sirens they heard during the war, even though the resemblance between the two sounds is limited.
The realistic portrayal of graphic violence in visual media may expose some affected people to triggers while watching movies or television.
Experiences
People who have experienced trauma and who have developed trauma triggers may panic when the trigger is experienced, especially if it is unexpected. For example, the noise of fireworks may seem unbearable to a combat veteran whose trauma is coupled with sudden, loud noises as the trigger.
Trigger Warnings
Trigger warnings, sometimes called content warnings, are warnings that a work contains writing, images, or concepts that may be distressing to some people. Content warnings have been widely used in mass media without any connection to trauma, such as the US TV Parental Guidelines, which indicate that a show includes content that some families may find inappropriate for their children. The term trigger warning, with its trauma-specific context, originated at feminist websites that were discussing violence against women, and then spread to other areas, such as print media and university courses. Although it is widely recognised that any sight, sound, smell, taste, touch, feeling or sensation could be a trigger, trigger warnings are most commonly presented on a relatively narrow range of material, especially content about sexual abuse and mental illness (such as suicide, eating disorders, and self-injury).
Although the subject has generated political controversy, research suggests that trigger warnings are neither harmful nor especially helpful. Among people without traumatic experiences, “trigger warnings did not affect anxiety responses to potentially distressing material in general.” Studies disagree on whether trigger warning cause transient increases in anxiety in those without traumatic experiences. For participants who self-reported a posttraumatic stress disorder (PTSD) diagnosis, or for participants who qualified for probable PTSD, trigger warnings had little statistically significant effect. Effect sizes on feelings of avoidance, decreased resilience, or other negative outcomes have been “trivial” in controlled research environments.
Controversy in Higher Education
The idea of giving content warnings to university students about their coursework has been disputed and politicised. Much of the dispute centres around content warnings given to all students about the presence of generally uncomfortable subjects in the curriculum, such as racism and misogyny. There is no significant dispute over providing reasonable accommodations to the small number of students (usually current and former military personnel and sexual assault survivors) who qualify as having a disabling level of post-traumatic stress disorder and whose ability to learn the normal curriculum can be improved, for example, by mentioning in advance that the next reading assignment contains a detailed description of a violent event or that an upcoming ballistic pendulum demonstration will produce loud sounds.
In 2014, the American Association of University Professors criticised the use of general content warnings in university contexts, stating:
“The presumption that students need to be protected rather than challenged in a classroom is at once infantilizing and anti-intellectual. It makes comfort a higher priority than intellectual engagement and…it singles out politically controversial topics like sex, race, class, capitalism, and colonialism for attention.”
This view is supported by some professors such as Richard McNally, professor of psychology at Harvard, and some psychiatric medical practitioners, such as Metin Basoglu and Edna Foa. They believe that trigger warnings increase avoidance behaviours by those with PTSD which makes it harder to overcome the PTSD, create a culture that decreases resilience, and more geared towards political virtue signalling, and are “counterproductive to the educational process”.
Since the publication of the American Association of University Professors’ report, other professors, such as Angus Johnston, have supported trigger warnings as a part of “sound pedagogy”. Other supportive professors have stated that “the purpose of trigger warnings is not to cause students to avoid traumatic content, but to prepare them for it, and in extreme circumstances to provide alternate modes of learning.”
Universities have taken different stances on the issue of trigger warnings. In a letter welcoming new undergraduates, the University of Chicago wrote that the college’s “commitment to academic freedom means we do not support so-called ‘trigger warnings’,” do not cancel controversial speakers, and do not “condone the creation of intellectual ‘safe spaces’ where individuals can retreat from thoughts and ideas at odds with their own”. Students at UC Santa Barbara took the opposite position in 2014, passing a non-binding resolution in support of mandatory trigger warnings for classes that could contain potentially upsetting material. Professors were encouraged to alert students of such material and allow them to skip classes that could make them feel uncomfortable.
While trigger warnings have garnered significant debate, few studies have investigated how students typically respond to potentially triggering material. In a 2021 study, three hundred and fifty-five undergraduate students from four universities read a passage describing incidences of both physical and sexual assault. Longitudinal measures of subjective distress, PTSD symptoms, and emotional reactivity were taken. Greater than 96% of participants read the triggering passage even when given a non-triggering alternative to read. Of those who read the triggering passage, those with triggering traumas did not report more distress although those with higher PTSD scores did. Two weeks later, those with trigger traumas and/or PTSD did not report an increase in trauma symptoms as a result of reading the triggering passage. Students with relevant traumas do not avoid triggering material and the effects appear to be brief. Students with PTSD do not report an exacerbation of symptoms two weeks later as a function of reading the passage. In 2021, a study of the effects of trigger warnings, published in the Chronicle of Higher Education, announced that “Trigger warnings don’t help”.
Thought suppression is a psychological defence mechanism. It is a type of motivated forgetting in which an individual consciously attempts to stop thinking about a particular thought.
It is often associated with obsessive-compulsive disorder (OCD). OCD is when a person will repeatedly (usually unsuccessfully) attempt to prevent or “neutralise” intrusive distressing thoughts centred on one or more obsessions. It is also thought to be a cause of memory inhibition, as shown by research using the think/no think paradigm. Thought suppression is relevant to both mental and behavioural levels, possibly leading to ironic effects that are contrary to intention. Ironic process theory is one cognitive model that can explain the paradoxical effect.
When an individual tries to suppress thoughts under a high cognitive load, the frequency of those thoughts increases and becomes more accessible than before. Evidence shows that people can prevent their thoughts from being translated into behaviour when self-monitoring is high; this does not apply to automatic behaviours though, and may result in latent, unconscious actions. This phenomenon is made paradoxically worse by increasing the amount of distractions a person has, although the experiments in this area can be criticised for using impersonal concurrent tasks, which may or may not properly reflect natural processes or individual differences.
Empirical Work (1980s)
In order for thought suppression and its effectiveness to be studied, researchers have had to find methods of recording the processes going on in the mind. One experiment designed with this purpose was performed by Wegner, Schneider, Carter & White. They asked participants to avoid thinking of a specific target (e.g. a white bear) for five minutes, but if they did, they were told then to ring a bell. After this, participants were told that for the next five minutes they were to think about the target. There was evidence that unwanted thoughts occurred more frequently in those who used thought suppression compared to those who were not. Furthermore, there was also evidence that during the second stage, those who had used thought suppression had a higher frequency of target thoughts than did those who had not used thought suppression; later coined the rebound effect. This effect has been replicated and can even be done with implausible targets, such as the thought of a “green rabbit”. From these implications, Wegner eventually developed the “ironic process theory”.
Improved Methodology (1990s)
To better elucidate the findings of thought suppression, several studies have changed the target thought. Roemer and Borkovec found that participants who suppressed anxious or depressing thoughts showed a significant rebound effect. Furthermore, Wenzlaff, Wegner, & Roper demonstrated that anxious or depressed subjects were less likely to suppress negative, unwanted thoughts. Despite Rassin, Merkelbach and Muris reporting that this finding is moderately robust in the literature, some studies were unable to replicate results. However, this may be explained by a consideration of individual differences.
Recent research found that for individuals with low anxiety and high desirability traits (repressors), suppressed anxious autobiographical events initially intruded fewer times than in other groups (low, high, and high defensive anxious groups), but intruded more often after one week. This difference in coping style may account for the disparities within the literature. That said, the problem remains that the cause of the paradoxical effect may be in the thought tapping measures used (e.g. bell ringing). Evidence from Brown (1990) that showed participants were very sensitive to frequency information prompted Clarke, Ball and Pape to obtain participants’ aposterio estimates of the number of intrusive target thoughts and found the same pattern of paradoxical results. However, even though such a method appears to overcome the problem, it and all the other methodologies use self-report as the primary form of data-collection. This may be problematic because of response distortion or inaccuracy in self-reporting.
Behavioural Domain
Thought suppression also has the capability to change human behaviour. Macrae, Bodenhausen, Milne, and Jetten found that when people were asked not to think about the stereotypes of a certain group (e.g. a “skinhead”), their written descriptions about a group member’s typical day contained less stereotypical thoughts. However, when they were told they were going to meet an individual they had just written about, those in the suppression group sat significantly farther away from the “skinhead” (just by virtue of his clothes being present). These results show that even though there may have been an initial enhancement of the stereotype, participants were able to prevent this from being communicated in their writing; this was not true for their behaviour though.
Further experiments have documented similar findings. In one study from 1993, when participants were given cognitively demanding concurrent tasks, the results showed a paradoxical higher frequency of target thoughts than controls. However other controlled studies have not shown such effects. For example, Wenzlaff and Bates found that subjects concentrating on a positive task experienced neither paradoxical effects nor rebound effects – even when challenged with cognitive load. Wenzlaff and Bates also note that the beneficiality of concentration in their study participants was optimised when the subjects employed positive thoughts.
Some studies have shown that when test subjects are under what Wegner refers to as a “cognitive load” (for instance, using multiple external distractions to try to suppress a target thought), the effectiveness of thought suppression appears to be reduced. However, in other studies in which focused distraction is used, long term effectiveness may improve. That is, successful suppression may involve less distractors. For example, in 1987 Wegner, Schneider, Carter & White found that a single, pre-determined distracter (e.g. a red Volkswagen) was sufficient to eliminate the paradoxical effect post-testing. Evidence from Bowers and Woody in 1996 is supportive of the finding that hypnotised individuals produce no paradoxical effects. This rests on the assumption that deliberate “distracter activity” is bypassed in such an activity.
Cognitive Dynamics
When the cognitive load is increased, thought suppression typically becomes less effective. For example, in the white bear experiment, many general distractions in the environment (for instance a lamp, a light bulb, a desk etc.) might later serve as reminders of the object being suppressed (these are also referred to as “free distraction”). Some studies, however, are unable to find this effect for emotional thoughts in hypnotized individuals when one focused distraction is provided. In an attempt to account for these findings, a number of theorists have produced cognitive models of thought suppression. Wegner suggested in 1989 that individuals distract themselves using environmental items. Later, these items become retrieval cues for the thought attempting to be suppressed. This iterative process leaves the individual surrounded by retrieval cues, ultimately causing the rebound effect. Wegner hypothesized that multiple retrieval cues not being forged explains, in part, the effectiveness of focused distraction (i.e. a reduction of mental load). This is because there may be an ideal balance between the two processes; if the cognitive demand that is not too heavy, then the monitoring processes will not supersede it.
Individual differences may also play a role in regards to the ironic thought process.
Thought suppression has been seen as a form of “experiential avoidance”. Experiential avoidance is when an individual attempts to suppress, change, or control unwanted internal experiences (thoughts, feelings, bodily sensations, memories, etc.). This line of thinking supports relational frame theory.
Other Methodologies
Thought suppression has been shown to be a cause of inhibition in several ways. Two commonly-used methods to study this relationship are the list method and the item method. In this list method, participants study two lists of words, one after the other. After studying the first list, some participants are told to forget everything that they have just learned, while others are not given this instruction. After studying both lists, participants are asked to recall the words on both lists. These experiments typically find that participants who were told to forget the first list do not remember as many words from that list, suggesting that they have been suppressed due to the instruction to forget. In the item method, participants study individual words rather than lists. After each word is shown, participants are told to either remember or forget the word. As in experiments using the list method, the words followed by the instruction to forget are more poorly remembered. Some researchers believe that these two methods result in different types of forgetting. According to these researchers, the list method results in inhibition of the forgotten words, but the item method results in some words being remembered better than the others, without a specific relation to forgetting.
Think/No Think Paradigm
A paradigm from 2009 to study how suppression relates to inhibition is the think/no think paradigm. In these experiments, participants study pairs of words. An example of a possible word pair is roach-ordeal. After all the word pairs are learned, the participants see the first word of the pair and are either told to think about the second word (think phase) or not to think about the second word (no think phase). The no think phase is when suppression occurs. Some pairs were never presented after the initial study portion of the study, and these trials serve as the control group. At the end of the experiment, the participants try to remember all of the word pairs based on the first word. Studies could also use the “independent probe” method, which gives the category and first letter of the second word of the pair. Typically, regardless of the method used, results show that the no-think trials result in worse memory than the think trials, which supports the idea that suppression leads to inhibition in memory. Although this methodology was first done using word pairs, experiments have been conducted using pictures and autobiographical memories as stimuli, with the same results.
Research has also shown that doing difficult counting tasks at the same time as a think/no think task leads to less forgetting in the no think condition, which suggests that suppression takes active mental energy to be successful. Furthermore, the most forgetting during the no think phase occurs when there is a medium amount of brain activation while learning the words. The words are never learned if there is too little activation, and the association between the two words is too strong to be suppressed during the no think phase if there is too much activation. However, with medium activation, the word pairs are learned but able to be suppressed during the no think phase.
fMRI studies have shown two distinct patterns of brain activity during suppression tasks. The first is that there is less activity in the hippocampus, the brain area responsible for forming memories. The second is an increase of brain activity in the dorsolateral prefrontal cortex, especially in cases where suppression is harder. Researchers think that this region works to prevent memory formation by preventing the hippocampus from working.
This methodology can also be used to study thought substitution by adding an instruction during the no think phase for participants to think of a different word rather than the word being suppressed. This research shows that thought substitution can lead to increased levels of forgetting compared to suppression without a thought substitution instruction. This research also suggests that thought substitution, while used as a suppression strategy during the no think phase, may work differently than suppression. Some researchers argue that thinking of something different during the no think phase forms a new association with the first word than the original word pair, which results in interference when using this strategy, which is different than the inhibition that results from simply not thinking about something.
Dream Influence
Dreams occur mainly during the rapid eye movement (REM) sleep and are composed of images, ideas, emotions, and sensations. Although more research needs to be done on this subject, dreams are said to be linked to the unconscious mind. Thought suppression has an influence on the subject matter of the unconscious mind and by trying to restrain particular thoughts, there is a high chance of them showing up in one’s dreams.
Ironic Control Theory
Ironic control theory, also known as “ironic process theory”, states that thought suppression “leads to an increased occurrence of the suppressed content in waking states”. The irony lies in the fact that although people try not to think about a particular subject, there is a high probability that it will appear in one’s dreams regardless. There is a difference for individuals who have a higher tendency of suppression; they are more prone to psychopathological responses such as “intrusive thoughts, including depression, anxiety and obsessional thinking”. Due to these individuals having higher instances of thought suppression, they experience dream rebound more often.
Cognitive load also plays a role in ironic control theory. Studies have shown that a greater cognitive load results in an increased possibility of dream rebound occurring. In other words, when one tries to retain a heavy load of information before going to sleep, there is a high chance of that information manifesting itself within the dream. There is a greater degree of dream rebound in those with a higher cognitive load opposed to those whose load was absent. With the enhancement of a high cognitive load, ironic control theory states thought suppression is more likely to occur and lead to dream rebound.
Dream Rebound
Dream rebound is when suppressed thoughts manifest themselves in one’s dreams. Self-control is a form of thought suppression and when one dreams, that suppressed item has a higher chance of appearing in the dream. For example, when an individual is attempting to quit smoking, they may dream about themselves smoking a cigarette. Emotion suppression has also been found to trigger dream rebound. Recurrence of emotional experiences act as pre-sleep suggestions, ultimately leading to the suppressed thoughts presenting themselves within the dream. One effecting factor of dream rebound is the changes in the prefrontal lobes during rapid-eye movement sleep. Suppressed thoughts are more accessible during REM sleep, as a result of operating processes having a diminished effectiveness. This leads to pre-sleep thoughts becoming more available “with an increased activity of searching for these suppressed thought[s]”. There are other hypotheses regarding REM sleep and dream rebound. For instance, weak semantic associations, post REM sleep, are more accessible than any other time due to weak ironic monitoring processes becoming stronger. More research is needed to further understand what exactly causes dream rebound.
Narrative transportation theory (or simply transportation theory) proposes that when people lose themselves in a story, their attitudes and intentions change to reflect that story.
The mental state of narrative transportation can explain the persuasive effect of stories on people, who may experience narrative transportation when certain contextual and personal preconditions are met, as Green and Brock postulate for the transportation-imagery model. As Van Laer, de Ruyter, Visconti, and Wetzels elaborate further, narrative transportation occurs whenever the story receiver experiences a feeling of entering a world evoked by the narrative because of empathy for the story characters and imagination of the story plot.
Defining the Field
Deighton, Romer, and McQueen anticipate the construct of narrative transportation by arguing that a story invites story receivers into the action it portrays and, as a result, makes them lose themselves in the story. Gerrig was the first to coin the notion of narrative transportation within the context of novels. Using travel as a metaphor for reading, he conceptualises narrative transportation as a state of detachment from the world of origin that the story receiver – in his words, the traveller – experiences because of his or her engrossment in the story, a condition that Green and Brock later describe as the story receiver’s experience of being carried away by the story. Notably, the state of narrative transportation makes the world of origin partially inaccessible to the story receiver, thus marking a clear separation in terms of here/there and now/before, or narrative world/world of origin.
Relevant Features
Most research on narrative transportation follows the original definition of the construct. Scholars in the field constantly reaffirm the relevance of three features.
Narrative transportation requires that people process stories – the acts of receiving and interpreting.
Story receivers become transported through two main components: empathy and mental imagery. Empathy implies that story receivers try to understand the experience of a story character, that is, to know and feel the world in the same way. Thus, empathy offers an explanation for the state of detachment from the world of origin that is narrative transportation. In mental imagery, story receivers generate vivid images of the story plot, such that they feel as though they are experiencing the events themselves.
When transported, story receivers lose track of reality in a physiological sense.
In accordance with these features, Van Laer et al. define narrative transportation as the extent to which:
An individual empathizes with the story characters;
The story plot activates their imagination; and
Which leads them to experience suspended reality during story reception.
Similar Constructs
Narrative transportation is a form of experiential response to narratives and thus is similar to other constructs, such as absorption, narrative involvement, identification, optimal experience or flow, and immersion. Yet several subtle, critical differences exist. Absorption refers to a personality trait or general tendency to be immersed in life experiences; transportation is an engrossing temporary experience. Flow is a more general construct (i.e. people can experience flow in a variety of activities), whereas transportation specifically entails empathy and mental imagery, which do not occur in flow experiences. Phillips and McQuarrie demonstrate that immersion is primarily an experiential response to aesthetic and visual elements of images, whereas narrative transportation relies on a story with plot and characters, features that are not present in immersion. Identification emphasizes the involvement with story characters, while narrative transportation is concerned with the involvement with the narrative as a whole.
Narrative Persuasion
Since narrative transportation’s conceptualisation, research has demonstrated that the transported “traveller” can return changed by the journey. Subsequent studies have confirmed that a story can engross the story receiver in a transformational experience, whose effects are strong and long-lasting. The transformation that narrative transportation achieves is persuasion of the story receiver. More specifically, Van Laer et al.’s literature review reveals that narrative transportation can cause affective and cognitive responses, beliefs, and attitude and intention changes. However, the processing pattern of narrative transportation is markedly different from that in well-established models of persuasion.
A 2016 meta-analysis found significant, positive narrative persuasion (i.e. narrative-consistent) effects for attitudes, beliefs, intentions and behaviours.
Rival Models
Before 2000, dual-process models of persuasion, especially the elaboration likelihood model and heuristic-systematic model, dominated persuasion research. These models attempt to explain why people accept or reject message claims. According to these models, the determination of a claim’s acceptability can result from careful evaluation of the arguments presented or from reliance on superficial cues, such as the presence of an expert. Whether receivers scrutinize a message depends on the extent to which they are able and motivated to process it systematically. As important variables, these models include empathy, familiarity, involvement, and the number and nature of thoughts the message evokes. If these variables are mainly positive, the receiver’s attitudes and intentions tend to be more positive; if the variables are predominantly negative, the resulting attitudes and intentions are more negative. These variables also exist in narrative persuasion.
Differences between Analytical and Narrative Persuasion
Analytical persuasion and narrative persuasion differ depending on the role of involvement. In analytical persuasion, involvement depends on the extent to which the message has personally relevant consequences for a receiver’s money, time, or other resources. If these consequences are sufficiently severe, receivers evaluate the arguments carefully and generate thoughts related to the arguments. Yet, as Slater notes, even though severe consequences for stories are relatively rare, “viewers or readers of an entertainment narrative typically appear to be far more engrossed in the message.” This type of involvement, or narrative transportation, is arguably the crucial determinant of narrative persuasion.
Though the dual-process models provide a valid description of analytical persuasion, they do not encompass narrative persuasion. Analytical persuasion refers to attitudes and intentions developed from processing messages that are overtly persuasive, such as most lessons in science books, news reports, and speeches. However, narrative persuasion refers to attitudes and intentions developed from processing narrative messages that are not overtly persuasive, such as novels, movies, or video games. Addressing the strength and duration of the persuasive effects of processing stories, narrative transportation is a mental state that produces enduring persuasive effects without careful evaluation of arguments. Transported story receivers are engrossed in a story in a way that neither is inherently critical nor involves great scrutiny.
Sleeper Effect
Narrative transportation seems to be more unintentionally affective than intentionally cognitive in nature. This way of processing leads to potentially increasing and long-lasting persuasive effects. Appel and Richter use the term “Sleeper effect” to describe this paradoxical property of narrative transportation over time, which consists of a more pronounced change in attitudes and intentions and a greater certainty that these attitudes and intentions are correct.
Plausible explanations for the sleeper effect are twofold.
According to post-structural research, language’s articulation in narrative format is capable not only of mirroring reality but also of constructing it. As such, stories could cause profound and durable persuasion of the transported story receiver as a result of his or her progressive internalisation. When stories transport story receivers, not only do they present a narrative world but, by reframing the story receiver’s language, they also durably change the world to which the story receiver returns after the transportation experience.
Research demonstrates that people analyse and retain stories differently from other information formats. For example, Deighton et al. show that analytical advertisements stimulate cognitive responses whereas narrative advertisements are more likely to stimulate affective responses.
Following this line of reasoning, Van Laer et al. define narrative persuasion as:
…the effect of narrative transportation, which manifests itself in story receivers’ affective and cognitive responses, beliefs, attitudes, and intentions from being swept away by a story and transported into a narrative world that modifies their perception of their world of origin.
The conceptual distinction between analytical persuasion and narrative persuasion and the theoretical framework of sound interpretation of narrative persuasion both ground the extended transportation-imagery model (ETIM).
Moderators
ETIM contains three methodological factors that moderate the overall effect of narrative transportation, as van Laer, Feiereisen, and Visconti detail. The narrative transportation effect is stronger:
For stories in the commercial (vs. non-commercial) domain;
In the family triangulation system, the third person can either be used as a substitute for direct communication or can be used as a messenger to carry the communication to the main party. Usually, this communication is an expressed dissatisfaction with the main party. For example, in a dysfunctional family in which there is alcoholism present, the non-drinking parent will go to a child and express dissatisfaction with the drinking parent. This includes the child in the discussion of how to solve the problem of the alcoholic parent. Sometimes the child can engage in the relationship with the parent, filling the role of the third party, and thereby being “triangulated” into the relationship. Alternatively, the child may then go to the alcoholic parent, relaying what they were told. In instances when this occurs, the child may be forced into a role of a “surrogate spouse” The reason that this occurs is that both parties are dysfunctional. Rather than communicating directly with each other, they utilise a third party. Sometimes this is because it is unsafe to go directly to the person and discuss the concerns, particularly if they are alcoholic and/or abusive.
In a triangular family relationship, the two who have aligned risk forming an enmeshed relationship.
Good versus Bad Triangulation
Triangulation can be a constructive and stabilising factor. Triangulation can also be a destructive and destabilising factor. Destabilising or “bad triangulation” can polarise communications and escalate conflict. Understanding the difference between stabilising triangulation and destabilising triangulation is helpful in avoiding destabilising situations. Triangulation may be overt, which is more commonly seen in high-conflict families, or covert.
A 2016 longitudinal study of adolescent relationship skills found that teens who were triangulated into parental conflicts more frequently used positive conflict resolution techniques with their own dating partner, but were also more likely to engage in verbally abusive behaviours.
The Perverse Triangle
The Perverse Triangle was first described in 1977 by Jay Haley as a triangle where two people who are on different hierarchical or generational levels form a coalition against a third person (e.g. “a covert alliance between a parent and a child, who band together to undermine the other parent’s power and authority”). The perverse triangle concept has been widely discussed in professional literature. Bowen called it the pathological triangle, while Minuchin called it the rigid triangle. For example, a parent and child can align against the other parent but not admit to it, to form a cross-generational coalition. These are harmful to children.
Child Development
In the field of psychology, triangulations are necessary steps in the child’s development. When a two-party relationship is opened up by a third party, a new form of relationship emerges and the child gains new mental abilities. The concept was introduced in 1971 by the Swiss psychiatrist Dr. Ernst L. Abelin, especially as ‘early triangulation’, to describe the transitions in psychoanalytic object relations theory and parent-child relationship in the age of 18 months. In this presentation, the mother is the early caregiver with a nearly “symbiotic” relationship to the child, and the father lures the child away to the outside world, resulting in the father being the third party. Abelin later developed an ‘organiser- and triangulation-model’, in which he based the whole human mental and psychic development on several steps of triangulation.
Some earlier related work, published in a 1951 paper, had been done by the German psychoanalyst Hans Loewald in the area of pre-Oedipal behaviour and dynamics. In a 1978 paper, the child psychoanalyst Dr. Selma Kramer wrote that Loewald postulated the role of the father as a positive supporting force for the pre-Oedipal child against the threat of re-engulfment by the mother which leads to an early identification with the father, preceding that of the classical Oedipus complex. This was also related to the work in Separation-Individuation theory of child development by the psychoanalyst Margaret Mahler.
Destabilising Triangulation
Destabilising triangulation occurs when a person attempts to control the flow, interpretation, and nuances of communication between two separate actors or groups of actors, thus ensuring communications flow through, and constantly relate back to them. Examples include a parent attempting to control communication between two children, or a relationship partner attempting to control communication between the other partner and the other partner’s friends and family. Another example is to put a third actor between them and someone with whom they are commonly in conflict. Rather than communicating directly with the actor with whom they are in conflict, they will send communication supporting his or her case through a third actor in an attempt to make the communication more credible.
Self-objectification is when people view themselves as objects for use instead of as human beings.
Self-objectification is a result of objectification, and is commonly discussed in the topic of sex and gender. Both men and women struggle with self-objectification, but it is most commonly seen among women. According to Calogero, self-objectification explains the psychological process by which women internalise people’s objectification of their bodies, resulting in them constantly criticising their own bodies.
Relationship to Objectification
Objectification and self-objectification are two different topics, but are closely intertwined. Objectification looks at how society views people (in this case, women) as bodies for someone else’s pleasure. This occurs in advertisements where the body but not the face of a woman is shown. These messages put an unrealistic standard on women’s bodies, dehumanising them to an object of visual pleasure, and self-objectification occurs in response. Women start to internalise the message that they are not individual human beings, but objects of beauty, pleasure, and play for men or women, and they start to look at themselves and their bodies as such.
The perpetuation of self-objectification can be described as a cycle. Objectification causes self-objectification which perpetuates objectification, and the cycle goes on. Both media and social interaction factor into that cycle as well. Media is everywhere, plastering seemingly perfect women across billboards, in music videos, and on covers of magazines. These ideals cause people to put on an unrealistic lens, thinking that they should look and act like the women in the media are portrayed, perpetuating the cycle of self-objectification. Social interactions affect this cycle as well, as the way people communicate with each other subconsciously furthers objectification as well. This type of talk is known as appearance related communication. Two types of appearance-related communication that have had an effect on the existence of self-objectification are fat talk and old talk.
Appearance-Related Communication
Fat talk, a term coined by Mimi Nichter, refers to women making comments about their own weight, dieting, or justifications of one’s eating or exercising habits. It includes comments such as, “I’m out of shape”, or “I’m just eating everything today”. Women who engage in fat talk are more likely to struggle with body dissatisfaction, self-objectification, depression, anorexia, bulimia, and other eating disorders.
Old talk refers to negative statements about wrinkles, skin tone, yellowing teeth, and other physical aspects of the natural aging process. Women who engage in old talk are more likely to be dissatisfied with their bodies, engage in self-objectification, suffer from depression and anxiety, and it may even decrease their quality of life and actual lifespan. Both fat and old talk result in higher self-objectification, as women measure themselves against and attempt to reach an unrealistic standard.
In Different Generations
One period of time in a woman’s life where self-objectification happens excessively is during pregnancy. Magazines offer pictures of pregnant celebrities with golden skin, toned legs, and a perfectly rounded, “cute” pregnant belly. The photo-editing makes it seem real, and people start to think that is how they ought to look when they are pregnant. Looking at these perfect pictures results in pregnant women feeling worse about themselves and being incredibly self-conscious about their weight even though their weight gain is normal and necessary. They see themselves as not good enough, again, objectifying their identity to a body that needs to be perfect. Studies have also been done on adolescent girls, and what heightens self-objectification at an early age. With the amount of over-sexualised media that children are exposed to, young girls start to identify themselves as a “prize” to be used and given away at an early age. This objectification is fuelled heavily by media and the fact that it is highly sexualised. The more a young girl is exposed to media that sexually objectifies women, the more they will internalise those beliefs and ideals and objectify themselves.
Self-regulation theory (SRT) is a system of conscious personal management that involves the process of guiding one’s own thoughts, behaviours and feelings to reach goals.
Self-regulation consists of several stages and individuals must function as contributors to their own motivation, behaviour and development within a network of reciprocally interacting influences.
Background
Roy Baumeister, one of the leading social psychologists who have studied self-regulation, claims it has four components:
Standards of desirable behaviour;
Motivation to meet standards;
Monitoring of situations and thoughts that precede breaking said standards; and
Willpower.
Baumeister along with other colleagues developed three models of self-regulation designed to explain its cognitive accessibility: self-regulation as a knowledge structure, strength, or skill. Studies have been done to determine that the strength model is generally supported, because it is a limited resource in the brain and only a given amount of self-regulation can occur until that resource is depleted.
SRT can be applied to:
Impulse control, the management of short-term desires.
People with low impulse control are prone to acting on immediate desires.
This is one route for such people to find their way to jail as many criminal acts occur in the heat of the moment.
For non-violent people it can lead to losing friends through careless outbursts, or financial problems caused by making too many impulsive purchases.
The cognitive bias known as illusion of control.
To the extent that people are driven by internal goals concerned with the exercise of control over their environment, they will seek to reassert control in conditions of chaos, uncertainty or stress.
Failing genuine control, one coping strategy will be to fall back on defensive attributions of control – leading to illusions of control (Fenton-O’Creevy et al., 2003).
Goal attainment and motivation.
Sickness behaviour.
SRT consists of several stages. First, the patient deliberately monitors one’s own behaviour and evaluates how this behaviour affects one’s health. If the desired effect is not realised, the patient changes personal behaviour. If the desired effect is realised, the patient reinforces the effect by continuing the behaviour (Kanfer, 1970; 1971; 1980).
Another approach is for the patient to realise a personal health issue and understand the factors involved in that issue. The patient must decide upon an action plan for resolving the health issue. The patient will need to deliberately monitor the results in order to appraise the effects, checking for any necessary changes in the action plan (Leventhal & Nerenz, 1984).
Another factor that can help the patient reach their own goal of personal health is to relate to the patient the following:
Help them figure out the personal/community views of the illness;
Appraise the risks involved; and
Give them potential problem-solving/coping skills.
Four components of self-regulation described by Baumeister et al. (2007) are:
Standards: Of desirable behaviour.
Motivation: To meet standards.
Monitoring: Of situations and thoughts that precede breaking standards.
Willpower: Internal strength to control urges.
Brief History and Contributors
Albert Bandura
There have been numerous researchers, psychologists and scientists who have studied self-regulatory processes. Albert Bandura, a cognitive psychologist had significant contributions focusing on the acquisition of behaviours that led to the social cognitive theory and social learning theory. His work brought together behavioural and cognitive components in which he concluded that “humans are able to control their behaviour through a process known as self-regulation.” This led to his known process that contained: self observation, judgment and self response. Self observation (also known as introspection) is a process involving assessing one’s own thoughts and feelings in order to inform and motivate the individual to work towards goal setting and become influenced by behavioural changes. Judgement involves an individual comparing his or her performance to their personal or created standards. Lastly, self-response is applied, in which an individual may reward or punish his or herself for success or failure in meeting standard(s). An example of self-response would be rewarding oneself with an extra slice of pie for doing well on an exam.
Dale Schunk
According to Schunk (2012), Lev Vygotsky who was a Russian psychologist and was a major influence on the rise of constructivism, believed that self-regulation involves the coordination of cognitive processes such as planning, synthesizing and formulating concepts (Henderson & Cunningham, 1994); however, such coordination does not proceed independently of the individual’s social environment and culture. In fact, self-regulation is inclusive of the gradual internalisation of language and concepts.
Roy Baumeister
As a widely studied theory, SRT was also greatly impacted by the well-known social psychologist Roy Baumeister. He described the ability to self-regulate as limited in capacity and through this he coined the term ego depletion. The four components of self-regulation theory described by Roy Baumeister are standards of desirable behaviour, motivation to meet standards, monitoring of situations and thoughts that precede breaking standards and willpower, or the internal strength to control urges. In Baumeister’s paper titled Self-Regulation Failure: An Overview, he express that self-regulation is complex and multifaceted. Baumeister lays out his “three ingredients” of self-regulation as a case for self-regulation failure.
Research
Many studies have been done to test different variables regarding self-regulation. Albert Bandura studied self-regulation before, after and during the response. He created the triangle of reciprocal determinism that includes behaviour, environment and the person (cognitive, emotional and physical factors) that all influence one another. Bandura concluded that the processes of goal attainment and motivation stem from an equal interaction of self-observation, self-reaction, self-evaluation and self-efficacy.
In addition to Bandura’s work, psychologists Muraven, Tice and Baumeister conducted a study for self control as a limited resource. They suggested there were three competing models to self-regulation: self-regulation as a strength, knowledge structure and a skill. In the strength model, they indicated it is possible self-regulation could be considered a strength because it requires willpower and thus is a limited resource. Failure to self-regulate could then be explained by depletion of this resource. For self-regulation as a knowledge structure, they theorised it involves a certain amount of knowledge to exert self control, so as with any learned technique, failure to self-regulate could be explained by insufficient knowledge. Lastly, the model involving self-regulation as a skill referred to self-regulation being built up over time and unable to be diminished; therefore, failure to exert would be explained by a lack of skill. They found that self-regulation as a strength is the most feasible model due to studies that have suggested self-regulation is a limited resource.
Dewall, Baumeister, Gailliot and Maner performed a series of experiments instructing participants to perform ego depletion tasks to diminish the self-regulatory resource in the brain, that they theorized to be glucose. This included tasks that required participants to break a familiar habit, where they read an essay and circled words containing the letter ‘e’ for the first task, then were asked to break that habit by performing a second task where they circled words containing ‘e’ and/or ‘a’. Following this trial, participants were randomly assigned to either the glucose category, where they drank a glass of lemonade made with sugar, or the control group, with lemonade made from Splenda. They were then asked their individual likelihoods of helping certain people in hypothetical situations, for both kin and non-kin and found that excluding kin, people were much less likely to help a person in need if they were in the control group (with Splenda) than if they had replenished their brain glucose supply with the lemonade containing real sugar. This study also supports the model for self-regulation as a strength because it confirms it is a limited resource.
Baumeister and colleagues expanded on this and determined the four components to self-regulation. Those include standards of desirable behaviour, motivation to meet these standards, monitoring of situations and thoughts that precede breaking standards and willpower.
Applications and Examples
Impulse control in self-regulation involves the separation of our immediate impulses and long-term desires. We can plan, evaluate our actions and refrain from doing things we will regret. Research shows that self-regulation is a strength necessary for emotional well-being. Violation of one’s deepest values results in feelings of guilt, which will undermine well-being. The illusion of control involves people overestimating their own ability to control events. Such as, when an event occurs an individual may feel greater a sense of control over the outcome that they demonstrably do not influence. This emphasizes the importance of perception of control over life events.
The self-regulated learning is the process of taking control and evaluating one’s own learning and behaviour. This emphasizes control by the individual who monitors, directs and regulates actions toward goals of information. In goal attainment self-regulation it is generally described in these four components of self-regulation. Standards, which is the desirable behaviour. Motivation, to meet the standards. Monitoring, situations and thoughts that precede breaking standards. Willpower, internal strength to control urges.
Illness behaviour in self-regulation deals with issues of tension that arise between holding on and letting go of important values and goals as those are threatened by disease processes. Also people who have poor self-regulatory skills do not succeed in relationships or cannot hold jobs. Sayette (2004) describes failures in self-regulation as in two categories: under regulation and misregulation. Under regulation is when people fail to control oneself whereas misregulation deals with having control but does not bring up the desired goal (Sayette, 2004).
Criticisms/Challenges
One challenge of self-regulation is that researchers often struggle with conceptualising and operationalising self-regulation (Carver & Scheier, 1990). The system of self-regulation comprises a complex set of functions, including research cognition, problem solving, decision making and meta cognition.
Ego depletion refers to self control or willpower drawing from a limited pool of mental resources. If an individual has low mental activity, self control is typically impaired, which may lead to ego depletion. Self control plays a valuable role in the functioning of self in people. The illusion of control involves the overestimation of an individual’s ability to control certain events. It occurs when someone feels a sense of control over outcomes although they may not possess this control. Psychologists have consistently emphasized the importance of perceptions of control over life events. Heider proposed that humans have a strong motive to control their environment.
Reciprocal determinism is a theory proposed by Albert Bandura, stating that a person’s behaviour is influenced both by personal factors and the social environment. Bandura acknowledges the possibility that individual’s behaviour and personal factors may impact the environment. These can involve skills that are either under or overcompensating the ego and will not benefit the outcome of the situation.
Recently, Baumeister’s strength model of ego depletion has been criticised in multiple ways. Meta-analyses found little evidence for the strength model of self-regulation and for glucose as the limited resource that is depleted. A pre-registered trial did not find any evidence for ego depletion. Several commentaries have raised criticism on this particular study. In summary, many central assumptions of the strength model of self-regulation seem to be in need of revision, especially the view of self-regulation as a limited resource that can be depleted and glucose as the fuel that is depleted seems to be hardly defensible without major revisions.
Conclusion
Self-regulation can be applied to many aspects of everyday life, including social situations, personal health management, impulse control and more. Since the strength model is generally supported, ego depletion tasks can be performed to temporarily tax the amount of self-regulatory capabilities in a person’s brain. It is theorised that self-regulation depletion is associated with willingness to help people in need, excluding members of an individual’s kin. Many researchers have contributed to these findings, including Albert Bandura, Roy Baumeister and Robert Wood.
Self-help groups for mental health are voluntary associations of people who share a common desire to overcome mental illness or otherwise increase their level of cognitive or emotional wellbeing.
This article focuses on groups for which members do not need to share a common diagnosis or aetiology of their mental illness. Improving mental health and wellbeing is also a desired outcome of groups like, for example, Alcoholics Anonymous and Survivors Network of those Abused by Priests. In those cases, for example, members share the trait of alcoholism or traumatic experiences of abuse by priests and those groups focus on improving the mental health and wellbeing of members while acknowledging their shared circumstances.
Despite the different approaches, many of the psychosocial processes in the groups are the same. Self-help groups have had varying relationships with mental health professionals. Due to the nature of these groups, self-help groups can help defray the costs of mental health treatment and implementation into the existing mental health system could help provide treatment to a greater number of the mentally ill population.
Types
Mutual Support and Self-Help
Mutual support or peer support is a process by which people voluntarily come together to help each other address common problems. Mutual support is social, emotional or instrumental support that is mutually offered or provided by persons with similar mental health conditions where there is some mutual agreement on what is helpful.
Mutual support may include many other mental health consumer non-profits and social groups. Such groups are further distinguished as either Individual Therapy (inner-focused) or Social Reform (outer-focused) groups. The former is where members seek to improve themselves, where as the latter set encompasses advocacy organisations such as the National Alliance on Mental Illness and Psychiatric Rehabilitation Association.
Self-help groups are subsets of mutual support and peer support groups, and have a specific purpose for mutual aid in satisfying a common need, overcoming a shared handicap or life-disrupting problem. Self-help groups are less bureaucratic and work on a more grassroots level. Self-help Organisations are national affiliates of local self-help groups or mental health consumer groups that finance research, maintain public relations or lobby for legislation in favour of those affected.
Behaviour Control or Stress Coping Groups
Of individual therapy groups, researchers distinguish between Behaviour Control groups (such as Alcoholics Anonymous and TOPS) and Stress Coping groups (such as mental health support groups, cancer patient support groups, and groups of single parents). German researchers refer to Stress Coping groups as Conversation Circles.
Significant differences exist between Behavioural Control groups and Stress Coping groups. Meetings of Behaviour Control groups tend to be significantly larger than Stress Coping counterparts (by more than a factor of two). Behaviour Control group members have a longer average group tenure than members of Stress Coping groups (45 months compared to 11 months) and are less likely to consider their membership as temporary. While very few members of either set saw professionals concurrently while being active in their group, Stress Coping members were more likely to have previously seen professionals than Behaviour Control group members. Similarly, Stress Coping groups worked closer with mental health professionals.
Member vs Professional Leadership
Member Leadership
In Germany, a specific subset of Conversation Circles are categorised as Talking Groups (Gesprächsselbsthilfegruppen). In Talking Groups all members of the group have the same rights, each member is responsible only for themselves (group members do not make decisions for other group members), each group is autonomous, everyone attends the group on account of their own problems, whatever is discussed in the group remains confidential, and participation is free of charge.
Professionally Led Group Psychotherapy
Self-help groups are not intended to provide “deep” psychotherapy. Nevertheless, their emphasis on psychosocial processes and the understanding shared by those with the same or similar mental illnesses does achieve constructive treatment goals.
Interpersonal learning, which is done through processes such as feedback and confrontation, is generally deemphasized in self-help groups. This is largely because it can be threatening, and requires training and understanding of small group processes. Similarly, reality testing is also deemphasized. Reality testing relies on consensual validation, offering feedback, seeking feedback and confrontation. These processes seldom occur in self-help groups, though they frequently occur in professionally directed groups.
Professional Affiliation and Group Lifespan
If self-help groups are not affiliated with a national organisation, professional involvement increases their life expectancy. Conversely, if particular groups are affiliated with a national organisation professional involvement decreases their life expectancy. Rules enforcing self-regulation in Talking Groups are essential for the group’s effectiveness.
Typology of Self-Help Groups
In 1991 researchers Marsha A. Schubert and Thomasina Borkman created five conceptual categorizations for self-help groups.
Unaffiliated Groups
Unaffiliated groups are defined as self-help groups that function independently from any control at state or national levels, and from any other group or professionals. These groups accept all potential members, and everyone has an equal opportunity to volunteer or be elected. Leaders serve to help the groups function by collecting donations not through controlling the members. Experiential knowledge is mostly found, and there is a high emphasis on sharing. An example of an unaffiliated group includes Wildflowers’ Movement in Los Angeles.
Federated Groups
Federated groups have superordinate levels of their own self-help organisation at state or national levels which makes publicity and literature available. The local unit of the federated self-help group retains full control of its decisions. These groups tend to rely on experiential knowledge, and professionals rarely directly interact. The leaders of these groups would be any members comfortable with the format and willing to accept responsibilities. Leaders do not need to have formal training to gain their title. Examples of a federated self-help group would be Depression and Bipolar Support Alliance (DBSA) and Recovery International.
Affiliated Groups
Affiliated groups are subordinate to another group, a regional or national level of their own organisation. Local groups conform to the guidelines of the regional/national groups. Leaders are self-helpers not professional caregivers, and meetings included educational activities and sharing, supplemented by research and professionals. Examples of an affiliated self-help group would be the National Alliance on Mental Illness (NAMI).
Managed Groups
Managed groups are based on a combination of self-help and professional techniques. These groups are populated generally through referrals and group activities are led by group members. Managed groups do not meet all the criteria for self-help groups, and so should be designated professionally controlled support groups. Examples of managed groups are common with support groups in hospitals, such as those with breast cancer survivors and patients that may be managed by a nurse or therapist in some professional fashion.
Hybrid Groups
The hybrid group has characteristics of the affiliated and managed groups. Like affiliated groups, hybrid groups are organised by another level of their own organisation. To participate in specialised roles, training is developed by a higher level and enforced through trained leaders or facilitators. Like a managed group, a hybrid group cooperates and interacts with professionals, and that knowledge is highly valued alongside experiential knowledge.
Group Processes
No two self-help group are exactly alike, the make-up and attitudes are influenced by the group ideology and environment. In most cases, the group becomes a miniature society that can function like a buffer between the members and the rest of the world. The most essential processes are those that meet personal and social needs in an environment of safety and simplicity. Elegant theoretical formulations, systematic behavioural techniques, and complicated cognitive-restructuring methods are not necessary.
Despite the differences, researchers have identified many psychosocial processes occurring in self-help groups related to their effectiveness. This list includes, but is not limited to: acceptance, behavioural rehearsal, changing member’s perspectives of themselves, changing member’s perspectives of the world, catharsis, extinction, role modelling, learning new coping strategies, mutual affirmation, personal goal setting, instilling hope, justification, normalisation, positive reinforcement, reducing social isolation, reducing stigma, self-disclosure, sharing (or “opening up”), and showing empathy.
Five theoretical frameworks have been used in attempts to explain the effectiveness of self-help groups.
Theory
Outline
Social Support
Having a community of people to give physical and emotional comfort, people who love and care, is a moderating factor in the development of psychological and physical disease.
Experiential Knowledge
Members obtain specialised information and perspectives that other members have obtained through living with severe mental illness. Validation of their approaches to problems increases their confidence.
Social Learning Theory
Members with experience become credible role models.
Social Comparison Theory
Individuals with similar mental illness are attracted to each other in order to establish a sense of normalcy for themselves. Comparing one another to each other is considered to provide other peers with an incentive to change for the better either through upward comparison (looking up to someone as a role model) or downward comparison (seeing an example of how debilitating mental illness can be).
Helper Theory
Those helping each other feel greater interpersonal competence from changing other’s lives for the better. The helpers feel they have gained as much as they have given to others. The helpers receive “personalized learning” from working with helpees. The helpers’ self-esteem improves with the social approval received from those they have helped, putting them in a more advantageous position to help others.
A framework derived from common themes in empirical data describes recovery as a contextual nonlinear process, a trend of general improvement with unavoidable paroxysms while negotiating environmental, socioeconomic and internal forces, motivated by a drive to move forward in one’s life. The framework identified several negotiation strategies, some designed to accommodate illnesses and others designed to change thinking and behaviour. The former category includes strategies such as acceptance and balancing activities. The latter includes positive thinking, increasing one’s own personal agency/control and activism within the mental health system.
Relationship with Mental Health Professionals
A 1978 survey of mental health professionals in the United States found they had a relatively favourable opinion of self-help groups and there was a hospitable climate for integration and cooperation with self-help groups in the mental health delivery system. The role of self-help groups in instilling hope, facilitating coping, and improving the quality of life of their members is now widely accepted in many areas both inside and outside of the general medical community.
The 1987 Surgeon’s General Workshop marked a publicised call for egalitarian relationships with self-help groups. Surgeon General C. Everett Koop presented at this workshop, advocating for relationships that are not superordinate-subordinate, but rather emphasizing respectful, equal relations.
A survey of psychotherapists in Germany found that 50% of the respondents reported a high or very high acceptance of self-help groups and 43.2% rated their acceptance of self-help groups as moderate. Only 6.8% of respondents rated their acceptance of self-help groups as low or very low.
Surveys of self-help groups have shown very little evidence of antagonism towards mental health professionals. The maxim of self-help groups in the United States is “Doctors know better than we do how sickness can be treated. We know better than doctors how sick people can be treated as humans.”
Referrals
A large majority of self-help users use professional services as a gateway to self-help services, or concurrently with professional service or the aftercare following professional service. Professional referrals to self-help groups thus can be a cost-effective method of continuing mental health services and the two can co-exist within their own fields. While twelve-step groups, such as Alcoholics Anonymous, make an indispensable contribution to the mental and/or substance use (M/SU) professional services system, a vast number of non-twelve-step groups remain underutilised within that system.
Professional referrals to self-help groups for mental health are less effective than arranging for prospective self-help members to meet with veterans of the self-help group. This is true even when compared to referrals from professionals familiar with the self-help group when referring clients to it. Referrals mostly come from informal sources (e.g. family, friends, word of mouth, self). Those attending groups as a result of professional referrals account for only one fifth to one-third of the population. One survey found 54% of members learned about their self-help group from the media, 40% learned about their group from friends and relatives, and relatively few learned about them from professional referrals.
Effectiveness
Self-help groups are effective for helping people cope with, and recover from, a wide variety of problems. German Talking Groups have been shown to be as effective as psychoanalytically oriented group therapy. Participation in self-help groups for mental health is correlated with reductions in psychiatric hospitalisations, and shorter hospitalisations if they occur. Members demonstrate improved coping skills, greater acceptance of their illness, improved medication adherence, decreased levels of worry, higher satisfaction with their health, improved daily functioning and improved illness management. Participation in self-help groups for mental health encourages more appropriate use of professional services, making the time spent in care more efficient. The amount of time spent in the programmes, and how proactive the members are in them, has also been correlated with increased benefits. Decreased hospitalisation and shorter durations of hospitalisation indicate that self-help groups result in financial savings for the health care system, as hospitalisation is one of the most expensive mental health services. Similarly, reduced utilisation of other mental health services may translate into additional savings for the system.
While self-help groups for mental health increase self-esteem, reduce stigma, accelerate rehabilitation, improve decision-making, decrease tendency to decompensate under stress, and improve social functioning, they are not always shown to reduce psychiatric symptomatology. The therapeutic effects are attributed to the increased social support, sense of community, education and personal empowerment.
Members of self-help groups for mental health rated their perception of the group’s effectiveness on average at 4.3 on a 5-point Likert scale.
Social support, in general, can lead to added benefits in managing stress, a factor that can exacerbate mental illness.
Select List of Organisations
Depressed Anonymous
Depressed Anonymous (DA) is based on the model pioneered by Alcoholics Anonymous and open to anyone who wants to stop saddening themselves.
Emotions Anonymous
Emotions Anonymous (EA) is a derivative programme of Neurotics Anonymous and open to anyone who wants to achieve emotional well-being. Following the Twelve Traditions, EA groups cannot accept outside contributions.
GROW
GROW was founded in Sydney, Australia, in 1957 by a Roman Catholic priest, Father Cornelius Keogh, and people who had sought help with their mental illness at Alcoholics Anonymous (AA) meetings. After its inception, GROW members learned of Recovery, Inc. (the organisation now known as Recovery International, see below) and integrated its processes into their programme. GROW’s original literature includes the Twelve Stages of Decline, which state that emotional illness begins with self-centeredness, and the Twelve Steps of Recovery and Personal Growth, a blend of AA’s Twelve Steps and will-training methods from Recovery International. GROW groups are open to anyone who would like to join, though they specifically recruit people who have been in psychiatric hospitals or are socioeconomically disadvantaged. GROW does not operate with funding restrictions and have received state and outside funding in the past.
Neurotics Anonymous
Neurotics Anonymous is a twelve-step programme open to anyone with a desire to become emotionally well. According to the Twelve Traditions followed in the programme, Neurotics Anonymous is unable to accept outside contributions. The term “neurotics” or “neuroses” has since fallen out of favour with mental health professionals, with the movement away from the psychoanalytic principles of a DSM-II. Branches of Neurotics Anonymous have since changed their name to Emotions Anonymous, which is currently the name in favour with the Minnesota Groups. Groups in Mexico, however, called Neuróticos Anónimos still are referred to by the same name, due to the term “neuroticos” having a less pejorative connotation in Spanish. This branch continues to flourish in Mexico City as well as largely Spanish-speaking cities in the United States, such as Los Angeles.
Recovery International
Recovery, Inc. was founded in Chicago, Illinois, in 1937 by psychiatrist Abraham Low using principles in contrast to those popularised by psychoanalysis. During the organisation’s annual meeting in June 2007 it was announced that Recovery, Inc. would thereafter be known as Recovery International. Recovery International is open to anyone identifying as “nervous” (a compromise between the loaded term neurotic and the colloquial phrase “nervous breakdown”); strictly encourages members to follow their physician’s, social worker’s, psychologist’s or psychiatrist’s orders; and does not operate with funding restrictions.
Fundamentally, Low believes “Adult life is not driven by instincts but guided by Will,” using a definition of will opposite of Arthur Schopenhauer’s. Low’s programme is based on increasing determination to act, self-control, and self-confidence. Edward Sagarin compared it to a modern, reasonable, and rational implementation of Émile Coué’s psychotherapy. Recovery International is “twelve-step friendly.” Members of any twelve-step group are encouraged to attend Recovery International meetings in addition to their twelve-step group participation.
Criticism
There are several limitations of self-help groups for mental health, including but not limited to their inability to keep detailed records, lack of formal procedures to follow up with members, absence of formal screening procedures for new members, lack formal leadership training, and likely inability of members to recognise a “newcomer” presenting with a serious illness requiring immediate treatment. Additionally, there is a lack of professional or legal regulatory constraints determining how such groups can operate, there is a danger that members may disregard the advice of mental health professionals, and there can be an anti-therapeutic suppression of ambivalence and hostility. Researchers have also elaborated specific criticisms regarding self-help groups’ formulaic approach, attrition rates, over-generalisation, and “panacea complex”.
Formulaic Approach
Researchers have questioned whether formulaic approaches to self-help group therapy, like the Twelve Steps, could stifle creativity or if adherence to them may prevent the group from making useful or necessary changes. Similarly others have criticised self-help group structure as being too rigid.
High Attrition Rates
There is not a universal appeal of self-help groups; as few as 17% of people invited to attend a self-help group will do so. Of those, only one third will stay for longer than four months. Those who continue are people who value the meetings and the self-help group experience.
Overgeneralisation
Since these groups are not specifically diagnosis-related, but rather for anyone seeking mental and emotional health, they may not provide the necessary sense of community to evoke feelings of oneness required for recovery in self-help groups. Referent power is only one factor contributing to group effectiveness. A study of Schizophrenics Anonymous found expert power to be more influential in measurements of perceived group helpfulness.
Panacea Complex
There is a risk that self-help group members may come to believe that group participation is a panacea – that the group’s processes can remedy any problem.
Sexual Predation and Opportunism
Often membership of non-associated self-help groups is run by volunteers. Monitoring of relationships and standards of conduct are seldom formalised within a group and are done on a self-regulating basis. This can mean undesirable and unethical initiation of sexual and intimate encounters are facilitated in these settings. Predatory and opportunistic behaviour in these environments which by association involve divulging volatile mental states, medication changes and life circumstances mean opportunities by those willing to leverage information that is often normally guarded and deeply personal, is a risk more-so than in other social meetup settings or professionally governed bodies.
Repression is a key concept of psychoanalysis, where it is understood as a defence mechanism that “ensures that what is unacceptable to the conscious mind, and would if recalled arouse anxiety, is prevented from entering into it.”
According to psychoanalytic theory, repression plays a major role in many mental illnesses, and in the psyche of the average person.
There has been debate as to whether (or how often) memory repression really occurs and mainstream psychology holds that true memory repression occurs only very rarely. American psychologists began to attempt to study repression in the experimental laboratory around 1930. However, psychoanalysts were at first uninterested in attempts to study repression in laboratory settings, and later came to reject them. Most psychoanalysts concluded that such attempts misrepresented the psychoanalytic concept of repression.
Sigmund Freud’s Theory
As Sigmund Freud moved away from hypnosis, and towards urging his patients to remember the past in a conscious state, ‘the very difficulty and laboriousness of the process led Freud to a crucial insight’. The intensity of his struggles to get his patients to recall past memories led him to conclude that ‘there was some force that prevented them from becoming conscious and compelled them to remain unconscious … pushed the pathogenetic experiences in question out of consciousness. I gave the name of repression to this hypothetical process’.
Freud would later call the theory of repression “the corner-stone on which the whole structure of psychoanalysis rests” (“On the History of the Psycho-Analytic Movement”).
Freud developed many of his early concepts with his mentor, Josef Breuer. Moreover, while Freud himself noted that the philosopher Arthur Schopenhauer in 1884 had hinted at a notion of repression (but he had only read him in later life), he did not mention that Johann Friedrich Herbart, psychologist and founder of pedagogy whose ideas were very influential in Freud’s environment and in particular with Freud’s psychiatry teacher Theodor Meynert, had used the term in 1824 in his discussion of unconscious ideas competing to get into consciousness.
Stages
Freud considered that there was ‘reason to assume that there is a primal repression, a first phase of repression, which consists in the psychical (ideational) representative of the instinct being denied entrance into the conscious’, as well as a ‘second stage of repression, repression proper, which affects mental derivatives of the repressed representative: distinguished what he called a first stage of ‘primal repression’ from ‘the case of repression proper (“after-pressure”).’
In the primary repression phase, ‘it is highly probable that the immediate precipitating causes of primal repressions are quantitative factors such as … the earliest outbreaks of anxiety, which are of a very intense kind’. The child realises that acting on some desires may bring anxiety. This anxiety leads to repression of the desire.
When it is internalised, the threat of punishment related to this form of anxiety becomes the superego, which intercedes against the desires of the id (which works on the basis of the pleasure principle). Freud speculated that ‘it is perhaps the emergence of the super-ego which provides the line of demarcation between primal repression and after-pressure
Therapy
Abnormal repression, as defined by Freud, or neurotic behaviour occurs when repression develops under the influence of the superego and the internalised feelings of anxiety, in ways leading to behaviour that is illogical, self-destructive, or antisocial.
A psychotherapist may try to ameliorate this behaviour by revealing and reintroducing the repressed aspects of the patient’s mental processes to their conscious awareness – ‘assuming the role of mediator and peacemaker … to lift the repression’. In favourable circumstances, ‘Repression is replaced by a condemning judgement carried out along the best lines’, thereby reducing anxiety over the impulses involved.
Reactions
The philosopher Jean-Paul Sartre challenged Freud’s theory by maintaining that there is no “mechanism” that represses unwanted thoughts. Since “all consciousness is conscious of itself” we will be aware of the process of repression, even if skilfully dodging an issue. The philosopher Thomas Baldwin stated in The Oxford Companion to Philosophy (1995) that Sartre’s argument that Freud’s theory of repression is internally flawed is based on a misunderstanding of Freud. The philosopher Roger Scruton argued in Sexual Desire (1986) that Freud’s theory of repression disproves the claim, made by Karl Popper and Ernest Nagel, that Freudian theory implies no testable observation and therefore does not have genuine predictive power, since the theory has “strong empirical content” and implies testable consequences.
Later Developments
The psychoanalyst Otto Fenichel stressed that ‘if the disappearance of the original aim from consciousness is called repression, every sublimation is a repression (a “successful” one: through the new type of discharge, the old one has become superfluous)’.
The psychoanalyst Jacques Lacan stressed the role of the signifier in repression – ‘the primal repressed is a signifier’ – examining how the symptom is ‘constituted on the basis of primal repression, of the fall, of the Unterdrückung, of the binary signifier … the necessary fall of this first signifier’.
Family therapy has explored how familial taboos lead to ‘this screening-off that Freud called “repression”‘, emphasising the way that ‘keeping part of ourselves out of our awareness is a very active process … a deliberate hiding of some feeling from our family’.
Experimental Attempts to Study Repression
According to the psychologist Donald W. MacKinnon and his co-author William F. Dukes, American psychologists began to attempt to study repression in the experimental laboratory around 1930. These psychologists were influenced by an exposition of the concept of repression published by the psychoanalyst Ernest Jones in the American Journal of Psychology in 1911. Like other psychologists who attempted to submit the claims of psychoanalysis to experimental test, they did not immediately try to develop new techniques for that purpose, instead conducting surveys of the psychological literature to see whether “experiments undertaken to test other theoretical assertions” had produced results relevant to assessing psychoanalysis. In 1930, H. Meltzer published a survey of experimental literature on “the relationships between feeling and memory” in an attempt to determine the relevance of laboratory findings to “that aspect of the theory of repression which posits a relationship between hedonic tone and conscious memory.” However, according to MacKinnon and Dukes, because Meltzer had an inadequate grasp of psychoanalytic writing he misinterpreted Freud’s view that the purpose of repression is to avoid “unpleasure”, taking the term to mean simply something unpleasant, whereas for Freud it actually meant deep-rooted anxiety. Nevertheless, Meltzer pointed out shortcomings in the studies he reviewed, and in MacKinnon and Dukes’s view he also “recognized that most of the investigations which he reviewed had not been designed specifically to test the Freudian theory of repression.”
In 1934, the psychologist Saul Rosenzweig and his co-author G. Mason criticized Meltzer, concluding that the studies he reviewed suffered from two basic problems: that the studies “worked with hedonic tone associated with sensory stimuli unrelated to the theory of repression rather than with conative hedonic tone associated with frustrated striving, which is the only kind of ‘unpleasantnesss’ which, according to the Freudian theory, leads to repression” and that they “failed to develop under laboratory control the experiences which are subsequently to be tested for recall”. In MacKinnon and Dukes’s view, psychologists who wanted to study repression in the laboratory “faced the necessity of becoming clear about the details of the psychoanalytic formulation of repression if their researches were to be adequate tests of the theory” but soon discovered that “to grasp clearly even a single psychoanalytic concept was an almost insurmountable task.” MacKinnon and Dukes attribute this situation to the way in which Freud repeatedly modified his theory “without ever stating clearly just which of his earlier formulations were to be completely discarded, or if not discarded, how they were to be understood in the light of his more recent assertions.”
MacKinnon and Dukes write that, while psychoanalysts were at first only disinterested in attempts to study repression in laboratory settings, they later came to reject them. They comment that while
“the psychologists had criticized each other’s researches largely on the grounds that their experimental techniques and laboratory controls had not been fully adequate, the psychoanalysts rejected them on the more sweeping grounds that whatever else these researches might be they simply were not investigations of repression.”
They relate that in 1934, when Freud was sent reprints of Rosenzweig’s attempts to study repression, he responded with a dismissive letter stating that “the wealth of reliable observations” on which psychoanalytic assertions were based made them “independent of experimental verification.” In the same letter, Freud concluded that Rosenzweig’s studies “can do no harm.” MacKinnon and Dukes describe Freud’s conclusion as a “first rather casual opinion”, and state that most psychoanalysts eventually adopted a contrary view, becoming convinced that “such studies could indeed be harmful since they misrepresented what psychoanalysts conceived repression to be.”
Writing in 1962, MacKinnon and Dukes state that experimental studies “conducted during the last decade” have largely abandoned the term “repression”, choosing instead to refer to the phenomenon as “perceptual defence”. They argue that this change of terminology has had a major effect on how the phenomenon is understood, and that psychoanalysts, who had attacked earlier studies of repression, did not criticise studies of perceptual defence in a similar fashion, instead neglecting them. They concluded by noting that psychologists remained divided in their view of repression, some regarding it as well-established, others as needing further evidence to support it, and still others finding it indefensible.
A 2020 meta-analysis of 25 studies examined the evidence that active memory suppression actually leads to decreased memory. It was found that in people with a repressive coping strategy, the wilful avoidance of remembering certain memory contents leads to a significant reduction in memory performance for these contents. In addition, healthy people were better able to do this than anxious or depressed people. These results indicate that forgetting induced by suppression is a hallmark of mental wellbeing.
Repressed Memories
One of the issues Freud struggled with was the status of the childhood “memories” recovered from repression in his therapy. He concluded that “these scenes from infancy are not always true. Indeed, they are not true in the majority of cases, and in a few of them they are the direct opposite of the historical truth”. Controversy arose in the late 20th century about the status of such “recovered memories”, particularly of child abuse, with many claiming that Freud had been wrong to ignore the reality of such recovered memories.
While accepting “the realities of child abuse”, the feminist Elaine Showalter considered it important that one “distinguishes between abuse remembered all along, abuse spontaneously remembered, abuse recovered in therapy, and abuse suggested in therapy”. Memory researcher Elizabeth Loftus has shown that it is possible to implant false memories in individuals and that it is possible to “come to doubt the validity of therapeutically recovered memories of sexual abuse … [as] confabulations”. However, criminal prosecutors continue to present them as evidence in legal cases.
There is debate about the possibility of the repression of psychological trauma. While some evidence suggests that “adults who have been through overwhelming trauma can suffer a psychic numbing, blocking out memory of or feeling about the catastrophe”, it appears that the trauma more often strengthens memories due to heightened emotional or physical sensations (However these sensations may also cause distortions, as human memory in general is filtered both by layers of perception, and by “appropriate mental schema … spatio-temporal schemata”).
A relaxation technique (also known as relaxation training) is any method, process, procedure, or activity that helps a person to relax; to attain a state of increased calmness; or otherwise reduce levels of pain, anxiety, stress or anger.
Relaxation techniques are often employed as one element of a wider stress management programme and can decrease muscle tension, lower the blood pressure and slow heart and breath rates, among other health benefits.
People respond to stress in different ways, namely, by becoming overwhelmed, depressed or both. Yoga, QiGong, Taiji, and Pranayama that includes deep breathing tend to calm people who are overwhelmed by stress, while rhythmic exercise improves the mental and physical health of those who are depressed. People who encounter both symptoms simultaneously, feeling depressed in some ways and overexcited in others, may do best by walking or performing yoga techniques that are focused on strength.
Background
Research has indicated that removing stress helps to increase a person’s health.
Research released in the 1980s indicated stronger ties between stress and health and showed benefits from a wider range of relaxation techniques than had been previously known. This research received national media attention, including a New York Times article in 1986.
Uses
People use relaxation techniques for a variety of reasons, including but not limited to:
Anger management.
Anxiety attacks.
Cardiac health.
Childbirth.
Depression.
General well-being.
Headache.
High blood pressure.
Preparation for hypnosis.
Immune system support.
Insomnia.
Pain management.
Relaxation (psychology).
Stress management.
Addiction treatment.
Nightmare disorder.
Techniques
Various techniques are used by individuals to improve their state of relaxation. Some of the methods are performed alone; some require the help of another person (often a trained professional); some involve movement, some focus on stillness; while other methods involve different elements.
Certain relaxation techniques known as “formal and passive relaxation exercises” are generally performed while sitting or lying quietly, with minimal movement and involve “a degree of withdrawal”. These include:
Autogenic training.
Biofeedback.
Deep breathing.
Guided imagery.
Hypnosis.
Meditation.
Pranayama.
Progressive muscle relaxation.
Qigong.
Transcendental Meditation technique.
Yoga Nidra.
Zen Yoga.
Movement-based relaxation methods incorporate exercise such as walking, gardening, yoga, T’ai chi, Qigong, and more. Some forms of bodywork are helpful in promoting a state of increased relaxation. Examples include massage, acupuncture, the Feldenkrais Method, myotherapy, reflexology and self-regulation.
Some relaxation methods can also be used during other activities, for example, autosuggestion and prayer. At least one study has suggested that listening to certain types of music, particularly new-age music and classical music, can increase feelings associated with relaxation, such as peacefulness and a sense of ease.
A technique growing in popularity is flotation therapy, which is the use of a float tank in which a solution of Epsom salt is kept at skin temperature to provide effortless floating. Research in the US and Sweden has demonstrated a powerful and profound relaxation after twenty minutes. In some cases, floating may reduce pain and stress and has been shown to release endorphins.
Even actions as simple as a walk in the park have been shown to aid feelings of relaxation, regardless of the initial reason for the visit.
The introspection illusion is a cognitive bias in which people wrongly think they have direct insight into the origins of their mental states, while treating others’ introspections as unreliable.
The illusion has been examined in psychological experiments, and suggested as a basis for biases in how people compare themselves to others. These experiments have been interpreted as suggesting that, rather than offering direct access to the processes underlying mental states, introspection is a process of construction and inference, much as people indirectly infer others’ mental states from their behaviour.
When people mistake unreliable introspection for genuine self-knowledge, the result can be an illusion of superiority over other people, for example when each person thinks they are less biased and less conformist than the rest of the group. Even when experimental subjects are provided with reports of other subjects’ introspections, in as detailed a form as possible, they still rate those other introspections as unreliable while treating their own as reliable. Although the hypothesis of an introspection illusion informs some psychological research, the existing evidence is arguably inadequate to decide how reliable introspection is in normal circumstances.
In certain situations, this illusion leads people to make confident but false explanations of their own behaviour (called “causal theories”) or inaccurate predictions of their future mental states.
Correction for the bias may be possible through education about the bias and its unconscious nature.
Components
The phrase “introspection illusion” was coined by Emily Pronin. Pronin describes the illusion as having four components:
People give a strong weighting to introspective evidence when assessing themselves.
They do not give such a strong weight when assessing others.
People disregard their own behaviour when assessing themselves (but not others).
Own introspections are more highly weighted than others. It is not just that people lack access to each other’s introspections: they regard only their own as reliable.
Unreliability of Introspection
The idea that people can be mistaken about their inner functioning is one applied by eliminative materialists. These philosophers suggest that some concepts, including “belief” or “pain” will turn out to be quite different from what is commonly expected as science advances. The faulty guesses that people make to explain their thought processes have been called “causal theories”. The causal theories provided after an action will often serve only to justify the person’s behaviour in order to relieve cognitive dissonance. That is, a person may not have noticed the true reasons for their behaviour, even when trying to explain it. The result is an explanation that mostly merely makes themselves feel better. An example might be a man who mistreats others who have a specific quality because he is embarrassed that he himself has that quality. He may not admit this to himself, instead claiming that his prejudice is because he has concluded that the specific quality is bad.
A 1977 paper by psychologists Richard Nisbett and Timothy D. Wilson challenged the directness and reliability of introspection, thereby becoming one of the most cited papers in the science of consciousness. Nisbett and Wilson reported on experiments in which subjects verbally explained why they had a particular preference, or how they arrived at a particular idea. On the basis of these studies and existing attribution research, they concluded that reports on mental processes are confabulated. They wrote that subjects had, “little or no introspective access to higher order cognitive processes”. They distinguished between mental contents (such as feelings) and mental processes, arguing that while introspection gives us access to contents, processes remain hidden.
Although some other experimental work followed from the Nisbett and Wilson paper, difficulties with testing the hypothesis of introspective access meant that research on the topic generally stagnated. A ten-year-anniversary review of the paper raised several objections, questioning the idea of “process” they had used and arguing that unambiguous tests of introspective access are hard to achieve. Updating the theory in 2002, Wilson admitted that the 1977 claims had been too far-reaching. He instead relied on the theory that the adaptive unconscious does much of the moment-to-moment work of perception and behaviour. When people are asked to report on their mental processes, they cannot access this unconscious activity. However, rather than acknowledge their lack of insight, they confabulate a plausible explanation, and “seem” to be “unaware of their unawareness”.
A study conducted by philosopher Eric Schwitzgebel and psychologist Russell T. Hurlburt was set up to measure the extent of introspective accuracy by gathering introspective reports from a single individual who was given the pseudonym “Melanie”. Melanie was given a beeper which sounded at random moments, and when it did she had to note what she was currently feeling and thinking. After analysing the reports the authors had mixed views about the results, the correct interpretation of Melanie’s claims and her introspective accuracy. Even after long discussion the two authors disagreed with each other in the closing remarks, Schwitzgebel being pessimistic and Hurlburt optimistic about the reliability of introspection.
Factors in Accuracy
Nisbett and Wilson conjectured about several factors that they found to contribute to the accuracy of introspective self-reports on cognition.[8]
Availability: Stimuli that are highly salient (either due to recency or being very memorable) are more likely to be recalled and considered for the cause of a response.
Plausibility: Whether a person finds a stimulus to be a sufficiently likely cause for an effect determines the influence it has on their reporting of the stimulus.
Removal in time: The greater the distance in time since the occurrence of an event, the less available and more difficult to accurately recall it is.
Mechanics of judgement: People do not recognise the influence that judgment factors (e.g. position effects) have on them, leading to inaccuracies in self-reporting.
Context: Focusing on the context of an object distracts from evaluation of that object and can lead people to falsely believe that their thoughts about the object are represented by the context.
Non-events: The absence of an occurrence is naturally less salient and available than an occurrence itself, leading non-events to have little influence on reports.
Nonverbal behaviour: While people receive a large amount of information about others via nonverbal cues, the verbal nature of relaying information and the difficulty of translating nonverbal behaviour into verbal form lead to its lower reporting frequency.
Discrepancy between the magnitudes of cause and effect: Because it seems natural to assume that a certain size cause will lead to a similarly-sized effect, connections between causes and effects of different magnitudes are not often drawn.
Unawareness of Error
Several hypotheses to explain people’s unawareness of their inaccuracies in introspection were provided by Nisbett and Wilson:
Confusion between content and process: People are usually unable to access the exact process by which they arrived at a conclusion, but can recall an intermediate step prior to the result. However, this step is still content in nature, not a process. The confusion of these discrete forms leads people to believe that they are able to understand their judgment processes. Nisbett and Wilson have been criticized for failing to provide a clear definition of the differences between mental content and mental processes.
Knowledge of prior idiosyncratic reactions to a stimulus: An individual’s belief that they react in an abnormal manner to a stimulus, which would be unpredictable from the standpoint of an outside observer, seems to support true introspective ability. However, these perceived covariations may actually be false, and truly abnormal covariations are rare.
Differences in causal theories between subcultures: The inherent differences between discrete subcultures necessitates that they have some differing causal theories for any one stimulus. Thus, an outsider would not have the same ability to discern a true cause as would an insider, again making it seem to the introspector that they have the capacity to understand the judgment process better than can another.
Attentional and intentional knowledge: An individual may consciously know that they were not paying attention to a certain stimulus or did not have a certain intent. Again, as insight that an outside observer does not have, this seems indicative of true introspective ability. However, the authors note that such knowledge can actually mislead the individual in the case that it is not as influential as they may think.
Inadequate feedback: By nature, introspection is difficult to be disconfirmed in everyday life, where there are no tests of it and others tend not to question one’s introspections. Moreover, when a person’s causal theory of reasoning is seemingly disconfirmed, it is easy for them to produce alternative reasons for why the evidence is actually not disconfirmatory at all.
Motivational reasons: Considering one’s own ability to understand their reasoning as being equivalent to an outsider’s is intimidating and a threat to the ego and sense of control. Thus, people do not like to entertain the idea, instead maintaining the belief that they can accurately introspect.
Criticisms
The claim that confabulation of justifications evolved to relieve cognitive dissonance is criticized by some evolutionary biologists for assuming the evolution of a mechanism for feeling dissonanced by a lack of justification. These evolutionary biologists argue that if causal theories had no higher predictive accuracy than prejudices that would have been in place even without causal theories, there would be no evolutionary selection for experiencing any form of discomfort from lack of causal theories. The claim that studies in the United States that appear to show a link between homophobia and homosexuality can be explained by an actual such link is criticised by many scholars. Since much homophobia in the United States is due to religious indoctrination and therefore unrelated to personal sexual preferences, they argue that the appearance of a link is due to volunteer-biased erotica research in which religious homophobes fear God’s judgment but not being recorded as “homosexual” by Earthly psychologists while most non-homophobes are misled by false dichotomies to assume that the notion that men can be sexually fluid is somehow “homophobic” and “unethical”.
Choice Blindness
Inspired by the Nisbett and Wilson paper, Petter Johansson and colleagues investigated subjects’ insight into their own preferences using a new technique. Subjects saw two photographs of people and were asked which they found more attractive. They were given a closer look at their “chosen” photograph and asked to verbally explain their choice. However, in some trials, the experimenter had slipped them the other photograph rather than the one they had chosen, using sleight of hand. A majority of subjects failed to notice that the picture they were looking at did not match the one they had chosen just seconds before. Many subjects confabulated explanations of their preference. For example, a man might say “I preferred this one because I prefer blondes” when he had in fact pointed to the dark-haired woman, but had been handed a blonde. These must have been confabulated because they explain a choice that was never made. The large proportion of subjects who were taken in by the deception contrasts with the 84% who, in post-test interviews, said that hypothetically they would have detected a switch if it had been made in front of them. The researchers coined the phrase “choice blindness” for this failure to detect a mismatch.
A follow-up experiment involved shoppers in a supermarket tasting two different kinds of jam, then verbally explaining their preferred choice while taking further spoonfuls from the “chosen” pot. However, the pots were rigged so that, when explaining their choice, the subjects were tasting the jam they had actually rejected. A similar experiment was conducted with tea. Another variation involved subjects choosing between two objects displayed on PowerPoint slides, then explaining their choice when the description of what they chose had been altered.
Research by Paul Eastwick and Eli Finkel (relationship psychologist) at Northwestern University also undermined the idea that subjects have direct introspective awareness of what attracts them to other people. These researchers examined male and female subjects’ reports of what they found attractive. Men typically reported that physical attractiveness was crucial while women identified earning potential as most important. These subjective reports did not predict their actual choices in a speed dating context, or their dating behaviour in a one-month follow-up.
Consistent with choice blindness, Henkel and Mather found that people are easily convinced by false reminders that they chose different options than they actually chose and that they show greater choice-supportive bias in memory for whichever option they believe they chose.
Criticisms
It is not clear, however, the extent to which these findings apply to real-life experience when we have more time to reflect or use actual faces (as opposed to gray-scale photos). As Professor Kaszniak points out: “although a priori theories are an important component of people’s causal explanations, they are not the sole influence, as originally hypothesized by Nisbett & Wilson. Actors also have privileged information access that includes some degree of introspective access to pertinent causal stimuli and thought processes, as well as better access (than observers) to stimulus-response covariation data about their own behaviour”. Other criticisms point out that people who volunteer to psychology lab studies are not representative of the general population and also are behaving in ways that do not reflect how they would behave in real life. Examples include people of many different non-open political ideologies, despite their enmity to each other, having a shared belief that it is “ethical” to give an appearance of humans justifying beliefs and “unethical” to admit that humans are open-minded in the absence of threats that inhibit critical thinking, making them fake justifications.
Attitude Change
Studies that ask participants to introspect upon their reasoning (for liking, choosing, or believing something, etc.) tend to see a subsequent decrease in correspondence between attitude and behaviour in the participants. For example, in a study by Wilson et al., participants rated their interest in puzzles that they had been given. Prior to rating, one group had been instructed to contemplate and write down their reasons for liking or disliking the puzzles, while the control group was given no such task. The amount of time participants spent playing with each puzzle was then recorded. The correlation between ratings of and time spent playing each puzzle was much smaller for the introspection group than the control group.
A subsequent study was performed to show the generalisability of these results to more “realistic” circumstances. In this study, participants were all involved in a steady romantic relationship. All were asked to rate how well-adjusted their relationship was. One group was beforehand asked to list all of the reasons behind their feelings for their partner, while the control group did not do so. Six months later, the experimenters followed up with participants to check if they were still in the same relationship. Those who had been asked to introspect showed much less attitude-behaviour consistency based upon correlations between earlier relationship ratings and whether they were still dating their partners. This shows that introspection was not predictive, but this also probably means that the introspection has changed the evolution of the relationship.
The authors theorise that these effects are due to participants changing their attitudes, when confronted with a need for justification, without changing their corresponding behaviours. The authors hypothesize that this attitude shift is the result of a combination of things: a desire to avoid feeling foolish for simply not knowing why one feels a certain way; a tendency to make justifications based upon cognitive reasons, despite the large influence of emotion; ignorance of mental biases (e.g. halo effects); and self-persuasion that the reasons one has come up with must be representative with their attitude. In effect, people attempt to supply a “good story” to explain their reasoning, which often leads to convincing themselves that they actually hold a different belief. In studies wherein participants chose an item to keep, their subsequent reports of satisfaction with the item decreased, suggesting that their attitude changes were temporary, returning to the original attitude over time.
Introspection by Focusing on Feelings
In contrast with introspection by focusing on reasoning, that which instructs one to focus on their feelings has actually been shown to increase attitude-behaviour correlations. This finding suggests that introspecting on one’s feelings is not a maladaptive process.
Criticisms
The theory that there are mental processes that act as justifications do not make behaviour more adaptive is criticized by some biologists who argue that the cost in nutrients for brain function selects against any brain mechanism that does not make behaviour more adapted to the environment. They argue that the cost in essential nutrients causes even more difficulty than the cost in calories, especially in social groups of many individuals needing the same scarce nutrients, which imposes substantial difficulty on feeding the group and lowers their potential size. These biologists argue that the evolution of argumentation was driven by the effectiveness of arguments on changing risk perception attitudes and life and death decisions to a more adaptive state, as “luxury functions” that did not enhance life and death survival would lose the evolutionary “tug of war” against the selection for nutritional thrift. While there have been claims of non-adaptive brain functions being selected by sexual selection, these biologists criticise any applicability to introspection illusion’s causal theories because sexually selected traits are most disabling as a fitness signal during or after puberty but human brains require the highest amount of nutrients before puberty (enhancing the nerve connections in ways that make adult brains capable of faster and more nutrient-efficient firing).
A Priori Causal Theories
In their classic paper, Nisbett and Wilson proposed that introspective confabulations result from a priori theories, of which they put forth four possible origins:
Explicit cultural rules (e.g., stopping at red traffic lights).
Implicit cultural theories, with certain schemata for likely stimulus-response relationships (e.g. an athlete only endorses a brand because he is paid to do so).
Individual observational experiences that lead one to form a theory of covariation (e.g. “I feel nervous. I always get nervous when I have to talk at meetings!”).
Similar connotation between stimulus and response.
The authors note that the use of these theories does not necessarily lead to inaccurate assumptions, but that this frequently occurs because the theories are improperly applied.
Explaining Biases
Pronin argues that over-reliance on intentions is a factor in a number of different biases. For example, by focusing on their current good intentions, people can overestimate their likelihood of behaving virtuously.
In Perceptions of Bias
The bias blind spot is an established phenomenon that people rate themselves as less susceptible to bias than their peer group. Emily Pronin and Matthew Kugler argue that this phenomenon is due to the introspection illusion. Pronin and Kugler’s interpretation is that when people decide whether someone else is biased, they use overt behaviour. On the other hand, when assessing whether or not they themselves are biased, people look inward, searching their own thoughts and feelings for biased motives. Since biases operate unconsciously, these introspections are not informative, but people wrongly treat them as reliable indication that they themselves, unlike other people, are immune to bias.
In their experiments, subjects had to make judgments about themselves and about other subjects. They displayed standard biases, for example rating themselves above the others on desirable qualities (demonstrating illusory superiority). The experimenters explained cognitive bias, and asked the subjects how it might have affected their judgement. The subjects rated themselves as less susceptible to bias than others in the experiment (confirming the bias blind spot). When they had to explain their judgments, they used different strategies for assessing their own and others’ bias.
Pronin and Kugler tried to give their subjects access to others’ introspections. To do this, they made audio recordings of subjects who had been told to say whatever came into their heads as they decided whether their answer to a previous question might have been affected by bias. Although subjects persuaded themselves they were unlikely to be biased, their introspective reports did not sway the assessments of observers.
When asked what it would mean to be biased, subjects were more likely to define bias in terms of introspected thoughts and motives when it applied to themselves, but in terms of overt behaviour when it applied to other people. When subjects were explicitly told to avoid relying on introspection, their assessments of their own bias became more realistic.
Additionally, Nisbett and Wilson found that asking participants whether biases (such as the position effect in the stocking study) had an effect on their decisions resulted in a negative response, in contradiction with the data.
In Perceptions of Conformity
Another series of studies by Pronin and colleagues examined perceptions of conformity. Subjects reported being more immune to social conformity than their peers. In effect, they saw themselves as being “alone in a crowd of sheep”. The introspection illusion appeared to contribute to this effect. When deciding whether others respond to social influence, subjects mainly looked at their behaviour, for example explaining other student’s political opinions in terms of following the group. When assessing their own conformity, subjects treat their own introspections as reliable. In their own minds, they found no motive to conform, and so decided that they had not been influenced.
In Perceptions of Control and Free Will
Psychologist Daniel Wegner has argued that an introspection illusion contributes to belief in paranormal phenomena such as psychokinesis. He observes that in everyday experience, intention (such as wanting to turn on a light) is followed by action (such as flicking a light switch) in a reliable way, but the processes connecting the two are not consciously accessible. Hence though subjects may feel that they directly introspect their own free will, the experience of control is actually inferred from relations between the thought and the action. This theory, called “apparent mental causation”, acknowledges the influence of David Hume’s view of the mind. This process for detecting when one is responsible for an action is not totally reliable, and when it goes wrong there can be an illusion of control. This could happen when an external event follows, and is congruent with, a thought in someone’s mind, without an actual causal link.
As evidence, Wegner cites a series of experiments on magical thinking in which subjects were induced to think they had influenced external events. In one experiment, subjects watched a basketball player taking a series of free throws. When they were instructed to visualise him making his shots, they felt that they had contributed to his success.
If the introspection illusion contributes to the subjective feeling of free will, then it follows that people will more readily attribute free will to themselves rather than others. This prediction has been confirmed by three of Pronin and Kugler’s experiments. When college students were asked about personal decisions in their own and their roommate’s lives, they regarded their own choices as less predictable. Staff at a restaurant described their co-workers’ lives as more determined (having fewer future possibilities) than their own lives. When weighing up the influence of different factors on behaviour, students gave desires and intentions the strongest weight for their own behaviour, but rated personality traits as most predictive of other people.
However, criticism of Wegner’s claims regarding the significance of introspection illusion for the notion of free will has been published.
Criticisms
Research shows that human volunteers can estimate their response times accurately, in fact knowing their “mental processes” well, but only with substantial demands made on their attention and cognitive resources (i.e. they are distracted while estimating). Such estimation is likely more than post hoc interpretation and may incorporate privileged information. Mindfulness training can also increase introspective accuracy in some instances. Nisbett and Wilson’s findings were criticized by psychologists Ericsson and Simon, among others.
Correction
A study that investigated the effect of educating people about unconscious biases on their subsequent self-ratings of susceptibility to bias showed that those who were educated did not exhibit the bias blind spot, in contrast with the control group. This finding provides hope that being informed about unconscious biases such as the introspection illusion may help people to avoid making biased judgments, or at least make them aware that they are biased. Findings from other studies on correction of the bias yielded mixed results. In a later review of the introspection illusion, Pronin suggests that the distinction is that studies that merely provide a warning of unconscious biases will not see a correction effect, whereas those that inform about the bias and emphasize its unconscious nature do yield corrections. Thus, knowledge that bias can operate during conscious awareness seems the defining factor in leading people to correct for it.
Timothy Wilson has tried to find a way out from “introspection illusion”, recounted in his book Strangers to Ourselves. He suggests that the observation of our own behaviours more than our thoughts can be one of the keys for clearer introspective knowledge.
Criticisms
Some 21st century critical rationalists argue that claims of correcting for introspection illusions or other cognitive biases pose a threat of immunising themselves to criticism by alleging that criticism of psychological theories that claim cognitive bias are “justifications” for cognitive bias, making it non-falsifiable by labelling of critics and also potentially totalitarian. These modern critical rationalists argue that defending a theory by claiming that it overcomes bias and alleging that critics are biased, can defend any pseudoscience from criticism; and that the claim that “criticism of A is a defence of B” is inherently incapable of being evidence-based, and that any actual “most humans” bias (if it existed) would be shared by most psychologists thus make psychological claims of biases a way of accusing unbiased criticism of being biased and marketing the biases as overcoming of bias.
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