All posts by John pullyblank

M. Jackson Group Update – September 2021 – Conspiracies and Trust in Science

A collection of postings on a range of issues is available on our website (  This month’s post is from the British Psychological Society Research Digest.


COGNITIONAugust 10, 2021People Who Trust Science Are Less Likely To Fall For Misinformation — Unless It Sounds Sciencey

By Matthew Warren

“Trust in the science” is the kind of refrain commonly uttered by well-meaning individuals looking to promote positive, scientifically-backed change, such as encouraging action against climate change or improving uptake of vaccines. The hope is that if people are encouraged to trust science, they will not be duped by those who are promoting the opposite agenda — one which often flies in the face of scientific evidence. But are people actually less likely to fall for misinformation when they have trust in science?

Yes and no, according to a new a study in the Journal of Experimental Social Psychology. Thomas C O’Brien and colleagues from the University of Illinois Urbana-Champaign find that people with greater trust in science are generally less likely to believe misinformation. But when that misinformation is presented with scientific-sounding content to back it up, they become more easily duped by it.

In the first study, 532 online participants read an article about the “Valza virus”, which stated that the virus had been created as a bioweapon in a government lab and subsequently covered up. The article was written informally, in a style meant to imitate real online posts made by conspiracy theorists. In one condition, the article cited scientists who said that studies in their own lab proved that there had been a conspiracy; in the other, the article instead quoted activists.

Participants then answered questions about how much they believed the article (e.g. to what extent they agreed it was “credible” or “probably true”) and whether they felt it should be shared with a class studying current affairs. (They also answered other questions about their comprehension of the text, in order to obscure the purpose of the study). Finally, participants rated their own trust in science, responding to statements like “scientific theories are trustworthy”, and answered questions that probed their own understanding of scientific methodology.

The team found that, overall, people with a greater trust in science and/or a stronger understanding of methodology were less likely to believe the conspiracy theory. But the article’s content made a difference: people who had a high trust in science were more likely to believe the article if it had quoted scientists than if it had not. Similarly, this group was more likely to say that the article should be shared with the current affairs class if it had apparently scientific content. For people with lower levels of trust in science, whether or not the article had cited scientists made no difference to their beliefs or intentions to share it.

A subsequent study looked at people’s belief in a conspiracy theory about genetically modified foods, and this time used real articles and pictures from websites. All participants read that genetically modified foods caused tumours, and that this was being covered up. In one condition, they saw articles that referred to an actual scientific paper which supported the theory (and which, unknown to participants, has since been heavily criticised and retracted). In the other condition, they again read arguments by activists, without any scientific content.

The results were the same: although, overall, people who trusted in science were less likely to believe this conspiracy theory, their levels of belief increased when the article contained supposedly scientific content.

In a final study, the team found that people were less likely to believe the conspiracy about genetically modified foods when they had first been asked to think about times when it is important to critically evaluate evidence, compared to when they had been asked to think of times when science had benefited humanity.

The research suggests that trust in science can actually increase people’s vulnerability to pseudoscience, the authors write. Broad campaigns to promote trust in science may therefore not be that useful; instead, it may be more beneficial to promote critical analysis skills.

That said, there is clearly some benefit to trusting science: people with low trust in science tended to believe the conspiracy theories regardless of their content, while those with high trust only showed a tendency to believe them if they contained some (pseudo)scientific content. So it seems likely that those broad campaigns could still have some positive effects. Still, to help people spot misinformation it seems important to teach them to critically evaluate evidence and understand that science isn’t infallible.

– Misplaced trust: When trust in science fosters belief in pseudoscience and the benefits of critical evaluation

Matthew Warren (@MattBWarren) is Editor of BPS Research Digest

M. Jackson Group Update – August 2021 – Maintaining a Healthy Heart

A collection of postings on a range of issues is available on our website (  This month’s post is again from Ken Pope’s listserv, where he kindly provides daily summaries of current articles in the field. 

The New York Times includes an article: “7 Habits for a Healthy Heart” by Anahad O’Connor

Here are some excerpts:
[begin excerpts]

Worldwide, heart disease and strokes are the leading causes of death. They’re also the leading killers of Americans, accounting for one out of every three deaths in the United States. 

But there’s good news, too. About 80 percent of all cases of cardiovascular disease are preventable. You can lower your risk markedly by making some changes to your lifestyle including doing some things that are easy, simple and even enjoyable. 

Just Move

Regular exercise improves nearly every aspect of your health.

A Magic Pill

Dr. Michael Emery, a sports cardiologist, tells his patients that there is one magic pill that can improve nearly every aspect of your health and well-being, and especially your cardiovascular health: exercise.
Large studies have consistently found a strong and inverse relationship between physical activity and heart disease. 
Clinical trials have also shed light on the precise reasons exercise strengthens the heart: 

  • It enhances the cardiorespiratory system.
  • It increases HDL cholesterol.
  • It lowers triglycerides, a type of fat that circulates in the blood.     
  • It reduces blood pressure and heart rate.      
  • It lowers inflammation and improves blood sugar control.
  • It increases insulin sensitivity. 

Best of all, exercise is the type of medicine that appears to produce benefits no matter how small the dose.

What to Aim For

Anything is better than nothing. But the ideal dose of exercise for adults, according to the Centers for Disease Control and Prevention, is as follows:  

  • 150 minutes of moderate-intensity aerobic exercise a week.      
  • 2 sessions of about 30 minutes each of resistance training a week.

You can spread the aerobic activity throughout the week however you like, such as 30 minutes five days a week, or 50 minutes three days a week. Examples include running, swimming, brisk walking, riding a bike, playing basketball or tennis, and doing yard work. As for strength-building activities, ideally, you should set aside at least two days a week for 30 minutes of exercise that works the major muscle groups, such as the legs, back, shoulders and arms. What counts as strength training? Lifting weights, using resistance bands, doing bodyweight exercises like yoga, push ups and sit ups….

If you’re ready for more intense workout sessions, you should aim for:      

  • 75 minutes of vigorous aerobic exercise a week.
  • 2 sessions of at least 30 minutes each of resistance training a week.

Vigorous exercise should get your heart rate up to 70 to 85 percent of your maximum heart rate. Not sure what that is? Here’s how to calculate it
Exercises like running, swimming laps, playing basketball or cycling fast are good options. If these amounts sound like a lot more than you’re used to, keep in mind that you’re not alone. Only half of Americans get the recommended amount of aerobic exercise each week, and only 20 percent meet the guidelines for both aerobic and resistance exercise. But studies show that people who do just 50 minutes of vigorous aerobic exercise each week (instead of the recommended 75 minutes) still lower their risk of dying from cardiovascular disease by half compared with people who avoid it altogether. People who do small amounts of moderate exercise that fall short of the guidelines see benefits, too. 

“Any amount improves cardiovascular morbidity and mortality, even if it’s just getting out of your chair and taking a walk,” said Dr. Emery. If you can’t get to the “sweet spot,” he said, that’s “not a reason to not do it because you’re still gaining way more benefit than if you were sitting on the couch and not doing anything.”

Get Your Blood Pressure Checked

Make sure your heart isn’t working harder than it should be.

Avoid High Blood Pressure

High blood pressure, also known as hypertension, puts mechanical stress on the walls of your arteries, causing them to narrow and stiffen. The stress can increase the development of plaque and ultimately cause your heart muscle to get weaker and thicker over time. It can also cause blood vessels in your brain to rupture, leading to a stroke. 

Ideally your blood pressure should be no higher than 120/80. The top number is your “systolic” pressure, the pressure when your heart is contracting, and the lower number is your “diastolic” pressure, when your heart is at rest. Keeping those numbers in check is critical. 

Hypertension is a leading cause of heart attacks, and the single-most important risk factor for strokes. Almost a third of the adult population in the United States has the condition but about 20 percent of them don’t know it. 

You’re especially vulnerable to hypertension if you:

  • Are older. The prevalence of the disease increases sharply with age, from 7.3 percent of people between 18 and 39 to as high as 65 percent of people 60 and over.
  • Are black. About 40 percent of black adults have the condition, compared with 28 percent of non-Hispanic whites, 25 percent of Asian Americans and 26 percent of Hispanic adults.       
  • Have diabetes. Two thirds of adults with Type 2 diabetes have hypertension.
  • Have other, complicating conditions, such as sleep apnea, kidney disease, obesity, high levels of stress and heavy alcohol consumption. When your blood pressure climbs above 120/80, you may have pre-hypertension. If your blood pressure reaches or exceeds 140/90, then you have full-blown hypertension. Blood pressure fluctuates throughout the day. It can rise or fall in response to caffeine, stress, alcohol or even the last meal you ate. So you need to measure it on at least two or more occasions to get an accurate idea of your average blood pressure. If your numbers are consistently high then the importance of getting your blood pressure down into the normal range can’t be overstated. 

A large study published last year in The Lancet found that for every decrease of 10 in your systolic blood pressure reading, you lower your risk of stroke by 27 percent, your risk of heart failure by 28 percent and your risk of heart disease by 17 percent.

If your doctor finds that your blood pressure requires treatment with medication, then you have a number of options. Some of the drugs available include ACE inhibitors, calcium channel blockers, diuretics and beta-blockers. 

How to Lower Your Blood Pressure

If you have hypertension, here are some things you can do to improve your numbers:

  • Lose weight. The famous, long-running Framingham Heart Study found that excess weight accounted for roughly 26 percent of all cases of hypertension in men and 28 percent of cases in women. Being overweight increases the amount of work your heart has to do to pump blood throughout your body.
  • Moderate your alcohol intake. Overconsumption can increase blood pressure. So try to consume no more than two drinks a day if you’re a man and one drink a day if you’re a woman.
  • Exercise. Not surprising, right? A meta-analysis of randomized controlled trials published in the Journal of the American Heart Association found that both aerobic exercise and resistance training significantly lower systolic and diastolic blood pressure.
  • Watch your salt and your sugar intake. The World Health Organization recommends keeping your salt intake to no more than five grams per day to reduce hypertension. The average intake in many countries is double that amount. Studies have found that a high sugar intake is also linked to hypertension. 

Know Your Cholesterol

While cholesterol is not the only thing that matters to your heart health, it’s important to keep an eye on your levels.

Understanding the Numbers

Cholesterol isn’t the only driver of heart disease. But it plays a big role, and you should know whether your numbers put you at high risk. 
Here’s what you should look for: 

  • HDL cholesterol: This is considered protective. Higher HDL levels correlate with better cardiovascular health.      
  • LDL cholesterol: High LDL is strongly linked to heart disease. Low LDL is better for cardiovascular health.  
  • Triglycerides: A type of fat that circulates in your blood stream. You want this number to be low. Elevated triglycerides are linked to both heart disease and diabetes. 

When Do You Need Statins?

In the past there was a disproportionate amount of attention paid to cholesterol. Doctors would typically prescribe cholesterol-lowering drugs like statins based on a person’s LDL cholesterol number alone. 

But the most recent guidelines call for doctors to take a more holistic and personalized approach, one that views cholesterol as just one factor along with things like age, gender, race, blood pressure and smoking history when determining a person’s cardiovascular risk.

In fact, if you’re 40 or older, you can use your cholesterol numbers, blood pressure and other personal information to determine your 10-year risk of having a heart attack or stroke by typing them into the American College of Cardiology’s risk calculator.   Be warned, though, the risk calculator isn’t perfect. Some leading cardiologists argue that in certain cases it can overestimate a person’s risk, leading many people to mistakenly think they need statins.

If you have high cholesterol, then you should discuss it with your doctor. Diet, exercise and lifestyle changes can improve your numbers. But it may not be enough. And when that’s the case, then a doctor can help you interpret your numbers, your family history and your personal risk to determine whether or not a statin makes sense. “That discussion is an important one to have,” said Dr. Lloyd-Jones. “I think statins are incredibly effective and safe. But they’re not one size fits all. We need to put them in the right context as we’re doing the decision-making.”

Eat Your Way to Lower Cholesterol

There are also many foods you can eat that can help improve your cholesterol levels. They include: 

  • Fatty fish, which lowers LDL and triglycerides.
  • Walnuts, almonds and other nuts. They increase HDL and lower LDL.
  • Soybeans, tofu and soy milk can slightly lower LDL.
  • Apples, strawberries and citrus fruits contain pectin, which helps reduce LDL.   
  • Olive oil and other unsaturated fats.
  • Beans, vegetables and flaxseeds, which contain a lot of soluble fiber, and may lower LDL. 
  • If you have high triglycerides, then one simple dietary change you can make is to cut back on empty carbs. For most people, triglycerides are driven largely by carbohydrate consumption. Removing sugar, bread, pasta, fruit juices and other refined carbs from your diet should lower your triglycerides.

Know Your Blood Sugar Level

Routinely checking your fasting blood sugar can help you monitor another factor in your heart disease risk.  

How to Lower Your Blood Sugar

So what should you do if your blood sugar levels raise some red flags? The first thing you should do is consult with your doctor to determine whether you have a medical issue. But there are also things you can do on your own to improve your blood sugar control – and they’ll sound familiar: exercise and eatingsmart

There are also some surprising things that can contribute to chronically high blood sugar or throw off a test. 
Here are some to be aware of: 

  • Not getting enough sleep.
  • Being overweight or obese. 
  • Consuming alcohol or caffeine.
  • Birth control pills, antidepressants, nasal decongestants and other medications.
  • Hormonal changes during menstrual cycles.
  • Chronic stress or illness. 

Get All the Numbers
Your routine blood tests should measure not only your cholesterol and triglycerides, but also your fasting blood sugar levels. That’s because many rigorous studies have found that chronically high blood sugar increases mortality and increases the risk of heart attacks and strokes. A high fasting blood sugar level can also signal that you have Type 2 diabetes or its precursor, pre-diabetes. 

And diabetics are four times more likely to die from heart disease
Your blood sugar levels should be measured after you’ve fasted for at least eight hours overnight. According to the Cleveland Clinic, here’s what you need to know: 

  • A normal fasting blood sugar level is less than 100 milligrams per deciliter.
  • A fasting blood sugar level between 110 and 125 mg/dL is considered pre-diabetes.
  • If you have two separate blood sugar readings that are greater than 126 mg/dL than you may have Type 2 diabetes. 

One of the drawbacks of a fasting blood sugar test is that it provides only a snapshot of your glucose levels at a single point in time. Another test that offers a better indication of your average blood sugar levels over time is the A1C test. It measures the amount of glycated hemoglobin in your blood, which indicates your average blood sugar levels over the past three months. A1C tests are often used to diagnose diabetes. 
Here’s what you need to know: 

  • An A1C score below 5.7 is considered normal.
  • An A1C in the range of 5.7 to 6.4 is indicative of pre-diabetes.
  • A score of 6.5 or above indicates diabetes.

A Heart Healthy Diet

Don’t get confused by conflicting studies on the best foods to eat — keep things simple with a straightforward system.

Understanding the Research

  • Nutrition and its effects on heart health tends to ignite heated debate. The problem is that many of the claims about which foods and diets are best for you are based on weak evidence. 
  • But there is a way to simplify things that cuts through all the noise and confusion, said Dr. Dariush Mozaffarian, a cardiologist and dean of the Tufts Friedman School of Nutrition Science and Policy. Dr. Mozaffarian has published numerous studies on foods and cardiovascular risk and has singled out foods that are backed by hard data from rigorous clinical trials. Ultimately he has found that most foods can be separated into three categories:
  1. Those that are good for your heart.
  2. Those that are bad for you.
  3. Those that are essentially neutral.

Foods that you should seek out and eat often:

  • Plant life, such as nuts, seeds, legumes, whole grains, beans and avocados.
  • Fruits and vegetables with no added sugar or preservatives.
  • Seafood, including shellfish and especially oily fish like wild salmon, sardines and mackerel. (Mercury levels can be high in some kinds of fish, so learn which types are of particular concern.)
  • Fermented foods, like yogurt, kimchi and tempeh.
  • Healthy fats like olive oil. 

You’ll see that the “good” category contains a lot of  plant-based foods. “These are foods that contain bioactive phytochemicals that are there to help protect a plant’s new life,” Dr. Mozaffarian said. “They have things that our bodies need as we age. We need their anti-inflammatory, pro-health phytochemicals and nutrients.” 

This first category also contains some other foods that have been shown in compelling studies to be strongly beneficial, like fish, which contains omega-3 fatty acids, and yogurt, which has probiotics that support gut health

Foods to avoid

  • Foods with added sugar, such as soft drinks, fruit juices and candy.     
  • Refined carbohydrates such as breakfast cereals, granola, white bread, bagels, crackers and pasta.
  • Processed meats, such as deli meats, salami, hot dogs and ham.
  • Packaged foods that are loaded with salt, sugar, trans fats, preservatives and other additives and artificial ingredients. Some examples are frozen entrees, potato chips, chicken nuggets, granola bars, microwaveable meals, canned soups, instant noodles and boxed snacks. 

The foods in this “bad” category are those that you should limit because there is strong evidence that they negatively impact cardiovascular health, Dr. Mozaffarian said.

 It consists of three groups: starch and sugar, highly processed meats and packaged foods. Most people understand that sugary drinks and other sources of added sugar can be harmful. But Dr. Mozafarrian calls starchy, refined carbohydrates like bagels and pasta “the hidden sugar in the food supply” because they contain long chains of glucose that essentially act like sugar in the body (sugar contains glucose and fructose). “And there’s five times more starch in the food supply than sugar,” he said.

Foods to be consumed in moderation

  • Butter      
  • Cheese     
  • Red meat       
  • Milk      
  • Eggs


Try the Mediterranean Diet

The best example of a heart healthy diet is one that follows a Mediterranean approach. A large clinical trial published in The New England Journal of Medicine in 2013 found that people assigned to a Mediterranean diet had significantly fewer heart attacks, strokes and deaths from heart disease than a group assigned to follow a conventional low fat diet. The foods that formed the bulk of the Mediterranean diet were things like olive oil, nuts, seafood, fruits, poultry, beans and vegetables.
The National Institutes of Health has a free cookbook you can download with dozens of delicious recipes designed to promote heart health. Some of the recipes are Mediterranean-inspired. But there’s also plenty of Latin, American and Asian flavors. 

Maintain a Healthy Bodyweight

It’s not just excess fat, but the type of excess fat that contributes to your heart risks. 

Another Reason to Reduce Your Pounds

Excess body fat isn’t just dead weight. Fat cells release many substances that increase inflammation, promote insulin resistance and contribute to atherosclerosis, the hardening of arteries. 

So it should be no surprise that obesity is among the leading causes of cardiovascular morbidity and mortality. That is especially the case for people who have a lot of visceral fat, the type that accumulates deep inside your abdomen around your internal organs. 

Visceral fat is much more dangerous than subcutaneous fat, the kind that resides just below your skin (you can pinch your subcutaneous fat with your fingers). It’s not entirely clear why but visceral fat is far more toxic to your body and especially to your cardiovascular system. An easy way to get a sense of the amount of visceral fat you carry and your risk is by measuring your waist circumference. According to Harvard Medical School, here’s how to interpret your waist circumference to determine if you’re in the healthy range.    

For Women

  • Low Risk:  31.5 inches or less
  • Intermediate Risk:  31.6 to 34.9 inches
  • High Risk:  35 inches or greater 

For Men

  • Low Risk:  37 inches or less
  • Intermediate Risk:  37.1 to 39.9 inches
  • High Risk:  40 inches or greater

Why B.M.I. Doesn’t Always Work

Another barometer you can use to determine your amount of visceral fat is your body mass index, or B.M.I. This calculation estimates your body fat based on your height and weight. You can determine your number by using the N.I.H.’s B.M.I. calculator

The American Heart Association defines an optimal B.M.I. as one that is below 25, which is the threshold for being overweight. But keep in mind that B.M.I. is a blunt instrument. People who have a lot of muscle mass, for example, might have a B.M.I. over 25 even if they have a low body fat percentage. And people who are thin but carrying a lot of visceral fat might have a B.M.I. under 25 even though they are technically high risk. 

Having a normal B.M.I. is a good starting point but it doesn’t necessarily mean you’re in the clear. Dr. Gina Lundberg, an assistant professor of medicine at Emory University School of Medicine and clinical director of the Emory Women’s Heart Center, said she has patients who are “skinny fat”: They have a normal B.M.I. but their blood pressure is high, they have low muscle tone and their cholesterol and other heart disease risk factors are out of whack. Dr. Lundberg said that having a normal B.M.I. does not mean you don’t have to be health conscious. “Just because someone looks healthy on the outside does not necessarily mean that they’re healthy,” she added. “They still have to go to the doctor, have an examination and be evaluated.” 

Avoid Tobacco

Smoking and the use of tobacco products isn’t just bad for your lungs, it’s bad for your heart, too. 

Just Don’t Smoke

This one should be a no-brainer. But it can’t be stressed too highly because it’s still an extremely common cause of heart disease. In fact, the American Heart Association found that many top experts rank smoking and use of tobacco products as the most important cardiovascular risk factor. The rate of tobacco use in the United States peaked more than a half century ago, when almost one in two adults were smokers. Decades of public health efforts have helped lower that number significantly. But today roughly 36.5 million Americans – equivalent to about 15 percent of the population – continue to smoke. That is still a lot of people. 

It’s the reason smoking remains the single largest preventable cause of death and disease in the country. Nationwide, it causes about one in every five deaths annually.

Smokers have double the risk of having a heart attack, and triple the risk of having a stroke compared with nonsmokers. E-cigarettes have also been linked in preliminary research to increased cardiovascular risks.   
Quitting will immediately lower your risk. Studies have found that smokers who have heart disease experience a 50 percent reduction in subsequent heart attacks or sudden cardiac death when they quit. 

To find resources that can help you or any friends or family members quit, you can contact the following health groups: American Cancer Society Toll-free hotline: 1-800-227-2345 American Lung Association Toll-free hotline: 1-800-586-4872 National Cancer Institute Toll-free hotline: 1-877-448-7848 
Or use these websites or apps:American Heart Association “Get Ready to Quit Smoking”    “Create My Quit Plan” page at smokefree.govQuitGuide: A free app that keeps you motivated, provides tips and ways to beat cravings, and helps you monitor your progress quitSTART: This free app gives you customized tips and inspiration to keep you from lighting up. It also helps you manage cravings, and can get you back on track after a slip-up.   

Honorable Mentions

Working to prevent heart disease doesn’t mean focusing only on the big things. There are plenty of other things you can do – some small, some fun, some weird, and some mundane – that can boost your cardiovascular health.

Get a Pet

Several years ago a panel of heart experts reviewed decades of data on the cardiovascular benefits of owning pets. They concluded that there was evidence from both large observational studies and small clinical trials that owning pets, and dogs in particular, could lower your risk of heart disease. Why? It could be a lot of things. For one, people who own dogs are more likely to get outside and take walks. But studies have also found that dog and cat owners tend to form such strong bonds with their pets that being around them lowers their heart rates and blunts the owners’ responses to stressful events.

Reduce Stress

Stress is normal. It’s a part of life and can even be good for you in small doses. Exercise for example is a type of short-term stress that improves health. But chronic stress, especially the mental and emotional kind, can take a toll on your heart. It can depress your immune system, increase your risk of high blood pressure, and eventually contribute to heart attacks and strokes. While stress is unavoidable in modern life, it doesn’t have to make you sick.

Optimize Your Sleep

Do you snore? Do you find yourself tired and fatigued throughout the day? Do you have difficulty concentrating, irritability and decreased alertness? Do you find you can’t get through the day without a steady stream of caffeine? 

These are some of the signs that you might have a sleep disorder, an issue that afflicts an estimated one-third of the country.

A sleep disorder can not only impair your quality of life, but significantly impact your cardiovascular health. 

Sleep apnea in particular – a condition in which a person experiences pauses in breathing at night – is strongly linked to heart disease. According to Harvard Medical School, untreated sleep apnea can increase your risk of dying from heart disease nearly fivefold.

Dr. Lundberg at Emory said that the importance of getting a good night’s sleep to protect your heart is often overlooked. “If you wake up not feeling refreshed or your partner says they hear you snoring, that needs to be evaluated at the doctor,” she said. “It could be causing serious heart problems.”

How to Get a Better Night’s Sleep

How do you become a more successful sleeper? Grab a pillow, curl up and keep reading to find out.


In recent decades, many studies have looked at the effects of meditation on cardiovascular risk factors. While the research is not definitive, there is some evidence that meditation can lower blood pressure and blunt the body’s response to stress. The best part about meditation is that it’s easy to learn and has no side effects. It can also help with many other aspects of health (including sleep). So why not give it a try?
Meditation is a simple practice available to all, which can reduce stress, increase calmness and clarity and promote happiness. Learning how to meditate is straightforward, and the benefits can come quickly.

Get to Know Your Dentist

Most people don’t think there’s any connection between their oral health and their cardiovascular health. But they’d be wrong. 
Many studies have found that gum disease increases your likelihood of having heart disease. A systematic review and meta-analysis published in The Journal of General Internal Medicine found that periodontal disease increases the risk of coronary heart disease by 24 to 34 percent.  One reason might be the presence of harmful bacteria in the mouth, which not only causes gum disease but also promotes systemic inflammation throughout the body. Whatever the mechanism, it’s a good idea to get regular dental checkups.  

Drink Tea

Eating plants is clearly good for your heart. But drinking them in the form of tea isn’t so bad either. Many large studies have linked regular tea consumption to cardiovascular benefits.

And smaller studies have suggested it may have something to do with the unique and potent compounds tea often contains, especially varieties like green, oolong and herbal teas.

For example, researchers have found that there are compounds in tea that lower inflammation, protect the endothelial cells that line the arteries, and have favorable effects on blood lipids. If you have a habit of drinking sugary beverages or diet drinks throughout the day, consider swapping those beverages with unsweetened tea.

Take a Hike … in the Forest

The Japanese have a term, shinrin-yoku, that loosely translates to “forest bathing.” 

It involves taking a leisurely visit to a forest and walking among the trees and plants; it is promoted as a way to achieve relaxation. They also believe that plant compounds circulating in the forest air provide a number of health benefits. The practice has been put to the test in many studies over the years and scientists have found some evidence that walking in nature can lead to slight cardiovascular benefits, like reduced blood pressure and lowered stress hormones and pulse rates. Whether it’s a result of the aerobic exercise alone, the mental relaxation, or the plant compounds in the air – or a combination of all three – is unknown. But taking a walk in the park is certainly good for your heart. 

But, Know the Symptoms

Even if you’re doing all you can to avoid cardiovascular disease, you should still know how to recognize the symptoms of a heart attack or stroke.
The classic symptoms of a heart attack are unbearable pain or discomfort in the center of your chest that lasts several minutes, and which comes and goes in waves. This is also known as the Hollywood heart attack, which is depicted in films as someone clutching their chest and dropping to the floor. But that’s not always the warning sign. In fact according to the American Heart Association there are many other common symptoms to look for, including the following:

  • Discomfort in your arms, back, stomach, neck or jaw. The pain can come on suddenly or it can start gradually and come and go.
  • Shortness of breath that occurs for no apparent reason. It can feel as if you just sprinted down the street and can’t catch your breath.
  • Breaking out in cold sweats and experiencing nausea or lightheadedness
  • Fatigue that is inexplicable. You may feel so tired that you have trouble getting up and walking even if you are not sleep deprived and haven’t done anything exhausting.

For a long time, doctors thought that men and women experienced different heart attack symptoms. 

But then it was discovered that men and women actually experience many of the same symptoms – they just tend to describe them differently, said Dr. Lundberg. “Men would point right to their chest and say they have pain,” she said. “Women would say different things. They’d say, ‘I have pressure and tightness in my chest or burning.’” As a result, it was not uncommon for doctors to dismiss the symptoms described by women as heartburn or indigestion. But experts are trying to educate both doctors and the public to recognize the differences in what to look for in men and women.

“One of the important things we’ve done was to re-educate physicians so that when they’re talking to women about possible symptoms, they know to ask them more than, ‘Are you having chest pain?’” said Dr. Lundberg.
 “You have to say, ‘Are you having chest tightness, pressure, heaviness or shortness of breath?’ It’s not the same thing as saying, ‘Are you having chest pain?’”

The classic symptoms of a stroke are typically very striking. The American Stroke Association uses the acronym FAST to describe them:

  • Face drooping: One side of the face droops or feels numb.
  • Arm weakness. One arm will feel weak or numb and difficult to lift up.
  • Speech difficulty: Look for slurred or confused speech patterns.
  • Time to call 911: If those symptoms appear separately or together, it’s time to call for help.

There could also be other signs that a stroke is occurring. A person may experience a very severe and sudden headache, confusion and trouble seeing out of one or both eyes. Or the person may feel dizzy and have a loss of balance or coordination and difficulty walking.

If you suspect that you or someone else is having a stroke or a heart attack, the critical thing is to act fast. Have your symptoms checked by a doctor or call 911.

The heart association says that calling paramedics is often the smartest thing you can do because they can begin treatment up to an hour sooner than if you drive to a hospital by car, and they can revive someone whose heart has stopped.

[end excerpts]
Ken Pope
Ken Pope, Melba J.T. Vasquez, Nayeli Y. Chavez-Dueñas, & Hector Y. Adames

Ethics in Psychotherapy & Counseling: A Practical Guide, 6th Edition (Wiley)

Paperback, Wiley e-Book, & Kindle

John Wiley & Sons accepts orders & faculty requests for evaluation copies

“Tell me, what is it you plan to dowith your one wild and precious life?”—Mary Oliver’s poem “The Summer Day”

M. Jackson Group Update – July 2021 – Pop Psychology and Quick Fixes

A collection of postings on a range of issues is available on our website (  This month’s post is again from Ken Pope’s listserv, where he kindly provides daily summaries of current articles in the field. 

The New York Times includes an article: “TED Talks Won’t Treat Your Depression” by Jesse Singal.

Here are some excerpts:
[begin excerpts]

Maybe chicken soup can treat depression.

That provocative claim was made not by a quack in a late-night infomercial but by John Bargh, a Yale social psychologist. He is an expert on “social primes,” the subtle cues that supposedly exert a major unconscious influence on our behavior. He has published research suggesting that, for example, exposure to words with geriatric associations like “wrinkles” primes people to walk slower.

In his 2017 book, “Before You Know It: The Unconscious Reasons We Do What We Do,” Dr. Bargh mentions a clinical trial in which severely depressed patients in a mental health facility appeared to improve after exposure to very high temperatures. He speculates that perhaps an outpatient approach involving soup could do the trick, too, since “the warmth of the soup helps replace the social warmth that may be missing from the person’s life.” Such remedies “are unlikely to make big profits for the pharmaceutical and psychiatric industries,” he writes, but they warrant further research.

Psychologists are welcome to research whatever they like. But if you have loved someone afflicted with treatment-resistant depression, as I have, this seems far-fetched: Every day, millions of depressed people drink coffee to no apparent salutary effect.

Dr. Bargh’s idea is one of the purest distillations of what I call “primeworld,” a myopic but seductive worldview. 

It suggests that human behavior is shaped rather easily by primes and other subtle influences — an irrational bias here, a too-pessimistic mind-set there — and that these influences can often be easily dispelled with low-cost psychological tweaks that target individuals to help solve societal problems. 
This understanding of society has flourished as a result of a general fascination with easily digestible pop-psychology nuggets — often delivered via TED Talks and best-selling books — that appears to have exploded in recent years.

But because it ignores the bigger, more structural forces that do far more to influence human behavior (from our exposure to early-life trauma to how much money we have to whether we grew up in a segregated neighborhood), it is flawed.

Worse, it might actually be hindering our ability to solve real-world problems. 

And now, with a replication crisis felling once highly regarded psychological findings, it’s probably time to be a little bit more skeptical of these quick-fix ideas.

It isn’t just psychologists who profit from this approach: There’s an influential ecosystem of journalists, pundits and other professional “thought leaders” who benefit from page views, book deals or the exposure offered by a viral TED Talk.

And these solutions, often framed as inexpensive and politically uncontroversial, are catnip not only to everyday consumers of pop science but also to policymakers hungry for quick fixes.

To be sure, there are kernels of truth to some of these ideas. At the margins, slight changes to our environment or a presentation of choices can affect our behavior. Some successful so-called nudges make people a bit more likely to save energy or a bit less likely to grab an extra doughnut in line at a college cafeteria.

But some psychologists have made much bolder claims — which are much less credible.

For Dr. Bargh, for example, seeing cleaner streets spurs prosocial behavior in a manner that, he says, can help explain New York City’s great violent-crime drop that started in the 1990s. 


 He acknowledges there were other factors, but he also states flatly in his book that the city’s resurgence “was a result of a new culture of cues for positive behavior being instituted.”

This is a vast oversimplification of a complicated problem. Few criminologists believe that these sorts of cues for positive behavior can tell us much, if anything, about the great crime decline.


Other recent blockbuster ideas in psychology are also steeped in this ideology. Take mind-set interventions, which are designed to shift people’s mind-sets from “fixed” (“I failed the test — I’m just stupid”) to “growth” (“I’ll do better next time if I work harder”). “For 30 years, my research has shown that the view you adopt for yourself profoundly affects the way you lead your life,” said Carol Dweck, the originator of that idea and a professor at Stanford, in her book “Mindset: The New Psychology of Success” (ideas she echoed in a TED Talk that has been viewed more than 12.5 million times).


Since these claims were first made, though, a full-blown replication crisis has hit psychology, meaning that when researchers attempt to redo previous studies, they often find either a much less impressive result or none whatsoever.

It turns out that the standard statistical methods long employed by psychologists (and other scientists) can easily produce false positive results. 
About 50 percent of published results from experimental psychology have failed to replicate, and the subfield of social psychology — the home base of most social priming, implicit bias and stereotype-threat research — tends to fare even worse.

Studies purporting to offer simple remedies to serious problems have been hit particularly hard. 


As for that fascinating social-priming magic embraced by Dr. Bargh, like people walking slower after seeing words with geriatric associations? “I don’t know a replicable finding,” said Brian Nosek, a psychologist and leading replication advocate, in 2019. “It’s not that there isn’t one, but I can’t name it.” The few social-priming effects that have survived this scrutiny tend to be small, inconsistent and not necessarily relevant outside of lab settings.

(In a series of emails, Dr. Bargh argued, as he has elsewhere, that his field’s replication tribulations have been overstated and pointed to some of the positive results.)


The cheerful, can-do vision of society these ideas help to spread is just as important as their statistical shortcomings. If reducing crime is a simple matter of priming would-be offenders with cleaner streets, then there’s little cause to become overwhelmed by the problems that surround us and also less reason to pursue expensive or politically contentious reforms (like truly attacking the root causes of crime).

The point is not that today’s most prominent primeworld psychologists deny that there’s a bigger world out there, beyond primes, biases and mind-sets; they would quickly acknowledge that, yes, there is. The problem is that their work, amplified by media, advances a set of very specific, zoomed-in priorities.


Sometimes people mistakenly believe that the best or truest scientific ideas rise to the top of the heap — that popularity implies accuracy and rigor.
This has never quite been the case, but it’s an even more questionable claim in an era in which pop science is so hotly marketable via TED Talks and other platforms.

Often the ideas that reach those heights are the ones that we most want to believe. 

And we’d like to think that we can fix the world easily.

[end excerpts]

Ken Pope

Ken Pope, Melba J.T. Vasquez, Nayeli Y. Chavez-Dueñas, & Hector Y. Adames: Ethics in Psychotherapy & Counseling: A Practical Guide, 6th Edition (publication date June 2021—John Wiley & Sons currently accepting preorders & faculty requests for evaluation copies)

Pope: Anti-Racism & Racism in Psychology as a Science, Discipline, & Profession: 57 Articles & Books (Citations + Summaries)
Pope: A Human Rights & Ethics Crisis Facing the World’s Largest Organization of Psychologists

“The truth is rarely pure and never simple.”—Oscar Wilde in The Importance of Being Ernest (1895)

M. Jackson Group Update – June 2021 – The Health Benefits of Coffee

A collection of postings on a range of issues is available on our website (  This month’s post is again from Ken Pope’s listserv, where he kindly provides daily summaries of current articles in the field. 

The New York Times includes an article: “The Health Benefits of Coffee” by Jane E. Brody.

Here are some excerpts:

[begin excerpts]

The latest assessments of the health effects of coffee and caffeine, its main active ingredient, are reassuring indeed. 

Their consumption has been linked to a reduced risk of all kinds of ailments, including Parkinson’s disease, heart disease, Type 2 diabetes, gallstones, depression, suicide, cirrhosis, liver cancer, melanoma and prostate cancer.

In fact, in numerous studies conducted throughout the world, consuming four or five eight-ounce cups of coffee (or about 400 milligrams of caffeine) a day has been associated with reduced death rates. 

In a study of more than 200,000 participants followed for up to 30 years, those who drank three to five cups of coffee a day, with or without caffeine, were 15 percent less likely to die early from all causes than were people who shunned coffee. 

Perhaps most dramatic was a 50 percent reduction in the risk of suicide among both men and women who were moderate coffee drinkers, perhaps by boosting production of brain chemicals that have antidepressant effects.
As a report published last summer by a research team at the Harvard School of Public Health concluded, although current evidence may not warrant recommending coffee or caffeine to prevent disease, for most people drinking coffee in moderation “can be part of a healthy lifestyle.”


Dr. Walter C. Willett, professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health: “Overall, despite various concerns that have cropped up over the years, coffee is remarkably safe and has a number of important potential benefits.”That’s not to say coffee warrants a totally clean bill of health. Caffeine crosses the placenta into the fetus, and coffee drinking during pregnancy can increase the risk of miscarriage, low birth weight and premature birth. Pregnancy alters how the body metabolizes caffeine, and women who are pregnant or nursing are advised to abstain entirely, stick to decaf or at the very least limit their caffeine intake to less than 200 milligrams a day, the amount in about two standard cups of American coffee.

The most common ill effect associated with caffeinated coffee is sleep disturbance. Caffeine locks into the same receptor in the brain as the neurotransmitter adenosine, a natural sedative. 


Dr. Willett said it’s possible to develop a degree of tolerance to caffeine’s effect on sleep. My 75-year-old brother, an inveterate imbiber of caffeinated coffee, claims it has no effect on him. However, acquiring a tolerance to caffeine could blunt its benefit if, say, you wanted it to help you stay alert and focused while driving or taking a test.


Among [other ingredients in coffee] with positive effects are polyphenols and antioxidants. 

Polyphenols can inhibit the growth of cancer cells and lower the risk of Type 2 diabetes; antioxidants, which have anti-inflammatory effects, can counter both heart disease and cancer, the nation’s leading killers.


Countering the potential health benefits of coffee are popular additions some people use, like cream and sweet syrups, that can convert this calorie-free beverage into a calorie-rich dessert. 

“All the things people put into coffee can result in a junk food with as many as 500 to 600 calories,” Dr. Willett said. 

A 16-ounce Starbucks Mocha Frappuccino, for example, has 51 grams of sugar, 15 grams of fat (10 of them saturated) and 370 calories.

With iced coffee season approaching, more people are likely to turn to cold-brew coffee.

Now rising in popularity, cold brew counters coffee’s natural acidity and the bitterness that results when boiling water is poured over the grounds. 
Cold brew is made by steeping the grounds in cold water for several hours, then straining the liquid through a paper filter to remove the grounds and harmful diterpenes and keep the flavor and caffeine for you to enjoy. Cold brew can also be made with decaffeinated coffee.

[end excerpts]

Ken Pope

Ken Pope, Melba J.T. Vasquez, Nayeli Y. Chavez-Dueñas, & Hector Y. Adames: Ethics in Psychotherapy & Counseling: A Practical Guide, 6th Edition (publication date June 2021—John Wiley & Sons currently accepting preorders & faculty requests for evaluation copies)

Pope: Anti-Racism & Racism in Psychology as a Science, Discipline, & Profession: 57 Articles & Books (Citations + Summaries)
Pope: A Human Rights & Ethics Crisis Facing the World’s Largest Organization of Psychologists
“Waste no more time arguing about what a good person should be.  Be one.”—Marcus Aurelius (April 26, 121-March 21, 180)

M. Jackson Group Update – May 2021 – The Importance of Friendship for Alzheimer’s Patients

A collection of postings on a range of issues is available on our website (  This month’s post is again from Ken Pope’s listserv, where he kindly provides daily summaries of current articles in the field. 

The Wall Street Journal includes an article: “The Importance of Friendship for Alzheimer’s Patients” by Clare Ansberry.

Here are some excerpts:
[begin excerpts]

Abbe Smerling and Judy Roeder, close friends for 30 years, raised their children, vacationed and celebrated holidays together. Abbe hosted the wedding rehearsal dinner for Judy’s daughter. “It was one of the best parties we ever had at our house,” Abbe says.

Now, after sharing many milestones in their lives, the two, who both live in the Boston area, have entered a new chapter in their friendship. About eight years ago, Judy, 75 years old and a former psychotherapist, was diagnosed with mild cognitive impairment, which progressed to Alzheimer’s. Abbe, 70, has remained at her side, taking her on road trips, on weekend retreats, and to events at their temple.
“I just want to make her happy,” Abbe says.

Judy, left, and Abbe, here on Cape Cod in 1998, met in 1989 and have been close friends since, sharing family milestones. Also in 1998, Judy and her husband, Gil, left, with Abbe and her husband, David.Photo: Abbe Smerling (2)

Many longtime friends are at similar crossroads as more people are diagnosed with Alzheimer’s, a degenerative brain disease and the most common form of dementia. An estimated 6.2 million Americans age 65 and older have Alzheimer’s and the number is expected to double by 2050 to 12.7 million, according to the Alzheimer’s Association.

The disease has no known cure, but loneliness was associated with a 40% increased risk of dementia, according to a 2018 study published in Innovations in Aging. A 2019 study found that among those with Alzheimer’s disease, having a close circle of friends is linked to better cognition. Maintaining those friendships, however, requires resolve and commitment.

“It’s difficult for people to see the changes in their friends. They don’t know what to say and do,” says Darla Fortune, an associate professor in the department of Applied Human Sciences at Concordia University in Montreal, who along with two colleagues conducted extensive interviews on friendship and dementia, publishing the findings in December.


Those who maintained long-term friendships often mentioned sticking to familiar and comfortable places, Dr. Fortune found. “She knows the waitresses and they all make a fuss over her, and she always gets a hug when she goes in,” explained one woman who always took her friend with dementia to the same restaurant. Those interviewed also said they made the friendship a priority. “I want to make sure there are certain things we do together now,” said one.It’s helpful for people in the early stages of Alzheimer’s to let close friends know, says Beth Kallmyer, who oversees care and support programs for the Alzheimer’s Association. “Tell your friends what is going on, talk about what you are experiencing, what you are comfortable doing,” she says.

The conversation can be difficult. Shortly after Arthena Caston, 56, was diagnosed with mild cognitive impairment, which later progressed to early-onset Alzheimer’s, she called her longtime college friend, Shaun Graham, to give her the news. The two women have been friends for more than 30 years, having met in 1982 as freshmen at Francis Marion University in Florence, S.C.

Arthena Caston, left, and Shaun Graham at a birthday celebration in 2018. They met in 1982, when they were college freshmen.Photo: John Graham

“She didn’t say anything,” recalls Arthena, who had been working in customer support for a large insurance company. “She was just quiet and then said, ‘Baby girl, I’ll call you back.’ I knew she was crying.”

Shaun didn’t return the call for two weeks. “I couldn’t talk to her, and I was hoping she wouldn’t call me,” she says. “I didn’t want to cry and make her feel bad. I needed to be strong and supportive. It took me two weeks to get myself together.” When she finally did call, she apologized. Arthena said she understood. A few months later, Arthena was matron of honor at Shaun’s wedding.

That was five years ago. They now talk on the phone at least five days a week—sometimes several times a day—keeping their ties close in spite of living six hours away from each other, one in North Carolina and the other in Georgia. Shaun accompanied Arthena to an Alzheimer’s Association conference in Chicago, sticking close to her in the disorienting airport and making sure Arthena’s hotel door was locked at night. Last year, before the pandemic, Shaun and her husband drove from her home in Fayetteville, N.C., to Orlando, Fla., to listen to Arthena address an Alzheimer’s summit.
“I love the fact she was there for me,” Arthena says. “We have gone on this journey together.” Both know that the disease will progress. “I want to be there for as long as I can be,” says Shaun, who served in the Air Force and now works in transportation planning for her local county.

Arthena gave Shaun a blanket this past Christmas with photos of the two of them over the years from college days to 2020, including a group shot with their husbands, Virous Caston, left, and John Graham.Photo: Shaun Graham

In Boston, Abbe and Judy, now both vaccinated, can visit, sitting on Judy’s couch. Conversations are shorter than they used to be. Judy tends to repeat things and is easily distracted.

They reminisce, Abbe prompting Judy, reminding her about outings with their kids to the Happy Chicken restaurant, their road trip to Judy’s hometown, Toms River, N.J., and how they danced together when their husbands, who were in a rock band called the Titanic, performed classics like “My Girl” at charity events. Judy hums the song.

They have been each other’s confidante, companion and support for much of the past three decades. “Now we are going through this together,” Abbe says.

A year ago, they went on a women’s retreat and roomed together. Judy lost her keys several times and locked Abbe out of their room at night. In a large group discussion, Judy, who was always expressive and opinionated, said little or told the same childhood stories.

“I lost my close friend that she was. I lost that Judy,” says Abbe. “I have another Judy, and I just want to do my best to keep her happy.”

Last week, Abbe, left, helped Judy pick out earrings to wear. ‘We like the same clothes and jewelry and always did a lot of shopping together,’ Abbe says.Photo: David Degner for The Wall Street Journal

Abbe, searching out new ways for the two to have fun together, heard about the Memory Café, started in 2014 in Boston to give people with dementia and their family and friends a place to listen to musicians, storytellers and artists. “It’s good,” says Judy. Before the pandemic, they would go, sit side-by-side, hold hands, and sing “Take Me out to the Ball Game.”

“We’re creating an environment where people can stay connected,” says Beth Soltzberg, who runs the program at the Jewish Family & Children’s Service. It’s one of about 1,000 such venues world-wide, listed in the Memory Cafe Directory.

Judy was self-aware going into Alzheimer’s, says Abbe. ‘She knew she was losing her memory. She wanted everyone to know it was OK to talk about it.’Photo: David Degner for The Wall Street Journal

Gil is grateful for Abbe and a few other friends who have remained close to Judy. The diversion is important, he says, because he is busy working from home, leaving Judy to spend most of the day sitting on the sofa, playing Scrabble on her phone. She no longer seems to notice that people don’t come around or call, although he does: “People have disappointed me. I don’t think they can deal with people so smart and vibrant going away and becoming someone different.”

Being a Friend

Don’t be afraid of silence, says Abbe Smerling, whose long-time friend has Alzheimer’s. Tell stories and share news and updates, even if you get no response.

Adjust, says Beth Kallmyer of the Alzheimer’s Association. If you and your friend liked to play cards, keep playing them. Maybe not bridge, but something less complex, like 21.

Be frank with your friend, says Arthena Caston, who has early-onset Alzheimer’s. “It’s a terminal diagnosis, and a lot of people don’t want to hear that. But it is.”

Focus on your friend, says Darla Fortune, who conducted a study on maintaining long-term friendships. Notice what interests them, makes them smile and laugh, and what makes them uncomfortable.

Call and visit, says Gil Roeder, whose wife, Judy, has Alzheimer’s. The sound of a friend’s voice and their presence can make his wife happy in the moment.

[end excerpts]
Ken Pope

Ken Pope, Melba J.T. Vasquez, Nayeli Y. Chavez-Dueñas, & Hector Y. Adames: Ethics in Psychotherapy & Counseling: A Practical Guide, 6th Edition (publication date June 2021—John Wiley & Sons currently accepting preorders & faculty requests for evaluation copies)

Pope: Anti-Racism & Racism in Psychology as a Science, Discipline, & Profession: 57 Articles & Books (Citations + Summaries)
Pope: A Human Rights & Ethics Crisis Facing the World’s Largest Organization of Psychologists
“Ring the bells that can still ring.Forget your perfect offering.There is a crack in everything.That’s how the light gets in.”—Leonard Cohen

M. Jackson Group Update – April 2021 – Best Treatments for Chronic Pain

A collection of postings on a range of issues is available on our website (  This month’s post is again from Ken Pope’s listserv, where he kindly provides daily summaries of current articles in the field. 

The new issue of British Medical Journal includes an article: “Offer exercise, therapy, acupuncture, or antidepressants for chronic primary pain, says NICE.”

Here’s an excerpt:

[begin excerpt]

Chronic primary pain should be managed with exercise programmes, cognitive behavioural therapy, acceptance and commitment therapy, and acupuncture, NICE has said in guidance on the assessment and management of chronic pain.1

The antidepressants amitriptyline, citalopram, duloxetine, fluoxetine, paroxetine, or sertraline are the only drug treatments that should be offered to patients with chronic primary pain because evidence shows these may improve quality of life, pain, sleep, and psychological distress, even in the absence of depression, says NICE.

For many commonly prescribed drugs, including paracetamol, non-steroidal anti-inflammatory drugs, benzodiazepines, or opioids there is little or no evidence that they make any difference.
[end excerpt]

Ken Pope

Ken Pope, Melba J.T. Vasquez, Nayeli Y. Chavez-Dueñas, & Hector Y. Adames: Ethics in Psychotherapy & Counseling: A Practical Guide, 6th Edition (publication date June 2021—John Wiley & Sons currently accepting preorders & faculty requests for evaluation copies)

Pope: Anti-Racism & Racism in Psychology as a Science, Discipline, & Profession: 57 Articles & Books (Citations + Summaries)
Pope: A Human Rights & Ethics Crisis Facing the World’s Largest Organization of Psychologists
“The good physician will treat the disease, but the great physician will treat the patient.”— Canadian physician William Osler (1849–1919)

M. Jackson Group Update – March 2021 – Academic Free Speech

A collection of postings on a range of issues is available on our website (  This month’s post is again from Ken Pope’s listserv, where he kindly provides daily summaries of current articles in the field. 

The Chronicle of Higher Education includes an article: “A New Group Promises to Protect Professors’ Free Speech” by Wesley Yang.
Here are some excerpts:

[begin excerpts]

When I spoke to the Princeton University legal scholar and political philosopher Robert P. George in August, he offered a vivid zoological metaphor to describe what happens when outrage mobs attack academics. When hunted by lions, herds of zebras “fly off in a million directions, and the targeted member is easily taken down and destroyed and eaten.” A herd of elephants, by contrast, will “circle around the vulnerable elephant.”

“Academics behave like zebras,” George said. “And so people get isolated, they get targeted, they get destroyed, they get forgotten. Why don’t we act like elephants? Why don’t we circle around the victim?”

George was then recruiting the founding members of an organization designed to fix the collective-action problem that causes academics to scatter like zebras. What had begun as a group of 20 Princeton professors organized to defend academic freedom at one college was rapidly scaling up its ambitions and capacity: It would become a nationwide organization. George had already hired an executive director and secured millions in funding.


In the summer, George emphasized that the organization must be a cross-ideological coalition of conservatives, liberals, and progressives who would be willing to exert themselves on behalf of controversial speakers no matter which constituency they had offended. 

Though the funding for the organization came from a primary conservative donor, and many of those who feel most besieged in today’s academic environment are on the right, the threats to academic freedom were myriad — and did not threaten only those on the right. 

A principled defense of core values would require scrupulous neutrality in application and significant participation from across the ideological spectrum. “If we were asked to defend Amy Wax, we would,” he said. “If we were asked to defend Marc Lamont Hill, we would.”

Today, that organization, the Academic Freedom Alliance, formally issued a manifesto declaring that “an attack on academic freedom anywhere is an attack on academic freedom everywhere,” and committing its nearly 200 members to providing aid and support in defense of “freedom of thought and expression in their work as researchers and writers or in their lives as citizens,” “freedom to design courses and conduct classes using reasonable pedagogical judgment,” and “freedom from ideological tests, affirmations, and oaths.”

The alliance will intervene in academic controversy privately, by pressuring administrators, and publicly, by issuing statements citing the principles at stake in the outcomes of specific cases. Crucially, it will support those needing legal aid, either by arranging for pro bono legal representation or paying for it directly.


“Universities know,” George told me, “that university faculty can’t afford to fight city hall or the university, so they know they can do anything to these people without any consequences. So we’re going to shift that — so that the university general-counsel offices will know that the university is in the fight of its life if it violates academic-freedom rights.”

All members of the alliance have an automatic right for requests for legal aid to be considered, but the organization is also open to considering the cases of faculty nonmembers, university staff, or even students on a case-by-case basis. The alliance’s legal-advisory committee includes well-known lawyers such as Floyd Abrams and the prolific U.S. Supreme Court litigator Lisa S. Blatt.

When I spoke to him in February, as the date of AFA’s public announcement drew closer, George expressed surprise and satisfaction at the success the organization had found in signing up liberals and progressives. “If anything we’ve gone too far — we’re imbalanced over to the left side of the agenda,” he noted wryly. 


The yield was higher, as George would learn, quoting one such progressive member, because progressives in academe often feel themselves to be even more closely monitored for ideological orthodoxy by students and activist colleagues than their conservative peers. 

“You conservative guys, people like you and Adrian Vermuele, you think you’re vulnerable. You’re not nearly as vulnerable as we liberals are,” George quoted this member as saying.

“They are absolutely terrified, and they know they can never keep up with the wokeness. What’s OK today is over the line tomorrow, and nobody gave you the memo.” 

George went on to note that some of the progressives he spoke with were indeed too frightened of the very censorious atmosphere that the alliance proposes to challenge to be willing to affiliate with it, at least at the outset.
Some of the founding members from outside of Princeton include Randall L. Kennedy, Orlando Patterson, Jeannie Suk Gersen, Janet Halley, and Cornel West at Harvard; Brian Leiter and Dorian S. Abbot at the University of Chicago; Sheri Berman at Barnard; Patricia Nelson Limerick at the University of Colorado at Boulder; and Kathryn L. Lynch at Wellesley.


He cited the case of Jeffrey J. Poelvoorde, an associate professor of politics and the sole Orthodox Jewish faculty member of a small college in South Carolina. Poelvoorde refused to attend mandatory anti-racism training in the wake of the George Floyd protests — he was the only one of his colleagues to refuse. “My quarrel is not so much with the content of these materials the administration would impose on us, but rather the coercive imposition itself,” Poelvoorde wrote in a letter to administrators at Converse College.

“They told him they would fire him, they would revoke his tenure,” George told me. “He stood up to them, we came in and provided legal and moral support, and after a whole lot of Sturm und Drang, they completely caved, backed down, and exempted him.” 

“These are the stories people don’t know,” George went on to say. “Everyone knows the stories of people getting destroyed — the struggle sessions, the abject apologies. … But here’s a case where somebody stood up to the bullies and won.”


Nadine Strossen, a New York University law professor and former president of the ACLU, emphasized the problem of self-censorship that she saw the alliance as counteracting. “When somebody is attacked by a university official or, for lack of a better term, a Twitter mob, there are constant reports from all individuals targeted that they receive so many private communications and emails saying ‘I support you and agree with you, but I just can’t say it publicly.’”

She hopes that the combined reputations of the organization’s members will provide a permission structure allowing other faculty members to stand up for their private convictions in public. 

While a lawsuit can vindicate someone’s constitutional or contractual rights, Strossen noted, only a change in the cultural atmosphere around these issues — a preference for open debate and free exchange over stigmatization and punishment as the default way to negotiate controversy in academe — could resolve the overall problem.

The Princeton University political historian Keith E. Whittington, who is chairman of the alliance’s academic committee, echoed Strossen’s point. The recruitment effort, he said, aimed to gather “people who would be respectable and hopefully influential to college administrators — such that if a group like that came to them and said ‘Look, you’re behaving badly here on these academic-freedom principles,’ this is a group that they might pay attention to.”

“Administrators feel very buffeted by political pressures, often only from one side,” Whittington told me. “They hear from all the people who are demanding action, and the easiest, lowest-cost thing to do in those circumstances is to go with the flow and throw the prof under the bus. So we do hope that we can help balance that equation a little bit, make it a little more costly for administrators.”

Whittington, who is the author of Speak Freely, a book-length defense of free speech that was assigned to every incoming Princeton freshman in 2018 as that year’s required “preread,” took a cautious attitude toward the amount of the difference he thought the organization could make.


“I don’t want to be Pollyannish,” Whittington said. “It’s a difficult environment, and university administrators are under pressure to react to these isolated cases. And often university administrators are simply not very committed to academic freedom.”

But he regarded the initial membership yield with satisfaction. “We were hoping to find a few dozen faculty members across the country. We wound up with nearly 200.” He also noted that once the organization establishes a track record, he hopes it can become a mass-membership organization.
Accompanying the announcement of the alliance’s founding is an essay by one of its members, Lucas E. Morel, professor of politics at Washington and Lee University. 

Morel observes the intense emphasis placed by the great abolitionist Frederick Douglass on the centrality of free speech to his cause.
When I spoke to him last week, Morel argued that Douglass’s faith that “truth must triumph under a system of free discussion” was at the very heart of the university. 

It was a terrible irony, he said, that some of the most vehement opposition to open discussion was coming from within the university itself.
Morel cited his own experience participating in a Zoom debate with the Northwestern University historian Leslie M. Harris over “The 1619 Project” as an instance of the erosion of good-faith truth-seeking. 


“These were two tenured professors speaking about what they know about,” he said, noting that the debate was a perfectly civil and collegial exchange of views between himself and Harris — though continually interrupted by students photo-bombing the proceedings with signs bearing denunciations of the very existence of the debate. 

“If I had to be there physically, who knows what could have happened?”
The peroration of Morel’s essay crisply summarizes the ethos of the organization through the words of the great abolitionist:

“We intend to remind universities of the principal way to fulfill their mission, which is to protect the right of free speech throughout every academic discipline, as well as administrative or staff position. Let us declare with Frederick Douglass, ‘There can be no right of speech where any man … is overawed by force and compelled to suppress their honest sentiments.’”

[end excerpts]

Ken Pope

TARGETED: SURVIVING SOCIAL MEDIA ATTACKS by Hector Adames, Nayeli Chavez-Dueñas, & Ken Pope
Ethics in Psychotherapy & Counseling: A Practical Guide, 6th Edition by Ken Pope, Melba J.T. Vasquez, Nayeli Y. Chavez-Dueñas, & Hector Y. Adames (publication date June 2021—John Wiley & Sons currently accepting preorders & faculty requests for evaluation copies)
A Human Rights & Ethics Crisis Facing the World’s Largest Organization of Psychologists by Ken Pope
“The peculiar evil of silencing the expression of an opinion is, that it is robbing the human race; posterity as well as the existing generation; those who dissent from the opinion, still more than those who hold it.  If the opinion is right, they are deprived of the opportunity of exchanging error for truth: if wrong, they lose, what is almost as great a benefit, the clearer perception and livelier impression of truth, produced by its collision with error.”—John Stuart Mill (1806-1873) 

M. Jackson Group Update – February 2021 – The “Learning Styles” Myth

A collection of postings on a range of issues is available on our website (  This month’s post is again from Ken Pope’s listserv, where he kindly provides daily summaries of current articles in the field. 

Research Digest includes an article: “The “Learning Styles” Myth Is Still Prevalent Among Educators — And It Shows No Sign of Going Away” by Emily Reynold.

Here are some excerpts:

[begin excerpts]

The idea that people learn better when taught in a way that matches their specific “learning style” — auditory, kinesthetic, visual or some combination of the three — is widely considered a myth. 

Research has variously suggested that learners don’t actually benefit from their preferred style, that teachers and pupils have different ideas about what learning styles actually work for them, and that we have very little insight into how much we’re actually learning from various methods.

Despite this evidence, a large proportion of people — including the general public, educators and even those with a background in neuroscience — still believe in the myth. And a new review, published in Frontiers in Education, finds no signs of that changing.

The team looked at articles that focused on belief in learning styles published between 2009 and April 2020. Articles with participant groups that were not made up of educators or trainee educators were excluded from analysis, as were surveys that focused not on whether learning styles actually existed but on other opinions — whether they explain differences in achievement, for example. Data from over 15,000 educators were included in the analysis.Overall, 89.1% of participants believed that people learn better when instruction is matched to their learning styles. A total of 95.4% of trainee educators believed in learning styles — slightly higher than the 87.8% of qualified educators who showed similar beliefs. 

And despite more widespread debunking of the myth, both in academic publishing and the mainstream media, there was no significant decrease in belief in studies conducted more recently.

This had a real impact on how teachers worked: in the seven studies that measured use or planned use of learning style-matched teaching, 79.7% of educators said they used or intended to use matched teaching methods. 
Interventions designed to disavow educators of their belief in learning styles did seem to make some difference, however — in the four studies that utilised training for these purposes, belief decreased significantly, from 78.4% to 37.1%.

The myth of learning styles, it seems, is as pervasive as ever. 

Future research could also look at the consequences of learning style-matched teaching — does it actually matter if the myth is perpetuated, and does it have a serious impact on how people learn? 

Studying how training can educate teachers on the learning style myth could also help us understand how it spreads and why it sticks — and might help students get the most out of education at the same time.

[end excerpts]

Ken Pope

Pope & Vasquez: Ethics in Psychotherapy & Counseling: A Practical Guide, 5th Edition

Pope: Anti-Racism & Racism in Psychology as a Science, Discipline, & Profession: 57 Articles & Books (Citations + Summaries)
Pope: A Human Rights & Ethics Crisis Facing the World’s Largest Organization of Psychologists

“Still, a man hears what he wants to hear and disregards the rest.”—”The Boxer” (1968), words and music by Paul Simon

M. Jackson Group Update – January 2021 – The Experience of Mental Health Problems

A collection of postings on a range of issues is available on our website (  This month’s post is from the British Psychological Society. 

FEATUREMENTAL HEALTHQUALITATIVEOctober 9, 2015What is it like to experience mental health problems?

We’ve rounded up some of the research we’ve covered over the years that’s explored what it’s like to live with mental health problems, from obsessive compulsive disorder to hearing voices. Psychologists call these kind of studies “qualitative research”, where the aim is not to put a score against particular symptoms, but to discover the first-hand perspective and experience of the people who take part, based on their own words. Such studies are often distressing to read, but their insights make a vital contribution to our understanding of the human condition.

Depression feels like a kind of emptiness

A recurring theme from interviews with seven people diagnosed with depression was their sense of depletion and emptiness, both bodily and in thinking about the past and future. “It’s like something’s gone inside me and swept my happiness away,” said one participant. “I feel like sometimes my life is on hold,” said another. Isolation was another key theme, as captured by this man’s description: “You get into a state I think mentally where, you’re just like out on an island … You can see from that island another shore and all these people are there, but there’s no way that you can get across [ ] or there is no way that you want to get across.” Writing in 2014, the researchers Jonathan Smith and John Rhodes said it was clear that all the interviewees had in common that they felt alone, empty and that they had no future.

Selective mutism does not feel like a choice
People with selective mutism can’t speak in certain situations even though there is nothing physically wrong with their vocal chords and they don’t have brain damage. Four people diagnosed with the condition were interviewed via Skype’s instant messenger interface. Their descriptions challenged the traditional idea that selective mutism is a choice. “It isn’t me,” said one participant. “I know who I am and I’m not shy or quiet, maybe that makes it harder. When I’m with my parents I can be myself but around everyone else it’s like it [selective mutism] takes over. I can get the words in my head but something won’t let me say them and the harder I try the more of a failure I feel like when I can’t.” The interviewees also revealed how the condition became self-fulfilling as people came to expect them to stay silent. And they talked about the extreme loneliness they experienced. “It’s like that scene from Scrooge where he looks through the window and he can see people having fun being together,” said one interviewee. “I’ll always be stuck outside looking in.”

To be a refugee with psychosis is to feel there is no future
The first-hand experience of refugees with symptoms of psychosis was documented for the first time in a heart-wrenching study published this year. Based on interviews with seven African refugees or asylum seekers, the researchers identified six main themes: bleak agitated immobility; trauma-related voices and visions (mostly the sounds or sights of lost relatives or attackers from the past); fear and mistrust; a sense of a broken self; the pain of losing everything; and the attraction of death. The last theme was captured by the words of 26-year-old Sando: “The worst part,” he said, “is I keep harming myself, … and you know knocking my head to the wall, kinda too much stuff in there, you know, I just want to open my head and finish with this.”

Some people have a love-hate relationship with their OCD
Based on their hour-long interviews with nine people diagnosed with obsessive-compulsive disorder, the researchers Helen Murphy and Ramesh Perera-Delcourt identified three main themes: “wanting to be normal and fit in”; “failing at life”; and “loving and hating OCD.” The first two themes were often related to the painful situations provoked by the interviewees’ compulsions. One man who house-shared described how he had to scrub the entire bathroom with powerful cleaning product for an hour every day before he could use it. But at the same time, the interviewees explained how they actually feared losing the crutch that the condition provides. “I wish I could do that [stop checking], I wish I could stop,” one man said, adding: “Well, not totally.”

Being labelled as “schizophrenic” feels hugely stigmatising but also unlocks much-needed treatment
In a 2014 study, seven patients diagnosed with schizophrenia described their dilemma: they needed the diagnosis to access treatment, but had also feared and avoided the label because of the stigma associated with it. The interviewees said they tried to hide their diagnosis from people, and they noted how mental health professionals used alternative words like “psychosis” as if aware of the stigma of schizophrenia. “People are always afraid of saying that word to me,” said said one woman, “… because it is a dirty word.” The interviewees also described the chasm between their clinician’s view of the illness as biological (a “chemical imbalance”) and the perspectives of other people in their lives. “My mother … all she said was ‘I told you, it’s because you’re psychic …,” said another interviewee. The researchers said more needs to be done to overcome delays in treatment caused by ill people’s fearful avoidance of a diagnosis.

For many people who self-harm, seeing their own blood makes them feel calm
Among 64 people who self-harm, recruited from a mass screening of 1,100 new psychology students, just over half said that the sight of their own blood was important to them. The most common explanation the students gave was that seeing their blood made them feel calm. Other explanations were that it “makes me feel real” and shows that “I did it right/deep enough”. Those students who highlighted the importance of seeing their blood tended to cut themselves more often than those who didn’t (a median of 30 times compared with 4 times) and they were more likely to say they self-harmed as a way of regulating their own emotions. Another study from 2013 asked self-harming teenagers to carry a digital device for two weeks, in which to record their motives for self-harming as they occurred. Just over half the sample reported self-harming to achieve a particular sensation, the most common being “satisfaction”, followed by “stimulation” and “pain”.

Anorexia starts out feeling like a solution but then takes over
“Anorexia became a friend,” said Natalie, one of 14 people recovering from anorexia who were interviewed as part of a study published in 2011. “When I was alone … I knew that at least I had A.” Eventually though, for Natalie and the others, anorexia became overpowering, almost like a separate entity which they had to fight against for control of their own mind. As Jon, another interviewee, put it: “It’s like there are two people in my head: the part that knows what needs to be done and the part of me that is trying to lead me astray. Ana [his nickname for anorexia] is the part that is leading me astray and dominates me.”

For some people, mirrors are addictive and imprisoning 
A diagnosis of Body Dysmorphic Disorder is made when someone has a disabling and distressing preoccupation with what they see as their perceived physical flaw or flaws. In upsetting interviews that were published this year, 11 people diagnosed with the condition described their complicated, troubling relationship with mirrors. One woman said she’d once stared into a mirror for 11 hours straight, searching for a perspective where she felt good enough about herself to be able to go out. Another interviewee, Jane, described mirrors as “f*cking bastards” and mirror gazing as a “form of self-harm”. The interviewees also described what they perceived as the ugliness of the person staring back at them. “I look like a monster,” said Hannah. Jenny said she is “truly hideous” and “repulsive”. Lucy said: “Everyone else, everyone is beautiful. I just feel that I am that one ugly person.”

People’s experiences of hearing voices vary hugely 
Last year, researchers analysed seven previous studies that had explored people’s first-hand experiences of hearing voices. Taken together, the most striking finding was that to hear voices that aren’t there is not a homogenous condition. While most people described attributing an identity to the voices, they differed in whether they saw the voices as separate from their own thoughts or not, and in whether they felt in control of the voices. Those who subscribed to a biomedical account, believing that their voices were caused by a chemical imbalance in the brain, tended to feel less in control of their voices. Similarly, heard voices could interfere with social relationships, for example by making critical comments about friends or family. But voices could also play a beneficial role by reducing loneliness. “I have not got many friends … so the only thing I can stay very close to are the voices and I do stay very close to them,” said one interviewee.

Positive change is a gradual process that is realised suddenly
As well as asking people about their experiences of mental illness, psychologists also research what the process of recovery feels like. In 2007, researchers interviewed 18 women and 9 men diagnosed with conditions like depression and anxiety about their experiences of positive change during Cognitive Behavioural Therapy. “It was gradual but the realisation was sudden,” one interviewee said. Many of the participants could remember the exact moment: “I could actually hear it,” one said. Other themes in the clients’ descriptions of how change happened were: motivation and readiness (“I was desperate to get back to my old self”); tools and strategies (“It’s the changes in behaviour that I learned”); learning (“I would take a lot of stuff home to read about assertiveness”); interaction with the therapist (“…they don’t judge your character or think they know you”); changes to self-perception (“I am a strong person mentally”); and the relief of talking (“Let me get everything out, let me relieve myself of everything”).

further reading
What is mental illness?
World Mental Health Day 2015

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

Our free fortnightly email will keep you up-to-date with all the psychology research we digest: Sign up!


M. Jackson Group Update – December 2020 – Psychiatrist as Patient

A collection of postings on a range of issues is available on our website (  This month’s post is again from Ken Pope’s listserv, where he kindly provides daily summaries of current articles in the field. 

It is perhaps revealing that I went looking for something that might be kind of “nice” for the holidays and this is the closest I could find in my collection. I could not face posting another list of coping hints, although those certainly have a role. Please just don’t try this at home.

Psychiatric Services has scheduled an article for publication in a future issue: “My Benefits From Electroconvulsive Therapy—What a Psychiatrist Learned by Being a Patient.”
The author is Rebecca E. Barchas, MD.
Here are some excerpts:
[begin excerpts]

I always thought of myself as a good psychiatrist, actually a very good psychiatrist. I saw much improvement in almost all of my patients and could control each person’s symptoms with psychopharmacological medications and with psychotherapy, which I loved to do. I never had to refer more than about 1% of my large patient population to hospitals, even though some of my patients were very ill. I could maintain treatment on an outpatient basis, and, in my 34 years of private practice, I never had a patient commit suicide. 

Now I am 71 years old and have been retired 8 years. Yet I realize now that despite having been a board-certified psychiatrist and a Life Fellow of the American Psychiatric Association, I was ignorant about something very important—the full range of patients who could receive the broad spectrum of benefits from electroconvulsive therapy (ECT). 

I rarely referred patients for ECT and always thought of it as a last resort. I was not sufficiently knowledgeable of the benefits of ECT until I myself was the beneficiary.

My husband died in the fall of 2019 after struggling for 9 years with progressive mental and physical decline from Parkinson’s disease. 
During those last 2–3 years, I developed symptoms of clinical depression, which became quite severe and were disturbing to both of us. I never felt suicidal, but I became extremely indecisive and lost my joie de vivre, my ability to experience pleasure, and my motivation; most important, I lost my resilience. Everything took such effort. 

I tried three antidepressants, but I could not tolerate their adverse effects and quit them before they could have conferred any benefit. I felt very discouraged and disheartened, especially when my primary care physician told me that my psychiatric symptoms were above and beyond his level of knowledge or training and that he did not have a clue how to help me. It made me feel that something was terribly wrong with me. 

Despite good insights from psychotherapy, I knew deep inside that my depression was not really getting better, but finally it improved for a few months. Nonetheless, my symptoms returned and got progressively worse during the last few months of my husband’s life. 

This time, no matter how good the insights were from psychotherapy, my depression only went downhill, especially after my husband’s death, and my cognition became so adversely affected that I developed irrational thoughts.

One of my sisters-in-law did some research and finally learned that Sheppard Pratt Hospital in Baltimore had one of the finest psychiatric units in the country. When she and my brother flew across the country to drive me to Baltimore to be admitted, I offered no resistance.

I was assigned to a wonderful psychiatrist who, after a thorough initial evaluation, recommended I get ECT. I was indignant at his suggestion because none of the five doctors I had previously consulted who knew that I was depressed had ever suggested I needed ECT. And I certainly was too impaired myself to recognize that I needed ECT. 

I was scared by the suggestion because I knew very little about the treatment, despite my training and despite my many continuing medical education courses in which ECT would inevitably be mentioned but never emphasized. I had thought it should be reserved just for the absolute sickest of the sick—which I did not consider myself to be. But my psychiatrist said in a very reassuring voice that it would certainly turn my symptoms around faster than anything else and that I needed to trust him because he would not have recommended it if he did not genuinely believe it would help me. Finally, after many days of resistance, I signed the consent form to undergo ECT.

It took only three ECT treatments to totally turn around my depression and to stop whatever irrational thoughts had developed.

I was more sensitive to the ECT treatment, resulting in seizures induced by the treatment that were longer than the seizure lengths typically achieved with ECT. This greater sensitivity had the advantage of making each treatment maximally effective in improving my mood but had the disadvantage of causing more post-ECT disorientation (i.e., when asked where I was, I would say “Tucson” instead of Baltimore).

But my orientation improved each day, and the confusion finally disappeared completely. I have no memory of the actual ECT treatment because a general anesthetic and a short-acting benzodiazepine had suppressed any memories during the treatment. I never felt the seizure and had no later discomfort from it.

On awakening from the general anesthetic, I was wheeled back to the psychiatric unit, whereupon I could eat a meal that had been delayed until after the treatment because of the general anesthesia.

Once my symptoms of clinical depression disappeared, which they did very rapidly, I could take pleasure in life, regaining my joie de vivre, my high level of motivation, and my ability to make decisions, and I once again had my resilience back. I no longer felt overwhelmed and could accomplish whatever I needed to do. What a difference a change in brain chemistry made!

The positive experience made me think that maybe I could do some good by writing this article and by recognizing that perhaps ECT is underutilized and should be considered more frequently as a treatment option than it usually is. After all, I now reap only the benefits of ECT and have no adverse effects at all. And for that I am very fortunate, because I had the best possible outcome. I realize that for too many people—for both patients who might be candidates for ECT and the doctors treating them—ignorance about the benefits of ECT and a persistent stigma may cause them to oppose the treatment. Even doctors who do not themselves “do ECT” or are not psychiatrists should have at least some basic understanding of the procedure and the types of patients who could benefit. When such a patient presents in their practice, they would then know to refer him or her to a more qualified specialist for evaluation for ECT. The patient will need a thorough discussion with the specialist so that the patient can gain a genuine understanding of both the benefits and risks of ECT and can be a partner with the physician in a shared decision-making process to decide on what might be the optimal treatment. Whenever a procedure is less mysterious, it is more acceptable. Mostly, stigma about any disease or any treatment occurs out of ignorance. For any of us, accurate knowledge and dialogue are essential in replacing the obstacles of fear and stigma. Even I, a doctor, desperately needed that thorough dialogue when I was in the role of being the patient. It enabled me, after several days of deliberation, to finally be willing to consent to ECT, a procedure that truly gave me my life back!

I would like to add that even when a doctor might feel a wall of resistance in discussions with a patient highly ambivalent about any treatment option, including ECT, the patient might become more understanding and accepting over time. With each day of more discussion, of more information being absorbed, and of more seeds being planted in the patient’s mind, arguments that might have been flatly rejected initially might become more understandable and acceptable to the patient several days later. I was given supplemental articles that were helpful for me to read and reach a decision. Some excellent websites educate patients about ECT, including

Because everything we learn helps to refine questions we can ask our treating physicians, we as patients become more empowered by this learning process to make the right decisions for ourselves.
[end excerpts]
TO OBTAIN A COPY OF THE ARTICLE: Contact info for reprint requests and questions or other correspondence about this article:
Ken Pope

Pope & Vasquez: Ethics in Psychotherapy & Counseling: A Practical Guide, 5th Edition

Pope: Anti-Racism & Racism in Psychology as a Science, Discipline, & Profession: 57 Articles & Books (Citations + Summaries)
Pope: A Human Rights & Ethics Crisis Facing the World’s Largest Organization of Psychologists
“Confidence, like art, never comes from having all the answers; it comes from being open to all the questions.”—E. G. Stevens