Letters, January 2006

Responding to Lord Layard

I READ with interest the news item in November's Psychologist on Lord Layard's radical vision to increase access to psychological therapies. Layard argues that the evidence base around psychological therapies is beyond doubt, and in the interest of both the well-being and economic health of the nation such therapies must be available to all in a timely fashion. He believes that this could be funded by savings in invalidity benefits, by helping those with mental health problems back to work.
These ideas are having a dramatic impact on both policy makers and the providers of psychological therapy services. How should the Society respond? The Division of Clinical Psychology has taken a proactive stance, meeting with Lord Layard twice to discuss his ideas and also attending a Department of Health/National Institute of Mental Health 'visioning day'.
Some brief reflections on our discussions to date. Although the primary focus has been perceived as assisting people's return to work, the current proposals encompass all clients in need of psychological therapies irrespective of their age, whether they are on invalidity benefit, and whether they also present with other problems (learning disability or chronic health problem). Although he has suggested the creation of treatment centres targeting anxiety and depression, the needs of people with more severe and enduring mental health problems would also need to be addressed. Whereas the evidence for the efficacy of CBT interventions exists, the contribution of other evidenced-based psychotherapeutic approaches could also be factored within the design of psychotherapy services to ensure that clients have a real choice of talking therapies on offer by the NHS.
There are many outstanding questions to be answered. What is the structure of Psychological Treatment Centres? What is the skill mix and competences of the staff that might work within them? What are the workforce problems to be resolved to ensure that the right staff are recruited in sufficient numbers? What are the implications for education and training? What impact will the creation of these new services have on existing service provision? If the money was found, what assurances are there that it would get spent on commissioning the right types of education and training, together with appropriate service provision, and not just dissipated within the over-stretched budgets of the primary care trust within the NHS?
Answers to these questions will be critical in ensuring the success of this ambitious project, and the Society with all its membership expertise is in a unique position to provide them. As a first step we will continue our involvement in meetings with the key policy makers charged with taking this programme forward. Second, within the Society we need an opportunity for our own reflections and debate about these proposals. I have proposed to the Professional Practice Board that we set up a Society-wide workshop in the new year to debate these ideas and formulate a Society response as to how psychologists can help drive this agenda forward. If you have an interest in participating in this, either from a Society subsystem perspective or from your own expertise within the area, please indicate your willingness to attend a PPB seminar by e-mailing Nigel Atter, the PPB administrator, on [email protected].
Graham Turpin
Chair, Division of Clinical Psychology

Ageism and euthanasia

ASK yourself this: If Harold Shipman had decided to murder children instead of older adults, how many would he have succeeded in killing before being found out? I doubt very much whether it would have been in the hundreds, as we now suspect was the case.
Discrimination against older adults, and ageism generally, whether we choose to acknowledge it or not, exists and is all about us. Frequently, some of the worst expressions of ageism I hear come from older adults themselves, who have internalised the message that they hear repeatedly in their communities: that they have no worth and that they are as a consequence socially invisible. I often hear this in my practice in the form of depressed elderly patients saying to me, 'Surely there is a younger person who deserves your attention more than me.'
What worries me most with the euthanasia question, prompted by reading of the possibility of psychologists being involved in the process ('Assessing the right to die', News, November 2005) is that I can see how easily some of my frail clients could be bullied into making a decision as to whether to live or die by those they depend on most, namely professionals or even family. This possibility I find horrifying, and it is for this reason that I am implacably opposed to assisted suicide where it carries no consequences at all for the professionals involved.
By all means, if you feel on humanitarian grounds obliged to take this course of action with a patient, do so. However, it should be evaluated on a case-by-case basis within the courts, and you should be prepared to have the courage to accept the consequences. Let us trust the judiciary (or at least some wholly independent representative body), however cumbersome this may be, rather than a carte blanche option for professionals, where the potential for abuse may carry truly horrifying consequences.
Stéphane Duckett
Royal Free Hospital
London

Falling into the prejudice trap?

WE are disappointed by the letter from Barker et al. ('Countering bi-invisibility', November 2005), written in response to our September letter on sexual orientation research. Our letter referred to a recent study (Chivers et al., 2004) in which male bisexual participants only showed a sexual response to one sex (most frequently, but not entirely, men). We made the simple methodological point that the discrepancy between stated identity and behaviour meant that it would be problematic to include self-identified bisexual men in studies where clear predictions are made about the behaviour of gay men and lesbians.Barker et al. have sidestepped any discussion of the scientific merits (or otherwise) of the Chivers et al. study, in favour of the claim that such research renders bisexual people 'invisible', that it echoes biophobic stereotypes, colludes with 'outmoded prejudicial practices' and forces people into the categories 'gay' or 'straight'. In our view, such rhetorical tactics are implicit exhortations to not ask certain questions lest they cause politically incorrect thoughts in the minds of others (in philosophical terms, a kind of 'epistemophobia').
We ourselves deplore prejudice and bullying of any kind, but bullies don't need science in order to justify what they do – they do it anyway. Bullies can use truth as well as myths as the basis of their bullying, as is often the case when people are taunted for being fat or having a big nose. And it seems to us that the hectoring of some researchers for their alleged collusion with prejudicial practices is little short of bullying itself.
We certainly defend the right of people to call themselves bisexual and don't want to make anyone 'invisible', but we also support scientific research into sexuality – and not just sexual identity, which appears to be what Barker et al. consider that sexuality research should be. We also look forward to reading about the methodological problems that Barker et al. refer to in relation to Chivers' research, for without criticism it is impossible for science to progress (readers interested in this issue should also see Chivers, 2005).
Finally, we should apologise for our lack of mention of female bisexuality. This is not because we are anti-bisexual bigots who wish to render certain groups invisible, but rather for reasons of space. Female bisexuality appears to differ from male bisexuality both in frequency and in kind, so rather than extend this letter further in an attempt to explain, we simply refer readers to Wilson and Rahman (2005) and Chivers (2005).
David Hardman
London Metropolitan University
Tom Dickins
University of East London
Mark Sergeant
Nottingham Trent University

References
Chivers, M.L. (2005). A brief review and discussion of sex differences in the specificity of sexual arousal. Sexual and Relationship Therapy, 20, 377–390.
Chivers, M.L., Rieger, G., Latty, E. & Bailey, J.M. (2004). A sex difference in the specificity of sexual arousal. Psychological Science, 15, 736–744.
Wilson, G. & Rahman, Q. (2005). Born gay: The psychobiology of sexual orientation. London: Peter Owen.

'No sex please, we're asexual'

I WAS interested to read in The Psychologist about the recent research linking sexual orientation to the production of 'pheromones' and to activation in a specific brain area (News, July 2005; Letters, September 2005). However, I would like to support Peter Hegarty's call for the whole range of sexual identities to be included in future research on sexuality: i.e. lesbians, as well as homosexual men, should be of interest even if their sexuality does not involve men! Nor should bisexuals be excluded because some research indicates that only one sexual preference can be identified physiologically (Letters, November 2005). If these results are replicated in other studies, then future research should be investigating other possible physiological and psychological correlates.
I also propose the inclusion in sexual orientation research of the recently identified category of 'asexuals'. Asexuality is described in an article entitled 'Glad to be A' in the 16 October 2004 issue of the New Scientist (www.newscientist.com), in which a number of research studies conducted in the USA were reported and also the creation of the AVEN web forum (Asexuality Visibility and Education Network) at www.asexuality.org.
From these studies it seems that asexuality can encompass varying degrees of sexual attraction and arousal, from zero upwards, but the connection is not made to 'put them into practice' with someone else. Yet this feels 'normal' for that person. It could therefore be thought of as a different sexual orientation or identity.
In our highly sexed society, it is difficult for asexuals to 'come out' but more individuals are beginning to do just that as they realise there are others who feel the same. In a recent study estimating the prevalence of asexuality in the population, Bogaert analysed the results of a survey of sexual practices published in 1994, which included more than 18,000 people in the UK. He found the incidence of replies indicating asexuality was close to the rate for same-sex attraction (New Scientist, 16 October 2004). However, many asexuals seek emotional intimacy, some in romantic relationships and even marriage, so they may not be obviously visible.
I hope British researchers will include 'asexuality' in their studies and not dismiss it as of 'uncertain status', as bisexuality has been. If these sexual orientations cannot be differentiated from others by the physiological criteria used so far, then further investigations are needed to add to our understanding of the psychobiological nature of sexual identity. I believe there may also be a genetic/hereditary connection.
Dee Williams
St Claire
1 Heath Farm Lane
St Albans

Finding sex differences

YOUR report from the British Association Festival (October 2005) quoted David Skuse as saying: 'The theory that autism is the extreme of the male brain is not strongly supported by these data.' These data referred to Skuse's new study that whilst girls were better than boys at recognising emotions at age six, this sex difference had disappeared by late adolescence; and that there was no difference at any age in boys' and girls' ability to remember faces or to detect eye contact. I think Skuse may be overstating things in the conclusions he draws from this study.
First, finding a sex difference (female advantage) in emotion-recognition at age six needs some explanation, and is in line with the empathising-systemising (E-S) theory of sex differences as proposed in my book The Essential Difference.
Second, there are many studies showing that this female advantage in emotion recognition does persist and is found at older ages, including adulthood. Just because Skuse didn't find it in his study doesn't mean it doesn't exist.
It could equally well reflect the test he used. For example, if he used the same stimuli for six-year-olds and for late adolescents, then there may well have been ceiling effects by the later age. Without more information on the test itself, or the results, we cannot rule out that the female advantage in emotion recognition exists across the lifespan.
Typically, sex differences are only revealed when the test is challenging enough to produce a wide range of scores. Complex emotional expressions (such as embarrassment or envy) would therefore be a better test of this than basic emotional expressions (such as happy or sad). No details of what emotional expressions were tested in Skuse's study were given. Tests obviously have to be age-appropriate, and sensitive enough as instruments for measuring subtle individual differences.
It is of interest that when we were putting together the Mind Reading DVD-ROM of brief video clips of every human emotional expression as enacted by actors – and there are 412 distinct emotional expressions (www.jkp.com/mindreading) – we had to audition 10 times as many male actors as female to find actors who were able to produce convincing complex emotional expressions. So the sex difference may extend to communicating emotions as well as recognising these.
Third, memory for faces or detecting eye contact may not entail any empathising, just good memory or being able to compute the geometry of gaze direction. So the E-S theory would not necessarily predict any sex difference on these aspects of face perception.
All this is not to criticise Skuse's study, which sounds worthwhile and interesting, but to caution what conclusions can be drawn from it.
Simon Baron-Cohen
Autism Research Centre
Cambridge University

Uncoolness of school: from the online forum

A recent posting on The Psychologist's online forum (accessed via www.thepsychologist.org.uk) asked why academic achievement appears to be frowned upon by peers in UK schools: it's uncool to be clever. Although to some extent this may have always been the case, there appears to be an added angle of homophobic bullying – boys who do well or try hard are not just teased as 'geeks', they are 'gay' geeks. The posting argues that this pervasive anti-academic atmosphere leads to children hiding or reducing effort, and is the major issue facing schools. Here is one of the responses. 

THERE have been some investigations into this phenomenon, although none (to my knowledge) that could be remotely considered empirical. They tend to focus on the following issues.
l    Anti-authoritarian arguments. To be interested in education would be to ally oneself with the 'establishment' and authority. This is in itself not cool, as there in an element to coolness that requires defying authority.
l    Detachment. Being cool requires detachment and a certain level of non-interest. To participate in any form of education requires a certain amount of engaging and caring for the subject matter, Ergo, this cannot be cool by definition.
l    Popularity. Paul Graham's essay delves into the reasons why academic pursuit may conflict with the demands required to secure peer popularity (a concept related to, but not necessarily synonymous with, cool). Read it here: tinyurl.com/9kdut.
l    Anti-intellectualism. There have been observations of an anti-intellectual bent in Western society. Intelligence/knowledge is sometimes considered as alienating from the experience of the 'common man'. This is best observed in US politics with the success of Jimmy Carter (the self-proclaimed 'peanut farmer'), and Richard Nixon (who derogated his opponent Adlai Stevenson by calling him an 'egghead'). This is not necessarily linked to jealousy, but may be related to a suspiciousness of erudition and an egalitarian mistrust of anything that is not easily accessible.
l    A dawning realisation that school's primary intention may not be to educate, but to facilitate obedience and servility and act as an agent of domination. Arbitrary teacher control in an undemocratic environment, combined with frequent summary punishments, make some socially aware teenagers realise that fascism didn't end in 1945. Social control is never cool, and neither are its lackeys/collaborators.

The issue of homophobic bullying may be related to perceptions of differences and non-conformity. Ironically, the ultimate paradox of coolness lies in its delicate balance of non-conformity and adherence to certain social norms (e.g. blue jeans as a sign of individualism despite most of the population wearing them). It should be that belonging to a minority should make you more detached, thus more cool. However, within coolness, there should be an understanding of the object one is detached from, which may not be the case if something (e.g. homosexuality) is too far removed for everyone else to easily comprehend.
I agree it is a serious topic that should be discussed, but I do not think that this issue ends at the school gates. Education is now a commodity that is used for profit, rather than being an end in itself. In an increasingly materialistic culture it seems inevitable
to me that the value of knowledge for its own sake
will diminish.
Ian Barkataki

Ed Stones (1922-2005)

PSYCHOLOGY in general and educational psychologists in particular owe much to the greatly distinguished Professor Edgar Stones. Born in a Yorkshire mining village, he attended a village school and then won the scholarship which gave entry to the newly established grammar school. Thus began Stone's distinguished journey from impoverishment to academic acclaim.
At aged just fifteen an RAF apprenticeship enabled Ed to widen his horizons, presenting opportunities to meet young people from all over Britain. However, he did not react well to authoritarians demanding blind obedience, or to the 'stupidity of military systems', and he purchased a discharge. Ed applied to read psychology at Sheffield University and graduated in 1951with a BA (Hons), rapidly followed by a Diploma in Education and an MA in Education. Whilst teaching English literature, Ed Stones took a very critical view of widespread practices which used IQ tests as main criteria for the selection of children for grammar school places. This interest led him to apply to Manchester University, where he qualified as an Educational Psychologist.
Teachers, educational psychologists, academics and those interested in the development of learning processes, intelligence and assessment are internationally indebted to Ed Stones' seminal work Introduction to Educational Psychology, which broke new ground in its critical appraisal of IQ testing, discussion of ways in which psychology might support teachers and an emphasis on essential connections between language development and learning.
Professor Ed Stones' impressive body of published work and his respected reputation amongst professional colleagues eventually resulted in an appointment to the William Roscoe Chair of Education and Director of the Institute of Education at Liverpool University, where he founded the British Educational Research Association and the British Journal of Teacher Education, which continues as a legacy to his innovative approach to the facilitation of the study of education.
When the British Psychological Society honoured Professor Ed Stones for his distinguished contributions in the teaching of psychology in 1998, it awarded further recognition of his eminence in the profession. However, Ed felt that explanations for a current neglect of his published work lay in political trends which threaten teacher education in this country by favouring the 'transmission culture,' at the expense of encouraging children to become independent thinkers and learners.
Professor Ed Stones founded JET (The International Journal of Education and Teaching), and initiated its International Colloquium, attended by leading educators from more than 50 countries. He leaves a legacy of continuing challenges to an anti-intellectualisation, which Ed Stones believed has driven the changes imposed by politicians on education in the United Kingdom. The passing of this stubborn, resilient and internationally esteemed academic – a persistent idealist to the end and a good-hearted man who neither lost touch with his roots nor suffered fools easily – will be mourned widely by free-thinking psychologists with an enduring fondness for searching after essential truths and justice. Ed is survived by his partner, his former wife and a son and daughter. Liverpool University flew its flag at half-mast, following his death on 27 September. 
Golda Zafer-Smith
42a Beechwood Avenue
London N3

Disciplining plagiarists

I DISCUSSED the recent case of alleged plagiarism by a noted British psychiatrist and psychologist with an American colleague, to whom I sent the Guardian article on the matter (7 November). He made the following very shrewd observations.
Who is going to check his past work to determine if similar mistakes exist? He may have been doing it for years…and just got caught this time. How would one even set out to do such checking? Who are his peers who might recognise the work of others embedded in his own? How much of this goes on? What do we do? If it's a student we flunk them. If it's a colleague with tenure, we say tsk, tsk. If it's a colleague without tenure, we might send him/her away.
I think that those who are professional role models should expect to be treated no less stringently than students – who should be firmly penalised for plagiarism. I think the Society should certainly tackle these matters.
J.M. Wober
Flat C, 17 Lancaster Grove
London NW3