Psychology For Physiotherapy

Psychology for Professional Groups
Psychology for Physiotherapists

Psychology for Professicmal Groups
Series Editors: Antony J. Chapman and Anthony Gale
Psychology for Professional Groups is a new series of major

textbooks published with the British Psychological Society.
Each is edited by a teacher with expertise in the
application of psychology to professional practice and
covers the key topics in the training syllabus. The editors
have drawn upon a series of specially commissioned topic
chapters prepared by leading psychologists and have set them
within the context of their various professions. A tutor
manual is available for each text and includes examination
questions, practical exercises and. projects, further reading
and general guidance for the tutor. Each textbook shows in a
fresh, original and authoritative way how psychology may be
applied in a variety of professional settings, and how
practitioners may improve their skills and gain a deeper
understanding of themselves. There is also a general
tutorial text incorporating the complete set of specialist
chapters and their associated teaching materials.
PnNisbecl with this hook

Psychology and Medicine. David Griffiths
Other titles
Psychology and Managers. Cary L. Cooper
Psychology for Social Workers. Martin Herbert
Psychology for Teachers. David Fontana
Psychology for Occupational Therapists. Fay Fransella
Psychology for Nurses and Health Visitors. John Hall
Psychology for Careers Counselling. Ruth Holdsworth
Psychology for Speech Therapists. Harry Purser
Psychology and People: A tutorial text. Antony J. Chapman
and Anthony Gale
Psychology for Professional Groups
Psychology for
Physiotherapists
E. N. Dunkin
o The British Psychological Society 1981
Softcover reprint ofthe hardcover 1st edition 1981
All rights reserved. No part of this publication may be

reproduced or transmitted, in any form or by any means,
without permission.
First published 1981 by THE BRITISH PSYCHOLOGICAL SOCIETY

and THE MACMILLAN PRESS LTD.
ISBN 978-0-333-31884-3 ISBN 978-1-349-16600-8 (eBook)

DOI 10.1007/978-1-349-16600-8
The paperback version of this book is sold subject to the

condition that it shall not, by way of trade or otherwise,
be lent, resold, hired out, or otherwise circulated without
the publisher's prior consent in any form of binding or
cover other than that in which it is published and without a
similar condition including this condition being imposed on
the subsequent purchaser.
Note: throughout these texts, the masculine pronouns have

been used for succinctness and are intended to refer to both
females and males.
The conclusions drawn and opinions expressed are those of

the authors. They should not be taken to represent the
views 0 f the publishers.
Contents
1 General introduction
PART ONE
General issues
Chapter 1
13 Scientific methodology
Chapter 2
40 Motivation
Chapter 3
66 Learning and teaching
Chapter 4
101 Intelligence and perception
PART TWO
The individual
Chapter 5
121 Biological bases of behaviour
Chapter 6
149 Personality and individual assessment
Chapter 7
174 Knowledge of self
PART THREE
Social and time factors in life
Chapter 8
197 Social development in early childhood
Chapter 9
229 Language development in young children
(v)
Chapter lO
254 The adult: interpersonal behaviour and social adjustments
Chapter 11
281 The adult: a review of his memory
Chapter 12
297 Ageing and social factors
PART FOUR
The iDdmdual ;mel crisi8
Chapter 13
327 Crisis, stress and the sick role
Chapter 14
353 The management of pain
Chapter 15
370 Dying and bereavement
392 Epilogue
395 Index
(vi)
Preface
Throughout their training and professional life, physio-

therapists spend a great deal of time trying specifically
to influence other people's behaviour, with the underlying
intention of improving the quality of the life of their
patients. Physiotherapists work with patients to help them
make the best use of their personal resources for recovery.
This book shares that principle of encouraging people, in
this case physiotherapists, so that they make the best
possible use of the accumulated observations of human
reactions, which are the foundation of psychology, and
achieve the ultimate aim of the training and practice of
physiotherapy more easily and rapidly. In moving towards
that goal, the book has three subordinate aims: (i) to deal
with the immediate needs of the student meeting psychology
for the first time; (ii) to continue discussion of some of
the major issues in psychology to a depth that will be
enough to whet the appetite of the reader for even more
information; and (iii) to apply some of the accumulated
information of psychology to illustrate the relevance of
psychology to the successful treatment of patients.
The relatively limited aim of helping students to pre-
pare for taking their qualifying examinations is only part
of the story, although information about the ways in which
human beings leam and under what conditions they make the
best job of doing this would certainly not come amiss: it
could be a first step towards reaching confidence in the
factual background and special techniques used in physio-
therapy. A broader aim is that of assisting the reader to
gain an accurate insight into the information that has been
accumulating and building the substance of psychology over
the centuries. The book introduces the commonly shared
structural and descriptive methods of psychologists, the
way they approach the involved problem of observing and
analysing human behaviour, and the language they have
developed to explain what they have found.
Not all the areas of psychological enquiry are equally
applicable to the practice of physiotherapy, but a great
deal of what is known about the processes that are peculiar
to the individual, and that go on between individuals, are
particularly apposite: these have been teased out from the
general fund of information and are discussed in greater
detail. Given these two types of data, some of a general
(vii)
nature and others related to the individual, the final goal
of the book is to apply them to the sort of problems that
physiotherapists and their patients deal with from day to
day.
This gives an outline of the purpose of the book but it
would not, on its own, be a sufficient reason for the exer-
cise of writing it unless it were coupled with an explana-
tion of how the book expects to carry out its purposes. If
it has no pretensions of being an exhaustive and definitive
textbook, covering all aspects of psychology from its in-
ception to the present day, what does it offer and how does
it set about its task? The general idea is that the reader
should take an active part in achieving the aims of the
book: questions are asked, to stimulate the reader who will,
it is hoped, be obliged to:
* discuss these questions with other people;

* search the literature for answers.
At the same time, it is hoped that these two activities

will induce further questions, further debate, and the for-
mation of a personal evaluation of the course in psychology
tha t forms part of the physiotherapist's training. In short,
the book is seen as the centre of a 'snowball effect' which
will promote interest that will remain active long after the
final page has been read.
To gain maximum benefit from this book, be prepared to
discuss the issues it raises with your fellow students or
colleagues (psychologists call them your 'peers'), follow up
the references for further reading to satisfy your curiosity
about human behaviour, and do not expect to find all the
answers here or in any other single textbook.
If the book uses unfamiliar words, pick up a dictionary
and find out their exact meaning rather than guess the
meaning from the context. This will have two advantages: you
will have an easier time understanding the text, and your
own vocabulary will increase, making it considerably easier
to express and maintain your opinions in a discussion.
Acknowledgement I am glad to have this opportunity of thanking Miss Jennifer

Lee, Principal of the South Teeside School of Physiotherapy,
and Mr David Hill, Reader, The School of Health Science at
Ulster Polytechnic, for their help and advice in assembling
the content of the book. I am most grateful for their will-
ingness to act as consultants at all stages of the prepara-
tion of the manuscript, despite their own heavily committed
advisory and teaching programmes.
(viii )
Foreword
This book is one of a series, the principal aims of which

are to illustrate how psychology can be applied in parti-
cular professional contexts, how it can improve the skills
of practitioners, and how it can increase the practitioners'
and students' understanding of themselves.
Psychology is taught to many groups of students and is
now integrated within prescribed syllabuses for an increas-
ing number of professions. The existing texts which teachers
have been obliged to recommend are typically designed for
broad and disparate purposes, and consequently they fail to
reflect the special needs of students in professional
training. The starting point for the series was the
systematic distillation of views expressed in professional
journals by those psychologists whose teaching specialisms
relate to the applications of psychology. It soon became
apparent that many fundamental topics were common to a
number of syllabuses and courses; yet in general intro-
ductory textbooks these topics tend to be embedded amongst
much superfluous material. Therefore, from within the
British Psychological Society, we invited experienced
teachers and authorities in their field to write review
chapters on key topics. Forty-seven chapters covering 23
topics were then available for selection by the series'
Volume Editors. The Volume Editors are also psychologists
and they have had many years of involvement with their
respective professions. In preparing their books, they have
consulted formally with colleagues in those professions.
Each of their books has its own combination of the
specially-prepared chapters, set in the context of the
specific professional practice.
Because psychology is only one component of the various
training curricula, and because students generally have
limited access to learned journals and specialist texts, our
contributors to the series have restricted their use of
references, while at the same time providing short lists of
annotated readings. In addition, they have provided review
questions to help students organize their learning and
prepare for examinations. Further teaching materials, in the
form of additional references, projects, exercises and class
notes, are available in Tutor Manuals prepared for each
book. A comprehensive tutorial text ('Psychology and
People'), prepared by the Series Editors, combines in a
(ix)
single volume all the key topics, together with their
associated teaching materials.
It is intended that new titles will be added to the
series and that existing titles will be revised in the light
of changing requirements. Evaluative and constructive
comments, bearing on any aspect of the series, are most
welcome and should be addressed to us at the BPS in
Leicester.
In devising and developing the series we have had the
good fortune to benefit from the advice and support of Dr
Halla Beloff, Pro fessor Philip Levy, Mr Allan Sakne and Mr
John Winckler. A great burden has been borne by Mrs Gail
Sheffield, who with skill, tact and courtesy, has managed
the production of the series: to her and her colleagues at
the BPS headquarters and at the Macmillan Press, we express
our thanks.
Antony J. Chapman
UWIST, Cardiff
Anthony Gale
University of Southampton
May 1981
(xj
General Introduction
E. N. Dunkin
Purpose of this book As the scope of psychology has grown so has its literature:
the number of textbooks and journals has multiplied until
printed resources are so great that the production of yet
another book would be inappropriate unless it had a specific
contribution to make. This book is addressed to the needs of
students and practitioners of physiotherapy for whom an
understanding of their own choices and prejudices is just as
important as their understanding of interpersonal behaviour.
The inclusion of psychology in their training will have a
greater value for them if it is linked to issues and experi-
ences that are central to their work. For those who are
meeting psychology on a formal basis for the first time, it
will be easier to appreciate much of its content if they are
introduced to the logic of experimental design and use of
statistics.
Structurally, the book consists of papers written by
psychologists with special interest and wide experience in
their topics. The chapters highlight particular aspects of
these topics and they are presented against the background
of the enthusiasm and skill of their writers. Each section
is preceded by an introduction to the particular subjects it
covers and in many cases by questions aimed at starting a
debate about the issues to be raised. Following each chapter
there are suggestions for further reading and for questions
based on the chapter content. After a general introductory
section, the formal arrangement of the chapters is achieved
by grouping topics so that they are seen to develop from
general issues in psychology, through consideration of the
individual, to a view of the individual over time and in
social settings. The final part of the book looks at the
person in some of the crises that commonly occur in life.
None of these sections exhausts the possibilities of dis-
cussion and debate and it is the editor's hope that the
issues each section raises will set off discussions about
the behaviour of self, family, patients and colleagues, and
send the reader to the nearest library (or local profes-
sional meeting) in search of confirmation or rebuttal of his
own ideas.
In search of a def"mition Discussions centred on psychology tend to attract general

interest arid participation because many people have their
I
Introduction
own ideas about the meaning of the word 'psychology'. It is

usually agreed that it denotes an area of particular inter-
est and academic pursuit, but personal opinions range from
dismissing the whole thing as 'just common sense' to accep-
ting its scientific value and scope and seeing it as a
respectable subject worthy of study. The main problem in
finding a suitable definition is that its emphasis has
changed and developed over the centuries since the word
'psychology' was coined by Aristotle. He used two Greek
words, PSYCHE and LOGOS, and combined the 'soul or spirit'
of mankind with 'propositions' about it. Following his lead,
early psychologists were very concerned with the inner life
of human beings, searching for a better understanding of the
reasons for their own thoughts and feelings, and speculating
on the minds and experiences of their fellows.
In the middle of the nineteenth century the bias of
psychology swung from examination of their own behaviour by
introspection towards the type of investigation that was
already going on in the natural sciences. A physicist-
philosopher called Fechner published his proposals for
linking sensations with physical events going on in the
world outside the person: this made it possible to measure
and record the physical events, bringing the processes going
on inside the person closer to some form of measurement.
Fechner's work reached the scholars virtually at the same
time as Charles Darwin's book, 'The Origin of Species', and
within 20 years Wilhelm Wundt had founded the first psycho-
logical laboratory in Leipzig (1879). Psychology continued
to move closer to the other sciences where events were not
only being seen to take place, but were being measured with
increasing accuracy and becoming predictable as more and
more information became available. Psychologists became
engrossed in reporting what they could see and hear other
people doing: this led to changes in the methods of study.
Man was abandoned as the prime creature to investigate,
largely because he had developed distinct ideas about his
rights and expectations and these did not include a favour-
able regard for pre-emptive interference in his personal
activities and life style! It was seen as unethical to jug-
gle with his environment so that, for example, the psycho-
logist could make accurate observations of the effects of
depriving him of his food, sleep or protection against the
elements. These ethical considerations seriously hampered an
experimental approach: they restricted the control of condi-
tions under which human subjects could be observed and made
comparisons between individuals relatively useless from a
scientific point of view. Psychologists began to concentrate
on the behaviour of other species, at the same time curbing
their curiosity about the processes going on inside their
subjects' 'minds' and limiting themselves to describing
patterns of activity. Their zeal for being careful and
accurate led them increasingly into a false position where
they implied, by ignoring the 'inner processes', that these
were not a proper setting for academic enquiry. The swing
away from studying human beings was more marked in North
2
Introduction
America than it was in Europe, where a proportion of psycho-

logists continued to use introspection as their main source
of information: they used the reports of personal experience
in analysing the inner processes of individual human beings,
some of whom were their patients. These analyses developed
a distinctly clinical flavour.
But there is one comfortable thing about pendulums and
matters that behave like them: they always swing back over
the area they passed on their first track. The state of
psychology at the latter part of the twentieth century is
that more attention is being given to mankind as a species,
with a considerable part of that attention being devoted to
the individual. Once again, it has become respectable to
admit that the thinking of other people is a compelling and
intriguing area for investigation and speculation. How can
scientific studies afford to ignore the mental processes
that precede, and probably determine, the selection and
skilful achievement of the actions we see and hear other
people doing?
Three f1Jndamental If it is difficult to set the limits of psychology and

questiODS establish a definition that is fully satisfactory, perhaps
it would be better to look at its most salient questions.
Essentially there are three questions about the life and
behaviour of living creatures that have been asked over and
over again.
* WHAT can a creature do?

* WHY does it do these things?
* WHEN (and under what conditions) does it do these
things?
What?
By checking their own repertoire of behaviour, earlier
psychologists distinguished two major categories of human
behaviour, the first involving the mind only (THINKING) and
the second involving the mind and the body (THINKING plus
MOVING in some way), with the second category including
speaking. The modern counterparts of this mind/body dicho-
tomy are seen in the so-called mental and physical activi-
ties, with behaviour being described as either 'concealed'
or 'overt', and experience said to be either 'subjective' or
'objective'. When 'thinking' (subjective behaviour) was the
focus of attention, all the sub-skills that could be ob-
served by introspection were itemized and reports of these
were collected by verbal means: at this point speaking and
writing were of paramount importance. A person could be
asked to report on the whole range of processes: receiving
stimulation, perceiving, interpreting, observing, analysing,
reasoning, learning, making decisions, constructing con-
cepts, recognizing things, recalling things and imagining
others, etc. In time a suspicion crept in: what would happen
to the reliability of a report if a person's imagination was
3
Introduction
stronger than his recollection? How could fantasy be dis-

criminated from facts in a report? In addition, there was an
increasing semantic problem because one person was experi-
encing and describing his reactions while another one relied
on that verbal description to interpret the experience. The
closer the psychologist came to the carefulness and preci-
sion of the natural sciences, the more dubious he became
about believing what his subjects said. So he turned to the
questions related to 'doing' (overt behaviour) as opposed to
'thinking' and found that he could bring under detailed
scrutiny the complete repertoire of waking and sleeping
activity for any animal or species, with the peculiarly
human capacity for language-linked behaviours offering a
convenient extension of these repertoires. This time the
catalogue of possible activities included walking, running,
feeding, naming, grasping, looking, etc., while considerable
attention was given to how the subject would 'respond' when
the experimenter applied a 'stimulus'.
Early attempts to explain the wealth of observable
activities were built into grand theories that were supposed
to be capable of being applied to the whole species with
some hope of predicting behaviour: later, the imperfections
of such gigantic explanations became a matter of some con-
cern and the wide application of the theories was rejected
so that the theories themselves became relatively useless.
There was a swing away from theory construction and
psychologists returned to detailed observation and precise
description of patterns of responses.
Why?
The question 'why' a creature does things has been tradi-
tionally studied under the heading of MOTN ATION. Failure
to reach a theoretical explanation of all behaviour led to
the idea that some patterns of activity that occur in
species are 'inborn', meaning that the individual inherits
particular patterns of behaviour as its INSTINCTS. The
individual comes equipped with DRIVES towards the satis-
faction of basic and physiological NEEDS which are linked to
survival. Other forms of behaviour were then seen to develop
in relation to experience: these were dubbed as LEARNED and
seen to depend on the individual's responses to changes in
the internal and external environment. These responses
seemed to be linked to gaining the maximum physical and
mental well-being once the basic needs of survival had been
achieved. Following this line of reasoning, we are obliged
to put forward ideas of gaining satisfaction or pleasure
and avoiding discomfort or pain: immediately we do this,
we are back in the realm of personal estimates and private
experience, and once again we find we are using words that
have sUbjective significance. As we said before, the pen-
dulum of interest has swung from one extreme to the other
in the development of psychology: psychologists have been
very disciplined with themselves while they concentrated on
the activity of species that cannot communicate verbally
4
Introduction
with human beings, and they have controlled the tendency to

guess what is going on inside the brains of their subjects.
In general, they have been less restrained with studies of
human beings and the reports of the subjects have been added
to the observable evidence. At present, the climate favours
explanations that trade in educated guessing about the
thinking that people do, and what a person says about his
thought processes tends to be respected and believed. How-
ever, there is an alternative means of investigation that
may offer a route away from the dilemma of being unable to
observe what a person thinks: the search is under way for
evidence of the precise biophysiological events that are
going on inside the central nervous system while a person
thinks. As more information about these physiological
changes in nerve cells becomes available, it may become
feasible to adopt Fechner's ideas of linking sensations with
recordable events once more, only this time the events could
be within a person rather than in his immediate environment.
This approach is being pursued at present under the general
'umbrella' of physiological psychology.
Why do psychologists ask questions? Since psychologists
themselves have had a basic interest in WHY things are done,
it is probably appropriate to ask at this stage WHY psycho-
logists have been investigating the behaviour of others,
human and sub-human, for so long. What is the purpose of
finding out what a creature will do under certain condi-
tions? Is learning about animal behaviour the same as satis-
fying any other form of curiosity: is it an end in itself?
If this is accepted, then 'knowing' and the search for
knowledge is rather like driving down a cul-de-sac. But
perhaps the aim is to be able to PREDICT patterns of
behaviour: in this case, there must be some extreme sat-
isfaction in being right about these predictions (a satis-
faction in being right for the sake of being right) or else
there must be some people somewhere with an ulterior motive,
searching for a way to CONTROL the behaviour of the creat-
ures they are observing. Once achieved, will this control be
used for the ultimate good of their subjects? And will it
benefit all of them, an individual, or an elite section of
the popUlation? In either case, what standards are to be
used to judge what is 'good for' the community, individual
or select few? Perhaps more crucially, who is going to make
the decisions and wield the controlling influence?
In fact, if we begin to challenge the purpose of psycho-
logy at large, we soon become involved in far-reaching
issues and we generate questions without finding any immedi-
ate answers for the basic ones of WHAT, WHY and WHEN
things are done.
Faced with such wide-ranging and philosophical ques-
tions, we have a choice: we could either spend a great deal
of time and many volumes in a colossal exposition of compe-
ting evidence, opinion and judgements, or we could contain
our enquiries within the immediate demands (but lesser
scope) of the medical sphere. The purpose of our studies,
5
Introduction
scope) of the medical sphere. The purpose of our studies,

and of this book, would then become to develop a fuller
understanding of human life, to identify human problems and
to discover ways of reducing these as we find them. Any
gains in knowledge would then be applied to the clinical and
social situations, where people have learned to tolerate the
idea of being 'controlled for their own good': they trust
those who have been trained to use this control in a bene-
volent way. To make the best use of this trust, medical and
paramedical students would be encouraged to apply the find-
ings of psychology to themselves, in order to gain insight
into their own reactions as well as those of their patients,
and to improve their self-knowledge, self-esteem and self-
control.
Adopting this second choice would lead us to concentrate
on human behaviour: as the pendulum of agreed interest is
already swinging in this direction, we seem to have made a
timely entrance!
When?
There is a logical relationship between the question 'When
does a creature do anything?' and the previous question that
asked WHY it did anything. It is possible to alter the
timing of particular behaviours:
* by changing the environment so that the usual time

schedule for that behaviour is upset, or
* by putting a creature in a situation where a decision
must be made between two alternative types of
behaviour.
Essentially this puts the animal and the changes in its

internal and external environment in a time scale: pre-
diction then moves from being a general statement on coming
events to being an accurate forecast of the time at which
these things will take place. Psychologists have noticed
that creatures will do particular things when things are
done to them: the concept of STIMULA nON followed by
RESPONSE is an experimental summary of the situation. For
example:
* general statement (WHY?): 'A creature will eat food to

satisfy a physiological need for food.'
* accurate forecast (WHEN?): 'If the supply of food is
restricted and the creature has experienced the restric-
tion, it will eat immediately food is available.'
If feeding is studied and the general statement on why an

animal eats is explored, there is evidence that the feasible
limits of its feeding depend on a combination of the size of
its stomach and its level of activity. Time is needed be-
tween meals for the stomach to empty and for the supply of
food to be used to energize activity. Feeding tendencies are
seen to have a rhythm and will recur perpetually. However,
6
Introduction
the time between one meal and the search for the next varies
between species, with hibernating animals providing an ex-
cellent example of a rhythm of feeding that has a long
period of suspension during the time that external condi-
tions are not favourable for any behaviour except sleeping
and keeping warm.
When an experimenter interferes with a creature's
ability to find its own food, there is less likelihood of
the natural and perpetual rhythm being shown. It is then
possible to predict that the animal will eat as soon as
(Le. when) food is offered to it.
There are other occasions and other activities that
defeat any attempts at accurate forecast: the psychologist
cannot detect any particular timing for a type of behaviour.
There is no obvious reason for the activity and no apparent
means of predicting when it will occur again. When this
happens the creature is said to be behaving in a random
fashion, which is a successful camouflage for the fact that
the observer can say no more than: 'he is doing it because
he feels like it, or when he wants to'. Despite having
detailed information about the physiological needs and
habits of human beings, it is more difficult to tell WHEN
they will do things. This is partly because human beings
PLAN their time and the plans are 'private' in many cases.
Some people manage to plan their time more effectively than
others, but even when the timing of their activities falls
behind schedule, people make decisions that adjust the
remainder of their day. A hard pressed businessman CAN
decide to forgo his regular meals and work for unusually
long periods: his wife may have no way of predicting WHEN
he will come back from the office. He is capable of putting
his physiological needs and his business commitments in a
mental balance and DECIDING to change his time schedule
in favour of finishing some important piece of business
before eating. He may make this decision although he knows
that the ultimate loss of his good health may be the price
he pays for delaying WHEN he eats. So, competing needs
require CHOICES to be made and these choices often deter-
mine when a particular piece of behaviour will happen.
The changing vocabulary Psychologists are no exception to the rule that people work-
of psychology ing in areas of special study develop some words to meet
their own needs and adopt others from general use, giving
these particular emphasis and interpretations. Before
leaving this introductory section, it is pertinent to look
at the changes that have occurred in the psychologist's
language. A chronological development in the use of key-
words has kept pace with the trends in investigation so
that, in following the progress of its special language, we
can trace the history of twentieth-century psychology. In
the first half of the century words such as 'cognition',
'conation' and 'affect' made the writings of psychologists
relatively obscure to the uninitiated and lent status to
7
Introduction
modern tendency amongst psychologists to call a spade a

spade and to use everyday words to describe commonplace
and basic activities. The language has become less exclusive
as the academic acceptance of psychology has grown.
'Knowledge', 'attitudes' and 'skills' form the current trio:
their relationship to the earlier terminology can be seen
in the following dictionary definitions:
* cognition: action or faculty of knowledge including

sensation and conception (forming in the mind,
imagining, fancying, thinking);
* conation: desire, exertion of will, striving, volition;
* affect: emotion, or feeling, as an antecedent of action.
From the welter of terms and areas available in psychology,

some emerge as clearly of greater relevance to people who
are working to improve the lot of their fellows:
* motivation;
* learning;
* personali ty;
* development;
* social interaction.
If we add to these some of the problems that human beings

face at different stages in their lives, such as
* pain
* physical and mental disturbance
* ageing
* dying and bereavement
we have the key words that have been used to set the
direction and to select the topics for the chapters in this
book.
Historically, psychology began as a branch of philosophy and

then became linked with the accumulating facts in the world
of physics. It now seems to be moving into the realms of
ana tomy, physiology and biochemistry. There is no reason
to see this as a flaw in the development of psychology: it
keeps pace with the general trend of considering mankind as
a whole, unable to exist divorced from our natural environ-
ment but capable of influencing that environment to a pro-
found extent (even to the point of encapsulating a suitable
amount of that environment and taking it on a return trip
through space). This holistic approach is the battle song
of modern medicine and paramedicine, with the 'team' who
have the primary and continued care of any patient being
seen to INCLUDE that patient and, by its combined efforts,
to be a constant reminder of the well-worn adage that 'the
whole is greater than the sum of its parts'.
Nevertheless, there must be some analysis of all complex
and co-operative wholes, if they are to be fully understood,
8
Introduction
Nevertheless, there must be some analysis of all complex

and co-operative wholes, if they are to be fully understood,
and the rest of this book will take some of the identifiable
and cogent parts of psychology and examine them one at a
time. On the assumption that scientists and their adherents
share a universal search for order, there has been a deli-
berate attempt to follow a plan in making this examination,
commencing with an introduction to scientific methodology,
its structured approach to enquiry and its consequent
capacity for passing on information to other people.
9
Part one
General Issues
11
I
Scientific Methodology
D. Legge
0peaiDg remarb Scientific achievement is a phrase that has attracted grow-

E. N. DUNKIN ing attention over the last 100 years, although at first it
was treated with considerable awe by the humble layman who
left scientists to discover and hand down 'Laws of Nature'
to their fellow men, who had lesser training. As mechani-
zation and automation have moved increasingly into the daily
life of the people who previously were the energy units of
industry, it has become necessary for everyone to be more
involved with scientific thinking and less awed by its
mysteries. General science is seen as a suitable subject for
basic education, and schoolchildren now take the discoveries
of physics, chemistry and biology in their stride: they are
involved, at first hand, in classroom experiments that
illustrate the laws that a few years ago were accepted as
gospel but rarely experienced in any meaningful way by the
general public. People are more aware of the methods that
were used in uncovering these facts and feel less bothered
by the exceptional cleverness of those who discovered them.
The search to push back the limits of exploration of the
universe is on and people appreciate the need for organi-
zation if the results of every investigation are to be used
constructively. Scientific methodology really represents a
deliberate attempt to make sure that all the details of a
study are as clear as possible to the investigator, to his
colleagues and to those following other lines of enquiry at
the same time, and to all those who may come after him in
search of similar truths.
Values of scieatific methodology in physiotherapy

The theme of asking questions was set in the Introduction.
To continue this theme, it is appropriate to ask why physio-
therapists need to have more than a general knowledge of
this disciplined way of studying their world. You may well
have your own opinion about the answers to this question but
it is worth considering the following list. Scientific
methodology offers:
* a standard way to evaluate the contribution made by the

profession to the care of patients, with the associated
possibility of improving treatment;
* a reliable base for communication within and outside the
profession;
13
Scientific methodology
* an effective means of improving self-knowledge for the

profession via research;
* in a climate heavy with scientific progress and academic
achievement, a chance of better status for the members
of the profession.
In this world, where the pursuit of science is a compelling

activity, there is a great need for any profession that is
responsible for other people's health to seek and express
clearly the scientific basis of its own ethos. The altru-
istic values of such strivings can be stated in terms of
better patient care and better communication amongst col-
leagues, but it would be unrealistic to deny that there is
also a need to establish an acceptable and secure academic
status for these professions, so that they are not seen as
the poor relations of the respected medical world, which is
itself fully supported by scientific findings.
Need for int~fessiODal cOJllllllDrieation

If we compare the development of psychology with that of
medicine over the same period, we find that while the
psychologists have been adding more studies based on physio-
logical interpretations to their original concern with the
mind, doctors and those who care for the physically ill have
become increasingly involved in examining the social and
mental aspects of their patients' health. The training of
physiotherapists has reflected this increasing bias in
medicine and there has been more emphasis placed on the
reactions of the patient to treatment than there used to be:
at the same time, physiotherapists are expected to be able
to report on the advantages and disadvantages of a patient's
socio-economic environment in the context of his chances of
full recovery.
Growing concern with the wide variety of needs shared
by sick people has fostered an equivalent variety of profes-
sional specialities. The original team of patient, doctor
and nurse was joined at the tum of the century by almoners,
but more recently it has expanded to include physiothera-
pists, social workers, dieticians, clinical psychologists,
occupational therapists and radiographers: in fact, all the
services that are now grouped as paramedical, ancillary to
medicine, or complementary to medicine. It is probably
invidious to have started such a list, as it is impossible
to quote the professions in any rank order and certainly
unlikely that all the important groups are even mentioned:
suffice to say that there are numerous people sharing the
same purpose of treating the patient as an entire person
and, consequently, it has become essential for all the
members of this large and somewhat loosely associated group
to be able to talk to one another easily, accurately and
swiftly. Despite differences in their techniques and res-
ponsibilities, they need to use similar language and to
follow the same rules when it comes to discovering and
reporting the facts about their contributions to the total
14
treatment plan. They also need to understand the principles

of each other's expertise. It was mentioned earlier that
specialized language (known as professional jargon) tended
to isolate the early psychologists from those who were not
fluent in its use: specialized pieces of behaviour can be
just as exclusive as jargon unless their purpose can be
explained via a common language. All in all it seems as
though the adoption of the scientists' methods of enquiry
and ways of analysing information might form a suitable
common denominator for inter-professional exchanges, in
much the same way as the adoption of English serves the
international exchanges in the world of finance and
business.
ObMnatiOll aDd accurate ft:CardiDIf a necaury habit

However, if we are advocating that everyone should use
this approach, it will be necessary for them to feel at ease
with it, to feel included, to ~oin the club~ and this will
depend on learning the skills of scientific methodology as
well as on learning how to talk about them. To achieve this,
each profession will have to do more than pay lip service to
the idea. If it is to be valuable, instruction in scientific
methodology should not be grafted on as an afterthought to
professional training. Students need to be sufficiently
familiar with it for it to become a habit that is expressed
in an organized approach to any situation. People are always
uneasy in an entirely new situation: there is a sense of
insecurity at first. The physiotherapist's contact with
scientific methodology must be enough to ensure that it
feels like a comfortable garment, not like a pair of new
shoes that announce their newness with every painful step.
As David Hill says, 'Measurement, evaluation and statistical
analysis should be taken seriously or not at all' (Hill,
1974). Psychology is included in the syllabus for training
of physiotherapists to make sure that the students become
aware of their own behaviour and that of others: how better
can this be done than on a basis of disciplined observation?
And if physiotherapists are involved in the business of
prediction (as they are each time they are asked to give
advice on the preparedness of their patients for discharge),
they are obliged either to set up some rules for observation
or to follow those that have been used for years by those
who began the business of prediction.
Most of us know that groups of people set up all sorts
of norms: at the moment, all the academic groups with
scientific leanings are adjusting their standards to the
norm of clarity of purpose and sharply defined organization.
They are involved in research and exact in their publica-
tions. 'Hunches' and 'flashes of inspiration' are still of
value, but there is general agreement that these should be
tested and that their real worth must be discovered through
careful observation of the way they work. Scientific method-
ology can be seen as a particular approach to the task of
observation: the respect due to its painstaking inspection
15
is expressed in equivalent accuracy in recording, analysis

and interpretation. It follows that the conditions under
which observations are made are as important as the instru-
ments that are used for taking measurements. In general,
machines are easier to calibrate than people, so mechanical
tools are used as much as possible. When people take the
place of instruments, as they do in manual muscle testing,
human variability becomes a problem. It is difficult to keep
a particular standard when there is a change of therapist
between one assessment and the next. However, it is easier
to achieve continuity of treatment, despite the change of
personnel, if as many details as possible are clearly
recorded and none is left to chance.
There is a tendency to think that all scientific methods
are associated with laboratory experiments but this is not
so, as you will see in the next section. There is also a
tendency to view the whole topic of statistics with some
scepticism or apprehension. It is easy enough for most of us
to have a personal interpretation of quantities expressed as
percentages, because it is familiar to us and because we
have experience of the idea of 'parts of a hundred'. Given
sufficient practice in the use of statistical ideas, it be-
comes relatively easy to read research papers published by
others: the number of research projects reported in the
professional journals of physiotherapy is increasing each
year and it is essential that all physiotherapists have
equal opportll11ities to benefit from these important
reports.
Scientific methodology and the student

A subsidiary question that may occur to some readers is,
'Why include details of scientific methodology in basic
training?' In answer to that question, and because research
is becoming a way of life, students need to develop a total
habit of enquiry and challenge, a habit of questioning, in
order to feel comfortable with the recent literature and its
style of presentation. Throughout training and practice,
physiotherapists should be searching for the real value of
the things they do, for a better understanding of the prob-
lems of their patients, and for the best available solutions
to those problems. The search is not always successful and
many diseases and disabilities still defy cure. With or
without cures, the objective remains the same: to discover
and show the patient how to make use of all his personal
resources and how to develop these to maximum efficiency.
While some people see little need for including details of
scientific methods in basic training, others feel that it is
only valuable if a thorough job is done with the introduc-
tion of the topic. A scant introduction can be shallow
enough to cause a reaction of boredom, while things that we
see as having no connection with our world, either as it is
now or as we expect it to be, are 'shed' from memory before
they can be put to use. There are others who feel that it
is most important to set the tone of future thinking by
16
'beginning as we mean to go on' and therefore to place an

analytical approach, and with it the consideration of sci-
entific methodology, at the beginning of a book. You must
decide whether you agree with this.
In the light of your own experience (based on your
general knowledge to date plus any information gleaned from
the preceding pages) consider the following questions and
discuss them with your fellow students.
* Is there any justification for striving for order and

accuracy in studying behaviour?
* Does the use of observation depend on logical investi-
gations?
* What is the definition of 'logical'?
* Is psychology an art or a science, and is this dis-
tinction fundamental and constructive or artificial
and unimportant?
* What is the definition of 'correlation' in the statis-
tical sense?
* What is the meaning of 'probability' in any reported
results?
Introduction Two fundamental questions that are central to all disci-

DAVID LEGGE plines are 'What do you mean?' and 'How do you know?' The
'What do you mean?' question is concerned with clarity of
expression, implication and establishing the topic in its
context. The 'How do you know?' question can be answered
in two ways depending upon the sort of discipline in ques-
tion. Some disciplines are essentially about ideas and need
not be influenced by, or aligned with, events outside their
own domain. Pure mathematics is, perhaps, one of the best
examples of this. Knowledge in the domain is valid insofar
as it relates logically and consistently to other statements
within the domain. So one answer to 'How do you know?' can
be 'By logical deduction'. Sometimes such knowledge can be
put to work in other domains. For example, application of
mathematics to the domain of materials offers a quantitative
structure for physics and engineering.
Nearly all disciplines are based on the assumption of a
world separate from the observer. The second answer to the
'How do you know?' question concerns the ways in which valid
additions are made to the body of knowledge about a defined
aspect of this external world. The body of knowledge will be
a model of that aspect of the world, and the value of the
model will depend on the degree to which it matches up to
the true nature of the external world. In general, science
is the set of these models that has been found to be in most
instances satisfactory for making projections about future
states of the world.
Empirical knowledge about the world may arise in many
ways but there are extreme and contrasting alternatives that
serve to highlight some important distinctions. At one
extreme is intuitive belief.
17
Intuitive belief contributes hugely to our views about

the world, being not only the basis of 'common sense' but
also playing an important role in the work of professional
scientists. An important problem with intuitive belief is
that it may be mistaken. The child, limited by his experi-
ence, may over-generalize and identify all men as his
father, or all dogs as the family pet, 'Killer'. Likewise
our own experience of the world will be limited, even as
adults, and our knowledge of it may be biassed as well as
incomplete.
Scientific disciplines have addressed the question of
finding out by developing a series of recommended practices
which, if followed, are expected to discourage the adoption
of inappropriate and invalid beliefs about the world. These
recommendations form the code known as 'scientific method'.
Application of such methods is no guarantee that one will
not be misled but it will help. It is not a substitute for
careful and critical thinking.
Sc:ieDtific methods
Classical analyses of how a body of knowledge is enlarged
contrasted inductive method with deductive method. The
former was characterized by the relatively unselective
collection of data from which generalizations could emerge
later. The hypothetico-deductive method emphasizes the
explicit development of a model from which a hypothesis is
developed and observations are then planned to test it.
Practical scientists have challenged the pragmatic value of
this analysis, since it is almost impossible to contemplate
collecting data without some degree of selection and, like-
wise, the source of the hypotheses tested in the deductive
process cannot be left unspecified. In fact, real science
makes progress in a much more untidy way than philosophers
of science would recommend. Serendipity, accidental
discovery, has probably been at least as important as
scientific method in the growth of scientific knowledge.
The body of knowledge that forms a scientific discipline
comprises two streams a flow of ideas which are a model of
the external entity and a set of observations which relate
the model to that entity. The creative aspects of research
entail developing new ideas (and therefore altering the
model) and devising new schemes for making observations with
which to enrich its data base. We know relatively little
about how to improve performance in theoretical innovation
but there are more clear-cut guidelines to carrying out
empirical investigations which will be reliable and infor-
mative. This latter specialization is called methodology. No
one who wants to understand the current status of a disci-
pline can afford to be ignorant of the methods used to ob-
tain the data which relate the substantive theory of the
discipline to reality. However, methodology is not magic and
could be likened to codified good sense sharpened on the
stone of intelligent scepticism.
Empirical methodology offers advice on two aspects of
the 'How do you know?' question. It makes recommendations
18
on how to plan observations so that the data collected are

interpretable with minimal equivocation, and it indicates
ways of making, recording and analysing those observations.
If appropriate, it is very likely that researchers will be
encouraged to quantify their observations in order both to
introduce the power of an appropriate mathematical calculus,
and to admit the use of statistical procedures in treating
the data. Quantification does not of itself confer special
value but, if it is appropriate, it does permit the fullest
possible enrichment of the recorded observations. It is its
power to render observations tractable to analysis while
taking into account the smallest amount of information that
makes quantification so attractive a step in the development
of methodology. However, some observations do not lend
themselves to such treatment and it would be an empty ges-
ture to forswear their use just because they do not admit
statistical treatment.
Scientific methods have been most fully developed
in those scientific disciplines which have the longest
histories and the most difficult, equivocal, empirical prob-
lems. The physical sciences have made immense strides in
measurement and the continuing challenges seem to be to
devise ways of making precise measurements even more sen-
sitive. They have many advantages, however, since most of
the attributes measured are reasonably stable and are not
usually disturbed or distorted by the act of measurement.
The biological sciences suffer special difficulties which
stem from the unstable, varying character of the material
under examination (especially differences between alter-
native 'samples' of the same species) and the extreme
difficulty in isolating specimens from the 'noisy' effects
of extraneous factors. These problems make phenomena dif-
ficult to detect against a varying background and encour-
age the use of statistics to highlight the distinction.
The social sciences, and particularly psychology and
sociology, suffer even more extreme problems. There is
fundamental uncertainty about what to observe and record,
dispute about the implications of any particular observa-
tion, and all the difficulties arising from individual dif-
ferences which are the consequence of observing biological
material. Furthermore, there are very serious and complex
ethical considerations about where to put the boundaries
of scientific curiosity.
From what has been said it is clear that the most
serious of these problems may be the lack of any clear
agreement about how to interpret observations that are made.
In these circumstances theoretical stances have a dispro-
portionate effect. Data which are suspected to be theory-
dependent also carry diminished credibility and it is easy
to see how an extreme scepticism could arise such that,
though accepting the desirability of empirical research, one
seriously doubted the advisability of doing it in our pre-
sent state of ignorance. The danger, of course, is that this
attitude provides a powerful argument for doing nothing ex-
cept develop theories: informed illicitly, perhaps, by the
19
undisciplined guidance of intuitive belief. A more construc-

tive approach is likely to result from attempting to conduct
empirical research while retaining a discerning awareness of
the intrinsic difficulties of interpretation.
Theory and data The stuff of which all academic disciplines are made is the
matter of ideas. Some disciplines are complete comprising
nothing but an orderly structure of ideas. Mathematics is
such a discipline. It is an intensively logical set of ideas
which are 'correct' insofar as an agreed set of rules for
combining propositions finds them consistent one with an-
other. There is no intrinsic assumption that any structure
(other than some aspect of mental activity in the mind of
the thinker) must necessarily mimic the mathematical
statement (or be mimicked by it).
It is, however, no accident that the kinds of mathe-
matics which have become popular are those which match up
with characteristics of the observable world. They are
useful because they help us deal with the world about us. In
a strict sense the mathematical system offers a model of a
set of relationships. If the observable world matches even
reasonably closely to this model it may make it easier to
understand and manipulate that world. In this way the
essential beauty of a mathematical relationship may be
complemented by its functional application. The functional
value has obvious utility. It is the basis of all the great
feats of engineering that enable us to communicate over
great distances, to fly and to harness energy in various
forms and convert it to serve our whims.
This section is devoted to considering the nature of
ideas, including ideas about the observable world, and the
relation between those ideas and that observable world.
The role of theory

The set of ideas about something is a theory. How satis-
factory a theory is depends on the degree to which it
matches up against data: that is, information about that
something. A good theory is one which allows a description
of the real world to be formulated in terms of the variables
which are the structural elements of the theory, and allows
predictions to be made about previously unobserved aspects
of the real world which are subsequently verified. A less
satisfactory theory provides a more approximate description
of the real world and predictions based on it will be
correspondingly less accurate: they will be less close
approximations. A poor theory predicts events that do not
happen and fails to predict events that do.
One interesting side issue in this discussion is the
sovereignty enjoyed by theory and data respectively. Logic,
and the need to survive the problems set for us by our en-
vironment, dictates that if data and theory fail to concur,
the theory should be adjusted or even radically altered to
the point of replacement. The development of science is
20
supposed to be c!iaracterized by the careful accumulation of

data, some collected in order to check out a precise theo-
retical prediction, some collected haphazardly 'to see what
it looks like', and maybe even some collected in the context
of testing some quite different theoretical speculation.
These data form the base on which to adjust and develop
theory. What this analysis overlooks, however, is the
difficulty of thinking of new theories, and the fact that
the psychology of scientists is much the same as that of
everyone else. A considerable degree of special pleading
may sometimes be called into play to explain away an
uncomfortable observation.
Such undignified wriggling is not likely to be found in
connection with very poor theories, but it becomes increas-
ingly likely as the ratio of useful (so-called 'correct')
aspects to incorrect aspects of the theory increases. It is
perhaps not difficult to understand this in terms of the
fear that in throwing out the bath-water the baby goes too.
A partially correct theory can seem a whole lot better than
no theory at all. It is no small wonder that old theories
are more likely to be replaced than just jettisoned. Demon-
strating that a theory is wrong is exceedingly difficult
unless a better one can be offered to fill the gap that
would be produced by throwing it out.
One of the defences that psychological theories attract
is the claim that the data collected to test them were the
wrong kind of data. This claim could be made in conjunction
with almost any kind of theory but it takes on special
significance in psychology because psychological theories
can be categorized into two quite distinct kinds. This
distinction can be sharpened by pointing to the essential
difference between a psychology of you and a psychology of
me (as seen from my perspective). My psychology of me will
contain all that is contained in and valid for my psychology
of you. But in addition there will need to be an account of
the me that only I can know about; my personal experience.
Public .... pri.ate~_

Eventually, when we are on the verge of an integrated
understanding of human behaviour and experience, it seems
inevitable that theories about my behaviour that everyone
can, in principle, experience, must converge on theories
about my experience to which only I have access. But we are
surely a long way off that point and it seems unreasonable
to anticipate that any significant degree of convergence has
yet taken place. Perhaps the only satisfactory posture to
adopt now is carefully to assign questions to one category
or the other and to seek to develop a compelling account
wi thin each domain.
There can be little doubt that the history of psychology
has made more progress with questions in the behavioural
domain than in the experiential domain. Perhaps this is
related to the similarity between an account of another
person's behaviour and a description of the attributes of
Zl
Scientific metnodology
some physical object under scrutiny. The potential for

generalization is the same. The observations that are made
are similarly objective in that they may, in principle, be
verified by other, independent, observers. At least some of
the skills of theory building and development learned in the
context of chemistry and biology should transfer and give
behavioural researchers a head start.
The experiential domain has none of these advantages,
but it does enjoy one very important feature. Most people
would probably argue that it is experience which dis-
tinguishes 'proper' psychology. So though it may be an
exceedingly difficult domain to work in, those that work in
it may draw strength from their belief that they are digging
in the quarry of true psychology.
The difficulties of experiential research are two-fold.
The first stems from the essential problem of codifying
experience in a communicable, manipulable and memorable
form. Even an experience as controllable as pain has not yet
yielded a very satisfactory system of pain descriptions. The
second problem is that, by de fini tion, experience is pri-
vate. There is no possibility of a person's experience being
verified by an independent observer, nor is there any cer-
tainty that an identical stimulus experienced by different
individuals will give rise to common experiences: in fact,
there is fairly good evidence to the contrary in certain
circumstances. However, the existence of individual differ-
ences is no surprise since they intervene to a very large
extent in all psychological research. Such intervention is
unfortunately a bigger problem in experiential research,
because there is the ever-present threat that the growing
understanding of a particular Joe Soap will be peculiar to
him and only the methods of enquiry will generalize to the
study of Jean Flake.
What happened aDd why? Cause and effect are easy to appreciate in an artificially
constrained and delimited example. It is simple to describe
a causative agent which acts upon a passive object causing
that object to alter in some way. Physical science, by and
large, can be represented by a model of that kind. The bio-
logical sciences begin to raise difficulties and in psycho-
logy the problems become serious. While it is possible to
conceive of a human being as an object influenced only by
the impact of external events, the reality revealed by
naturalistic observation is quite different. The person is
himself actively exploring, manipulating, dominating and in
every way changing the environment, social and physical,
which otherwise impinges upon him. Only for very brief
snatches of time is it plausible to conceive of man as a
passive reactor thrown hither and thither by the varying
impacts of his environment.
One of the greatest problems for psychology is that
individuals carry within them a set of variables which can
modify and modulate the impact of external influences. In
22
human terms, one responds to the perceived meaning of an

event rather than to the event itself. A verbal insult may
be treated as a sign of familiarity coming from an old and
trusted friend, but a challenge to one's honour coming from
a stranger. Only an appreciation of the relevant features of
the total context can ensure successful disambiguation.
Few psychologists would claim that their science was
yet superior to the intuitive psychological skills of some
individuals who, without any training, seem to have acquired
remarkable skills in understanding their fellows. To some
extent these informal psychological skills are essential for
a satisfactory social life. Part of what are now called
social skills comprises an appreciation of one's effect on
other people and sensitivity to the needs of others. Such
skills betray an implicit understanding of psychological
processes. It would not be an unreasonable first goal for
psychology to codify this unconscious knowledge that so many
people possess and which they would probably consider to be
a part of common sense. Psychology has some way to go to
achieve even that limited objective.
The reason for this, of course, is that codified know-
ledge has to be expressed in unambiguous statements that can
be SUbjected to rigorous scrutiny and verification. One's
informal psychology can rub along happily enough as a hit-
and-miss affair. Maybe a success rate approaching 30 per
cent is enough to avoid the worst excesses of social inept-
ness. The codified version, however, will be expected to be
right all the time, so producing it will be rather more
demanding than simply putting common sense into words.
Stages in adftDciDg kDo_ledge

If one is to adopt even a limited cause and effect model,
there are three stages that have to be passed through. The
first requires an unambiguous statement of events: what
happened. The second involves the identification of asso-
ciated events as opposed to independently occurring events.
The third demands the attribution of the cause of certain
specified events to specific antecedent variables.
The first stage might be thought to be a trivial one. In
fact, establishing what has occurred can be a very confusing
business. There are two main reasons for this. Clusters of
events in time can be too complex for total recording and
human perception and memory is sufficiently individual for
endless variations to be found amongst different observers'
impressions of their experiences of the same happening.
Furthermore, the event of interest may be small and diffi-
cult to detect against the background variations of errors
in the recording system, individual differences and various
other sources of 'noise' in an investigation.
The advantage of specifying in advance what is interes-
ting to observe and record is associated with the poten-
tially serious disadvantage that the unexpected may go
unremarked. Since the choice of what to look for will depend
very heavily upon existing theories, there is a very real
PFP _ C
possibility that data will be tainted by the theoretical

perspective that informed the design of the investigation.
There is no obvious way of avoiding this problem except by
maintaining as wide a range of theoretical perspectives as
possible. It is also worth remembering at the same time
that, no matter how distorted and difficult they may be,
there is no substitute for data and without them our
theoretical models would have to remain mental curiosities
unconnected with the world we seek to understand.
The second stage of our enquiry is to discover what goes
with what, what happens when and in association with what.
This is really little more than a very complex extension of
stage one. It would invite the use of the inductive method
which exhorts the unselective observation and recording of
all events, categorizing and organizing them later. The
Linnaean classification of plants was supposedly developed
in this way. There are, however, serious doubts that a truly
inductive approach can ever be achieved. This is partly
because the inherent complexity of the real world virtually
prohibits unselective recording of any aspect of it, and
partly because the nature of human beings is such that they
tend naturally to impose order of some kind on any set of
chaotic data. It is very hard to accept that Linnaeus did
not develop hypotheses about a plant taxonomy as he was
going along, and subsequently tended to react to new flowers
as confirming or embarrassing his prevailing theoretical
views.
Stage two investigations may well show how particular
variables co-vary. Co-variation (or correlation, as it is
called in statistics) does not necessarily imply causation,
however. Several decades ago a substantial association was
found between the number of radio licences purchased per
year and the incidence of first entries to mental hospitals.
Such an association, once noticed, might prompt in some
people the hypothesis that listening to the wireless 'drives
you mad', but no psychiatrist would find it a plausible
aetiology of mental illness.
A more recent example is the association between cancer
(particularly, but not exclusively, of the lung) and ciga-
rette smoking. Many studies have found that smokers are
more likely to contract cancer than non-smokers. There is
also some evidence that smokers who give up are less likely
to develop cancer than those who do not. Considering that
cancer of other kinds can be induced experimentally in skin
tissues by contact with chemical irritants and smoking
involves inhaling small, hot particles of complex organic
chemicals, the conclusion of cause is not at all unreason-
able. But plausibility is not enough. It has been suggested,
for example, that the association could arise because people
likely to develop cancer (and it is developed by total
abstainers) may be people who obtain particular solace in
smoking cigarettes bordering on serious dependence. A pre-
dilection to cancer and a need to smoke may be due to a
common cause, factor X. There is no way in which, with
Z4
absolute certainty, this explanation can be dismissed with-

out denying to individuals the choice of whether or not they
may smoke. Only in that way can the association otherwise
attributable to factor X be ruled out.
The third stage in establishing causational accounts
depends upon identifying unique attributions of effect. This
is no more than defining the set of conditions sufficient to
bring about a specific event. It may be that the same event
can arise from the influence of ' several different clusters
of variables, or it may be that there is at least one
necessary condition though its influence may be variously
modified by any number of other variables. The job of
science is to establish this knowledge so that the conse-
quences of specified contexts could be predicted and the
conditions required to bring about a particular event could
be prescribed.
Rules of correspcmdence
Part of the specification of a satisfactory model of the
system will be the rules relating the essential elements of
the model to observables. Unless these rules of correspon-
dence are unambiguously spelt out, the relationship between
the model and the system itself will be an uncertain one.
While such a loose articulation may have the apparent ad-
vantage of making it difficult to show how the model is
wrong (which may be good for its author's reputation) ,
equally it will ensure that while very good at post hoc
explanation it will be incapable of predicting anything but
the most obvious events.
Yet again the powerful role of theory is clear. Essen-
tially, our understanding resides in the explicitly stated
theory. It should be complete when our understanding is
complete. But it is all too easy to forget that every
theory, if it is to be of something, needs an associated
meta-theory which defines the mapping of the theory on to
the real-world system it has been developed to describe.
FinctiDg out Psychological enquiries have to proceed along a rather

indirect path. The data available tend to be inarticulate
and progress depends on the skill of the investigator in
framing questions. In that sense it is a bit like playing
'20 Questions' or interrogating spirits in a seance. There
is no freely flowing source of psychological knowledge that
only has to be tapped. Instead, there is a painstaking
assembly of hard-won knowledge acquired by asking questions
that seem relevant to the growing model.
Asse==nent
In both academic research and professional enquiries an
essential feature of the investigations is to penetrate the
immediate data and establish something about the persisting,
underlying nature of the subjects being studied. A fairly
common analogue of this situation is the problem of
25
appointing a person to a job. One most important aspect of

this problem is to make an assessment of each applicant's
long-term suitability in terms of as many dimensions as
possible. In fact, this is a problem to which a range of
psychological techniques and procedures could be applied.
The ways in which appointment enquiries develop illustrate
the use of alternative sources of information, the seeking
of corroboration and the development of more pertinent and
precise questions as the growing model of the applicant
becomes increasingly complete.
Staudardized teRiDg
Scientists tend to be sceptical of procedures which rest
heavily upon haphazard inspiration and are reputed to prefer
systematic schemes that eliminate the need for flair.
Various examples of such systematization have been intro-
duced in order to reduce the skill demands of the enquirer
role. The best-known schemes involve presenting a standar-
dized test situation, perhaps in the form of a questionnaire
or a strongly structured interview. A carefully devised
instrument of this kind can be thought of as a psychometric
measuring device that can relate the individual presently
under scrutiny to perhaps very large numbers of people who
have previously been given the same test.
A test instrument of this kind has to have satisfactory
operational properties before any great reliance should be
put on it. It is even more important to establish the
operational characteristics of tests than of free-flowing
interview situations because the test may seem to promise
to provide analytical skills without training. A completely
undeserved degree of confidence may be felt in the power
the test gives the tester.
Reliability
Two operational characteristics are assessed. The basic one
is reliability. This is about whether the test measures
accurately. For example, a metre 'stick' made of elastic
would have very limited value since its reading would be
altered by how much it was stretched. A favourite measure
of reliability is to apply the test to the same property on
two occasions and calculate the correspondence between the
pairs of readings. Test-retest reliability of 1.00 would
indicate a perfectly reliable test. Although theoretically
possible, this would not be expected to occur in practice
because all tests are vulnerable to errors and mistakes in
their applications.
Validity
The other operational characteristic is validity. This is
really about whether the test measures what it is supposed
to measure. It is also, therefore, concerned with whether it
measures anything of value. For example, if intelligence
tests measure no more than the capacity of people to do
intelligence tests, it is questionable why anybody bothers
Z6
with them. If, however, they predict something about an

individual's preparedness for intellectual activity they may
make valuable contributions to the educational scene. Vali-
dity is difficult to establish because it is often difficult
to determine the criterion against which to assess the test.
A starting point is to take peer-group evaluation and to use
self-evident criterion groups. Perhaps the most successful
members of our society, be they professors, prime ministers,
bishops, consultants or leaders of industry, have something
in common: and perhaps it is intelligence. Of course, it
migh t be ruthlessness, industriousness, tenacity, single-
mindedness and a desperate need for achievement either
instead of or as well. A reliable test measures something,
but the real problem may be to discover just what.
Scaling
Psychometric tests tend to claim to measure some inaccess-
ible and fundamental aspects of human personality. There are
also tests with more modest aims, which seek to provide an
organized framework within which the subject can express his
judgements either about some external state of affairs of
which he is aware, or about an attitude or opinion which he
holds. The main purpose of developing scales for these
purposes is to attempt to avoid the difficulties of inter-
pretation and comparison that can arise from people's
idiosyncratic use of language. Imposing discipline on
subjects' responses can avoid endless post mortems about,
say, the relative magnitude of 'colossal', 'stupendous',
'gigantic' and 'exceedingly great'.
Quite sophisticated scales can be developed using com-
plex mathematical procedures in an attempt to ensure that
the resulting scale approximates as closely as possible to
the physical scales of time, mass and distance with which we
are familiar and which have very desirable properties when
it is necessary to compare and summate measurements.
Schemes for investigation It is very important that an investigation should give rise
to unambiguous results. Ideally there should be no doubt
about what occurred, or to what conditions that event should
be attributed. In practice there are a multitude of factors
which jeopardize this achievement.
Controlled e%(ICi'imeDts
There are a variety of patterns of investigation but the
most satisfactory to have been devised so far is undoubtedly
the controlled experiment. It is characterized by careful
recording of events, but most importantly by the control of
all variables in the si tuation except the ones under inves-
tigation. In the simplest situation subjects' performance is
measured under two conditions of variable A, with all other
variables held constant (controlled). Logically any change
in performance that is observed can now be attributed to the
change in variable A, because nothing else has changed. In
27
more sophisticated experimental designs, several variables

may be studied in the same experiment so that both the
individual and joint effects of variables A, B, C, D, and
so on, may be examined. In more complex designs still, more
than one aspect of performance may be included in the
investigation.
The principal advantage of the controlled experiment is
that, provided it has been prope~ly designed, there is no
doubt about how to account for the results it produces.
Unfortunately, there are many situations in which controlled
experiments are precluded, and in those cases where they
are not, experiments contain flaws in design or execution
so that the desired unequivocality of the results is lost.
There are many specialists in experimental design who argue
that the perfect experiment has yet to be conducted. So even
under near ideal circumstances the perfectly controlled
experiment is a rarity.
Where ezpeI'ime.u1B are prohibited

Human fallibility is only one reason for carrying out
studies which produce equivocal results. Rather more sym-
pathy goes out to those workers in areas where constraints
prevent perfection. The classic example is in astronomy. A
controlled experiment is ruled out because we lack the power
to manipulate the system under observation. Yet without it
astronomers have managed to piece together a sufficiently
accurate model of the solar system, if not the galaxy, to
provide the basis for manned space travel to the moon and
unmanned exploration beyond Mars. The key to their success
is twofold: very careful and precise observation, and the
fact that the system is in motion. Were it static we should
have a single, permanent view and it would be virtually
impossible to establish even relative distances, let alone a
three- or four-dimensional model of the universe.
The two main reasons for not doing controlled experi-
ments are lack of power and ethical constraints. The first
is similar to the problem for astronomers. For example,
testing ideas about interaction in large social systems
cannot be done in a controlled experiment because the degree
of intervention necessary to exert sufficient control cannot
be achieved. It may be said that the controlled experiment
is not appropriate in such a situation. The ethical issue is
somewhat different and is, to some extent at least,
negotiable.
There are certain kinds of intervention which would
almost certainly be ruled out by common consent; experi-
mental brain surgery on otherwise fit, normal human beings
would be, for example. However, experimental brain surgery
carried out to relieve severe epilepsy would not, and such
surgery might give rise to useful information about the
association of particular bits of brain, say, with parti-
cular kinds of behaviour. Such an event is analogous to the
occurrence of a particular configuration of stars and
planets.
Z8
Similarly, H would have been ethically unacceptable in

studying the origins of lung cancer to press subjects (who
did not otherwise choose) to smoke cigarettes for several
years in order to provide an experimental test of the
effects of smoking. In order to resolve the ambiguity
surrounding the correlational evidence it was necessary to
resort to an experiment on animals. Beagles were required
to breathe cigarette smoke and a proportion of them deve-
loped tumours. The association between cigarette smoking and
cancer was confirmed as a causal one. The question arises,
however, about the ethical acceptability of subjecting any
species to potentially damaging or noxious procedures. It
may be that there will be an extension of the range of
experimental interventions which have to be forsworn on
ethical grounds. The role of the controlled experiment will
thereby be further reduced.
It is becoming clear that many investigations either
cannot use a controlled experiment because it is precluded
by circumstances, or they do not use one through oversight
or design. The consequence is simply that the ultimately
desirable feature of unequivocal data is forfeited: it does
not mean that the investigation is worthless. Even a snap-
shot of the heavens says something, even if it is not enough
to navigate to Saturn. The redeeming feature of the con-
trolled observation (as opposed to controlled experiment)
and of the quasi-experimental design is that the system
under investigation is a dynamic one. We have, therefore,
the advantage that astronomers have exploited. The system
goes through a series of states as time passes and succes-
sive observations accumulate sets of varying data which need
to be accommodated by whatever model is proposed. Without
intervening ~o manipUlate the system, it may take a very
long time to eliminate incorrect hypotheses, but eventually
both modes of progress should arrive at the same point.
Correlated observations and quasi-experiments cannot
offer unambiguous attribution but they can undoubtedly give
rise to data which attract 'plausible accounts'. What seems
plausible will depend very much on the totality of accumu-
lated data, since none of these quasi-experiments is a com-
plete entity, and the implications of each may have to be
reconsidered in the light of newly obtained data. Plausi-
bility will depend very much on prevailing theory. The
dominance of theory in influencing what is observed is
reinforced now by favouring some explanations rather than
others. Since no single quasi-experiment has definitive
status it may take many investigations to accumulate enough
evidence to overturn an accepted theoretical position, even
if an alternative theory is waiting in the wings ready to
take over the centre of the stage.
Generalizing research procedures

This section has been about research strategy and the use of
available methods of data gathering. This might seem to be
an issue more relevant to those engaged in fundamental
29
academic research than to those who are seeking to apply

that knowledge in their professional commitments. The
techniques appropriate for use by the scientist, however,
are essentially similar to those suitable for use by the
consultant, therapist or counsellor. He needs to develop a
mental model of the presenting issues and difficulties. In
order to know that he has developed an appropriate model it
will be necessary to obtain corroboration from a range of
data sources.
This may sound very complicated but we are, in fact,
doing it all the time. When we meet someone new we quickly
pick up cues from dress and speech, and the general social
situation. These cues lead us to select, unconsciously, a
model of a person which we then, through conversation to or
about them, seek to verify and adjust. As adults we have met
so many new people that we have a vast 'library' of people-
models which helps us to find appropriate ways of relating
to new people quickly. People whose professional life
depends on their ability to interact sensitively with indi-
vidual people need these skills to be very finely tuned.
However, the basic skills are the same and the rules for
seeking information and drawing valid conclusions from data
are the same no matter whether the enquiries are formalized
in the psychological laboratory or informal ones in a
drawing-room, consulting room or personnel director's
office.
This section is a discussion of how investigations go wrong:

how they fail to live up to their early promise and even
produce data which in one way or another are actually mis-
leading. We have already pointed to the limited value of
using non-experimental methods of enquiry. They are a lot
slower in building up a data-base for assembling and evalu-
ating theory, and they may, in principle, never justify the
leap from an hypothesis of plausible causation to a causal
conclusion. However, there are problems over and above the
essential limitations of the procedures used.
Judicious 'bat illicit selec:tiaa

One of the most fundamental difficulties that any theorist
has to battle against is sUbjectivity. The problems arise
immediately when some selection of data or data-gathering
procedures take place. It is not possible to collect all
relevant data just on practical grounds. So inevitably there
is the danger that data will be preferentially selected to
favour the currently preferred theory. This problem is re-
duced when it is possible to conduct experiments, but when
other modes of data-gathering are used the problem may grow
uncontrollably.
Perhaps historical research is as vulnerable as any to
this problem, because the data may be inaccessible or even
irretrievably lost. No new enquiry can be made since a
letter or court record, once destroyed, can never be
30
reconstructed. Under these circumstances of incomplete data

it is easy for an historical researcher to emphasize some
data at the expense of others in order to find a particular
theory about past events the more credible.
This problem of the differential importance of data is
not restricted to history. Psychology at present inherits a
vast empirical literature, much of it confusing and appa-
rently mutually contradictory. In such circumstances a
judicious selection of past experimental results may appear
to provide incontrovertible support for the validity of a
particular theory. In general, these problems stem from
vaguely specifying the conditions under which the data arose
and loose theoretical formulations which make advocacy more
important than logic.
Subject-...iated data
The subjects in an investigation are a potent source of
bias. Unlike geologists' rocks, psychological subjects can
play an active role in an enquiry and their initiative could
'swamp' the phenomena under investigation. Even assuming
that there is no bias introduced simply by selecting the
particular people taking part in the experiment, what they
think it is all about can have serious effects. It is an
almost inevitable feature of psychological enquiry that the
subjects are volunteers, but it is not inevitable that those
who volunteer are identical with those who do not. In one
important sense they are different by virtue of their
choosing to volunteer, so subject self-selection could be an
initial problem. But once inside the enquiry each subject
will be adopting an attitude to the investigation. For
example, some may see it as an opportunity to contribute to
the progress of science and adopt a suitably dispassionate
and objective attitude to their individual performance.
Others may view their participation as an opportunity for
self-revelation or analysis, or as a chance to make a per-
sonal impression on their experimenter. Either way perfor-
mance may well be sensitive to the attitude the subjects
adopt; and there is no guarantee that telling subjec.ts which
attitude to adopt will ensure its adoption.
Most people who have carried out psychological experi-
ments will, at some time, have come across the 'overly
helpful' subject. Such a person, deducing the purpose of the
experiment, may seek to help the experimenter by behaving
in a particular way. More subtle influences may affect his
behaviour without the subject being aware of the demand
characteristics of the situation. Sometimes the reverse is
found: the bloody-minded subject who, having volunteered,
seeks to prevent the phenomenon under examination from
emerging by his sabotage.
Local Yalidity
The third main source of bias is from the form of enquiry.
Scientists have generally sought to develop circumstances
which allow them to obtain data uncontaminated by
31
uncontrolled influences. Laboratories are established to

allow careful measurements to be made under controlled con-
ditions. In many instances the laboratory situation is by no
means identical with the real-world situation but pains are
taken to ensure that crucial features are represented in the
laboratory. In chemistry, physics and engineering this
arrangement works reasonably well, partly because a sample
under test is unaware of its surroundings.
In psychology there are different problems. SUbjects
usually know they are involved in an experiment (and that
realization may be enough to produce some change in their
behaviour). As a result, their behaviour in the experiment
may be systematically different from their normal beha-
viour. Even if the subjects do not alter their attitude away
from their natural one, the laboratory test and situation
might introduce a significant distortion so that it would be
inappropriate to generalize from the laboratory to the real
everyday world. This difficulty (or at least the fear of
this difficulty) has led a number of researchers to become
inordinately suspicious of artificial, specially-devised
tasks examined in laboratory settings as a data-base for
general psychological theories. Instead, they would prefer
to use natural observation as being less contaminated. The
trouble is, of course, that each approach has its advan-
tages and disadvantages. Maybe some laboratory results are
laboratory-specific but the data are generally more likely
to be repeatable. Naturalistic observation has the advantage
of ecological validity (it is about real people in real
situations) but it is far more difficult to fathom what is
going on, and impossible to record everything, so some
theory-based distortion of the data is inevitable.
Clearly, theoretical blinkers create important prob-
lems. It is very easy to construe an investigation within a
particular framework so that all aspects of study are inter-
pretable directly in terms of the theory. The problems arise
when the theory is both essential for making sense of the
data and yet the data are supposed to provide a test of the
theory. In no time at all such an arrangement is locked into
the descending spiral of self-fulfilling prophecy. There may
be a greater danger of this happening in investigations
which cannot be tightly controlled within an experimental
framework. The prevailing (and to-be-tested) theory can be
a valuable source of order in construing the complexity of
the real world, and so the observations tend to become
organized within the structure of the very theory that is
supposed to be being tested. Apart from trying as many
theories as possible against data, there is no certain way
of avoiding this problem. Perhaps the attitude of the
Devil's Advocate is the best one to adopt: that is, to be
excessively sceptical of any claims.
From the foregoing it should now be clear how it can be
that theories survive even after the discovery of contra-
dictory data. Basically, it is because theories are held by
theorists who evaluate them and the data that are supposed
32
to inform them. Many data are questionable and their impli-

cations challenged. It is very seldom that any experiment is
accepted as providing the ultimate authoritative statement.
In such a situation argument is inevitable and progress is
painfully incremental. It does not necessarily proceed,
moreover, by a series of tight, logical steps. A fluent and
persuasive advocate may be more important for the survival
of a theory than the data adduced in its support. But es-
pecially important will be the existence of an heir to the
theoretical throne. If the succession is not guaranteed the
ailing monarch is most unlikely to be deposed.
Dea1iDg with data One of the problems with conducting investigations is

knowing what to do with the data that they throw up. There
are two sides to this. One concerns the fact that human
minds have very real limits in their abilities to encompass
and digest disorganized detail, so there is the problem of
remembering and communicating data. The other issue concerns
how to interpret the data that have been collected. Fortun-
ately, statistics have been developed as a branch of applied
mathematics and come to the psychologist's rescue on both
counts.
Varioas datiatica
Two different branches of statistics have been developed to
handle data of different kinds. Parametric statistics re-
quire data from interval or ratio scales for the conclusions
arising from their use to be valid. This sometimes produces
difficulties for psychologists because many psychological
measures, of attitudes for example, may not meet the cri-
teria required of an interval scale. Non-parametric tech-
niques have been developed for the treatment of data on
nominal and ordinal scales. In general, these data are not
so powerful and more are required to reach the same degree
of confidence about what has been observed than if para-
metric data had been available. Often, however, this com-
parison is fatuous because there is no option but to use the
only data available to the enquiry.
The tool provided by statistics helps us to answer three
types of questions: how to render data down to provide eco-
nomical and communicable descriptions, how to draw infer-
ences about unobserved data, and how to test hypotheses
about data. All this is possible because collections of
data, provided they are reasonably large, are found to have
a number of properties in common which can then be assumed,
and the calculus of probability turns out to be a reasonable
model for the sort of data turned up by psychological
investigations.
Desc:ripti~ datistica
It is a primary feature of psychological data that they
contain intrinsic variability. Whereas an assessment of the
hardness of a sample of steel or the resilience of a copper
33
wire would be expected to produce almost exactly the same

value in successive tests of the same samples, biological
material behaves differently. The survival of any species is
due to its capacity to adapt to circumstances, a capacity
which depends upon differences between individuals that can
be exaggerated and allowed to take new forms through the
mechanism of sexual reproduction. Individual differences are
therefore intrinsic to psychology. In addition, however, the
processes underlying human behaviour are exceedingly complex
and may very well never act in exactly the same way twice.
As a consequence the same individual is most unlikely ex-
actly to duplicate any particular piece of behaviour. There
are, therefore, two major sources of variability in recorded
data.
It is a remarkable fact that many naturally occurring
biological features are distributed in the same way. The
bulk of the elements have a mid-range value, and relatively
few have extreme values, either high or low. This distri-
bution' which is bell-shaped when drawn out as a graph, can
be precisely defined as an algebraic equation. It is called
Normal or Gaussian (after Gauss who defined its equation).
The great advantage of discovering the Normal Distribution
equation, and that natural measurements conform to it, is
that only two numbers are necessary to code all the data
that would otherwise require a laborious listing of the
values of each element in the set. One of these values
describes the central point of the distribution (the arith-
metic mean), the other defines its dispersion (the standard
deviation). Therefore, provided measurements have been made
on a parametric scale (interval or ratio scale), nearly all
the information conveyed by a vast number of measurements
can be condensed into two easily remembered and communicated
numbers, the mean and standard deviation. If the data are
non-parametric in form it will be necessary to use different
descriptive statistics such as the median or mode instead of
the mean, and the semi-interquartile range in place of the
standard deviation.
GeDeralisaticm
Sometimes all that is required is to describe a particular
aggregate of data in an economical way. Often, however,
there is no intrinsic interest in those particular data
except insofar as they throw light upon some general issue.
In other words, we often want to be able to say something
about the data we might have collected as well as those
which we actually did collect. We want to make a general
statement about the nature of the popUlation from which
our particular sample was drawn. Statistics provide us with
rules for making such generalizations which in tum will be
the basis for establishing and testing theoretical models of
psychological processes.
Hypothesis testing
The most exciting use of statistics, however, is its use in
34
decision making. Let us assume that a particular theory

asserts that performance should be improved by making a
particular change to the conditions. For example, problem-
solving performance might be changed by the introduction of
a non-participating audience. It looks quite a simple job to
set up an experiment in which one group of subjects is set
problems to solve in isolation while another group is given
the same task to perform before a silent audience. The
average performances of the two groups are likely to differ
from one another, but the ranges of value would overlap. It
would not be clearly the case that the 'audience' improved
performance. The question that has to be answered is whether
the difference between the two groups of data is a real one
(and, because the way the experiment was designed, attri-
butable to the presence of the audience), or did it arise
simply from the chance variation which is always a feature
of biological and psychological data?
One of the remarkable advantages that statistics give us
is that they make it possible to calculate the probability
of the observed difference arising by chance alone. We can-
not say whether any particular difference was due to chance,
or was due to some systematic real effect, but we can assign
probabilities to these outcomes. Of course, this leaves it
up to the researcher to make the final decision attributing
the observed difference to chance or not. He can be guided
by statistics but statistics will not allow him to abdicate
his responsibility for making the actual decision. Another
way of looking at his statistical calculations is to see
them as an assessment of his likelihood of making a mistake
if he makes the decision one way or another.
It is appropriate to add a note of caution to temper the
possible conclusion that statistics are a rather wonderful
set of techniques that can always help psychologists under-
stand what they have done. Unfortunately, statistics can
only help when the statistical model matches the reality
represented by the psychological data. It is all too easy
to collect data that lie outside the domain within which
statistics can be applied. In that case there are no
techniques to bail out the unwary researcher.
To avoid finding oneself knee-deep in a welter of data
that defy analysis, it is essential to take into account the
analysis of prospective data before settling on the design
of the investigation. This will also ensure that the re-
searcher faces up to his limitations and he can seek more
expert help at a stage early enough to make a difference.
Many statisticians would be delighted to wave a magic wand
over messy data turning them into clear-cut findings. But
that is fantasy: they no more possess magical powers than we
do.
Coda Finding out consists essentially of developing a model, the

structure of which is known by its constructor, and then
matching it up against the real world. To the extent that
35
the model fits, predictions about the unknown world can be

made by using the known structure of the model. If the fi t
is not too good, the predictions will be inaccurate. If the
model is very poor, the predictions will be very wide of the
mark. It is quite likely that only a circumscribed aspect of
the world will be represented by a particular model, and it
is important to define the boundaries of the model's
relevance.
Generating models is a hit-and-miss affair. There are no
formulae that will guarantee having bright or even relevant
ideas. It may help to look over the 'ground', but attempting
to gather data unselectively so that an inductively deter-
mined theory can emerge later is an unrealistic view of how
it happens. Equally, the strict hypothetico-deductive model
is unbelievable because hypotheses are not going to pop up
without some kind of assistance. A mixture of both, pro-
ceeding by successive approximations, would seem to be the
general course of model development.
Testing models against data is better understood and
there is a lot of advice about good and not so good ways of
doing it. It is clear that very little headway can be made
unless the rules of correspondence linking the model to
reality have been spelt out. If controlled experiments are
possible and permissible they offer the quickest and surest
method of establishing the worthiness or otherwise of a
particular theory. All other empirical methods are better
than none but are limited in their implications, and a long
laborious period of investigation may be necessary to build
up confidence in the exclusive validity of a particular
theoretical view.
The basic lessons of how to find out by collecting
relevant data apply to everyday professional enquiries as
they do to fundamental research. In both instances it is
possible to make logical mistakes by, for example, asking
redundant questions which deliver non-discriminating an-
swers. Independent corroboration is a watchword that applies
to both situations and it is generally unwise to rely too
heavily on a single line of evidence. Needless to say, it is
important to be aware of the distortions and biasses that
can be inadvertently introduced into an investigation. Some
sources of inaccuracy may be unwitting, some may result from
unfortunate sampling and some may arise from a deception
introduced by the subjects. The Devil's Advocate position is
the best one to adopt, always searching for alternative
explanations of the developing patterns of data.
It is improbable that psychologists are any more likely
to make logical errors in their development of theories than
any other kind of scientist, but they should be more aware
of the pitfalls that await them. Intuitive non-analytic
evaluation is an attractive way to proceed and, since the
way ideas occur is obscure, it is attractive to leave theory
testing to unconscious processes as well. The problems
that arise from doing so are, however, very considerable,
especially since the tendency to identify with one's own
36
theories threatens to.make one less critical of them than

one should be. A very careful exposition of the theory de-
fining its boundary conditions and connection points with
the real world is essential, even in its most primitive
form.
There are a number of books which offer treatments of
methodology and the associated techniques of statistical
analysis. An increasing number are sensitive to the limited
mathematical competence of many social scientists which
makes them easier for us to handle. The following are of-
fered as suggestions for further reading or as reference
books for those who actually get into the business of
finding out in psychology.
References Blalock, B.M. (197Z)

Social Statistics. New York: McGraw-Hill.
~, Y. (ed.) (1977)
Sociological Research Methods. London: Macmillan.
Cook, T.D. and Campbell, D.T. (1979)
Quasi-experimentation: Design and analysis issues for
field settings. Chicago: Rand McNally.
Bill, D.A. (1974)
Psychology syllabus for students of physiotherapy.
Psychology Teaching, Z, 191-
Kraun, E. and Yiller, S.B. (1974)
Social Research Design. London: Longman.
Legge, D. (1975)
An Introduction to Psychological Science. London:
Methuen.
Yeddis, R. (1973)
Elementary Analysis of Variance for the Behavioural
Sciences. London: McGraw-Hill.
Miller, S.B. (976)
Experimental Design and Statistics. London: Methuen.
SDodgraaB, J.G. (1977)
The Numbers Game: Statistics for psychology. Oxford:
Oxford University Press.
1. Discuss different ways of determining the age of a

horse. Consider analogues in psychology.
z. Write a short essay on the function of theory in
psychological research.
3. What are the principal advantages of experimental
enquiries? Are there any disadvantages?
4. 'One can never step into the same stream twice.' Discuss
in relation to the problems of conducting psychological
research.
5. Statistics developed in order to clarify the results of
agricultural research. Why should they have been applied
so enthusiastically to psychological research?
6. Discuss how theoretical generalizations might inform
enquiries about a particular individual.
37
7. The two main methods of obtaining data about the

development of processes and behaviour are longitudinal
and cross-sectional. Discuss the advantages and
disadvantages of each.
8. 'Quasi-experiments are merely poor experiments.'
Discuss.
9. 'There are lies, damn lies and st atistics.' Are there?
10. Some researchers argue that if the research method and
the task for the subject have been properly designed,
statistics are redundant. What does that say for the
widespread use of statistics in psychology?
11. What is meant by 'statistical control'?
12. Discuss, with particular reference to intelligence, the
use of tests to explore personal psychological
characteristics.
13. Laboratories permit more exact control over experiments
but may condition the results that are obtained. Is
there a resolution of this dilemma?
14. Discuss the limitations imposed on research by the
exclusive use of correlational methods.
Amlotated readiDg Barber, T.X. (1977) Pitfalls in Human Research. Oxford:

Pergamon Press.
Jung, J. (1971) The Experimenter's Dilemma. New York: Harper

& Row.
Some books have analysed the sources of difficulty in
finding out; these are two useful ones.
Cook, T.D. and Campbell, D.T. (1979) Quasi-experimentation:

Design and analysis issues for field settings. Chicago: Rand
McNally.
Describes techniques that may be available when
experiments cannot be used.
Meddis, R. (1973) Elementary Analysis of Variance for the

Behavioural Sciences. London: McGraw-Hill.
The student can acquire more advanced treatments for
complex experiments from this text.
Miller, S.H. (1976) Experimental Design and Statistics.

London: Methuen.
Robson, C. (1973) Experiment, Design and Statistics in

Psychology. Harmondsworth: Penguin.
Two relatively simple and accessible paperback volumes
which act as starter texts in psychological statistics.
Siegel, S. (1956) Non-parametric statistics for the

Behavioural Sciences. New York: McGraw-Hill.
The 'bible' of the non-parametric techniques that has
proved indispensable to psychologists.
38
Snodgrass, J.G. (1977) The Numbers Game: Statistics for

psychology. London: Oxford University Press.
The student who masters the first two may want to go
further. This should provide some help to that
progress.
AcknowledgeDlellt I am most grateful for the assistance I have received from

Dr Hilary Klee who offered much constructive criticism and
Ms Christine Harrison who painstakingly translated my
manuscript into a readable form.
PFP _ 0 39
2
Motivation
Philip D. Evans
0peuiDg :remarks From the general introduction you will know that this book
E. N. DUNKIN includes contributions from several authors. Its main themes
have been introduced earlier and they will be restated and
elaborated as the work progresses, rather like a fugue.
Since there is a facetious definition of a fugue that des-
cribes it as 'a piece of music in which the musical instru-
ments come in one at a time while the audience goes out one
at a time', we hope that this fugue-like progression of the
book is not going to defeat its object and cost us the
attention of the reader.
This chapter on motivation takes up one of the basic
questions already introduced - 'Why does a creature do
things?' - and discusses the NECESSARY and SUFFICIENT
conditions for activity. Recalling my own confusion as a
beginner in facing both these adjectives in a single state-
ment, I think that it would be as well to make sure that the
way the psychologist and other scientists use these words is
fully understood. The following explanation and example is
for those readers who are not already confident about these
words.
Necessary conditions are those that are indispensable
for an activity: each one must be available but ON ITS OWN
IT IS NOT ENOUGH to ensure that a particular activity will
take place.
Sufficient conditions INCLUDE necessary conditions that
have a cumulative effect until a particular activity is
bound to take place.
For example: if feeding activity (eating) is to happen
some of the necessary conditions are that the creature
* is awake and generally in good health

* has an intact set of digestive organs
* has a capacity for food (i.e. its stomach is not
overflowing as a result of a recent meal)
* is not distracted by a competing but also basic need
(such as the need to escape from danger or to protect
its offspring)
and that material is available for eating
* within reach of the creature

* of a size that can be managed by the creature
40
Motivation
* of a type that is normally included in its its natural

diet (or is a known alternative).
When sufficient of these requirements are satisfied, the

creature will feed.
There are some other words that might need attention to
understand the chapter: it would be worth while checking the
exact meaning of 'perception' and discriminating it from
other terms that are used in discussing thought processes.
Some of the theories and types of learning mentioned
in this chapter recur in the next one on learning and
teaching: this overlap is unavoidable as motivation and
learning are interdependent. There is further reference to
phobias, which are discussed here, in the chapter on psycho-
pathology, while Freud's contribution to psychology and
psychoanalysis in general has ensured that his work is
mentioned in several chapters.
As a physiotherapist, you will find that an understand-
ing of the theories of motivation gives you insight into the
difficulties of a patient who is unco-operative or who
frankly rejects the treatment that is prescribed for him.
This may make it possible for you to gain his co-operation
by helping him to deal with the underlying reasons for his
antagonism, such as pain, fear of failure, or rejection by
his family. It will also help you to recognize and re-direct
the efforts of patients who are using compensatory actions
rather than the ones strictly required by a particular exer-
cise: they may understand the details of the exercise and
have an intellectual appreciation of its aim to strengthen
their weak muscle groups, but their need for approval from
the therapist may mislead them into 'cheating', using joints
and muscles that are not under treatment at the time. When
you have read this chapter, you will be able to decide, on
the evidence, whether it is better to scold the patient for
carrying out the exercise incorrectly or to withhold
approval until it is done correctly.
A set of questions and assignments is given at the end
of the chapter: some of these are specifically linked to
the treatment of patients, and they are either for use as
discussion topics or as suggestions for clinical studies.
IDbodacticm An author of a recent text on motivation has spoken about

PBIL1P D. BYANS the difficulties of writers in the area deciding 'what is
the main tent and what are the side-shows of their circus'
(Atkinson and Birch, 1979). In a large tome one may well
be able to include the whole travelling company, but in a
chapter such as this there must be a drastic selectivity.
The objective, therefore, has been to provide rather a
flavour of the area of motivation as a whole, and to des-
cribe some of the research in more detail which we think
may provoke some interest on the part of the reader.
This preamble is relevant when we consider the scope of
motivation. Poetically speaking it is about the 'springs of
action'; more prosaically, the theorist of motivation asks
41
Motivation
himself what are the necessary and sufficient conditions

pertaining to the onset of any activity or, still more accu-
rately, what makes an organism change from one activity
to another in the ever-flowing stream of behaviour? Any kind
of human or animal behaviour might come under the scrutiny
of a motivation theorist, and so the literature reviewed in
most large motivation texts is often almost as diverse as
that in a general psychology book.
Many psychologists studying, say, perception or memory
are interested in 'how' questions: how does this bit of men-
tal processing work? Psychologists of motivation are more
likely to be interested in 'why' questions: why is this
student studying rather than doing something else? Why is
that rat turning that wheel? In everyday life human beings
answer 'why' questions by giving reasons, but usually we
give these after the event: that is, post hoc. They cannot
therefore scientifically account for behaviour. The psycho-
logist is more interested in specifying conditions before-
hand which, if they pertain, inevitably lead to a prediction
that some behaviour probably will or will not occur. Where
do we find these all-important conditions? Traditional
wisdom in the case of human behaviour has told us that the
answer lies inaccessibly in the mind. The mind wills the
body, and since the will is supposedly free, we might as
well give up any attempt to predict human behaviour I Fortu-
nately, that traditional wisdom was overturned during the
last century by the work of Charles Darwin. The fact that
the scientific study of animal behaviour was already under
way, coupled with the inescapable Darwinian conclusion that
no theologically convenient hiatus interrupts the passage
from monkey to man, meant that it was possible at last to
approach psychology, and particularly the psychology of
motivation, in a scientific manner. The history of motiva-
tion research and theory in this first century of truly
empirical psychology is beyond our scope in these pages and
details can be found elsewhere (Evans, 1975). We offer here
a mere 'sketching in', sufficient only to illuminate modern
trends.
Naked and "".Shamed When Ivan Pavlov (1849-1936) discovered the phenomenon that
behaviourism we now call classical conditioning (i.e. that a supposedly
neutral stimulus, when paired with another stimulus which
reflexively triggers a certain response, comes to elicit
that response in its own right) the scene appeared to be set
for explaining all behaviour as the sum of responses, which
in turn could be traced inexorably back to their controlling
stimuli. The answer to the question: 'What motivated that
particular response?' would simply be: that particular sti-
mulus. We might as humans be aware of conscious intentions
or reasons for our behaviour, but these were to be thought
of as no more than incidental by-products of a predetermined
stimulus-response sequence. In the United States this
revolutionary behaviourism was preached loudly and
effectively by John B. Watson.
4Z
Motivation
The neo-behaftoarism of Clal'k Run

Like Watson, Hull believed that all behaviour could be seen
as stimulus-response chains. However, he was also influenced
by the earlier work of a psychologist called Thorndike who
had shown how animals can learn to solve certain problems
by trial and error if successful responses are followed by
rewards such as food or drink. Hull believed that rewarding
behaviour in the presence of a stimulus REINFORCED the
connection between stimulus and response. Now a reinforcer
such as food is only as good as the motivation on the part
of the animal to eat it. In trying to define the nature of
reinforcement, Hull committed himself to a belief in inter-
nal mediators of performance. Briefly, he believed that
physiological needs resulting from deprivation of food,
water, etc., brought about a generalized drive state (D)
within the organism which goaded the animal into activity.
When this activity finally resulted in finding the goal
object (e.g. food) and the consuming of it, the physio-
logical need would be satisfied and the drive reduced. But
also the responses in the stimulus situations leading up to
the final goal would be variously reinforced. Thus re-
inforcement could be defined as DRIVE REDUCTION. The
amount of 'cementing' that had taken place between stimuli
and responses Hull termed habit strength (H). Hull stated
that the probability of any particular behaviour can be
predicted by multiplying variable H and variable D. If D is
hunger-induced, we might say something like this: if the
animal is not hungry, it will not perform since D is zero
and, whatever His, the product of D and H is zero; simi-
larly, if H is zero (mentalistic ally the animal does not
know how to get food), the animal's performance is once
again zero even if its drive is quantitatively large. As a
blue-print for a theory of motivated behaviour it seems all
right. It is true that it seems over-simplified and appli-
cable more to food-deprived rats in simple mazes than human
beings in more complex situations, but Hull had not forgot-
ten Pavlov or Watson and assumed that more complex motives
could be acquired by simple association with primary sources
of drive and, similarly, that things encountered in close
contiguity with primary reinforcers could themselves become
secondary reinforcers. In fact, Hull built up a mighty
edifice of mathematically-stated theory, from which he en-
deavoured, quite successfully at times, to predict animal
and human behaviour. If that edifice has now tumbled down,
it is nevertheless the case that echoes of Hull reverberate
still in the current less grandiose theories which tend to
look at motivational questions within certain areas of human
behaviour.
Putposift behaYiourism
Hull's great contemporary and rival was a psychologist
called Tolman. Tolman was just as committed as Hull to
predicting behaviour, but he was a man who valued more
everyday terms. Whereas Hull, in recognizing the importance
of intervening variables within an organism, speculated
43
Motivation
about internal stimuli and responses, Tolman was quite wil-

ling to talk about things such as expectations, even with
respect to humble laboratory rats. It seemed clear to Tolman
that a rat which EXPECTED to find something of VALUE at
place A rather than place B would more probably go to place
A. Could not behaviour be a multiplicative relationship
between expectancy and value rather than drive and habit?
In fact, the answer to that question need no longer concern
us, since in essence they amount to much the same thing and
merely reflect a penchant for different kinds of vocabulary.
However, Hull was an out-and-out determinist and believed
that his way of putting the argument at least ensured that
the animal, or indeed human, was pushed towards the goal
by a pre-existing drive force, and he thought it fundamen-
tally unscientific to say that the valued goal object (a
future 'incentive') pulls the organism towards it. In fact,
what Tolman was saying was that the expectation of the
future consequence had its own motivation attached - an
incentive motivation - which could rival Hull's own drive
construct. The debate between Hull and Tolman stimulated
a good deal of research in both camps and the result was
that some sort of INCENTIVE MOTIVATION had to be ad-
mitted by the Hullians. Animals shifted from one amount of
reward to another would show changes in their running speed
to the goal: clearly the amount of incentive had motiva-
tional properties in its own right. One of Hull's star
pupils, Kenneth Spence, was finally responsible for integ-
rating incentive effects within the Hullian framework. The
Hullians talked of anticipatory response feedback rather
than moti-vation resulting from expectancy, but clearly the
two schools were now only separated by language.
Since those days of grand theorizing there has been a move-

ment within psychology as a whole to develop mini-theories
which can tell us something useful about more limited areas,
and particularly areas of human behaviour. Whereas Hull had
been content to speculate that human motives could be ulti-
mately traced back to biological imperatives shared by all
organisms, that formidable task of tracing the development
of motives has lost ground to theories which simply assume
motives, demonstrate that despite their covertness they can
be measured, and then propose predictions about how such
motives interact within the context of the environment to
produce behaviour related to that motive. This type of
theory is still in the Hullian tradition but, by being more
narrow in its scope, has more chance of useful application.
There are two areas of research outlined in the next section
which fall into this category. First, work on achievement
motivation, that is, striving behaviour in human beings, is
discussed immediately after a general theory of human needs
is outlined in the form of Maslow's hierarchy of motives.
Second, research in the field of anxiety as a motive
is examined. This second area was a natural area of
44
Motivation
specialization for the latter-day Hullians as they sought a

human focus of interest for a theory that was becoming too
vague and all-embracing.
The experimental analysis of the minutiae of behaviour
in the laboratory using primarily small animals such as rats
and pigeons still goes on unabashed, but is now straight-
forwardly empirical rather than theoretical in a grand
fashion. The high priest of the area is B. F. Skinner, for
whom motivation has never posed any problems. For Skinner,
a knowledge of environmental stimuli and reinforcers, to-
gether with the history of reinforcement of any organism,
is all that is needed for perfect prediction of behaviour.
Mediating internal events within the organism are not, he
says, relevant to such prediction. The difficulty of apply-
ing this to human beings is that here we do not know the
total reinforcement history of any individual. However, re-
inforcers can be shown to motivate change in human subjects,
notwithstanding individual differences; and certainly a
knowledge of the exact scientific way in which reinforcers
affect behaviour generally can be extremely important, es-
pecially when we want to motivate change 'on the average'
in a relatively large number of people, for example, a
supermarket owner who wishes to increase visits by potential
customers. Unlike Hull, the Skinnerians do not ask what is
the nature of a reinforcer; they simply define it as some-
thing which increases the probability of the response which
it follows. We have something to say about this view a
little later. that is to say, the view that we are simply
motivated to do that for which we are reinforced. We now
move away from our broad overview and consider aspects of
motivation research in more detail.
Aspec:ta of moti. .ticm Maslow's thecRy of bumaD needs

n=searcb Maslow, like Hull, believed that actions spring from needs,
but whereas Hull wanted to trace all needs and all motives
back ultimately to biological survival needs, Maslow was not
interested in derivation. Rather, he put forward the in-
teresting idea that the whole gamut of human needs could
achieve some sort of order and usefulness if those needs
were hierarchically arranged. First of all he reduced human
needs to five basic categories and then put them into hier-
archical order, and postulated a theoretical prediction that
needs higher up the ladder would only produce striving for
fulfilment if those lower down the ladder were themselves
satisfied. His categories ordered from lowest and most basic
needs to the highest were
* biological survival needs for example, need for food,

water, oxygen, etc.;
* safety needs for example, need to avoid danger, need
for security;
* affiliative needs for example, love, friendship,
acceptance by others;
45
Motivation
* self-esteem needs: for example, acceptance by oneself,

success in life;
* self-actualization needs: for example, achievement of
one's full potential.
Although Maslow's ideas were not in themselves earth-

shattering, they were put forward at a time (just after the
Second World War) when people were becoming receptive to
such ideas, and were no longer going to form a docile work
force. If prosperity was to arise out of the ashes, it was
going to be a prosperity shared by all. Managers of industry
were of necessity becoming interested in the wider question
of what motivated men at work in a society where the satis-
faction of survival needs had to be taken for granted by a
more caring Welfare State. Nineteenth-century notions of
keeping a man at work by keeping a wolf of hunger at his
door were no longer tenable. Maslow's theory of human needs
was soon taken up by business sc~ools, particularly in the
United States, where it was used to generate ideas about how
work conditions could be arranged to satisfy higher-level
needs rather than just provide a pay-packet at the end of
the week. Applied researchers were stimulated to ask whether
a particular job allowed affiliative needs to be satisfied;
alternatively, did another kind of job foster a sense of
personal responsibility which could satisfy self-esteem
needs? Al thollgh Maslow's theory could not be said to be
predictive - it is far too vague for that - it was genera-
tive of many piecemeal research projects which paid divi-
dends in terms of productivity and job satisfaction. It was
also a reference point for later, more specific, theories of
work motivation which related performance to an interaction
of non-monetary need variables and monetary incentive
variables (see Murrell, 1976).
Maslow's views of human motivation have also been taken
up in the field of psychotherapy. Traditionally, psycho-
therapy has been concerned with resolving problems with
affiliative and self -esteem needs. Maslow's theory, however,
hints that a person who is reasonably well satisfied with
respect to these needs will inevitably turn his attention to
satisfying the final self-actualization needs: fulfilment of
full potential. The idea that so-called 'normal' people may
seek therapy to help them on their way to ultimate self-
actualization is for Maslow no more than a necessary corol-
lary of his theory. It is therefore less than surprising
that the human 'growth' movement with its 'encounter' groups
and 'sensitivity training' groups should have grown up par-
ticularly in the rich state of California, where lower-level
needs may have been satisfied to the point of boredom!
What is weak, however, in Maslow's theory is predictive
power. We can only put a said motive into a predictive
equation if we can measure it and quantify it to a reason-
able degree of accuracy. Since almost every human need that
we could envisage is contained in Maslow's hierarchy, there
are obviously going to be difficulties. The recipe we want
46
Motivation
now is to find ourselves just one motive arising from just

one need; and, to make sure it works for us, we ensure that
it is measurable in a reliable and valid fashion; finally,
we shall select a motive which seems to offer interest in
the way of application in the real world. The last sentence
reflects the guiding considerations of those psychologists
of motivation who have researched the area of achievement.
Acbiewemeat motiYatioll
In many areas of life one could point to standards which
define excellence, achievement, success. A person's moti-
vation to achieve those standards is called 'need achieve-
ment motivation' or 'nAch' for short. The first research in
this area clearly had to demonstrate that an underlying need
to achieve was a genuine and reasonably stable personality
trait, which therefore could be measured reliably from one
person to another. It also had to demonstrate that dif-
ferences in this measured motive would predict real differ-
ences in achievement tasks which were designed to arouse
nAcho This necessary research was, in fact, undertaken by
McClelland, who became interested first of all in the
question as to whether a person's motivational concerns,
tendencies not yet expressed in behaviour but pushing from
below the surface as it were, might be tapped through the
medium of fantasy. Certain personality tests, called pro-
jective tests, make active use of fantasy, and probably the
most well known is the Rorschach Ink-Blot Test, where the
testees are asked to say what they can 'see' in what is, in
fact, no more than a series of ink blots. McClelland and his
co-workers chose a different projective test, called the
Thematic Apperception Test (TAT), with which to work. In
the TAT, people are asked to weave stories around rather
ambiguous pictures which could suggest many different
'themes'. The stories are then analysed to see what of his
own concerns the person has projected into them. Although
projective tests have tended to be used in clinical diag-
nostic work rather indiscriminately and have therefore been
the object of much warranted criticism, projective test
results can be scored objectively if care is taken to en-
sure, first, that fantasy content is analysed objectively
according to pre-established rules and with the minimum of
subjective interpretation and, second, that more than one
person scores the same test records, so that a measure of
agreement between judges can show reliability. McClelland
showed that this was possible when TAT stories were analysed
for the amount of achievement-related themes shown. Judges
did agree very well about the same records, and even though
people's derived nAch scores were not very stable over time,
it was certainly the case that samples of people could be
reliably classified as high achievers and low achievers,
even if their exact scores fluctuated somewhat.
What predictive validity do these scores have? To what
extent do people, classified as high or low on nAch, show
differing patterns of performance in achievement-related
47
Motivation
tasks? In the laboratory a whole host of experiments have

been done to show different patterns of performance for the
two groups. High nAch subjects persist longer at tasks; if
in a series of tasks the experimenter deliberately termi-
nates certain ones by telling the subjects that time is up,
subjects will afterwards show a tendency to recall inter-
rupted tasks better than completed ones: this is a well-
known phenomenon called the Zeigarnik effect. If nAch
measures of subjects were also taken beforehand it can be
shown that in conditions where subjects undertake the tasks
in a competitive atmosphere the subsequent Zeigarnik effect
is much heightened in the high nAch subjects. Outside the
laboratory, studies have shown that high nAch subjects are
far more likely to have been 'upwardly mobile' in terms of
socio-economic status, whilst low nAch subjects have
probably stayed still or gone down the scale.
However, it became clear to the researchers that
achievement-related behaviour was probably powerfully
affected by more than just nAcho Although the results of
experiments like the ones illustrated above broadly dif-
ferentiated high and low scorers, it seemed in certain
cases that subjects were acting more to avoid failure than
to achieve success. Taking up this idea, Atkinson proposed
a more predictive theory of achievement-related behaviour.
He postulated that performance in such situations was a
function of two opposing tendencies: (i) to approach the
task and succeed; (ii) to avoid the task and thus avoid
failure. The strength of each tendency was itself the
multiplicative product of three variables; in the case of
the approach tendency, the three variables are: (i) the
strength of the underlying motive towards succeeding in
general, that is, nAch; (ii) the degree to which that motive
is aroused by the perceived probabili ty of success; and
lastly (iii) the incentive attached to succeeding. The
latter two variables are, of course, related since a very
easy task (where probability of success is high) offers
li ttle in the way of incentive. Success at a very difficult
task, contrarily, offers a high incentive. If, overall, the
tendency to approach success is higher than the tendency to
avoid failure, then further predictions can be made about
the conditions under which approach and striving is maxi-
mized. Recall that the two variables, probability of success
and incentive, are reciprocally related. This means that if
probability of success in an easy task is, for example, put
at 0.9 - success nine times out of ten - we can put the
incentive value at 1 minus 0.9, or in other words 0.1. Any
value for the one variable between 0 and 1 sets the other
variable at one minus that value. Now remember that we have
to multiply these two values together to get our total
approach tendency value. It can be seen that the highest
product value of two reciprocally-related variables is
obtained when they are equal, that is, both 0.5.
The arithmetic is less important than the prediction
that arises from it, namely that striving is maximized when
48
Motivation
the perceived difficulty of the task is intermediate (when

probability of success is 0.5). In the case of the tendency
to avoid failure, the arithmetic works in the same way,
except here the prediction is that the avoidance tendency is
maximized where the perceived probability of success/failure
is intermediate at 0.5. Hence, if the person who is rela-
tively higher in fear of failure motivation than achievement
motivation is induced by force of circumstances to get in-
volved in an achievement situation, we can predict that he
will seek out either very difficult tasks or very easy ones,
but definitely not intermediate ones. We may understand why
he chooses an easy task to avoid failure, but why might he
also choose a very difficult task? Our answer might be that
here the negative incentive, the 'shame', 'embarrassment'
(call it what you will) associated with failing is mini-
mized. People might say instead: 'It was very difficult; he
didn't pull it off; but he did try.'
So much for the arithmetically-stated motivational
theory. Are its predictions borne out in practice? Let us
now look at how the theary has been tested and then look
at its possible applications in the real achievement world
of schools, colleges, and careers.
A standard laboratory method of testing Atkinson's
theory has been to use the familiar hoop-Ia game in which the
task is to throw a hoop over a peg. Probability of success
can easily be measured since it is largely a function of how
close one stands to the peg. The predictions of the theory
are pretty well borne out. SUbjects whose dominating tend-
ency is to succeed show a much more pronounced propensity
for standing a medium distance from the peg, whereas sub-
jects whose primary motivation is to avoid failure show
more evidence of standing closer or further away.
AtkiDaon's theory appHed to academic and career problems

One of the perennial discussions in education is whether
streaming children within their own abili ty ranges is a good
idea or not. The issues raised are usually in terms of
whether streaming might be good for bright children and not
so for the less bright. Discussion might also centre on what
implications there may be for teaching methods and so on.
However, in line with the motivational theory outlined
above, we should perhaps expect that the level of nAch
relative to fear of failure may be an even more important
variable in the equation than the child's ability or any
practical considerations. Let us make the reasonable assump-
tion that a child will gauge his own probabili ty of success
in the classroom in terms of his classroom peers: in other
words, they provide the standard by which he measures his
success. This means that a child who is in a class with his
own ability range will put his estimated probability of
success at about 0.5. In the case of a child who is rela-
tively more motivated to achieve success than avoid failure,
we should predict that he will find this state of affairs
desirable since achievement motivation is optimally aroused.
49
Motivation
Contrarily, a child who is more concerned with fear of

failure should find this streaming situation more threaten-
ing than being in a mixed-ability group. O'Connor et al
(1966) partially verified the theory's predictions. Children
from both types of class were asked to indicate their level
of interest in their school work. Children in equal-ability
classes showed higher levels of interest than children in
mixed-ability classes only if their motivation to succeed
was higher than their fear of failure. Those children who
were relatively stronger on fear of failure reversed the
findinlJ in other words, their interest was reported higher
when in mixed-ability classes. In the case of interest in
school work then, it might well be that the motivational
dispositions of the child are more important than his
abili ty in itself in determining the kind of classroom that
is appropriate.
It would be surprising if interest in school work did
not reflect itself to some extent in performance as well.
The same researchers, therefore, looked at the improvement
rates of pupils from one academic year to the next. It was
to be expected, of course, that all pupils would improve to
some degree during a school year, but the rate of improve-
ment followed broadly the predictions of the theory, and was
maximized in streamed pupils who, in addition, had stronger
success than failure motivation. In terms of performance,
however, it should be stressed that streaming might have
effects which are beneficial to all pupils notwithstanding
the motivational aspects with which we are dealing.
Certainly O'Connor's results suggested this.
Atkinson's theory has also been applied in higher edu-
cation. Researchers have looked at the pattern of motiva-
tion to succeed and motivation to avoid failure in students
of different disciplines. These disciplines were first of
all categorized independently as being easy, middling, or
difficult options. Students whose motivation to succeed was
higher showed the predicted tendency to choose middling
options in terms of difficulty, whereas students who were
relatively higher in fear of failure motivation, even if
they did not show clear-cut avoidance of such options,
exhibited no such preference.
Lastly, some research has been done in the field of
career choices, and the results were equally impressive.
Students highly motivated to achieve tended to go for
careers in which they estimated they would have a middling
probability of succeeding. Failure-motivated students, on
the other hand, tended to be more unrealistic in their
career choices either by aiming too high or too low.
Can 80Cietiea be Aid to This is an interesting area of enquiry which has been taken
sbaw different cJeareea of up by the originator of nAch research, McClelland. The first
Ac:bienmeDt Uotift.tiaa? question which springs to mind is how you go about measuring
the nAch of a whole society. You can hardly give it a
Thematic Apperception Test. Since, however, nAch is
50
Motivation
assessed by the analysis of TAT stories, it might be pos-

sible to analyse a society's literature and count up the
number of achievement themes which are shown. McClelland
in fact has often chosen to look at literature and stories
written for children. Some interesting findings have come
out of the work. Catholic countries show less nAch than
Protestant ones. Countries which have high nAch levels as
measured by samples of literature from a definite period
show subsequent higher levels of economic achievement as
measured by electrical output. Levels of nAch from English
literature were determined at regular intervals from 1500 to
1800, and were beautifully correlated over the period with
England's economic performance as measured by coal imports
into the Port of London. The same sort of thing was done
for American nAch between 1810 and 1950, using the number
of patents issued per million of population as the index of
economic achievement. Non-literate tribal societies and pre-
classical cultures have not escaped scrutiny, since nAch
measures have been taken from orally-transmitted folk tales
or vase paintings! The really interesting finding in all
this work is that nAch measures, although related to eco-
nomic achievement over periods of time, are out of step and
predict what will happen to real achievement in a society
some 50 or so years later. According to nAch measures, the
outlook for American civilization is pretty bleak since nAch
is on the way down and it looks as if American nAch traced
from 1600 onward went over its peak around the year 1945!
Such findings are extremely tenuous. They are correla-
tional in nature and difficult to interpret without a degree
of arbitrariness creeping in. They are also crucially
dependent on measurement which is difficult to assess in
terms of reliability and validity. Nevertheless, McClel-
land's work is nothing if not stimulating and he is the
nearest psychologist yet to the psychohistorian hero in-
vented by Isaac Asimov who was able, by concentrating on
the behaviour of society as a unit, to predict the decline
{and arrange the resurrection} of a galactic empire!
McClelland (1961) states that scientists should turn away
'from an exclusive concern with the external events of
history to the internal psychological concerns that in the
long run determine what happens in history'. It is a view
worthy of consideration.
Amdety as a motiYe
Ask any person in the street whether anxiety motivates some
activity for the better or for the worse and you are likely
to find that opinions are divided. We all know those indi-
viduals who claim to thrive on 'adrenalin', as they say, and
who seem to need the challenge of at least some anxiety in
order to reach the peak of their performance (indeed, talk-
ing of performances, it is often members of the acting pro-
fession who speak in these terms). On the other hand, any
university teacher will have had to speak up on some occa-
sion or other for a bright student who has not given of his
51
Motivation
best in a written examination because of 'nerves'. Here one

is pointing to the disruptive effects of anxiety.
Which theory then is right? Obviously, in some measure
the answer must be both. To predict the kind of effect that
anxiety will have we shall have to be more specific about at
least three things. First, we shall have to specify the
level of anxiety that pertains in any instance. Second, we
can assume that the nature of the task being considered will
be relevant. Third, we should expect that people will differ
in their capacity for being anxiously aroused. Let us deal
wi th these points one by one.
The overall level of anxiety in a situation may be low
or high. Common sense would predict that the higher the
anxiety the more likely it is that the effect will be dis-
ruptive. This is indeed the usual finding. If we say that
anxiety reflects some state of the organism that may be
termed 'arousal', or in the Hullian fashion a general push-
ing level of drive, then there is a long-standing 'law' in
psychology which relates drive to performance by a so-
called 'inverted U function'. This is simply illustrated
in figure 1.
The predictions that it makes are equally simple. It
states that, other things being equal, performance will be
enhanced by increasing levels of drive but only up to a
certain point. Beyond this, further increases in drive will
gradually lead to poorer performance. Note that we have
qualified the statement of this law with the phrase 'other
things being equal'. It is important to realize that the
other factors that we mentioned in the last paragraph are
going to interact in the operation of this law and make
predictions about behaviour more complicated.
One of those factors that we mentioned was that the
effect of anxiety was likely to vary depending on the task.
One of the obvious ways in which tasks differ is in their
ease or difficulty. By and large we might predict that
anxiety will be more disruptive if a task is a difficult and
demanding one. Our final point concerned individual differ-
ences in the capacity to be anxiously aroused. There are
some situations which we should expect most people to find
anxiety-provoking, such as walking through a mine field.
However, if we avoid considerations of such extremes and
concentrate on more everyday situations, we may hypothesize
that here different people bring different degrees of
anxiety to bear on their performance.
In an attempt to put all these factors together, two
researchers, Spence and Taylor, undertook the seminal work
which tried to make theoretical predictions in this area.
First of all, Taylor devised a questionnaire called the
'Taylor Manifest Anxiety Scale' which aimed to measure
differences in the anxiety of different people. On the basis
of these questionnaire scores Spence and Taylor selected two
groups of subjects for their experiment: high-anxiety sub-
jects and low-anxiety subjects. They also selected two types
of learning task for their subjects: an easy task and a
52
Motivation
Figure 1
The inverted-U function relating drive to perfCInIIaDce
Performance
Drive
difficult task. Both tasks were of the same nature, requir-

ing subjects to learn to respond to one word with another,
which is called 'paired-associate learning'. The words that
were paired together could be readily associated, such as
table-chair, uncle-aunt, in which case the learning task was
simple; alternatively the pairs of words could have no pre-
existing associative connection and the resulting learning
task could be thought of as much more difficult.
Spence and Taylor reasoned that in the case of the easy
task, high-anxiety subjects would perform better than low-
anxiety subjects since the motivational push associated with
the anxiety would be greater for them. However, in the case
of the more difficult task, high anxiety would be disruptive
and lead to worse performance. The exact reasoning behind
this was as follows: any general state of drive in the
Hullian sense, including that which has anxiety as its
source, is a blind force which energizes any and every
response. There actually is a good degree of evidence to
support this belief: animal studies have shown that when
rats are performing some response to avoid a noxious event
53
Motivation
and where the major source of drive is fear, they will give
a more vigorous performance if they are in addition hungry
(i.e. an added drive source); similarly, a rat which is
eating (a major source of drive being hunger) will eat
even more vigorously if a mild electric shock is given
(i.e. additional drive source which, so long as it is not so
strong as to motivate a new response such as escape, will
actually serve to help energize the eating response). Thus,
in the case of our high-anxiety subjects, the tendency to
make INCORRECT responses is as much energized by a higher
level of drive as the tendency to make correct responses. In
simple learning situations we can assume that the correct
response is so dominant that it alone benefits from inc-
reased drive. In more difficult learning tasks, however,
incorrect response tendencies can be assumed to be high, in
which case increased levels of drive are counter-productive
since they serve only to increase competing response ten-
dencies, which might otherwise remain below threshold.
Spence and Taylor's results confirmed their expectations.
High-anxiety subjects outperformed low-anxiety subjects in
the simple task, but the results were reversed for the more
complex task.
Having considered the experimental evidence, we can now
re-address ourselves to the everyday instances which were
mentioned at the outset of this section. We said that there
were some people, notably actors, who claimed to thrive on
anxiety to give a good performance. Well, so they should if
we can assume that they have rehearsed sufficiently to know
their lines off by heart. We might not expect the same fear-
motivated peak performances if, in addition to facing their
public, they were having to search their minds for the
correct words to utter. In the case of the exam-anxious
student, the situation is usually very different. He is
faced with an unseen problem which has to be worked on in
as unique and original a way as is possible; if anything he
must resist the temptation to regurgitate previously re-
hearsed material in a habit-like fashion, although interes-
tingly that is often the result in the anxiety-provoking
atmosphere of an examination room.
Recent trends in 'trait' The aspects of research covered so far can be encompassed
motiyatiOD research by the term trait motivation research in the sense that a
stable motive, rather like a personality trait, is consi-
dered to interact with an environmental state of affairs to
create some measure of performance or behaviour. The bare,
but we hope interesting, bones of research have been des-
cribed. From the almost exclusive concern with animal work
in the initial Hullian research, we have seen how some
modem psychologists have retained the idea that motives
interact with environmental expectancies, but have moved
towards a more detailed examination of human behaviour.
Within this tradition there is now a great deal of integ-
ration going on (Weiner, 1972; Atkinson and Birch, 1979).
54
Motivation
When we described Atkinson's theory of nAch we did not

consider it in relation to the inverted U-function mentioned
in relation to Spence and Taylor's work, and yet clearly it
is relevant and is presently being integrated. The results
of Spence and Taylor are likewise discussed as if anxiety
were the only motive to be considered in the equation,
whereas we know from Atkinson's work that it is important
to consider more than one motive at work in the same situ-
ation. By integrating the results from a variety of ex-
periments and by considering a wider array of interacting
motives, such as the need for affiliation motives, the
models of the theorists are becoming more complex and the
mathematical formulations more expansive. No wonder, then,
that the modern researcher welcomes the increasing aid of
computing science, which enables him to simulate easily and
efficiently the workings and predictions of ever more
notationally complex models of motivated behaviour.
However, it is at this point that we should pause and
consider awhile. What are these motives - nAch, anxiety,
fear of failure, etc. - which enter our equations? At the
beginning of Our discussion of nAch we talked about its
measurement by means of the TAT and concluded that such
measures were reliable in terms of inter-rater agreement and
valid insofar as the measures did predict real achievement-
type behaviour. And yet, even in the case of nAch, we find
that reliability in terms of the stability of a person's
nAch score over time and its validity in predicting indivi-
dual behaviour are not brilliant. The theory works well for
broad groupings of low nAch scorers and high nAch scorers,
but if we move to more precise prediction our measurement
seems lacking. Why should this be? To answer that question
we must re-assess this word 'motive'.
Thus far we have confined the cognitive aspects of
behaviour to the person's appreciation of the environmental
conditions under which he is expected to perform. In nAch
theory he is seen as cognitively involved with respect to
assessing his probability of success. The motive, however,
we have left as a sort of pushing imperative which is
measured as a 'lump' but left essentially unanalysed. And
yet motives are usually thought of as things which are FELT
(think of anxiety!), and it is no accident that motivation
and emotion have the same Latin root. What we are saying,
then, is that an emotion, or a motive with its emotional
accretions, has to be recognized and fully appraised BEFORE
it can have its effect in action. You may say that we are
merely splitting hairs; one does not actually have to
scrutinize one's inner feelings and decide what emotion is
there. Or does one?
One of the foremost of modern social psychologists,
Stanley Schachter, has put forward an extremely influential
theory about human emotion which suggests that in some sense
we do have to make up our minds about what emotion we
are feeling. To over-simplify somewhat, Schachter suggests
that there is no such thing as a specific emotion inside a
PFP _ E 55
Motivation
person; the only thing which happens inside is a kind of

general emotional arousal. The person then LABELS that
general arousal according to the context in which he finds
himself: if the context suggests to him that he should feel
angry then he feels angry; if it suggests that he should
feel euphoric, he feels euphoric. Now the evidence that
backs up Schachter's theory is, in fact, only tentative and
in some instances suspect. However, there is one emotion
which it is beneficial to think of in a broadly Schachterian
fashion: that emotion is fear or anxiety (fear and anxiety
can be thought of as much the same emotion: we tend to
use the word 'fear' when we are referring to an intense and
often transient reaction to a definite stimulus; anxiety has
overtones of chronicity and vagueness of cause). Now we have
talked a lot about measuring fear as a prelude to seeing it
as a motive, but we have tended to see this fear or anxiety
as a motivational unitary entity. If, however, it is not
so, if it is not a 'lump' (as Rachman calls it, 1978), then
clearly we need to re-examine the question of how we measure
it, given that the concept of a single 'it' is suspect.
The last paragraph has been theoretical. Let us try and
make the point more concretely, and let us do so in the
context of fear and anxiety as seen in a clinical
situation.
Fear as a motiYe to aYOid: IIOIIIe cliDical ,mam.dies

Clinical psychologists have become increasingly interested
in the investigation and treatment of those neurotic dis-
orders known as phobias, where a patient has an intense but
irrational fear of an object or situation which most of us
would consider harmless. These disorders are particularly
interesting since most neurotics also have phobic features
even in a more general disorder, and most normal people have
some small isolated phobia which, though irritating, is not
sufficiently incapacitating to make them seek treatment.
The traditional view of phobias is that they result from
some usually unspecified conditioning experience which leads
the patient to avoid the phobic object, and that by tak-
ing avoiding action fear is reduced; such fear reduction,
though, tends to reinforce and strengthen the phobia. Fear,
by motivating avoidance, prevents the patient from testing
out his fear and perhaps realizing that the feared object is
not really so terrifying as imagined.
This is all very well until one looks in more detail at
this thing, this motive, called fear. If we ask someone to
describe their feelings of fear, they might in some cases
stress certain bodily symptoms such as a pounding heart, or
sweaty hands, which reflect known physiological functioning
and can be accurately measured in the laboratory. We might,
however, choose to gauge the person's fear by asking for a
verbal description or rating of its intensity, in the belief
that the person himself should be the best judge of his own
fear. Alternatively, we might take a totally behaviouristic
view and gauge the degree of his fear by reference to the
56
Motivation
intensity of his avoidance behaviour towards the feared

object. You may say that all three strategies - measuring
physiological processes, asking for verbal ratings of
intensity of fear, or looking at avoidance behaviour - are
all tapping the strength of that same motive which we call
fear. If so, it is none too comforting to find that the
three measures do not show very high levels of agreement.
They may relate to one another in some instances but in
others they do not, which indicates that, when we are
looking at individuals, the measurement of a motive - the
essence of the approach we have been considering so far -
is extremely hazardous. The picture is just as murky when we
look at what happens when successful therapy gets under way,
and psychologists have been peculiarly successful in devis-
ing new techniques in this area. Tradition again teaches us
that, since fear motivates avoidance, removal of fear is
necessary to reduce avoidance. And yet this is by no means
the reality in successfully treated patients. Usually non-
phobic behaviour increases before diminution of fears, as
measured by physiological response or verbal report, occurs.
The patient is, if you like, learning to cope with fear or,
to put it in a more Schachterian way, is learning to label
his inner feelings in a different fashion or, even more
paradoxically, is learning to be less afraid of fear. An
analogy can be drawn with a mountaineer who, if we could
attach him to a physiological recording machine as he
dangles over a precipice, may well give us readings indica-
tive of fear, but when we ask him to describe his emotion
he chooses to label his obvious arousal as something more
like 'thrill' or 'exhilaration'.
To conclude this section, then, let us state clearly
what we consider to be the limitations of the approach to
motivation research which deals in the prr.diction of per-
formance as in some wayan interaction of 'measured trait'
motives and perceived environmental conditions. It is simply
this: at the level of the individual, a motive turns out to
be a complex, loosely inter-related constellation of feel-
ings, cognitions, and tendencies towards certain acts rather
than others, and this constellation itself has to be looked
at in detail for an individual in order to make possible
predictions for that individual. Note that we have said that
this is a limitation of an approach, not a criticism. To be
capable of reasonable prediction of the behaviour of broad
types of people in a reasonably wide variety of situations
is no mean achievement. The work described so far has
demonstrated that this is possible.
The reinforcement .iew of motivatioa: DO hidden motiftS

We mentioned at the beginning that certain psychologists,
notably the followers of B. F. Skinner, have eschewed the
study of motivational problems in terms of covert and in-
ternal traits, unseen tendencies towards action, and have
sought to provide an account of behaviour totally in terms
of existing and pre-existing environmental events. In this
57
Motivation
scheme of things everything is (or was) observable. The

limitation of this approach in the case of human beings was
so obvious that we mentioned it at the outset: we may indeed
behave totally in accordance with how we have been and are
reinforced for our actions, but specifying the reinforcement
history of any person is an impossible task. Nevertheless, a
knowledge of this area of psychological enquiry, usually
called the experimental analysis of behaviour, can be ex-
tremely valuable when we find, as we often do, that new
reinforcement contingencies can have powerful and predict-
able effects on behaviour, notwithstanding individual
differences in reinforcement history.
If reinforcers are so important we had better define
what they are. This is where Skinnerians are admirably
empirical. Because so many introductory books on psychology
leave the reader with the impression that a reinforcer is a
psychologist's jargon word to refer to what could more
easily be termed a reward, let us state unequivocably that
a reinforcer is not a reward. A reinforcer is anything which
increases the probability of an action that precedes it.
Regardless of certain philosophical difficulties of such a
possibly circular definition, it is one that should be tho-
roughly learnt by any intending practitioner of reinforce-
ment theory. If a child's bad behaviour increases as a
result of some instituted 'punishment', that 'punishment' is
not punishment in the psychologist's book; it is by opera-
tional definition a positive reinforcer. Similarly, if a
'reward' is given to a child for some good behaviour and the
result is that the behaviour decreases in frequency, the so-
called reward is, in fact, punishment (for a diagrammatic
representation of the psychologist's terms see figure Z).
Anyone wishing to apply reinforcement theory to motivate
behavioural change must first and foremost observe and
classify reinforcers and punishers on the basis of docu-
mented observation of their effects. Only then can he go
on to apply reinforcers, proven reinforcers, according to
principles which have been established in the laboratory.
What are some of those principles? In this short survey
we shall select from a vast literature just two examples of
principles, which we hope pointedly illustrate the motiva-
tional properties associated with particular ways in which
reinforcers can be dispensed.
Some of the most robust principles have concerned the
reliably different patterns of performance which can be
motivated by different patterns (or schedules) of
reinforcement. This is a particularly interesting area of
investigation because it mirrors the vicissitudes of re-
inforcement in everyday life. The pattem of reinforcing
every response of a certain kind is an exceptional situ-
ation, and more often than not responses are reinforced
sometimes rather than always: for example, it is rare for a
parent to praise (and therefore presumably to reinforce) a
child's poli teness to guests on every occasion; nevertheless
partial - or intermittent - reinforcement we know to be more
58
Motivation
Figure 2
Psychological terms
AND ACTION FREQUENCY
/
increases
\decreases
presence or
~ presentation of reinforcement punishment
ACTION stimulus procedure procedure
~~ADS~
~absence or escape (or omission

removal negative procedure
of stimulus reinf or cemen t
procedure)
effective than continuous reinforcement in maintaining

behaviour in the long term.
It is beyond the scope of this chapter to describe
schedules of reinforcement in great detail, but we can look
at one concrete problem and show how a knowledge of re-
inforcement schedules can be of help. Suppose you are a
manufacturer of Superchoc chocolate bars and you wish to
promote your sales using the usual 'gimmick' of getting your
young customers to collect and send in a certain number of
wrappers which will be redeemed for the ultimate reinforcer
of a Superchoc plastic spaceship. If the number of wrappers
required per space ship were, say, 50, this would be what
psychologists would call a simple FIXED-RATIO schedule of
reinforcement. It is the equivalent of getting a rat in the
laboratory to press a bar 50 times for a food pellet. A
psychologist would predict identical patterns of performance
in both cases, and would in fact predict a lull in respond-
ing (a 'scallop', as it is called) after each reinforcement.
Now a lull in responding is not profitable, so anything that
59
Motivation
reduces that lull will be desirable. What can be done in

this regard? One solution lies in making the schedule more
complicated by REDEFINING THE RESPONSE UNIT. Let us
then define ONE response as collecting TEN wrappers; these
are then redeemed for a certificate which 'signals' that one
response has been completed. As soon as FIVE certificates
are sent in, in other words as soon as five of our redefined
larger response units have been completed, the reinforcement
is given and a spaceship arrives in the post. This situation
in the laboratory would resemble that in which a rat still
has to press the bar 50 times to get his food pellet, but is
perhaps given an auditory click from the apparatus after
every ten responses. Now in terms of what (of value) is
given away for number of responses made, there is no differ-
ence between the procedures. The fact that one procedure
is fixed-ratio 50, and the other fixed-ratio 5 superimposed
on a fixed-ratio 10 may seem a distinction of li ttle rele-
vance. You may therefore be surprised that the two situa-
tions motivate different patterns of responding. In the
case of the larger response unit, that lull we talked of is
shortened and, moreover, responding generally is at a higher
rate: a worth-while motivational property to know about.
My second example of research in this area which is of
particular interest to a motivation theorist involves what
is termed choice of behaviour. What determines how much time
an organism spends in one type of activity and how much in
another? This is of central importance since, as was pointed
out at the beginning, behaviour is a continuous stream of
activity and the question of what motivates any behaviour
should really be seen as what motivates a change of acti-
vity. The beginning of one action is by definition the end
of some other action.
Once again research with rats and pigeons, initially,
has paid dividends in the discovery of a robust and general
law of behaviour that would seem to apply to all organisms,
including man. This law is called the 'Matching Law'. In
brief, it states that the amount of time engaged in ac-
tivity 'A' as a ratio to the amount of time engaged in
activity 'B', is exactly the same as the ratio of re-
inforcement for 'A' to reinforcement for 'B'. Thus if a
pigeon is given so much reinforcement for pecking at a red
key and so much reinforcement for pecking at a yellow key,
then:
time spent pecking red reinforcement for red

=
time spent pecking yellow reinforcement for yellow
If we are considering one type of behaviour in isolation, it

follows that the proportion of time spent in that activity
rather than any other activity should be a function of the
amount of reinforcement for that activity divided by the
total reinforcement accruing from all other activities. This
symmetrical way of approaching matters is once again impor-
tant if you wish to apply our theory. Suppose you wished to
60
Motivation
increase the use of public transport in a city. Looking at

the task in a one-sided fashion suggests that you increase
the reinforcement for using public transport. However, our
matching law tells us that we ought just as much to consider
the totality of reinforcement for not using public trans-
port. Since the two activities make up an enclosed universe
of behaviour (see figure 3) both types of reinforcement are
equally important. Moreover, the matching law tells us
something else which is very important: the reinforcement
increase or decrease which will have maximal effect will be
that which leads to the greatest PROPORTIONAL rather than
ABSOLUTE change. Thus whether to increase the reinforcement
for using public transport, or decrease the reinforcement
for not using it, will depend on how the pie, in figure 3,
is initially divided.
Figure 3
People's "public transport using behaYiour' looked at

proporticmally
NOT
using using
puhlic public
transport transport
The vast area of motivating change of behaviour by the

use of reinforcement is really another area in its own right
and the interested reader is referred to any major text such
as Rachlin (1976). The examples of research work that we
have outlined can but give a flavour of a fascinating area
of enquiry.
CoDcluaiOllS and a As this chapter draws to a close, let us try and pull some
paetacript aD Freud of the theoretical strands together. Motivation, we have
said, is potentially a vast and wide-ranging area of
psychology •
61
Motivation
Traditionally it has been about the causes of action,

but we have seen that actions do not take place in isolation
and that it is better to see the problem in terms of pre-
dicting change of activity. Broadly speaking, there are two
traditions which define the major approaches to the study of
motivation. One sees action as the result of an interaction
between current environmental variables - the context of the
act if you like - and a motivational tendency within the
organism. Such a tendency may be considered a convenient
fiction, since no one supposes that motives are real things
like tables and chairs; to talk of a motive is to use a kind
of shorthand for referring to a stable propensity for en-
gaging in certain kinds of activity. The other broad tradi-
tion is the Skinnerian approach which tries to avoid the
positing of any variables within the organism. If we think
of behaviour as output, the Skinnerian would have us believe
that all output can in principle be predicted from a know-
ledge of input, without going into details about what hap-
pens in between. The upshot of this latter approach is that
motivation, as traditionally conceived, is rather redundant.
Motivation becomes everything and nothing, and, since the
approach is a vast area of psychology, we have had to be
content to 'frame' it for the reader by example rather than
describe it any detail.
The former approach which does allow for the term
'motive' stems directly from the Hullian (or equally Tol-
manian) tradition. Note how similar Atkinson's theory is to
Hull's. Probability of success is like habit strength and
both reflect the capability of the organism; nAch is like
drive and reflects the motivational push to perform; fin-
ally, both admit an incentive variable which attracts or
pulls the organism towards a goal. All three variables, in
both cases, interact in a broadly multiplicative fashion.
Lastly, in this introduction to the topic of motivation,
the reader may well be surprised that we have not yet men-
tioned that historically important gentleman called Sigmund
Freud, who was of course a primary contributor to thoughts
on motivation by his insistence that we often do things for
reasons of which we are unaware. In other words, Freud
pointed to the importance of unconscious motivation. The
reason why we have not dwelt on Freud is that what is valu-
able in his contribution is, in a sense, already granted.
Very few psychologists today would deny that many processes
go on unconsciously. In the field of perception, memory and
attention, various experiments show that, for example,
visual stimuli can to some extent be seen 'subliminally',
things which are associated with painful or traumatic
memories can be subject to purposive forgetting (repres-
sion), and unattended messages can be unconsciously pro-
cessed to a high degree of meaning, ready for consciousness
if they prove to be important but may otherwise go 'un-
heard'. There is no reason, then, to suppose that motiva-
tional processes are any different: sometimes the reasons
for our actions may be focussed in consciousness and some-
times they may not be. The point is solely this: is there
62
Motivation
enough predictability in a person's behaviour in a certain

situation to assume the existence of what we have already
admitted is a convenient fiction: that is, a motive? The
unconsciousness of the motive is neither here nor there.
Unfortunately, Freud is often at his most interesting and
most suspect when he lacks the evidence of predictability.
He goes for once-off bits of behaviour, incapable of repli-
cation, and postulates the existence of some unconscious
motivation which can only be arbitrary. For example, he
comments in his 'Introductory Lectures' on the single act of
a woman who cannot recall the married name of her friend.
He then points out that the woman dislikes her friend's
husband and that this dislike has unconsciously motivated
her act of forgetting. The verdict on this Freudian state-
ment and on so many others must be 'not proven', or even,
as Eysenck has constantly pointed out, unprovable. Freud's
many instances of unconsciously motivated behaviour are
often therefore no more than interpretations, although
meaningful, and often because they are meaningful they may
also be enlightening and even valuable; what they are not
are explanations of behaviour.
The same comments apply to the even more general and
vague core of Freudian theory which seeks to 'explain' all
motivation as being grounded in the often tortuous channel-
ling of impulses or motivational 'pushes' which are ulti-
mately either sexual or aggressive in origin. Like Hull's
belief that the most complex motives may ultimately be
traced back to the satisfaction of biological needs, the
best that can be said is that science is not yet ready or
equipped to make any sort of test of such, for the moment,
articles of faith.
References AtkiDson, J.W. and Birch, D. (1979)

An Introduction to Motivation. Princeton, NJ: Van
Nostrand.
EYaDS, P. (1975)
Motivation (Essential Psychology Series). Lonnon:
Methuen.
McClelland, D.C. (1961)
The Achieving Society. Princeton, NJ: Van Nostrand.
Murrell, H. (1976)
Motivation at Work (Essential Psychology Series).
London: Methuen.
O'COJIDCIr, P.A., AtkiDson, J.W. ;md Homer, M. (1966)
Motivational implications of ability groupings in
schools. In J.W. Atkinson and N.T. Feather (eds) , A
Theory of Achievement Motivation. New York: Wiley.
Racblin, H. (976)
Introduction to Modern Behaviourism (2nd edn). San
Francisco: Freeman.
Racbman, S.J. (1978)
Fear and Courage. San Francisco: Freeman.
Weiner, B. (1972)
Theories of Motivation. Chicago: Markham.
63
Motivation
1. What do you understand by the term 'drive' as used by

psychologists? Discuss its merits and demerits.
Z. Write a short essay examining the proposition that we
avoid things because we fear them.
3. We have to 'interpret' a stimulus before we react to it
as that particular stimulus. Do we have to interpret our
motives before we act on the basis of that particular
motive?
4. Discuss the contribution of one of the following to our
understanding of motivation: (a) Hull; (b) Maslow; (c)
McClelland.
5. How do nAch and fear of failure work together in
determining the extent to which different people
approach achievement-orientated situations?
6. Outline and illustrate with experimental evidence
Atkinson's theory of achievement-related behaviour.
7. Write an essay on the topic of unconscious motivation.
8. Compare and contrast the ideas of Hull and Freud on
motivation.
9. 'Reinforcement equals motivation.' Discuss.
10. Write an essay on the motivat.ional properties of
reinforcers and 'secondary' reinforcers.
11. What can psychologists working in the animal behaviour
laboratory tell us about motivating changes in behaviour
patterns in individuals and groups of individuals by the
operation of reinforcement principles?
1Z. Are some societies more 'motivated' to achieve than
others?
13. Examine the proposition that motives can be measured by
looking at fantasy themes.
14. To what extent are TAT measures of nAch reliable and
valid?
15. Why might anxiety give the edge to one person's
performance and take the edge off another's?
16. What human needs may underlie the motivation of human
behaviour?
17. Is fear a unitary motive?
18. What aspects of a patient's behaviour might a physio-
therapist want to influence?
19. Can you identify Maslow's hierarchy of needs in those of
a patient with (a) hemiplegia affecting the dominant
side of the body and (b) severe facial burns?
ZOo Do you agree that Maslow's ideas were accepted because
of the socio-economic climate at the time of their
publication? Can you offer any other possible reasons
for their acceptance?
Zl. What is boredom? Discuss this in relation to motivation.
ZZ. 'The purpose of studying motivation is to seek means of
predicting human behaviour.' Do you agree with this
statement? Are there other purposes related to the
general aims of medicine and the particular aims of
physiotherapy?
Z3. Discuss the 'aim of success' as a positive goal with the
'avoidance of failure' as its realistic, but negative,
64
Motivation
counterpart. Do you know people who show either or both

of these tendencies? Is there any real difference
between trying to succeed and trying to avoid failure?
24. Explain the meaning of the word 'probability'. Do you
understand its use in the example in this chapter? (If
not, check the information about it in the chapter on
scientific methodology.)
Z5. Discuss 'reinforcement' and its place in the progress of
a patient with the goal of recovery.
Amaotated readiDg Atkinson, J. W. and Birch, D. (1979) Introduction to

Motivation. Princeton, NJ: Van Nostrand.
This book covers the area of human motivation quite well
from the point of view of internal trait motives inter-
acting with environmental contingencies. It fills in the
details of recent research in achievement motivation and
allied topics. At times the mathematical statements of
theory might be too much for certain arts-biassed
students, but the essential logic - all that is needed
for an introductory appreciation - is usually clear.
Evans, P. (1975) Motivation (Essential Psychology Series).

London: Methuen.
This is a short book which should not present the reader
with any difficulty. It is very much a theoretical cum
historical overview of approaches to the study of
motivation, leaving it to other texts, such as the one
above, to fill in details of particular approaches. It
also has chapters on instinct and on biologically based
mot iva tions such as hunger, thirst, sex and sleep. This
might interest a student who wishes to extend the
chapter's coverage at a still introductory level.
Rachlin, H. (1976) Introduction to Modem Behaviourism.

San Francisco: Freeman.
This is the best introductory book for the student who
is interested in following up the idea mentioned in the
chapter that 'Motivation = Reinforcement'. In line with
that view, it is no surprise that the word 'motivation'
does not occur in the index! (Reinforcement, however,
does.)
Do not be afraid to dip into any (reasonably modern)

psychology text and, using the index, obtain your own
further reading on any topic which might have sparked off
an interest whilst you were reading the chapter.
65
3
Learning and Teaching
David Fontana
0peniDg remarks This chapter discusses some of the characteristics of human

E.N.DUNKIN learning and of its counterpart, teaching. It considers the
'learner' as a person and there are references to the low
and high achievers that featured in the previous chapter.
The work of B. F. Skinner and of Bruner provides the main
framework for the discussion which also demonstrates the
relationship between their theories and the stages of cog-
nitive development described by Piaget. Further information
on Piagetian theories can be found in the introduction to
chapter 8.
Physiotherapists should find two uses for the material
covered in this chapter:
* it can help them to tackle and master the basic facts

and techniques of the profession {both before qualifying
and in extending that basic knowledge afterwards};
* it can be applied to the job of working as an instructor
and adviser to the patients they treat.
Much of the analytical detail about learning will be of

primary interest during student days but any improvements in
study habits that are developed in training are likely to
serve you in later specialization studies, post-registration
courses and the like. The information about improving teach-
ing methods can be of direct value to physiotherapists in
teaching and encouraging patients to do particular exer-
cises, to master the lost skill of walking or to develop a
new capacity for relaxation. Although most of the material
in David Fontana's paper is tied to the formal teacher/pupil
or tutor/student situation, it can readily be transferred to
the equivalent relationship between physiotherapists and
patients. The structure of this relationship is different
and in many instances it lacks the dogmatic element that is
associated with formal education. This instructional atmos-
phere is frequently replaced by one of dependency: patients
see themselves as depending on the therapist and they have
high expectations of the therapists' powers to 'make them
better'. Such expectations are more demanding than the aver-
age expectations of the success of teachers and tutors. The
myth of teachers having some magical ability of transferring
facts from their private store of information to the memory
of their pupils has long since been exploded. The available
66
Learning and teaching
facts are now too copious to be mastered by sheer memori-

zation: learning and recall depend on the experience of
making sense of new information and no one can do this for
the learner. (The topic of memory is discussed more fully in
chapter 11, pp. 2.81-2.96.) In the same way, patients have to
accept that it is ultimately only their own efforts, not
those of the physiotherapist, that will lead to better co-
ordination and increased muscular strength.
As a sequel to the main section on learning and tea-
ching, the development of motor skills is given special con-
sideration. This type of learning is very much the concern
of physiotherapists and the effective principles of motor
skill training are discussed, together with the role of the
physiotherapists in the process of re-education of patterns
of motor activity that were originally mastered in
childhood.
The importance of In spite of its critical importance within education, the

learning problem of explaining how learning takes place, and ana-
DAVID FONTANA lysing the factors that influence it, remains a confused
area. Teachers, and educators generally, often blame the
psychologist for this, and claim that he either presents
them with several conflicting explanations of learning, each
one based upon a different psychological theory, or a single
coherent explanation with which he has to admit other
psychologists would probably not agree. Yet perhaps this
blame, though understandable, is a little unfair. The prob-
lem is that learning is such a highly complex activity. We
all receive a constant and varied stream of experiences
throughout our waking moments, each one of which potential-
ly can give rise to learning, yet most of which apparently
vanish without trace from our mental lives. What is it that
makes some things memorable and others not? Why is it that
a particular event can prompt learning in one person yet
have no measurable effect upon someone else? Why does an
individual learn readily from one teacher but not from
another? How is it that we are able to make sense of our
experience, and put that knowledge to good effect when it
comes to tackling new situations and problems? Questions
such as these and many others make the psychologist's task
of understanding and explaining learning, and above all of
advising on how learning can be made more efficient and more
permanent for all types and conditions of learner, an almost
herculean one. Perhaps the wonder is not that the psycho-
logist has so far failed to come up with all the answers
during the 50 years or so in w;lich he has made a systematic
study of learning, but that he has come up with as many as
he has done.
The def"mitiOD of learning

Since it is always helpful to start with a definition, let
us say that most psychologists would agree that learning is
a relatively persistent change in an individual's possible
behaviour due to experience. This definition draws attention
67
to three things: first, that learning must change the indi-

vidual in some way; second, that this change comes about as
a result of experience; and third, that it is a change in
his possible behaviour. The first of these points of empha-
sis is obvious enough. Unless we are changed in some way,
learning cannot be said to have taken place. This change
can, of course, be at a relatively simple level (as, for
example, when we learn a skill like tying a shoe-lace) or
at a more complex one (as, for example, when we encounter
a great work of art for the first time), but the principle
remains the same. The individual is in some definable way a
different person with his learning from the person be was
without it. The second point of emphasis stresses that the
change must come about as a result of experience. This
therefore excludes the kinds of change that accrue from
maturation and physical development. The third point stres-
ses that although a change has taken place, it is a change
in potential rather than in actual performance. We may
learn something, but give no hint of this learning in our
actual performance until months or years later (as, for
example, when a child sees some facts about a foreign
country on television and surprises everyone by trotting
them out when his class starts to study that country at
a later date) •
Armed with this definition, we can now look at the
psychologist's attempt to develop a convincing theory of how
learning comes about. At this point we must acknowledge
the existence of the sharpest divergence between psycho-
logists, a divergence which in effect sometimes puts them
into two opposed camps, neither of them prepared to accept
the potential usefulness of the other's point of view. With-
out wishing to become drawn too deeply into the issues that
divide these two camps, we can say that one adopts an es-
sentially connectionist (or behaviourist) approach and the
other a cognitive (or cognitive-field) one. The behaviourist
approach maintains that if psychology is to be an exact
science it must restrict itself to the study of observable
behaviour: that is, to the responses made by the individual
and to the conditions under which they occur. Such an ap-
proach sees learning in terms of connections between stimu-
lus and response or between response and reinforcement, and
places great stress upon the role played by the environment.
Structure the environment correctly, and learning will fol-
low, irrespective of the particular volition of the learner.
The cognitive approach, on the other hand, holds that if we
are to understand learning we cannot confine ourselves to
observable behaviour, but must also concern ourselves with
the learner's ability mentally to re-organize his psycho-
logical field (i.e. his inner world of concepts, memories,
etc.) in response to experience. This latter approach,
therefore, lays stress not only upon the environment, but
upon the way in which the individual interprets and tries to
make sense of his environment. It sees the individual not as
the somewhat mechanical product of his environment, but as
an active agent in the learning process, deliberately trying
68
to process and categorize the stream of information fed into

him by the outside world.
As we attempt to show, these two sets of theories are
not mutually contradictory. The teacher, concerned as he is
with the practicalities of learning, can draw usefully upon
them both, and see each of them as having greater or lesser
relevance dependent upon the level at which he intends
learning to occur. To clarify this we must first look in
turn at one example from each of these sets of theories,
examples which have direct practical relevance for education
and which will provide us with a theoretical underpinning
for much of what we have to say in this chapter.
Theories of leanUu.g Although usually referred to as theories, the two views of

learning that we are about to discuss are really descrip-
tions. That is, they confine themselves to describing what
actually happens when learning takes place, instead of
entering into theoretical speculation on why and how it
happens. This will come as something of a relief to the
teacher, since it is a common complaint that theories of
learning, for all their undoubted complexity, are not really
that much help when it comes to the practicalities of help-
ing students learn. Descriptions of learning, on the other
hand, are of much more immediate benefit because they des-
cribe the kinds of activity carried out by both pupil and
teacher that appear to lead to enhanced levels of learning
on the part of the former. They thus assist teachers to plan
classroom strategies, to monitor pupils' learning, and to
isolate the possible reasons for the success and failure of
this learning.
The first of these descriptions of learning is drawn
from the behaviouristic school of thought and is known as
operant conditioning.
Operant conditicmiug
The principle of operant conditioning is most dearly ex-
pounded by the American psychologist B. F. Skinner, who
has spent over 40 years in the experimental investigation
of learning. Skinner (1969) holds that the learning act
involves three identifiable stages: first, the stimulus or
situation (S) with which the learner is confronted; second,
the behaviour (B) which it elicits from him; and third, the
reinforcement (R) which follows this behaviour. Such re-
inforcement can best be thought of by the teacher as the
results that follow on from B. Obviously these results can
either be favourable to the learner (in which case they are
known as positive reinforcement or R+), or they can be un-
favourable (in which case they are known as R-). R+ in-
creases the likelihood of the learner producing the same
piece of behaviour again in the future, while R- decreases
this likelihood. To take a straightforward example; a stu-
dent is asked by the teacher to give the present participle
of the verb 'avoir' (S): he answers 'ayant' (B), and the
teacher says 'correct' (R+). When confronted by the same
69
question in the future, the likelihood of his answering

'ayant' is accordingly increased. Had he responded with
'avant', however, the teacher would have said 'incorrect'
(R-) ,and he would have been less likely to offer this answer
again.
Obviously R+ and R- need not always come from the tea-
cher. The learner can find out in all sorts of ways whe-
ther his answer to a particular task or problem is right or
wrong. But the principle that R+ increases and R- decreases
the likelihood of behaviour recurring remains the same. The
reader may regard this as self -evident, but Skinner and his
associates consider that the relative inefficiency of much
school-based learning stems from a basic failure to grasp
both the S-B-R (or operant conditioning) model itself and
its many implications. We look at some of these implications
in due course, but first we must examine an example of the
cognitive-field approach to learning.
IDatrumental conceptualism
This somewhat intimidating title is used by Bruner to define
his own attempt at a coherent and consistent description of
learning (Bruner, 1966). Bruner's approach is very much in
the cognitive tradition since it sees learning not merely as
a passive unit of behaviour elicited by a stimulus and
strengthened or weakened by reinforcement, but as an active
process in which the learner infers principles and rules and
tests them out. Learning, in other words, is not simply
something that happens to the individual, as in the operant
conditioning model, but something which he himself makes
happen by the manner in which he handles incoming informa-
tion and puts it to use. For the teacher, the main differ-
ence between Bruner's model and that of Skinner is that,
while not denying the potential importance of the stimulus
and the reinforcement in the S-B-R paradigm, Bruner con-
siders that Skinner pays insufficient attention to the
element that comes in between, namely the learner's own
behaviour (B). This behaviour is not simply something
'elicited' by a stimulus and strengthened or otherwise by
the nature of the reinforcement that follows, it is in fact
a highly complex activity which involves three major
processes, namely:
* the acquisition of information;

* the manipulation or transformation of this information
into a form suitable for dealing with the task in hand;
* testing and checking the adequacy of this transformation
(Bruner, 1973; Bruner and Anglin, 1973).
The learner achieves transformation by codifying and clas-

sifying incoming information: that is, by fitting it into
(and sometimes thereby modifying) the categories he already
has for understanding the world. This codifying and cate-
gorizing is therefore an internal mediating process that
comes between the stimulus (S) and the learner's overt
behaviour (B) in response to it. As this process becomes
70
more developed through age and experience the learner

increasingly transforms the stimulus and gains freedom from
stimulus control. What this means - and we must understand
it if we are to grasp fully the differences between Skinner
and Bruner - is that whereas Skinner sees the stimulus as a
relatively discrete unit, an objective event distinct from
the learner himself and evoking a fundamentally mechanistic
response from him, Bruner sees it as something identified
and recognized by the learner in his own individual and
subjective way. Thus the stimulus, in a sense, becomes a
personal thing, which the individual interprets (or mis-
interprets) and transforms in his own fashion dependent upon
the previous experiences, thoughts, aspirations and so on he
has about it. Far from his response being purely mechanical,
therefore, the learner can ignore a stimulus altogether if
he regards it as inappropriate, or he can use it to help
construct internal hypotheses and models ('anticipatory
categories' as Bruner calls them) which allow him to predict
future events and which in turn influence the way in which
he perceives and transforms fresh stimuli. Similarly, he can
also become increasingly independent of immediate reinforce-
ment (R), and work towards long-term goals since such goals
are essentially the anticipatory categories which he
predicts will give him the greatest satisfaction.
Before leaving this !heoretical discussion and moving on
to more practical matters, we must say something about the
manner in which the learner transforms incoming informa-
tion. Bruner believes this transformation is linked to three
methods of representation (i.e. systems for representing
past experiences in the memory and utilizing them to deal
with the present). The mature person is capable of using all
three systems, and acquires them one by one in childhood at
ages determined both by environmental opportunities and by
maturation. These systems, in the order in which they are
usually acquired, are labelled by Bruner, Goodnow and
Austin (1965) the enactive, the iconic and the symbolic
respectively.
The enactive is a highly manipulative mode, using
neither imagery nor words. It operates through action, and
is apparent in, for example, motor skills, which we learn by
doing and would find difficult to represent internally in
terms of language or pictures.
The iconic mode is more developed in that it does use
imagery, though still does not employ language. This ima-
gery, which depends upon visual or other sensory organi-
zation, represents a concept without fully defining it. A
child of five, for example, has mental and aural images of
a wide range of things which allow him to recognize and use
them, though he would be unable to define or describe them
in terms of words. Similarly an adult may, for example, have
a clear picture of the geographical route from A to B, yet
find himself hard put to it to give verbal directions to a
stranger.
Finally, the symbolic mode goes beyond action and
imagery and employs representation through language. Such
PFP _ F 71
representation leads to thought and learning of a much more

abstract and flexible kind, allowing the individual to
engage in reflective thinking, to consider propositions as
well as concrete examples, and to arrange concepts in a
hierarchical structure. Symbolic representation can, of
course, employ symbolic systems other than language, such
as the symbolism used in mathematical and scientific logic.
Bruner (1966) considers that Skinner's operant condi-
tioning model may be an adequate account of the way learning
takes place when the learner is operating in the enactive
mode, but that it tells us little about the iconic and
symbolic modes. Whether this is correct or not, the teacher
may well find that Bruner's description of learning is of
more practical help than Skinner's when it comes to dealing
with the problems of facilitating pupils' abstract learning,
though as we see both have their place in helping the tea-
cher plan learning experiences at different levels.
Finally, Bruner and Anglin (1973) consider that when we
undertake such planning, or indeed when we think about any
learning activity, we must consider three important vari-
ables, namely the nature of the learner, the nature of the
knowledge to be learned, and the nature of the learning
process. Although we are not concentrating simply upon
Bruner in the remainder of this chapter, this threefold
division forms a convenient and productive way of ordering
our thinking on the practical aspects of learning, and
accordingly we examine each of these variables in turn.
The Datme of the There are a number of factors within the learner himself
Ieamer that influence his ability to learn. Perhaps best known of
these are cognitive factors such as intelligence and creati-
vity, but there are many others of equal relevance to the
teacher with which he is often much less familiar. These
include affective (i.e. emotional) factors, motivation,
maturational factors, the learner's age, sex and social
background, study habits and, above all, memory.
AffectiYe facton
Strictly speaking, the term 'affective' refers only to the
emotions, but psychologists tend to use it more broadly to
cover all the things related to personality. Of particular
importance amongst these from our point of view is the
learner's level of anxiety. From gener al classroom experi-
ence the teacher soon discovers that a mild degree of
anxiety can be a useful aid to learning, but that too much
can have an inhibiting effect and interfere with it. Pre-
cisely what degree of anxiety motivates and what degree
inhibits varies from child to child and from task to task
(the more difficult the task, the more likely a given degree
of anxiety is to interfere with it). One of the most potent
sources of anxiety in children is the fear of failure. We
see this particularly in exams where a great deal is often
at stake, or in unhappy classrooms where teacher anger or
ridicule from classmates is the usual consequence of
7Z
failure. But some sources of anxiety are less obvious than

this. Trown and Leith (1975) and Bennett (1976) produce
evidence that suggests habitually anxious children may find
the informal classroom, where they are often unsure of what
is expected of them, more anxiety-provoking than a more
formal, less ambiguous environment. Even in higher educa-
tion, where habitual anxiety seems to be more of an advan-
tage than it does at school (for the possible reason that it
motivates students to make better use of their time outside
lectures!), recent research (Franson, 1977) indicates indi-
viduals do better at specific learning tasks in the presence
of low rather than high anxiety.
Closely linked to anxiety is the question of self-esteem
(i.e. the regard in which we hold ourselves). In a number
of studies, Coopersmith (e.g. 1968) has demonstrated that
children with high self-esteem consistently perform better
than children of similar ability with low self-esteem. They
also set themselves higher goals, show less need for adult
approval, are less deterred by failure, and have a more
realistic view of their own abilities. High self-esteem
seems to be due in large measures to parental attention,
encouragement, physical affection, consistency, and demo-
cratic behaviour (i.e. to the things that make a child feel
a valued, significant and responsible member of the family),
but the teacher can help to give the child confidence in his
own abilities by giving him opportunities for success, by
encouraging rather than censuring him when he is confronted
by failure, and by demonstrating personal belief in his
competence.
High and low self-esteem can be referred to as a dimen-
sion of personality. Another such dimension that has impli-
cations for learning is that of extraversion-introversion.
Typically the extravert is an individual who enjoys change
and variety and is orientated towards the external world of
people and experiences, while the introvert is more con-
cerned with stability and with the inner world of thoughts
and feelings. All of us find our place at some point on this
dimension between extreme extraversion and introversion, and
research with children (Entwistle, 197Z) suggests that
success in primary school (where the emphasis is often upon
group work and social activity) may be linked to some extent
to extraversion, but that the balance swings towards intro-
version (more rapidly for girls than for boys) in the se-
condary school and even more markedly in higher education
(where the emphasis is more upon solitary, static activity).
Further evidence that extraverts prefer unstructured and
introverts structured learning environments comes from
Rowell and Renner (1975), while Lewis and Ko (1973) demon-
strate that introversion may be of most value in terms of
school learning and achievement when it is combined with
high levels of intelligence.
Note that the relative progress of introverts and
extraverts at school level appears determined, partly at
least, not so much by some quality in themselves as by the
way in which we organize the leaming environment for them.
73
The inference for the teacher is that just as he adopts

different approaches for children of differing cognitive
ability, so should he for children·of differing personality,
making sure that the introvert enjoys ample opportunities
for quiet, structured work and the extravert for more
active, socially-orientated activities. In particular, he
should avoid ordering his classroom (and his value system)
so that only children with personalities similar to his own
find it a suitable environment for learning.
Moti. .tioa
Satisfactory school learning is unlikely to take place in
the absence of sufficient motivation to learn. We have
already mentioned one possible source of motivation, namely
anxiety, but there are many others. For convenience we can
divide these into intrinsic forms of motivation, which come
from the individual himself, and extrinsic, which are
imposed upon him by the environment. Taking intrinsic first,
research studies suggest (e.g. Harlow and Harlow, 1962;
Charlesworth, 1966) that there may be a natural curiosity
drive in animals and man, a drive that does not appear to be
directed towards an apparent material end but is engaged in
for itself and which prompts exploration and discovery from
an early age. As the child matures, so the response of
others to this drive will help determine its development. If
his attempts at exploration are met with adult disapproval
and consequent frustration to himself, then through operant
conditioning such attempts are likely to become less fre-
quent, and to be replaced by apathy or possibly by random
purposeless activity. If, on the other hand, they are fre-
quently rewarded and reinforced by discovery, excitement,
and adult approval they are likely to continue, and to
become more directed and productive.
Closely linked to a child's curiosi ty as a motivator is
the degree of interest that he derives from a learning
experience. If we had to say why some things capture a
person's interest and others do not we would probably argue
that the former have direct relevance to his daily life.
Either they make him feel better by amusing him or taking
his mind off unpleasant thoughts, or they enable him to cope
more effectively with the tasks and people he meets. As he
grows older they may also help him to understand himself ,
and develop some coherent and consistent philosophy of
life. But the problem with much school learning is that it
appears to lack this relevance. It takes place in an envi-
ronment distinct from the outside world, and much of what
it teaches is a preparation for tasks way ahead in the
future rather than in the present (or for tasks which the
child meets only in school and nowhere else). By knowing
both his subject and his children the lively, imaginative
teacher can do much to make school work appeal directly to
children's interests. Essentially, this means starting from
what children already know, their curiosities, their
ambitions, their problems, and showing how these relate to
74
what is studied in school, and how such study can provide

answers that will help them lead more satisfying lives.
Nevertheless, however stimulating the teacher, there
will always be occasions when the children's intrinsic moti-
vation is insufficient and recourse has to be made to
motivation of an extrinsic kind. Such motivation usually
consists of marks, grades, school reports, tests, exami-
nations and, of course, teacher approval. Success at such
things helps build up a child's prestige in his own eyes and
in the eyes of teachers, peers, and paren ts, and thus
assists the development of what is called achievement moti-
vation (sometimes called need for achievement, or nAch for
short). The child finds success to be rewarding, and builds
up expectations which he has to work ever more purposefully
to fulfil. But extrinsic motivation raises a number of
important considerations at school level (quite apart from
the danger that it may increase anxiety to an inhibiting
level), the most important of which we summarize below.
* Instead of success, some children experience only

failure. This tends to produce either low self-esteem or
a rejection of school as 'boring' and 'stupid' (i.e. a
defensive attempt to convince everyone that 'I could do
the work if it was worth doing'). In combatting the
harmful effects of constant failure, the golden rule
of the class teacher is to provide opportunities for
success at however low a level. Through this experience
of success the child gradually builds up a new self-
image, and can be encouraged to set his sights
progressively higher.
* Sometimes motivation suffers because children have to
wait too long for the results of their work. The operant
conditioning model demonstrates that the longer the gap
between performance and results the less efficient the
learning, and the greater the likelihood that the child
will lose interest in the task and in how well he has
done it.
* Competition between children is a useful motivator,
though if it becomes too intense it can lead to bad
feeling and the harmful effects of failure. A situation
where the child competes against himself, steadily
improving his performance, is often more helpful, as is
a spirit of co-operation where children adopt group
norms and work together to achieve them.
* Wherever the pressures of extrinsic motivation are too
strong, children may resort to strategies like cheating,
absenteeism, or feigned illness to avoid the
consequences of failure.
Age, sex ad social facton

Age variables in learning bring us to the concept of readi-
ness. Such a concept has it that children are unable to
undertake certain kinds of learning {whether it be simple
skills like colour discrimination or more complex ones like
75
classification and seriation) until their cognitive pro-

cesses have matured to the appropriate levels. Piaget's
well-known developmental stages of sensori-motor operations,
concrete operations, and formal operations (with their
various sub-divisions) provide a context within which to
study this concept, as do the enactive, iconic, and symbolic
systems of Bruner referred to above. Both Piaget and Bruner
stress that learning is related closely to thinking. As the
child becomes more capable of complex thinking, so the
nature of the learning he is able to undertake changes in a
range of important and subtle ways. For the teacher the most
important difference between the developmental psychologies
of Piaget and Bruner is that although Bruner believes we
acquire the stages proposed by his system in a set order and
we continue to use each of them throughout life, Piaget
argues that generally we progress beyond each stage as we
acquire the next one above it. The subject is too complex to
debate fully here, but the teacher should study both the
systems of Piaget and Bruner and ensure that learning
experiences are presented to a child in a form suited to his
particular level of thinking. Thus, for example, a child in
the early stages of concrete operations (Piaget) and capable
only of iconic thinking (Bruner), should not be taught by
methods that employ elaborate linguistic definitions, and
highly abstract concepts. Bruner, in particular, stresses
that a child is ready to tackle virtually any subject pro-
vided it can be presented to him in a form appropriate to
his level of thinking.
Just as the ability to learn is influenced by age vari-
ables, so is it influenced by sex. Girls are generally more
verbal than boys at school age, and have fewer reading,
speech, and general backwardness problems (Davie et aI,
1972), while boys are more advanced in nwnber skills. These
verbal and speech differences tend to disappear by age 16,
and boys between five and ten years old also appear twice
as likely to show an increase in measured intelligence as
girls (Kagan et aI, 1958). Throughout school life, however,
girls tend to be better all-rounders, while boys are better
at the subjects they enjoy and spurn those they do not.
These sex-related differences could be in part genetic and
in part related to the home (where girls are taught to be
more dependent, and more concerned for parental approval) ,
but research in the USA swnmarized by Mussen, Conger and
Kagan (1979), suggests they could also be due to the fact
that most early school teaching is done by women, and boys
therefore associate school with feminine values. Where such
teaching is done by men, the higher rate of backwardness and
school rejection shown by boys apparently declines. Sadly,
at all ages, girls tend to show lower self-esteem than boys,
and may even artificially depress their levels of perfor-
mance in conformity with an outmoded and unfortunate social
conception of the inferiority of the female role.
A nwnber of studies (e.g. Davie et aI, 1972) show that
children from deprived social backgrounds lag behind child-
ren from more favoured environments in every aspect of
76
school learning. Extended discussion of the reasons for this

belong elsewhere, but obviously poorer economic circum-
stances, fewer facilities, less parental interest and en-
couragement, and a higher level of emotional upheaval will
all play their part. It may be also that since schools, for
better or worse, uphold the so-called middle-class values
of thrift, respect for authority, professional ambition,
poli teness, and deferral of satisfaction (i. e. the willing-
ness to put off short-term gain in the interest of long-
term), then children who share these values are more likely
to fit in successfully than those who do not.
Memory
Clearly, learning depends intimately on memory. At the
practical level psychologists recognize the existence of two
kinds of memory, short-term and long-term respectively (a
further sub-division into immediate or sensory memory is of
li ttle practical importance to the teacher). All information
received by the senses and to which we pay attention seems
to enter short-term memory, but it can only be held there
briefly and is either then forgotten (as when we look up a
telephone number and forget it the moment we have dialled
it) or transferred to long-term memory where it can be held
more permanently (though it is still, of course, subject to
forgetting). Obviously this transfer from short- to long-
term memory is vital for the teacher. Available evidence
suggests it involves some form of consolidation, typically a
short pause during which the information is held consciously
in the mind. Even after an interesting lesson children often
remember little, probably because each piece of information
is so quickly followed by the next that there is no time for
consolidation. However, a munber of strategies exist both
for helping consolidation and for increasing the efficiency
of long-term memory generally.
* Pausing, repeating, and questioning: each of these

prompts children to dwell sufficiently upon material for
transfer from short- to long-term to take place.
* Relevance and interest: children best remember those
things that appeal directly to their own experience and
feelings.
* Attention span: the process of concentrating on a task
for any length of time is difficult for some children.
Their attention wanders, and material is neither
listened to nor remembered. A rough rule is that the
teacher can expect to hold attention with a normal class
at anyone point, even with interesting material, for no
more than a minute to a minute-and-a-half for each year
of the children's age (e.g. 10-15 minutes for a class of
ten year olds).
* Practical use: material that is put to practical use
tends to be remembered better than material which is
not.
* Meaning: material which is understood by the child is
more memorable than material which is not.
77
* Overlearning: skills or knowledge that the child goes on

practising and revising even after he has apparently got
them off to perfection (i.e. material that is over-
learned) persist better in the memory than material that
he does not. This is especially true of material re-
quired to be remembered in a stressful situation (e.g.
in the examination room, on the concert platform).
* Association: unfamiliar material is remembered more
effectively if it is associated with something fami-
liar. Realization of the truth of this lies behind
the old (and good) primary school adage that learning
should always go from the known to the unknown; that
is, that new material should be keyed in by reference to
the association between it and something already known.
Research (e.g. Bugelski, 1968) indicates that visual
association is particularly helpful: hence the impor-
tance of visual aids. Such aids need not necessarily be
closely linked in terms of meaning to the material to be
learned {witness the highly successful advertisements on
television!}, but they must be presented concurrently
with this material so that a strong association is built
up'.
* Recognition and recall: there appears to be a functional
difference between recognition (where we spot as fami-
liar some stimulus physically presented to us) and re-
call (where we have to retrieve some word or fact from
memory itself). Recogni tion appears to come more readily
than recall (e.g. it is easier to recognize a face than
to recall a name, to recognize a word in a foreign
language than to recall it from memory), and in conse-
quence, where practical, the teacher should aid child-
ren's recall by providing appropriate recognition cues.
So much for the factors that aid long-term memory. Now

for those that appear to interfere with it. One of these,
anxiety, has already been touched upon. Material that can
readily be recalled in a relaxed state may prove elusive
when in a stressed state. Two others of importance are known
as retroactive and proactive interference respectively.
Retroactive interference occurs when recently learned
material appears to inhibit the recall of that learned
earlier. The phenomenon appears to take place at all levels
of learning and is apparent in the student, for example, who
crams for an examination and finds the facts he learned the
night before keep coming back when he tries to recall those
he studied earlier in the week. Proactive interference, on
the other hand, occurs when earlier learning seems to block
the recall of later, as when, for example, a child starts
learning a second foreign language and finds himself unable
to remember the word he wants because the equivalent in the
first foreign language keeps coming to mind. We shall dis-
cuss ways of minimizing the risk of retroactive inhibition
when we deal with study habits below, but little can be
done, within the confines of the classroom, to lessen
78
proactive interference in the early stages of a new learning

task. Such interference is more likely where the two sub-
jects being studied share certain similarities, but it is
generally less of a problem than retroactive interference
and tends to disappear as the new material becomes more
familiar and overlearning takes place.
Finally, we come to the subject of memory training.
Some teachers still assume they are 'training' children's
memories when they require them to learn long pieces
of poetry, as if the act of memorizing in itself effects
improvement. There is no consistent evidence that it does.
True, actors and others who spend their professional lives
memorizing material seem to become extra good at it, but
this comes from acquiring skills on how to memorize rather
than from memorizing per se. Some of these skills have al-
ready been mentioned, and others are discussed in the next
section, but some reference should be made here to mnemonic
devices, which are devices created specifically to aid re-
call. They range from simple tricks like tying a knot in
a handkerchief and short jingles like 'thirty days hath
September ••• ' to the elaborate devices used by stage
'memory men'. One such device is the so-called peg-word
system, where the digits 1-10 (or more) are each associated
with a rhyming word (e.g. 1 is a bun, Z is a shoe, 3 is a
tree, etc.). These associations are learned, and then facts
to be memorized are associated with them in turn, preferably
using visual imagery. Thus, for example, if we wished to
learn (for some reason) the agricultural produce exported by
New Zealand we could visualize first butter spread on a bun,
second a lamb wearing shoes, and so on. Such devices are
remarkably effective in the learning of lists of facts, but
their use beyond this is limited.
Study habits
As the child grows older and comes to take more responsi-
bility for his own learning, so good study habits become
increasingly important. Some of these habits, like working
in an environment free from distraction, are obvious while
others, like overlearning, have already been covered. We can
summarize the remainder as follows.
* Realistic work targets: realistic work targets, which

the student plans in detail, are far more effective than
impossibly ambitious or vague commitments. Ideally these
targets should be expressed publicly, so that he will
stick to them to protect his prestige.
* Rewards: the student can build small rewards, as re-
inforcers, into his work schedule, like a cup of coffee
and a five-minute break after every hour of solid work.
He should be strong enough to withhold the reward from
himself if he fails to earn it.
* Punctuality: work should be started promptly at the
appointed hour. This forestalls the elaborate (and
plausible) strategies we each develop to put off
79
actually sitting down at our desks and getting on with

it.
* Whole and part learning: a new learning task should be
read through first in its entirety, to get the general
drift of it, before being broken down into small units
and learned methodically.
* Organizing material: often textbooks (and lecturers) do
not present material in a way which accords best with
the learner's own experience and understanding. Time
spent making notes and reorganizing the material into a
more palatable form is never wasted. Similarly, time
spent in ensuring that notebooks are attractive and neat
is also time well spent. Scruffy notes, with pages out
of order, are a powerful disincentive to learning.
Revision notes should also contain all important
references and information likely to be needed later.
Many things that seem unforgettable at the time soon
fade from memory, as does the meaning of the cryptic,
home-made shorthand that many students employ in
lectures!
* Revision: a programme of phased revision throughout
the duration of a course is of far more value than an
attempt to cram everything in during the final few weeks
before an exam. Retroactive inhibition is the almost
inevitable consequence of such cramming. Phased
revision, however, leads to a growing mastery of the
whole course as the student works his way through it,
with each new piece of knowledge being placed in its
proper context. When it comes to final examination
preparation the student is therefore looking back over
material that has already been overlearned. Revision is
best done before material has actually been forgotten.
This is known as maintenance revision.
The nature of the From time to time one still hears the view expressed that
knowledge to be learned the experienced teacher can teach any subject, no matter how
unfamiliar, simply by keeping one page ahead of the class in
the textbook. The fallacy of this view is most clearly
emphasized by Bruner (1966), who insists that the ultimate
aim of teaching a subject is to help children understand its
structure: that is, the basic principles that help define
it, give it identity, and allow other things to be related
to it meaningfully. Without a thorough specialist knowledge
of the subject himself, the teacher can neither understand
its structure nor help others achieve such an understan-
ding. By knowing the structure of his subject the teacher is
able to abstract from it material that is suited to the
level of comprehension of his class, and that represents
coherent, logical, and meaningful elements of the whole.
This material can then be expressed in terms of clear
learning objectives which state the 'purpose and point of
the whole enterprise'.
80
Emphasis upon the essential nature of such objectives,

if learning is to be rendered efficient, also comes from
operant conditioning theorists who argue that such objec-
tives must be couched in behavioural language so that we can
judge by the changes in student behaviour whether or not the
desired learning has taken place. In other words, objectives
must state clearly what a student should be able to do at
the end of a successful lesson. The most detailed attempt to
provide guidance on the preparation of learning objectives
comes from the work of committees under the direction of
Bloom (1956) and Krathwohl (1964) working respectively in
the cognitive domain (the area of learning concerned with
intellectual outcomes) and the affective domain (the area
concerned with feelings and emotions). Bloom and Krathwohl
and their colleagues have produced a set of general and
specific categories that encompass all the learning outcomes
that might be expected in the class or lecture room. These
categories are arranged in hierarchical order, from the
simplest to the most complex. Each of the higher categories
includes the outcomes at the levels inferior to it (e.g.
outcomes at level Z will include those at level 1 also), and
we now summarize them in ascending order, taking the cogni-
tive domain first.
Categories ill the cogaitiYe domain (after Bloom et ai,

1956)
* Knowledge: simple knowledge of facts, of terms, of

theories, etc.
* Comprehension: an understanding of the meaning of this
knowledge.
* Application: the ability to apply this knowledge and
comprehension in new and concrete situations.
* Analysis: the ability to break material down into its
constituent parts and to see the relationships between
them.
* Synthesis: the ability to re-assemble these parts into a
new and meaningful relationship, thus forming a new
whole.
* Evaluation: the ability to judge the value of material
using explicit and coherent criteria, either of one's
own devising or derived from the work of others.
Armed with this taxonomy the teacher is able to examine

whether or not he is keeping a balance between his expec-
tations. For example, is he placing too great an emphasis
upon expectations connected with level 1 of the taxonomy
(e.g. by concentrating the attention of his class upon the
memorization of facts and figures) at the expense of the
more complex outcomes? More important still, is he able
to separate educational outcomes (i.e. the behaviours ex-
pected of children at the end of the learning task) from
81
educational processes (i.e. the behaviours expected of

children -and of the teacher - during the task itself)?
Educational processes are, of course, a major concern, and
we deal with them in the next section, but the tendency to
confuse these processes with outcomes is a prime cause of
the vague and well-nigh valueless objectives with which many
teachers and student teachers preface their lesson notes.
For example, a teacher may state that his objective is to
demonstrate to his class a particular skill (whether it be
in science, craft, PE or whatever). But this is not really a
learning objective at all. It is simply a statement of what
he plans to do, and therefore belongs more properly under
the heading of process (or methodology). It fails to say why
he is going to demonstrate this skill, and how children's
behaviour is going to be changed as a consequence. Instead
of a misstated objective of this kind, therefore, the tea-
cher should have said that his objective was one or more of
the following (dependent upon the level of Bloom's taxonomy
at which he planned to work). At the end of the lesson the
class should be able:
* to recognize and identify the various elements involved

in the particular skill (these elements would then be
specified.: this is an objective at the knowledge
level) ;
* to define these elements and to know the part they play
in the particular skill (an objective at the compre-
hension level)i
* to practise the skill itself (an objective at the
application level);
* to describe what is happening - and why - during this
practice (an objective at the analysis level);
* to utilize elements of this skill in solving a parti-
cular novel problem (an objective at the synthesis
level);
* to assess the degree of success achieved in this
solution and to propose improvements (an objective at
the evaluation level) •
Note that if we were using objectives at more than one level

we would not necessarily always deal with them in their
hierarchical order. To do so would lead to formal and
stereotyped lessons. We might prefer, at times, instead of
first presenting the class with knowledge and then going on
to the practical activities, to start by confronting the
class with the problem and then feed in the knowledge (and
the comprehension) as the objective necessity for it arose
during the course of problem solving. Note also that the
verbs in our extended example of objective writing above are
of an essentially unequivocal behavioural kind. Bloom and
other workers in the field lay great stress upon the need
for this. It is all very well for the teacher to write that
he wants his class 'to appreciate' a particular thing, or
'to become proficient' at something else, but what do these
82,
terms actually mean when translated into directly observable

changes in children's behaviour? Instead of such impreci-
sion, Bloom proposes examples of the kind of concrete verbs
that should be used, with appropriate variations dependent
upon the level at which we are working. Thus if we were
working at level 1 (knowledge) we would express objectives
in terms of class members being able to state, or list, or
identify, or reproduce; at level 2 (comprehension), we would
talk of their being able to explain, or distinguish, or in-
fer, or give examples; at level 3 (application), we would
expect them to be able to demonstrate, or operate, or show,
or solve, or use; at level 4 (analysis), to describe, or
break down, or discriminate, or select; at level 5 (syn-
thesis), to combine or compile, or design, or create, while
at level 6 (evaluation), we would expect behaviour that
would show them able to appraise, to contrast, to criticize
and to justify.
The categories in the affective domain are rather
different from those in the cognitive, and can be taken to
refer not just to classroom learning but to all those values
and attitudes that a student derives from the institution of
which he is a member. Thus the affective domain must not
be seen as something quite separate from the cognitive. The
affective categories advanced by Krathwohl and his col-
leagues are summarized below, and this time we include in
each of the categories the kind of concrete verbs in which
objectives might be expressed.
Categories in the affecti.e domain (after Krathwohl et aI,

11)64)
* Receiving (willingness to attend): the student listens,

or asks, or sits erect, or looks at.
* Responding (willingness to participate actively): the
student answers or complies, or helps, or obeys, or
reads, or writes.
* Valuing (the ability to assign value to things; this
differs from evaluation in the cognitive domain in that
it involves attitudes and moral and social judgements
rather than the application of the specific principles
of a given subject or discipline): the student joins, or
justifies, or prefers, or commits himself, or shares.
* Organization (the ability to bring separate values
together and compare and relate them): the student
modifies, or relates, or organizes, or accepts
responsibility.
* Char'lcterization by a value or value complex (the
ability to take the organizational level a step further
and build up a coherent value system or philosophy of
life which informs all of one's behaviour): the student
serves, or acts, or influences, or shows self-
awareness.
83
The committees that met under Bloom and Krathwohl

originally intended to produce a taxonomy of educational
objectives in the third major domain, the psycho-motor, in
addition to those produced in the cognitive and affective
domains. This work was never finished, but various attempts
have been made to remedy this omission, the best known
probably being that by Simpson (1972). The psycho-motor
domain is concerned with motor skills, such as those used in
sport, in operating machinery and equipment and in
manipulative exercises such as handwriting. Simpson's
taxonomy, in ascending order, consists of perception (the
acquisition by the senses of cues to guide motor activity),
set (the readiness to take a particular kind of action),
guided response (the ability to copy an instructor or to be
guided by knowledge of results), mechanism (the ability to
carry out simple movement patterns with confidence and
proficiency), complex overt responses (the ability to carry
out more complex patterns with smooth and accurate control),
adaptation (the ability to modify established movement
patterns to meet special situations and problems), and
finally origination (the ability to create new movement
patterns) •
It would be wrong to suggest that all psychologists and
curriculum theorists interested in school-based learning
agree that with the help of the above (or any other) taxo-
nomies it is necessarily possible to write specific objec-
tives for all learning situations. Stenhouse (1970) argues,
for example, that the teacher cannot plan in advance the
precise impact that great literature is likely to have upon
young minds and behaviour, and this argument is perfectly
valid. Indeed, it would not be a good thing if the teacher
could. Great literature is an intensely personal experience
and it is not the teacher's job to circumscribe this experi-
ence by imposing too many of his own reactions upon his
class. Nevertheless, even with great Ii terature the teacher
should have a good idea of the kinds of responses from
children that can be regarded as appropriate and those that
cannot. He will expect, to give an instance, that even those
who reject the literature will be able to show some know-
ledge and comprehension of it, that they will be able to
analyse the plot, the characterization and perhaps the
techniques that it contains, and that they will be able to
offer some considered evaluations and take part in informed
debate •
.A8a ""eAt The preparation of specific learning objectives plays an

important part in helping the teacher to structure the
learning experience and evaluate its success. Such evalu-
ation, however, involves more than the teacher sitting back
and observing whether or not the children evidence the kind
of behaviour for which he hoped. Often he will want to offer
them specially devised opportunities for such behaviour, and
this brings us to a consideration of assessment in its
various forms.
84
The first point to stress is that the teacher's choice

of assessment techniques will be strongly influenced by the
level (in terms of the taxonomies discussed above) at which
he intends learning to take place. All too frequently,
particularly in arts and social science subjects, assessment
simply takes the form of a written essay, which may be ideal
for gauging progress at the more complex cognitive and
affective levels (such as synthesis and evaluation, or
valuing and organization), but which is a very limited
measure of such things as knowledge and comprehension. It
may also be that students have little idea of the kind of
essay likely to appeal to a particular teacher, or the
precise meaning of a given title, or of the criteria which
will be employed in marking it. Thus their essays may be a
poor reflection of the actual learning that has taken place,
and of the use to which they can put this learning in
environments other than the classroom. The value of essays
in assessment can be increased considerably if teacht:rs pay
attention to these points, making their expectations clear
to their students and explaining the details of their
marking schedules.
The main alternative to the essay, in the cognitive
domain at least, is the so-called objective test, each of
whose items carries only a single right answer. The prin-
ciples behind the construction of such a test can be simply
stated.
* From the objectives of the various lessons that the

teacher wishes to assess, a list is made of the student
behaviours that represented the desired outcomes of
these lessons. These behaviours yield the general area
to be tested.
* From the contents of these lessons a list is made of
the knowledge and comprehension (or whatever) that were
expected to figure in these behaviours. For example, the
lesson objective may have stated that the student should
be able to quote the terms or the parts of speech or
the procedures associated with a particular skill, while
the lesson content will have stated what these various
things actually were. This knowledge and comprehension
yield the precise subject matter to be tested.
* From these two points, a schedule is drawn up of the
relative importance of each of the various items of
subject matter to be tested. This provides guidance on
the number of test questions that will be constructed
for each item.
* Finally, the test questions are prepared. In an
objective test these are usually of the multiple choice
variety, with the student being asked which of a range
of possible answers is the correct one= for example,
The Theory of Association was first advanced by:
Herbart/W illiam James/Francis Gal ton/none of these.'
However, some operant conditioning theorists claim tnat
in getting a multiple choice question wrong, a student
may unwittingly form an association in his mind between
85
the question and the incorrect response. To avoid this,

it is sometimes suggested that the question should be
left to stand on its own, without the addition of a
range of possible answers. The reader will note at once
that in this form such a question would be testing
recall, whereas when presented in its multiple choice
guise it is testing recognition.
It is often objected that tests of this kind take much

longer to construct than does a test of the essay type.
There is no gainsaying this, but on the other hand they are
much quicker to mark, and the teacher is left with the
satisfaction of knowing that he has adequately tested the
knowledge, comprehension and application that he set out to
test. Further, the student is motivated to acquire this
knowledge since he knows it is to be comprehensively tested,
rather than fractionally sampled as in an essay. He is also
left with the reassurance that good marks really do mean
that he knows the field and is equipped with the basic
grammar of his subject.
Tbe :aatme of the Consideration of the practical aspects of the learning

learning proc:e88 process brings us to the question of teaching methods and
techniques. Many of these are specific to the particular
subject or subjects being taught, and therefore lie outside
the scope of a text in psychology. However, there are a
number of general points to which we can draw attention.
Gagne (1974), who draws upon both Skinner's operant condi-
tioning model and (though to a lesser extent) the kind of
conceptual model associated with Bruner, suggests that the
learning act typically consists of a chain (!If eight events,
some internal to the learner and others external. These are,
in their usual order of occurrence:
* motivation (or expectancy);

* apprehending (the subject perceives the material and
distinguishes it from the other stimuli competing for
his attention);
* acquisition (the subject codes the knowledge);
* retention (the subject stores the knowledge in short-
or long-term memory);
* recall (the subject retrieves the material from
memory);
* generalization (the material is transferred to new
situations, thus allowing the subject to develop
strategies for dealing with them);
* performance (these strategies are put into practice);
* feedback (the subject obtains knowledge of results).
Where there is a failure in the learning process, Gagne

argues, it will take place at one of these eight levels, and
it is the task of the teacher to ascertain which. We have
already discussed motivation at some length, but Gagne
considers that the teacher can help avoid failure at the
86
other levels by bearing in mind that a learning sequence

should consist of five steps:
* STEP 1: the learner is informed of the performance to

be expected of him at the end of the learning
experience. This is best done by presenting him with a
list of the teacher's objectives. Neglect of this basic
step, suggests Gagne, is a frequent cause of learning
failure. The learner is unsure of teacher expectations
and thus unable to monitor his own progress adequately;
* STEP Z: the learner is questioned in a way that requires
a re-statement of earlier concepts upon which the
current learning depends;
* STEP 3: the teacher provides cues that help the learner
put together the current learning as a chain of concepts
in the correct order;
* STEP 4: the learner is questioned in a way that allows
him to demonstrate concrete applications of his
learning;
* STEP 5: the learner is questioned in a way that allows
him to make statements of the rule or rules that he has
learned.
Note tha,t the 'questions' referred to in Steps Z, 4 and

5 can take the form of project work and discovery learning
as well as simple verbal presentations on the part of the
teacher. Such project and discovery work is also likely to
incorporate Step 3, and here we can turn from Gagne to
Bruner (1966) for further helpful comment. Bruner believes
that far too often when providing the learner with the cues
mentioned in Step 3 we deal only in the 'middle language'
of our subject: that is in the facts, formulae, techniques,
ideas and so on developed by other people. The learner is
not allowed to discover these facts for himself. True, if we
do allow him to discover these facts for himself they are
not 'new' discoveries in any absolute sense, but this,
suggests Bruner, is not the point. The point is that they
are new for him, and by going through the discovery process
he is much better able to grasp the concepts and the
structure that underlie them.
By allowing the learner to use the discovery method,
Bruner argues, we are also closing the gap between elemen-
tary and advanced knowledge. After all, the university pro-
fessor and the higher degree student employ the discovery
method, and if we deny it to learners functioning at a less
exalted level we are preventing them from really experi-
encing the subject they are attempting to study. An academic
subject is defined not just by the knowledge that it has
amassed over the years, but also by the methods used to
amass it. If we teach merely the middle language of the
subject we are teaching the one without the other, and
hindering genuine understanding on the part of the learner.
Bruner is aware that too often discovery learning is
used as an excuse for vague and haphazard goings on, with
neither teacher nor class very certain of what is supposed
PFP _ G 87
to be happening. This is one of the reasons for his emphasis

upon objectives. The teacher should hold the ends of learn-
ing constant, while providing a scaffolding within which the
means can be varied to suit the level of thinking and of
conceptualization of the class. For example, when teaching
the working of an electrical circuit the teacher will be
quite clear on the principles that have to be learned, yet
instead of simply listing these principles to the class he
will present them with the necessary wires, bulbs, and bat-
teries and set them a problem which can only be solved when
they are connected up correctly. Having done these connec-
tions, the class will then be expected to state the rules
that can be derived from the experience (Step 5 of GagnEf's
learning sequence above). It is sometimes objected that this
approach is less suited to arts and social science subjects
than to mathematical, technical and scientific subjects, but
here Bruner stresses the value of simulation exercises. Such
exercises present the learner with imagin'l.ry problems de-
signed to mimic those faced, for example, by historical
figures, economists and social workers, and ask him to
produce solutions. These solutions are then compared with
genuine case histories, and comparisons and contrasts are
drawn which promote debate, understanding and the efficient
workings of memory.
Natur'l.lly it is not possible to carry out all classroom
learning by means of the activities advocated by Bruner.
However, whatever the nature of the lesson, the teacher can
ensure that the questions he directs at his class (whether
verbal or in the form of written exercises) contain a fair
proportion designed to prompt the kind of reflective think-
ing that leads to discovery. Too often questions invite only
middle language answers, such as 'What is the population of
Great Britain?'; 'What is the formula for water?'; 'In what
metre is this poem written?' Such questions are useful at
their own level, but they demand nothing from the student
other than a single answer delivered in the form in which he
first heard or read it. On the other hand, reflective ques-
tions (or 'springboard' questions, as they are often called)
usually contain an element of controversy or contradiction.
They introduce material which may not fit in with the stu-
dent's knowledge or beliefs, and which therefore disturbs
him and stimulates him to produce an answer which is more
personal and original. Good springboard questions often
contain the word 'why'. For example, 'The north and south
poles are equidistant from the equator yet it is colder at
the south. Why?' 'Christianity teaches you to love your
enemies, yet many of the most terrible massacres have been
carried out in its name. Why is this?' 'The higher an aero-
plane flies, the nearer it gets to the sun, yet the colder
the air becomes. Why?' Springboard questions can also take
the form of statements, such as 'You have to be unscrupulous
to succeed in business', 'Milton was a greater poet than
Shakespeare', or 'There is no such thing as a scientific
law'.
88
Crea ting springboard questions is, of course, best done

by a teacher who is an expert in the subject being taught,
and who knows its structure and its challenges. Their
essential feature is that, by making the student reflect
upon some critical aspect of the subject he is studying,
they help him to understand the subtle ways in which the
subject works, the relationship between cause and effect,
and the methods of procedure and enquiry. Thus is he helped
actively to advance his understanding of the subject and of
the structure that underlies it. As a consequence, not only
does he acquire knowledge, he acquires a grasp of the way
in which that knowledge is generated, and of how it may be
generalized to solve new problems. By contrast, PRO-
GRAMMED LEARNING concentrates upon providing the learner
with a simple unit of knowledge and then testing his reten-
tion of it. It owes much to the operant conditioning tech-
niques of Skinner, with their emphasis upon learning by
small steps and immediate knowledge of results. An example
of an item from a programme on electrical wiring illustrates
the principles behind this form of instruction.
Stage 1 (information): in wiring a 13 amp plug the brown

wire is connected to the live terminal.
Stage 2 (question): what colour wire is connected to the

live terminal of a 13 amp plug?
Stage 3 (response):
A. the blue
B. the brown
C. the green and yellow
Stage 4 (answer): the brown
The student looks at each of these stages in turn, and if he

gets the answer wrong turns back and re-reads Stage 1.
Programmed learning is a vast subject in its own right, and
we have no space to deal with it fully here. However, since
the principles behind it are so simple the teacher can
easily select programmes suitable for his class or, indeed,
construct his own programmes which children can work through
individually. Programmed learning theorists criticize dis-
covery learning because it allows children to make frequent
mistakes, thus setting up incorrect associations which may
persist in the child's mind. Advocates of discovery learn-
ing, on the other hand, claim that mistakes are an essential
part of learning, because they prompt the learner to ask
questions of his own in an attempt to discover why and how
he went wrong. Too often the teacher instils in the child a
fear of making mistakes and of showing his failure to
understand, and this leads to conservative and stereotyped
patterns of learning which inhibit reflective thinking and a
genuine grasp of the principles upon which knowledge is
based. Doubtless the reader will want to make up his own
89
mind on these matters, but a crucial consideration could be

the level at which learning is intended to take place, with
programmed learning proving particularly effective where the
objective is to impart straightforward knowledge, and the
reflective springboard approach where the aim is to
stimulate thinking and further enquiry.
Motor sJdll learning As a species, Man spends a lot of his time complicating his
E.N.DUNKIN behaviour by finding ways to re-organize what he has learnt
so that he can solve each new problem as it comes. For pa-
tients dealing with temporary or permanent loss of sensori-
motor abilities, the need for re-organization of their
residual patterns of behaviour is the key to their maximum
recovery.
What is motor sJdll learniDg?

In contrast to the acquisition of factual information, which
can be called academic learning, the perfection of special
patterns of movement depends on the integration of many
physiological events which can be recognized and described,
but which must be practised over and over again before the
learner is said to be skilled. Once a person has the ability
to keep himself upright against the pull of gravity, to use
his lower limbs as weight-bearing and propelling levers and
to use the upper limbs to serve his grasping intentions,
the job of learning special skills is largely one of re-
organizing fragments of these fundamental patterns of physi-
cal activity. In some skills, such as archery, the indivi-
dual responses have to be made in a particular sequence and
if the person makes a mistake in the SEQUENCE, he will have
to work out where he went wrong and start again at a point
before that stage. There are other complex activities, such
as playing the piano or typing, that are more flexible even
though they are more complicated: their sequences are less
predictable and the skilled performer rarely loses his
place.
Bow is sJdll acquired?

Curves that represent the rate of motor skill learning
usually rise very steeply when the learner begins, but this
initially rapid gain becomes much slower after a while. In
the phase just before complete mastery, improvement is
extremely slow and very slight. This type of curve is known
as one of 'negative acceleration'. Sometimes the learning
curve shows patches of unchanged performance at an inter-
mediate stage: these are known as 'plateaux' in the learning
and they are particularly likely to happen when an entirely
new piece of behaviour has to be added to the ones that are
being taken and re-organized from previously learned reper-
toires. There may be other reasons for these temporary
pauses in the person's progress, such as a definite loss of
interest in the whole thing (and when this happens, the
learner is just 'going through the motions' of the task), or
90
a need to have enough time to consolidate the gains made by

the earlier practice. Alternatively, the person may become
physically tired and there will be no more real improvement
until he has had a chance to rest. In general, plateaux tend
to occur when the activity is a very complicated one; there
is far less likelihood of any prolonged plateaux in the
learning of simple tasks. Skills that have to be learnecl
almost totally from scratch, so to speak, and which can
depend very little on re-organization of existing fragments
of motor responses, generally follow a different curve of
learning: in this case, progress is very slow at first and
it rises much more sharply as the person approaches full
mastery. In contrast to the previously described curve, this
one is said to show 'positive acceleration'.
In learning a skill such as playing a musical instru-
ment, no two learners are exactly alike. The rate of im-
provement varies from person to person, and even from time
to time for the same person. One player may show rapid im-
provement at first while another has to practise for ages
before his playing is any better. In either case, whether
the player follows a negative or positive learning curve, he
will be obliged to practise regularly and carefully if he is
to maintain a high level of skill for the rest of his life.
'What we don't use we lose' is an ordinary observation that
applies to all forms of skilled performance as well as to
factual learning: it is possible to revitalize or re-Iearn
an earlier skill, but the mastery and high standard of most
skills drop off if it remains unused for any length of time.
A concert pianist or ballet dancer must practise daily, and
even two days without practice can cause a noticeable change
in performance.
Two-phase actioas and feedback

Many motor skills can be subdivided into two-phase actions
which show preparation for action followed by the action
itself. A footballer draws his leg back before kicking the
ball: a tennis player carries his racket and arm backwards
before hitting the ball. In reading, the two-phase unit is
organized with the scanning movement coming before the
fixation: visual input is blurred during the scanning move-
ment but the words are seen clearly in each fixation. In
continuous skilled actions, these units are thought to be
built up into complex behaviours in a hierarchical struc-
ture. Years ago, we learned from a series of staggering and
individual steps the pattern of walking. Now it is only
necessary for us to decide to get up and walk across the
room: there is no need for our conscious brain to dictate
each movement separately and in sequence. However, the co-
ordination of such a complicated motor activity as walking
depends on an equally complicated and continuous stream of
sensory information reaching the central nervous system.
There must be feedback about the consequences of each
movement (or response) in the chain. Frequent repetition
of the chain of responses, plus feedback, leads to the
91
behaviour becoming 'automated', and as long as both input

and output channels remain intact, our co-ordination centres
can maintain accurate supervision over the situation. If we
try to carry out these automated activities under difficult
conditions, conscious attention has to be paid to all the
sensory information that can be gleaned from the surround-
ings: for example, walking along a beam of wood only four
inches wide in a dimly lit attic can lead to loss of balance
(and damage to the underlying plaster) because the extra
visual information needed by the walker is not available. It
is largely because the beam-walking activity is not prac-
tised or skilled that it may go wrong on a single attempt.
With more opportunity to use information coming from the
balance organs of the ear, joints of the limbs and tactile
receptors of the feet, it would be possible to make the
right judgements and adjustments in movements, in spite of
the reduced visual cues. As a person moves towards mastery
of a skill, he monitors his performance against an internal
standard and develops an increasing speed and frequency in
making the necessary judgements to correct his performance:
the motor adjustments follow with greater punctuality and
accuracy. Each response that is more 'successful' than the
last, when measured against his internal standard, acts as
an instant reinforcement.
Knowledge of results
When someone is developing skilled performance under the
supervision of a trainer, the feedback derived from compa-
rison of his achievement with his own internal standard can
be augmented by spoken advice from the trainer. This sort
of verbal knowledge of results (KOR) is most effective if it
is given immediately and if the learner finds it easy to
understand.
In complicated activity, KOR can be given about the
relative success of each part of the activity: comments from
the trainer should point out exactly where the learner needs
to change his responses, so that he knows which parts of the
action need attention and correction. It is essential that
any adjustments he is asked to make are within his ability:
he must be given enough time to practise the motor adjust-
ments until they are automated. Where possible, emphasis
should be placed on the part of the action that is under
correction by the use of a verbal 'chant' that prompts the
learner: if the activity has a rhythm, the timing of the
'chant' should stress this. An observer in the daily 'class'
attended by all professional ballet dancers would finel. the
ballet master and every member of the chorus chanting the
count and step-names of each dance routine, as a personal
reminder of the beat of the piano accompaniment.
In addition to this step-by-step prompting and correc-
tion, most people who are striving for mastery of a skill
rely on the more general comments that their trainer gives
them from time to time. This accumulated, or second-order,
KOR is important in sustaining the interest of the learner
when his progress seems to be rather slow. It is even more

effective if the trainer is prepared to discuss his progress
and analyse the reasons for his relative success, as well as
highlighting the places that still need attention. In the
case of patients working to regain muscle power, joint
range, and co-ordination, the physiotherapist can help to
maintain the patient's efforts if the goals set for the
patient are relatively short term and if he is kept informed
about every achievement he makes.
Ultimately, the learner has to be weaned from his reli-
ance on extrinsic KOR and encouraged to be self-sufficient
in monitoring his own performance; in other words, the
trainer's support must be withdrawn gradually until the
learner is able to keep up the standard he has reached by
independent and internal judgements of his own.
Spacing of practice
A great deal of investigation has been done on the subject
of the optimum conditions for acquiring motor skills, both
with animals and with human beings. It is generally agreed
that distributed practice, interspersed with brief rests, is
more effective than massed practice. There does not seem to
be any great advantage in taking long rest periods unless
the physical fitness of the person does not allow him to
meet the energy requirements of the task. From a practical
point of view, it may be very time consuming to organize
short, frequent practice sessions for individual patients:
it usually requires the establishment of a general policy of
treatment during ward visits, so that the individual physio-
therapist has a timetable that allows her to make two short
visits to each patient (each of five minutes) per day rather
than one longer visit. This policy presents less of a prob-
lem where treatment is going on in a class situation or in a
gymnasium. Each patient can be given an individual time
schedule and several patients can be supervised by the same
therapist.
Limits of proficiency in skilled performance

The anatomical and physiological limits of human efficien-
cy provide a 'ceiling' for the skills that individuals can
develop. These can be summarized in terms of the sensitivity
of receptors, the speed of propagation of impulses and the
maximum power available in skeletal muscles. All three can
be demonstrated in a single stimulus-response sequence.
* The effect of the original stimulus and the subsequent

feedback depend on the sensitivity of the receptors.
Sight and hearing are limited by the absolute acuity of
the sense organs in the eyes and ears; discrimination of
touch depends on the clustering and sensitivity of the
tactile receptors in the skin.
* The speed at which the receptor-propagated impulse
reaches the brain and the motor impulse reaches the
muscles is a function of the characteristic rate of
93
transmission of the particular neurons in use. Some

have a higher speed of transmission than others, de-
pending on structural features such as the thickness
and arrangement of their myelin sheaths, but each type
of neuron has a fixed speed determined by this struc-
ture (provided that the tissue is healthy).
* Individual muscle cells work on an all-or-none basis,
while the whole muscle is capable of a graded response,
depending on the number of motor units within the muscle
that are active at anyone time. Muscles cannot exceed
their maximum capacity for contraction which is achieved
when all the available motor units are working.
Re-educaticm: motor skilla and damaged DeI1I'OIIIIIScular

.,.tems
Due to congenital abnormalities, disease or injury, the
patients that are treated in physiotherapy departments have
difficulties with the patterns of motor behaviour that
healthy people can take for granted. Balance, posture main-
tenance, walking and upper limb activity may be disorganized
and the physiotherapist has responsibility for helping the
patient to regain maximum function. In some cases, the
ultimate aim is a return to normal efficiency as fractures,
lacerations or infections are resolved: in other cases,
activity patterns have to be revised on a permanent basis
and altered skills have to be developed, such as those
needed by amputees and patients who have permanent nervous
system damage. Whether the input (sensory) apparatus, cen-
tral area, or output (motor) apparatus is affected, the
normal feedback loop is interrupted and this makes re-
education in skilled activities difficult or, in some cases,
impossible. Patients may be trained to compensate for loss
in proprioceptive and tactile information by increased
attention to visual cues. Upper limb amputees who have lost
a dominant hand can be trained to increase the dexterity and
power of the remaining one. Some patients, such as those
recovering from peripheral nerve lesions, where surgical
repair has offered a good prognosis, face a long struggle
towards a level of skill below their original one, but
possibly great enough to provide them with complete inde-
pendence. In all these treatment situations, the principles
of normal motor skill acquisition are the starting point:
toe physiotherapist will need to apply these and the details
known about learning in general, if the patient is to have
the best opportunities for rehabilitation.
It is in the late stages of recovery and returning skill
that the maintenance of motivation is of the utmost impor-
tance: a slowing down in achievement, resembling that of a
normal negative acceleration curve, can lead to a reaction
of depression, frustration, 'giving up' and resignation to
unsolved problems. The patient will then fail to make a full
recovery unless extra efforts are made to offer external
motivation and incentives.
94
The physiotherapist's role in !raiDing or n-t:niDiDg

From what we have already said about the acquisition of
skill, it seems that practice, coupled with ever-increasing
approximations to the person's internal standards, will
eventually lead to skilled performance. However, this trial
and error progress can be very time consuming and in the
case of people struggling with adjustments to physical
handicap, whether these are temporary or permanent, there
are distinct advantages to be gained if guidance is given to
the learner. This may include the step-by-step verbal expla-
nations that were discussed under the heading of knowledge
of results, but further guidance may be given by demonstra-
tions of the actions that the therapist wants the patient to
imitate. Alternatively, the physiotherapist may take the
patient's limb passively through the pattern of movement
that is wanted.
1. VERBAL GUIDANCE: a simple explanation of the movement,

accompanied by a slow-motion demonstration of a complex
action such as walking, can be made more effective if it is
summarized by a set pattern of words: the therapist and the
patient both say these key words as each component movement
is made. This is particularly useful when an altered form
of walking (e.g. using axillary crutches for a partially
weight-bearing gait) is being taught. The verbal chant
reminds the patient of the necessary sequence until that
sequence becomes automated.
During practice, the physiotherapist may use praise and
advice to correct the patient's attempts or to remind the
patient about general postural control when he is
concentrating on a particular limb exercise.
z. DEMONSTRATION: showing the patient what is wanted

is often more effective than any amount of detailed 'tell-
ing', but the therapist must remember that it is easy to
cause confusion if the action to be imitated has to be
reversed in the imagination of the patient. In the C"lse of
demonstrating to a class of patients, the technique of
'mirror teaching' makes imitation easier, but with an indi-
vidual patient who has to make a unilateral movement it is
often better for the therapist to demonstrate at the side of
the patient. The demonstration should include performance at
normal speed, so that the patient understands the final
goal, and performance in slow motion so that he can see and
imitate the component movements.
3. PASSIVE MOVEMENT: to complete the guidance, it is

sometimes necessary to carry the arm or leg of the patient
passively through the action, at first with the limb fully
relaxed and then with the patient trying to do the action at
the same time as the therapist is moving the limb for him.
Once the learner understands what is needed, he will reach
mastery of the skill more quickly if he is supervised
95
sufficiently to prevent the development of faulty habits.

This is particularly true of patients with muscular
weakness, limited joint range or poor co-ordination.
Ccmditicma of practice and tr..-fer of traiDiDg

Satisfactory transfer of patterns of movement that have been
built up in the department to the patient's home or work
situation represents the final phase of the therapist's
responsibility: the fairly common complaint that the patient
does much better in the clinic or department than he does at
home is not entirely due to a family tendency to over-
support the patient, or to his resignation of his indepen-
dence once he crosses his own threshold. If he has only
practised using his crutches on the flat, uncluttered sur-
face of a gymnasium, it is not surprising that narrow pass-
ages, small rooms with a lot of furniture and uneven floor
covering reduce his efficiency in walking. The conditions of
practice in the department must be similar to those of the
home: otherwise the physiotherapist will need to supervise
several practice sessions in the real situation of the home.
Refaences BeJmett, N. (1976)

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1. Think about the definition of learning offered in the

text. Can you suggest ways in which it could be made
more satisfactory?
2. An individual may learn readily from one teacher yet not
from another. Assuming both teachers are equally
knowledgeable in their subjects, and generally produce
comparable results with their classes, suggest possible
reasons for this.
3. Identify your own attitude towards the behaviourist and
the cognitive approach to learning respectively. Which
seems to accord more closely with your own experience?
4. What is the difference between a theory and a
description of learning? Which appears to be of more
potential practical value to the teacher and why?
97
5. What are the three identifiable stages in Skinner's

description of learning?
6. What is meant, in Bruner's language, by freedom from
stimulus control? Skinner considers such freedom is
illusory. Why?
7. Is there any way in which we can prove that freedom of
choice is possible?
8. Bruner suggests it is not enough to regard behaviour as
simply something elicited by a particular stimulus.
Why?
9. Give examples of Bruner's three modes of representation
as you might witness them in normal classroom work.
10. Sometimes anxiety is an aid to learning and sometimes
the reverse. Why is this? Do you think the teacher is
ever right to encourage even mild anxiety in a child?
11. The debate on formal versus informal class teaching has
tended to ignore the variable of the child's own per-
sonality. In what ways do you think this variable should
influence the debate in the future?
lZ. Make a list of some of the topics that you have found
particularly interesting in your own education. Can you
say why they captured your interest?
13. List the six suggested ways in which study habits can be
improved. Can you think of any further ways of your
own?
14. From your own experience do you think operant
conditioning theorists are right to lay such an emphasis
upon immediate knowledge of results?
15. Bruner maintains that a child is ready to tackle
virtually any learning task provided it is presented to
him in a form appropriate to his level of thinking. Is
this realistic? Can you think of exceptions?
16. Make a list of the extrinsic motivators in common use in
schools. Can you decide what effect they are each likely
to have upon different types of children?
17. How can we ensure Bruner's discovery method does not
lead to classroom activities in which the children
appear to be busily occupied but where there is little
clear purpose and little identifiable learning?
18. What are the arguments for and against allowing children
freedom to make mistakes during the learning process?
Which set of arguments do you favour and why?
19. List some of the factors both in the home and in the
school that may influence the respective rates at which
boys and girls learn.
ZOo What are the eight events in a leaning chain according
to Gagne?
Z1. Write out the six categories in Bloom's taxonomy of
educational objectives and list against each one some of
the verbs in which objectives can be expressed. Repeat
the same exercise with Krathwohl's and with Simpson's
taxonomies.
ZZ. Why do correctly written objectives of instruction lay
stress upon learning outcomes rather than upon learning
processes?
98
23. Write a set of learning objectives for teaching a

patient one or more of the followins: (a) partial
weight-bearing gait using axillary crutches; (b) how to
transfer from bed to chair (paraplegic patient); (c) non
weight-bearing exercises for quadriceps; (d) relaxation;
(e) pendulum exercises for a shoulder joint with range
of movement limited by pain.
24. When and in what circumstances must the physiotherapist
be alert to possible interference with the process of
remembering?
25. Write short descriptions of three television advertise-
ments that you have seen recently and that appear to
apply association as an effective aid to memory.
Consider ways in which similar techniques can be used
in the classroom.
26. What changes in performance mark the progress of a
learner as a skill is acquired?
27. How does feedback differ from reinforcement in its
effect on learning a motor skill?
28. Discuss the forms of feedback available to a learner
under supervision.
29. What is the value of distributed practice as a condition
of learning?
30. What is meant by 'transfer of training'? Explain the
conditions under which transfer of training may be
negative.
31. What factors may set a 'ceiling' of achievement for an
individual learning a new skill or striving for the
return of a prior skill following disease or trauma?
ADnotated readiDg Bigge, L. (1976) Learning Theories for Teachers (3rd edn).
New Yorlc Harper & Row.
One of the best and most comprehensive surveys of
learning theories and their application to teaching.
Bruner, J .S. (1961) The Process of Education. Cambridge,

Mass.: Harvard University Press.
Bruner, J .S. (1966) Towarci.s a Theory of Instruction.

Cambridge, Mass.: Harvard University Press.
Bruner, J .S. (1973) The Relevance of Education. New Yorlc

Norton.
Bruner's ideas are expounded in a number of highly
readable texts, of which these three are good examples.
Fontana, D. (1977) Personality and Education. London: Open

Books.
Gives a more general discussion, with an examination of
the implications for the teacher.
Hintzman, L. (1978) The Psychology of Learning and Memory.

San Francisca Freeman.
A good choice for those who want to take their study
99
of learning theories rather further, and examine their

relationship to memory.
Hunter, I.M.L. (1964) Memory (rev. edn). Harmondsworth:

Pelican.
Difficult to beat as an examination of all aspects of
memory.
Klatsky, R.L. (1980) Human Memory (ZIld edn). San Francisco:

Freeman.
A more up-to-date picture of this subject.
Mace, C.A. (1968) The Psychology of Study (rev. edn).

London: MacDonald.
Rowntree, D. (1976) Learn How to Study. Harmondsworth:

Pelican.
Both these are highly recommended among the good books
currently available on study habits.
Marjoribanks, K. (1979) Families and Their Learning

Environments. London: Routledge & Kegan Paul.
Provides a thorough and scholarly survey of the research
into the relationship between intelligence, personality,
family variables and learning.
Neisser, U. (1976) Cognition and Reality. San Francisco:

Freeman.
Contains some of the major tenets of the cognitive
position.
Rachlin, H. (1976) Introduction to Modern Behaviorism (ZIld

edn). San Francisco: Freeman.
An excellent and very readable statement of the
behaviourist position within psychology.
Skinner, B.F. (1969) Contingencies of Reinforcement. A

theoretical analysis. New Yl)rk: Appleton-Century-Crofts.
Sets out Skinner's own theoretical position fully.
Skinner, B.F. (l97Z) Beyond Freedom and Dignity. London:

Jonathan Cape.
Covers the application of his ideas to learning within
society generally.
Wheeler, H. (ed.) (973) Beyond the Punitive Society.

London: Wildwood House.
Provides a full debate on Skinner's ideas.
100
4
Intelligence and Perception
E. N. Dunkin
IDteDigeDce Before leaving the topic of learning and teaching, it would

be useful to consider intelligence and the ways in which
thinking varies from one person to another. Intelligence is
a word that has been in general use for nearly a century,
but very few laymen or psychologists have managed to say
what they really mean when they describe someone as intel-
ligent. We accept that some people are more intelligent than
others, that some people learn more rapidly (and apparently
more easily) than others, and at times we are tempted to
dismiss the debate on intelligence with the comment that it
is all a matter of having more, or less, 'common sense'.
Just as there was with the fundamental word 'psychology',
there seems to be a serious problem in finding an exact
definition. A quick look at some of the statements made
about intelligence by psychologists who have been particu-
larly concerned with measuring differences of intelligence
may be the best, and indeed the only, way to sharpen our
own ideas on the subject.
At the turn of the century, a Frenchman called Alfred
Binet felt that intelligence included judgement, common
sense, initiative and the ability to adapt oneself. From
this, he derived a definition which stated that intelligence
is 'The tendency to take and maintain a definite direction;
tbe capacity to make adaptations for the purpose of attain-
ing a desired end; and the power of autocriticism'. By the
19405, Wechsler, an American, summarized his opinion about
intelligence: 'Intelligence is the aggregate or global
capacity of the individual to act purposefully, to think
rationally and to deal effectively with his environment'.
Returning to Britain in the late 1950s, we find Raven giving
his version of intelligence as a combination of two
capacities:
* a capacity to acquire experience;

* a capacity to use experience already acquired.
If an attempt is made to summarize these definitions by

finding their common features, we might suggest that 'In-
telligence is the ability of a creature to adapt to its
total environment.' Another pungent definition, that could
be classed as an epigram, suggests that 'Intelligence is
101
Intelligence and perception
intellect put to use': this assumes that we know how to

define intellect itself, and we might do worse than to look
for its definition in a standard dictionary, where we find
that intellect is the 'faculty of knowing and reasoning'.
When we return to our brief definition and feed in that
meaning, the result is yet another echo of the earlier
definitions, each of which alludes to three main abilities
or capacities: thinking, acting and benefitting from experi-
ence. Collectively the preceding suggestions set some of the
limits of this nebulous property known as intelligence but,
because the people who became interested in studying it also
tried to find ways of measuring it, there is another less
rewarding (and almost trivial) comment that is frequently
made: 'Intelligence is what is tested by intelligence
tests.' This has no inherent value from the point of view of
increasing our information about intelligence in general,
but it does emphasize the point that the test instruments
available so far have their limitations!
Intelligence tests ad related ideas on intelligence

It would be inappropriate at this stage to offer an exhaus-
tive description of the whole range of tests (chapter 6
deals with the question of individual differences and tests
in general). This section will use a brief history of the
development of testing to demonstrate how the psychologist's
analysis and understanding of intellectual abilities have
progressed.
Before there was general interest in quantifying the
mental processes, Esquirol pioneered this study in France at
the beginning of the nineteenth century, while Weber, MUller
and Wundt began similar explorations in Germany. It was not
until 1905 that Binet published his first proposals for
testing the intelligence of children. This was revised and
republished in 1908 and it attracted a great deal of atten-
tion because educators were interested, on a world-wide
basis, in the possibility of predicting which pupils could
be expected to learn readily. It was also seen as valuable
to be able to identify and help those who were likely to
have difficulties in schooling. As his definition demon-
strates, Binet considered that intelligence was a wide-
ranging ability but his tests have been criticized because
of their heavy dependence on academic or educational facets
of ability. At Stanford University between 1910 and 1937,
Terman invested a great deal of conscientious work in re-
fining and adjusting the original Binet tests. Merrill
combined forces with him and a further revision was pub-
lished in 1960. This version was supported by norms of
performance in the tests for different age groups. Terman
and Merrill put forward the proposition that the mental age
(estimated on the highest level reached in the age-related
test items) of a child could be divided by the chronological
age and expressed as a percentage, to give an 'intelligence
quotient'.
102
mental age (MA) x 100 = intelligence quotient

chronological age (CA) (IQ)
Example: 9 (MA) x 100 = 90

10 (CA)
While the American psychologists were developing the French

ideas, there was a parallel enquiry going on in Britain,
inspired by the work of Spearman (1910 onwards): however,
his firm belief in a single intelligence component ('g' for
general intelligence) eventually lost him the support of
those who tried to apply his theory. He claimed that 'g'
could be teased out from the characteristic approach a per-
son made to every complex activity. He also proposed that
there were specific attributes of intelligence (s) which
could be assessed by testing a person with different classes
of task: a mathematical flair would give a person a high s
rating in a test of numerical reasoning.
Movement towards examining a whole range of mental
abilities as the foundation of intelligence was inspired by
the work of Thurstone: he extended the use of factor ana-
lysis that Spearman had introduced and demonstrated at least
seven different abilities that were seen to contribute to
intelligence. The tests he devised covered a greater age
range. They sampled:
* verbal comprehension V
* spa tial abili ty S
* reasoning ability R
* numerical abili ty N
* word fluency W
* memory M
* perceptual speed P
The last of these depended heavily on visual stimulation and

a further ability called 'motor ability' (Mo) was added;
this was concerned with evaluation of eye and hand co-
ordination.
Although the results of these tests were good for detec-
ting spatial abilities, they were not of great value in com-
paring one person with another. Consequently they were not
adopted immediately to any marked extent by educators and
experimental psychologists, who continued to rely on tests
that gave an indication of general ability. However, since
1960 psychologists at London University have been developing
the British Intelligence Scale based on six of the compo-
nents that Thurstone identified. Originally the tests were
to be suitable for the age range 5-12, but a second stage of
this work increased the age range and the complexity of the
tests themselves. The British Intelligence Scale (BIS) may
replace the North American ones that have been in general
use in the UK educational system for many years.
Some time after Thurstone's approach to intelligence had
been added to the search for suitable test instruments,
PFP _ H 103
Guilford, in the 1950s, put forward a very complicated

analysis of intelligence. He identified no less than 120
components but grouped these under three basic abilities:
cognition, memory and evaluation. Although the detailed
application of his ideas for splitting intelligence proved
to be unrealistic when it came to sorting people into cat-
egories for educational or employment purposes, it is inter-
esting to see that the foundations of his theory (the three
basic abilities) are not so very different from the items
that feature in the early attempts to define intelligence
(Binet's definition, p. 102).
The world wars of this century prompted a considerable
expansion of the field of intelligence testing, which had
been developed in the first place in response to a need to
predict scholastic success or difficulty. During the wars,
it became essential that the vital resource of manpower was
used to maximum efficiency, and the psychologists serving
the armies of the combatant countries devised many tests to
make it easier to put the right man in the right job. These
tests were not always successful: at least one leader of a
world famous Philharmonic Orchestra spent the Second World
War in a state of perpetual anxiety over the damage done to
his hands by the constant chores of peeling potatoes and
filling innumerable salt and pepper pots for the British
Army.
Since then, the assessment of adult intelligence has
received more attention, with the Wechsler adult test,
having verbal abili ty and performance scales, leading the
field for some time. In England, Raven developed a two-part
test that could be used for different age groups: this con-
sisted of one section of problem-solving items {Progressive
matrices} and another of word recognition and recall (Mill
Hill Vocabulary Test).
It has not been possible in this brief account to intro-
duce all the investigators who have increased the awareness
of intelligence and of its testing, but it would be unfor-
tunate to omit one other psychologist, Alice Heim, whose
work on the assessment of intelligence and personality
represents a major contribution, particularly in the field
of adult and group testing. Further information about her
work is best sought via her own book {Heim, 1970}. Finally,
a potential point of confusion lies in the coincidence that
an early American psychologist who studied under Wundt in
Leipzig shared his name and a preoccupation with individual
differences with a modern psychologist J. McKeen Cattell
devised a set of tests (1890) that some people regard as the
first real instruments for measuring intelligence, and his
namesake, R. B. Cattell, is still contributing to the ass-
essment of people as individuals. The work of the present
day Cattell is considered in chapter 6.
Creativity, divergent tbjnking and. convergent thinking

One of the particular parts of intelligence, creative think-
ing, has attracted considerable investigation in America and
Britain. The work started in Chicago, where Getzels and
104
Jackson began studying the creative thinking and imaginative

abilities of adolescents who had been selected as having
above average intelligence (their mean IQ was 132). These
young people were asked to devise as many uses as possible
for common objects such as paperclips, bricks, etc., to
supply endings to unfinished tales, and to give the maximum
number of meanings that they could generate for multipurpose
words such as 'stage', 'drum', and 'bill'. The greater the
number of uses and definitions, and the more vivid the
imagery in the tale, the higher their inventor was placed
in the rank order for creative thinking. Once the original
group of adolescents had been ranked for creative thinking
and intelligence, Getzels and Jackson compared the ones who
showed the highest ability in ONE (but not both) of these
test situations in terms of their scholastic achievement.
There seemed to be little difference in academic record
as long as the individual had made a high score in EITHER
the traditional intelligence tests OR in the new tests of
creative thinking. This finding was not, in itself, revo-
lutionary but it did demonstrate that the traditional
intelligence tests were not sampling people's capacity for
creativity.
As an extension of the basic work done on creativity,
several psychologists continued to pursue two types of
thinking which appeared to be required for dealing with the
usual items in intelligence tests on the one hand, and with
those of the creative thinking test items on the other hand.
The first of these became known as 'convergent thinking',
reflecting the enclosed quality of the thinking that was
limited by the style of the questions, while the second one
became known as 'divergent thinking', reflecting the open
invitation given to the testee to use his ability to think
and imagine in the widest possible way. The career choices
of British schoolboys were found to be correlated with their
tendencies to be predominantly convergent or divergent
thinkers (Hudson, 1967).
It is not surprising that the world of industry, which
is constantly looking for people who are likely to invent
new machines or better ways of tackling problems, has
adopted many of the ideas of the divergent/convergent
thinking studies. Full-scale conferences often incorporate
sessions of divergent thinking to promote the generation of
new ideas such sessions are then reviewed, with the promi-
sing ideas being culled for future use and pure flights of
fancy being rejected at least for the time being. This se-
quence of events underlines the realistic need for a process
of evaluation to follow periods of divergent thinkin~ in
other words, some measure of convergent thinking must be
incorporated into the total scheme if divergent thinking is
to serve one of Wechsler's functions of intelligencec 'to
deal effectively with (the) ••• environment'.
From this brief review, it looks as though the discus-
sion of the exact composition of intelligence will be with
us well into the futurec another long-standing debate re-
lated to intelligence is concerned with where it comes from
105
and what are its determinants. Is it determined by inherited

characteristics or does it depend on the experiences the
individual has once he is born? Whatever the approach of the
psychologist - philosophical, behavioural, experimental or
humanistic - it has always been academically respectable to
see a creature's progress through life as a dialogue between
that individual and its external environment. This allows
the person to be seen as a product of what he was at birth
(the sum of his inherited attributes) and what he has ex-
perienced since then (environmental effects). The perpetual
argument on the exact amount contributed by each of these
two continues and appears to be no nearer to agreement than
when it began. It features again in chapter 6. At this
stage, the main argument is losing its impetus as psycho-
logists turn their attention to the QUALITY of inheritance
and experience, rather than to their proportionate (or
quantified) contributions to intelligence.
Perception It is debatable whether it is better to discuss learning

before looking at perception or the other way round, as the
activity of perceiving must logically come before retaining
any information about our perceptions. But it is also logi-
cal that we must have SOME (learned. or innate) awareness
of the external world to be able to perceive anything about
our world in the first place. For better or worse, this
introduction to the wide and fascinating field of perception
is made AFTER we have talked about learning, on the as-
sumption that the greater part of adult perception depends
on previous lear;1ing, on knowledge of some of the charac-
teristics of the world around us, and of the types of events
and situations we expect to come across from day to day. At
the same time, we acknowledge that it is an extremely im-
portant and necessary part of all the learning we shall
continue to do in our three score years and ten.
What is perception?
If perception is the basis of all knowledge for the
individual, we could see it as part of a continuum
sensitivity - - - perception ---knowledge
but it is very difficult to decide the limits of each of

these three: we can see many sensory functions of perception
and we may say that perceptions, which are capable of being
recalled, form the units of our memory and hence of our
knowledge. This leaves us with a long list of sensations,
and a concept of recognition that we have not defined and
which seems to lie somewhere in the picture, if memory has
to be considered as the reservoir of knowledge for the indi-
vidual. We can readily make up a list of separate senses
that can be stimulated by changes outside and inside the
person, but it is less easy to decide the exact activity of
recognition, although a quick sortie into introspection
tells us that a great deal of perception hinges on
106
recognizing attributes of a present situation and comparing

these, possibly on a rapid check-list system, with past
experiences so that WP. can find a meaning for the things
that are happening at the moment.
To begin with the sensations that set off a perception
seems a reasonable approach to the problem, and the early
psychologists endorsed this idea. When they started looking
for ways to measure perception they concentrated on the
attributes of changes in the em.ironment that were capable
of stimulating a human being or other animal. Before these
attempts to measure at least one part of perception, all the
investigations had been by introspection: this is not sur-
prising, perception being a very private experience. How-
ever, the reliability of introspection was constantly under
attack because of four main complaints:
* its results could not be verified by objective analysis;

* its skilful use meant that the person had been trained,
thus making the observations directed or 'set';
* its verbal descriptions could be interpreted in many
ways;
* its errors of observation could not be separated from
lack of awareness of stimulus qualities, when the
situation was a complex one.
Under pressure to be less subjective and, it is hoped, more

reliable, investigators were fairly prompt in their response
to the temptation to concentrate on the one observable part
in the three-link chain: the sensitivity of the person doing
the perceiving. The earliest experiments of Fechner and
Wundt were taken up and re-examined: a great deal of 'per-
ception' has been inductive, drawn from increasingly accu-
rate and gradual charting of the limits of sensitivity for
human beings.
The official 'count' of the available senses includes
sight, hearing, tasting, smelling and touching (from the
exteroceptive category), and the sense of tension, re-
sistance and pressure (from the proprioceptive category).
Realistically, many of the studies have concentrated on
sight, hearing and touching, with their counterparts of
visual, auditory and shape discrimination. The sensation of
pain was also studied and it seemed to be associated with
one of the extremes (that of over-stimulation) of sensiti-
vity for several, if not all, receptors. There was a very
careful search for the lowest intensity of stimulation that
can be detected by 'normal' sense organs. Once established,
these were termed 'threshold levels of stimulation', and the
limits of sensitivity could then be quoted commencing with
barely perceptible sensation and ranging to pain and
ultimate destruction of tissue.
Within this section on perception, visual and spatial
inter-relationships that serve the healthy adult are consi-
dered; some of the issues that are explored are particularly
pertinent in rehabilitation. Patients with perceptual
problems related to sight, spatial awareness, shape
107
discrimination and body image need accurate assessment of

their difficulties so that special guidance can be given as
they learn to compensate for the disturbances in their
nervous systems.
How do we manage to perceive?

Since there is some difficulty in agreeing a definition of
perception, beyond saying that it is the process by which
creatures are aware of their environment, let us move on to
consider what seems to be going on during the process.
1. RECOGNITION OF SIMILARITIES AND DIFFERENCES:

by introspection and by using some unusual visual patterns,
it is possible to slow down the processes of receiving a
sensory input {sensation} and giving it a meaning based on
previous visual experience {perception}. This leads to the
assumption that each person has developed a set of models
or 'templates' with which incoming data are compared and
sorted into categories. The more complex the object, the
greater the number of comparisons that must be made before
the current sensation-conglomerate has a perceived identity
or meaning. A topical example of this slow-motion perception
can be seen in one of the current television quiz programmes
{'Ask the Family'}, in which a familiar object is partially
displayed, at high magnification: the amount of information
about the object is slowly increased by reducing the amount
of magnification, bringing more and more of the object into
view. In this example, the contestants vie with each other
to reach an identification of the object as quickly as pos-
sible: we must assume thl'l.t the winner reaches a 'sufficient'
level of information either by being more rapid in his
personal search routines or by choosing those properties of
the visual experience that are more strongly comparable
with, or that contrast more vividly with, his selection of
'templates' •
2. SELECTION, PATTERN GENERALIZATION AND

CATEGORIZATION: making use of the observations in our
first look at the internal processes involved in perception,
we can draw out some statements about perception.
* Perception is selective: individuals select some

attributes of a particular group of available sensations
and examine these. Each person pays attention to some,
but rarely all, the possible cues in any situation.
* Physiological stimulation alone is not enough: although
sensation is a necessary component of perception, it is
not in itself sufficient for perception to take place.
* Central thought processes act on sensory input to
achieve perception: the expectations, memory and imagery
of the person are used in testing the present input and
checking it against previous experience of the world.
3. APPRECIATION OF 'WHOLENESS': one of the chief
108
difficulties that afflicts introspection is the relative in-

sensitivity of human beings to short time intervals. We are
not particularly good at observing the high-speed checking
and sorting that is characteristic of the 'search routines'
we apply to our imagery and verbal summaries of the things
we know about familiar objects and situations. Nor are
we particularly good at detecting exactly how much of the
available information in any set of stimuli is all we need
to make a quick and accurate identification. However, it has
been known for a long time that human beings have a great
tendency to group stimulus information so that complete
basic shapes are perceived from partial data. A quick look
at the two diagrams below in figure 1 shows that they are
both squares, although diagram B has sides that are not
complete.
Figure 1
-,,
,
I
I
Diagram Diagram
A B
In the early part of this century, a group of German psycho-

logists pursued this observation and developed an expla-
nation for perception which became known as the GESTALT
theory, from its dependence on the idea of 'Gestalt' or
'form'. They were opposed to the idea that greater and
greater splitting of the perception process would yield a
more complete understanding of it. To support their argu-
ment, they used the analogy of a tune or musical melody. Any
tune CAN be divided into its component notes and each note
can be examined as a unit as well as a part of the whole
tune. Yet that tune can be played (and recognized) in any
available key without losing its identity: the original
notes that were examined would then be useless in the
analysis of the transposed tune. Their value only exists in
terms of their inter-relationships, of their contributions
to the 'wholeness', or 'form quality', of the tune.
Continuing this explanation, the Gestalt psychologists
proposed Laws that forced the perception of whole figures
from collections of stimuli. Some forms were clearly more
effective than others and these obeyed laws of:
109
* proximity of stimuli (in space or time): 'clustering';

* similarity (in quality, e.g. brightness in the case of
light) ;
* good continuation (of line);
* symmetry.
Final judgements of identity tend to be made on the basis of

'the simplest is the best'. You can check some of these on
the following diagrams in figure 2.
Figure 2
I II III IV
Because diagram I can be perceived as a simple two-

dimensional (flat) drawing of a geometrical shape, by which
interpretation it is granted symmetry, there is a tendency
NOT to see it as a drawing of a cube, whereas diagram II
with its possible interpretation as a drawing of a three-
dimensional object tends to be seen, partly because of its
lack of symmetry, as that object (a cube). Both of these
diagrams CAN be perceived as drawings of a cube.
Similarly, the patterns of dots (all full stops from
normal typeface) are perceived differently, even though both
diagram ill and diagram IV are made up of groups of four
dots in triangular clusters.
4. FURTHER ORGANIZATION OF STIMULUS EFFECTS:

in addition to this tendency to impose 'wholeness' on the
sensations received, we learn to organize the features of
particular classes of objects when these are relayed to our
brains by several different sense organs at the same time.
This is particularly evident in our personal forecasts about
the weight of objects, since the way we co-ordinate our
muscular actions in weight management depends to a large
extent on the estimate we make of the resistance to be
overcome in picking anything up. If you advance on a seven-
foot high sculpture of a seated unicorn (destined to act as
a decorative sentinel at the entrance to a ballroom and
clearly looking as though it is made of some substantial
material such as white plaster of Paris) and attempt to lift
it, the result is bound to be comic (if not disastrous for
the unicorn as its hom hits the ceiling) when it turns out
to be made of a thin shell of papier mache. A less pictur-
esque example often happens in the household kitchen, when
110
one member of the family fills the kettle and leaves it to

boil while going to another room to carry out some other
chore. In the meantime, someone else comes in, finds the
kettle boiling and uses the water to make a pot of tea. When
the first person returns and picks up the expectedly full
kettle, he is deceived into putting too much force into his
efforts to lift it and the empty kettle flies up from the
counter at an alarming rate. To estimate the weight of an
object, we may use cues that include the look of the mat-
erial it is made of, the sound it makes if we tap it, the
'feel' of its outer surface and our previous experience of
trying to lift it.
It is a general observation that the sensory features of
the world around us are fused in our perceptions. Of these
fused attributes, some remain constant and some change
as a particular class of things takes up different uses or
guises. For example, the metal lead is usually described as
grey, hard, heavy (its weight is great in proportion to its
size) and bendable: but some of these properties may not
always be observable, as in lead soldiers that are brightly
painted, or in a large mass of lead that cannot be bent with
the bare hands. Similarly, ice is known to be cold and hard:
it may also be shiny, wet and of a particular shape, but
these qualities will vary depending where the ice is loca-
ted. Nevertheless we can identify ice whether it occurs in
the frozen majesty of Niagara Falls in December or floating
in a cool drink in August.
Mistakes in perceptiaD
Based on careful studies, there are many devices for trick-
ing the perceptual abilities of human beings. Such induced
errors in perception are called 'illusions' and they repre-
sent purposeful interpretations of the spontaneous errors we
discussed in the previous paragraph, where we dealt with the
question of forecasting the weight of things.
One 0 f the simplest, yet most persuasive, of these
illusions is a visual one known as the Miiller-Lyer illusion.
In figure 3, below, the two lines joined at the arr0w-head
pointing to the right are of the same length: despite know-
ing this and even despite measuring this for yourself, it
will be impossible for you to perceive this equality. Try
it.
Figure 3
~<-----7)----------«
111
Illusions of this sort, where the observer is obliged to

have a perceptual bias because of the conditions surrounding
the stimulus material, have been exhaustively studied and
documented over the last 100 years. The suggestions for
further reading at the end of the chapter include some which
will give you more details on this subject.
Attention and its influence on perception

It is tautologous to comment that it is impossible to per-
ceive things which have not been noticed. If the central
processes {central nervous system activities} take no ac-
count of the available stimuli that are impinging on the
sense organs at a particular time, the simplest comment we
can make is that the person is 'not paying attention' at the
time. It is true that, in a complicated situation, human
beings cannot att~nd to the entire range of possible sensa-
tions available, but it is equally true that each individual
sets his own level of awareness in a particular situation,
so that few people take the same information at the same
time from a shared environment.
Some situations and their stimulations are more compel-
ling than others: an audience at an orchestral concert will
be listening to the sound of the music and, in general, will
not react to the noise of an overhead aircraft, unless it
!1.appens to be flying at a very low altitude. Individuals in
the audience are not likely to be paying attention to the
tactile or visual cues of the auditorium until the seats
prove to be uncomfortable or the house lights are suddenly
switched on. It is a common observation that attention is
altered as changes occur in the environment {internal or
external} and that the greater the change, the more
immediate is the attention paid to it.
It is also true that the sum of previous experience will
influence the tendencies of an individual to pay attention
to a particular class of stimulus change; such previous
experience may be of a very general nature, reflecting the
life style of a family or a culture, or it may be due to a
special 'training' that the individual has been given. The
former can be illustrated by the Eskimo child's ability to
perceive many different types of snow, and the latter by the
ability of a trained nurse to detect changes in the sounds
of respiration of the sleeping patients in her care.
Some detailed investigations into the question of atten-
tion, and alterations in this, have been carried out by
using ambiguous figures and checking the rate at which
observers report 'seeing a change' in the figure. Perhaps
the most famous of these ambiguous diagrams is the one shown
below in figure 4: it is known as the 'Necker cube' and if
you look steadily at it you will see the side nearest you as
lower dovvn, but this will suddenly change so that the side
nearest you is higher up. However hard you try, you will
be unable to stop these reversals altogether.
During experiments, it was found that people who
were given no instructions about trying to control these
IlZ
Figure 4
/ /
/ V
reversals demonstrated a great variation in their reports of
frequency of reversal. When people were asked to 'make the
change happen as often as possible', the median frequency
was doubled, but when they were asked to resist the rever-
sals, the median frequency was halved. This shifting of
attention in the presence of continuous sensory input is
typical of the 'scanning', sampling and re-sampling that
goes on all the time we are searching for the meaning of
the events and structures in the world. It results, on many
occasions, in revision of our first judgement (perception)
of a set of stimuli, while in others we are eventually ob-
liged to adjust the models or templates we use for making
our personal identifications or perceptions. If the facts
will not fit the framework we have already learned for
interpreting the world, then we must learn to incorporate
some new elements into our framework.
The discussion has brought us in a full circle to the
point where we began: having read both this section and the
one on learning, you should now be considering a perceptual
explanation of learning as an alternative to classical
conditioning, operant conditioning, chaining, association,
etc.
If we make one more move before leaving perception, and
introduce the idea that once people have learned about the
shape and mass of particular things, about their colour and
their texture, they are very persistent in their belief in
these properties despite contradictory sensory evidence,
then we can ask you to follow this up in the work of Piaget
and his colleagues. They have been exploring the chronolo-
gical patterns in which children build up these stubborn
beliefs, which are usually known as 'concepts of constancy'
(see chapter 8).
CODBtancy of object attributes and interactiug aeDSOry

information
Most people believe that things exist and remain wit!J.in the
material world as we know it, even if they change their
relationship to those things. A businessman flying to the
USA in Concorde does so in full expectation that his office
and its busy workers will be there throughout his absence as
well as on his return. Once someone has learned that a plate
is circular, he will not give up this opinion of a plate
even though its position may be changed relative to him, so
113
that the pattern made on his retina by the light from the
plate is now elliptical. He will not part with the percep-
tion of the plate as 'circular' even if the plate is held at
eye level for him and all that he actually sees is a white
linear shape. We can trace similar ideas of constancy, and
of a person 'making allowances' for differences in the rela-
tionship between himself and a source of sensory informa-
tion, if we think about the way we interpret different
loudness in spoken words. A soft voice may be either from
a person whispering a few feet away from us or from someone
shouting to us from several yards. If we deprive the listen-
er of information about the distance of the speaker, the
loudness alone will make it difficult to achieve an accurate
perception. Studies of this type, where faulty information
or partial information is given to the observer, have helped
psychologists to unravel the problems of the cues people use
to estimate distance, depth and relationship of the self,
physically, to the surrounding world.
DeficieDt IIeIISOrJ' receptors

A further interesting approach to the secrets of perception
has been made via studies of the forced selection of stimuli
(or more accurately, the obligatory ignoring of available
information from objects) that is imposed on people who have
congenital or acquired loss of one of their sensory func-
tions. A particularly lively area of investigation has been
that of 'colour blindness', and- many visual displays have
been developed to show that people with altered colour ap-
preciation (colour blindness) select patterns within a
display that are only seen as a second choice by people with
normal colour vision. Since ten per cent of the male white
population has some deficit in colour appreciation, it has
been an area well stocked with possible experimental sub-
jects; studies have led to greater understanding of the
physiology of the eye as well as to improvement of ideas
about perception.
"!be implicaticma of seJUIOI'f loa 01' of thinking capacity

Once perception is seen as depending on sensory stimulation
and on central processes applied by the person to that
sensory input, the importance of losses in either or both of
these becomes obvious. The perceptual problems of the brain-
damaged child or adult are likely to be due to lack of the
organizing fUnctions of parts of the cerebral cortex.
Patients with sensory deficits, such as hemianopia, may be
able to compensate for imperfect reception of visual cues by
using the normal tendency to see 'whole' objects on the
basis of partial information, but total loss of sight,
hearing, tactile sense or proprioception must inevitably
force the patient to learn to exploit more fully the recep-
tors that he has left: we are familiar with the greater
tactile appreciation of the blind person, and reading and
communicating in Braille has been an alternative to the use
of graphic ciphers for many years. As physiotherapists, it
114
is often necessary to encourage patients with proprioceptive

loss to develop visual compensation and heightened factual
learning about the equipment they use daily so that they may
adjust the templates by which they perceive weight, re-
sistance and distance in their co-ordination training.
The foregoing review has only scratched the surface of
the intriguing realm of perception. It is offered as an
invitation to you, the reader, to look further into the
interesting discoveries that have been made about our
ability to make sense of our own surroundings.
References Beim, A. (1970)

Intelligence and Person ali ty. Harmondsworth: Penguin.
Hudson, L. (1967)
Contrary Imaginations. Harmondsworth: Penguin.
QuestiODS 1. Do you think that Raven's definition of intelligence is

adequate?
2. In the context of the broad. definitions of intelligence
given by Wechsler and Raven, can you justify the
relatively narrow 'tests' that are supposed to measure
the intelligence of human beings?
3. Why are people in general so interested in
'intelligence'?
4. Construct your own definition of intelligence. Is your
definition wide enough to include the behaviour of all
species or is it limited to human beings? Identify any
differences between your definition of intelligence and
those of Binet, Raven and Wechsler.
5. Given that intelligence has a strong reliance on the
ability of the individual to adapt to its environment,
is it possible to consider the behaviour of insects,
hibernating mammals and migrating birds as intelligent?
6. Explain the meaning of 'perception' in your own words.
How is perception related to sensory input?
7. List some of the causes of errors in perception.
8. Give a definition of an illusion and illustrate your
definition. In what ways are delusions and hallucina-
tions different from illusions?
9. Explain the Gestalt theory of perception in your own
words.
10. What is the value of redundant information in
perception?
ADIlOtated reading Intelligence

Bruner, J. et al (1956) A Study in Thinking. New York:
Wiley.
Bruner applies perceptual principles to learning,
thinking and other aspects of behaviour: his analyses of
these processes are made in a stimulating style.
115
Butcher, H.J. (1968) Human Intelligence: its nature and

assessment. London: Methuen.
This book presents arguments for intelligence being far
more than achievement in intelligence tests. It argues
that intelligence is not narrow and exclusive, and
stresses the need for research to bridge the gaps
between psychological, philosophical and sociological
factors of the intelligence of individuals. The book
also offers a survey of research already done on
intelligence and ability.
Heim, A. (1970) The Appraisal of Intelligence. Slough:

National Federation of Educational Research.
This is a more advance text, assuming familiarity with
psychometric terminology. It voices criticisms of the
idea that intelligence is a unitary trait that can be
quantified and emphasizes the complex nature of
intelligence. It also calls attention to the effects of
education within a culture and to general environmental
features.
Vernon, P.E. (1979) Intelligence, Heredity and Environment.

A useful book dealing with the interrelationship between
intelligence in the dual framework of the nature/nurture
debate.
Vernon, P.E. (1979) Intelligence testing and the naturp./

nurture debate 192.8-1978: what next? British Journal of
An article reviewing the debate on the same topic as
presented in the book.
Wiseman, S. (ea.) (1973) Intelligence and Ability: Selected

readings. Harmondsworth: Penguin.
A collection of extracts covering 100 years of specu-
lation, theory and research, the selection of these
being made against many years of experience in this
field of psychology.
Creativity
McKellar, P. (1957) Imagination and Thinking: A
psychological analysis. London: Cohen & West.
An early text dealing with creative thinking, giving
examples and written in an easy style.
Vernon, P.E. (ed.) (1970) Creativity: selected readings.

Harmondsworth: Penguin.
Organized in six parts and covering empirical studies,
introspection, theories, psychometry and personality,
this set of readings makes stimulating reading.
Perception
Coren, S., Porac, C. and Ward, L.M. (1978) Sensation and
Perception. New York: Academic Press.
116
A recent text: comprehensive cover of these allied

topics. It is easy to read and very clear: the writers
involve their readers in thinking about the issues
discussed.
Dodwell, R.C. (ed.) (1970) Perceptual Learning and

Adaptation. Harmondsworth: Penguin.
A collection of readings dealing with the question of
the influence of experience on perception. Development
and ct)gnition are covered by Hebb, Reisen and Tinbergen:
theoretical considerations are discussed by Fantz and
Piaget. General issues debated by the Gibsons, Postman
and Selfrage.
Held, R. and Richards, W. (1971) Perception: Mechanisms and

models. San Francisco: Freeman.
This is another set of readings, each with a detailed
introduction. The papers are selected from areas that
have either increased the scientific understanding of
perception or that suggest fresh ways of approaching
that greater understanding.
Vernon, M.D. (1966) Experiments in Visual Perception.

An alternative selection of readings (over 30 con-
tributions) dealing with perception of form, space and
distance, constancy and movement. The book also includes
details on variations of visual perception between and
within individuals.
117
Part two
The Individual
PFP _ I 119
5
Biological Bases of Behaviour
Irene Martin
Opening remarks In the first chapter of this part of the book, you meet
E. N. DUNKIN again, but briefly, some of the subjects that have been
discussed in earlier chapters, namely, motivation, intelli-
gence testing and the inheritance/environment debate. These
make fleeting appearances and serve to link this part of the
book with the preceding ones. By now you will have realized
that the book is based on statement and re-statement: no
apology is offered for this policy, as familiarity and
comfortable confidence should develop from such repetition
providing that it is interspersed with new ideas and enough
challenge to the reader.
Irene Martin's paper is concerned with the idea that
creatures, particularly human ones, might be more interes-
ting in their differences than they are in their similari-
ties. This is an idea which we will be pursuing throughout
the second and third parts of the book. In this chapter,
emphasis is placed on the interaction between the person and
his environment: a deliberate attempt is made to approach
the 'psyche' of the individual, that is, his concealed
behaviour, in terms of his brain activity and bodily
functions.
Examine your own capacity for concealed behaviour: what
can you do without giving any evidence of it to an alert
human observer? If your activity is limited to thinking
only, what can you do? That is, what subdivisions of think-
ing can you discover in your own thinking? To start your
list, let us suggest that you can
* generate ideas at random

* arrange ideas logically
* carryon a discussion with an imaginary opponent
* imagine a highly delectable meal
* recall a vivid experience
and there is no doubt that you can add to this list a wide
variety of other thinking activities. At the same time, all
the internal activities of your body continue: working cells
of different tissues carryon their regular functions in the
heart, blood vessels, brain, kidneys, liver, etc. However,
some of these can be affected if you imagine a situation
that provokes fear, that anticipates excitement, or if you
fall asleep.
121
Biological bases of behaviour
It is a small step from these introspective activities

to the concept that behaviour might be explained by detailed
examination of its biological substrates. Knowing the struc-
ture and function of tissues (in other words, trading on the
bank of information accumulated in allied disciplines), we
can follow many of the cellular events that are co-existent
with particular reactions of the organism. Some of these
reactions and states we express as fear, excitement, sleep,
rest and motor activity.
If we agree that it is feasible to accept commonly re-
ported symptoms coupled with particular signs as FEAR, we
can investigate co-existent biochemical changes, but in the
case of individual thought processes, peculiar to one indi-
vidual, it is not yet possible to trace the exact changes in
the biochemistry of brain cells. An alternative means of in-
vestigating activity of the brain has been by bio-electrical
changes, rather than by biochemical ones: this has been
done for some years now, using the technique of electro-
encephalography. To date, it is only possible to relate such
broad areas of activity as 'awake with the eyes open', or of
inactivity, 'resting with the eyes closed', or 'sleep' with
the patterns of electrical output that can be recorded from
the brain. And here again, some of the most interesting
findings reveal that the individual variations are not only
present but somewhat embarrassing to those who are trying
to formulate theories based on brain waves. Many people,
possibly the majority of people, have larger brain waves
(Alpha waves), recordable from the occipital part of their
brains by surface electrodes, when they are resting with
their eyes closed. These waves give place to a much smaller
variety (Beta waves) when the person opens his eyes. It is
distinctly discouraging to come across willing subjects for
experimental studies who have no Alpha waves, and therefore
no Alpha attenuation (disappearance of Alpha waves) to be
used as an indicator of activity in the visual cortex! How-
ever, these differences do not mean that there is no future
in pursuing electrical evidence of brain cell activity: they
merely emphasize the point that more sophisticated equip-
ment, coupled with gradually increasing knowledge of the
physiology of nervous tissue, will improve our chances of
appreciating the full harmony of mind and body which finds
its expression in the individuality of each human being.
Introduction Effective human survival on this earth is achieved by

IRENE MARTIN adaptive behaviour, made possible by the evolution of a
brain and nervous system which bear the imprint of solutions
to survival over millions of evolutionary years. For man,
some large part of his knowledge has been acquired during
his lifetime, but for him as for all living creatures there
are innate programmes which regulate many functions. What-
ever we do, my writing, your reading, our sitting, breathing
and wakefulness involve countless electrical and chemical
events within us, most quite beyond conscious awareness.
IZZ
The focus in this chapter is on adaptive behaviour, and

includes attention, emotionality, ways of evaluating events
in the environment, conditioning, and mechanisms of coping
with stress. First we need to consider what is meant by the
term 'behaviour', and how it can be classified, described
and explained; next, we consider the relationship which
psychological concepts have to the brain and nervous system.
Individual differences form an important part of this exami-
nation: individuals differ markedly in almost all aspects of
behaviour, in memory, learning, intelligence, and in their
general ability to cope with life events. Some theories of
personality are discussed which relate differences between
people to differences in the reactivity of physiological
systems. The question of maladaptive behaviour is considered
in such contexts as excessive anxiety, stress, and psycho-
somatic reactions, and modes of investigations described in
which psychological and physiological principles interact.
We begin by asking such questions as: what kinds and
classes of behaviour interest us, what is their importance,
and what theories can account for them? These questions are
asked with specific reference to the contribution which
psychology can make to a general biological view of man.
What is behaviour? To begin with human behaviour at its most accessible level,
we can watch the individual in action, speaking, sociali-
zing, playing games, and going to work: that is, performing
the usual range of human activities and interactions with
the world around. Suppose we begin like modern ethologists
- those who study the behaviour of animals in natural set-
tings - and extend the study to man so that we become man-
watchers. Suppose, further, that just as in the study of
animals we cannot ask the people we are watching why they
do certain things or what they are feeling: we simply ob-
serve. We would see how people greet one another, dress,
flirt, fight and demonstrate. It might be useful to use some
classification such as parental behaviour, work behaviour,
social behaviour, or illness behaviour.
However, parental behaviour is very broad. It includes
reproduction, home-making, maternal/paternal roles, feeding,
education and development of the young. For purposes of
analysis it needs to be broken down, and when this is done
we quickly arrive at hundreds of small units of behaviour:
feeding the baby, cuddling and contact, organizing a daily
schedule, and so on. If we ask one simple question, such as
how does a baby's perception of the mother's face develop,
we need to take careful measurements in a laboratory-type
setting, comparing and measuring reactions to 'mother's
face' with reactions to other faces and objects in the
environment. In this way psychologists are led from the
straightforward observation of the stream of life to much
more detailed aspects of activities and behaviour; and in
doing so they encounter charges of living within ivory
towers removed from real-life situations. But the breaking
123
down of what we observe into manageable segments is essen-

tial for understanding and measurement, as all sciences have
recognized.
Rapid advances in a science often follow the identifi-
cation of a meaningful and measurable unit: for example, the
cell in physiology, the neuron in neurophysiology, the gene
in genetics. It may be that psychology has not yet found the
most appropriate units for describing behaviour, and at
present it deals with both narrow (e.g. reflexes) and broad
(e.g. play) types of responses. Once meaningful and measur-
able units of behaviour have been identified there are
several features which have to be considered. An important
one relates to measurement such as assigning a ranking or
rating to the unit of interest. Suppose our unit is a set of
responses used to define aggressive behaviour; we might then
record how often a child engages in this aggressive be-
haviour: very frequently, often, sometimes, rarely or never?
Having made a measurement for one child a next step is to
interpret this. Is it unusual? An individual measurement
needs to be compared with the norm of an appropriate sample;
boys, for example, may show aggressive behaviour more com-
monly than girls; fourteen-year-old boys more commonly than
six year olds.
The ultimate usefulness of any isolated unit or concept
of behaviour lies in its relation to explanation; at a more
fundamental level there are theories about aggression as
about many kinds of behaviour. What motivates what we do?
Just as important, how long do we persist or when do we stop
what we are doing? It is understandable that we eat when
hungry, but why do some people never know when to stop?!
Behaviour like eating is clearly directed towards certain
ends: food alleviates certain tissue deficiencies and its
intake restores equilibrium: it may have analogies with
people feeling 'better' when they have had a good cry or a
good row.
This, then, is an outline of some of the factors which
govern behavioural analysis and its interpretation. They
range from the need to define appropriate units of beha-
viour, to measurement which involves norms and variation,
to the abstraction of certain concepts and to theories which
postulate underlying principles of behaviour such as seeking
and enjoying an equilibrium of functioning.
Evolution The opening of this chapter emphasized the role of the

brain. It is possible for evolutionary development to follow
many routes, each of which offers a specific adaptive ad-
vantage. Some animals survive better in their environments
because of their strength, speed or camouflage. The story of
man's evolutionary development centres on the brain, and the
elaboration of the brain and nervous system in conjunction
with developing manual dexterity. Lowly organisms do not
possess a recognizable brain, but gradually it develops to
become the complex structure which we know.
124
One consequence of an evolutionary approach is to view

behaviour as being adaptively fitted to a given environ-
ment. This can be achieved by the inheritance of instinc-
tive responses which are built into the nervous system as
part of its inherited structure, and which appear virtually
ready-made at their first performance. Even these, however,
typically improve in efficiency with experience. The ability
to modify behaviour through learning and experience
characterizes all animals, but man above all.
It also follows from an evolutionary perspective that
man's behaviour can be viewed as continuous with that of
other animals and explanations of motivation, emotion and
learning should be applicable across species. In the case of
learning principles this has been a good workable assump-
tion: all animals habituate to a repeated event which is
harmless and many show critical periods at which learning is
optimally effective; they shape their behaviour according to
principles of reward or punishment.
In other instances, for example speech and concept
formation, such an assumption has been questioned. It may
be that spoken language is species-specific to man, and that
infra-human animals do not have the brain structure or
development which makes such language possible. Attempts
to teach spoken language to chimpanzees have not progressed
far. Complex forms of non-verbal communication exist among
most social animals: in gesture, in the proximity or dis-
tance which we put between ourselves and other people, in
eye-gaze and direction, and in a very extensive set of
facial expressions and vocalizations. It is possible to gain
at least as much information about social interactions from
these sources as from the spoken word.
The development of language and abstract concepts lead
to the co-existence in man of an elaborate cognitive struc-
ture based on strong emotional-motivational foundations.
Although he learns to fulfil and express these primitive
requirements in socially acceptable ways, sexual needs,
needs for dominance, interdependencies, rivalries and infant
care all form a basic and powerful set of motivations which
interact in complex ways with the more sophisticated set of
cogniti ve skills.
Attempts to assess the relative contribution of these
factors in human behaviour have generated a number of
controversies in which protagonists often take an overly
simplistic point of view. Some have maintained that be-
haviour is dominated by instincts; others by learning; some
that intelligence (and personality and illness) is in-
herited, others that it is a result of the environment;
some that man's emotionality is powered by physiological
drives, and others that it results from a cognitive inter-
pretation of life events. As is often the way with extre-
mist arguments, the work of analysing the real issues is
laborious, lengthy and technical.
The nature/nurture debate has recently been carried
to within the context of sociobiology; this is defined by
125
Wilson (1975) as the study of the biological basis of social

behaviour, particularly of animal societies but also early
human and contemporary human societies. It seeks to extend
genetic analysis to human social organizations and argues
that such socio-cultural systems represent a new stage of
evolution. This viewpoint has been vigorously attacked by
those who object to the 'hiologizing' of human society
because of complex ethical and political implications.
A biologically-based psychology has to make assumptions
about the working organization of the brain. Textbook des-
criptions point out that it has an input sensory system
which provides information about the world through eyes,
ears, touch, taste, etc., a central processing unit which
stores, codes and elaborates the input, and an output
muscular system, through which we move and act in the
environment. This provides a convenient descriptive struc-
ture within which sensations, perceptions, memory and
motor skills can be studied.
While an input/central-processor/output description of
the brain may be a useful shorthand device it tends to
over-emphasize the importance of structural divisions. In
practice, most behaviour is a patterning of perceptions,
learning and executive skills which are linked in complex
ways. The act of attention, for example, involves the bodily
alignment of the sense organs to receive information, a high
degree of selectivity of sensory input, an interpretive ele-
ment, and the preparation for movement should the attended-
to signal require prompt action. A view which emphasizes
function rather than structure is preferable in that it
stresses the active, organizing role of the brain; it re-
flects the way in which the individual is actively scanning
his world, interpreting and evaluating what goes on in terms
of what is important for survival and effective behaviour.
A fundamental assumption is that an organism cannot
survive unless it has an innate mechanism which tells it
when it is favourably or un favourably correlated with its
environment. This carries the implication that the only way
it can 'get the message' is by some form of SUbjective
awareness of its own welfare and comfort, including the
machinery for not liking to be uncomfortable.
A welfare IIJStem Bodily activity ensures that we approach or move away from
different classes of events; towards those which are good,
benefit us and promote welfare, and away from those which
are bad, dangerous and destructive of life.
Detection of the positive and negative in the world is
an innate feature of all forms of life. A plant turns to-
wards the sun and light through mechanisms of phototropism;
it absorbs water and minerals as required. For animals,
positive or negative evaluations are accompanied by a pat-
tern of physiological changes organized towards approach or
withdrawal. In the natural environment many stimuli will be
neutral while others, such as extremes of temperature and
12,6
pressure, will produce an unlearned evaluative response on

every exposure.
These positive and negative evaluations and perceptions
of beneficial and harmful factors can be generalized to
other environmental events through processes of condition-
ing, and in this way many likes and dislikes can be ac-
quired. Experiments with humans have shown that if neutral
stimuli are paired closely in time either with pleasant
conditions (a good lunch) or unpleasant (putrid odours), the
neutral stimuli will subsequently be rated as more pleasant
or more unpleasant. It is a common experience that tastes
which were once pleasant become disagreeable or even re-
volting when they have been associated with discomfort or
nausea. An enormous advantage is gained when new evaluations
can be acquired through this process of conditioning in that
they permit the anticipation of favourable or unfavourable
events and enable the organism to ensure a better adjustment
to its environment.
Concepts of behaviour Arousal

One of the most striking and easily observable features of
human activity is its shift along a dimension of arousal.
Humans, in line with many animals, show phases of sleep,
wakefulness and high energy output. At high levels of
arousal, many cognitive functions such as speed of reacting,
memorizing, learning, etc., improve. But there is a limit
for every individual, and once past this limit performance
tends to decline. The spur of high arousal when writing
examination papers must be a common experience; extreme
agitation, on the other hand, can exert an unpleasant handi-
capping effect. It seems that up to a certain optimal point
arousal acts as a spur to do well, but when it becomes too
intense and spills over into anxiety, behaviour is dis-
organized and people are unable to perform efficiently on a
whole range of tasks.
The psychological concept of general arousal and its
relationship to performance has been made more phusible by
the discovery of a structure within the brain, the reticular
formation, which seems to serve as a general arousal system
for the cortex. Traditional sensory physiology recognized
that sensory pathways travel from the peripheral sense
organs up through the brainstem to the appropriate sensory
region of the cortex. It is now known that neural messages
going along the classical sensory pathways also send mess-
ages into the ascending reticular activating formation and
the diffuse thalamocortical system which in turn send
arousal messages to the cortex, serving to maintain its
level of wakefulness and alertness. Thus the function of
these arousal systems includes the maintenance of cortical
and behavioural arousal.
As individuals become more aroused and excited, a higher
level of energy mobilization (i. e. release of stored energy
from the liver, muscles, etc.) is required to support the
127
energetic activity which may be required. At the sleep end

of the continuum, sleep itself has been broken down into a
variety of stages which are differentiated according to the
pattern of brain (electro-encephalographic) activity. One of
them is called REM (rapid eye movement) sleep, or dream
sleep, in which muscle relaxation co-exists with electro-
cortical arousal, muscle twitches and often dramatic
increases in autonomic activity.
Evidence indicates that the sleep-waking cycle is
regulated by a stable internal clock, with characteristics
peculiar to the individual. It is a dimension of relevance
to the understanding of individual differences, since people
vary in their level of arousal throughout the 24-hour cycle
and the experience of stress tends to be associated with
disturbed sleep and arousal patterns.
Emotion
Another important concept which links the study of behaviour
and brain is that of emotion, a term which can be viewed
from a hundred different viewpoints but which in the present
context is examined with respect to its physiological
implications.
Many observations indicate that emotionality is related
to the activity of the autonomic nervous system, and inter-
nal bodily upheaval is one of the surest signs we have that
we are emotionally disturbed. It was an imaginative leap,
however, to suggest that this disturbance has a biological
utility which lies in preparation for action. Cannon (1963)
assigned an 'emergency' function to the sympathetic divi-
sion, pointing out that pain and major emotions such as
fear and rage are manifested in the activity of the sympa-
thetic nervous system. He demonstrated that the wide dis-
tribution of sympathetic fibres permits diffuse action
throughout the body, whereas the cranial and sacral divi-
sions of the parasympathetic system with their restricted
distributions allow for more specific action.
Sympathetic impulses to the heart make it beat faster.
They cause constriction of the blood vessels of the gut and
control blood flow in such a way as to direct more blood to
brain and skeletal muscles. Sympathetic effects are closely
connected with the release of hormones which circulate in
the blood to augment and prolong sympathetic neural
effects.
The importance of Cannon's work was his experimental
approach in linking emotional behaviour with its physio-
logical substrate, in pointing to the utility of these
bodily changes in terms of mobilizing the organism for
prompt and efficient fight or flight, and in trying to
elucidate the physiological structures within the brain
which govern this type of behaviour. Those implicated are
located in the visceral brain (limbic system): that is, the
hippocampal structures, amygdala, cingulum and septum. This
part of the brain plays an important role in elaborating the
emotional feelings that guide behaviour.
128
Investigations with human subjects have attempted

to elucidate the role of cognitions in the experience of
emotion. It is not known how many emotions there are which
can be differentiated in terms of physiologically based
activity (fear and anger are emotions which are likely to
show different patterns of autonomic and muscular activity,
but the range could be much wider) or whether emotion refers
to a general state of arousal which we learn to label as
love, depression, envy, etc., depending upon the situation
and the interpretation of the events which have produced the
arousal.
The significance of concepts of arousal and emotionality
lies in their linkage with the brain and nervous system, and
in their role in stress, health and well-being. Man no
longer lives in a jungle but the 'emergency' services he has
inherited still act as though he did; the signs of danger
are not from predators but become conditioned to stimuli,
events and people in the course of everyday interaction with
the environment. Excessive physiological arousal occurs in
states like anxiety, generalizes to all kinds of stimuli and
is highly unpleasant to experience.
MotiYatioD
One popular conception of motivation is that of 'drives'
which energize behaviour in specific directions, that is,
towards food, water and sexual partners and away from pain
and punishment. Animals deprived of fundamental biological
needs become restless and active, cross obstructions and
leam different responses in order to achieve their goals.
It is therefore implied in many theories of motivation that
organisms act mainly to reduce basic drives, and that many
forms of responding are learned because the reduction of
drives (by eating, drinking, etc.) is rewarding.
In a general biological sense both motivation and
emotion can be viewed as a complex integration of behaviour
involving selective attention to certain events, a heigh-
tened physiological state of excitement, and certain pro-
bable patterns of action. These patterns of action are
common to most higher species of animals and have a clear
biological utility in coping with the environment and with
survival. However, it has always seemed evident that bio-
logical theories of motivation are thinly stretched when it
comes to human experience. Various social needs relating to
achievement, power, affiliation, etc., have been postulated
which do not readily fit into existing drive theories, and
to date no single satisfactory theory of motivation has been
formulated in human psychology.
CcmditioaiDg
We learn to do certain things and learn not to do others.
Of the skills we learn, some of the most dramatic involve
muscular co-ordination, as in tennis, skating or swimming.
Another set involves mental skills, such as extensive memo-
rizing and the development of concepts about the world.
12.9
There is another category of responses - evaluations, per-

ceptions, feelings and emotions, many of which occur out-
side normal conscious awareness - which are believed to be
learned through the process of conditioning. This mechanism
is also useful as an explanation of the development and
maintenance of maladaptive habits such as persistent and
neurotic anxiety which involve the wide-ranging physio-
logical concomitants which have been discussed. Since
conditioning can occur in physiological systems of such
diversity as the viscera, the endocrine and the immuno-
suppressive system, it has been implicated in the physio-
logical stress responses associated with psychosomatic
disorders.
The process of conditioning relates to the pairing in
time of a 'neutral' with a 'significant' stimulus. Most
people are familiar with the outline of Pavlov's condi-
tioning methods with dogs, in which a quiet tone (neutral
conditioned stimulus, CS) is followed by food (a significant
unconditioned stimulus, UCS). Pavlov recorded the salivation
which occurred as a natural response (unconditioned res-
ponse, UCR) to the food, and demonstrated that the salivary
response gradually comes to be given to the CS (a condi-
tioned response, CR). Though the outline may be familiar,
however, the connection between salivating dogs and human
behaviour, personality and illness is not self-evident.
Suppose we replace the terms CS and UCS with life events
and the CR and UCR with widespread physiological responses
related to emotionality and pain. The implications become
clearer. If one has ever been in a car crash, the general
constellation of events - sounds, place, people, shouting -
act as a significant and traumatic UCS, arousing great fear
and widespread bodily reactions (UCRs). Return, even many
years later, to the place where the accident occurred and
the once neutral cues of the road and surrounding terrain
will probably re-evoke the previous sensations and emotions
(as CRs) quite powerfully. The significant aspects of con-
ditioning are that two events have become associated in
such a way that feelings and bodily reactions can be ac-
tivated by certain stimuli, once of themselves 'neutral'
but having preceded important events, come to exert strong
and lasting effects on our feelings and reactions. In labo-
ratory situations the CS and UCS are usually paired on many
occasions, but in real life (as well as some laboratory con-
ditions) a single pairing is sufficient if the events are
sufficiently great in their impact.
Once the CR is acquired it will be reliably given pro-
vided that the CS-UCS pairing is continued. If, however, the
UCS is omitted and the CS is given alone, the CR will ex-
tinguish: that is, it will gradually die away. Conditioning
experiments usually include an acquisition phase, during
which the CR develops, and an extinction phase during which
it disappears.
The development of conditioned fears has obvious bio-
logical utility in preparing for and avoiding dangerous
130
situations which might lead to pain and death. However,

many human fears become attached to a variety of relatively
harmless objects such as birds and insects, high places and
aeroplanes, having injections, walking in the streets, or up
stairs: that is to say, situations in which it is inappro-
priate to have anything more than a mild anxiety response.
How some people acquire conditioned fears, who they might
be, and what can be done about it are themes which are
considered later.
Problems .ith concepts Terms like arousal, emotion and conditioning have been
iD psychology derived from the analysis and observation of behaviour, and
are related to underlying physiological mechanisms. Psycho-
logists are divided, however, as to whether (i) they want
to relate psychological concepts to physiology and the
brain, and (ii) even if they want to, whether this is always
a feasible thing to do. There is, therefore, a recurring
debate as to the meaning which a psychological concept can
have if it is independent of physiology. In practice, of
course, a great deal of psychological research has continued
quite successfully with the analysis and development of
concepts such as attention, memory and learning without any
reference to the nervous system.
In trying to develop purely behavioural concepts, one
influential group of psychologists (the behaviourists)
turned their attention to the nature of the interaction of
the individual with his environment. They attempted to
identify those situational/environmental factors (the
general term 'stimulus' is used in this context) which
precede certain kinds of responses, and to establish regu-
larities ('laws') between stimuli and responses. In such a
stimulus-response analysis the on-going state of the person
may be important, but it need not refer to a physiological
condition. A purely psychological description is possible of
an individual's cognitions and perceptions of the stimulus
events and of his decisions to act.
This leads to one of the greatest difficulties in
psychology. If we want to know how a person perceives or
feels in a situation, what kind of information do we gain
when we ask him? This requires him to 'introspect' and
requires us to accept his verbalization of his judgements
and reasons about how he feels. Clinicians frequently have
to rely on the patient's answers to such questions as 'How
do you feel?' or 'Where is the pain?' Many psychological
studies have tried to investigate this problem, recognizing
that in its basic form none of us has more than a very
limited access to our own mental and physiological pro-
cesses, and that what people say and what they feel and do
are often not very highly related. Therefore asking a person
how he feels may not provide an adequate answer: (il he
may be so 'mixed up' he genuinely does not know how he is
feeling; (ii) he may not want to be truthful, for a whole
variety of reasons; or (iii) he may have learnt to use
131
Biological bases of bebaviour
words like 'anger', 'anxiety', 'pain' and 'depression' in an

unusual way. Without very precise definitions there is no
way we can be sure that your use of words to describe
subjective experience is the same as mine.
When Van Gogh paints a chair and a physicist describes
the atomic properties of wood they are looking at the same
object from completely different perspectives. When psycho-
logists use terms such as 'emotions' and 'stress' they are
using everyday, common-sense language, used freely by
everyone, but they may mean something quite different.
Common-sense explanations insist that people have expec-
tations, awareness, emotions, beliefs, etc. Psychological
concepts have to be developed in accordance with scientific
criteria: that is to say, they must be properly defined,
have minimal ambiguity, and ultimately have implications for
causal analyses. In such a goal it will almost certainly be
necessary to clear up some of the misunderstandings between
the use of terms as 'ordinary language' explanations and as
scientific concepts.
JDdiYidual differences
There are many ways of considering variations in human
behaviour. Not all of them relate to the brain and nervous
system, but in this section we concentrate on those which
relate personality to arousal and emotion systems of the
brain. Medical and veterinary clinicians, animal breeders
and observant farmers have long been aware of marked indi-
vidual differences in the susceptibili ty of different ani-
mals to disease, responsiveness to injury, and drugs; yet
recognition of individual differences in people has often
been neglected.
One set of investigations, originating with Pavlov's
observations on dogs, has postulated that a dimension of
general cortical excitability ranging from high (excited) to
low (inhibited) states underlies individual differences in
behaviour. As neurophysiological knowledge has grown, this
simple system has become elaborated to refer to the func-
tions of the frontal cortex and of sub-cortical regions,
particularly the reticular activating system (involved in
arousal) and the hypothalamic/pituitary circuit (involved in
emotionality). In addition, the concept has been extended to
include the regulation of function between the two
hemispheres.
Subsequent workers have added their refinements to
Pavlov's original observations, but have kept the general
notion clear that individuals differ in levels of cortical
arousal and emotional arousability, and that these dif-
ferences are directly due to brain and nervous system
functioning.
Eysenck, for example, has retained the Pavlovian concept
of a balance of inhibition/excitation and postulates that
individuals range along this continuum, with a few at either
end and the majority centrally placed in the distribution,
but has changed the description of the basic mechanisms. In
HZ
his formulation, extraverts have a chronically lower level

of cortical arousal than introverts, who have a relatively
high level. Because of this, the introvert has a reduced
need for external stimulation to attain his optimal level of
arousal. Thus a high level of internal excitation (arousal)
accounts for the introvert's relative aversion to stimu-
lating activities, exciting events and social contact. By
contrast, the extravert's low level of internal arousal
leads to a search for external stimuli in order to achieve
the optimum level of arousal; he is impelled to seek noise,
excitement, new experiences and many social contacts. If he
is prevented from seeking these kinds of varied stimuli he
becomes bored and readily distracted.
Eysenck's personality scheme also includes dimensions of
neuroticism and psychoticism. The former has been related to
excessive activity of the autonomic nervous system; people
who are high on the neuroticism dimension are described as
having strong and labile emotions, while those at the other
end experience less strong and more stable emotions. Taken
together, the two dimensions of extraversion-introversion
and neuroticism form four quadrants. Those people who are
both introverted and unstable tend to be moody, anxious,
reserved, unsociable; those both introverted and stable tend
to be calm, even-tempered, careful and thoughtful. People
who are both extraverted and unstable tend to be touchy,
restless, aggressive, excitable and impulsive; those who are
both extraverted and stable are lively, easy-going, out-
going, carefree people. Further descriptions refer to the
introvert as reacting to low levels of sensory stimuli, as
amplifying stimuli and as being especially sensitive and
reactive to frustration.
Other personality scales measure such traits as impul-
siveness (e.g. the tendency to act on the spur of the moment
without planning) and sensation-seeking, which refers to
unusual activities such as sky-diving, speed-racing, taking
drugs, etc. Attempts have been made by many investigators
to relate personality measures derived from such question-
naires to general autonomic reactivity, cortical excita-
bility, adrenalin/noradrenaline output, and, more recently,
to a number of biochemical variables.
Contemporary studies are recognizing the importance of
biogenic amines such as serotonin, dopamine and noradrena-
line in psychiatric illness, since the discovE'!ry that both
anti-psychotic and anti-depressant drugs interfere with the
turnover of one or several of the amine neurotransmitters.
Investigators are working on the assumption that biochemical
variables may not be directly related to psychiatric illness
as such but rather to a constitutional vulnerability which
is evidenced in personality types and which may lead to
illness and breakdown, provided other factors (psychosocial
or somatic) are present.
Intelligence is another source of variation between
individuals which is believed to have a biological/genetic
basis. Conventional tests of intelligence (IQ) usually
133
Biological bases of bebaviour
measure cognitive tasks similar to those involved in schol-

astic examinations, and might give disadvantageous results
for members of minority groups from different cultural and
educational backgrounds. This has stimulated a search for
alternatives to the usual IQ test, and in recent years
measurements of small electrical changes obtained from
surface scalp electrodes have been made as indices of
'neural efficiency', the hypothesis being that when a
stimulus occurs, neurons which are fast and efficient
generate characteristic waves of evoked potential.
Several studies have reported correlations between
these measures and intelligence, but it is too early to say
whether this approach will have any practical value in the
intelligence issue.
The application of Many writers have implicated a mechanism of conditioning to

conditioning principles account both for the acquisition of emotional responses and
for their failure to extinguish. Following from this, neuro-
tic behaviour can be regarded as learned behaviour, and
distinguished from other types of behaviour in that it is
maladaptive; that is, it produces actions with predominantly
unfavourable and unsatisfactory consequences. In spite of
this they may persist over a period of months, years or a
lifetime.
It is impossible to trace back through an individual's
history in order to establish how he acquired neurotic be-
haviour patterns. One can, however, investigate the ease
with which different individuals condition to different
stimuli both in the acquisition and extinction phase, and
once a conditioned emotional response has been acquired its
extinction can be followed in time. Though we cannot be sure
how conditioned fears and phobias have developed (such as
those to small insects like spiders, the dark, heights,
etc. ), we know that they are common in small children and
usually extinguish over the years. However, some people
extinguish slowly, if at all, and for them persistent emo-
tional responding to certain stimuli can last a very long
time indeed. And, of course, in human subjects conditioning
stimuli become generalized, verbalized, and symbolized; that
is, they become extended both in range and in power.
This extreme resistance to extinction is difficult
to treat. However, these reactions can sometimes be ex-
tinguished in accordance with well-known principles of con-
ditioning, which try to remove, step by step, the series of
responses to a range of related stimuli of which such fears
and phobias are invariably made up. This could involve
training in techniques of relaxation and skills in the
evocation of pleasant imagery and thoughts which counteract
fear and desensitize the individual to aspects of the feared
object. Subsequently he is encouraged to apply learned
coping skills to those real-life situations which evoke the
fear.
The fundamental conditioning research on which
basis clinical application is possible is carried out in
134
laboratory studies, frequently with laboratory rats, in

which noxious (i.e. disliked, unpleasant) stimulation such
as electric shock is used as a UCS to produce an 'emotional'
UCR and, after pairing of CS and UCS, an emotional CR.
These have shown that the CR can become associated not only
to the specific CS but also to any object in the environ-
ment, the room, and even the experimenter. Thus a process
of generalization takes place such that the conditioned fear
spreads rapidly to a whole series of stimuli. This makes
very plausible the notion that in real-life situations the
acquisition and spreading of fear to many different stimuli
can readily occur.
EnviromDental stresson Conditions on which life and health depend are found both
inside and outside the living organism. Within there is the
whole complex machinery which regulates the internal envi-
ronment, that is, the circulating organic liquid which
surrounds and bathes all the tissue elements. An important
principle in physiology, first stated by Claude Bernard, the
French physiologist, emphasizes that the aim of physio-
logical mechanisms is the preservation of the constancy of
this internal environment.
Outside the living organism are all the changing fea-
tures of the environment which require powers of adaptation
and learning to cope with change. Most animals are innately
equipped to deal with the specific changes of importance
they are likely to encounter; but a more flexible response
repertoire is evident in higher animals who in the case, for
example, of reaction to danger tend to inherit an 'alarm
reaction' which is triggered by a wide range of rather
general danger signals, such as moving objects, novel sti-
muli, or stimuli of sudden or unusually high intensity. This
mechanism, with its associated wide range of behavioural
tactics, ensures that they are on guard against most of the
usual risks of life, and an equally important mechanism of
habituation damps down responding when responding is no
longer necessary. Thus animals once alarmed by the irregular
rattle of passing trains will soon leam that they can
safely graze in adjacent fields without generating
continuous fear responses to them.
Such adaptive mechanisms seem to ensure survival and
also a kind of equilibrium of physiological functioning in
relation to the constant flux of external events. Presumably
they help conserve bodily resources since any animal failing
to take appropriate action would die, yet if responding
interminably to events around would rapidly become
exhausted.
There are several theories of stress which involve the
concept of the individual being driven beyond his powers of
coping or adaptation such that equilibrium is not easily
restored, and beyond some optimum at which he can function
most effectively.
It has already been suggest ed in the case of sensory
stimulation that individuals have a preferred optimum, and
PFP _ J 135
seek to maintain that optimum. Some individuals will prefer

to reduce sensory stimulation when it is excessive, while
others will seek to increase it when it falls below a
certain level. Experiments in which volunteers have been
deprived of practically all sensory input, by eliminating
visual, auditory and tactile stimuli, have revealed marked
individual differences in the degree of tolerance to these
conditions, with some individuals finding them unbearable.
Periods ranging from a few hours to several days under such
conditions produce deficits in a wide variety of intellec-
tual and perceptual tests, and often hallucinations and
dream-like states occur in which coherent thinking is dif-
ficult. Such studies demonstrate that normal behaviour
disintegrates when the general sensory input falls in amount
below a certain level. There are also studies which show the
deleterious effect of too much noise, as suffered, for ex-
ample, by workers in factories and people living in flight
paths near airports.
The psycho-biological use of the term 'stress' had its
origins in the work of Selye in Canada, who saw stress as
a succession of physiological stages within the organism
following failure of the normal mechanisms of adaptation. If
stressor agents (Selye's work was mainly with rats and
involved such stressors as intense heat, cold, virus infec-
tions, intoxicants, haemorrhage, muscular exercise, drugs,
injury and surgical trauma) are applied intensely or long
enough, they produce certain general systemic changes which
represent the animal's attempt to cope with the situation.
These changes seem to be common to quite different stres-
sors, and according to Selye they constitute the response
pattern of systemic stress. They include autonomic excita-
bility, adrenalin discharge, and such symptoms as an in-
creased heart rate, decreased body temperature and muscle
tone, anaemia, blood sugar changes and gastro-intestinal
ulcerations. These changes occur as an initial response to
the stressor agent and Selye labelled them the alarm re-
action. If noxious stimulation continues but is not too
severe a second phase occurs, labelled the stage of resis-
tance, in which the adaptive powers of the body act to
counteract the stressor. If noxious stimulation persists,
this stage gives way to the final stage of exhaustion which
may ultimately lead to death.
It is important to know whether psychological stimuli
can also induce a systemic stress syndrome, with similar
physiological response patterns occurring in similar sta-
ges. Men in stressful situations such as paratroopers, sub-
mariners, pilots and combat infantrymen, have demonstrated
that life-threat and social-status-threat situations can
induce symptoms of systemic stress, the degree of stress
depending on the type, intensity and duration of the threat
and on certain pre-stress sensitizing factors such as per-
sonality and previous conditioning experiences. However, the
attempt to extend Selye's idea of general systemic stress to
include psychological aspects has met with many problems.
136
Psychological stress factors are less easy to define,

measurements of the physiological changes are less easy to
make and there are obvious ethical limitations on laboratory
research with human volunteers.
Certain issues in psychological stress are more readily
amenable to laboratory-type investigations with both human
and animal subjects, and one theme explored in recent years
relates to general 'coping behaviour', particularly with
reference to the control which an individual has over frus-
trating situations. These studies indicate that stress
reactions to aversive stimuli which are unavoidable and
uncontrollable are much more severe than those resulting
from exposure to situations over which the individual can
develop control. It seems to be not only the exposure to,
say, painful and unpleasant stimuli which leads to distress,
but the knowledge of not being 'in control' of them which
leads to feelings of helplessness in susceptible indivi-
duals. Contemporary life provides many frustrating situa-
tions over which we have little or no control: for example,
bureaucratic decisions, cancellation of scheduled trains,
being treated rudely when no retaliation is possible, and so
on: situations in which there may be few successful methods
of coping. One speculation is that repeated exposure to such
conditions can generate feelings of hopelessness and help-
lessness which may contribute towards lack of motivation and
possibly even to depression.
Re1atiODS between A fundamental assumption is that the unique character of

physiology and behaviour human beings, their ability to think, feel, learn and re-
member, lies in the brain and in the pattern and chemistry
of inter-connections between neurons. Exactly how infor-
mation is received about the world, how it is processed,
interpreted, learned, memorized and stored are questions
being pursued in pharmacology, neurochemistry, electro-
physiology and psychology using an enormous range of sophi-
sticated techniques. These include recordings of electrical
events within single cells and multiple units, and the
analysis of the biochemical events occurring in synaptic
transmission. Many brain regions are being explored, for it
is still unsettled whether memory and learning can be local-
ized within specific areas or whether they are multiply
represented throughout the brain. Most of our knowledge
about neuronal changes comes from animal experiments,
whereas information about cognitive processes comes from
recordings of cortical potentials from human subjects.
Given the broad scope of this work, the boundaries
between diffe!'ent disciplines is loosening, and terms such
as neurobiology, neuroscience, brain research and physio-
logical psychology are being used interchangeably and often
overlap in their interests. Illustrations from the latter
two categories are given in the following sections. Two
other disciplines, those of psychosomatic illness and
psychophysiology, focus entirely on human behaviour and
137
Biological bases of be~aviour
the interacting effects of psyche and behaviour, but differ

inasmuch as the former relates to clinical and the latter to
research problems.
Brain research Studies involving brain implantation techniques, that is,

the placing of electrical or chemical stimulation devices in
strategic brain tissues, have provided many illustrations of
how brain stimulation affects motivational and emotional
behaviour. Another line of investigation has shown the dra-
matic effects of destroying localized regions of the brain.
Ablation of portions of the limbic system in the temporal
lobe has produced monkeys that are extremely tame and
hypersexual; and wild, unmanageable animals have been
transformed into gentle creatures that could be fed by hand.
Other procedures have produced a state of violent rage even
in very tame laboratory rats, a state labelled 'septal rage'
since it is produced by destruction of the septal area of
the limbic circuit.
As a result of the development of surgical techniques
and the powerful effects of brain intervention observed on
behaviour, a large number of neurosurgeons throughout the
world performed operations on selected psychiatric patients
in the 1950s and 1960s (of which leucotomy is perhaps the
best known) with the hope that appropriate surgery might
afford some relief from severe suffering. The advantages and
disadvantages of the approach have been debated, and few
operations of this kind are performed today. The original
hope that a physical, anatomical abnormality of the brain
could be detected and corrected in psychiatric patients has
not been realized.
More recently it has been discussed whether brain
intervention might alleviate severe and intractable beha-
viour problems such as hyperexcitability and violent, des-
tructive and uncontrollably aggressive behaviour, and some
exploratory attempts have been made in this direction. It is
not easy to evaluate the results of these operations: on the
whole there is always a cost-benefit factor in neurosurgery.
No miraculous recovery is ever accomplished with the kinds
of very severe behavioural problems which have been re-
ferred, and although relief from disabling symptoms may be
obtained there is always the possibility that it will create
other difficulties. A very readable account of this work
and thoughtful discussion of its results are available in
Valenstein's 'Brain Control'.
Innumerable ethical problems are associated with brain
surgery. Some people have argued that violent prisoners
should be treated by surgical means rather than spend a
lifetime in prison. Others feel that because the brain is
the reservoir of creativity and individuality it should
never be disturbed unless it is clearly diseased or
injured.
Many brain-behaviour studies arise from accidental brain
lesions, following which a variety of disorders have been
138
noted in speech, motor behaviour, memory and perception.

These vary in extent and quality as a function of the nature
and place of injury, and detailed mapping of the disability
can lead to a better understanding of how speech, memory,
etc., are organized psychologically and within the brain.
Sometimes the nature of the deficits is minutely recorded
by the patients themselves, and these provide insight into
the disruptions in ability to think, talk, and understand
the speech of others. One particularly careful account as
experienced by a soldier and observed by a Russian neuro-
psychologist is described in Luria's 'Man with a Shattered
World' (1973). The patient describes the fragmentation of
his visual and perceptual world following a gunshot wound
and of his struggle to re-combine the fragments, and Luria
relates the disorders to the sites of the injury which in
this case had destroyed that part of the brain which com-
bines the multiple impressions received by the brain into
a coherent whole.
Accurate assessment of cognitive deficits associated
with perception, speech and memory may be assisted by the
development of appropriate tests. In the case of emotional
deficits no tests are available, and assessment is more
difficult. As a result, much less is known about the effects
of brain and central nervous system damage on normal human
feelings. Again, some of the information which is available
has been obtained from accidental lesions, and there are
some reports on the emotional life of paraplegics and
quadriplegics obtained through structured interview and
concerning sexual excitement, anger, fear, grief and sen-
timentality. These suggest a reduction in the intensity of
feeling, and an awareness of a more 'mental' kind of emo-
tional response than of a powerful physiological drive.
Recent work has highlighted the psychological importance
of brain chemistry. There are good reasons to believe that
it is involved in the control of sleep, eating, sexual and
aggressive behaviour, neuropsychological processes such as
attention and sensitivity to pain, and in mood and emotion-
ality. One theory, for example, is that levels of catecho-
lamines in the brain determine a person's mood, high levels
being correlated with euphoria and low levels with depres-
sion. If amines act in this way, it might seem to follow
that a correction for imbalance could be achieved by the
administration of drugs such as monamine-oxidase inhibitors,
and contemporary pharmacological research, some carried out
on laboratory animals and some on patients in clinical
trials, is investigating this hypothesis. There are, how-
ever, many complications when human beings are involved in
assessments of this kind, for as well as direct pharmaco-
logical effects, psychological factors such as expectan-
cies of both the therapist and patient and aspects of the
therapeutic setting also playa part. An incidental and
related observation made in the context of hallucinogenic
drugs similarly suggests that the effects which are experi-
enced are partly due to setting and expectation. Another
139
interesting finding which is well-documented is that some

patients claim satisfactory pain relief from placebos (i.e.
completely inactive, 'dummy' tablets) for many kinds of
symptoms, and attempts have been made, so far without clear
resolution, to identify who these people are and what the
mechanism is by which the effect is produced.
Physiological psychology Among the important psychological functions investigated are

those of memory and learning, a major question being whether
there is a single anatomical site or physiological process
responsible for learning. Forms of learning which are most
often studied are habituation to a repeated stimulus, and
simple classical conditioning: that is, situations where
both stimuli and responses can be precisely controlled and
measured. A traditional method of studying this question is
by lesions in specific regions of the brain to examine the
effect on a previously learned response. On the whole,
extensive cortical lesions appear to have no adverse effect
on classical conditioning, and confirm the belief that this
type of learning can occur sub-cortically. This does not
deny the importance of the cortex in analysing complex
stimuli or the possibility that the cortex is involved in
more complex forms of conditioning.
Another approach is to correlate electrical events
within the brain in the course of learning as observed in
external responding. The evidence is clear that widespread
electrical changes in neuronal activity occur throughout the
brain, especially during the initial phases, and that this
generalized activity decreases leaving activity at only the
primary sensory and motor response areas. Which aspects of
neural activity are causes or consequences of learning and
which are associated with the motivational and attentional
variables essential to learning can only be determined with
the use of careful control procedures, and in many studies
these have not been incorporated.
In recent years there has been a particular interest in
the role of the hippocampus in learning and the storage of
short-term memories: the hippocampus has inputs from many
sensory modalities, access to motor systems, and connections
with parts of the limbic system allegedly concerned with
reinforcement and reward. In humans, bilateral lesions asso-
ciated with this area have been shown to cause a severe and
lasting memory deficit characterized by the inability to
learn new information. Patients with such lesions appear to
have undiminished powers of perception, but they are largely
incapable of incorporating new information into their long-
term store.
Synaptic connections between the neurons of the brain
have long been thought to relate to learning and memory, and
progress has been made in identifying the various chemical
transmitters at the synaptic junction, in mapping their
distribution in the brain and in analysing their mode of
action. Instead of searching for a unique memory molecule,
140
many investigators are trying to analyse the metabolism of

neurons responding to various kinds of stimulation. They
feel that the physical basis of memory is likely to comprise
a complex chain of metabolic reactions, with initial chemi-
cal changes occurring in short-term memory and different
changes subsequently mediating the transfer to long-term
memory. The final chemical changes associated with long-term
memory must be stable and long-lasting in order to preserve
the memory trace from degrading.
A topic of profound importance is how we register and
record the events of the world about us. Research in the
past decade has revealed the existence of cells within the
brain which appear to react quite specifically to different
aspects of a sensory stimulus. They have been termed 'fea-
ture detectors' in that some cells will fire at the onset of
a stimulus, others to its colour, and others again to its
duration, intensity and localization in space. Some neurons
are specially tuned to respond to complex stimuli, to time
characteristics and to novelty. Thus incoming stimuli leave
traces of their characteristics within the nervous system.
These traces or 'neuronal models' preserve information about
the intensi ty, quality, duration and so on of past stimuli,
and it is against these stored models that new events are
compared. Several theorists have proposed that there is an
analysing mechanism within the brain which assesses the
novelty and significance of incoming events in such terms
as: is this event new or has it happened before? Is it
significant or irrelevant? It then activates the appropriate
response or damps down responding (as in habituation) if the
event has occurred many times before and is unimportant. In
this way we build up an internal picture of the external
world, and act on that information.
Again, theorists have pondered whether the basis of
perception and cognitive processes is to be sought in single
cells or localized anatomical structures; the facts are that
while some degree of brain localization occurs it is also
true that information and function in anyone sensory moda-
lity is redundantly distributed throughout anatomically
extensive regions.
The brain appears to have two halves (hemispheres) which
were once assumed to be similar in function, as are the two
kidneys and two lungs. Actually, there are some specialized
functions which are found only in one or other of the two
sides. The best example is that of language: damage to a
particular region of the cortex on the left side of the
brain leads to aphasia; damage to the corresponding area on
the right side leaves the faculty of speech intact. This
asymmetry is also reflected in memory defects arising from
lesions in a single temporal lobe. A left temporal lobectomy
can impair the abili ty to retain verbal material but leave
intact the ability to remember spatial locations, faces,
melodies and abstract visual patterns.
One of the most interesting recent findings is that
different emotional reactions follow damage to the right and
141
left sides of the brain. Comprehension of the affective

components of speech is impaired with right but not with
left temporal-parietal lesions, and the comprehension of
humorous material is different in patients with left and
right hemisphere lesions. Under special laboratory condi-
tions it is possible to ensure that information from the
world reaches only one hemisphere at a time, and if pictures
are shown either to the right or the left hemisphere, those
on the right are rated more emotionally and as being more
unpleasant. While this specialization of hemispheres should
not be over-exaggerated, it does suggest a unique kind of
specialization within the human brain.
PsychOBOlllatic medicine One of the most striking features of psychosomatic illness

is the marked individual difference in suscepti bili ty to
illness, in modes of precipitation and in the patterning of
symptoms. Why one patient should develop gastric ulcers
while another develops hypertension is a question that has
often been asked and not yet satisfactorily answered.
There is reasonably general agreement that deleterious
physiological effects can arise from prolonged stress; that
the functional disturbance of a vegetative organ or system
can be caused by emotional disturbances which include con-
flict, stress and life events, and that chronic functional
disturbance may lead to tissue change and organic disease.
Some of the possible mechanisms have been outlined in
Cannon's concept of an organism preparing for fight or
flight, and in Selye's work on systemic reaction to
prolonged, severe stressors.
There have been many theories concerning the psycho-
physiological specificity, or patterning of response, which
is a feature of psychosomatic disorders. One possibility is
a genetic component which determines the organ system in-
volved; another is that this combines with a learning pro-
cess such as classical conditioning. Conditioned visceral
responses and associated feelings of anxiety can occur to
all sorts of stimuli and can be remarkably persistent over
time. They are of particular interest in that, while these
organs have cortical representation, the activity of the
organs is not easily discriminated and is generally below
normal conscious awareness. This suggests that an individual
might become conditioned to respond to inappropriate inter-
nal or external stimuli over long periods of time during
which he would have no knowledge of the progressive
disturbance of function.
Another factor which seems to be significant in the
precipitation of symptoms is the recent occurrence of con-
flict, emotional upheaval or environmental stress. Attention
has been focussed on recent changes in individuals' lives
prior to illness onset and an association between them has
been repeatedly documented. However, even the highest of
these correlations is relatively modest, suggesting that
recent life changes alone do not exert a strong primary
142
effect on illness onset. What effect they do exert is in-

fluenced by the way in which an individual perceives them,
as well as by the individual's coping capabilities and
illness behaviour characteristics.
It is clear that of the people who experience recent
life changes there are far more who do not go on to report
illness symptoms than there are those that do. Therefore a
major research question is how do the majority of indivi-
duals tolerate their recent life change experience and re-
main healthy? Certainly a good deal needs to be done in the
systematic quantification of subjects' stress tolerance
characteristics.
Investigations into coronary heart disease (CHD) both
in the USA and Europe have reported a constellation of
personali ty traits, attitudes and life styles alleged to
characterize this illness. A 'Type A' behaviour pattern,
comprising ambitious, driving, competitive work behaviour
with a sense of urgency towards deadlines and associated
with more intense cardio-vascular reactions, has been com-
pared with the more placid, less reactive 'Type B' indivi-
dual who is less inclined to develop CHD. However, no clear-
cut method of dividing patients into 'Type A' or 'Type B'
categories is available, and correlations between behaviour
patterns and illness are still at a preliminary stage.
A fully satisfactory explanation of psychosomatic ill-
ness has to account for the continuity, chronicity and
specificity of symptoms which recur throughout time, and
explanations of these phenomena, which are still being
sought, are likely to be multifactorial in nature. The
specificity of diagnosis is also important. Psychosomatic
disorders traditionally include asthma, gastric ulcers, some
cardio-vascular disorders, hypertension, and tension head-
aches. These are very globally defined illness categories,
and what is needed is the identification of sub forms of the
illnesses. Different subforms of a disease may arise from
diff<?rent aetiologic or pathogenic mechanisms. Conversely,
the same mechanism may produce different lesions or dis-
turbances. To illustrate specifically, allergic mechanisms
playa role in only 30-50 per cent of all patients with
bronchial asthma. In the rest, viral infections combined
with psychological factors playa part in exciting asthmatic
attacks. Progress in psychosomatic investigations could be
enhanced in the future by characterizing patient groups
according to the sub forms of the disease from which they
suffer. The subforms could then be compared socially and
psychologically with one another.
Psyc:hopbJsi.ology Attention, interest, thinking and feelings are accompanied

by generalized changes throughout the brain and nervous
system. Against this background are the specific excitations
required for specific tasks: looking at a picture entails a
complex mosaic of eye movements, playing tennis in vol ves the
patterning of muscle action potentials, and attending to a
speaker requires the inhibition of other sensory input.
143
How the psychological constructs of attention, thinking

and feeling interact with physiological changes, and what
the nature of their interaction is, remains a complex and
fascinating research problem. The direction of causality is
obscure: is it the perception of a threatening situation
which arouses the physiological concomitants of anxiety, or
does the physiological arousal come first and determine the
nature of the perception?
Psychophysiology is an area of study which concentrates
on human behaviour, and tries to analyse the cognitive,
verbal and psychological aspects of behaviour in relation to
the physiological. The term physiological in this context
refers to those variables which can be recorded by means of
small disk electrodes attached to the surface of the skin.
The range of variables which can be recorded in this way is
very wide and includes heart rate, palmar skin resistance
(attributable to palmar sweating), skin temperature, blood
flow, respiration and cortical potentials recorded from the
surface of the brain.
Most of these variables show constant on-going activity:
the heart, lungs and cortical potentials show rhythmic
changes and also show quite striking changes in response to
simple stimuli such as lights and tones. More complex situ-
ations, such as verbal instructions, conversation, calling
the individual by name, mental arithmetic tasks, and so on,
can produce significant changes of long duration. In addi-
tion, many of these systems show a considerable amount of
spontaneous activity, that is, changes which occur in the
absence of any clearly defined event.
When the individual is left quietly to relax this
activity shows a steady decline. If now an unexpected
stimulus is given, a startle or orientating ('what is it?')
response occurs. When the same stimulus is repeated, the
response becomes smaller on each subsequent occasion until
it no longer occurs: that is, it has habituated. If a mild
stimulus (CS) is paired with an unpleasant stimulus (UCS)
such as an electric shock, conditioned responding occurs.
Among psychophysiologists there is substantial interest in
the physiological changes which occur in habituation, in the
acquisition of conditioned autonomic responses, and in the
nature of reactivity of different individuals to mild stres-
sors such as unpleasant noises, pictures, etc. There is a
great deal of variation between individuals and character-
istic response profiles have been described in which high
reactivity is evident in one aspect of responding - certain
skeletal muscle groups or cardiac changes or blood pressure
- while other aspects show minimal activity. Whether such
a pattern of 'response specificity' relates to symptom pat-
terns in certain individuals awaits longitudinal studies.
A major source of information concerning the neuro-
physiology of cognitive processes in humans is the scalp-
recorded event-related potential (ERP). The combined
electrical activity of millions of neurons in the brain
as a whole is recorded in these and allied electro-
encephalographic (EEG) recordings. There is clear
144
evidence that certain components of the ERP are related to

the physical attributes of the stimulus such as sensory
modality and intensity, while other components reflect the
individual's evaluation of the significance or meaning of
the stimulus.
Selective attention to one stimulus and not to another
can be demonstrated by instructions to subjects to monitor
one stimulus and to ignore another: components of the cor-
tical potential response to the monitored stimulus are
enhanced as compared with those to the irrelevant stimulus.
Various studies in schizophrenia have attempted to relate
observed behavioural abnormalities to aspects of psycho-
physiological responding within the context of deficits in
arousal and/or attention. It has been hypothesized that in
the acute stage of his illness the schizophrenic is con-
stantly aware of a wide range of stimuli other than those
which should strictly be in the forefront of his attention;
that he orientates to these irr~levant stimuli and does not
habituate to them. This can be tested not only by recording
and comparing cortical evoked responses to different tones,
some of which carry information while others are irrelevant
as indicated above, but also by recording autonomic activity
to assess the rate at which habituation occurs to signi-
ficant and non-significant stimulus events.
Psychophysiological responsivity has often been consi-
dered in relation to clinical anxiety. Anxious patients
frequently report trembling, sweating, shortness of breath,
palpitations and muscular tension, and these have been re-
corded in situations where the patient is at rest trying to
relax and also in response to different stimuli. There are
several reports of anxious groups typically responding more
readily, habituating more slowly, and taking longer to re-
cover from stimulation. The effect of training and biofeed-
back on levels of physiological activity is the subject of
much contemporary research.
Another area has concentrated on whether psychophysio-
logical reactivity is an indicator of 'good' performance;
that is, whether it correlates with speedy reactions, better
perception, memory, etc. Recordings of cortical potentials
have been related to the way in which people process in-
formation, and to such concepts as expectancy, attention
and vigilance. Recordings of brain activity during sleep
have been used to delineate the function of sleep, to define
quantitatively what is good sleep, effects of drugs on
sleep, and what role sleep plays in illness and well-being.
Psychophysiological measures can provide useful indica-
tors of autonomic and cortical reactivity in response to
stimuli of many kinds. They are helpful in their demonstra-
tion of individuals' idiosyncratic response profiles, in the
study of habituation, relationship to task performance,
processing of information, and in their indication of the
variety of changes which occur along the sleep-wakefulness
continuum. Perhaps the future may also see further links
between psychophysiological research and the problems of
psychosomatic medicine and psychiatry.
145
CODCbJding COIIIIDCDts If the aim of psychology is to clarify man's behaviour in

this world it must accord a central position to biology,
since this of all disciplines is the most directly linked to
the understanding of living beings. The biological basis of
behaviour refers to evolutionary, genetic, physiological and
brain-behaviour mechanisms, and more recently has been
extended to human social behaviour. Triumphs of molecular
biology, of technology and field observation have been
accomplished. The discovery of deoxyribonucleic acid (DNA)
and the theory of the genetic code tell us how the infor-
mation is coded which determines that a new life will in-
herit the characteristics of its parents; technological
developments make it possible to record electrical events
from single neurons within the brain, and to measure minute
traces of brain chemicals. Studies by ethologists have made
us familiar with the behavioural repertoire of animals in
their natural habitat.
The evolution of the brain and central nervous system
has led to the increasing role of learning as a strategy
whereby the organism attains information about the envi-
ronment and itself during its own lifetime. This implies
an increasing flexibility of gene/behaviour interaction,
though a genetic basis of learning probably resides in the
emotional/motivational states that help define reward and
punishment. These aspects of behaviour are augmented by the
evolution of socio-cultural organizations in which knowledge
and ideas are perpetuated through socialization and
teaching.
There are many challenges to the understanding of human
nature. The work which psychologists have to do centres on
the analysis of behaviour into useful segments, and the
derivation of meaningful concepts such as attention and
arousal, emotion, memory and stress. It must contend with
individual variation, possibly along dimensions such as
extraversion, neuroticism and impulsiveness, and elucidate
the psychophysiology of neurosis a..T1d stress reactions.
These in turn can be examined in relation to practical
issues. Some would account for the genesis of neurosis in
terms of maladaptive patterns of learning, and aim to treat
anxieties and phobias according to conditioning principles.
Psychophysiological illnesses such as the psychosomatic
disorders can be viewed as a combination of genetic pre-
disposition, faulty learning and environmental stress, and
each of these factors needs to be studied. The contribution
of physiological arousal, perceptions and attitudes in the
experience of emotion remains to be unravelled.
The goal which lies ahead in the biological context is
the fitting together of psychologiCal facts and factors with
the patterns of bodily activity which form the basis of
human individuality and welfare.
References CaDIIDD, W.B. (1915)

Bodily Changes in Pain, Hunger, Fear and Rage. New
York: Harper & Row.
146
Luria, A.R. (1973)

The Man with a Shattered World. London: Jonathan Cape.
Valenstein, E.S. (1973)
Brain Control: A critical examination of brain
stimulation and psychosurgery. New York: Wiley.
Wilson, E.O. (1975)
Sociobiology: The new synthesis. Cambridge, Mass.:
Belknap.
QuestiODS 1. Discuss the contribution of the autonomic nervous system

to emotional experience.
2. Describe some of the methods by which brain research
can develop insight into human behaviour.
3. Ho'.... would you expect different levels of arousal to
affect (a) ordinary behaviour, (b) performance of a
specific task under experimental conditions?
4. Give an account of some of the methods popularly used
for reducing tension.
5. Compare the relative value of information obtained from
(a) an individual's verbal report of his emotional
state, (b) another person's observation of the
individual's behaviour.
6. What is the evidence that many aspects of personality
are inherited? What conclusions can be drawn from this
evidence?
7. Describe the method of classical conditioning and
illustrate how it can be used as an explanation of
acquired fears.
8. What objective measures have been used in the assessment
of personality? Describe some of the major personality
factors which have been identified.
9. Give an example of how brain damage might affect speech
or reading.
10. Discuss the view that individuals seek a 'preferr'3d'
optimum of stimulation. How does this relate to
differences in personality?
11. WhOl.t do you think are the ethical problems associated
with brain intervention in psychiatric disorder?
12. There is controversy about the extent to which
intelligence is inherited. What do you think are the
social implications of this controversy?
Amlotated reading Boddy, J. (1978) Brain Systems and Psychological Concepts.

Chichester: Wiley.
Van Toller, C. (1979) The Nervous Body: An introduction

to the autonomic nervous system and behaviour. Chichester:
Wiley.
Two useful books, both in very readable style, which
cover in much greater depth the topics outlined in this
chapter. They are detailed and informative, and worth
sampling on topics which interest the student.
147
Gray, J. (1971) The Psychology of Fear and Stress. London:

Weidenfeld & Nicolson.
Deals not only with innate and acquired features of fear
and stress but also with mechanisms of conditioning and
reinforcement.
Eysenck, H.J. (1976) Psychology as a bio-social science.

In H.J. Eysenck and G.D. Wilson (eds) , A Textbook of Human
Psychology. Lancaster: MTP.
An introduction to psychology as the study of behaviour
with special reference to the interaction of social and
biological factors.
Martin, I. (1976) Emotions. In H.J. Eysenck and G.D. Wilson

(eds) , A Textbook of Human Psychology. Lancaster: MTP.
Strongman, K.T. (1978) The Psychology of Emotion (Znd edn).

Chichester: Wiley.
The above two references discuss a number of facets
concerning the study of emotion.
Valenstein, E.S. (1973) Brain Control: A critical

examination of brain stimulation and psychosurgery. New
York: Wiley.
An interesting account of a number of topics involving
brain and behaviour studies, including a good discussion
of the effects of psychosurgery in psychopathological
disorders.
148
6
Personality and Individual
Assessment
P. Kline
What is personality? It has been defined as the total pattern of an individual's

E. N. DUNKIN abili ties, beliefs, habits, expectations, prejudices,
strengths and weaknesses, and the way in which these are
combined to achieve a distinct and unique person. This is a
cumbersome definition, yet if it is simplified to manageable
proportions and expressed as 'that which makes a person
unique', there is very little definitive value left. Whether
the long or short form of the definition is adopted, a brief
check on the environment of persons in general is enough to
remind us that although each person is unique, he comes from
a gregarious species: men are interdependent, and there are
social consequences of, and social effects on, personality.
We have already looked at perception of things in the
environment and decided that this involves a complicated
process of sensory stimulation, analysis, matching and
sorting to identify anything and give it a meaning. The per-
sonalities of the people in our lives give them their iden-
tities, their individuality; the personalities we grant them
are the sum of the observations we make about them in our
'person perceptions'. If we found perception of objects to
be rather complicated, person perception is likely to prove
even more intricate: people have rather more differences
than they have similarities. It is relatively easy to iden-
tify a collection of two upper limbs, two lower limbs, a
trunk, head and neck in suitable arrangement as a fellow
human being, but it is wildly optimistic to expect it to
react, or to have opinions, to believe, etc., as we do our-
selves. Experience of human beings tells us one thing: they
are highly unpredictable on the first encounter and may
remain so unless we 'get to know them better'. This process
of getting to know a person better is a gentle disguise for
our continuous attempts to remould them, or our impressions
of them, so that they fit into our personal summaries of the
people we have met before: we are hunting for a 'category'
into which they fit and which we can use as a ready made
device for monitoring our own behaviour and adjusting it to
suit what we predict theirs will be.
Our first attempts to summarize the qualities of a new
acquaintance are a bit clumsy: there is a tendency to use
stereotypes in this first 'sorting' exercise. Stereotypes
come to hand easily as they are ready made, adopted from
149
Personality and individual assessment
cultural and familial beliefs, often racist and all highly

prejudiced. If we are asked what we think of someone after
a brief meeting, we may say of the round, jolly person that
he 'looks cheerful', or of the thin, agitated person that he
'looks anxious'. Someone who smiled at us several times is
likely to seem 'friendly'. After a further meeting or con-
versation, we might allow ourselves to say that 'Joe has a
warm, cheerful personality', which probably means that as
far as we can tell he has a tendency to remain cheerful
whatever happens to him and to his immediate environment.
There have been some very determined efforts to explain
WHY people develop a certain characteristic way of dealing
with themselves and their surroundings. The search is still
going on, and in addition there is an increasing interest
in finding ways of encouraging people to demonstrate HOW
they perceive qualities of personality in their fellow human
beings. The following section is a rapid review of some of
the theories and styles of investigation that have occupied
students of personality in the distant and recent past. It
begins by setting out the agreed requirements of a good
theory so that you will be able to judge the merits of the
competing ideas of the theorists.
Requirements of a * The basic assumptions of the theory must be relevant to

good theory the area it is said to COVE'r.
* The theory must have rules which define the relationship
between its assumptions and which make it possible to
explain their interactions.
* The theory must be internally consistent: contradictory
elements in a theory destroy its value, since it is
equally possible to prove it or to disprove it.
* The variables that are considered in the theory must be
described in operational terms.
* The theory must make use of all the established
knowledge of the field it attempts to describe and its
concepts must be compatible with that body of knowledge.
* The theory must have predictive potential in new
situations.
In general, theories of personality have had difficulty

in meeting these six requirements, particularly the one that
specifies that a theory must be comprehensive, and so must
include all the facts that are known about personality. The
greatest pressure for such sweeping explanations and pro-
found theories has come from the medical world in the past.
Attempts to solve the problems of mental disorders have been
made via analysis of personality and interpretation of un-
usual or socially unacceptable behaviour. This has led to
some of the broader theories being founded on clinical data
rather than on observations of the normal, healthy members
of the population. The detailed exposition of personality
proposed by Freud is an example of a general theory derived
solely from clinical evidence, combined with a generous
amount of introspection and SUbjective interpretation.
150
Despite these obvious infringements of the rules for setting

up a 'good theory', Freud's contribution to the psycholog-
ist's understanding of the unconscious aspects of behaviour
has proved to be valuable: in common with other partially
complete theories, Freud's ideas on personality and its
development have stimulated a great volume of investigation
and enquiry. Psychologists have looked at hundreds of
people, sorted their observations and come up with some
theories of personality: others have taken these theories,
continued their studies and decided to abandon the theories
in favour of detailed observations of traits that can be
isolated from the many ingredients of personality.
In spite of the difficulties in expressing the details
of personality, or perhaps because of those difficulties,
the work that has been done on this aspect of human life is
interesting and a summary of some of the ideas that have
been offered in the past demonstrates that, with guidance,
people can improve their awareness of the needs and
resources of others.
Theories attempted: On a historical basis, it is possible to go back to the time

personalities described of Hippocrates for the first evidence of people sorting out
by types their fellows into 'types', as if this made them easier to
manage. The four original types were supposed to possess
different proportions of the bOQy fluids that were known at
the time, each type being named by the fluid that was con-
sidered to predominate: blood, phlegm, yellow bile and black
bile were linked to sanguine, phlegmatic, choleric and
melancholic personalities. These constitutional types were
seen as the counterparts of the four elements in the cosmos,
namely air, water, fire and earth. This may sound very far
fetched in the light of our present knowledge of our world
and its universe, but remnants of this possibility of sort-
ing people into personality types by their physique per-
sisted well into the present century. A review of some of
these ideas will demonstrate how the theme of searching for
an explanation of a person's habitual moods and behaviours
in his physical appearance has run through the thinking of
psychiatrists and modern psychologists.
Kretschmer
In the 192.0s, a German psychiatrist called Kretschmer
noticed that many of the schizophrenic patients in his care
looked similar. They were thin and tall, with long, oval
faces. In contrast, many of the patients who had manic-
depressive mood fluctuations were inclined to be short,
plump and had round rather than long faces. He moved his
observations outside the hospital and noticed that the
general popUlation had many people whose physique resembled
that of the schizophrenic or manic-depressive patients:
their respective personalities showed the non-morbid equi-
valents of the personalities of his two groups of patients.
Kretschmer described a complete classification of persona-
lity in which he related physical and mental qualities.
PFP _ K 151
The tall, slight pbysique was called ASTHENIC and indi-

ca ted a SCHIZOID personality; the short, plump physique was
called PYKNIC and was associated with a CYCLOID person-
ali ty; while a third bodily type showing muscular, broad
build was called ATHLETIC. Kretschmer considered that the
athletic type had a personality which was a mixture of the
schizoid and cycloid ones, with a probable bias towards the
schizoid.
Although studies and subsequent ideas have not always
coincided with Kretschmer's original classifications, there
is a definite consistency between his findings and the more
recent thinking about the basic differences between person-
ality types. The schizoid/cycloid division shows remarkable
similarity to the limits set by Eysenck for one of his
personality scales which measures the introversion/
extraversion dimension of personality.
Sheldon
Sheldon continued the search for clues to personality that
might be found in the physical appearance of people. He
sorted thousands of photographs of young men into types that
he called ectomorphs, endomorphs, and mesomorphs. It is
almost possible to hear the echoes of medieval beliefs in
his claim that the ectomorphs had a predominant nervous
system, the endomorphs had a predominant digestive system,
while the mesomorphs had a predominant muscular system (his
terminology tallying nicely with the three differentiating
layers of the week-old embryo). Sheldon did not expect to
find absolute examples of these archetypes in great numbers
in the popUlation: individuals were judged for each of the
three body-types on a seven-point scale so that many people
ended up with a 4-4-4 rating. This put them in the large
middle grouping of a normal distribution. Sheldon also pro-
posed that there were personalities that went with these
'somatotypes'. The ectomorph had a CEREBROTONIC persona-
lity, the endomorph had a VISCEROTONIC personality while
the mesomorph had a SOMA TOTONIC personality. Each of
these personality types could be examined via 20 traits that
Sheldon proposed. Once people had been given a sornatype
rating, examination of their personalities using these
traits gave some interesting correlations. However, there
are some methodological criticisms that can be made of
Sheldon's work. Despite enthusiastic collection of data, he
may have been guilty of the type of bias that occurs when
one's assistants know too much and believe too deeply: all
the people who made the ratings for his experiments were
familiar with his theories and their underlying assumptions,
so it is likely that this familiarity had a considerable
effect on their observation of personality traits.
Theories attempted: Jung

personalities located Jung, who was a contemporary of Kretschmer, assembled his
on a continuous personal observations and clinical evidence into a theory
dimension which recognized the relative importance that people gave to
152
Personali ty and individual assessment
their surroundings. He decided that there were two major

classifications that he called introvert and extravert
personalities. He felt that the introvert was primarily
concerned with himself and had little interest in the out-
side world while the extravert was devoted to the values and
interests of the world about him. As subdivisions of these
two main types of personality, Jung proposed that there were
four other factors that should be used to separate people.
These factors were thinking, feeling, sensation and intui-
tion; they were to be used in conjunction with one of the
main types to describe any individual. A person might be
a 'thinking extravert', which probably meant that he was
interested in looking for solutions to the material problems
of the world: such a person might become involved in scien-
tific investigations. A 'thinking introvert' was more likely
to be a philosopher or a psychologist, being concerned with
the intriguing mysteries of the inner life of mankind.
Within the apparent rigidity of Jung's theory there was a
further proposition that is often missed by the enthusiast
who is pleased with Jung's realistic and appealing typology.
This frequently missed proposition claims that the greater
part of the population belongs to an intermediate type that
Jung called 'ambivert'. The main trouble with Jung's theory,
as with those of Kretschmer and Sheldon, is that it was
never verified by impartial investigations and objective
measurements. Instead, psychologists have selected parts of
his theory and used them as the basis for itemizing person-
ality traits that have been rated and examined in a variety
of ways. The most obviously linked approach is that of
Eysenck whose early work was directed towards establishing
a means of sorting out personalities by their ratings on an
introversion/extraversion dimension. This was to be used in
conjunction with ratings on a second dimension known as the
'neuroticism scale' and a third known as a 'psychoticism
scale'.
Theories in terms of Eysenck

trait observation Although it is possible to detect some overlap in the sorts
of personality being proposed by Jung and Eysenck, the
approach of the two men is completely different. Whereas
Jung's theory relied on his empirical findings, Eysenck has
been to great lengths to ensure that all possible means have
been found to keep the data he records free from the criti-
cism of SUbjectivity on the part of the investigator. The
questionnaires that he uses, and their interpretation, have
been put through rigorous statistical analysis and the three
factors that he advocates are claimed to be genuine traits
of personali ty rather than tendencies induced artificially
by inept test items.
In addition to his insistence on precise statistical
management of any test instruments he has developed, Ey-
senck's work has been characterized by emphasis on the
physiological correlates of personality. It is interesting
to note that the very early attempts to explain personality
153
Person ali ty and individual assessment
in terms of bodily properties are represented in contempo-

rary studies, albeit with a precision that reflects the
detailed knowledge that has accrued in neuroanatomy and
neurophysiology. It is part of Eysenck's refinement of his
original theory to explain the differences between extra-
version and introversion in terms of the function of the
ascending reticular formation of the brain stem. Variations
in the activity of these neurological structures lead to
differences in the AROUSAL of an individual.
An interesting feature of Eysenck's dimensions of
personality is that they apply to everybody, whether they
are considered to be mentally healthy or mentally dis-
turbed. Those people who might be described as neurotic or
psychotic and, as such, be receiving treatment to help them
deal with their problems, are only different in DEGREE from
the rest of the population. (See p. 170 for further
discussion of Eysenck's ideas on personality.)
Cattell
Working independently on the idea that personality can be
expressed and measured in terms of a finite number of
traits, Cattell isolated 16 discrete traits, or factors,
which he studied in hundreds of subjects. Like Eysenck, he
used factor analysis to establish the power of the selection
he made, and his work is well documented in his own and his
colleagues' publications (see suggestions for further read-
ing, p. 173). Bothered by the connotations that people give
to words that are adopted from the general vocabulary, he
has coined many new words to express the 16 traits he re-
cognizes. For example, the eighth factor on his list is a
Harria-Premsia factor: this usually has a subsequent expla-
nation in brackets to the effect that this factor covers
tough-minded and self-reliant tendencies and their opposite,
tender-minded and clinging tendencies. Without their new
names, many of the traits that Cattell uses correspond with
the traits that have been emphasized in the work of Eysenck
apd some of the earlier personality theorists. The greatest
single difference in Cattell's approach is that he considers
it more valuable to be able to give a 'profile' of a person
by rating him on 16 traits than to locate that person on two
or three maj or personality dimensions. In other words,
Cattell's assessment of personality is more descriptive than
Eysenck's.
Theories abandoned in More recently, psychologists interested in personali ty have

favour of personality given up searching for broad theories which would attempt to
inventories and traits take in all facts and speculations on the matter. Instead of
looking for a universal explanation, they have been more
concerned with building up a thorough understanding of the
individ:tal: measurement and comparisons with norms, with the
possibility of putting a person into one of a limited number
of categories, have given way to detailed study of the way
each individual reacts with the human and non-human parts of
154
his environment. In the first of the schemes that con-

centrated on interpretation of the individual, projective
techniques were used. The person was given a series of des-
criptive tasks, based on rather vague 'stimulus material':
most of the tasks required the person to give an explanation
or interpretation of visual stimuli, and it was thought that
these interpretations would reflect the needs, wishes,
frustrations and so on of the speaker, who would 'project'
these into the test material. Two examples of these tests
were introduced in the earlier chapter on motivation:
* the Rorschach Ink Blot Test;

* the Thematic Apperception Test.
The first of these consists of a series of patterns made by

folding a piece of paper so that an ink blot would be spread
by the pressure of the fold: since the patterns have no
prior identity, the person being tested has nothing to use
for interpretation except the internal standards with which
he sorts out novel sensory information. In the second test,
the person is given a picture and asked to make up a story
based on the scene it depicts. Both of these tests have been
widely used and the information available after a test
session is certainly rich in clues to the personality of the
person who gives it, but there is a major problem if any
attempt is made to quantify these data, as they are, by
design, extremely open-ended. There is an unavoidable fac-
tor of subjectivity introduced by the person who scores or
examines the data and these and similar tests have had a
decreasing use in Britain because their validity is suspect.
The tests are still in use on a fairly wide scale in North
America.
George Kelly, an American, has extended the idea of
deriving information about the person directly from that
person and combined it with strict methodology and 'built
in' measurement. He works from the basic assumption that
every personality is an orderly structure of the standards
by which the individual predicts events, particularly in his
external environment. These personal standards are called
'constructs' by Kelly and they are identified by their
limits, which are usually made up from contrasting adjec-
tives that could be applied to things, experiences, abstract
ideas, etc. Sample 'constructs' might be:
* hard/soft;
* kind/unkind;
* pleasant/unpleasant;
* good/badj
* warm/cold;
* hostile/friendly.
All of these would be eminently useful in judging the value

of anything' or anyone that the individual comes across. The
personal constructs of one individual and the way in which
155
they relate to one another, or cluster, are unique. But the

clustering will change from time to time, due to the modi-
fying effects of experience, particularly when the person-
ali ty is still developing. Starting from Kelly's original
ideas, Bannister and his colleagues have developed a precise
and effective way of assembling a picture of the personality
in terms of the way in which the individual 'sees' his fel-
low human beings. It is a very flexible system and as the
constructs are tested, the results for the individual are
entered on a grid or matrix. (Further details about the
repertory grid system are included in chapter 7, in
Bannister's section. )
The test material is either selected by the tester or
suggested by the person being tested: the 'elements', or
items, may be people from the person's acquaintances or
family, or they may be photographs of strangers, famous
people or physical objects provided by the psychologist.
The task is to sort out the elements using a series of con-
structs which may either be provided by the tester or taken
from an earlier sorting task in which the person is asked to
give his opinion on three people, for example, three of his
relatives: this tends to elicit contrasting adjectives which
can be used as the basis for 'generous/mean', 'easy to get
along with/difficult to please' types of construct. Once a
matrix has been recorded for a range of elements, the result
is factor analysed.
Personality and We now examine individual differences among human beings,

individual assessment how such differences are measured, and the psychological
P. KLINE implications of such differences for understanding
personali ty and behaviour.
First of all we discuss psychological tests and testing
techniques, for it is by the application of these measures
that individual differences have been discovered.
The characteristics of Efficient testing devices must be (i) reliable, (ii) valid
good psychological and (iii) discriminating.
tests and how these
may be achieved Reliability
Reliabili ty has two meanings: first, self -consistency. Tests
must be self-consistent; each item should measure the same
variable. An instrument, for example, which measured in part
pressure as well as temperature would not give a reliable
measurement of either of these. The second meaning is con-
sistency over time: that is, test -retest reliability. If a
test is administered a second time to a subject then, unless
a real change has taken place, the score on the two occa-
sions should be the same. Reliability is measured by the
correlation coefficient, an index of agreement running from
+1 (perfect agreement) to -1 (perfect disagreement). A
correlation of 0 shows random agreement. Good tests should
have a reliability coefficient of at least 0.7 which rep-
resents 49 per cent agreement (square the coefficient).
156
1. FACTORS INFLUENCING RELIABILITY
* Test length: it can be shown that reliability increases

with the length of a test. The typical university essay
exam has only four items, four essays, and is thus not
highly reliable. To increase reliability, most psycho-
logical tests have a large number of items. Twenty items
are about the minimum necessary for reliability.
* Objective scoring: scores should be objective: that is,
there should be no personal judgement required of the
scorer. Where judgement is required, as in essays,
differences arise, often large, between different
markers and with the same marker if he rescores the
test. A good test has items that are objectively
scored.
If a test is reliable then it can be valid. Notice the

'can'. It is possible to devise a highly reliable test that
measures virtually nothing. A test for measuring the length
of people's noses would be easy to devise and would be
highly reliable, but it is unlikely to be a valid test of
intelligence or personality. On the other hand, an unreli-
able, inconsistent test which gives different scores on
different occasions cannot possibly be valid.
Validity
A test is said to be valid if it measures what it claims to
measure. This may sound obvious but many tests are quite
invalid. For example, essay-type tests of scientific sub-
jects are highly unlikely to be valid since essay writing
demands verbal ability, and ability in physics is somewhat
different from this. The term validity is used in psycho-
logical testing (psychometrics) in different ways.
1. F ACE VALIDITY: this refers to the appearance of a test

which is said to be face valid if it looks as if it measures
what it claims to measure. This is important in testing
adults who may balk at doing tests which look absurd. They
may simply refuse to co-operate or even treat the test as a
bit of a joke. Children, however, are used to overlooking
such niceties. Face validity is not usually related to true
validity.
2. CONCURRENT VALIDITY: this refers to studies of the

validity of a test made on one occasion. For example, the
concurrent validity of a new test of intelligence would be
assessed by its correlation with well-established intel-
ligence tests; does the new test give a similar score to the
score on an existing test? Concurrent validity studies are
beset by problems of criteria: what tests or other measure-
ment should be used in establishing the concurrent validity
of a test? If other similar tests are used, and the cor-
relation is very high, the question arises as to what value
the new test has since it is measuring the same variable as
the old.
157
3. PREDICTIVE VAUDITY: this refers to the capacity of a

test to correlate with some future criterion measure. This
C311 be the most powerful evidence for the validity of a
test. Some examples will clarify this point. A good test of
anxiety should be able to predict future attendance at the
psychiatric clinic, and a good test of intelligence given at
11 years of age should correlate with future academic per-
formance in 0 and A level examinations and at university.
Thus the test predicts events external to itself.
4. CONSTRUCT VALIDITY: the construct validity of a test

is defined by taking a large set of results obtained with
the test and seeing how well they fit in with our notion of
the psychological nature of the variable which the test
claims to measure. Thus it embraces concurrent and predic-
tive validity. In effect, we set up a series of hypotheses
concerning the test results and put these to the test. For
example, if our test was a valid measure of intelligence
we might expect:
* high-level professional groups would score more highly

than lower-level professionals;
* children rated highly intelligent by teachers would
score more highly than others;
* scores would correlate positively with level of
education;
* scores would correlate highly with scores in public
examina tions;
* scores would correlate highly with scores on other
intelligence tests;
* scores would not correlate with scores on tests not
claiming to measure intelligence.
If all these hypotheses were supported then the construct

validity of our test would be demonstrated. It is deserving
of note that it is always useful to show (as in the final
point above) what tests do not measure, a technique used by
Socrates in his examination of the meaning of words.
Unlike reliability, for which there can be clear unequi-
vocal evidence, the validity of a test is to some extent
subjective. Nevertheless, most well-known tests, especially
of ability, have now accumulated so much evidence relating
to vaiidity that there is no dispute about them. It is more
difficult to demonstrate the validity of personality tests
but, as we shall see, it can be done. Many psychological
tests have little support for their validity and a large
number are clearly invalid.
Discrimiuatory power
Good psychological tests should be discriminating: that is,
they should produce a wide distribution of scores. For
example, if we test 10 children and all score 15 we have
made no discriminations at all. If four score 13, three
score 12 and three score 14 then we have made only three
158
discriminations. If, on the other hand, each child scores a

different score, then the distribution of scores is wide.
The scatter of scores in a distribution is known as the
variance and the standard deviation is the usual measure-
ment. A good test has a large standard deviation.
With reliable, valid and discriminating tests it is
possible to investigate the nature of individual differences
in human beings. In fact, this has been going on since the
tum of the century when Binet began the assessment of the
educability of Parisian children.
Types of tests and Individual differences among human beings fall into rela-
categories of individual tively independent categories for which different types of
differences tests have been developed.
Intelligence and ability testa

The most important ability as studied by psychometrists is
general intelligence, the ability to educe correlates; a
general reasoning ability which underlies much problem-
solving ability. Modem studies of this general reasoning
factor (e.g. Cattell, 1971) tend to reveal two aspects: (i)
fluid ability which is close to inherited reasoning ability;
and (ii) crystallized ability, which is fluid ability as it
is evinced in a culture. The old-fashioned 11+ intelligence
tests were largely concerned with crystallized ability. More
will be said about intelligence later in this chapter.
Other typical abilities are: verbal ability, V; numeri-
cal ability, N; and spatial ability, K. Performance on
various tasks will depend upon our status on these vari-
ables. For example, a writer and an engineer may both score
much the same on general intelligence, but on verbal ability
the writer will be higher, whereas on numerical and spatial
abili ty the engineer will be superior. Intelligence can be
thought of as a general factor, while verbal and numerical
ability are group factors. Intelligence plays its part in
almost all skills, while verbal ability is involved only in
certain groups. Some factors are more narrow thar. this;
auditory pitch discrimination would be an example.
Aptitude testa
Aptitude tests comprise a group of tests related to tests of
ability. Aptitude tests tend to be of two different kinds.
One type may be identical with the group tests discussed
above. Thus it would be difficult to distinguish between
verbal ability and verbal aptitude. However, computer
aptitude tests are clearly different; they should test the
collection of traits (perhaps more than just abilities)
necessary for this particular job. In some instances, such
as clerical apti tude, the necessary skills are quite dis-
parate and unrelated to each other. Generally, aptitude
tests measure the separate abilities demonstrated to be
important for a particular job or class of jobs.
159
Personality tests
Personality tests can be divided into tests of temperament,
mood and dynamics. Temperament tests measure how we do
what we do. Temperamental traits are usually thought of as
enduring and stable, such as dominance or anxiety. Dynamic
traits are concerned with motives; why we do what we do.
These attempt to measure drives such as sexuality or pug-
nacity. Moods refer to those fluctuating states that we all
experience in our lives: anger, fatigue or fear.
Temperament tests
The most used type of temperament test is the personality
questionnaire. These consist of lists of items concerned
with the subject's behaviour. Typical items are: do you
enjoy watching boxing? Do you hesitate before spending a
large sum of money? Items come in various formats. Those
above would usually require subjects to respond 'Yes' or
'No'; or 'Yes', 'Uncertain' or 'No'. Sometimes items are of
the forced choice variety; for example, 'Do you prefer: (i)
watching boxing; (ii) going to a musical; or (iii) sitting
quietly at home reading?'
The disadvantages of questionnaires are considerable,
yet in spite of them many valid and highly useful person-
ality questionnaires have been constructed. These disadvan-
tages are outlined below.
* They are easy to fake: that is, subjects may not tell
the truth for one reason or another. This makes them
difficult to use in selection, although for vocational
guidance or psychiatric help, where subjects have no
reason to fake, this is not too serious.
* They require a degree of self-knowledge and some
subjects, while attempting to be honest, may respond
qui te unrealistically.
* They are subject to response sets. An important set is
social desirability, the tendency to endorse the
socially desirable response. People like to present
themselves in the best possible light. For example, to
the item 'Do you have a good sense of humour?', the
response 'Yes' would be given by about 95 per cent of
subjects. The other serious response set is that of
acquiescence; the tendency to put 'Yes' or 'Agree' to an
answer, regardless of content. Balanced scales, with
some responses keyed 'No', obviate this to some extent.
OBJECTIVE TESTS: these, defined by Cattell (cf. Cattell

and Kline, 1977) as tests of which the purpose is hidden
from the subject and which can be objectively scored (see
the section on reliability), have been developed to overcome
the disadvantages of questionnaires. Ironically, because
their purpose is hidden from subjects, considerable research
is necessary to establish their validity and as yet most are
still in an experimental form. These tests will probably
take over from questionnaires when the necessary research
160
has been done. The following examples indicate their

nature.
* Balloon blowing: subjects are required to inflate a bal-

loon as much as they can. Measures taken are the size
of the balloon, time taken in blowing it up, whether
they burst it, and delay in beginning the task. This
test may be related to timidity and inhibition.
* The slow-line drawing test: subjects are required to
draw a line as slowly as possible. The measure is the
length of line over a fixed time.
In fact more than 800 such tests have been listed and more
can easily be developed, depending upon the ingenuity of the
researcher. The technique is to administer a large battery
of such tests and to determine experimentally by so-called
validity studies what each of them measures.
PROJECTIVE TESTS: these essentially consist of ambiguous

stimuli to which the subjects have to respond. These are
some of the oldest personality tests and one, the Rorschach
test (the inkblot test), has achieved a fame beyond psycho-
logy. The rationale of projective tests is intuitively bril-
liant: if a stimulus is so vague that it warrants no parti-
cular description, then any description of it must depend
on what is projected on to it by the subject. Projective
testers believe that projective tests measure the inner
needs and fantasies of their subjects.
A serious problem with projective tests lies in their
unreliability. Responses have to be interpreted by scorers
and often considerable training, experience and expertise is
necessary. Inter-marker reliability is low. Generally, too,
it is difficult to demonstrate test validity. However, the
present writer has experimented with entirely objective
forms of scoring these tests and some evidence has now
accrued that this is a useful procedure.
PROJECTIVE TEST STIMULI: although any ambiguous stimulus

could be used as a test, the choice of stimulus is generally
determined by the particular tbeory of personality which the
test constructor follows. For example, a psychoanalytically-
orientated psychologist would select stimuli relevant to
that theory, such as vague figures who could be mother and
son (the Oedipus complex) or figures with knives or scissors
(the castration complex). The TAT (Thematic Apperception
Test) developed by Murray uses pictures which, it is hoped,
tap the inner needs held by Murray to be paramount in human
behaviour.
Mood aDd motivatioa testa

Mood and motivation tests are essentially similar to tem-
perament tests, but relatively little work has been done
with these and their validity is not so widely attested as
that of temperament tests.
161
Mood tests generally use items that concentrate, as

might be expected, on present feelings rather than on usual
ones. With these, high test-retest reliability is not to be
expected. However, fluctuations in scores should not be
random but should be related to external conditions. Thus
experiments can be conducted in which the tests, if they are
valid, can be retaken. If the experimental manipulations are
good and the tests valid, the relevant scores should
change in response to these changes in mood.
The results of motivation tests should be similarly
fluctuating, according to whether drives are satisfied or
frustrated. In a well-known study by the present author the
scores of a single subject over a 28-day period were related
to a diary recording all that happened to her and everything
she felt or thought (Kline and Grindley, 1974). In fact, the
relation of scores to diary events was close. For example,
the fear drive rose each weekend when the subject went
touring in a dangerous car. The career drive was flat except
on the day when the subject was interviewed for a course in
teacher-training, and so on.
Motivation tests can be of the questionnaire variety,
although objective and projective tests are more frequently
used. For moods, questionnaire tests are more usually em-
ployed though they suffer, of course, from the same response
sets as bedevil questionnaire measures of temperamental
traits.
Interest tests
The tests of motivation described above are very general:
that is, they measure variables thought to account for a
wide variety of human behaviour. Vocational and industrial
psychologists, however, have long felt the need for more
specific measures of motivation, assessing the variables
which seemed of immediate relevance to them: for instance,
interests. We all know of motoring enthusiasts who seem to
have an all-embracing interest in cars, which seems to
account for much of their behaviour and conversation.
A number of interest tests have been developed which
attempt to assess the major interests such as outdoor,
mechanical, or interest in people. In some tests, the
scoring of items is in terms of occupational groups. The
performance of particular occupational groups on the tests
is known and if, for example, foresters score high on a
particular item then this item contributes to the 'interest
in forestry' score. In other tests, the scoring involves
little more than subjects having to rank jobs. In other
words, interest tests of this type are like formalized
interviews.
Generally, the correlations of interest test scores with
success in a job relevant to those interests are modest and
little better than the correlation obtained between job
success and the subject's response to the question of
whether he thinks he would enjoy a job or not.
162
Attitude tests
Social psychologists have attempted to measure attitudes for
many years now. Usually, the attitudes tested apply to im-
portant aspects of a subject's life: for example, attitudes
to war, or to coloured people (in white populations) or to
religion. Obviously, if efficient measures of such attitudes
are possible then progress can be made in understanding how
such attitudes arise or are maintained; important knowledge,
it is thought, in a complex multi-racial society. There are
three kinds of attitude test, differing in their mode of
construction.
1. THE THURSTONE SCALESe in these tests items are given

to the judges to rank 1-11 (favourable-unfavourable) in res-
pect of an attitude. Items on which there is good agree-
ment among the judges are then retained. The subject then
taking the test is given the highest judged rank score of
the items with which he agrees. The reason for this is clear
if we consider a few examples. (1) 'War is totally evil'
would probably be ranked high as unfavourable to war.
(Z) 'Wars sometimes have to be fought if there is no alter-
native~ this is clearly against war, but not strongly.
(3) 'Wars are not always wrong~ this is yet further down
the scale, while the item (4) 'Wars are good: they select
the finest nations' is favourable. Thus a subject who agreeu
with (1) would not agree with (Z), (3) or (4). Similarly,
a subject agreeing with (3) would not agree with (4). These
tests are difficult to construct because much depends on
obtaining a good cross-section of judges. A more simple
alternative is the Likert scale.
Z. LIKERT SCALESe in the Likert scales statements relevant

to the attitude being measured are presented to the subject
who has to state on a five-point scale the extent of his
agreement. Thus a 'Hitler' would score 100 on a ZO-item
attitude to war scale. A 'Ghandi' would score zero, one
presumes. To make the scale less obvious, items are so
written that to agree with items represents both poles of
the attitude.
3. THE GUTTMAN SCALE: this is a scale constructed so

that if tne items are ranked for positive attitude, then any
subject who endorses item 10 will also endorse items 1-9
below it. While this tends to happen by nature of its con-
struction with the Thurstone scale, such perfect ordering of
items can usually only be achieved by leaving huge gaps
between the items (in terms of attitude) which means few
items and rather coarse measurement.
Such, then are the main types of psychological tests with

which individual differences are measured in psychology.
Needless to say, these are not the only kinds of test. In
the remainder of this chapter we briefly describe some in-
telligence tests, discuss some of the substantive findings
163
that have emerged from these tests and examine their

application in practical psychology.
IntelligeDce tests Intelligence has been most widely studied of all test vari-
ables and, since it is a topic of considerable importance in
applied psychology and education, we shall examine in detail
some intelligence tests to help us to understand the nature
of intelligence as conceptualized by psychologists.
Individual intelligeDce Some intelligence tests are given to subjects individually.

tests This enables the tester to measure not only the intelligence
of the subject but also to see whether a child panics at
difficulties or goes on and on obsessionally even when it is
obvious that no solution will result. Similarly, it can be
seen whether he is easily distracted, and all this is
valuable in attempting to understand any educational
difficulties which he may have.
The WISe
The Wechsler Intelligence Scale, WISC (Wechsler, 1938),
consists of the following sub-tests which fall into two
groups: verbal tests and non-verbal tests. A total IQ score
is obtainable, as are a verbal IQ and a performance IQ.
Large differences between these two sub-scores are of some
psychological interest and call for further study. Some of
our examples are taken from Kline (1976).
1. THE VERBAL TESTS
* Vocabulary. a straightforward vocabulary test.

Vocabulary is highly related to intelligence although
social class differences in reading habits do,
obviously, affect this particular sub-test. Never-
theless, if forced to make a selection of intelligent
children or adults ~s quickly as possible, the vocabu-
lary sub-test would be about the best measure
obtainable.
* Informatio~ a test of general knowledge.
* Ari thmetic: an ordinary arithmetic test.
These three tests are heavily affected by school learning

and social class. They therefore reflect what Cattell
called crystallized intelligence, or the result of cultural
influences upon innate ability.
* Comprehensio~ this is an interesting test because it

presents problems which are dependent upon how much
the child is capable of making sensible decisions on its
own initiative. One example (which is not in the test)
might be a question like 'What would you do if you saw
a burglar in the house next door?' Two points would be
scored by a response such as 'Phone the police - dial
164
999'; one pohlt by the response 'Run and tell Mummy',

and no points by 'Shoot him with my bow and arrow' or
'Push his car over'. At the higher level this sub-test
requires abstract analytical reasoning on such questions
as 'Why is there a Hippocratic oath?'
* Similarities: a common form of intelligence test item,
simple to write and easy to vary the level of diffi-
culty. For example, 'What is similar about peaches
and prunes?' The correct response requires that the
essential similarity (fruit) is recognized.
* Digit span (forward and reverse): digits are read out
and the subjects repeat them immediately. Seven or eight
digits is the usual span for bright adults.
In the majority of cases most psychologists give five of the

six tests, the last two of which in part measure fluid
abili ty.
Z. THE NON-VERBAL TESTli these are generally quite

novel to most subjects, so they are more a measure of fluid
(inherited) ability than are the verbal tests. Large dis-
parities between the verbal and performance score are often
found in middle-class children whose upbringing is highly
verbal. The performance sub-tests are as follows.
* Block design: patterns are presented to the child in a

booklet and he must then make them up by arranging
building blocks such that their top surfaces represent
the pattern. This test can be made of varying diffi-
culty. It is also one which indicates well how a child
tackles a strange problem.
* Picture arrangement: here series of strip cartoons tell
stories. Each series is presented in jumbled order and
the child must put them in their correct sequence: a
neat way of testing a child's ability to work out the
relationships involved.
* Object assembly: this is a timed jigsaw-like task of
arranging broken patterns.
* Mazes: the child is required to trace his way through
pencil and paper mazes.
* eodin~ here the key to a simple cipher system is
given. The child then completes as many examples as
possible (presented in random order) in a fixed time.
* Picture completion: pictures with a missing element,
often only a small detail, are shown to the subject who
is required to spot this.
This, then, is the Wechsler Intelligence Scale, one of the

standard individual intelligence tests. The verbal and
performance IQ scores are highly reliable, as is the total
score: aU around 0.9 or beyond.
The wIse is an individual test. It is obviously not
suitable for group administration. We shall now look at some
item types used in group intelligence tests (rather than
165
examine anyone test in detail) since these are widely used

in applied psychology.
Group intelligence tests

Items can be verbal or non-verbal, testing largely fluid or
crystallized ability.
1. AN ALOGIES
Easy: a is to c as g is to
sparrow is to bird as mouse is to
Difficult Samson Agonistes is to Comus as the

Bacchae are to ••.
With analogy items all kinds of relationships may be tested,

as in the examples where we find sequence, classification,
double classification (by author and type of play, for
example), and opposites. Analogy is thus a useful form for
encapsulating a wide variety of relationships. We can use
shapes for this type of item, as distinct from verbal forms.
0
Thus is to
D
as is to .••
6
Here we would supply possible answers in multiple choice
forin;
is to
Q)
(0
as is to •••
166
Odd-men-out items also allow us to test wide varieties of

relationships in many materials. Some examples are given
below.
carrot, turnip, swede, beetroot, cabbage

valley, coomb, hillock, gorge, chasm
early, greasy, messy, swiftly, furry
For these three examples some knowledge is required of

vegetables, geography and grammar, but this alone is not
enough.
Similarities are essentially the same item form (where
the common relationship must be worked out), but are more
difficult to write for a group test, because the multiple
choice answer will give the game away.
Non-verbal odd-men-out items are simple to produce, as
shown below.
These are the kinds of items used in abstract reasoning

tests.
Numbers, of course, offer easy ways of creating com-
plex relationships without needing any special knowledge of
mathematics and hence sequences are a useful item form. For
example, 20, 40, 60, 80 ••• is entirely unequivocal. Sequen-
ces allow also for the development of highly complex or
multiple relationships.
For example,
followed by a multiple choice to complete.
PFP _ L 167
Raven's Matrices is an example of a test composed

entirely of such sets of non-verbal items. Many forms have
been produced and it is capable of extending the intelli-
gence of subjects from about five years upwards to the
limits. It is one of the best single measures of fluid abi-
lity. Despite its non-verbal appearance, however, it is
related to some extent to verbal ability, presumably because
verbalization improves performance.
These, then are typical items in tests of intelligence.
From our description of these and of the WISC scale, it
should be possible to get an insight into what it is that
intelligence tests measure.
We have concentrated on intelligence tests in our more
detailed study of tests because they have been at the centre
of so much controversy, both in respect of their use as
selection devices for secondary school education and more
recently in respect of the heritabili ty of success in these
tests. It is to this latter topic, which is of great social
importance and intellectual interest, that we shall now
turn, a further reason for ensuring that the nature of such
tests is fully appreciated.
The heritability of This is so large and complex a subject that inevitably our
intelligence test scores summary must be somewhat assertive and dogmatic. To make
it even more difficult, well-known writers reviewing the
same evidence come to opposite conclusions. For example,
Cattell (1971) and Eysenck (1971) conclude that about 80
per cent of the variance in intelligence test scores is
heritable, at least in the west. Kamin (1974) , reviewing the
same evidence, comes to the conclusion that there are no
sound data to reject the hypothesis that differences in test
scores are determined by different life experiences.
To make our discussion of this matter comprehensible
rather than comprehensive we shall establish first a number
of important points.
* All results of heritability studies refer only to the

popUlation from which the sample was drawn. Thus re-
sults in Great Britain are not applicable in other cul-
tures. If culture has any effect, then in a country with
a diverse cultural background (such as India), the
heritability index would be smaller than in a more
homogeneous culture.
* AU workers in the field argue that there is an INTER-
ACTION between genetic and environmental determinants
of intelligence test scores. Where there is disagreement
is in the matter of how large is the influence of each
factor.
* In principle, an ideal method of studying the topic is
to investigate the differences in intelligence test
scores of monozygotic twins (Le. twins with the same
genetic endowment) reared apart. All differences in
test scores within such pairs must be environmentally
168
determined (ignoring differential effects of placental

deprivations, etc., in such pairs which would exaggerate
any differences) •
Critics of this approach argue that it is vitiated by the

fact that twins are, by definition, a different population
from singleton children. Furthermore, there is a tendency
for identical twins to be placed in foster homes similar to
each other, thus making their scores similar.
* Burt carried out the most extensive twin studies. His

data, however, must be ignored. It appears, alas, that
he doctored the figures.
* However, all other twin studies show the same results,
namely that in America and Great Britain there is a
substantial hereditary component in the determination of
test scores, the critical finding being that identical
twins reared apart show less differences in intelligence
test scores than do non-identical twins reared together.
* Kamin's (1974) arguments attempting to refute these
results are statistically weak, as has been fully
exposed by Fulker (1975). Kamin's work here may be
safely ignored.
* More sophisticated methods of statistical analyses known
as biometric genetic methods, which have been demon-
strated as powerful in animal work, have been employed
in the study of human intelligence test scores. These
can assess the kind of gene action and the mating system
in the population by analysing within and between family
differences and their interactions. The results of these
methods are difficult to impugn and it appears from such
studies that: (i) around 70 per cent of the variance in
lQ score is heritable in Great Britain and the USA; Oi)
there is a polygenic dominance for lQ and that assorta-
tive mating is an important influence.
* Such biometric methods can be applied to any variable
to reveal its heritability. The major personality
variables such as extraversion, neuroticism and psycho-
ticism, are also similarly highly genetically
determined.
The factorial description Factor analysis is a statistical technique for simplifying

of personality correlations: this is extremely useful in the study of
personality by personality questionnaires, of which there
are very large numbers. Factor analysis reveals dimensions
which can mathematically account for the observed correla-
tions. For example, almost all tests of ability are highly
correlated together. Factor analysis reveals that this is
largely due to the operation of two related factors: fluid
and crystallized ability.
Personali ty questionnaires have been subjected, over the
years, to factor analyses in the hope of discovering what
are the basic temperamental dimensions. The main researchers
169
in this area have been Cattell (working in Illinois), Ey-

senck (in London), both students of Burt, and Guilford (in
California). Although superficially each has produced what
looks like a separate set of factors, recent research in
this field has enabled some sort of consensus to be arrived
at (see Cattell and Kline, 1977, and Kline, 1979, for a full
discussion of this work). In effect, the study of indivi-
dual differences has led to the establishment of the main
dimensions of personality. These dimensions are therefore
those that demand study, and are outlined below.
Extraversion
The high-scoring extravert is sociable, cheerful, talkative
and does not like to be alone. He enjoys excitement, takes
risks and is generally impulsive: an outgoing optimist,
active and lively. The introvert is the opposite of this:
cold, retiring and aloof. This dimension has been related by
Eysenck to the arousability of the central nervous system.
Scores on tests of this factor have a large genetic
component.
Neuroticism (or anxiety)

The highly anxious subject is one who worries a lot, is
moody and often depressed. He is highly emotional and takes
a long time to calm down. He tends to sleep poorly and to
suffer from psychosomatic disorders. This variable is
claimed to be related to the lability of the autonomic
nervous system. These variables are both measured by the
Cattell 16PF test and Eysenck's EPQ.
If we know an individual's status on these two factors,
then already we know a good deal about his temperament.
Psychoticism
This variable has not been as extensively studied as
extraversion and anxiety and o~ly recently (1975) has it
appeared in a published questionnaire: the EPQ. Neverthe-
less, the nature of psychoticism is clear. The high scorer
on this dimension is soli tary, uncaring of people, trouble-
some, lacking in human feeling and empathy, thick skinned
and insensitive. He is cruel, inhumane, hostile and aggres-
sive, reckless to danger, aggressive even to his own family.
Naturally enough, most normals score low on P but many
criminals score high. This factor has been related by
Eysenck to masculinity, and to be related to levels of male
sex hormones.
It is to be noted that these three factors have not only
been clearly identified from the factor analysis of question-
naires there is also a considerable mass of experimental
data supporting their identification and nature.
These are the three second-order factors claimed by
Eysenck to be the most important in accounting for tempera-
mental differences. (Second-order factors are factors
arising from the correlations among first-order factors,
i.e. the factors accounting for the original correlations.)
170
The first-order or primary factors are more problematic than

the second-orders but, as the work of Cattell has shown, can
be of considerable power in applied psychometrics.
In brief, the factorial analysis of personali ty has
revealed three basic dimensions, each tied to the basic
physiology of man and hence largely heritable.
The application of The study of individual differences, which has been des-
findings in applied cribed in this chapter, has implicit within it a model of
psychology Man which might be called the psychometric model.
Explanation of this model, which is remarkably simple, will
make the application of results obvious.
The implicit psychometric model

This model states that any given piece of behaviour is
related to that individual's status on the main factors in
the sphere of ability, temperament, motivation and mood.
This model does not ignore past experience because this
itself affects status on these variables. The psychometric
model is therefore a variant of a trait model of behaviour.
Thus, for example, performance at GCE depends upon intelli-
gence, verbal and numerical abili ty, extraversion, anxiety,
psychoticism, mood at the time of taking the exam and the
various motivation variables discussed above (to take the
main variables). Obviously, for different behaviours (e.g.
exam passing and serving well behind a bar) different
weights for each of the factors is required.
How important each factor is - that is, what its weight
is - has to be determined empirically. In fact, the statis-
tical technique of multiple correlation or regression does
this precisely. Thus, the argument runs, we put all the test
variables into a multiple correlation with the criterion and
these are then weighted to achieve the highest possible
correlation. These weights (beta weights) indicate the
relative importance of the variable for the behaviour in
question. Cattell and Butcher (1968) have done exactly this
with academic success both in America and Great Britain and
found multiple correlations around 0.7.
Thus in educational guidance and selection we find the
beta weights of the variables and select and guide children
accordingly. If X, Y and Z have the highest weights for
academic success, then we select and encourage children high
on these variables. In industrial psychology, we can choose
and guide people to various jobs according to their scores
on the highest weighted variables. In clinical psychology,
too, we can find the tests most related to psychiatric
breakdown or diagnose into clinical groups. Then we know who
in the population is at risk and can avoid putting them into
stressful condititions.
Conclusions This brief summary of individual assessment and personality

shows how precise measurement of individual differences by
171
well-designed tests can yield a corpus of knowledge which is

not only of theoretical interest but is also of considerable
practical importance, since it gives a rational basis for
selection and guidance both in education and industry, as
well as being helpful in the psychiatric clinic.
References Cattell, R.B. (1971)

Abilities: Their structure, growth and action. New
York: Houghton-Mifflin.
Cattell, R.B. and Butcher, B.J. (1968)
The Prediction of Achievement and Creativity. New York:
Bobbs Merrill.
Cattell, R.B. and Kline, P. (1977)
The Scientific Analysis of Personality and Motivation.
London: Academic Press.
EJSeIlck, B.J. (1971)
Race, Intelligence and Education. London: Temple-
Smith.
Fulker, D. (1975)
The science and politics of IQ. American Journal of
Psychology, 88, 505-537.
Kamin, L.J. (1974)
The science and politics of IQ. Harmondsworth: Penguin.
Kline, P. (1976)
Psychological Testing. London: Malaby Press.
Kline, P. (1979)
Psychometrics and Psychology. London: Academic Press.
Kline, P. and Grindley, J. (1974)
A 28-day case study with the MAT. Journal of
Multivariate Clinical Experimental Psychology, 1, 13-32.
Wecbsler, D. (1938)
The Wechsler Intelligence Scale for Children. New York:
Psychological Corporation.
Questicms 1. What is meant by test reliability?

2. Why should psychological tests be reliable?
3. What is the meaning of test validity?
4. What factors contribute to the efficiency of
psychological tests?
5. What are the main types of psychological test? Give a
brief description of them.
6. Compare projective and questionnaire personality tests.
7. Discuss the main types of attitude tests.
8. Outline the main arguments concerning the heritability
of intelligence.
9. Discuss the concept of intelligence as factorially
defined.
10. What are the main factors of personality?
11. Compare the work of Eysenck and Cattell on the factor
analysis of personality.
12. If individuals are unique, how can they be measured by
tests of lmiversal dimensions?
172
13. If individuals are unique, how can there be a science of

personality?
Amlotated reading Cattell, R.B. and Kline, P. (1977) The Scientific Analysis
of Personality and Motivation. London: Academic Press.
A full account of the factor analysis of personality
where the results are related to clinical theories.
Cronbach, L. (1976) Essentials of Psychological Testing.

Chicago: Harper & Row.
A clear comprehensive discussion of psychological
testing and tests.
Freud, S. (1978) New Introductory Lectures. Harmondsworth:

Penguin.
A brilliantly told account of Freudian theory by the
Master himself.
Hall, G.S. and Lindzey, G. (1973) Theories of Personality.

New York: Wiley.
A good stuDmary of a variety of personality theories.
Heim, A. (1970) Intelligence and Personality. Harmondsworth:

Penguin.
This is a basic text, introducing the subject of psycho-
metry. It is entertaining, lively and critical; the
author is determined that her readers should appreciate
that assessment of people in narrow 'compartments' of
thinking is not appropriate.
Vernon, P.E. (1979) Intelligence, Heredity and Environment.

Vernon is well-known for his balanced account of issues
relating to intelligence, its measurement, and social
significance. This is one of the most recent reviews of
topics in the field and is written in a lucid style.
173
7
Knowledge of Self
D. Bannister
Introduction To conclude this part of the book, we turn to consideration

E.N.DUNKIN of the most personal of individuals, the self. If it is
necessary for paramedical workers to be able to relate to
their patients and to have a keen awareness of the persona-
lities and needs of other individuals, it is equally neces-
sary for them to have a reliable appreciation of their own
range of reactions. Given enough time, we can become expert
at knowing our own strengths and weaknesses: given many
years of contact with patients who need physiotherapy,
anyone can build up a sound understanding of the way a
therapist makes the best use of these individual character-
istics in the treatment of those patients. But it will be a
less haphazard process if the business of reaching self-
knowledge, and one's own capacity for responding in a
variety of social settings, is given the benefit of the
years of enquiry that have gone before us.
Don Bannister's chapter needs little introduction:
it presents some challenging issues and invites you, the
reader, to explore these on a personal basis. The topic of
trait examination, which was mentioned in chapters Z and 6,
is discussed in relation to interpretation of the self and
the adjustments we endeavour to make in that self. In the
latter part of his chapter, Bannister emphasizes the social
implications of being an 'individual', considering the vari-
ety of roles that individuals adopt to meet the demands of
changing situations. (A more detailed debate on the indi-
vidual in a social setting follows in Part ill, and the
role of the sick person is considered in Part IV.)
Knowledge of seH Definition is a social undertaking. As a community we

D. BANNISTER negotiate the meaning of words. This makes 'self' a pecu-
liarly difficult term to define, since much of the meaning
we attach to it derives from essentially private experiences
of a kind which are difficult to communicate about and agree
upon. Nevertheless, we can try to abstract from our private
experience of self qualities which can constitute a working
definition. Such an attempt was made by Bannister and
Fransella (1980) in the following terms.
1. Each of us entertaiDs a notion of OUI' own separateness
174
Knowledge of self
from others aDd relies on the essential privacy of our own

cDDllCiowmesa
Consider differences between the way in which you communi-
cate with yourself and the way in which you communicate with
others. To communicate with others involves externalizing
(and thereby blurring) your experience into forms of speech,
arm waving, gift giving, sulking, writing and so on. Yet
communicating with yourself is so easy that it seems not to
merit the word communication: it is more like instant recog-
nition. Additionally, communicating with specific others
involves the risk of being overheard, spied upon or having
your messages intercepted, and this contrasts with our in-
ternal communications which are secret and safeguarded.
Most importantly, we experience our internal communications
as the origin and starting point of things. We believe that
it is out of them that we construct communications with
others. We know this when we tell a lie because we are aware
of the difference between our experienced internal commu-
nication and the special distortions given it before
transmission.
2. We entertain a notion of the integrity and completeness

of our own ezperience in that we believe all parts of it to
be relatable because we are, in some vital sense, the
experience itself
We extend the notion of ME into the notion of MY WORLD.
We think of events as more or less relevant to us. We dis-
tinguish between what concerns and what does not concern
us. In this way we can use the phrase 'my situation' to
indicate the boundaries of our important experience and the
way in which the various parts of it relate to make up a
personal world.
3. We entertain the DOtion of our own continuity over time,

we poaess our biography aDd we live in relation to it
We live along a time line. We believe that we are essen-
tially the 'same' person now that we were five minutes ago
or five years ago. We accept that our circumstances may have
changed and we may have changed in this or that respect,
but we have a feeling of continuity, we possess a 'life'. We
extend this to imagine a continuing future life. We can see
our history in a variety of ways, but how we see it and the
way in which we interpret it is a central part of our char-
acter. Kelly (1955), in arguing against a simple, determi-
nistic view of a person's life, pointed out that you are not
the victim of your autobiography but you may become the
victim of the way in which you interpret it.
4. We entertain a DOtion of ourselves as causes, we have

purposes, we intend, we accept a partial responsibility for
the ccmsequences of our actions
Just as we believe that we possess our life, so we think of
ourselves as making 'choices' and as being identified by our
choices. Even those psychologists who (in their professional
175
Knowledge of self
writing) describe humankind as wholly determined and persons

as entirely the product of their environments, talk person-
ally in terms of their own intentions and purposive acts
and are prepared to accept responsi bili ty, when challenged,
for the choices they have made.
5. We work towards a notion of other persons by analogy

with ourselves; we assume a comparability of subjective
experience
If we accept for the moment the personal construct theory
argument (Kelly, 1955, 1969) and think not simply of 'self'
but of the bipolar construct of self versus others, then
this draws our attention to the way in which we can only
define self by distinguishing it from and comparing it to
others. Yet this distinction between self and others also
implies that others can be seen in the same terms, as
'persons', or as 'selves'. Our working assumption is that
the rest of humankind have experiences which are somehow
comparable with, although not the same as, our own and
thereby we reasonably assume that they experience them-
selves as 'selves'.
6. We renect; we are consciOUS; we are aware of self

Everything that has been said so far is by way of reflect-
ing, standing back and viewing self. We both experience and
REFLECT upon our experience; we summarize it, comment on
it, analyse it. This capacity to reflect is both the source
of our commentary on self and a central part of the experi-
ence of being a 'self'. Psychologists sometimes, rather
quaintly, talk of 'consciousness' as a problem. They see
consciousness as a mystery which might best be dealt with by
ignoring it and regarding people as mechanisms without
awareness. This seems curious when we reflect that were it
not for this problematic consciousness there would be no
psychology to have problems to argue about. Psychology
itself is a direct expression of consciousness. Mead (1925)
elaborated this point in terms of the difference between'!'
and 'me', referring to the'!' who acts and the 'me' who
reflects upon the action and can go on to reflect upon the
'me' reflecting on the action.
It may be that 'self' is one of those terms which is
difficult to define but not so difficult to recognize and
use. It is a term which is obviously complex but one which
arouses immediate and strong echoes in our experience to
which we are able to respond. That we experience life as
individual 'selves' is a truism but it is a truism which can
be explored.
Do we or do we Dot The question 'do you know yourself?' seems to call forth a
know ourselves? categorical yes by way of answer. We know, in complete and
sometimes painful detail, what has happened to us, what we
have to contend with, what our thoughts and feelings are. We
can reasonably claim to sit inside ourselves and know what
176
Knowledge of self
is going on. Certainly, relative to the degree to which we

know other people, we know ourselves very well.
Yet we all have kinds of experience which cast doubt on
the idea that we completely know ourselves. A basic test {in
science and personal life} of whether you understand someone
is your ability to predict accurately what they will do in a
given situation. Yet most of us come across situations where
we fail to predict our own behaviour; we find ourselves
surprised by it and see ourselves behaving in a way we
would not have expected to if we were the sort of person we
thought we were. We have phrases that refer to this kind of
experience= for instance, 'it was not the real me' that did
X, Y or Z. This leaves open the intriguing question of who
it was if it was not the real you. The phrase 'being in two
minds' refers to a confused self.
We also sense that not all aspects of ourselves are
equally accessible to us. There is nothing very mysterious
in the notion of a hidden storehouse. We can confirm it very
simply by reference to what we can readily draw from it. If
I ask you to think about what kind of clothes you wore when
you were around 14 years old you can probably bring some
kind of image to mind. That raises the obvious question;
where was that knowledge of yourself a minute ago, before
I asked you the question? We are accustomed to having a vast
knowledge of ourselves which is not consciously in front of
us all the time. It is stored. It is not a great step to add
to that picture the possibility that some parts of the
'store' of your past may not be so easily brought to the
surface. We can then go one stage further and argue that
although parts of your past are not easily brought to the
surface, they may nevertheless influence the present ways
in which you feel and behave.
The best known picture of this kind of process is the
Freudian portrait of the unconscious. Freud portrayed the
self as divided. He saw it as made up of an id, the source
of our primi tive sexual and aggressive drives; a super-ego,
our learned morality, our inhibitions; and an ego, our
conscious self, struggling to maintain some kind of balance
between the driving force of the id and the controlling
force of the super-ego. Freud argued that the id is entirely
unconscious and a great deal of the super-ego is also uncon-
scious, and that only very special strategies such as those
used in psychoanalytic therapy can give us access to the
contents of these unconscious areas of self. We do not have
to accept Freud's particular thesis in order to accept the
idea of different levels of awareness, but it may well be
that the enormous popularity of Freudian theory is due to
the fact that it depicts what most of us feel is a 'pro-
bable' state of affairs, namely, that we have much more
going on in us than we can readily be aware of or name.
Indeed, if we examine our everyday experience then we
may well conclude that we are continually becoming aware
of aspects of ourselves previously hidden from us. Someone
draws our attention to a kind of gesture we make or a facial
177
Knowledge of self
expression we use and as soon as it is pointed out we real-

ize that it is characteristic of us, although previously it
was unconscious. At a more profound level, we become aware,
with or without the assistance of others, of some overriding
attitude or belief, which has been influencing us for a long
time and which, once we can name and understand it, explains
and links any actions we previously thought of as unconnec-
ted. We become aware of patterns in our behaviour. A great
deal of psychotherapy, education and personal and inter-
personal soul-searching is dedicated to bringing to the
surface hitherto unrecognized consistencies in our lives.
Although there is something of a taboo, in our culture, on
self-examination (which is often seen as a form of unhealthy
self-indulgence) we often reinterpret the meaning of our
life in such a way as to reveal to ourselves long-standing
but hidden features.
Bow do we know ounel.es? There is evidence that getting to know ourselves is a deve-
lopmental process: it is something we learn in the same way
that we learn to walk, talk and relate to others. In one
study (Bannister and Agnew, 1977), groups of children were
tape-recorded answering a variety of questions about their
school, home, favourite games and so forth. These tape-
recordings were transcribed and re-recorded in different
voices so as to exclude circumstantial clues (names, occu-
pations of parents and so forth) as to the identity of the
children. Four months after the original recording the same
children were asked to identify their own statements, to
point out which statements were definitely not theirs and to
give reasons f or their choice. The children's abili ty to
recognize their own statements increased steadily with age,
and the strategies they used to pick out their own answers
changed and became more complex. Thus, at the age of five,
children relied heavily on their (often inaccurate) memory
or used simple clues such as whether they themselves under-
took the kinds of activity mentioned in the statement 'That
boy says he plays football and I play football so I must
have said that'. By the age of nine, they were using more
psychologically complex methods to identify which statements
they had made and which statements they had not made. For
example, one boy picked out the statement 'I want to be a
soldier when I grow up' as definitely not his because 'I
don't think I could ever kill a human being so I wouldn't
say I wanted to be a soldier.' This is clearly a psycho-
logical inference of a fairly elaborate kind. When the
children were asked directly 'How do we come to be differ-
ent?', five-year-old children had no answer to give. Nine
year olds could often provide answers which, though hesi-
tant, suggested they were becoming aware of processes
whereby we become individuals: for example, the argument
that if we like dancing we tend to do a lot of it, and then
we like it even more and become more different from people
who have avoided it. Not surprisingly, though significantly,
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Knowledge of self
children who made statements which were very like the

statements of their peers had more difficulty identifying
their own contributions than more original children. When
all the statements that the children made were classified as
being 'usual' or 'unusual', it was found that the 'unusual'
statements were much more often correctly identified by the
speaker as belonging to them. This underlines the point that
'knowing ourselves' is not simply a matter of some kind of
self-knowledge skill but relates to the issue of what there
is to be known, how much there is about us that is
recognizably original and characteristic.
In the same study an attempt was made to get adults to
ponder the issue of self-identification by asking them to
write down their first memory of becoming aware of them-
selves as individuals. They were asked to write an account
of any childhood experience which significantly contributed
to them developing the feeling of being a separate person,
a 'self'. Interestingly, many of the experiences that were
written about by adults were in no sense happy experiences.
They were often accounts of rejection by others, being lost
and lonely, practising deceit or being in conflict with
others. Yet out of such experiences some notion of 'self'
seemed to have been born.
Obviously, in considering ourselves, we have much mat-
erial to work with. We can look at evidence from a distance
by thinking over our own history: the deeds and misdeeds of
our past. Sometimes this evidence is available to us in pre-
served forms such as diaries, letters written by or to us
long ago, stories told about us by other people, school
reports and all kinds of formal assessments, old photographs
and mementoes. Such sources illustrate both change and
continuity: they give a picture of us over a time line. But
there can be no observation without interpretation. Any
effort we make to understand ourselves and our past, present
and future cannot be simply a question of assembling the
bare facts of our behaviour. Pondering our past involves
theorizing about how changes occur in people and aspects
of ourselves that we need to bring to the surface are our
implicit psychological theories.
Underlying our notions about ourselves and other people
are personal psychological theories which roughly parallel
those put forward in formal psychology.
A common kind of theory is what would be called in
formal psychology a 'trait theory'. Trait theories hinge on
the argument that there are in each of us enduring charac-
teristics which differentiate us from others, who have more
or less of these characteristics. The notion that we or
others are 'bad tempered' is closely akin to the notion in
formal psychology that some people are constitutionally
'introverted' or 'authoritarian' and so forth. The problem
with trait descriptions is that they are not explanatory.
They are a kind of tautology which says that a person be-
haves in a bad-tempered way because he is a bad-tempered
kind of person. This kind of attribution offers little in
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Knowledge of self
the way of ideas about process. Just as, in formal psycho-

logy, trait theorists tend to fall back on ideas of genetic
causality, so in lay psychology we use trait arguments when
we are least able to explain why we are doing what we are
doing.
Environmental and learning theories in psychology have
their equivalents in our everyday arguments about our own
nature. The fundamental assertion of stimulus-response
psychology, that a person can be seen as reacting to his
environment in terms of previously learned patterns of
reponse, is mirrored in our own talk when we offer as
grounds for our actions that it is all 'due to the way I was
brought up', or 'there was nothing else I could do in the
circumstances'. Those theories and approaches in formal
psychology which treat the person as a mechanism echo the
kinds of explanation which we offer for our own behaviour
when we are most eager to excuse it, to deny our responsi-
bility for it and to argue that we cannot be expected to
change. Such approaches tend to distract our attention from
what is going on between us and other people by firmly
lodging 'causes' in either us or the other person. If I say
that I am angry with you because I am 'a bad-tempered per-
son', that relieves me of the need to understand what is
going on specifically between you and me that is making me
angry. Similarly, if I say 'You are a boring person', that
puts on one side the alternative viewpoint which is that
boredom is something that is between you and me, and that
both of us need to be taken into account if we are to
understand what is happening.
Any theory or attempt to explain how we come to be what
we are and how we change involves us in the question of what
kind of evidence we use. Kelly (1955) argued that we derive
our picture of ourselves through the picture which we have
of other people's picture of us. He was arguing here that
the central evidence we use in understanding ourselves is
other people's reactions to us, both what they say of us and
the implications of their behaviour towards us. He was not
saying that we simply take other people's views of us as
gospel. Obviously this would be impossible because people
have very varying and often very disparate reactions to us.
He argued that we filter others' view of us through our view
of them. If someone you consider excessively rash and impul-
sive says that you are a conventional mouse, you might be
inclined to dismiss their estimate on the grounds that they
see everyone who is not perpetually swinging from the chan-
delier as being a conventional mouse. However, if someone
you consider very docile and timid says that you are a
conventional mouse, then this has quite different impli-
cations. You do not come to understand yourself simply by
contemplating your own navel or even by analysing your own
history. You build up a continuous and changing picture of
yourself out of your interaction with other people. You are
influenced by their portrait of you but always in terms of
what kind of painter you think they are. We can make most
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Knowledge of self
sense of ourselves not by thinking simply of self but of

self versus others. Our picture of ourselves is not derived
by sitting in isolation, but is generated by our engagement
with others.
Do we clumge ounelYeS? That we change in small ways seems obvious enough. Looking
at ourselves or others we readily notice changes in pre-
ferred style of dress, taste in films or food, changes in
interests and hobbies, the gaining of new skills and the
rusting of old and so forth.
Whether we change in large ways as well as small in-
volves us in the question of how we define 'large' and
'small' change. Kelly (1955) hypothesized that each of us
has a 'theory' about ourselves, about other people and about
the nature of the world, a theory which he referred to as
our personal construct system. Constructs are our ways of
discriminating our world. For many of them we have overt
labels such as nice-nasty, ugly-beautiful, cheap-expensive,
north-south, trustworthy-untrustworthy and so forth. He also
distinguished between superordinate and subordinate con-
structs. Superordinate constructs are those which govern
large areas of our life and which refer to matters of cen-
tral concern to us, while subordinate constructs govern
the minor detail of our lives. Using this superordinate/
subordinate distinction we can find a way of distinguishing
between major and minor change.
If we take constructs about 'change in dress' at a
subordinate level then we refer simply to our tendency to
switch from sober to bright colours, from wide lapels to
narrow lapels and so forth. If we look at such changes
superordinately then we can make more far-reaching
distinctions. For example, we might see ourselves as having
made many subordinate changes in dress while not changing
superordinately because we have always 'followed fashion'.
Thus at this level of abstraction there is no change because
the multitude of our minor changes are always governed and
controlled by our refusal to make a major change, that is,
to dress independently of fashion. Equally, if we were
changing our preferences for holidays we might go to many
different places and indulge in many different activities
(subordinate change) while always focussing our various
holidays on an abundance of social contact and lots of
mixing with other people, whether this be in a holiday camp,
a ski resort or a pony trekking group. Then, one year, we
might make a superordinate change and switch to having a
holiday walking alone or sitting on a cliff top painting. In
this way we would not simply have changed the detail of our
holiday, while holding constant its central 'social'
character: we would have made a major change.
It can be argued that this discussion of 'activity'
ignores the issue of whether we have changed in our 'char-
acter' or 'personality' or whatever term we want to use when
referring to our personal nature. Here again, we are using
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Knowledge of self
notions such as 'personality' as superordinate constructs to

refer to the cumulative significance of a large number of
subordinate changes in activity. If we see ourselves as
being 'withdrawn' and we see this as actively manifest in
our failure to go to parties and our nervousness of inter-
personal relationships, then a cumulative change in activity
over the years (whereby we slowly come more into contact
with people) would eventually merit construing ourselves as
'outgoing'. Apparently sudden, major changes (e.g. a reli-
gious conversion) often seem on close examination to have
been foreshadowed by earlier minor changes. Direct exami-
nation of personal experience suggests that Kelly may have
been right in referring to 'man as a form of motion and not
a static object that is occasionally kicked into movement'.
Psychologists differ greatly in their view of how much
change takes place in people and how it takes place. Trait
psychologists tend to set up the notion of fixed personality
characteristics which remain with people all their lives,
which are measurable and which will predict their behaviour
to a fair degree in any given situation. The evidence for
this view has been much attacked (e.g. Mischel, 1968).
Psychological measurement, to date, suggests that people
change their character, if only slowly, and have complex
natures so that behaviour is not easily predictable from one
situation to another. Psychologists have also tended to
argue that where change takes place it is often unconscious
and unchosen by the person. The issue of whether we choose
change or whether change is something that happens to us is
clearly complex. One way of viewing it might be to argue
that we can and do choose to change ourselves, but that
often we are unaware of the direction which chosen change
may eventually take.
A person in a semi-skilled job may decide to go to
night-school classes or Wldertake other forms of training in
order to qualify themselves for what they regard as more
challenging kinds of work. They might be successful in gain-
ing qualifications and entering a new field. Up to this
point they can reasonably claim to have chosen their direc-
tion of personal change and to have carried through that
change in the terms of their original proposal. However, the
long-term effect may be that they acquire new kinds of res-
ponsibility, contacts with different kinds of people, new
values and a life style which, in total, will involve per-
sonal changes not clearly envisaged at the time they went
to their first evening class.
On the issue of how we go about changing ourselves,
Radley (1974) speculated that change, particularly self-
chosen change, may have three stages to it. Initially, if we
are going to change, we must be able to envisage some goal
or we must have a kind of picture of what we will be like
when we have changed. He argued that if we have only a vague
picture or no picture at all then we cannot change; we need
to be able to 'see' the changed us in the distance. He went
on to argue that when we have the picture then we can enact
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Knowledge of self
the role of a person like that. That is to say, we do not at

heart believe that we are such a person but we can behave
as if we were such a person, rather like an actor playing a
role on stage or someone trying out a new style. (This may
relate to the old adage that adolescence is the time when
we 'tryout' personalities to see which is a good fit.) He
argued that if we enact in a committed and vigorous way for
long enough then, at some mysterious point, we become what
we are enacting and it is much more true to say that we are
that person than that we are our former selves. This is very
much a psychological explanation, in that it is about what
is psychologically true, rather than what is formally and
officially true. Thus the student who qualifies and becomes
a teacher may officially, in terms of pay packet and title,
be 'a teacher'. Yet, in Radley's terms, the person may still
psychologically be 'a student' who is enacting the role of
teacher, who is putting on a teaching style and carrying out
the duties of a teacher but who still, in his heart of
hearts, sees himself as a student. Later, there may come a
point at which he becomes, in the psychological sense, a
teacher.
What is certain is that most people have enough faith
in the idea of changing themselves to embody the idea in
action. Traditional ventures like making New Year's reso-
lutions, taking up a political cause or changing our envi-
ronment in order to change ourselves, are born of our faith
in the possibility of change. Equally, we have lengthy for-
mal processes, such as education or psychological therapy,
which are based upon the notion of people changing,
developing and elaborating.
However, we are also aware that there is much that
is problematic and threatening about change. The set
expectations of others about us may have an imprisoning
effect and restrict our capacity to change. People have a
picture of us and may attempt to enforce that picture. They
may resist change in us because it seems to them unnatural
and it would make us less predictable. Phrases such as 'you
are acting out of character', or 'that is not the true you',
or 'those are not really your ideas' all reflect the diffi-
culty people find and the resistance they manifest to change
in us. Often the pressure of others' expectations is so
great that we can only achieve change by keeping it secret
until the change has gone so far that we can confront the
dismay of others.
Equally, when we attempt to change we may find the
process personally threatening. We may lose sight of the
fact that change is inevitably a form of evolution: that is
to say, we change from something to something and thereby
there is continuity as well as change. If we lose faith in
our own continuity we may be overwhelmed by a fear of some
kind of catastrophic break: a fear of becoming something
unpredictable to ourselves or of falling into chaos. Whether
or not we are entirely happy with ourselves, at least we are
something we are familiar with and quite often we stay as
PFP _ 1\/ 183

Knowledge of self
we are because we would sooner suffer the devil we know than

the unknown devil of a changed us. Fransella (1972) explored
the way in which stutterers, who seem to be on the verge
of being 'cured' of their stutter, often suddenly relapse.
She argued that the stutterer knows full well how to live as
'a stutterer', and he understands how people react and re-
late to him as a 'stutterer'. Nearing cure he is overwhelmed
with the fear of the unknown, as he comes near to being a
'fluent speaker'.
'Self' in relation to Our view of ourselves is inextricably bound up with our view
'others' of other people. Each of us has some kind of picture of
human nature whereby we explain ourselves and understand
other people. We judge ourselves continuously by comparison
with others and we draw our evidence about what we are like
from the unfolding of our relationship with others. This is
a complicated process since on the one hand we use other
people's reactions to us as evidence of what we are like,
while we also try to influence the views of others to con-
firm our assumptions about our own nature. If you think of
yourself as a 'clean minded' person who does not relish
dirty jokes and you present yourself as such, you will hear
remarkably few dirty jokes. People will respond to you, to a
fair extent, in terms of the implicit rules of relationship
which you have set up.
Interactions within personal relationships can be des-
cribed at two levels. First, there is the question of your
personal role in relationship to others. When you confront
another person you have a picture in your mind of how they
view you. Your behaviour towards them will be guided by this
picture. This does not mean that you will simply do what
they want you to do, but you will try to talk and act in
such a way that your behaviour relates to them and makes
sense to them. Even if you set out to upset them you will
do this in terms of your understanding of them.
Tied to this personal role relationship each of us has a
series of what might be called social roles. For example,
you will see yourself and others will see you as either male
or female, and socially we have come to look on certain
behaviours and attitudes as typically masculine or typically
feminine. Thus you may play out the role of the practical,
competitive, tough male or the sensitive, sympathetic, rela-
tively timid female. Old-young is another social role and
there are behaviours considered appropriate to older and
younger people; a kind of reckless exuberance might be con-
sidered acceptable in a young person, but not necessarily in
an older person, who might be expected to be more sober in
manner. Particular jobs, soldier, parson, stage entertainer
and so forth, have come to have behavioural styles which are
thought fitting and we are puzzled by the randy parson, the
timid soldier or the shy stage entertainer. Fortunately,
since neither individuals nor society are static, we can and
do break out of such social stereotypes.
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Knowledge of self
Our early experience as members of a family teaches us

to negotiate our view of ourselves and other people. From
our family we acquire, at an early age, ideas (conscious or
unconscious) about how we ought to behave and these may
become our picture of what we really are.
All of this is not to argue that we are simply moulded
and brainwashed by our society and our family so that we are
merely puppets dancing to tunes played by others. We are
clearly influenced by others and everything, the language we
speak, the clothes we wear, our values, ideas and feelings,
is derived from and elaborated in terms of our relationships
with other people and our society. But the more conscious
we become of how this happens, the more likely we are to
become critical of and less automatically accepting of what
we are taught (formally and informally), and the more we may
independently explore what we wish to make of ourselves as
persons.
Monitoring of sell One of the marked features of our culture is that it does
not demand (or even suggest) that we formally monitor our
lives or that we record our personal history in the way in
which a society records its history. True, a few keep
diaries and practices such as re-reading old letters from
other people give us glimpses into our past attitudes and
feelings. For the most part our understanding of our past is
based on our often erratic memory of it. Moreover, our
memory is likely to be erratic not just because we forget
past incidents and ideas but because we may actively 're-
write' our history so as to emphasize our consistency and
make our past compatible with our present.
Psychologists have tended to ignore the importance of
personal history. The vast majority of psychological tests
designed to assess the person cut in at a given point in
time, are essentially cross-sectional and pay li ttle heed to
the evolution of the person. It would be a very unusual
psychology course that used biography or autobiography as
material for its students to ponder. There are exceptions to
this here-and-now preoccupation. In child psychology great
emphasis is laid on the notion of 'development', and a great
deal of the research and argument in child psychology is
about how children acquire skills over a period, how they
are gradually influenced by social customs, and how life
within the family over a period of years affects a child's
valuing of himself. Additionally, clinical psychologists
involved in psychotherapy and counselling very often find
themselves engaged in a joint search with their clients
through the immediate and distant past in order to under-
stand present problems and concerns. This does not neces-
sarily argue that a person is simply the end product of
their past. We need to understand and acknowledge our past,
not in order to repeat it but in order either to use it or
to be free of it.
A way of looking at present in relation to past was
suggested by George Kelly (1955) in the form of a self-
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Knowledge of self
characterization. This is a very free form of psychological

'test' primarily used in psychotherapy but obviously not
limited to that context. The client is asked to write a
self -portrai t, much as if he were a character in a play,
but to write this portrait in the third person as if it were
written by a sympathetic friend. Thus it might begin, 'Joe
Smi th is ••• ' and go on to outline the major characteristics
of the person. It is interesting to note for how many people
such an apparently simple task is novel. They find that they
are attempting, for the first time in their lives, to review
'self' in a formal way. Such free-flowing material cannot be
scored in the standard fashion of many psychological tests,
but we can ask a wnole series of questions about a self-
characterization. What is its main theme? Are there contra-
dictions in it (are there sentences which if placed side by
side would appear to be making incompatible claims)? Does
it refer to the view of others or focus entirely on the
person's own concept of himself? How sympathetic is the
'friend' who wrote this characterization? What sort of
notions of psychological cause and effect are implicit in
the self-characterization? And in line with the point we are
making about history, a self-characterization can be studied
to see whether it refers back to the history of the person
and whether the person sees himself as a kind of continuous
evolution, or whether it is cut off from history and simply
refers to the here and now.
A more quantifiable way of enquiring into a person's
view of himself, past, present and future, is repertory grid
technique as devised by Kelly. There are many forms of grid
technique (Fransella and Bannister, 1977), but in a fairly
typical mode the subject is asked to make a series of
judgements about individuals known to him. Thus he may
characterize each of a list of acquaintances as being sel-
fish or unselfish, as being bold or timid, and so forth. At
a very basic level an examination of the way in which the
characterizations correspond or do not correspond will tell
us something about the way in which the person's ideas are
related. For example, if people who are nominated as un-
selfish are mostly nominated as timid, then we can see that
for the person who is completing the grid the notions of
selfishness and boldness are closely related. We can ask the
person completing the grid to characterize his acquaintances
in terms of constructs (adjectives) such as 'like me in
character', 'like I used to be in character' and 'like I
would like to be in character', and then see how these
notions about self relate to each other. For some people,
particularly those who are suffering some form of personal
breakdown, the past and the futUre are both seen as golden
ages and certainly very like each other. The aim for the
future is to achieve again that kind of good, strong charac-
ter which they apparently see themselves as having once
been. The present, 'like I am now' character, is seen as the
weakling. Others see themselves as making a continuous pro-
gress towards an ideal and their present character is seen
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Knowledge of self
as closer to that ideal than their past character. Most of

us have an ideal ('like I'd like to be') which is superior
(in terms of being more marked by morally positive charac-
teristics) to our present state. Quite often there is only a
modest and travellable distance between the two. For others
the ideal is seen as so far away from their present charac-
ter that it must appear to them as fantasy rather than plan.
The doctrine that we should learn from our past requires
that our past be accessible to us. It may be that psycho-
logists should take up more seriously the question of bio-
graphy and offer ideas and ways in which people might
explore their history.
Obstacles to self- To try and understand oneself is not simply an interesting

knowledge aud self-cbaDge pastime, it is a necessity of life. In order to plan our
future and to make choices we have to be able to antici-
pate our behaviour in future situations. This makes self-
knowledge a practical guide, not a self -indulgence. Some-
times the situations with which we are confronted are of a
defined and clear kind so that we can anticipate and predict
our behaviour with reasonable certainty. If someone asks you
if you can undertake task X (keep a set of accounts, drive
a car, translate a letter from German and so forth) then it
is not difficult to assess your skills and experience and
work out whether you can undertake the task or not. Often
the choice, the undertaking, is of a more complex and less
defined kind. Can you stand up in conflict with a powerful
authority figure? Can you make a success of marriage to this
or that person? Can you live by yourself when you have been
used to living with a family? The stranger the country we
are entering the more threatening the prospect becomes; the
more we realize that some degree of self-change may be
involved, the more we must rely upon our understanding of
our own character and potential.
In such circumstances we are acutely aware of the dan-
gers of change and may take refuge in a rigid and inflexible
notion of what we are. Kelly (1955, 1969) referred to this
tendency as 'hostility'. He defined hostility as 'the con-
tinued effort to extort validational evidence in favour of a
type of social prediction which has already been recognised
as a failure'. We cannot lightly abandon our theory of what
we are, since the abandonment of such a theory may plunge
us into chaos. Bannister (1977) described this situation in
the following terms.
We can recognise the plight of the scientist who has

made a considerable personal and professional investment
in his theory, but who is faced by mounting piles of
contradictory evidence. He may well recognise the fail-
ure of his expectations in the immediate sense, i.e.
that what he has predicted in a particular experiment
has not happened. What he may be unable to recognise
and accept is the overall implication that a series of
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Knowledge of self
such mispredictions negates his total theory. His in-

vestment may be too great, his lack of an alternative
theory too oppressive and he may proceed. to cook the
books, torment his experimental subjects and bully his
co-scientists in a desperate attempt to maintain a dying
theory. All of us have experienced this situation per-
sonally. Clearly hostility is not simply 'a bad thing'.
Sometimes we cannot readily afford to abandon a belief.
If the belief is central to our way of viewing ourselves
and others and if we have no alternative interpretation
available to us, then it may be better to maintain that
belief for a while, by extorting validational evidence,
rather than abandon the belief and plunge into chaos .••
We can recognise hostility readily when we witness
someone destroying their relationship with someone else
in order to 'prove' that they are independent. We see it
in the teacher who has growing doubts of his/her own
cleverness and therefore begins to bully his/her stu-
dents into stupidity so that his/her superiority as a
teacher is demonstrated. The whole conception of the
nature of change and resistance to change implied in the
idea of hostility recalls the traditional philosopher's
model which compares the problem of life to the problem
of rebuilding a ship while at sea. If we have to rebuild
our ship while sailing it we obviously do not begin by
stripping out the keel. We use the strategy of removing
one plank at a time and rapidly replacing it so that,
given good fortune, we may eventually sail in an en-
tirely new ship. This kind of conception is particularly
important in areas of deliberately undertaken change,
such as psychotherapy, education, religious and
political conversion.
Closely connected to this definition of hostility is Kelly's

definition of guilt as 'the awareness of dislodgement of
self from one's core role structure'. Core constructs are
those which govern a person's maintenance processes; they
are those constructs in terms of which identity is estab-
lished, the self is pictured and understood. Your core role
structure is what you understand yourself to be.
lt is in a situation in which you fail to anticipate
your own behaviour that you experience guilt. Defined in
this way guilt comes not from a violation of some social
moral code, but from a violation of your own personal
picture of what you are.
There are traditional ways of exploring the issue of
'what am I like'. We can meditate upon ourselves, ask
others how they see us, and review our history. Psycho-
logists have devised numerous tests for assessing 'persona-
lity', though insofar as these are of any use they seem to
be designed to give the psychologist ideas about the other
person rather than to give the people ideas about them-
selves. Two relatively recent attempts to provide people
with ways of exploring their own 'personality' are offered
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Knowledge of self
by McFall (in Bannister and Fransella, 1980) and Mair

(1970) .
McFall offers a simple elaboration on the idea of talk-
ing to oneself. He suggested that any person (this is a
lonely exercise: there is no psychologist about) can get a
tape-recorder and simply switch it on and think aloud, talk-
ing into it for about lO minutes and pouring out thoughts
freely without any attempt to make them logical or give them
a fixed topic. At the end of the lO minutes the person plays
back that tape-recording and then starts recording again,
this time going for a longer period, at least an hour. The
person plays back that tape-recording, two or three times
if they wish. Finally (and this is the absolute rule for the
exercise) the person erases the whole of the tape so that no
record is left. The purpose of the first lO-minute period
of talking aloud and then playing it back is to remind the
person that there is no audience and therefore no need to
censor, edit or tamper with their thoughts in order to make
them acceptable to someone else. The absolute rule (the
erasing of the tape) means that there can be no future
audience, not even the person himself. Most people who have
tried this exercise report that the first 20 minutes of talk
sounded odd when they listened to it because they became
aware that they were to some extent posturing and leaving
out thoughts which might have embarrassed them if others had
heard them. The effect of listening to it was to raise ques-
tions of the order 'who am I kidding, since the here-and-now
"me" is the only audience this tape will ever have'. The
effect of noticing this was to make the long run which fol-
lowed a more uninhibited pouring out of thought and feeling.
The exercise is simple but curiously novel, in that we may
often talk to others and even to ourselves but it is rela-
tively unusual for us to listen to ourselves. By listening
we may detect some of the kinds of themes, concerns, fears
and preoccupations that are edited out of our normal talk to
others and which flow too fast for us to catch in the usual
process of thinking.
Mair (1970) was preoccupied with the question of people
using each other as evidence. He began by pointing out that
our most commonly used method of psychological investigation
is conversation and he wondered if there was any way of
formalizing conversation so that we can explore how we see
others and how we are seen by them. Can we use a conver-
sational model (rather than a 'physics' model) in profes-
sional and lay psychology? He proposed a simple exercise
which can have many forms but at its most elementary in-
volves two people working in something like the following
manner. X writes a character sketch of Y, a description of
how he sees Y, which he is prepared to let Y read. One rule
is that this sketch must be designed to be helpful. That is
not to say that it will be devoid of criticism, but that it
is designed to be something the other person can understand,
draw from and accept. Y writes a similar sketch of X, and
we can refer to these as the public portraits. X then writes
189
Knowledge of self
a sketch of Y which he is not prepared to let Y peruse,

which X will keep to himself. Y writes a similar private
portrait of X. Finally, X writes a prediction of the kind of
things he thinks Y will say about him and Y similarly writes
a prediction of the kinds of things he thinks X will say
about him. The pair then exchange their public portraits of
each other and discuss them. The discussion can be wide
ranging, but should cover at least the question of the
meaning of the words in the portrait. It is one thing to
be called 'sensitive' if you think this means artistic and
perceptive and quite another thing to be called 'sensitive'
if you learn that, for the person who used the word, it
means nervous and timid. Second, the discussion should range
around the question of evidence: what kinds of evidence,
what kinds of behaviour, what kinds of style has the other
person observed which leads them to the conclusions which
are set out in the public portrait? The private portraits,
by definition, are not given to the other person but if you
have in front of you your public portrait and your private
portrait of the other person, then the difference between
the two, the discrepancies, may give you some indication of
the nature of the relationship between you and the other
person. Predictions about the other's public portrait can
(if the pair so wish it) be discussed and such a discussion
would obviously focus on the issue of why some of the
predictions were accurate and others were misconceived.
Although we have formal ways of exploring how we see
and how we are seen by others (the encounter group) and
informal ways (the party), it can be argued that there is
something of a taboo in our society on direct expression of
our views of each other. It may be that we fear to criticize
lest we be criticized, it may be that we are embarrassed by
the whole idea of the kind of confrontation involved in
telling each other about impressions which are being
created. Certainly if you contemplate how much you know
about the way you are seen by others, you may be struck by
the limitations of your knowledge, even on quite simple
issues. How clear are you as to how your voice tone is ex-
perienced by other people? How often do you try and convey
to someone your feelings and thoughts about them in such an
oblique and roundabout way that there is a fair chance that
they will not grasp the import of what you are saying?
Psychologists are only vel'y slowly seeing it as any part
of their task to offer ways to people in which they may
explore themselves and explore the effect they have on
others.
Role aDd penon Social psychologists have made much use of the concept of
'role'. Just as an actor plays a particular role in a drama,
it can be argued that each of us has a number of roles in
our family, in work groups and in our society. We have
consistent ways of speaking, dressing and behaving which
reflect our response to the expectations of the group around
190
Knowledge of self
us. Thus within a family or small social group we may have

inherited and developed the role of 'clown' or 'hard-headed
practical person' or 'sympathizer'. Jobs often carry im-
plicit role specifications with them so that we perceive
different requirements in the role of teacher from the role
of student or the role of manager from the role of worker.
Society also prescribes very broad and pervasive roles for
us as men or women, young or old, working class or middle
class and so forth. It is not that every word of our scripts
is pre-written for us, but the broad boundaries and charac-
teristics of behaviour appropriate to each role are fairly
well understood. These social roles can and do conflict with
personal inclinations and one way of defining maturity would
be to look on it as the process whereby we give increasing
expression to what we personally are, even where this
conflicts with standard social expectations.
Kelly chose to define role in a more strictly personal
sense in his sociality corollary which reads: 'to the extent
that one person construes the construction processes of
another he may playa role in a social process involving the
other person'. He is here emphasizing the degree to which,
when we relate to another person, we relate in terms of our
picture of the other person's picture of us. Role then
becomes not a life style worked out by our culture and
waiting for us to step into, but the on-going process
whereby we try to imagine and understand how other people
see the world and to relate continuously our own concept to
theirs.
In these terms we can see our notion of ourselves as
part of, and intimately bound up with, our personal psycho-
logical theory. Psychological theories about the nature of
humankind are obviously not copyright to professional
psychologists but a necessary part of the outlook of each
person. If we take the view that people are simply the
products of external conditioning by their environment or
are simply the automatic working out of their genetic
inheritance, then this must affect our way of viewing
ourselves, unless we care to think that we are entirely
exceptional and unlike the rest of the human race. If, on
the other hand, we think of people as creative, inventive
and purposeful, then we can see ourselves as in many ways
self-invented and we can see changes in ourselves as being
part and parcel of our purposes.
The paradO% of We reasonably assume that our knowledge of something

self-knowiDg does not alter the 'thing' itself. If we come to know that
Guatemala produces zinc or that the angle of incidence of
a light ray equals its angle of reflection, then this new
knowledge of ours does not, of itself, affect Guatemala or
light. However, it alters us in that we have become 'know-
ing' and not 'ignorant' of these things. More pointedly, if
we come to know something of ourselves then we are changed,
to a grea ter or lesser degree, by that know ledge. Any
191
Knowledge of self
realization by a person of the motives and attitudes under-

lying their behaviour has the potential to alter that
behaviour.
Put another way, a person is the sum of their under-
standing of their world and themselves. Changes in what we
know of ourselves and the way in which we come to know it
are changes in the kind of person we are.
This paradox of self-knowledge presents a perpetual
problem to psychologists. An experimental psychologist may
condition a person to blink his eye when a buzzer is
pressed, simply by pairing the buzzer sound with a puff of
air to the person's eyelid until the blink becomes a res-
ponse to the sound of the buzzer on its own. But if the
person becomes aware of the nature of the conditioning
process and resents being its 'victim' then he may not con-
dition at all, or at least take much longer to condition.
The person's knowledge of what is going on within him and
between him and the psychologist has altered the person and
invalidated the psychologist's predictions. Experimental
psychologists seek to evade the consequence of this state of
affairs by striving to keep the subject in ignorance of the
nature of the experimental process or by using what they
assume to be naturally ignorant subjects, such as rats. But
relying on a precariously maintained ignorance in the ex-
perimental subject creates only a mythical certainty in
science. Psychotherapists, on the other hand, generally work
on the basis that the more the person (subject, patient,
client) comes to know of themselves, the nearer they will
come to solving, at least in part, their personal problems.
This self-changing property of self-knowledge may be a
pitfall for a simple-minded science of psychology. It may
also be the very basis of living, for us as persons.
References Bmmister, D. (ed.) (1977)

New Perspectives in Personal Construct Theory. London:
Academic Press.
Bmmister, D. and Agnew, J. (1977)
The Child's Construing of Self. In A. W. Landfield (ed.),
Nebraska Symposium on Motivation 1976. Nebraska:
University of Nebraska Press.
Bmmister, D. ;mel Franse11a, F. (1980)
Inquiring Man (2nd edn). Harmondsworth: Penguin.
Franse11a, F. (197Z)
Personal Change and Reconstruction. London: Academic
Press.
Franse11a, F. and Bamdster, D. (1977)
A Manual for Repertory Grid Technique. London: Academic
Press.
Kelly, G.A. (1955)
The Psychology of Personal Constructs, Volumes I and ll.
New York: Norton.
Kelly, G.A. (1969)
Clinical Psychology and Personality: the selected papers
of George Kelly (ed. B.A. Maher). New York: Wiley.
192
Knowledge of self
Yair, J .Y.M. (1970)

Experimenting with individuals. British Journal of
Medical Psychology, 43, 245-256.
Mead, G.B. (1925)
The Genesis of the Self and Social Control.
International Journal of Ethics, 35, 251-273.
Mischel, W. (1968 )
Personality and Assessment. New York: Wiley.
Radley, A.R. (1974)
The effect of role enactment of construct alternatives.
British Journal of Medical Psychology, 47, 313-320.
Questicms 1. Discuss the problem of defining 'self'.

2. Examine the way in which a person's idea of 'self' is
affected by the nature of their work.
3. Discuss the nature of sex differences m ideas about
'self' •
4. How can we 'keep track' of ourselves?
5. What does Kelly mean by 'hostility'? Give examples.
6. Outline one theory of 'self' you have read about.
7. Describe some way in which you have increased knowledge
of self.
8. Comment on Radley's idea of change through role
enactment.
9. Outline Freud's picture of self as made up of id, ego
and super-ego.
10. How would you go about teaching a course in 'self-
knowledge'?
11. How do parents influence their children's ideas about
'self'?
12. To what extent is our picture of our self influence" by
our physical state and appearance?
13. Some institutions require their staff to meet regularly
and formally to discuss how their personal differences
affect their work. Is this a good idea?
14. We come to understand ourselves through our relationship
with others. Discuss.
15. Examine the way in which social customs inhibit our
revealing of 'self'.
16. Self is just a product of our environment. Discuss.
17. People are born with a fixed character which they cannot
alter. Discuss.
18. Adolescence is the time when we experiment with self.
Discuss.
19. Write an essay on 'roles'.
20. Can psychologists measure personality?
21. What, in your view, are the main hindrances of self-
knowledge?
22. Write an essay on 'guilt'.
23. 'He is not himself today.' What triggers off this kind
of comment, and does it say more about the speaker than
the person of whom it is said?
24. How can we go about changing ourselves?
193
Knowledge of self
25. What idea about 'self', proposed by anyone (psycho-

logist, poet, friend or whatever) has impressed you
most? Why?
26. Your family teaches you what to think of yourself.
Discuss.
27. Your job enables you to express yourself. Your job
prevents you being yourself. Discuss.
Amlotated reading Axline, Virginia M. (1971) Dibs: In search of self.

A finely written description of a withdrawn and
disturbed child who in the process of psychotherapy
comes vividly to life. It casts light on our early
struggles to achieve the idea of being a 'self'.
Bannister, D. and Fransella, F. (1980) Inquiring Man: The

psychology of personal constructs. Harmondsworth: Penguin.
The second edition of a book which sets out the way
George Kelly sees each of us as developing a complex
personal view of our world. The book describes two
decades of psychological research based on the theory
and relates it to problems such as psychological
breakdown, prejudice, child development and personal
relationships.
Bott, M. and Bowskill, D. (1980) The Do-It-Yourself Mind

Book. London: Wildwood House.
A lightly written but shrewd book by a psychiatrist on
the ways in which we can tackle serious personal and
emotional problems without recourse to formal
psychia try.
Fransella, F. (1975) Need to Change? London: Methuen.

A brief description of the formal and informal ways in
which 'self' is explored and change attempted.
Rogers, C.R. (1961) On Becoming a Person. Boston: Houghton

Mifflin.
Sets out the idea of 'self-actualization' and describes
the ways in which we might avoid either limiting
ourselves or being socially limited and come to be what
Rogers calls a fully functioning person.
194
Part three
Social and Time Factors
in Life
195
8
Social Development in Early
Childhood
H. R. Schaffer
Opening remarks In the discussions so far, we have emphasized the pervasive

E.N.DUNKIN human activity of sorting and fitting into categories the
objects, events and people that contribute to the diversity
of external environments. Given that the scope of psychology
is so great that we had difficulty finding an agreed defini-
tion of it, it should come as no surprise that psychology
itself can be divided into a large number of specialities
and that psychologists come in a wide variety of types, de-
pending on the bias of their investigations. The special-
ities can be recognized by the way in which they:
* reflect a particular theoretical approach;

* concentrate on specific processes and activities;
* adopt particular species for study.
These three major ways of dividing specialities are inter-

linked and it is easy enough to identify and quote examples
of them. A sample from the first of these might include
behavioural psychology, experimental psychology, physio-
logical psychology and social psychology. In the second
category the processes and activities may be grouped under
such headings as motivation, perception, learning, linguis-
tics, etc. The third category is broadly divisible into two,
dealing with human and sub-human species, and the latter has
many further subdivisions with clear demarcations between
types of creatures (e.g. primates, birds, fish, small
quadrupeds, insects, etc.).
That each of the three major categories is not exclusive
is demonstrated by taking examples of the work of particular
psychologists such as B. F. Skinner, who began his study of
behaviour with animals and animal training, and subsequently
extended his theory and observations to include language
acquisition by children. Whatever his subscription to one or
more of our three major categories, a psychologist may show
a fUrther division of interest: it is possible to look at
the adult creature as it is or look at adults in the making.
Presumably, in the first case, the investigator is content
to observe and describe, being satisfied with the status quo
of his subject, while in the second case, observation and
description is tempered by an explicit curiosity, a quest
for a description of how it came to be as it is. Intuitive-
ly, the second alternative seems more stimulating: taking
197
Social development in early childhood
this hint of greater exploration, the next section of the

book is concerned with the way the individual is modified by
age and experience. In doing this, we follow the development
of some of the adult behaviours that have been specified in
the earlier chapters.
The iluti:ridual in a time From general observation, people know that their fellow
cUmenaiOll human beings change with time as well as in response to
differences in their circumstances. Developmental studies
pay exact attention to these changes, following the periods
of a person's life from conception to death, and exploring
the notable features of pre-natal, natal and post-natal
experience. Within this complete time scale, specialists
concentrate on behaviours that occur in infancy, childhood,
adolescence and old age. Psychologists are not alone in
making these distinctions: they share these broad chrono-
logical divisions of their clients with physicians, surgeons
and psychiatrists. Physical and mental disorders are
recognized and grouped by age incidence.
Since the most logical place to start in any time di-
mension is at the beginning, our first area of enquiry is
'childhood', where the child is certainly seen in a time
scale but he is also studied from the point of view of
his reactions to other people. This forges a link between
'the individual' of Part n of the book and the social
interactions that provide the theme for Part m. We inves-
tigate the beliefs and reasoning of the child, and the stra-
tegies which he develops in order to manage the unavoidable
interactions between himself and his surroundings.
The theories of Freud have been introduced in earlier
chapters, and whether one agrees with all the details of
these theories or not, his contribution to our understanding
of the relationships between the bodily needs and the
emotional needs of a small human being cannot be denied.
Another psychologist who made a single-minded and detailed
contribution to the body of knowledge about children was
Jean Piaget, who was the Director of the Institut Jean-
Jacques Rousseau in Geneva for 60 years. His studies were
totally committed to discovering the kinds of 'imperfect'
reasoning that occur in children and which regularly come
before the type of reasoning that we expect from mature
adults. Not everyone agrees with him: many people are in-
clined to disapprove of what he claimed to have found, on
the basis that his explorations were limited to one culture
and, within that culture, to a particular socio-economic
climate. The debate on the acceptability of his theories
continues, but there can be no doubt that the continuous
research in Geneva has generated an equally continuous
series of attempts to replicate or to disprove his findings,
with the net result that our understanding of the 'special
world of children' has more fact and less fantasy than it
showed before Piaget proposed his interpretations of the
development of cognitive abilities.
198
The work of Piaget and The names of Piaget, and of his colleague Inhelder, are
lDhelcler synonymous with a tightly-delineated ideology on the
SEQUENCE in which children develop reasoning and think-
ing that is 'adult' in type. What they tell us is that the
child's WAYS of thinking are very different from our own
and that it is possible to demonstrate the differences by
setting problems for children to solve. The ways in which
children of various ages deal with such problems can be
interpreted in terms of the concepts that the adult observer
detects, either by asking the child who can talk to explain
what he is doing or by making painstaking observations of
the reactions that a child makes in a novel situation even
before he can talk.
The Institut in Geneva has close links with the schools
and pre-schools of the city and Piaget seems to have had
access to a very large sample of children over the years.
However, it is worth noting that his main theory was con-
structed from the basic observations he made of his own
children: the sequence of developmental stages that he
noticed and described in the 1920s has not changed, although
a never-ceasing series of investigations has consistently
led him to claim that this sequence is invariable, despite
differences in immediate cultural and social settings. He
did not claim that the sequence has an absolute age rela-
tionship; some children may be slower than others in reach-
ing the recognizable levels of development. Nevertheless,
all children will pass through the stages in the same order.
Stages of cognitiye These may be roughly related to the age of the child, but
deyelopment Piaget always stressed that it is unwise to assume that each
child will have completed a particular stage of development
by a certain age. He frequently indicated that in some
cases, adults fail to reach the final stage of reasoned
thought. There are four clearly defined periods:
* sensori-motor period, with a suggested duration of 18

months;
* pre-operational period, lasting from approximately 18
months to 4 years;
* concretely operational period, lasting for a longer
period and marked by gradual change over the years from
5-12;
* formal operational period, extending from 12 years to
maturity which is possibly reached by the age of 18.
Seuorillotor period
In the first of these periods, the child has no inner
thought processes by which it can represent the world.
Piaget believed that the new-born child has no imagery and
that a primitive form of imagery develops between the second
and fourth years of life. The child's thought processes
start by figuratively 'bringing actions inside' him, and the
child's ability to engage in intellectual thought increases
199
as these internalized actions are gradually liberated from

their original reliance on sensory appreciation and motor
activity.
Pre-operatioaal period
During this period, the child learns to name things and to
match these names with the images he is making of the world.
Questions from the child seem to the adult to be unceasing,
and the child learns to understand the things he is told to
do, although this does not guarantee that he will do as he
is told. He becomes increasingly adept at issuing orders of
his own, which meet with varying success. Throughout the
period from two to twelve years the child's ability to use
language makes it progressively easier for him to build up a
multitude of concepts which serve him as he tries to make
an organized interpretation of the world.
Concrete operatioaal period

In this stage, the child will use and manipulate concrete
objects if he is given a physical problem to solve. This is
typical of the five- to seven-year-old child and Piaget used
ingenious problem situations to demonstrate the child's use
of concrete operations. For example, if the concrete opera-
tional child is shown two groups of six objects, one group
arranged so that all six are close together and the other
arranged so that they are spread over a larger area, he can
decide that there are the same number of objects in each
group if he is allowed to handle them and rearrange them so
that both groups take up the same amount of space.
Formal operatioaal period

When the child has passed through all the other stages of
cognitive development, he finally moves on to constructing
abstract ideas which make it feasible for him to arrange and
rearrange his impressions of the world without having to go
through the 'real thing'. His language skills and vocabulary
enable him to exchange ideas with other people.
General ideas of cbildren Once children can talk, the observer can find out some of
and their wOI'ld the ideas that they use to justify the events that happen
around them. In the long period leading to concrete opera-
tions, the child's conception of causality, space and time
show progressive transformation. Early in this period, the
child believes that all moving things are 'alive'. This is
equally true for him whether he is justifying the movements
of the sun and moon, or of a patch of grass swaying in the
wind. This quality of being alive is not confined to the
occupants of the sky and fields: bicycles, cars and trains
are also thought to be alive and able to feel things hap-
pening to them. As this first animistic stage gives way to a
more accurate explanation of moving things, children see the
adults in their lives as the organizers and controllers of
all that is going on. Their parents are the most powerful
200
people of all, they know about everything and they manage

to be everywhere. It is suggested that the child's eventual
disillusionment on the matter of his parents' control of the
world leads him to search for a replacement 'power' and sets
the stage for the development of a conception of God as the
creator.
Piaget referred to this pre-operational style of explana-
tion and thought as 'egocentric'. The child is isolated from
the ideas and opinions of older people by his firm belief
in the ones he has developed for himself. He is virtually
trapped in his own interpretation of the world, which exists
primarily because it belongs to him. Since he believes that
the whole thing is fixed and immutable, he is not too keen
on making lengthy explanations of what is going on. Piaget
suggested that this is because the child fully expects that
everyone else thinks as he does, so there is no need to
explain his experiences. Essentially, the world is related
TO HIM and he expects it to maintain that relationship. This
can be demonstrated if you ask a five- or six-year-old child
at the outset of a walk where his home is: he will duly
point to the door behind him, probably with a certain amount
of surprise that a grown-up person needs to ask such an
obvious question. Later, when he is on his way back from the
walk, the same question will be given the same answer; the
child will point to a spot BEHIND him (i.e. to the position
which his home had relative to him when be left it), even
though he has turned round and is now walking back towards
it. Eventually, and nearing the end of the pre-operational
period, the child's concepts are transformed. The governing
thought that this world has a constant relationship TO HIM
is replaced by the more appropriate idea that the charac-
teristics of objects have a constancy of their own.
Repeatedly, Piaget demonstrated that young children have
no idea that the mass of a lump of plasticine remains the
same despite alterations in its shape, until they have been
through the earliest part of the period of concrete opera-
tions. Neither do they realize that the volume of a certain
amount of fluid remains the same whatever the shape or size
of the container it is put into. When Piaget asked children
to make judgements about these 'constancies', he used very
familiar materials and containers, to reduce the possibility
of distorting the children's reactions. For example, he let
a child watch him fill two glasses of the same shape with
milk and he made sure that the child agreed that there was
the same amount of milk in each glass. Then, with the child
still watching, he poured the milk from one of the glasses
into an unusually tall, thin glass container, being very
careful not to spill any of the milk. In answer to Piaget's
question 'Is there the same amount of milk in the tall glass
as there is in the shorter one?', the pre-operational child
would say that there was more milk in the taller glass,
whereas the concrete operational child was satisfied that
the amounts must be the same, since they were judged to be
the same in the first place.
ZOl
It is at points like these that some people do not

accept all of Piaget's findings or have cause to question
his methods. Does the younger child give an answer that
adults consider incorrect because he is unable to grasp the
meaning of the words used by Piaget? Or was Piaget not
giving the words used by the child the meaning that they
have for the child? Piaget claimed that the younger child
cannot deal with the width and the HEIGHT of the container
at the same time: that the child is not only unaware of the
interactions of these dimensions, but he is also unaware of
the conservation of the material. At least one further in-
terpretation is available if we return to the child's style
of egocentric thinking that we were discussing earlier. The
pre-operational child is aware of an identity, a self, but
he interprets this as being 'contained' by the surrounding
world. If the child extends this idea of 'being contained'
to other material things, he may be judging THE AMOUNT
OF SPACE LEFT in the glass, rather than either its height
or its width. Should this be the case, his answer that there
is 'more milk' in the tall, thin glass would be a correct
reflection of his judgement that the milk left less empty
space in the glass! In fact, it is impossible to decide
whether the child is making accurate judgements as we do not
shar~ his ideas on the world in general nor his concepts of
measurement in particular. Whatever one believes about the
exact explanations he offers, there is no doubt that Piaget
emphasized that children and adults have a far from perfect
basis for verbal communication until the child has adopted
the 'grown-up' meaning for words such as 'more', 'less' and
'the same'. If there are problems with these comparisons we
may reasonably expect that our use of language and that of
children varies on many other scores.
Another way of explaining the inability of the younger
child to manage some of the problems set by Piaget depends
on the idea that memory span and ability to concentrate seem
to become greater as the child develops. This offers the
possibility that the younger child is unable to deal with
the complications of some of the questions he is asked
because he cannot 'hold' the necessary information long
enough in his head (short-term memory). Either he has a
shorter memory span than an adult or he takes longer to
carry out the mental processes that the problem demands.
There is room for debate on this question, and we return to
the topic of memory in chapter 11.
In his detailed studies, Piaget confronted children of
different ages with similar problems of conservation and he
regularly observed a sequence in which children become con-
fident about the solutions. Conservations of quantity and
number are gained in the early part of the concrete opera-
tional period (around the age of five), and conservations of
weight al'ld volume follow, one after the other, as the child
reaches seven or eight years of age. In his interpretations
of space, the child learns to adjust his ideas about size so
that he is able to estimate the relative measurements of an
202
object in terms of its distance from him. In other words,

the perceptions that he makes on the basis of his original
information about objects are modified to take account of
the changes that occur in distance. Similar 'allowances' are
made by the child when the lighting of an object alters its
absolute visibility or colour. As the child moves nearer to
the adult style of perception, he makes increasing use of
the knowledge he is building up about the world: this pro·-
cess shows the combination of two elements that Piaget
identified as 'accommodation' (in which the child makes
adaptive changes to his outer world) and 'assimilation' (in
which the child incorporates the facts from his outer world
into his internal organization, and learns the art of gener-
alizing his rules to serve novel si tuations). Referring to
the quality of experience, Piaget commented that 'the more
an infant has seen and heard, the more he later wants to
see and hear'. It is worth considering that this statement
has a familiar ring: it echoes the Skinnerian principle of
reinforcement that makes operant conditioning so effective.
Despite great differences in approach, it is reassuring to
note that many psychologists eventually reach similar
conclusions.
Similarities between the By the time the child has reached the level of formal
formal operatioaal child operations, he is capable of making and holding logical
aDd adult propcsitions about the world, and the problems it presents,
in his head. This is equally true whether he is asked to
carry out a mathematical process such as multiplying one
number by another (mental arithmetic), or whether he is
searching for the correct way to combine some colourless
liquids in orner to produce a coloured one. Before the
formal operational period, a child will tackle the latter
problem by deciding to set one of the liquids aside and to
combine each of the other liquids with it, one at a time. He
will not see all the other possibilities of combination. The
formally operational child will not only detect the whole
range of possible combinations: he will probably plan the
entire experimental routine and be able to dp.scribe what he
is going to do, without actually touching any of the mat-
erials. In other words, the formally operational child has
the potential for setting up a truly scientific investi-
gation and of appraising his efforts. His skill in making
use of his own ability to organize and plan his activities
will improve with practice but his style of thinking is
comparable with that of the mature adult.
We leave this introduction to the work of Piaget with
some questions we would like you to consider.
Did Piaget offer a true description of all early human
development, or a study of the way in which the cultural and
educational trends of the western world continue to deter-
mine the intellectual development of its children?
In other words, is the regularity of the sequences he
observed a natural phenomenon or an artifact of the social
203
pressures that have given simihrities of family and school

in many parts of Europe and America?
It is only fair to add that other psychologists, such as
Bruner, acknowledge much of Piaget's work but consider that
it is possible to teach a child anything as long as it is
presented in the idiom that the child is using at the time,
whereas Piaget believed that it is useless to try to teach a
child certain mathematical concepts until he has acquired
the concept of conservation of number. (For details of
Bruner's educational principles, see J. S. Bruner, 1964:
The course of cognitive growth', in American Psychologist,
19, 1-15.)
The incIi.idual in a A complement to the cognitive development of a child is his

social dimension social development. While he is moving steadily towards
adult competence in planning the strategies he needs for
solving the sort of problems that Piaget used in his studies
(i.e. problems related to mathematics, physics and chemis-
try), he is also becoming more efficient in adjusting his
talking, gestures and general behaviour so that he can make
friends and enjoy satisfactory social exchanges. The next
section, on social development, stresses the fact that
success of one-to-one social interaction is dependent on the
capacity of each person to notice, and to make allowances
for, the needs and responses of the other.
In adult social exchanges, this sensitivity must be
accompanied by an appropriate willingness to forfeit the
immediate realization of some of one's own plans in order to
avoid ignoring or suppressing the hopes of the other person
in the relationship. From the limitations imposed by his
early 'egocentric' thinking, the child begins to develop the
'other-centred' thinking which he is going to need in later
life.
In this chapter, Schaffer traces the details of social
progress from infancy onwards.
Introduction Child development is one of the fastest growing fields of

H. R. SCHAFFER psychology. In the last few decades a considerable body of
knowledge has accumulated regarding the nCl.ture of develop-
ment from conception onward. As a result we know quite a
lot about how children behave at various ages; we are also
beginning to disentangle the much more difficult question as
to the causes of behaviour: that is, why children behave as
they do.
There are two basic reasons why psychologists study
children. In the first place they want to investigate the
nature of development: to discover what it is that accounts
for the helpless, naIve, and totally dependent new-born baby
becoming in due course a competent, knowledgeable adult
capable of such skills as language, creative thought, and
forming relationships with other people. The second reason
stems from the many social problems associated with child-
hood: in today's rapidly changing society especially
204
questions continually arise as to the 'right way' of bring-

ing up children. Should we protect children from viewing
violence on television? Are children of mothers who go out
to work more likely to become delinquents? Does hospitali-
zation in the early years produce later difficulties? How
can one mitigate the effects of divorce on children? Why
do some parents become baby batterers? Increasingly the
psychologist is asked to examine these and many other such
problems and produce answers useful to society. It is pri-
marily to this aspect of child psychology that we pay
attention here.
Let us first of all distinguish two ways of tackling the
problems of child rearing. One is represented by the advice-
givers, the professional experts, from Dr Spock onwards.
Their large number - as found on radio and television, on
bookshelves and in the women's magazines - is a striking
feature of today's society and is surely a response to the
considerable uncertainty which parents feel about their
task. But however well-intentioned and experienced these
advice-givers may be, we have to recognize that their
statements generally reflect only their personal opinions
and prejudices, and rarely the results of systematically
carried out research investigations. Take the question of
the mother going out to work. In the last 30 or 40 years
there has been a dramatic increase in the number of women
taking up employment, and this has included a large number
of those with young children. Are such children harmed
thereby? A heated debate has raged around this question,
often carried out at a 'some cases I have known' level.
Experience of individual cases may well provide a useful
insight, but the numbers involved are generally few, they
may well be atypical, and the conclusions are usually based
on subjective impressions. No wonder different people then
arrive at different answers. Contrast this with the second
way in which such problems may be tackled: that is, with the
approach of the social scientist. Care will be taken to
select a reasonably large and representative sample of
working mothers and their children; this will be compared
with a group as similar as possible except that the mothers
are not at work; and both groups will be assessed by means
that, as far as possible, will eliminate the influence of
any subjective biasses that the investigator may have. If,
moreover, several studies of different groups all arrive at
the same conclusion, one is justified in having faith in
their findings. This is indeed what has happened in this
case: comparisons of the children of working and non-working
mothers have generally shown no differences between them:
in some cases, for example, when the child is in some form
of suitable day care, the children of working mothers may
even have gained from their increased opportunities of
contact with other children and adults.
By the use of methods such as these child psychology
is gradually accumulating knowledge about the factors that
playa part in furthering or, alternatively, holding back
children's development. In this chapter we examine this
205
knowledge, with particular reference to the child's social

development in the early years.
The c:bild's soc:ializatiOD. How a child develops depends to a quite large extent on the
people around him. From them he learns the skills and values
needed for social living: from the use of knives and forks
to knowing the difference between right and wrong. Other
people are always near the child, influencing him by example
and command, and none more so at first than the members
of his own family. On them depend the initial stages of his
socialization.
DisadYaDtaged children aDd their families

It is, of course, only too apparent that not every family
carries out its socializing task with equal effectiveness.
By way of illustration, let us look at the way in which the
child's intellectual development is shaped by his social
environment.
We have long ago given up the idea that intelligence is
entirely determined by an individual's innate endowment and
not at all influenced by the circwnstances of his own life.
Studies of infants brought up in grossly depriving institu-
tions have drawn attention to the powerful effect a child's
environment may exert on his development. Such a child,
reared in conditions that provide him with little stimula-
tion through play and social interaction, may progressively
deteriorate and, irrespective of his original endowment, end
up grossly retarded. With improvements in such features as
the staff-child ratio of the institution and the introduc-
tion of a more stimulating regime, the child's deterioration
can be halted and even be reversed.
Less dramatically but on a more extensive scale, a
similar phenomenon has been described in relation to school
failure. In the United States in particular, increasing con-
cern came to be expressed a nwnber of years ago regarding
the large nwnber of children, generally from the economi-
cally and socially most deprived sectors of the community,
who are at a severe disadvantage when first starting school.
Such children (as someone once put it) 'have learnec' not to
learn'. Their failure in the education system, in other
words, is ascribed not so much to some genetic inferiority
as to factors operating in the home which result in an
inability to make use of whatever intellectual capacities
they have.
A great many schemes have been launched to counter this
situation. Some of the early 'Operation Head Start' experi-
ments, designed to give children some extra training in
basic cognitive skills before school entry, were clearly
inadequate. Whatever effects such one-shot inoculations
produced were of short duration and soon disappeared. This
is partly because the schemes were too brief, partly because
they were started too late in the child's life, but partly
also because they were directed at the child alone and left
Z06
untouched the home situation. Given a conflict of values

about education between home and school it is highly likely
that the home will win. It is therefore significant that
more recent efforts have been directed· at much younger
children (some schemes starting even in infancy) and that
they have attempted to involve the parents as well as the
child, or even to work solely through the parents.
There is now Ii ttle doubt that parents can enhance or
suppre:ss the child's educational potential. The question is
how they do so. Work by Basil Bernstein has indicated
language use to be one of the main factors that differen-
tiate the mothers of various social groups and that may well
be implicated in shaping children's intellectual develop-
ment. Not only are there social class differences in the
style of language adopted (at least for the English mothers
studied by Bernstein), but some American work has also shown
that mothers from disadvantaged homes engage in face-to-face
talking with their infants less frequently and for shorter
periods than middle-class mothers. The child from a poor
family may live in extremely noisy surroundings, where the
overcrowded conditions and the constant blare of radio or
television might appear to provide him with far more
linguistic stimulation than is the case for the middle-class
child in his quiet suburban home. Yet to profit from stimu-
lation the young child must be exposed to it under the
intimate, personalized, challenging conditions that only the
to-and-fro reciprocity of a face-to-face situation can
provide, and it is in this respect that many children from
deprived backgrounds are at a disadvantage.
Child effects OIl adults

We must not now jump to the conclusion that the development
of children is totally a matter of what parents do to them,
and that the child is merely a passive organism wholly at
the mercy of those around him. Socialization would then
become a kind of clay-moulding process: the child, that is,
arrives in the world as a formless lump of clay and society,
as represented by mothers and fathers and other authority
figures, proceeds to mould him into whatever shape it
desires. The end product could then be wholly explained in
terms of the actions of these people, and if by chance this
product turned out to be undesirable it would be entirely
the responsibility of the socializing agents.
Such a view is misleading. How parents bring up their
child is not just a matter of their own ideas, preferences
and predispositions; it depends also on the nature of the
child, which from the very beginning can exert a definite
influence on how the parents treat him. Even the very
youngest baby is already a psychologically active being,
with demands which he has no hesitation in making known and
peculiarities to which other people must adjust. He brings
these demands and peculiarities to even the very earliest
encounters with others, whose behaviour towards him he will
thereby affect.
Z07
Take an obvious example: babies cry and thereby draw

attention to themselves. They may not yet be able to speak
and so call the mother by name; they may not yet be capable
of walking and so fetching the mother to help. However,
nature has equipped them with a very powerful device that
will influence from the very beginning both the amount and
the timing of attention which others provide. It is a sound
that can have a most compelling effect on the adult: we have
all heard of the mother who can sleep through a thunder-
storm, but is immediately awoken by her child's whimper in
the next room. What is more, there are several quite dis-
tinctive types of cry, signalling hunger, anger and pain
respectively. Mothers can distinguish these, and the last in
particular tends to arouse them to immediate action. The
baby, that is, initiates the interaction; he can also main-
tain it by use of another powerful device, namely the smile,
which mothers generally find so delightful that they will
want to remain with the child.
Another illustration of children's influence on parents
comes from the markerl differences that exist in the beha-
viour of even quite yOlmg babies. Some are highly active and
restless, others quiet and content; some are sensi tive and
liable to be upset by the slightest change in routine,
others are emotionally robust and easy:"'going. The kind of
care provided for one is therefore inappropriate for
another, and any sensitive mother will therefore find her-
self compelled to adopt practices suitable for her indivi-
dual child. A good example is provided by babies' differ-
ences in 'cuddliness'. N at all babies love being held and
cuddled: some positively hate it and resist such contact by
struggling and, unless released, by crying. It has been
found that these 'non-cuddlers' tend to be much more active
and restless generally, and to be intolerant of all types of
physical restraint (as seen when they are being dressed or
tucked into bed). Their behaviour with the mother is thus an
expression of a general disposi tion and has Ii ttle to do
with the way in which the mother has been handling the
child. The mother, however, is forced to treat her child in
a manner that takes into account his 'peculiarity': when
frightened or unwell these children cannot be comforted by
being held close, but have to be offered other forms of
stimulation such as bottles, biscuits or soothing voices.
Each mother must therefore show considerable flexibility in
adjusting to the specific requirements of her child.
There is one further, and perhaps unexpected, example
one can quote of the way in which parents are influenced by
their children. It concerns the phenomenon of baby bat-
tering, which has attracted so much attention in recent
years. It is by no means a new phenomenon: historically
speaking, it is probably as old as the family itself, and
there are indeed indications that in previous centuries the
killing of young children (and especially of new-born
infants) was far more prevalent than it is today. What is
new is public concern that such a thing can happen, and this
zos
in tum has given rise to the need for research into such
cases. As a result of various investigations it is now
widely agreed that violence results from a combination of
several factors: the presence of financial, occupational and
housing problems facing the family; the paren ts' emotional
immaturity which makes it difficult for them to deal with
such problems; their social isolation from potential sources
of help such as relatives and neighbours; and, finally, some
characteristic of the battered child that singles him out as
a likely victim.
It is the last factor that is particularly relevant to
us, for it illustrates once again that the way in which
parents treat their children is influenced by the children
themselves. There is evidence that children most likely
to be battered are 'difficult': they are more likely to be
sickly, or to have been born prematurely, or to have feeding
and sleeping problems. Being more difficult to rear they
make extra demands that the parents are just not able to
meet. The child's condition acts on the parent's inadequacy,
and so the child, unwittingly, contributes to his own fate.
Mother-c:bild mutuality
It is apparent that children do not start life as psycho-
logical nonentities. From the beginning they already have an
individuality that influences the adults around them. Thus a
mother's initial task is not to create something out of
nothing; it is rather to dovetail her behaviour to that of
the child.
Such dovetailing takes many forms. Take our previous
example of the non-cuddlers. Such a child demands a parti-
cular kind of contact that might well not tally with the
mother's own preferences. After all, she too has certain
requirements of her own which she brings to the relationship
and wishes to fulfil therein; if, however, she has a pre-
ference for close physical contact with the baby which the
latter then rejects, some mutual readjustment will need to
take place. This cannot happen if the mother rigidly insists
on providing her child with a type of stimulation that he is
unable to accept. Fortunately most mothers quickly adjust
and find other ways of relating to the child. It is only
when they are too inflexible, or interpret the baby's
behaviour as rejection, that trouble can arise from a
mismatch.
Mutual adjustment is the hallmark of all interpersonal
behaviour; it can be found in even the earliest social
interactions. The feeding situation provides a good example.
Should babies be fed by demand or by a rigid, pre-determined
schedule? Advice by doctors and nurses has swung fashion-
wise, sometimes stressing the importance of exerting disci-
pline from the very beginning and of not 'giving in', at
other times pointing to the free and easy methods of primi-
tive tribes as the 'natural' way. In actual fact each mother
and baby, however they may start off, sooner or later work
out a pattern that satisfies both partners. On the one hand,
209
there are few mothers who can bear to listen for long to a
bawling infant unable as yet to tell the time; on the other
hand, one should not under-estimate the ability of even very
young babies to adjust to the demands of their environment.
An example is provided by an experiment, carried out many
years ago, in which two groups of babies were fed during the
first ten days of life according to a three-hour and a four-
hour schedule respectively. Within just a few days after
birth each baby had already developed a peak of restlessness
just before the accustomed feeding time, and this became
particularly obvious when the three-hour group was shifted
to a four-hour schedule and so had to wait an extra hour for
their feed. In time, however, these babies too became
accustomed to the new timetable and showed the restlessness
peak at four-hourly intervals. We can see here a form of
adaptation to social demands that must represent one of the
earliest forms of learning.
When one examines in detail the manner in which feeding
proceeds, yet other kinds of mutual adjustment become clear.
Feeding is, of course, not a one-sided task like shovelling
coal into a boiler, for the baby has an active say in deter-
mining just how things proceed. Babies suck in bursts, with
pauses in between: a rhythmic form of behaviour controlled
by inborn mechanisms in the brain. Mothers need to adjust
their own behaviour to this rhythm. As detailed film ana-
lyses of bottle- or breast-feeding sessions have shown, they
do so by being generally quiet and inactive during bursts;
during pauses, on the other hand, they jiggle, stroke and
talk to the baby, thereby setting up a kind of dialogue in
which the partners take it in turns to be actor and spec-
tator. Thus the mother allows herself to be paced by the
baby, fitting in with his na.tural sucking pattern, respon-
ding to his signals such as ceasing to suck, and accepting
the opportunity to intervene offered by his pauses. At the
same time the baby too shows that he has learned about the
mother's patterning by, for instance, responding to the end
of her jiggling with resumed sucking. A to-and-fro thus
occurs from which both parties may gain satisfaction.
Not surprisingly, the major responsibility for mutual
adjustment lies initially with the adult. The degree of
flexibility one can expect from very young children is
limited. Yet the fact that they are involved in social in-
teractions from the very beginning of life means that they
have the opportunity of gradually acquiring the skills
necessary to become full partners in such exchanges. Obser-
vations of give-and-take games with babies at the end of the
first year have made this point. Initially the baby knows
only how to take: he has not yet learnt that his behaviour
is just one part of a sequence, that he needs to take turns
with the other person, and that the roles of the two parti-
cipants are interchangeable (one being a giver, the other a
taker). Such and other rules of behaviour he will learn in
time; they form the basis for much of social intercourse,
and it is through social intercourse that the child acquires
them in the first place.
2.10
Socialization is sometimes portrayed as a long drawn-out

battle, as a confrontation between wilful young children
and irritated parents that must at all cost be resolved in
favour of the latter. Goodness knows such battles occur, yet
they are far from telling us everything about the process of
socialization. There is a basic mutuality between parent and
child without which interaction would not be possible. The
sight of the mother's face automatically elicits a smile
from the baby; that produces a feeling of delight in the
mother and causes her in turn to smile back and to talk or
tickle or pick up, in this way calling forth further res-
ponses from the baby. A whole chain of interaction is thus
started, not infrequently initiated by the baby. Mother and
child learn about each other in the course of these inter-
actions, and more often than not mutual adjustment is
brought about by a kind of negotiation process in which both
partners show some degree of flexibility. On the mother's
part, this calls for sensitivity to the particular needs and
requirements of her child which is an ingredient of parent-
hood that we return to subsequently; on the child's part, it
refers to one of the most essential aspects of social living
that he must learn early on.
Some ccmditioaa that If the environment in which a child is reared can have
foster development marked effects on him, it is necessary to learn how this is
brought about. We need to identify those factors in the
child's experience that promote mental health and social
integration in order then to try and eliminate whatever
obstacles there may be to the child's optimal development.
And if this smacks of social engineering, it is in fact none
other than the strategy so successfully used in the field of
physical health. Any action taken to identify and eliminate
the causes of infant mortality, tuberculosis or polio needs
no defence; any action required to get rid of deprivation,
maladjustment and antisocial behaviour is similarly
justified.
Let us admit immediately that we are still woefully
ignorant as to what the factors are that bring about
inadequate or undesirable development in children. It is
easy to make guesses and put all the blame on not enough
parental discipline, too much violence on television, the
declining influence of religion, the social isolation of
today's family, too much pocket money ••• the list of
favourite explanations could go on for a long time yet. It
is, however, much more difficult to substantiate the
influence of anyone factor, for to produce research
findings sufficiently credible to form the basis for social
action is a long and painful process. There are, neverthe-
less, some conclusions to which we can point.
The blood-bcmcI: myth or reality?

Is it essential, or at least desirable, that children should
be brought up by their natural parents? Is a woman who
211
conceived and bore a child by that very fact more fitted to

care for this child than an unrelated individual?
This is no academic question. Children have been removed
by courts of law from the foster parents with whom they had
lived nearly all their lives and to whom they had formed
deep attachments, in order to restore them to their bio-
logical mother from whom they may have been apart since the
early days of life, and all because of the 'blood-bond'. Yet
such a thing is a complete myth. There is nothing at all to
suggest that firm attachments cannot grow between children
and unrelated adults who have taken over the parental role.
The notion that the biological mother, by virtue of being
the biological mother, is uniquely capable of caring for her
child is without foundation.
Were it otherwise, the whole institution of adoption
would be in jeopardy. Yet there is nothing to suggest that
adoptive parents are in any way inferior to natural par-
ents. In a study by Barbara Tizard (to which we refer
again), children who had been in care throughout their early
years were followed up on leaving care. One group of child-
ren was adopted, another returned to their own families. It
was found that the latter did less well than the adopted
children, both in the initial stages of settling in and in
their subsequent progress. The reason lay primarily in the
attitudes of the two sets of parents: the adoptive group
worked harder at being parents, possibly just because the
child was not their own. There have been a good many studies
which have examined the effects of adoption, and virtually
all stress the high proportion of successful cases to be
found. And this can happen despite the difficulties such
children may have had to face, such as problems in the pre-
adoption phase and the knowledge gained later on of the fact
of their adoption. Successful parenting is a matter of
particular personality characteristics that need to be
identified, not of 'blood'.
Fatben as parents: mare myths?

Men go out to work and eam a livelihood; women stay at
home and look after the children. Such division of labour is
clear-cut and traditional. It suggests that women are speci-
fically fitted for child care and that they, not men, should
be encouraged to devote themselves to this task.
The facts of modern family life tell a different story.
Over the last few decades men have increasingly come to
participate in the care of their children. They push prams,
change nappies and give bottles to their babies. They are
no longer the stern and distant figures that Victorian
writers such as Freud depicted. And with increasing unemp-
loyment it is no longer uncommon to find families in which
a complete role reversal has taken place: mother, having
found a job, goes out to work, leaving her unemployed
husband in charge of home and children. Fortunately there
is no evidence to indicate that the biological make-up of
men makes them unfit for this task or even, necessarily,
ZIZ
inferior to women in this respect. Parenting is unisex; the

reasons for the traditional division of labour (such as the
need to breast-feed the child and the importance of using
men's greater physical strength for hunting and tilling the
fields) are no longer applicable.
A father's prolonged absence from a family (because of
military service, for instance) can produce some harmful
effects on a child. A number of studies have described
these, with particular reference to the absence of a model
for a boy to imitate. Whether sex-appropriate behaviour is
indeed acquired through such imitation remains controver-
sial; on the other hand, the need for the often onerous task
of parenting to be shared is widely agreed upon. We have
here one of the reasons why the children of single-parent
families can be so vulnerable, for the remaining parent
must cope with a great multiplicity of stresses: financial,
occupational and emotional. This applies particularly when
the single-parent status is due to illegitimacy, desertion,
divorce or death. In nearly all these cases it is still
mostly the woman who is left holding the baby. If one then
finds ill-effects in the children it is usually very diffi-
cult to single out the particular factors that brought these
about: the absence of the father, or any of the other
concomitant stresses.
Nevertheless, there is one respect in which the father-
less child is usually deprived, and that is the opportuni ty
early on to diversify his social relations. We have long ago
given up the idea that social development can be explained
in terms of the mother-child relationship alone. On the
contrary, the child needs to be provided with other rela-
tionships that will increasingly acquaint him with the
complexities of the social world. The very fact that he has
two parents helps him to learn from the start that not all
people are alike and that he must adapt his own behaviour
according to their different characteristics and different
demands upon him. A child isolated with his mother and
caught up in one all-encompassing relationship does not have
the same chance of learning this vital lesson, and his
social development may well be impoverished thereby. It is
in this sense, more than any other, that fathers matter in
the early years.
Parenthood: full-time or part-time?

In the early 19505, as a result of a report drawn up by John
Bowlby, people became aware of the harmful effects that
maternal deprivation might bring about. The children in whom
these effects had been found were mainly those who had spent
a large part of their childhood in institutions or had suf-
fered long-term hospitalization: an experience that we look
at in a later section. However, in the years following
Bowlby's report, the idea that children require continuous
mothering was taken to an extreme which Bowlby himself never
implied. There were many parents, as well as professional
workers and public authorities, who thought it was the
213
mother's duty to stay with her child night and day, 2.4 hours
on end, throughout the pre-school years. As a result,
mothers felt guilty if they left the child for just an
afternoon; a halt was called to the expansion of nursery
school facilities; and a propaganda drive to declare mother-
ing a full-time total commitment was launched in order to
save the mental health of young children. But is such a
commitment really necessary or even desirable?
We can look at this situation from both the mother's and
the child's point of view. As far as mothers are concerned,
a crucial consideration is the recent finding of an extreme-
ly high incidence of depression among house-bound women.
This applies particularly to working-class women, and is
associated with such factors as the lack of a close rela-
tionship with the husband, having three or more children
under the age of 14 at home, and not being employed. In
short, these women suffer from being isolated. On the other
hand, as the Court Committee on the future of the Child
Health Services made clear in its 1976 report, mothers who
go out to work are less likely to suffer from depression,
anxiety and feelings of low self-esteem. And yet 'the sad
truth is that our society has in no way come to terms with
this social fact nor tried to use the opportlmity it could
afford through day care and education to improve the qu~lity
of services for children'.
As far as the children are concerned, there is some
evidence that those remaining at home during the pre-school
years with their depressed mothers are more likely to be
developmentally delayed in functions such as language, as
well as being emotionally more vulnerable. In general (as we
mentioned earlier on) children of mothers going out to work
do not suffer adverse effects. However, an important proviso
concerns the quality of their care. For one thing, there is
a need for consistency: a young child always being left with
different people is likely to become bewildered and upset.
And for another, we have the enormous problem of illegal
childminders looking after an estimated 100,000 children in
Britain. According to recent findings, the quality of care
provided by such childminders is only too frequently of an
unsatisfactory nature, being marked by ignorance and neglect
that in some cases can be quite appalling.
However, officially provided facilities such as nursery
schools often do have beneficial effects, both intellec-
tually and socially. The intellectual effects have been of
most interest in relation to children from deprived back-
grounds. Despite some earlier doubts, it is now becoming
clear that compensatory schemes such as Operation Head Start
in the United States can be successful in improving child-
ren's educational progress. They are even financially worth
while, in that they save the need for subsequent expensive
remedial action. As to effects on social development, there
has been some concern that day care might in some way
'dilute' the child's attachment to the mother and danger-
ously weaken this basis for security. The most recent
214
evidence does not support this view: a daily period away

from the mother need not impair the relationship; fostering
the tie between mother and child is not a 24-hours-a-day
activity.
One undoubted advantage for the child's social develop-
ment which day care does usually bring with it is the oppor-
tunity to play with other children. This important topic
deserves a separate section.
Re1atioaships with other children

Until quite recently child psychologists paid little atten-
tion to this aspect. This was partly, once again, due to the
idea that no relationship matters other than that with the
mother. It was partly also because of the idea (originl111y
put forward by Piaget, the influential Swiss psychologist)
that children are totally self-centred in the early years,
to the extent that they are incapable of playing with others
in any significant way.
A closer look at children's groups has shown this to be
manifestly untrue. Children as young as one year can meaning-
fully interact with one another: usually briefly, sometimes
violently, but already in a manner very different from the
'parallel play' that was supposed to be the only joint acti-
vity of which young children are capable. The form which
these interactions take rapidly becomes more and more com-
plex: given the opportunity, children will soon acquire the
great variety of social skills that playing with others
demands. Thus, hy the age of four, children are already
capable of taking turns in reciprocal games like hide-and-
seek, of holding a question-and-answer conversation, of
helping or providing comfort, and many other such ingredi-
ents of the ability to relate to another person.
The opportunity of regular experience with other child-
ren has two sorts of effect. The first takes us back to a
previously mentioned point: the importance of diversifying
social behaviour. The more a child is encouraged to adapt to
a variety of other individuals, the more his repertoire of
social skills will grow. Learning that an aggressive, self-
assertive playmate needs to be handled differently from a
quiet, shy one is the kind of lesson that may be most useful
for survival.
The second effect concerns the socializing influence of
other children. The values and ideals children acquire do
not all come from their parents; from middle childhood on
especially, but also earlier, the peer group can exert a
considerable influence. This may happen in some cultures
more than in others: the Soviet Union, for instance, lays
great stress on techniques of collective upbringing; as a
result, it has been claimed, Russian children develop a
concern for others and a sense of community at quite an
early age. In the Israeli kibbutz system the peer groups
play an even greater role in the child's socialization:
though not surprisingly, for the child is part of the group
from birth, having all along spent the major portion of his
215
daily life in the communal nursery rather than in the family

home. Yet even in our culture peer influence is marken: on
choice of clothes, musical taste, and television viewing;
but also on racial prejudice, religious beliefs, and
delinquency.
Seasitive and iuseasitive parents

A child's development does not take place in a vacuum; it
occurs because the people responsible for his care carefully
and sensitively provide him with the kind of environment
that will foster his growth. They do so not only by such
conscious decisions as to what toys to buy for Christmas or
which nursery school to send him to, but also quite uncon-
sciously by the manner in which they relate to him.
Take the language which adults use in talking to a
child. This is in many ways strikingly different from
language addressed to other adults: in fact it constitutes a
quite distinctive style of address which has recently been
given the horrible label 'mother ese' • The characteristics of
motherese are not just a restricted vocabulary, but also a
considerably simplified grammar, a great deal of repetition,
a slowing down of speech, a high pitch of voice, and the use
of special intonation patterns. Not only mothers but most
adults, confronted by a young child, will quite uncon-
sciously adopt this style. What is more, the younger the
child the more marked are the features of motherese. If one
films mothers talking to their babies and then plays back
the film in slow motion, one can see clearly what highly
exaggerated gestures and facial expressions mothers use in
this situation, as though they are trying to ensure that the
child attends and continues to attend to them. Their vocal
phrases are greatly slowed down, with long pauses in be-
tween, as though they are making allowance for the fact that
the child can absorb only a limited amount of information at
a time. The mothers, that is, appear to be highly sensitive
to the abilities and requirements of the particular child
and are continously adjusting their input to him to ensure
that he can assimilate it. It is believed that the child's
task of learning language is made easier thereby.
Such examples of quite unconscious sensitivity in rela-
ting to children are numerous. They occur all the time: in
the feeding situation, when (as we have seen) the mother
makes sure that her stimulation does not clash with the
baby's bursts of sucking; during mutual play, when the
mother carefully adjusts the speed and the manner with which
she offers the baby a toy in the light of his still uncer-
tain skills in reaching and grasping; or even when the child
is merely sitting on the mother's knee and looking around
him, and she quite automatically follows the direction of
his gaze in order then to share his interest. In relating to
their children mothers do not arbitrarily descend on them
bolt-out-of-the-blue fashion; they mostly take the child's
own interests, abilities and on-going activities as their
starting point, in order then to provide him with the
'right' kind of stimulation.
216
Sensitivity is the capacity to see things from the

child's point of view, to be aware of his requirements and
to be able to respond to them appropriately. There are
indications that it is an essential part of helping a child
to develop. Children brought up in institutional environ-
ments, in which they are all treated the same and where care
is never personalized, become developmentally retarded. Most
adults quite naturally display sensitivity in their contacts
with children. Unfortunately (as social workers so often
find out to their cost), some parents seem to be devoid of
this vital part of parenting. Why this is so we still do not
know for certain. It does seem, however, that parents who
themselves had a depriving childhood and did not experience
sensitive care are more likely to show the same attitude to
their own children. Case work, counselling, and educational
programmes may be measures that need to be employed for
the sake of short-term solutions in such families. In the
long-term, however, it is essential for us to find out far
more about the conditions that foster or hinder parental
competence.
Are the early years That children need to be studied for their own sakes re-
'special'? quires no justification. If we are to provide better methods
of child care and education it is imperative that we find
out precisely how children at particular ages and stages
function and how their behaviour is affected by the various
kinds of social environments that adults create for them.
Childhood is therefore of interest because of concern for
the child per se.
There is, however, another reason for this interest,
namely the fact that children become adults. A widespread
belief exists that experience in childhood, and particularly
so in the earliest years, has a crucial formative influence
on later personality, that the child is father to the man,
and that what happens to him early on will in some way mark
him for the rest of his life. It follows from such a belief
that the earliest years are more important than subsequent
years and that special care needs to be taken during this
period to protect the child against experiences that might
well leave their irreversible imprint on him. The idea that
the very young child is particularly vulnerable may seem
plausible, but what is the evidence?
The influence of cbild-rearing practices

It is easy to assert that early experience is important, but
the problem is in fact a complex one. What sort of experi-
ence? How early? Important in what way?
More than any other individual, Freud had attempted to
provide answers to these questions. Children, he suggested,
pass through a series of phases (oral, anal, genital) during
which they are specially sensitive to certain kinds of
experience. During the or al phase, for example, the baby is
mainly concerned with activities such as sucking, chewing,
swallowing and biting, and the experiences that matter to
217
him most are those that impinge on these activities. These

include the extent to which his need to suck is gratified,
whether feeding is timed according to his own requirements
or some pre-arranged schedule, whether weaning is gradual
and late or sudden and early, and so on. When these experi-
ences are congenial to the child he passes on to the next
developmental phase without difficulty; when they are frus-
trating and stressful, however, he remains 'fixated' at this
stage in that, even as an adult, he continues to show
characteristics such as dependence and passivity in his
personality make-up that distinguish babies at the oral
stage.
Freud's theory therefore suggests that there are defi-
nite links between particular kinds of infantile experiences
on the one hand and adult personality characteristics on the
other. If borne out, such a theory would help to explain why
people's personali ties can differ so dramatically; what is
more, it would enable parents to choose among particular
infant-care practices should they wish to foster a parti-
cular kind 0 f personality in their child.
The theory, however, has not been borne out. A large
number of investigations have compared breast-feeding with
bottle-feeding, self-demand with rigidly scheduled regimes,
early with later weaning, and other aspects of the child's
early experience that could be expected to produce lasting
after-effects. No such effects have been found. The sum
total of these investigations adds up to the conclusion that
specific infant-care practices do not produce unvarying
traces that may unfailingly be picked up in later life.
Whatever their impact at the time, there is no reason to
believe that these early experiences mark the child for good
or ill for the rest of his life.
And just as well! Were it otherwise we would all be at
the mercy of some single event, some specific parental
aberration, that we happened to have encountered at some
long-distant point in our past. Freud's theory made little
allowance for the ameliorating influence of later experi-
ence, yet the more we study human development the more
apparent it becomes that children, given the opportunity,
are able to recuperate from many an early misfortune. Let
us consider some other examples that make this point.
Maternal deprivation
The biologist Konrad Lorenz once suggested that the young
of certain species, such as chicks and ducklings, are able
to form a lasting attachment to the parent animal only
during a quite specific critical period in the earliest
stage of development. They do so by merely being with the
parent for a few crucial hours; if they miss this opportu-
nity and have no contact with the parent during the criti-
cal period they are unable ever again to form attachments.
There are many who have generalized Lorenz's findings
to human beings, believing that the child too goes through
a period (albeit a more extended one) during which he must
ZIB
be with his mother if he is to develop the ability to form

affectionate relationships with other people. Deprived of
a relationship with a mother-figure at that time, such an
ability will never develop. This view was most clearly
formulated by Bowlby, whose 1951 report reviewed the evi-
dence on the after-effects of maternal deprivation. This
evidence, he believed, showed that children in institutions,
long-stay hospitals, and other such impersonal settings,
where they had no opportunity to form a continuous and
emotionally meaningful relationship with one specific mother
figure, showed various pathological characteristics in
subsequent years. The main syndrome of these after-effects
was labelled by Bowlby as 'affectionless character', refer-
ring to the inability of the individual to make anything but
highly superficial relationships with other people, be it
with wife or husband, children, friends or colleagues. In
short, the child became like Lorenz's isolated duckling: he
had missed out on a vital experience, namely being mothered,
and as a result was mentally crippled for life.
Bowlby's theory suggests a definite link between early
experience and later pathology. A continous loving relation-
ship with the mother in the early years is necessary if the
child is to become capable of forming meaningful bonds with
other people. We need to learn to love, and can only do so
in the context of a secure relationship with a mothering
person. Bowlby was, moreover, quite specific as regards the
age range within which this had to occur, proposing that the
first two and a half years constitute the critical period in
which the bond with the mother has to be formed. If for any
reason (such as prolonged hospitalization or being in care)
this does not take place at that time, no amount of good
mothering subsequently can remedy the situation. The child
is condemned to become an 'affectionless character'.
There is no doubt about the tremendous influence on
the practice of caring for children that Bowlby's ideas have
had. And no wonder, for so many children are thereby impli-
cated. Take the annually issued statistics on children in
care: in England and Wales more than 100,000 children were
in care in 1978, representing some 7 per 1,000 of the esti-
mated population under the age of 18. In Scotland the pro-
portion was even greater, being approximately 11.5 per 1,000
children. Not all these children are, strictly speaking,
'maternally deprived' (some even continue to live at home,
though under the supervision of the local authority). Never-
theless, many have suffered the kind of disruption in family
life that Bowlby regarded as pathogenic. The same applies to
hospitalized children: here, too, a considerable proportion
of the childhood population is affected by the traumatic
separation from the mother to which Bowlby drew attention.
Anything that can be done to improve the lot of so many
children is therefore worth considering, and there is no
doubt that in the last two decades a great deal has been
done. Children's institutions have become less impersonal
with the introduction of family group systems; there is
219
greater emphasis on fostering children with ordinary fami-

lies; and, most important, far more stress is placed on
prevention and keeping children with their own parents.
Similarly, the psychological care of children in hospitals
has improved greatly during this period: visiting by parents
is nowhere near as restricted as it was at one time; mother-
baby units make it possible for parents to stay with their
children; and again the emphasis on prevention means that
rather more thought is now given to the need to admit the
child in the first place.
Anyone who has ever seen a young child separated from
his mother and admitted, say, to a strange hospital ward,
where he is looked after by strangers and may be subjected
to unpleasant procedures like inj ections, knows the extreme
distress that one then finds. It is perhaps difficult for an
adult to appreciate the depth of a child's panic when he has
just lost his mother: a panic that may continue for days and
only be succeeded by a depressive-like picture when the
child withdraws into himself from a too painful world.
Parents also know only too well about the insecurity which
the child shows subsequently on return home, even after
quite a brief absence, when he dare not let the mother out
of sight. There is no doubt about these dramatic short-term
effects, and for their sake alone the steps taken to
humanize procedure have been well worth while.
Far more problematic, however, is the question of long-
term effects: that is, the suggestion that periods of pro-
longed maternal deprivation in the early years impair the
child's capacity to form interpersonal relationships. What
evidence we have here suggests that things are not as cut
and dried as Bowlby indicated, and to make this point we can
do no better than to tum to the report by Barbara Tizard to
which we have already referred.
Tizard investigated the development of children who had
spent all their early life in institutions. All had origin-
ally been admitted to care in the early weeks of life, and
all were reared in children's homes which provided them with
good physical care but with no opportunity to form any
stable attachments to any adult. Indeed, by the age of two
these children had been looked after by an average of 24
different people: by four and a half years they had had as
many as 50 different mother-figures. In their social
behaviour these children were, not surprisingly, totally
indiscriminate.
At varying ages, but mainly beyond the end point of
Bowlby's critical period of two and a half years, some of
these children were adopted. One might have expected them
by now to be so marked by their earlier experience that they
were incapable of forming ties to their adoptive parents:
to show all the irreversible signs, in other words, of the
affectionless character. Yet this proved not to be the case.
Nearly all these children developed deep attachments to
their adoptive parents, and this included even a child
placed as late as seven years of age. Compared with a con-
trol group of normally reared children the adopted group did
220
show a number of aberrant symptoms, such as poor concen-

tration at school and being over-friendly with strangers.
There was no indication, however, that the inevitable
outcome of their earlier upbringing was the 'affectionless
character' •
Once again we can conclude that a child's experience in
the early years does not necessarily and irreversibly mark
him for life. There are now a number of reports available
that make the same point. In each case the crucial factor
concerns the nature of the new environment in which the
child is placed. Had the children studied by Tizard con-
tinued to live under the same impersonal regime they might
well have become affectionless; as it was, the adoptive
parents involved were prepared to invest a great deal of
time, effort and emotion into the care of the child: perhaps
rather more than one might normally find in parents' rela-
tionships with their own children. Given such favourable
circumstances, the outlook for children would appear to be
good: they need not be condemned by previous misfortune;
their recuperative powers should not be under-estimated.
Mother-baby contact in the new-born period

The idea that the bond between mother and child must not
be broken, particularly during certain critical periods of
development, has recently surfaced again, though in a some-
what different form. Again the idea originated with obser-
vations on animals. Female goats and sheep, it has been
found, must remain close together with their new-born young
for a specified period of some hours after birth. If they
are separated, the mother will subsequently butt the young
away and refuse to have anything to do with it. Mothering
in these animals can therefore only emerge if nothing
interferes with this early contact.
Two American paediatricians, Marshall Klaus and John
Kennell, have generalized this idea to human mothers.
According to their observations, the practice adopted by
most western maternity hospitals of separating mother and
baby except for feeding periods impairs the mother's subse-
quent ability to look after the child. Mothers, on the other
hand, who are allowed to keep their baby during this time
show more interest in and a higher commitment to the child
who in turn is more likely to thrive. Moreover, Klaus and
Kennell believe that this effect is not confined to the
period in the maternity hospital: when they followed up two
groups of mothers and children, identical except in the
amount of contact during the first few days of the child's
life, they claim to have found differences months, even
years, later. The mothers belonging to the extended contact
group were more devoted, more sensitive; the children's
development was more advanced both socially and intellec-
tually: supposedly all because of a few hours of being
together just after the child's birth.
Again, it is useful to distinguish between short-term
and long-term effects. The work of Klaus and Kennell has
been most influential in humanizing practices in maternity
221
hospitals in many different countries. In particular, it has

drawn attention to the need for extra stimulation of babies
in Special Care Units, kept isolated in incubators. More
generally, it has made medical and nursing staff consider
carefully the way in which the psychological relationship
between mother and her new-born baby should be managed.
From that point of view, it may well be that greater contact
in those early days produces beneficial results for both
parties concerned. As to long-term effects, however, the
situation is quite different. A number of other investi-
gators have in fact completely failed to replicate Klaus and
Kennell's findings: accorciing to them, whatever short-term
effects there may be disappear quite soon. The relationship
between mother and child is thus not determined forever by
that one specific experience occurring at one specific point
of time. And just as well, for the sake of all those mothers
who are too drugged or too ill in the immediate post-natal
period to care at once for their babies, and, for that
matter, for the sake of adoptive mothers who may have no
contact at all with the child till he is several months or
even years old. As we saw from Tizard's study, such mothers
may well be 'super-mums', just because they missed out on
the child's earlier development.
Birth abnormalities and social class

Some children arrive in the world so severely damaged that
no amount of good care will rectify the handicap. They can
certainly be helped to make full use of whatever capacities
they do have, yet the limits imposed by nature are such that
functioning as normal members of society will always be
beyond their reach.
In less severely affected cases the course of develop-
ment is not so easy to predict. Two children coming into the
world with the identical kind of pathology may develop along
quite different lines. In one case, the child's condition at
birth may give rise to a whole sequence of problems that
continue and even mount up throughout his life; in the
other, the difficulty is surmounted and the child functions
normally.
Take such a birth complication as anoxia, the severe
shortage of oxygen in the brain. This is a considerable
trauma to the child's system at so early a point of its
life, and several studies have followed up such children in
the full expectation that they will turn out to be impaired
in their intellectual and other functions. Yet this has not
been the case: some children may indeed show the apparent
after-effects of this condition, yet in others they may
disappear completely. Or take another birth hazard that
has traditionally been associated with later difficulties,
namely prematurity. A very low birth weight means that the
child arrives in the world in a very precarious condition,
and his future development may be affected accordingly. Or
so at any rate it was thought, for recently it has become
clear that, as with anoxia, the expected unfortunate conse-
quences are by no means inevitable. In many cases, though
222
deficits may be evident in the early stages of development,

complete recovery has taken place by the time the child
reaches school age. In other, apparently identical cases,
the deficit remains.
The answer to this paradox lies in the different kinds
of social environment in which the children develop. Where
these are favourable the effects of the initial handicap may
be minimized and in due course be overcome altogether. Where
they are unfavourable the deficits remain and may even be
amplified. The outcome, that is, depends not so much on the
adverse circumstances of the child's birth as on the way in
which his family then copes with the problem. And this, it
has been found, is very much related to the social class to
which the family belongs.
Social class is in many respects a nebulous concept,
particularly in these days of rapidly changing educational
and occupational opportunities. Neverthel~ss, it does help
one to pinpoint the extent to which families may be advan-
taged or disadvantaged, and especially so in relation to the
care of their children. Moreover, it represents a continuing
influence: poor housing, poor health, poor job prospects,
inadequate educational facilities; such a constellation of
factors is not easily reversed and thus defines the environ-
ment in which a child may spend all his formative years. It
is therefore not surprising that social and economic status
tum out to have a much stronger influence on the course of
development than some specific event at birth.
Thus even organic damage, just as the other aspects of
a child's early experience, cannot in and of itself account
for the particular course which that child's development
takes. The irreversible effects of early experience have no
doubt been greatly overrated. To believe in such effects is
indeed dangerous for two reasons: first, because of the
suggestion that during the first few years children are so
vulnerable that they are beyond help if they do encounter
some unfortunate experience; second, because it leads one
to conclude that the later years of childhood are not as
important as the earlier years. All the evidence indicates
that neither proposition is true: the effects of early
experiences are reversible if need be, and older children
may be just as affected by unfortunate circumstances (though
possibly different ones) as are younger children.
ConclusiODB A child's development always occurs in a social context.

Right from the beginning he is a member of a particular
society, and the hopes and beliefs and expectations of those
around him will have a crucial bearing on his psychological
growth. There is nothing inevitable about a child's develop-
ment: he may come into the world with the capacity for
language, but when he begins to speak, in what way and for
what purposes depends on the kind of environment in which
he is reared. And that environment is a complex affair:
psychologists are still, as it were, taking it to pieces in
order to see what parts of it are crucial to the child. We
223
may not have got very far yet with this task, but at least
we can make one negative statement with some very positive
implications: development can never be explained in terms of
single causes. Thus we have seen that isolated events,
however traumatic at the time, do not on their own bring
about lasting change; that early experiences do not preclude
later influences; that the one relationship with the mother
does not account for everything. For that matter, develop-
ment is not simply a matter of the environment acting on the
child, for the child too can act on his environment. Not
surprisingly, when confronted with a specific problem such
as child abuse, we find invariably that a combination of
circumstances needs to be considered if one is to explain
it. Simple-minded explanations of the kind ~uvenile
delinquency is due to poverty (or heredity or lack of
discipline)' will not do justice to such a complex process
as a child's development. And similarly, action taken to
prevent or treat which focusses only on single factors is
unlikely to succeed.
At a time of rapid material progress the conditions
under which children are brought up can change drastically.
The invention of the feeding bottle, the great reduction
in infant mortality, the introduction of television, the
availability of central heating and of washing machines:
these are just some of the material changes which in turn
have changed the task of those responsible for children's
upbringing. Unfortunately, we do not usually become aware
of the psychological implications until well after the new
technological developments have been instituted: high rise
blocks of flats are built, and we discover only subsequently
what living on the twentieth floor may mean to families with
young children; television can be beamed into every home in
the country, and only now are questions being asked about
the possible harmful effects of children viewing certain
types of programme. Ideally, psychological implications
ought to be considered from the beginning; let us for the
present at least recognize that they exist and need to be
monitored. The same applies to social changes: the increas-
ing number of single-parent families, the rising incidence
of divorce and remarriage, the various experiments in
communal living that have been instituted, the changing
roles of the sexes: there are many features of today's
society that can have profound effects on children's
development. All may bring problems of adjustment which
various professional workers are then asked to solve. This
cannot simply be done by guesswork; fortunately child
psychology is increasingly able to offer some help and
guidance on the basis of objective investigations into the
nature and course of development.
Questions 1. Cognitive development can be described in four periods,

according to Piaget. Name these periods and summarize
the limits of each of them.
224
Z. From your experience, give examples of the 'egocentric

thinking' that occurs in pre-school children (approxi-
mate ages 5-6 years old) •
3. Explain the concept of 'conservation of mass'. At what
stage in a child's cognitive development does such a
concept become available to the child? Do you agree with
the ways in which Piaget investigated the presence or
absence of this concept in a child's thinking?
4. Explain the difference between 'accommodation' and
'assimilation' as used by Piaget.
5. 'It is misleading and dangerous (to take the view that)
the course of human development can be viewed
independently of the educational process we arrange to
make that development possible' (J. S. Bruner). Discuss
this statement.
6. 'Since language is a tool and its use a technique, the
sooner mastery of the technique is encouraged the sooner
the child will move to competence in rational thought'
(J. S. Bruner). In the light of Piaget's theories about
cognitive development do you agree with this statement?
7. What are the principal controversial issues that have
been raised by the study of maternal deprivation?
8. In what way can a child's social experience affect his
intellectual development?
9. Can and should children be studied scientifically?
10. What advice would you give to the mother of a three year
old who is considering taking up employment?
11. Why are the effects of early experience not necessarily
permanent? Describe the circumstances under which you
do find them to be long-lasting.
1Z. What is known about the reasons for baby battering? What
effects on the child would you expect such treatment to
have?
13. Discuss the pros and cons of parent education schemes.
On what principles would you organize such a scheme?
14. What is the role of the father in the family?
15. How can one mitigate the effects of social disadvantage
on the young child's intellectual development?
16. The parent-child relationship is said to be 'recipro-
cal'. Explain what is meant and provide examples.
17. Discuss the role of language in intellectual develop-
ment, and examine the suggestion that there are class
differences in language use.
18. Socialization - conflict or mutual adjustment?
19. What principles ought to guide a child's adoption?
ZOo Should education begin during the pre-school years?
Explain what you mean by 'education' and discuss the
settings in which it could take place.
Zl. Describe some of the social skills that children
generally acquire during the early years, and the
conditions that foster their development.
ZZ. Explain what is meant by 'sensitivity' in a parent, and
describe the likely effects on a child of its absence.
Z3. In what way is a family's social class likely to affect
a child's development?
ZZ5
24. How do relationships with other children affect

development during the pre-school years?
25. What implications does our knowledge of social
development in the early years have for the upbringing
of handicapped children?
26. What psychological principles should be taken into
account in looking after children in residential care?
Annotated reading Booth, T. (1975) Growing up in Society. London: Methuen

(Essential Psychology Series) •
A general account of the influences that determine the
way in which people grow up together. It takes into
account not only the contribution of psychology but of
such other social sciences as sociology, anthropology
and social history. Its main value lies in the way child
development is seen as occurring within the social
context of each particular culture.
Bowlby, J. (1965) Child Care and the Growth of Love.

A more widely available version of Bowlby's classic
report, first published in 1951, concerning the link
between maternal deprivation and mental pathology. It
should be read in conjunction with Rutter's book (see
below) •
Brown, R. (1966) Social Psychology (chapters 5-8). London:

Macmillan/Free Press.
These chapters, in a book written in a flowing,
attractive style, give a thorough introduction to
Piaget's theories and studies. The reader is invited to
think about the topics that are discussed and the
examples of the children's behaviour are vividly
presented.
Bruner, J .S. (1964) The course of cognitive growth. American

Psychologist, 19, 1-15.
Bruner, J .S. (1965) The growth of mind. American

Psychologist, 20, 1007-1017.
These two articles give relatively concise accounts of
Bruner's theories of cognitive development: they offer
an alternative interpretation to that of Piaget.
Bruner, J .S. (1966) Towards a Theory of Instruction.

Cambridge, Mass.: Harvard University Press.
This book has a dual theme; it concentrates on how
children learn and on how they can best be helped to
learn, so that they reach the highest possible level
within their capabilities. It raises issues that were
controversial in 1966 and which are still being explored
in the practical classroom situation. The book sum-
marizes 50 years of research and reflection on the
process of mental growth.
226
Clarke, A.M. and Clarke, A.D.B. (1976) Early Experience:

Myth and evidence. London: Open Books.
A collection of contributions by different authors, all
concerned with the question of whether early experienc~
exerts a disproportionate influence on later develop-
ment. A wide range of research studies is reviewed,
and the consensus is against seeing the early years as
in some sense more important than later stages of
development.
Dunn, J. (1977) Distress and Comfort. London: Fontana/Open

Books.
Discusses some of the issues that concern parents during
the early stages of the child's life, with particular
reference to the causes and alleviation of distress, but
places these issues in the wider context of the parent-
child relationship and its cultural significance.
Geber, B. A. (ed.) (1977) Piaget and Knowing. London:

Routledge & Kegan Paul.
A collection of eight papers relating Piaget's theories
to different areas of psychological research: knowing
and perception, language, social behaviour, reasoning,
memory and intelligence.
Kempe, R.S. and Kempe, H. (1978) Child Abuse. London:

Fontana/Open Books.
An account by the foremost experts on child abuse of the
state of knowledge regarding all aspects of this vexed
area: causation, treatment and prevention.
Lewin, R. (1975) Child Alive. London: Temple-Smith.

Various researchers summarize in brief and popularized
form what we have learned about child development in
recent years. Most contributions deal with young
children, and the book as a whole emphasizes how
psychologically sophisticated even babies already are.
Richmond, P.G. (1970) An Introduction to Piaget. London:

Routledge & Kegan Paul.
This is relatively concise and easy to read, presenting
Piaget's theories and studies in a relatively simple
form. It also explores some of the criticisms of
Piaget's theories.
Rutter, M. (l97Z) Maternal Deprivation Reassessed.

A systematic review of the evidence on this
controversial topic that has accumulated since Bowlby
highlighted its importance. Discusses the various
studies that have been carried out on the effects, both
short- and long-term, of early deprivation of maternal
care.
227
Schaffer, H.R. (1971) The Growth of Sociability.

A description of work on the earliest stages of social
development. It shows how sociability in the early years
has been studied, and reviews what we have learned about
the way in which a child's first social relationships
are formed.
Schaffer, H.R. (1977) Mothering. London: Fontana/Open

Books.
An account of what is involved in being a parent. Brings
together the evidence from recent studies of the mother-
child relationship, and examines different conceptions
of the parent's task. Gives special emphasis to the
theme of mutuality in the relationship.
Tizard, B. (1977) Adoption: A second chance. London: Open

Books.
An account of an important research study on children
in residential care who were subsequently adopted.
Raises some crucial issues regarding the effects of
early experience and the public care of young children.
2.2.8
9
Language Development in Young
Children
W. P. Robinson
()peDiDg remarks In the progressive socialization of children, as in their

E.N.DUHKIN cognitive development, words and language make a major
contribution. As the child's verbal ability increases, he
moves from representing the world by simple images to using
flexible and abstract ideas. With these, he can more easily
'carry' the outside world into himself so that he can think
about its ever-changing array of material and non-material
features. In addition to this private experience of con-
templation, he has the satisfaction of becoming increasingly
able to express his 'needs', 'wishes', 'feelings', etc., by
using words: they become the vehicles for a whole range of
central reactions that subsume 'thinking'. In the sociali-
zation situation, language is instrumental in setting up
satisfactory patterns of communication with other word
users.
Since all healthy adults have been through this experi-
ence of learning to use words, we may safely assume that it
is a common experience for physiotherapists, their patients
and the remainder of the human popUlation. If this is so,
what is the point of offering a more detailed examination of
language development? We can reach a partial answer to this
question by recalling one of the basic observations about
perception: in any situation, people select SOME of the
available sensory information to be used for interpreting
(or perceiving) that situation. So, in the thousands of
contacts we have had with language in the past, it is most
unlikely that we have paid attention to all the details of
its underlying structure. Yet it will be necessary for
physiotherapists to be aware of this structure, and many
more of its characteristics, if they are to be able to
discuss the management of patients with speech-related
difficulties.
To anyone who has wanted, or been obliged, to learn a
foreign language, it is painfully obvious that there is far
more to using a language than learning the vocabulary that
supports it. However, we all use our own language at some
level of competence. Some people are better at it than
others, while some know how to analyse the complicated
chaining of sounds that the rest of us accept as words.
These people describe the ways in which words are combined
into meaningful units such as phrases, sentences and so on.
229
Language development in early childhood
They look beyond the apparently spontaneous use of words

to discover the rules that are shared by the users of a
particular language and that make it possible for one person
to understand the spoken or written comments of another. But
now we come back to our earlier question; since we can use
language without being able to discuss all its rules, why
should anyone attempt to know more about it? Perhaps an
analogous answer would be more convincing than any other.
It is not necessary to know all the details of the construc-
tion and working of a car to be able to drive it safely and
effectively: provided that the car is in sound running
order, the skills of driving are adequate. But when problems
arise, greater expertise of a mechanical kind is an asset.
The driver will be a more effective user of his car if he
knows not only that it has four wheels but also how to
change one of them if it develops a flat tyre! Given that
the language skills of our patients may be altered by ill-
ness or by congenital problems, it is unwise for physio-
therapists to feel unprepared and insecure when it comes to
discussing these problems with other members of the treat-
ment team. It is worth the trouble of learning the basis of
language analysis and linking this with the principles of
speech therapy. Peter Robinson deals with language develop-
ment and, in so doing, he introduces words that may be
unfamiliar to the reader but which ar~ the 'stock-in-trade'
of linguistics experts. Conscious of this professional
jargon, he provides a glossary which will pay dividends
if the reader uses it wisely.
There are two situations in which an understanding of
language is of special value to the physiotherapist:
* in communication with speech therapists and linguistics

experts;
* in communication with patients who have speech-related
difficul ties.
COIIIIDIIDication with speech therapiats

As we have already indicated, there is a vocabulary.peculiar
to the detailed investigation of language and this generally
acts as a barrier to those who are not aware of the special
words. There is a tendency to be wary of, or to retreat
from, expertise that is greater than one's own and this can
discourage the exchange of ideas and information between
members of the health professions. The need for communi-
cation between allied professions was stressed in the intro-
duction of the first chapter: counselling and treatment of
speech disorders is one of the areas where this interpro-
fessional co-operation is vital. Speech therapists are
fluent in the terminology of linguistics and they frequently
share the responsibility of treating patients with physio-
therapists, for example in the case of patients with cerebro-
vascular accidents complicated by aphasia.
Commaaication with patients

Language plays an important part in establishing a working
230
relationship with patients, and physiotherapists may meet

problems of three main types:
* those associated with recently acquired aphasia and

allied disturbances;
* those associated with long-standing speech deficits
such as that of congenital brain damage;
* those associated with primary hearing handicaps.
In addition, there may be difficulties due to mismatch of

the dialects and styles of speech between physiotherapists
and patients. These may be indicative of underlying differ-
ences in socio-economic, educational or racial backgrounds.
The effective and experienced physiotherapist is able to
adjust instructions and advice, praise and cautionary com-
ments, so that the patients readily understand what is ex-
pected of them and when their efforts are acceptable. With
the wide range of problems that can occur in a patient load,
this may require much more than just speaking clearly as the
instructor. It often involves being able to 'unscramble'
some very unusual sounds that are the patient's best efforts
to speak. Probably every physiotherapy student COULD make
all the observations needed for becoming better and better
at dealing with the language demands of the therapist/
patient situation, but this would be a lengthy process if it
depended solely on the slow accumulation of personal experi-
ence. The decision to include a discussion about the deve-
lopment of language has been taken in the hope that this
fundamental information will speed up the students' appre-
ciation of the ways in which problems related to speech can
be analysed and managed. This is seen as a first step: there
is really a case for even more awareness of communication
than can be given in one introductory discussion on the
development of language. With that in mind, the whole matter
of communication, verbal and non-verbal, is taken up again
in chapter 10. This still leaves the large area of specific
speech disorders and communication difficulties that you may
wish to follow up. You will find these reviewed in texts
concentrating on dysfunctions of articulation, verbal com-
prehension, etc., and suggestions for further reading are
given at the end of this chapter.
The developmental aspects of language should have the
added value of guiding the physiotherapist in estimating the
level of language competence of any children being treated.
As you read through the section that follows, you will
come across general similarities between the processes that
serve the development of language and those that were des-
cribed in relation to the learning of motor skills (chapter
3). When it comes to guiding the patients who have co-
ordination, muscle strengthening, or mobilization needs,
overlaid by speech difficulties, it is very important that
the physiotherapist uses the standard corrections and cueing
instructions which the speech therapist has established with
each patient.
PFP _ P 231
Robinson makes the interesting observation that the

language units lear~ed by children come and go before they
are established and that language skills are acquired in a
very haphazard way. This raises the question that we might
profitably adopt Skinnerian training principles for teaching
everyone to speak at an earlier age; perhaps we could speed
up language acquisition by being more precise with re-
inforcement of the child's attempts to speak. This is likely
to be impractical as parents and other adults would have to
become full-time trainers, with no time for doing anything
else. But parents, like all human beings, essentially pursue
their own ends and have their own systems of priority
(chapter 10). It is unlikely that they have at the top of
their list the aim of making sure that their child speaks
earlier than their neighbour's child. Parents may only be
motivated to help their children speak as soon as possible
if they have already seen evidence that the children are
'backward'. Alternatively, parents who have not already
become fascinated by their own remarkable ability to trans-
late the non-verbal requests and instructions of their
children may be the only ones who might be inspired to
take an active part as 'speech trainers'. Even if it is
not realistic or feasible to accelerate the skilled use of
language by children, it is known to be effective to keep
guidance as consistent as possible for those who have speech
difficulties, and to avoid delay in reinforcing each verbal
success the patient achieves.
IDtroducticm: a frame For over 15 years now a steady river of books about language
of reference development in children has flowed on to the market, while
w. P. ROBINSON the journals have been flooded by research on the same
topic. Much of this work has been clever and ingenious; not
all of it has been sensible in its point 0 f departure. It is
encouraging that the more recent productions (see de
Villiers and de Villiers, 1979) have begun at the starting
point that common sense would have recommended; Halliday
(1975) expresses the contrast between the earlier and some
of the later work in terms of the questions asked by
psycholinguists and sociolinguists. The former have tended
to focus upon the child mastering the syntax of language
(rules for combining words) at the expense of the other
components of language: phonology (sounds), lexis (words),
semantics (meaning), and pragmatics (significance for ac-
tion). They have asked: how does the child combine units
into structures (combinations of units), particularly words
into sentences? What do a child's errors, in terms of what
is acceptable in the adult language, tell us about the
system his brain uses for generating sentences? Are these
errors universal, common to all children learning all
languages? Are there fixed sequences of syntactic develop-
ment within and across all languages? What are the charac-
teristics of the language acquisition device that all
children are born with? With the possible exception of the
232
last, all these questions are proper in that evidence could

be and has been collected to answer them.
Flow charts have been drawn up setting out stages in the
development of negation and question formation, and these
have been 'explained' by writing out rules that the child's
mind appears to be following in producing these forms. The
grammatical errors of child.ren learning different languages
have been examined for similarities and differences, and
explanations have been offered for the patterns observed.
However, this emphasis upon syntactic structure and
a corresponding neglect of function is alien to the socio-
linguistic stance. From that perspective the questions are
liable to be asked in terms of the ways in which units and
structures develop to serve functions. Function is primary:
children talk to communicate. Introductory questions would
be: why do children talk? What kinds of meanings do they
encode to what ends? We can proceed to ask how they code
meanings: that is, what units and structures they use. How
do the functions and their associated structures change in
development and why?
The main reason for preferring the functional/structural
to the purely structural approach might be summarized by
stating that young children issue commands rather than utter
imperative forms ('Stand up!'); they make requests and ask
questions rather than form interrogatives; they comment
about themselves, about others and about the world rather
than utter declarative sentence forms; they achieve purposes
by communicating meanings rather than construct linguistic
structures. In addition and crucially, a functional/struc-
tural approach obliges us to ask questions about the nature
of children and their learning as well as about the language
they are mastering.
That being so, if we wish to find out which units and
structures are learned when and how, we have to turn to
examine ways in which children can be encouraged to exercise
fUnctions requiring such units and structures. If we are to
be able to specify what children can learn, what they do
learn, and how, we have to look closely and attentively at
theories of development, learning and instruction.
Three approaches have dominated thinking about the
learning of children: associative principles, ideas of
modelling, and the cognitive developmental. The first
stresses that events occurring close to each other in terms
of time and space are likely to become associated: the fact
of their co-occurrence is likely to be learned. The work of
Pavlov showed that new artificial stimuli could be substi-
tuted for the original stimuli to elicit responses already
in the animal's repertoire, under certain conditions
(classical conditioning). Thorndike, and latterly Skinner,
have shown that new responses to stimuli can be learned
if these are followed quickly by rewards or punishments
(operant conditioning). What roles can classical condi-
tioning and operant conditioning play for which aspects of
language development? Have rewards and punishment and their
233
contingent use a significant part which they can and do

play?
What determines when and how imitation can be important?
Children can and do learn through observation as well as ac-
tion; how might observational learning fit into the picture?
Piaget offers a portrait of the child as an active organizer
of experience, building up schemes for action through pro-
cesses of assimilation and accommodation. These schemes
grow in number. They become co-ordinated and differentiated.
They become organized so as to afford symbolic as well as
physical solutions to problems. The symbolic systems them-
selves become qualitatively more powerful with growth, which
is promoted through different interaction with a challenging
environment. How is language development to be integrated
into this approach and how do these developments relate to
language mastery? The existence of each of these kinds of
learning is thoroughly established. What we have yet to
determine is whether they are relevant to language learning,
and if so, how and under what conditions. Sadly, even recent
texts are relatively reticent about these issues, but less
so than those of earlier writers.
After closely observing the development of language,
particularly the syntax, in three children over a number of
years, Brown (1973) concluded: 'What impels the child to
"improve" his speech at all remains something of a mystery'.
At least two weaknesses in his reasoning might be offered to
explain this pessimism. First, the actual tests made of the
possible relevance of principles of reinforcement (rewards
and punishments), and confirmation/correction, or of obser-
vational learning examined only very few linguistic features
in very few children. We have, however, no reason to expect
that identical processes will be of equal significance for
all aspects of language learning in all children. Brown is
not enthusiastic about common sense, but common sense easily
observes that children learn the language and dialect of
their caretakers rather than one of the several thousand
other languages in the world. That being so, modelling must
have some potential role to play in part of the learning
process, even if we cannot as yet be precise in saying how
and when it occurs. While imitation and reinforcement
principles of learning and performance may not be able to
explain some features of language mastery - for example, how
adults become capable of generating an infinite number of
novel sentences - it does not follow logically that these
principles are irrelevant to everything else that is
involved in learning to use language.
The second weakness in Brown's approach is revealed by
the stripped-down characteristics of the data examined.
Child speech was analysed as transcripted sequences of
words. Prosodic features of intonation, pitch, and stress
were not included. The caretaker's utterances and the non-
verbal context in which utterances were made were generally
but not entirely ignored. But the child's speech is only one
component of the co-operative action involving conversation,
234
and conversations are not about nothing. Imagine trying

to describe and explain the learning of a trapeze artist's
skills without mentioning the behaviour of his partner or of
the trapeze! How can one expect to examine the role of
the child's caretakers in the development of speech if their
possible contribution to the interaction is not included in
full measure? And how can one expect to study either without
reference to the contextually embedded actions and inter-
actions to which speech is directed? And if you have no
theories of learning to test, then none will prove to be
helpful in explaining the data.
The perspective adopted here recognizes that the grow-
ing child is an active self-organizing subject capable of
building up action schemes, symbolic schemes, and sign
systems through interaction with events, things and people
(following Piaget), but we recognize that the child is at
the same time an object whose behaviour can be shaped and
developed through the contingent use of rewards and punish-
ments (following Pavlov and Skinner). We also need to accept
the idea that to produce and understand speech is to mani-
fest a set of at least semi-automated skills (see Claim 7)
whose mastery will need repeated and varied practice in
situations where others in the environment offer corrective
feedback. Accepting this eclectic view of a child as a
growing person who is both agent and victim allows us to
conceive of him as inventing functions as well as units and
structures to realize these skills, and as discovering them
to be already available in the speech of others. We can also
conceive of him as being responsive to direct instruction
and training, both for learning new features and for
deploying these fluently in action.
What follows is a list of claims about the child's
mastery of language and the role of his caretakers in this
endless task. The claims may need amendment or partial
abandonment in the light of advances in knowledge, but in
1981 they represent what is intended to be a balanced
assessment of the evidence to hand.
Claims about language Claim 1: the use of language develops out of already
development established Don-verbal means of communication
From birth the child interacts with his caretakers; child
and caretaker act upon and react to each other. This
reciprocity involves an exchange of signals each to the
other. The child responds differentially (e.g. with smiles
or cries) to different maternal actions, such as different
facial expressions (Bruner, 1975). For example, the care-
takers endeavour to decode distress signals and cease to
search for further solutions when their actions result in
signals of satisfaction from the child. It is out of this
interchange of communication through body movements,
gestures, facial expressions, and vocalizations that
verbal communication emerges; it does not arise suddenly
with a first 'word'.
235
Claim Z: initial functions of laDguage are social-

interactional
If we distinguish broadly between language uses which
attempt to comment upon the nature of things, for example,
making statements which are either true or false, and those
which appear to be attempts to regulate the states or
behaviour of self and others or to define role relationships
(see Robinson, 1978), then in Halliday's child, Nigel, the
former began to appear over nine months after the first
socially relevant language units had emerged. Halliday found
that instrumental (getting things for self), regulatory
(making others do things), interactional (encounter-
regulation), and personal (reactions to events or states)
units were the first to appear. Among these were na (give
me that), b¢ (give me my bird), ~ (do that again), do (nice
to see you), ill) (that tastes nice) (see glossary under
Phonology). This child began to talk, it seems, because
verbal interaction with others was pleasurable; it was not
because he was hungry or in pain. The design of the baby
includes an impetus to interact with people, an impetus to
interact with other features of the environment, and an
impetus to develop the schemes of interaction. If one wishes
to say that the reasons why babies begin to talk are bio-
logical, then they are socio-biological: joint action with
caretakers. That being so, the promotion of co-ordinated
joint action may be one form of inducement to develop
communicative skills.
As Halliday illustrates, Nigel later expanded his func-
tional range to include the heuristic (finding out) and
imaginative (let's pretend) functions, and he increased the
number of communicative acts associated with each of these
until by the age of one-and-a-half he had over 50 in his
repertoire. This 50 is a misleading figure because from the
outset the child had both general and specific variants of
each function, for example, na (give me that - general), bill
(give me my bird - specific). The general form may be an
important growth point as well as having general utility, in
that it affords the caretaker an opportunity to respond non-
verbally with the appropriate action, verbally to label the
unspecified object, and to continue the conversation, all at
the same time. The opportunity to learn a specific referent
for the particular 'that' can be fitted into the sequence of
activity, without this constituting a major diversion.
About the time Nigel reached his 50 meanings he also
ceased to rely solely upon inventing his own units (mainly
un-English in form and actually heavily reliant on tone).
Two important changes occurred.
First, Nigel interpolated a third level of linguistic
structure, the lexico-grammatical, between soundings and
meanings. Individual sounds ceased to be expressive of
individual meanings. Combinations of sounds were used to
form 'words', and words and tones were sequenced to create
'meanings'. Thus the tri-stratal essence of language became
established. (At some later point in time the child has also
236
to learn to distinguish between the semantic and pragmatic

levels; different forms can serve the same general functions
and the same form can serve different functions, the appro-
priate choice requiring knowledge of the cultura.l norms of
the society.}
Claim 3: the child makes deliberate effort to learn

laDguage
Second, Nigel's speech began to distinguish between using
language and learning language. He deliberately solicited
from his caretakers 'names' of objects, attributes and
actions and he practised combinations and alterations both
in monologue and dialogue. Whether all children do this
we do not yet know. How do caretakers respond to these
enquiries about words {and structures}? On the principles of
any associative theory of learning {see de Cecco, 1968},
supplying the requested items emphatically, clearly and with
some measure of repetition and extension should increase the
chances of the child learning the language feature and its
use. It should also encourage him in the process of finding
out more. Not supplying the requested information or sup-
plying it in a form that the child cannot assimilate in the
short run forgoes an opportunity for learning about the spe-
cific matter in hand, and in the long run should result in
the child ceasing to make enquiries.
Claim 4c units and structures are accumulated piecemeal but

inezorably
An extreme position might argue that units are mastered one
at a time, always being linked to some unit or structure
already in the child's repertoire. They may be learned and
lost again. The cycle may be repeated until the unit dis-
appears or becomes established. The units which become
finally established and relatively stable will be those in
the speech of the child's circle of interactants, parti-
cularly of those with whom he is most frequently in a
learning and interactive relationship.
By 'unit' is meant any feature of the language at any
level, such as phonemes, morphemes, words, groups, clauses,
sentences, utterances, rules of explicitness, rules of pol-
iteness or rules of differential social status. It should be
remembered that a unit at one level caD be a stru<:ture at
another, for example, a sequence of particular pitches can
form an intonation pattern, but this pattern serves as a
unit if it forms an interrogative; a principle or rule can
therefore become a unit when treated as such.
A new unit will be more likely to enter and remain in
the child's repertoire if he is intellectually capable of
grasping some aspect of its approximate meaning or signi-
ficance. Capability is not the only factor; a unit is more
likely to be mastered if its meaning and significance is
relevant to something the child wishes to communicate or
comprehend. Reasons for a unit not entering would be that
the child may already be using his energies and available
237
capacity to develop other units or structures of verbal or

non-verbal behaviour. He may also be performing and living
rather than learning; there is more to life than learning. A
unit will only become stabilized in use if it is encouraged
to do so by others (see Claim 6).
Claim 5: the new is often first learned in terms of the old

An ancient Greek paradox points to the impossibility of
change, and this principle is sometimes invoked as a reason
why children cannot learn language! If understanding a word
must precede the learning of that word, how can it be
learned? If learning must precede understanding how can the
child come to understand something that has no meaning?
And yet children clearly do learn. One of several lines of
escape from the paradox is to argue that the child can
express new meanings 'badly' with old, already available
units and structures, and that caretakers can reformulate
the child's meaning with the new units and structures which
the child may then be able to assimilate to the meaning
intended. Evidence is consistent with the idea that the
child learning to associate the various kinds of negation in
English with the appropriate adult lexical and syntactic
structures can rely on adults continuing to supply the new
forms upon the occasions of the child using those already in
his repertoire.
Since syntactic systems such as interrogation and nega-
tion are compound and complicated, it may follow that the
developing child will only master them piecemeal, generating
transitional forms, if Claim 4 is valid. The evidence
pointing to the many transitional forms of syntactic con-
struction (e.g. 'Why it is raining?'; see Brown, 1973) is
probably consistent with the idea that these variants are
best left to correct themselves unless particular examples
of them appear to have stabilized over many months. If
a child cannot learn quickly from a correction there is
probably little point and may be harm in pursuing it.
Claim 6: caretakers control the probability of new features

being learned and remaining in the child's repertoire
Montessori is responsible for the last observation made in
Claim 5, and a second injunction of hers may be used to
introduce Claim 6. Her 'cycle of three' for teaching was:
This is an X - Show me the/an X - What is this? (pointing
to X). The first labels the activity, event, object or
attribute, the second checks the child's capacity for
recogni tion, and the third encourages him to produce the
label. She adds that repeated failures to elicit appro-
priate reactions from the child are best taken as sugges-
tions for dropping the matter and returning to it later.
This model can easily be abused if taken too literally, but
it has considerable value if used as a framework to bear in
mind when combining instruction with conversation.
How is a chiM to find out the conventional linguistic
means of expressing meanings but from his caretakers? Why
Z38
should they leave him to extract features as best he can

from their discourse? Why not structure his learning oppor-
tunities as clearly as possible leaving him to accept or re-
ject them? (Many mothers object to viewing themselves or
being viewed as teachers. Whether or not they are to be
seen as teaching is contingent only upon the definition of
'teach'. If the provision of opportunities for learning is
enough to be called 'teaching' then all people interacting
with children are teachers. If this provision has to be in-
tended to help learning, then fewer people are teachers of
children, but presumably there are some things all mothers
intend that their children should learn. My own view is that
mothers should accept that there is much they can teach
their children and that they can enjoy this role to the
benefit of all concerned.)
Two studies can be quoted to illustrate the power of
caretakers at the relatively early period of language
development when the child's utterances are on average
between one-and-a-half and three MLU (mean length of
utterCUlce: at this stage of development the number of
morphemes is closely related to the number of words).
Ellis and Wells (1980) contrasted the maternal inter-
action characteristics of slow language developers (12
months to move from MLU 1.5 to MLU 3.5) with those of
early fast developers (less than 6 months to make this
change and achieved before 21 months old). At the outset
mothers of the two groups differed, the former talking
generally more during routine household activities, issuing
more instructions and commands, being more likely to
acknowledge their child's utterances, and more likely to
repeat or correct these. By the time the children had
reached 3.5 MLU, maternal differences were still present,
but they were different in type, the early fast children's
mothers using more statements and questions, particularly
teaching-type questions, to which the mother already knew
the answers. Cross (1978) found in a contrast between faster
and slower developers that different maternal speech vari-
ables discriminated at different ages. The implications of
these two studies are several. Optimal facilitation of deve-
lopment may require the employment of different tactics
at different points in development and may also require the
application of different principles.
More basic general principles are also relevant. Mothers
whose speech is more unintelligible, in that it is mumbled
and incoherent with no clear breaks and stresses at custo-
mary points, are likely to have children whose speech is
developing more slowly.
In a study of the mother-child interaction among six
year olds (see Robinson, in press) it was found that child-
ren who asked more questions, more complex questions, and
revealed more verbally mediated knowledge about an assort-
ment of obj',~cts, games, and toys, had mothers who were more
likely to:
239
* set any remark in a previously shared context;

* answer any question with a relevant, accurate reply that
extended somewhat beyond the question posed;
* confirm children's utterances which were true and well-
formed and to point out or correct errors;
* maintain themes over several utterances.
These findings probably need qualification and supplemen-

tation. Pointing out and correcting errors is likely to be
productive only if the child can learn from this, and pro-
vided he does not become afraid to make mistakes. One
feature of maternal behaviour that was unrelated to child-
ren's performance was the mother's questioning of the child;
it seemed that at least in this context questioning may have
been intended to re-focus the interest of children who were
already actively attending to something else and were unwil-
ling to be distracted. Hess and Shipman (1965), for example,
treated questioning as motivating and found it to be posi-
tively associated with more advanced performance, but
perhaps in their case the questioning was creating and
achieving concentration rather than trying to re-direct
attention. Questioning which encourages extension of
interest may have different consequences from questions
which are failed attempts to direct the child. (These two
may be distinguishable in terms of quality of voice and
intonation. )
If two words were to be used to sum up the contrast they
would be 'push' versus 'pull'. Pushing did not work, pulling
did: adults could set up the context of the situation in
which activity took place, but beyond that the child decided
what he was interested in. Adults can set the scene, offer
suggestions, and tempt the child, but he directs the form
and content of his script. The 'push' is already there; it
is a design characteristic of human children. By their re-
active behaviour adults can encourage and develop both this
intrinsic motivation and the learning which results from its
activity. They may also be able to treat it in ways which
may slow down, check, deflect, distort, prevent or otherwise
impede development.
Providing, tempting and modelling appear to be the main
activities caretakers can offer to facilitate language (and
general) development. How far the success of these actions
depends upon the caretaker's genuine concern with the child
and his behaviour remains unknown. One would have to say,
as an act of faith, that caring in action, realized as an
expression of a sincere liking and cheerful interest in what
children find important, is certainly desirable, if not
essential. Entering both intellectually and emotionally into
the spirit and perspective of the child's orientation to his
world must make the processes easier to achieve.
Claim 7: coming to "bow that' reorgcmizes the possibilities

of clevelopiDg "bow how'
Halliday (1975) noted that, at an early age, young Nigel
240
discriminated between using the language and learning the

language. Some children of four already 'know that' there
are rules governing how things are to be said and can say
something about their nature. We can also ask how children
come to realize that speech can be ambiguous: that a speaker
may send messages too vague for correct comprehension and
appropriate action. At an early stage children do not real-
ize a message should refer uniquely to its referents if it
is to be acted upon appropriately. In a situation where
speaker and listener have identical sets of cards, each set
depicting stick-men holding flowers differing in size and
colour, they will pick up a card in response to 'A man with
a flower' without necessarily asking for more information.
If their choice turns out to be wrong they will state that
the speaker had said enough (told properly) and that it was
their fault that the mismatch had occurred (phase 1 below).
When older they will be more likely to demand more informa-
tion by asking questions, and if a mismatch does still occur
they can blame the inadequacy of the message and the speaker
for the failure. They 'know that' messages can be inade-
quate. They can reflect upon and analyse the efficiency and
precision of their own speech and that of others (phase 2
below) •
At present we can only speculate about the general
significance of this work, but the possible implications are
considerable and can be represented roughly in a three-phase
model that could apply to many aspects of language develop-
ment. Let X be a truth, principle or fact about language.
* PHASE 1: the child is mainly a victim of X. His capa-

city for being an agent with control over X is limited
by his ignorance of the character of X and how it
functions in the language in communication. However, he
achieves a measure of mastery of X in use (know how)
as a result of associative learning both in its clas-
sical and instrumental conditioning guises, and he may
also learn about X in use through observation. He is
additionally an agent and can purposefully use X,
relying on corrective feedback from others for the
development of context-bound rules of use. These various
processes acting separately and in combination may lead
to the child using X successfully much of the time.
However, limitations of intellectual capacity and an
absence of opportunitites and/or capacities for reflec-
ting upon the workings of X will be manifested wilen his
rules for using X fail. He will not be able to diagnose
the reasons for failure and will not be able to formu-
late a diagnosis and act effectively upon it.
* PHASE 2: either through his own reflective efforts or as
a result of a competent other teaching and telling him
about the workings of X, he will come to realize how
(and perhaps why) X works as it does. As a result of
reflective analysis, in particular new situations or
through a consideration of past events, or through
241
imaginative rehearsing of situations involving X, he

will consciously develop and organize his knowledge
about X. We might expect an associated period of
learning-practice in which the use of X is tried out
with care and awareness. The child (or adult) has be-
come a reflecting agent in respect of X organizing his
'know"ing that', and perhaps temporarily less efficient
in his 'know how'.
* PHASE 3: the use of X will become reduced to an auto-
mated skill except for situations where for various
reasons it might be important not to make mistakes with
X and for situations where trouble in using X occurs. In
the face of trouble the problem can be raised to a con-
scious reflective analysis, diagnoses made and correc-
tive action taken, other things being equal. The 'know
how' is greater than at the transition from phase 1 to
phase 2 and is in a potential dialectic relation to a
'knowing that' of understanding.
We are thinking in this fashion only about the child's

control of ambiguity in verbal referential communication,
but see a range of possible applications to a whole variety
of behaviours within the orbit of language in communication:
learning the meanings of words, rules of spelling in the
written language, rules of pronunciation in the oral, rules
of grammar, rules for varying forcefulness and politeness
of requests, rules of etiquette more generally, rules for
taking the listener into account and rules for telling jokes
well.
Perhaps one important set of reasons why school childrer.
have difficulty in learning to use language more competently
is that we ourselves cannot formulate the rules for them.
Instead we leave them to continue to operate at a particular
and concrete level, learning many instances rather than
fewer principles and rules. And when we do find out the
rules and principles we do not necessarily set up conditions
of learning and practice that carry the child's competence
through to the phase of out-of-awareness efficient use with
reflective facilities for analysis when trouble occurs or is
anticipated. It is worth comparing the relative ease of
learning a game like chess or tennis with and without the
help of information about rules. To learn how to play will
require observation, practice and correction, but knowing
the rules renders these easier. Discovering them for your-
self could be simply a frustrating waste of time and effort.
Erroneous beliefs
The most fundamental, and possibly the most common, false
assumption is that the rate and extent of younger and older
children's learning how to use language is not affected by
the behaviour of their caretakers; that some innate features
of the child's brain or temperament determine what emerges.
(We have avoided mentioning ages of children at points where
readers might have preferred them to be specified. The
242
arguments in the section on backwardness offer some reasons

why it is misleading and dangerous to hold firm expectations
as to what individual children ought to have achieved at
particular ages. The educational problems with children are
to advance their knowledge, understanding, values and moti-
vation, not to categorize them.} While systematic investi-
gations of parents' and teachers' beliefs about language
development have yet to be made, it is quite clear that
within some cultures, some parents believe that the child
will become what it will become regardless of what they do.
The empirical evidence is that these beliefs do not cor-
respond to reality; while many facts about relations between
caretaker behaviour and language development have yet to be
discovered, the positive results already established are too
numerous and theoretically plausible to be discounted.
Unfortunately, academic thinking about these matters is
still dominated by a simplicity that is na"ive. One common
assumption in research seems to be that if a certain kind of
caretaker behaviour can be shown to be beneficial then the
more of it the better: that its efficacy will hold true for
all children at all phases of language development regard-
less of the context of operation and the state of relation-
ship between caretaker and child. Neither the basic assump-
tion nor its presumed generali ty is likely to be true.
For example, it is likely that caretakers can talk too
much with children as well as too little. And they can over-
teach particular features. Developmental social psycho-
logists have been slow to appreciate that many relations
between variables are likely to be curvilinear rather than
monotonic. 'The more the better' may have a limit beyond
which 'more' may mean worse or nothing and not better.
Just as caretakers may talk too much as well as too
little, they can talk at or past children instead of with
them. They can initiate and control without responding. Some
adults seem anxious to hurry their replies without having
listened first; they act, but do not react or interact. One
of the first lessons to be learned in dealing with young
children is not to impose oneself too quickly upon them, and
this applies to continuing as well as initial encounters.
While the child has to learn how and when to listen, he
needs to be listened to as well. It has been argued that
mothers listen attentively to children, trying to decipher
the meanings of their cries, but one can be sceptical about
the continuing and pervading applicability of such parental
commitment to all children as they grow older. Brown (1973)
showed that 40 per cent of his children's questions were met
with replies that were unrelated to the sense of the ques-
tion: one therefore wonders how many caretakers make serious
efforts to listen to children, encourage them to talk about
their activities, and maintain interest and cohesion in such
conversations. Those caretakers who are concerned to promote
development may push too hard or pull too hard. On the
evidence to date, 'pushing' is not productive; 'pulling',
pitched at the right level with not too high or Iowa
243
frequency, is an important facilitator of development,

however. Caretakers can pitch their initiations and reac-
tions to children at too low a level or too high a one. Too
low may be generally uncommon, but certainly some mentally
retarded children appear to be kept at a lower standard of
performance by adults unwilling to extend their conversation
with them. But how are caretakers to judge what is too much,
too often, or too hard?
Caretakers can solve these problems only in context. A
monitoring of the child's actions and reactions in combina-
tion with an appraisal of the verbal interaction itself
should suffice to indicate whether the child is attentively
involved. Adults should be able to appraise whether or not
their remarks are understood by the child both from his non-
verbal reactions and from his succeeding remarks. Adults
should be able to judge whether they themselves are
understanding and reacting appropriately to the child's
utterances. Does the child have great difficulty construc-
ting replies? Are there many disfluencies and intervening
silences? Are themes maintained over a succession of
utterances? In short, does the conversation have an orderly
structure? Does the talk relate to the contextual features
of the situation in which it is occurring? If it does, and
if the adult is injecting new information about the world
and about language at such a rate that the child can take up
and use some of the features being introduced, the worst
mistakes are being avoided.
This capacity to adjust speech to a developing child is
itself a skill that has to be learned. Child-rearing manuals
(Leach, 1978) or pre-school teachers' advice (Tough, 1977)
offer much constructive (and some wrong!) advice on such
matters. Perhaps both under-estimate the value of two acti-
vities: conversation as such, and the appropriate injection
of small doses of teaching about language during
conversations.
Finally, the conversation has to be anchored to the
outside world of actions and events and/or the inner per-
sonal world of wishes, intentions, feelings and ideas. The
talk has to be more than wording. Experiences have to be
arranged and/or exploited. Topics have to be selected. If
they are not, the child is in danger of separating rhetoric
from reali ty (or fantasy). He can come to believe that he
has to accommodate to a world of words and another world
of things and fail to realize that the two ought to be in a
dialectical and corresponding relation to each other.
Special problems Backwardness

Backwardness is not an absolute concept but a relative
one. Backwardness can exist only after a norm is defined.
For various reasons our society has selected biological age
from birth as a reference point. For many aspects of growth
and development we have devised ways of measuring charac-
teristics of children that give a spread of scores about an
244
average norm of some kind for children of a particular age.

Then we use our tests to obtain scores for individual child-
ren. However, to expect then that each individual child
should score close to the average is importantly irrational:
such an expectation is logically and empirically inconsis-
tent with the spreading procedures adopted to construct the
test.
This is not to say that it is foolish to ask why a child
or group of children is below (or above) average. Answers
to such questions may enable us to take constructive action
to facilitate the development of particular children who are
unnecessarily and undesirably backward in certain respects.
Many people in our society may also adopt a moral posi-
tion that special efforts should be made to promote more
rapid development in some sub-sample of the population
defined as 'backward'; say, the lowest ten per cent. That is
defensible. However, it is not logically or empirically
possible to eliminate a bottom ten per cent. We can take
action to raise the absolute performance or characteristics
of children; what we cannot do is use norm-referenced tests
and eliminate the variation about the norm.
We must also accept the fact that, at any moment in any
society, there are limits both to what can be done and what
the members of society think it is important to do. There
are biological, sociological-historical and economic limits
to what can be done. There are moral limits as to what we
might consider it proper or fair to do.
We can also observe that there are wrong ways of con-
ceptualizing these problems. Over the last 20 years and
before, questions have been asked about why children fail at
school. Some have blamed the biology and psychology of
failing children. Others have blamed bad homes. Bad teaching
and bad schools have been cited, as have curricula. The
government and the social structure of the society have not
escaped blame. In reality, the reason why n per cent of
children fail eSE, 0 level or A level is that the examiners
have set a fail rate of n per cent: and that is the sole
reason. We can sensibly proceed to ask why children from
certain identifiable groupings are particularly at risk of
failure.
We ought also to note that explanations for such failure
have generally made appeals to deficiency models of some
kind, deficiency in language being a frequently cited
factor. Oddly, we have only resorted to this kind of
explanation within age groups, particularly for social
categories such as social class, rurality, cultural minori-
ties and psychological categories such as the mentally
retarded or the maladjusted. We do not see infant school
children as language-deficient adults who need to be brought
up to a state of adult competence forthwith. Education is
normally seen as promoting and facilitating development and
not in terms of removing deficiencies. And yet, within a
particular age cohort, we have tended to apply the defi-
ciency model to the backward, even for 'normal' children.
2.45
Whether a glass of water is seen as half full or half empty

is a fact about the observer, not the water. The fate of
water may not be affected by that perception. However, when
a child is seen as more empty (or filled with the wrong
stuff) than he ought to be, there are likely to be conse-
quences for himself, his family, his teachers and ultimately
the society of which he is to become a citizen.
However, need we consider the language of a developing
child normatively, and if so, against which norms? If we are
to make special educational or other provision for those
defined as being in special need then testing individuals
against norms is essential as a diagnostic means of some
objectivity. Age-based norms may constitute the single most
efficient screening frame of reference for operation. Once
the presenting characteristics are defined by reference to
test scores, the hard work of explanation and decision
making starts. Are the scores deviant enough from the age
per norm to warrant further enquiry? Are the scores deviant
enough from what might be expected from this individual to
warrant further enquiry? If either is true, are the scores
themselves what are important or are they symptoms of some-
thing else? If the scores are judged to be indicators of
problems rather than problems in themselves, are these best
treated by being left to remedy themselves with subsequent
monitoring? Or should we intervene? Where intervention is
judged as desirable, the norm-referenced tests are likely to
have played a crucial role in detection and perhaps in
diagnosis, but not in the explanation or specification of
treatment as such.
Dialects aud accents

'Standard English' (SE) can be usefully thought of as that
dialect of British English whose rules of prosody, grammar,
lexis, semantics and pragmatics have become institution-
alized as the variety of English towards whose mastery the
educational endeavour aspires. 'Received Pronunciation' (RP)
refers to the accent that defines the corresponding phono-
logy. The components of standard English which are stressed
most frequently are its grammar and lexis; it is usually in
respect of those characteristics that SE is contrasted with
other regional and social dialects. When a variety is
accorded the status of a dialect is not closely defined.
Dialectologists have mapped out the distribution of regional
dialects in Britain, particularly rural ones. Socially-
stratified dialects have not been well investigated. And for
both we have yet to learn what their similarities and dif-
ferences are. Are dialects more alike than they are differ-
ent in each of their components? The number of differences
in grammatical rules is probably few in relation to the
total in the language.
Those responsible for educating children need to dis-
tinguish between features in their speech that indicate
ignorance of language and its workings and those which mark
social identity, through the dialect of the child's home. If
246
teachers denigrate the local dialect while teaching SE, they

are denigrating the people who speak that dialect and may
eventually force a child to choose between SE and the local
dialect. Is he to equip himself for upward social mobility
at the cost of social separation from his family and local
community? But why create conditions where a choice has
to be made?
One false belief is that people can master only one
dialect. Where the need for mastery of two different
languages exists, children learn two, often without the
benefit of schools to teach them. The factors that operate
to prevent children mastering several dialects are mainly
socio-cultural and not biological-cognitive.
If education is to open up opportunities rather than
to close them down, that system has to facilitate the
development of control of the dialects and languages of
greatest potential significance to the child, of which the
two most important are his local social/regional dialect or
language and SE, so that he may be able to use each as and
when appropriate.
Similarly, arguments can be advanced for the educational
support of more than one accent. It is now well documented
that people do not always utter the same sound in the same
way; it is a matter of proportion. And the proportions vary:
this has been shown most frequently through manipulations of
the formality-casualness of the situation.
Moreover, we also converge towards and diverge away
from the speech of our fellow conversationalists (Giles and
Powesland, 1975), such movements being interpreted as indi-
cative of goodwill and separateness respectively. Giles and
Powesland review studies which show how accents are eva-
luated in Britain. Evaluation can be along more than one
dimension, and in this case two emerge that may be most
simply summarized as expertness and trustworthiness. Un-
fortunately these are not independent, RP speakers being
seen as untrustworthy experts and broadly-accented country-
folk as trustworthy but ignorant. But children as well as
adults are judged by their accents, and it must be incumbent
upon the expert caretakers to increase their knowledge and
understanding about these matters.
In sum, we need to extend and disseminate our knowledge
about the way language functions in our community. We need
to develop and act upon policies that enable children to
master in sufficient measure those varieties of language
which will both promote their learning and enable them to
retain or gain access to membership of those social groups
in and through which their identity is realized.
Conclusions One common complaint made by members of the public, their

elected representatives and their paid servants is that aca-
demics address problems rather than solve them; they spend
too much time posing questions and too little answering
them. At least in language development we have now moved
PFP _ Q Z47
to a position where the types of question being asked begin

to embrace a comprehensive functional-structural framework.
We have begun to ask how children learn units and structures
to communicate meanings which have significance for action.
We are confronting language as a four-component system
(language in its pragmatic, semantic, lexico-grammatical and
phonological aspects), just as the developing child himself
confronts, copes with and learns to use all four interdepen-
dently. We have appreciated that, although function may be
a useful primary focus, we have to note that a child who can
distinguish between 'knowing how to' and 'knowing that' is
in a strong position to hold and develop both structures and
functions in a dynamic interactive relation to each other,
and that this capacity in fact predates the conscious onset
of this discrimination. The questions being posed now are
more likely to lead to progress than some of those narrower
and stranger questions of 20 years ago.
Furthermore, we have begun to answer quite a number of
questions. The claims made here are a distillation focussing
on processes and mechanisms of development rather than
content. What is now known about the content and sequence
of language development is considerable, especially in young
children. The claims made are couched in a form at as low
a level of abstraction as appears to be compatible with the
evidence. To be more specific would require the prior spe-
cification of more details of the particular children, care-
takers, context of situation, and learning problems under
consideration; the claims are principles that may guide
practice but cannot prescribe its concrete characteristics.
They also mark a departure from what might be called the
'one-answer-only' mentality. Psychologists have tried to
look for the process that converts all substances to gold,
or in this case all pre-linguistic babies into verbally com-
petent toddlers. We have seen the invalid logic that takes
the form of arguing that, because process X may not be
invariably necessary for mastering Y, it has no relevance.
It is likely that all learning processes are relevant or can
be made relevant to some aspects of language development
in some children. Once we ask whether, when, and how a
process can be used to facilitate development, our answers
may become more positive and useful.
But are the claims made here any improvement on common
sense? They are, in two ways. Unfortunately, a particular
form of sense is not common to all people, as can be speed-
ily demonstrated by revealing the extent of individual sub-
cultural and cultural differences as to what it is sensible
to believe. At present we know next to nothing about par-
ents' (or even teachers') beliefs about language develop-
ment, but we do know they differ. Some are wrong. This is
not to insult them. We are all wrong in some of our beliefs,
and none of us is omniscient. Appeals to common sense will
not yield the truth. At present, too, the experts continue
to disagree among themselves as to ways and means likely to
facilitate language development. If we mean by 'common
248
sense' the accumulated wisdom of experienced caretakers,

then experts would surely be well advised to solicit their
opinions; if they have learned through observing the conse-
quences of their teaching methods then they are a prime
population for ideas. But the convictions that have derived
from their private experience have then to be checked in
the publicly demonstrable contexts of systematic investiga-
tion. While the evidence obtained through scientific pro-
cedures is prone to errors of various kinds, investigators
are trained to try to avoid these. Hence the evidence and
the interpretations they offer should be less prone to
error, especially when empirical studies conducted in a
variety of settings yield results which can be shown to be
consistent. The claims put forward have been subject to
systematic scrutinizing activity, and that is why they,
rather than others, are presented.
Glossary Accommodation
A Piagetian term referring to the development of new schemes
arising out of the failure of current schemes to regulate
action. Hence sensori-motor schemes for sucking will not
enable an infant to drink from a cup: new schemes have to
be constructed.
Adaptation
In Piagetian development, adaptation is the combination of
the processes of assimilation and accommodation.
Assimilation
The application of currently available schemes to inter-
action with the environment. If a baby has a sucking scheme
used for breast feeding, it may readily assimilate the
sucking of a bottle teat to this scheme. The sucking scheme
will also be applied to fingers and toys but this transfer
will not, in the long run, be adaptive. New schemes will be
required to accommodate to the use of toys.
Intonation
Patterns of variation in pitch and stress that distinguish
(il between what is believed to be accepted already by
conversation partners and what is new, and (ii) the charac-
ter of utterances as questions, statements, commands, etc.
Lezico-grammar
The rules governing what is generally acceptable within a
language system. Grammar is said to have two components:
morphology and syntax. Rules in morphology define changes
to words themselves as their functions in sentences change;
for example, 'he' is subject, 'him' is the form for object.
Syntax defines the possible sequences, substitutions and co-
occurrences of weirds, phrases and clauses permitted in the
construction of sentences.
About 150 special words in English (conjunctions, pre-
positions, pronouns, etc.) are sometimes seen as having
249
predominantly grammatical/semantic significance. The

remaining half -million or so are lexical items. Both are
listed in dictionaries.
Morpheme
The smallest unit of meaning in language.
Norm
In its descriptive sense, norm refers to the typical or most
common behaviour of members of a group. It is also used
evaluatively to assert what is to be expected of such
members. The failure to separate the two can lead to the
idea that everyone has to be average, which is self-
contradictory.
Phonology
The study of sound systems of languages. Within a language,
which sounds make a significant difference to meaning? What
are the rules which define which combinations of sounds can
occur? To aid these descriptions, linguists have devised an
International Phonetic Alphabet that attempts to write down
sounds so that their pronunciation is defined. This does not
yet include conventions that represent stress or pitch.
Pragmatics
See semantics. Pragmatics is concerned with the significance
for action of utterances. To use language effectively,
people have to be able to interpret the speech of others and
to know how their own utterances are likely to be inter-
preted. This requires a knowledge of rules of the culture
and not just the semantics.
PsycholiDguistics
The study of the psychological processes that underlie
speech performance. The main focus in child development has
been upon the encoding and decoding of syntax, but a com-
prehensive study would include comparable analyses of sounds
and written symbols and meanings. Some people would also
include pragmatics.
Scheme
The procedures that regulate an action or set of actions.
Hence if an infant has a sucking scheme, his brain must
contain a set of instructions for action that result in a co-
ordinated sequence of movements that relate his body, mouth
and hands to nipples. Not all schemes relate to sensori-
motor skills: they can also relate to intellectual products.
Semantics
Units at and above the level of morpheme have meanings.
A cat is nat a dog; 'on' does not mean the same as 'in'. It
is through their combinations, in accordance with lexico-
grammatical rules, that sequences of sounds come to have
meaning. Some people have difficulty in grasping the
zso
distinction between semantics and pragmatics; pragmatics is

concerned with action. 'The door is open', uttered by a
teacher in a classroom means what it says. The semantics
declares a state of affairs to be true. The pragmatic sig-
nificance could be 'The last child to have come in should
get up and shut the door'. Unfortunately, we can use the
question 'What did he mean?' to refer to both the semantics
and the pragmatics. 'Meaning' is ambiguous.
SocioliDgaistics
Traditionally the study of language variation in relation to
variations in the nature of the setting, participants, ends,
aesthetics, key, mod ali ty, norms, and genre, within a speech
community. The focus is upon pragmatics and how functions
relate to the forms used. Sociolinguistics and psycho-
linguistics over lap.
Syntax
The rules for combining words into phrases, clauses and
sentences.
References Brown, R. (1973)

A First Language: The early stages. London: Allen &
Unwin.
Bruner, J.S. (1975)
The ontogenesis of speech acts. Journal of Child
Language, 2, 1-19.
Cross, T.G. (1978)
Mother's speech and its association with role of
linguistic development in the young child. In N.
Waterson and C. Snow (eds) , The Development of
Communication. Chichester: Wiley.
De Cecco, J.P. (1960)
The Psychology of Learning and Instruction. Englewood
Cliffs, NJ: Prentice-Hall.
DeV"llliers, R.A. and De V"illiers, J. (1979)
Early Language. Glasgow: Fontana/Open Books.
Ellis, R. and Wells, C.G. (1980)
Enabling factors in adult-child discourse. First
Language, 1, 46-62.
Giles, H. and Powesland, P.F. (1975)
Speech Style and Social Evaluation. London: Academic
Press.
Halliday, M.A.K. (1975)
Learning How to Mean. London: Arnold.
Hess, R.D. and Shipaan, V. (1965)
Early experience and the socialization of cognitive
modes in children. Child Development, 36, 860-886.
Leach, P. (1978)
Baby and Child. London: Michael Joseph.
RobiDson, W.P. (1978)
Language Management in Education. Sydney: Allen &
Unwin.
251
RobiDaon, W.P. (ed.) (in press)

Communication in Child Development. London: Academic
Press.
T~, J. (1977)
Talking and Learning. London: Ward Lock.
Questious 1. What can adults do to facilitate language development in

young children?
Z. Write a government leaflet giving advice to young
mothers about language development in their children.
3. If mothers wish to facilitate language development in
their children, which is it more important for them to
know: details about the nature of language, or rules of
interaction?
4. Is it the ignorance of parents and teachers rather than
the incapacity of children that delays their
development?
5. Describe and comment upon the child's development of
syntax.
6. What learning processes underlie which aspects of
language development?
7. What roles can, and does, imitation play in language
development?
8. Why do children stretch familiar units to cope with new
meanings?
9. Why encourage language development in children?
10. What should be done in infant schools about the dialects
of children?
Amlotated reading Ausubel, D.P. (1978) Theory and Problems of Child Develop-
ment (Znd edn). New York: Grune lit Stratton.
A general textbook about child development from an
educational perspective.
Byers-Brown, B. (1981) Speech Therapy: Principles and

Practice. Edinburgh and London: Churchill Livingstone.
A recent publication, basically written for speech
therapists. It describes the nature of speech disorders
and gives details of speech therapy. The first half of
the book deals with speech therapy itself, but the
second part of the book gives a comprehensive cover of
the disorders of speech and delays in speech
development.
Coulthard, C.M. (1977) An Introduction to Discourse

Analysis. London: Longmans.
What are the relations between linguistic form and the
discourse functions of speech? Coulthard offers some
suggestions.
De Stefano, J .S. (ed.) (1973) Language, Society and

Education. Worthington, Ohio: Charles Jones.
A collection that brings life to varieties of American
Z5Z
English and discusses learning simply and clearly. No

comparable book on British English, alas.
De Stefano, J.S. (1978) Language, the Learner and the

School. New York: Wiley.
Introductory books about language are still liable
to concentrate upon syntax and ignore language in use.
This is a welcome exception. Examples of language
varieties are mainly American.
De Villiers, J .G. and de Villiers, P.A. (1978) Language

Acquisition. Cambridge, Mass.: Harvard University Press.
The most balanced, comprehensive clear, introduction to
language acquisition. Cognitive rather than social
emphasis.
De Villiers, J. G. and de Villiers, P.A. (1979) Early

Language. London: Fontana/Open Books.
A simplified and highly readable version of the authors'
more substantial text. Compulsory reading.
Holt, K. and Reynell, J. (1967) Assessment of Cerebral

Palsy. London: Lloyd Luke.
A well-written book covering all aspects of cerebral
palsy but having chapters devoted to speech and
perceptual disorders.
Moerk, E.L. (1977) Pragmatic and Semantic Aspects of Early

Language Development. Baltimore: University Park Press.
The emphasis on pragmatics is compatible with
contemporary concerns.
Renfrew, C.E. (1972) Speech Disorders in Children. Oxford:

Pergamon Press.
This book gives an account of speech difficulties in
children only: it is a good descriptive text, but the
scope of language difficulties is greater (i.e. the book
does not examine the problems of the adult acquired
speech disorder). The scope of speech therapy has
expanded since publication, but basic information re
abnormal speech is accurate.
Rutter, M. and Martin, J. (eds) (1972) The Child with

Delayed Speech. London: Heinemann.
This concentrates on one particular problem, its under-
lying difficulties and possibili ties for their manage-
ment.
Waterson, N. and Snow, C. (eds) (1978) The Development

of Communication. Chichester: Wiley.
A collection of papers illustrating the kinds of
questions being posed and answers being offered in
respect of the communicative development in young
children.
253
10
The Adult: Interpersonal Behaviour
and Social Adjustments
Michael Argyle
Adolescence After two chapters devoted to childhood, and to maintain the

E.N.DUNKIN continuity of our time scale, we should look at the next
stage in development. What of the adolescent, the individual
whose body has almost finished growing and who has managed
to leam a great deal about language and the manipulation of
his human and non-human environment? We should consider this
before turning our attention to adults. We might expect to
see a smooth continuous progress, a steady growth of per-
sonality and physique from infancy to maturity. Instead,
adolescence seems to be something ,of a hurdle, located at
the time when the individual is no longer a child but is not
yet fully accepted as a mature adult. In some cultures, this
transition is marked by joyful celebration, with the ado-
lescent being welcomed into the older group in an atmosphere
of appreciation for the energy and enthusiasm that the young
people bring to the management of group responsibilities.
This is not characteristic of the so-called more advanced
societies. For the past 70 years or more, western civili-
zation has been trying to sort out a problem that it seems
to have produced for itself.
Adolescence is seen as a period of difficult adjustment
for parents and their erstwhile children, lasting anything
up to ten years. Perhaps it is a surrogate battle, a fash-
ionable and permitted outlet for aggression that occurs
between human beings, polarized at a point between adjacent
generations. Certainly, there seems to be no counterpart of
this conflict between grandchildren and grandparents, possi-
bly because the elderly do not feel remotely threatened by
the very young. Perhaps the emergence of adolescence as a
problem stage reflects the modem trend towards reduced
parental control, and the rejection of the Victorian image
of authoritarian parents and compliant children. In its
place, there has grown up an idolization of Youth, a pre-
tence of preoccupation with the fresh young ideas that show
such promise when they are seen against the tired, grey
world of weary and competitive adults.
In the animal world, this revolt of the young against
the old is seen in the dominance battles that occur between
generations of primates, lions, sea lions, wolves and other
species, where a power hierarchy determines the survival of
the group. In these fights, the strength and vigour of the
Z54
The adult: interpersonal behaviour and social adjustments
young males usually wins the day: they take over the leader-
ship and the old ones are discarded. But this is not the
inevitable outcome of the first engagement. If the young
male cannot prove himself to be strong enough to take over,
he is routed and he must go back to his subservient position
while he lives longer, gains more strength and experience,
and prepares for the next battle with a greater chance of
victory. In our comparison of the human fray with that of
other species, perhaps we are inclined to leave our analogy
too early and at too simple a level, seeing only the even-
tual replacement of the old by the young as a threat to the
security of the adults, and failing to see the value of the
'try-out' period. The adolescent is partially protected from
full responsibili ty within the society until he has proved
to himself and others that he is able to consider all the
implications of reconciling his beliefs with the practical
problems of managing millions of disparate human beings
and their material possessions.
Whatever the reasons for the social ailments between
generations, adolescence seems to be a period of emotionally
charged theorizing about deep and philosophical issues. The
adolescent sees all the problems of society and works out
convincing proposals for putting everything to rights. At
least, the proposals are convincing to himself and as he
believes in the power of his logical deductions, he has
equal faith that sooner or later (and if left to him, most
definitely sooner) the problems will be solved according
to his prescription. He is all set to reform the whole of
society and to restore the absolute values of right and
wrong. He seems to have made a temporary return to the
egocentric thinking that Piaget regarded as typical of the
thinking of very young children. He has sublime belief in
his own wisdom, integrity and inspiration, and an inexhaus-
tible enthusiasm for removing the indolence of society.
Unfortunately, the adolescent has not had enough experience
of managing the daily crises of the community at large, and
he does not have a realistic estimate of what he can do. One
of his chief resolutions is that he will never get like his
'elders and betters', who seem to be complacently unaware
of the conflict between what they believe is right and the
practical evils that surround them. The adolescent has the
great advantage of being able to contemplate all the issues,
(focussing his attention so that everything is clear cut,
seen in sharp contrast, and amenable to corrective action) ,
at a time when he is not really involved in dealing with
them.
Perhaps it is na'ive to consider that people have changed
over the centuries, because the lively interest of the ado-
lescent for solving the problems of the world before he has
sorted out his own is reminiscent of a topical situation
that caused one of the comments made in the Sermon on the
Mount some 20 centuries ago: 'Thou hypocrite, cast out first
the beam out of thine own eye and then shalt thou see
clearly to put out the mote that is in thy brother's eye'
255
(St Luke 6: 42.). In many ways, adolescents are no different

from the rest of us. Human beings in general have a resili-
ent conceit in their own ability. It is just that the ado-
lescent has not come across the harsh reality that brick
walls are harder than the average head and that there are
no immediate solutions for large-scale social inequalities.
It certainly seems that before long he meets enough rebuffs
to force him to channel his energies into managing his own
life and that of his family, leaving the settlement of the
universal ills to the next generation.
There is at least one other way of considering the
turmoil of adolescence and that is via the biological
adjustments that are concluded in this period. Puberty
brings a different set of interpersonal responses to the
repertoire of the individual, while the bodily changes asso-
ciated with maturation of the reproductive system do not
always go smoothly. Again, there seems to be more difficulty
in the western world. A cross-cultural comparison gives the
impression that western adolescent girls have more problems
than girls in 'less advanced' societies, but it is not clear
whether this is due to alterations in physical and organic
factors induced over successive generations (by inability to
relax, reduced participation in regular exercise, 'unnatural
diet', etc.), or to racial differences of a genetic type.
Another possible explanation for the greater difficulties of
the western girl lies in the expectations and superstitions
that have grown up within the society over the years. It is
hard to establish the origin of individual discomfort, but
the incidence of pain in the early months of menstruation is
observable and certainly seems to be far greater in cultures
that are particularly marked by competition, anxiety and the
accumulation of material possessions.
In the last 15-2.0 years, adolescents in the modern wes-
tern world have been more likely to experiment with sexual
behaviours than they were in the earlier part of this cen-
tury. The consequences of sexual intercourse do not seem to
be well controlled by the contraceptive expertise that has
been publicized during the same time. Although there has
been some relaxation of the social reaction to early and
illicit sexual intercourse, the fact that it is still re-
garded as 'illicit' (i.e. illegitimate if it occurs out of
wedlock) is not fully compatible with the apparent change
in moral standards in favour of tolerating experiments in
heterosexual living. Successive generations have gone into
print to support the right of individuals to have sexual
relationships as and when they choose, but there is a
residual stigma attached to people who are exercising that
right and at the same time manage to conceive unwanted
children. The social feelings run particularly high when
schoolgirls of 12.-15 years of age have babies: there is a
general feeling that they have insufficient experience to
make a good job of motherhood at the same time as they
are dealing with the balance of their own basic education.
Judgements in this matter are often highly prejudiced: very
few British or North American adults know any details about
256
the parental efficiency of 12 year olds in other cultures,

where early child-bearing is a social expectation. From the
discussion so far, it seems that the whole matter of sexual
freedom and its relation to the laws regulating monogamous
marriage must be resolved before the adult population can
expect to be a reasonable model for the adolescent popula-
tion. It is unlikely that promiscuity in the very young will
be replaced by more lasting relationships while adults re-
main confused about the need for marriage as a foundation
for family life.
In the past, one of the reasons put forward for the
unrest and rebellion of adolescents was that young people
must search for group membership so that they satisfy a
basic need for affiliation. With the liberalization of codes
of social behaviour and increased freedom for the indivi-
dual, the adolescent really has no problem finding a group
wi th which he can identify. The strict 'teenage' conformity
in dress that has developed in the last few years is an
indication of the facility with which young people can set
themselves apart as a recognizable group. It is curious and
paradoxical that their rejection of other people's standards
has trapped them so completely into a uniformity that they
would never have tolerated if it had been suggested to them
by their elders! Doubtless the manufacturers of jeans and
anoraks have no complaints, as their trade must be booming.
If the young person can find his sartorial needs so easily
met by the producers, surely it must be just as easy for him
to find people who share his ideology, likes and dislikes?
We are left to ponder on the wisdom of treating young people
as a special case. It is probably high time that western.
cultures de-emphasized the differences between young adults
and older adults, and gave more thought to channelling the
vigour and enthusiasm of the reasoning of teenagers into
actual solution of some of our social ills. It would help if
parents abandoned their traditional attitude of patronizing
and discounting the ideas of their offspring.
Leaving that salutary thought, we are now about to move
on to considering social behaviour in general, with special
attention being given to the ways in which people commu-
nicate. Michael Argyle's section will take us beyond the
spoken word of inter-personal exchanges to examine the signs
and gestures (the semiology) which support, and in some
cases replace, verbal language. Argyle is another adherent
of the Skinnerian interpretation of operant conditioning and
he stresses the importance of giving strong and immediate
reinforcement in order to increase the acceptable responses
of interacting people. In the chapter dealing with the
development of language (chapter 9), the example of a car
driver served to clarify one of our arguments: you will find
that Argyle also uses the driver and his driving behaviours
as a convenient analogy for the perpetual personal
adjustments that typify social interactions.
The planning abili ty that Piaget sees developing towards
the end of the concretely operational period of thinking,
and which in its fully developed form allows the individual
2,57
to reason logically, crops up again as the adult ability to

plan his behaviour in response to other people's actions.
Argyle warns us that bias in social situations is often
induced because people make mistakes in interpreting other
people's characteristics. For members of the health pro-
fessions, the warning has a particular significance, as
initial reactions to patients can have a lasting effect on
the patient/therapist relationship. Where this is unfavour-
able, it can prejudice the success of a treatment regime.
Because the whole question of person perception is under
examination, this time from the aspect of exchanged gestures
as well as other activities, the ideas of person perception
that were introduced in chapter 6 and expanded in chapter
7 appear again.
You will also find that the suggestions for further
reading indicate the breadth of social psychology and empha-
size that this section concentrates on introducing the adult
in a social setting.
Introduction: social We start by presenting the social skill model of social

beba9iour as a skill behaviour, and an account of sequences of social inter-
MICHAEL ARGYLE action. This model is very relevant to our later discussion
of social skills and how these can be trained. The chapter
then goes on to discuss the elements of social behaviour,
both verbal and non-verbal, and emphasize the importance and
different functions of non-verbal signals. The receivers of
these signals have to decode them, and do so in terms of
emotions and impressions of personality; we discuss some of
the processes and some of the main errors of person per-
ception. The sender can manipulate the impression he creates
by means of 'self-presentation'. The processes of social
behaviour, and the skills involved, are quite different in
different social situations, and we discuss recent attempts
to analyse these situations in terms of their main features,
such as rules and goals.
We move on to a number of specific social skills.
Research on the processes leading to friendship and love
makes it possible to train and advise people who have dif-
ficulty with these relationships. Research on persuasion
shows how people can be trained to be more assertive. And
research on small social groups and leadership of these
groups makes it possible to give an account of the most
successful skills for handling social groups.
Social competence is defined in terms of the successful
attainment of goals, and it can be assessed by a variety of
techniques such as self-rating and observation of role-
played performance. The most successful method of improv-
ing social skills is role-playing, combined with modelling,
coaching, videotape recorder (VTR) playback, and 'homework'.
Results of follow-up studies with a variety of populations
show that this form of social skills training (SST) is very
successful.
Harre and Secord (1972) have argued persuasively that
much human social behaviour is the result of conscious
Z58
planning, often in words, with full regard for the complex

meanings of behaviour and the rules of the situations. This
is an important correction to earlier social psychological
views, which often failed to recognize the complexity of
individual planning and the different meanings which may be
given to stimuli, for example in laboratory experiments.
However, it must be recognized that much social behaviour
is not planned in this way: the smaller elements of beha-
viour and longer automatic sequences are outside conscious
awareness, though it is possible to attend, for example, to
patterns of gaze, shifts of orientation, or the latent
meanings of utterances. The social skills model, in empha-
sizing the hierarchical structure of social performance, can
incorporate both kinds of behaviour.
The social skills model also emphasizes feedback pro-
cesses. A person driving a car sees at once when it is going
in the wrong direction, and takes corrective action with the
steering wheel. Social inter actors do likewise; if another
person is talking too much they interrupt, ask closed ques-
tions or no questions, and look less interested in what he
has to say. Feedback requires perception, looking at and
listening to the other person. Skilled performance requires
the ability to take the appropriate corrective action
referred to as 'translation' in the model: not everyone
knows that open-ended questions make people talk more and
closed questions make them talk less. And it depends on a
number of two-step sequences of social behaviour whereby
certain social acts have reliable effects on another. Let
us look at social behaviour as a skilled performance similar
to motor skills like driving a car (see figure 1).
Figure 1
The motor skill model (from Argyle, 1969)
feedback
I oop
perception ....
motivation
goal
---.. !
translation changes in
outside world
~
motor
responses
In each case the performer is pursuing certain goals, makes

continuous response to feedback, and emits hierarchically-
259
organized motor responses. This model has been heuristically

very useful in drawing attention to the importance of
feedback, and hence to gaze; it also suggests a number of
different ways in which social performances can fail, and
suggests the training procedures that may be effective,
through analogy with motor skills training (Argyle and
Kendon, 1967; Argyle, 1969).
The model emphasizes the motivation, goals and plans of
interactors. It is postulated that every interactor is try-
ing to achieve some goal, whether he is aware of it or not.
These goals may be, for example, to get another person to
like him, to obtain or convey information, to modify the
other's emotional state, and so on. Such goals may be linked
to more basic motivational systems. Goals have sub-goals;
for example, a doctor must diagnose the patient before he
can treat him. Patterns of response are directed towards
goals and sub-goals, and have a hierarchical structure:
large units of behaviour are composed of smaller ones, and
at the lowest levels these are habitual and automatic.
The role of reinforcement

This is one of the key processes in social skills sequences.
When interactor A does what B wants him to do, B is pleased
and sends immediate and spontaneous reinforcements: smile,
gaze, approving noises, etc., and modifies A's behaviour,
probably by operant conditioning; for example, modifying the
content of his utterances. At the same time A is modifying
B's behaviour in exactly the same way. These effects appear
to be mainly outside the focus of conscious attention, and
take place ver.y rapidly. It follows that anyone who gives
strong rewards and punishments in the course of interaction
will be able to modify the behaviour of others in the des-
ired direction. In addition, the stronger the rewards that A
issues, the more strongly other people will be attracted to
him.
The role of gaze in social aIdlls

The social skills model suggests that the monitoring of
another's reactions is an essential part of social perfor-
mance. The other's verbal signals are mainly heard, but his
non-verbal signals are mainly seen; the exceptions being
the non-verbal aspects of speech and touch. It was this
implication of the social skills model which directed us
towards the study of gaze in social interaction. In dyadic
interaction each person looks about 50 per cent of the time,
mutual gaze occupies 25 per cent of the time, looking while
listening is about twice the level of looking while talking,
glances are about three seconds, and mutual glances about
one second, with wide variations due to distance, sex
combination, and personality (Argyle and Cook, 1976).
However, there are several important differences between
social behaviour and motor skills.
* Rules: the moves which interactors may make are governed
260
by rules; they must respond properly to what has gone

before. Similarly, rules govern the other's responses
and can be used to influence his behaviour; for example,
questions lead to answers.
* Taking the role of the other: it is important to per-
ceive accurately the reactions of others. It is also
necessary to perceive the perceptions of others; that
is, to take account of their points of view. This
appears to be a cognitive ability which develops with
age (Flavell, 1968), but which may fail to develop
properly. Those who are able to do this have been found
to be more effective at a number of social tasks, and
more altruistic. Meldman (1967) found that psychiatric
patients are more egocentric; that is, talked about
themselves more than controls, and it has been our
experience that socially unskilled patients have great
difficulty in taking the role of the other.
* The independent initiative of the other sequences of
interaction: social situations inevitably contain at
least one other person, who will be pursuing his goals
and using his social skills. How can we analyse the
resulting sequences of behaviour? For a sequence to
constitute an acceptable piece of social behaviour, the
moves must fi t together in order. Social psychologists
have not yet discovered all the principles or 'grammar'
underlying these sequences, but some of the principles
are known, and can explain common forms of interaction
failure.
Verbal and DOD-verbal Verbal cOIIIDMmicatiOD

cDlDlDUDicatiOD There are several different kinds of verbal utterance.
* Egocentric speech: this is directed to the self, is

found in infants and has the effect of directing
behaviour.
* Orders, instructions: these are used to influence the
behaviour of others; they can be gently persuasive or
authoritarian.
* Questions: these are intended to elicit verbal infor-
mation; they can be open-ended or closed, personal or
impersonal.
* Information: may be given in response to a question,
or as part of a lecture or during problem-solving
discussion.
(The last three points are the basic classes of utterance.)
* Informal speech: consists of casual chat, jokes, gossip,

and contains little information, but helps to establish
and sustain social relationships.
* Expression of emotions and interpersonal attitudes: this
is a special kind of information; however, this
information is usually conveyed, and is conveyed more
effectively, non-verbally.
2.61
* Per formative utterances: these include 'illocutions'

where saying the utterance performs something (voting,
judging, naming, etc.), and 'perlocutions', where a goal
is intended but may not be achieved (persuading,
intimidating, etc.).
* Social routines: these include standard sequences like
thanking, apologizing, greeting, etc.
* Latent messages: in these, the more important meaning
is made subordinate ('As I was saying to the Prime
Minister ••• ') •
There are lDany category schemes for reducing utterances to

a limited number of classes of social acts. One of the best
known is that of Bales (1950), who introduced the 12 classes
shown in figure 2.
Non-verbal signals accompanying speech

Non-verbal signals play an important part in speech and
conversation. They have three main roles:
* completing and elaborating on verbal utterances:

utterances are accompanied by vocal emphasis, gestures
and facial expressions, which add to the meaning and
indicate whether it is a question, intended to be
serious or funny, and so on;
* managing synchronizing: this is achieved by head-nods,
gaze-shifts, and other signals. For example, to keep
the floor a speaker does not look up at the end of an
utterance, keeps a hand in mid-gesture, and increases
the volume of his speech if the other interrupts;
* sending feedback signals: listeners keep up a con-
tinuous, and mainly unwitting, commentary on the
speaker's utterances, showing by mouth and eyebrow
positions whether they agree, understand, are surprised,
and so on (Argyle, 1975).
Other functioua of Don-verbal cmmmmication (NYC)

NVC consists of facial expression, tone of voice, gaze,
gestures, postures, physical proximity and appearance. We
have already described how NVC is linked with speech; it
also functions in several other ways, especially in the
communication of emotions and attitudes to other people.
A sender is in a certain state, or possesses some
informaticn; this is encoded into a message which is then
decoded by a receiver.
sender encodes message
Encoding research is done by putting subjects into some

state and studying the NV messages which are emitted. For
example Mehrabian (1972) , in a role-playing experiment,
asked subjects to address a hat-stand, imagining it to be a
262
FigUre 2.
The Bales categories (from Bales, 1950)
1 SHOWS SOLIDARITY, raises

other's status gives help,
reward:
Social-emotional A.-< 2. SHOWS TENSION RELEASE,

Area: positive jokes, laughs, shows
satisfaction:
3 AGREES, shows passive

acceptance, understands,
concurs, complies:
4 GIVES SUGGESTION, direction,

implying autonomy for other:
B« 5 GIVES OPINION, evaluation,

analysis, expresses feeling, t---
wish:
Task
Area: neutral
6 GIVES ORIENT A nON, information,
repea ts, clarifies, confirms:
7 ASKS FOR ORIENTA nON,

n a b c d e f
information, repetition,
confirmation: W
c -< 8 ASKS FOR OPINION, evaluation,
t---
analysis, expression of feeling:
9 ASKS FOR SUGGESTION, direction,

possible ways of action:
10 DISAGREES, shows passive

rejection, formality,
withholds help:
Social-emotional D -< 11 SHOWS TENSION, asks for help,

Area: negative withdraws out of field:
12. SHOWS ANTAGONISM, deflates

other's status, defends or
asserts self:
KEY
a problems of communication A positive reactions

b problems of evaluation B attempted answers
c problems of control C questions
d problems of decision D negative reactions
e problems of tension reduction
f problems of reintegration
PFP _ R
2.63
person. Male subjects who liked the hat-stand looked at it

more, did not have hands on hips and stood closer.
Non-verbal signals are often 'unconscious': that is,they
are outside the focus of attention. A few signals are uncon-
sciously sent and received, like dilated pupils, signifying
sexual attraction, but there are a number of other possi-
bili ties as shown in table 1.
Table 1
Awareness of DOD-verbal sigaaJs
Sender ~I Signal .. I Receiver

SENDER SIGNAL RECEIVER
aware verbal aware
mostly most NVC mostly

unaware aware
aware trained unaware

sender
unaware trained aware

receiver
unaware some NVC unaware
Strictly speaking pupil dilation is not communication at

all, but only a physiological response. 'Communication' is
usually taken to imply some intention to affect another; one
criterion of successful communication is that it makes a
difference whether the other person is present and in a
posi tion to receive the signal; another is that the signal
is repeated, varied or amplified if it has no immediate
effect. These criteria are independent of conscious inten-
tion to communicate, which is often absent.
* Interpersonal attitudes: inter actors indicate how much

they like or dislike one another, and whether they think
they are more or less important, mainly non-verbally. We
have compared verbal and non-verbal signals and found
that non-verbal cues like facial expression and tone of
voice have far more impact than verbal ones (Argyle et
aI, 1970).
* Emotional states: anger, depression, anxiety, joy,
surprise, fear and disgust/contempt, are also communi-
cated more clearly by non-verbal signals, such as facial
expression, tone of voice, posture, gestures and gaze.
264
Interactors may try to conceal their true emotions, but

these are often revealed by 'leakage' via cues which are
difficult to control.
Person perception In order to respond effectively to the behaviour of others

it is necessary to perceive them correctly. The social
skills model emphasizes the importance of perception and
feedback; to drive a car one must watch the traffic outside
and the instruments inside. Such perception involves selec-
ting certain cues, and being able to interpret them cor-
rectly. There is evidence of poor person perception in
mental patients and other socially unskilled individuals,
while professional social skills performers need to be
sensitive to special aspects of other people and their
behaviour. For selection interviewers and clinical psycho-
logists the appraisal of others is a central part of the
job.
We form impressions of other people all the time, mainly
in order to predict their future behaviour, and so that we
can deal with them effectively. We categorize others in
terms of our favourite cognitive constructs, of which the
most widely used are:
* extraversion, sociability;
* agreeableness, likeabili ty;
* emotional stability;
* intelligence;
* assertiveness.
There are, however, wide individual differences in the con-

structs used, and 'complex' people use a larger number of
such dimensions. We have found that the constructs used vary
greatly with the situation: for example, work-related con-
structs are not used in purely social situations. We also
found that the constructs used vary with the target group,
such as children versus psychologists (Argyle et aI, in
press) •
A number of widespread errors are made in forming
impressions of others which should be particularly avoided
by those whose job it is to assess people:
* assuming that a person's behaviour is mainly a product

of his personality, whereas it may be more a function
of the situation he is in: at a noisy party, in church,
etc.;
* assuming that his behaviour is due to him rather than
his role; for example, as a hospital nurse, as a patient
or as a visi tor;
* attaching too much importance to physical cues, like
beards, clothes, and physical attractiveness;
* being affected by stereotypes about the characteristics
of members of certain races, social classes, etc.
265
During social interaction it is also necessary to perceive

the emotional states of others: for example, to tell if
they are depressed or angry. There are wide individual
differences in the ability to judge emotions correctly
(Davitz, 1964). As we have seen, emotions are mainly
conveyed by non-verbal signals, especially by facial expres-
sion and tone of voice. The interpretation of emotions is
also based on perception of the situation the other person
is in. Lalljee at Oxford found that smiles are not neces-
sarily decoded as happy, whereas unhappy faces are usually
regarded as authentic.
Similar considerations apply to the perception of
interpersonal attitudes, for instance who likes whom, which
is also mainly based on non-verbal signals, such as proxi-
mity, gaze and facial expression. Again use is made of
context to decode these signals: a glance at a stranger may
be interpreted as a threat, an appeal for help or a friendly
invitation. There are some interesting errors due to
pressures towards cognitive consistency: if A likes B, he
thinks that B likes him more than B on average actually
does: if A likes both B and C, he assumes that they both
like each other more than, on average, they do.
It is necessary to perceive the on-going flow of inter-
action in order to know what is happening and to participate
in it effectively. People seem to agree on the main episodes
and sub-episodes of an encounter, but they may produce
rather different accounts of why those present behaved as
they did. One source of variation, and indeed error, is that
people attribute the causes of others' behaviour to their
personality ('He fell over because he is clumsy'), but their
own behaviour to the situation ('I fell over because it was
slippery'), whereas both factors operate in each case (Jones
and Nisbett, 1972.). Interpretations also depend on the ideas
and knowledge an individual possesses: just as an expert on
cars could understand better why a car was behaving in a
peculiar way, so also can an expert on social behaviour
understand why pa tterns of social behaviour occur.
SituatiODS, their We know that people behave very differently in different

rules and other situations; in order to predict behaviour, or to advise
features people on social skills in specific situations, it is
necessary to analyse the situations in question. This can
be done in terms of a number of fundamental features.
Goals
In all situations there are certain goals which are commonly
obtainable. It is often fairly obvious what these are, but
socially inadequate people may simply not know what parties
are for, for example, or may think that the purpose of a
selection interview is vocational guidance.
We have studied the main goals in a number of common
situations, by asking samples of people to rate the impor-
tance of various goals, and then carrying out factor ana-
lysis. The main goals are usually:
266
* social acceptance, etc.;

* food, drink and other bodily needs;
* task goals specific to the situation.
We have also studied the relations between goals, within and

between persons, in terms of conflict and instrumentality.
This makes it possible to study the 'goal structure' of
situations.
Rules
All situations have rules about what mayor may not be done
in them. Socially inexperienced people are often ignorant
or mistaken about the rules. It would obviously be impos-
sible to playa game without knowing the rules and the same
applies to social situations.
We have studied the rules of a number of everyday situ-
ations. There appear to be several universal rules; to be
poli te, friendly, and not embarrass people. There are also
rules which are specific to situations, or groups of situ-
ations, and these can be interpreted as functional, since
they enable situational goals to be met. For example, when
seeing the doctor one should be clean and tell the truth;
when going to a party one should dress smartly and keep to
cheerful topics of conversation.
Special skills
Many social situations require special social skills, as in
the case of various kinds of public speaking and inter-
viewing, but also such everyday situations as dates and
parties. A person with little experience of a particular
situation may find that he lacks the special skills needed
for it (cf. Argyle et aI, in press) •
Repertoire of elements
Every situation defines certain moves as relevant. For
example, at a seminar it is relevant to show slides, make
long speeches, draw on the blackboard, etc. If moves
appropriate to a cricket match or a Scottish ball were made,
they would be ignored or regarded as totally bizarre. We
have found 65-90 main elements used in several situations,
like going to the doctor. We have also found that the
semiotic structure varies between situations: we found that
questions about work and about private life were sharply
contrasted in an office situation, but not on a date.
Roles
Every situation has a limited number of roles: for example,
a classroom has the roles of teacher, pupil, janitor, and
school inspector. These roles carry different degrees of
power, and the occupant has goals peculiar to that role.
Cognitive structure
We found that the members of a research group classified
each other in terms of the concepts extraverted and enjoy-
able companion for social occasions, but in terms of
Z67
dominant, creative and supportive for seminars. There are

also concepts related to the task, such as 'amendment',
'straw vote' and 'nem con', for committee meetings.
Environmental setting and pieces

Most situations involve special environmental settings and
props. Cricket needs bat, ball, stumps, etc.; a seminar
requires a blackboard, slide projector and lecture notes.
How do persons fit into situations, conceived in this
way? To begin with, there are certain pervasive aspects of
persons, corresponding to the 20 per cent or so of person
variance found in P x S (personality and situation) studies.
This consists of scores on general dimensions like intelli-
gence, extraversion, neuroticism and so on. In addition,
persons have dispositions to behave in certain ways in
classes of situations; this corresponds to the 50 per cent
or so of the P x S variance in relation to dimensions of
situations like formal-informal, and friendly-hostile.
Third, there are more specific reactions to particular
situations; for example, behaviour in social psychology
seminars depends partly on knowledge of social psychology,
and attitudes to different schools of thought in it. Taken
together these three factors may predict performance in, and
also avoidance of, certain situations - because of lack of
skill, anxiety, etc. - and this will be the main expectation
in such cases.
Friendship This is one of the most important social relationships:

failure in it is a source of great distress, and so it is
one of the main areas of social skills training. The con-
ditions under which people come to like one another have
been the object of extensive research, and are now well
understood.
There are several stages of friendship: (i) coming into
contact with the other, through proximity at work or else-
where; (ii) increasing attachment as a result of reinforce-
ment and discovery of similarity; (iii) increasing self-
disclosure and commitment; and sometimes (iv) dissolution
of the relationship. Friendship is the dominant relationship
for adolescents and the unmarried; friends engage in charac-
teristic activities, such as talking, eating, drinking,
joint leisure, but not, usually, working.
Frequency of interaction
The more two people meet, the more polarized their attitudes
to one another become, but usually they like one another
more. Frequent interaction can come about from living in
adj acent rooms or houses, working in the same office,
belonging to the same club, and so on. So interaction leads
to liking, and liking leads to more interaction. Only
certain kinds of interaction lead to liking. In particular,
people should be of similar status. Belonging to a co-
operative group, especially under crisis conditions, is
268
particularly effective, as Sherif's 'Robbers' cave' experi-

ment (Sherif et aI, 1961) and research on inter-racial
attitudes have shown.
R.eblfarcemeat
The next general principle governing liking is the extent to
which one person satisfies the needs of another. This was
shown in a study by Jennings of 400 girls in a reformatory
(1950). She found that the popular girls helped and pro-
tected others, encouraged, cheered them up, made them
feel accepted and wanted, controlled their own moods' so as
not to inflict anxiety or depression on others, were able
to establish rapport quickly, won the confidence of a wide
variety of other personalities, and were concerned with the
feelings and needs of others. The unpopular girls on the
other hand were dominating, aggressive, boastful, demanded
attention, and tried to get others to do things for them.
This pattern has been generally interpreted in terms of the
popular girls providing rewards and minimizing costs, while
the unpopular girls tried to get rewards for themselves, and
incurred costs for others. It is not necessary for the other
person to be the actual source of rewards: Lott and Lott
(1960) found that children who were given model cars by the
experimenter liked the other children in the experiment
more, and several studies have shown that people are liked
more in a pleasant environmental setting.
Being liked is a powerful reward, so if A likes B, B
will usually like A. This is particularly important for
those who have a great need to be liked, such as individuals
with low self-esteem. It is signalled, as we showed above,
primarily by non-verbal signals.
Similarity
People like others who are similar to themselves, in certain
respects. They like those with similar attitudes, beliefs
and values, who have a similar regional and social class
background, who have similar jobs or leisure interests, but
they need not have similar personalities. Again there is a
cyclical process, since similarity leads to liking and lik-
ing leads to similarity, but effects of similarity on liking
have been shown experimentally.
Physical attractiYeDe88
Physical attractiveness (p.a.) is an important source of
both same-sex and opposite sex liking, especially in the
early stages. Walster et al (1966) arranged a 'computer
dance' at which couples were paired at random: the best
prediction of how much each person liked their partner was
the latter's p.a. as rated by the experimenter. Part of the
explanation lies in the 'p.a. stereotype'. Dion et al (1972)
found that attractive people were believed to have desirable
characteristics of many other kinds. However, people do not
seek out the most attractive friends and mates, but com-
promise by seeking those similar to themselves in
attractiveness.
269
SeH-discloaure
This is a signal for intimacy, like bodily contact, because
it indicates trust in the other. Self-disclosure can be
measured on a scale (1-5) with items like:
What are your favourite forms of erotic play and sexual

lovemaking? (scale value 2.56)
What are the circumstances under which you become

depressed and when your feelings are hurt? (3.51)
What are your hobbies, how do you best like to spend

your spare time? (4.98) (Jourard, 1971).
As people get to know each other better, self-disclosure

slowly increases, and is reciprocated, up to a limit.
Commitment
This is a state of mind, an intention to stay in a rela-
tionship, and abandon others. This involves a degree of
dependence on the other person and trusting them not to
leave the relationship. The least committed has the more
power.
Social sIdlls trainiDg

The most common complaint of those who seek social skills
training is difficulty in making friends. Some of them say
they have never had a friend in their lives. What advice can
we offer, on the basis of research on friendship?
* As we showed earlier, social relations are negotiated

mcl.inly by non-verbal signals. Clients for social skills
training who cannot make friends are usually found to
be very inexpressive, in face and voice.
* Rewardingness is most important. The same clients
usually appear to be very unrewarding, and are not
really interested in other people.
* Frequent interaction with those of similar interests and
attitudes can be found in clubs for professional or
leisure activities, in political and religious groups,
and so on.
* Physical attractiveness is easier to change than is
social behaviour.
* Certain social skills may need to be acquired, such as
inviting others to suitable social events, and engaging
in self-disclosure at the'right speed.
The meaning and By social competence we mean the abili ty, the possession
assessment of social of the necessary skills, to produce the desired effects on
competence other people in social situations. These desired effects may
be to persuade the others to buy, to learn, to recover from
neurosis, to like or admire the actor, and so on. These
results are not necessarily in the public interest: skills
270
may be used for social or antisocial purposes. And there is

no evidence that social competence is a general factor: a
person may be better at one task than another, for example,
parties or committees. Social skills training for students
and other more or less normal popUlations has been directed
to the skills of dating, making friends and being assertive.
SST for mental patients has been aimed at correcting fail-
ures of social competence, and also at relieving subjective
distress, such as social anxiety.
To find out who needs training, and in what areas, a
detailed descriptive assessment is needed. We want to know,
for example, which situations a trainee finds difficult:
formal situations, conflicts, meeting strangers, etc., and
which situations he is inadequate in, even though he does
not report them as difficult. And we want -to find out what
he is doing wrong: failure to produce the right non-verbal
signals, low rewardingness, lack of certain social skills,
etc.
Social competence is easier to define and agree upon in
the case of professional social skills: an effective thera-
pist cures more patients, an effective teacher teaches
better, an effective saleswoman sells more. When we look
more closely, it is not quite so simple: examination marks
may be one index of a teacher's effectiveness, but usually
more is meant than just this. A saleswoman should not simply
sell a lot of goods, she should make the customers feel they
would like to go to that shop again. So a combination of
different skills is required and an overall assessment of
effectiveness may involve the combination of a number of
different measures or ratings. The range of competence is
quite large: the best salesmen and saleswomen regularly sell
four times as much as some others behind the same counter;
some supervisors of working groups produce twice as much
output as others, or have 20-25 per cent of the labour
turnover and absenteeism rates (Argyle, 1972).
For everyday social skills it is more difficult to give
the criteria of success; lack of competence is easier to
spot: failure to make friends, or opposite sex friends,
quarrelling and failing to sustain co-operative relation-
ships, finding a number of situations difficult or a source
of anxiety, and so on.
Methoda of social skills Role-playiDg with coa.c:hiDg

traiuiDg This is now the most widely-used method of SST. There are
four stages:
* instruction;
* role-playing with other trainees or other role partners
for 5-8 minutes;
* feedback and coaching, in the form of oral comments
from the trainer;
* repeated role-playing.
271
A typical laboratory set-up is shown in figure 3. This also

shows the use of an ear-microphone for instruction while
role-playing is taking place. In the case of patients, mere
practice does no good: there must be coaching as well.
For an individual or group of patients or other trainees
a series of topics, skills or situations is chosen, and in-
troduced by means of short scenarios. Role partners who can
be briefed to present carefully graded degrees of difficulty
are used.
It is usual for trainers to be generally encouraging,
and also rewarding for specific aspects of behaviour, though
there is little experimental evidence for the value of such
reinforcement. It is common to combine role-playing with
modelling and video playback, both of which are discussed
below. Follow-up studies have found that role-playing
combined with coaching is successful with many kinds of
mental patients, and that it is one of the most successful
forms of SST for these groups.
Role-playing usually starts with 'modelling', in which a
film is shown or a demonstration given of how to perform the
skill being taught. The feedback session usually includes
videotape playback and most studies have found that this is
advantageous (Bailey and Sowder, 1970). While it often makes
trainees self-conscious at first, this wears off after the
Figure 3
A social skills traiDiDg Iaboratmy
TV camera 1
• one-way screen
stooge
•
candidate
, [}- IOUdSPeaker
, microphone
LJY
I
I I
I
·
t rcunee • I
I
interviewer I
, I
,,
I
• trainer
•
I
other
trainees
TV monitor
and videotape-recorder
zn
second session. Skills acquired in the laboratory or class

must be transferred to the outside world. This is usually
achieved by 'homework': trainees are encouraged to tryout
the new skills several times before the next session. Most
trainers take people in groups which provides a source of
role partners, but patients may need individual sessions as
well for individual problems.
Other methods of tl'aiDiDg

TRAINING ON THE JOB: this is a widely used traditional
method. Some people improve through experience but others
do not, and some learn the wrong things. The situation can
be improved if there is a trainer who regularly sees the
trainee in action, and is able to hold feedback sessions at
which errors are pointed out and better skills suggested. In
practice this method does not appear to work very well, for
example with trainee teachers (see Argyle, 1969).
GROUP METHODS: these, especially T-groups (T stan-
ding for training), are intended to enhance sensitivity and
social skills. Follow-up studies have consistently found
that 30-40 per cent of trainees are improved by group me-
thods, but up to 10 per cent are worse, sometimes needing
psychological assistance (e.g. Lieberman et aI, 1973). It
has been argued that group methods are useful for those who
are resistant to being trained.
EDUCATIONAL METHODS: these, such as lectures and
films, can increase knowledge, but to master social skills
it is necessary to try them out, as is the case with motor
skills. Educational methods can be a useful supplement to
role-playing methods.
Areas of application of SST

NEUROTIC PATIENTS: role-playing and the more specialized
methods described above have been found to be slightly more
effective than psychotherapy, desensitization, or other
alternative treatments, but not much (Trower et aI, 1978).
Only one study so far has found really substantial differ-
ences; Maxwell (1976), in a study of adults reporthlg social
difficulties and seeking treatment for them, in New Zealand,
insisted on homework between training sessions. However, SST
does produce more improvement in social skills and reduction
of social anxiety. A few patients can be cured by SST alone,
but most have other problems as well, and may require other
forms of treatment in addition.
PSYCHOTIC PATIENTS: these have been treated in the
USA by assertiveness training and other forms of role-
playing. Follow-up studies have shown greater improvement
in social behaviour than from alternative treatments. The
most striking results have been obtained with intensive
clinical studies of one to four patients, using a 'multiple
baseline' design: one symptom is worked on at a time over a
total of 20-30 sessions. It is not clear from these follow-
up studies to what extent the general condition of patients
has been improved, or how well they have been able to
273
function outside the hospital (Hersen and Bellack, 1976). It

has been argued by one practitioner that SST is more suit-
able than psychotherapy for working-class patients in view
of their poor verbal skills (Goldstein, 1973).
Other therapeutic uses of SST

ALCOHOUCS have been given SST to improve their assert-
iveness, for example in refusing drinks, and to enable them
to deal better with situations which they find stressful and
make them drink. Similar treatment has been given to drug
addicts. In both cases treatment has been fairly successful,
though the effects have not always been long-lasting; SST is
often included in more comprehensive packages.
DEUNQUENTS AND PRISONERS have often been given
SST with some success, especially in the case of aggressive
and sex offenders. SST can also increase their degree of
internal control.
TEACHERS, MANAGERS, DOCTORS, etc.: SST is
increasingly being included in the training of those whose
work involves dealing with people. The most extensive
application so far has been in the training of teachers by
'micro-teaching'. The pupil teacher is instructed in one of
the component skills of teaching, such as the use of differ-
ent kinds of question, explanation or the use of examples;
he then teaches 5-6 children for 10-15 minutes, followed by
a feedback session and 're-teaching'. Follow-up studies show
that this is far more effective than a similar amount of
teaching practice, and it is much more effective in era-
dicating bad habits (Brown, 1975). In addition to role-
playing, more elaborate forms of simulation are used, for
example to train people for administrative positions.
Training on the job is a valuable addition or alternative,
provided that the trainer really does his job.
NORMAL ADULTS: students have received a certain
amount of SST, especially in North American universities,
and follow-up studies have shown that they can be success-
fully trained in assertiveness (Rich and Schroeder, 1976),
dating behaviour (Curran, 1977), and to reduce anxiety at
performing in public (Paul, 1966). Although many normal
adults apart from students have social behaviour diffi-
cuI ties, very little training is available unless they seek
psychiatric help. It would be very desirable for SST to be
more widely available, for example in community centres.
SCHOOLCHILDREN: a number of attempts have been
made to introduce SST into schools, though there are no
follow-up studies on its effectiveness. However, there have
been a number of successful follow-up studies of training
schemes for children who are withdrawn and unpopular or
aggressive, using the usual role-playing methods (Rinn and
Markle, 1979).
Conclusion In this chapter we have tried to give an account of those

aspects of social psychology which are most relevant to the
274
work of teachers, social workers and others, both in under-

standing the behaviour of their clients and also in helping
them with their own performance. We have used various models
of social behaviour, such as the social skills model and the
model of social behaviour as a game. Some of the phenomena
described cannot be fully accounted for in terms of these
models: for example, the design of sequences of interaction.
A number of practical implications are described; in parti-
cular, discussion of the skills which have been demonstrated
to be the most effective in a number of situations, and the
methods of social skills training which have been found to
have most impact. It should be emphasized that much of this
research is quite new and it is expected that a great deal
more will be found out on these topics in the years to
come.
COIDIIIUIIication with The one-to-one relationship between physiotherapist and

patients patient obliges both of them to be involved in verbal ex-
E.N.DUNKlN changes. When these exchanges are successful, the physio-
therapist acts as an instructor and adviser while the
patient acts as the learner or obedient (compliant) fol-
lower. Occasionally there are failures in the pattern of
communication: either the physiotherapist is not making a
good job of instructing, or the patient is being less than
fully co-operative. Variations in success are not limited to
particularly 'difficult' patients. Even patients who are
normally compliant, or those therapists who usually make
effective instructors, have their 'off days'.
We can realistically assume that the present expertise
of human beings as communicators is not ideal and that until
telepathy replaces our clumsy words and gestures, we have to
be prepared to try again when our imperfect systems misfire.
One of the unfortunate consequences of lapses in accurate
communication is the tendency of patients to neglect their
exercise routines unless they are in the department and
under direct supervision. Although this state of affairs is
well suspected (if not well known) at an intuitive level,
the extent to which it occurs is variable: there is room for
study and research to establish a baseline of failed com-
munications from which to move in trying to improve staff/
patient interchanges.
Perhaps it is tautologous to say that the patient will
not remember to do what he neither understands nor considers
important. It follows that physiotherapists must take care
not to assume that the patients are able to keep up with the
whole vocabulary that is familiar to them. Things that seem
easy to the professional may be incomprehensible to the
patient. This may be because of:
* the use of language style that is unfamiliar to the

patient;
* the use of special terminology and the inhibiting effect
of a patronizing tone on the part of the
physiotherapist.
275
Most physiotherapists are sensitive to the latter problem

and make a sustained effort to avoid it, but when it comes
to personal style of language it is not always amenable to
our own observation. There are distinct differences in
styles of English that correlate with social class. Most
people rely on their own style of English without being
conscious of it; it follows that they will communicate most
readily with people who have the same socio-economic and
educational background. A syllable count of the words that
different speakers use in their part of a conversation may
be one way of identifying differences, while the variety of
words used by each speaker is another means of classifying
the sort of English being used.
A further problem is becoming increasingly evident as
the multi-racial nature of our large cities becomes greater.
Many English-speaking people whose mother tongue is not
English do not understand what is said to them but they try
to conceal this. They are diffident about their 'foreign'
status and are afraid of appearing ignorant or stupid. They
are not likely to make much progress unless they admit
their difficulties, as fear is a well-known hindrance to
communication.
In the above section, Argyle has paid special attention
to non-verbal communication and we have followed this with
a brief comment on physiotherapist/patient interactions.
Earlier in the book, a discussion of the acquisition of
motor skills (chapter 3) drew attention to augmenting verbal
instructions by demonstration and passive movements; physio-
therapists commonly use these techniques to make sure that
their patients understand what they are being asked to do.
Despite this, some patients become confused, and particular-
ly the elderly ones find it difficult to remember their ex-
ercises or the detailed movements they should make as they
are learning an altered pattern of walking or a new way of
transferring from a wheelchair to a bed. We have yet to con-
sider in detail the memory and comprehension factors that
can make or break the situation when therapists talk to
their patients. In the next chapter, we look at memory in
general, and then concentrate on the factors that are be-
lieved to have a beneficial effect on memory. This serves
as a prelude to the section on ageing and its attendant
problems.
References Argyle, M. (1969)

Social Interaction. London: Methuen.
Argyle, M. (1972)
The Social Psychology of Work. London: Allen Lane and
Penguin Books.
Argyle, M. (1975)
Bodily Communication. London: Methuen.
Argyle, M. and Cook, M. (1976)
Gaze and Mutual Gaze. London: Cambridge University
Press.
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Argyle, M., Furnham, A. and Graham, J.A. (in press)

Social situations. London: Cambridge University Press.
Argyle, M. and Keadcm, A. (1967)
The experimental analysis of social performance.
Advances in Experimental Social Psychology, 3, 55-98.
Argyle, M., Salter V., Nicbolscm, B., Williams, M. and
BUrgeas, P. (1970)
The communication of inferior and superior attitudes by
verbal and non-verbal signals. British Journal of Social
and Clinical Psychology, 9, ZZI-Z31.
Bailey, K.G. and Sowder, W.T. (1970)
Audiotape and videotape self-confrontation in
psychotherapy. Psychological Bulletin, 74, lZ7-137.
Bales, R.F. (1950)
Interaction Process Analysis. Cambridge, Mass.: Addison-
Wesley.
Brown, G.A. (1975)
Microteaching. London: Methuen.
Curran, J.P. (1977)
Skills training as an approach to the treatment of
heterosexual-social anxiety. Psychological Bulletin, 84,
140-157.
Davitz, J.R. (1964)
The Communication of Emotional Meaning. New York:
McGraw-Hill.
Dion, K., Bencheid, E. and Walster, E. (197Z)
What is beautiful is good. Journal of Personality and
Social Psychology, Z4, Z85-Z90.
Flavell, J.B. (1968)
The Development of Role-taking and Communication Skills
in Children. New York: Wiley.
Goldstein, A.J. (1973)
Structured Learning Therapy: Toward a psychotherapy for
the poor. New York: Academic Press.
B~, R. and Secord, P. (197Z)
The Explanation of Social Behaviour. Oxford: Blackwell.
Berseo, M. and Bellack, A.S. (1976)
Social skills training for chronic psychiatric patients:
rationale, research findings, and future directions.
Comprehensive Psychiatry, 17, 559-580.
Jennings, B.B. (1950)
Leadership and Isolation. New York: Longmans Green.
Jones, E.E. and Nisbett, R.E. (197Z)
The actor and the observer: divergent perceptions of the
causes of behavior. In E.E. Jones et al (eds) ,
Attribution: Perceiving the causes of behavior.
Morristown, NJ: General Learning Press.
JounJ'd, S.M. (1971)
Self Disclosure. New York: Wiley Interscience.
Lieberman, M.A., Yalom, I.D. and Miles, M.R. (1973)
Encounter Groups: First facts. New York: Basic Books.
Lott, A.J. and Lott, B.E. (1960)
The formation of positive attitudes towards group
members. Journal of Abnormal and Social Psychology, 61,
Z97-300.
Z77
Maxwell, G.M. (1976)

An evolution of social skills training. (Unpublished,
University of Otago, Dunedin, New Zealand.)
Mehrabian, A. (197Z)
Nonverbal Communication. New York: Aldine-Atherton.
Meldman, M.J. (1967)
Verbal behaviour analysis of self-hyperattentionism.
Diseases of the Nervous System, 28, 469-473.
Paul, G.L. (1966)
Insight v. Desensitization in Psychotherapy. Stanford,
Ca: Stanford University Press.
Rich, A.R. and Schroeder, H.E. (1976)
Research issues in assertiveness training. Psychological
Bulletin, 83, 1081-1096.
Rhm, R.C. and Markle, A. (1979)
Modification of social skill deficits in children. In
A.S. Bellack and M. Hersen (eds) , Research and Practice
in Social Skills Training. New York: Plenum.
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Sherif, C. (1961)
Intergroup Conflict and Cooperation: The Robbers' Cave
experiment. Norman, Oklahoma: The University of Okla-
homa Book Exchange.
Trower, P., Bryant, B. and Argyle, M. (1978)
Social Skills and Mental Health. London: Methuen.
Walater, E., Aronson, V., Abrahams, D. and Rottmann, L.
(1966)
Importance of physical attractiveness in dating
behavior. Journal of Personality and Social Psychology,
5, 508-516.
Questions 1. 'The problems of adolescence are artifacts of wester.n

cultural patterns.' Discuss this statement.
2. From your own experience, give examples to support
or to refute the idea that difficulties in adolescence
indicate a power struggle between two adjacent genera-
tions. Are there other explanations that occur to you?
3. 'The individual is more secure when the limits of
acceptable behaviour are clearly expressed.' Do you
agree with this statement? Give reasons for your answer
and relate your arguments to current observations of
adolescent behaviour.
4. 'If young adults are given inadequate or confused models
of behaviour they develop their own norms which tend to
exaggerate the dominance of their group over the
individual.' Discuss this statement. Can you support
your opinion from examples in your own experience?
5. Is it useful to look at social behaviour as a kind of
skill?
6. What do bad conversationalists do wrong?
7. What information is conveyed by non-verbal
communica tion?
8. In what ways do non-verbal signals supplement verbal
ones?
278
9. How is the perception of other people different from the

perception of other physical objects?
10. What information about a social situation would a
newcomer to it need to know?
11. Do we like other people primarily because they are
rewarding?
12. Why do some people have difficulty in making friends?
13. Can social competence be measured?
14. How can the effectiveness of social skills training be
assessed?
15. Is social skills training successful with mental
patients?
16. If someone has inadequate social behaviour, what else
may he require in addition to SST?
17. What criticisms have been made of experiments in social
psychology? What other methods are available?
18. Does social behaviour take the same form in other
cultures?
19. Are there fundamental differences between social
behaviour in families, work-groups and groups of
friends?
Amlotated. reacting Argyle, M. (1978) The Psychology of Interpersonal Behaviour

(3rd edn). Harmondsworth: Penguin.
Covers the field of the chapter, and related topics, at
Penguin level.
Argyle, M. and Trower, P. (1979). Person to Person. London:

Harper & Row.
A more popular account of the area covered by the
chapter, with numerous coloured illustrations.
Argyle, M. (1975). Bodily Communication. London: Methuen.

Covers the field of non-verbal communication in more
detail, with some illustrations.
Berscheid, E. and Walster, E.H. (1978). Interpersonal

Attraction (2nd edn). Reading, Mass.: Addison-Wesley.
A very readable account of research in this area.
Bower, S.A. and Bower, G.H. (1976). Asserting Yourself.

Reading, Mass.: Addison-Wesley.
An interesting and practical book about assertiveness,
with examples and exercises.
Cook, M. (1979). Perceiving Others. London: Methuen.

An account of basic processes in person perception.
Goffman, E. (1956). The Presentation of Self in Everyday

Life. Edinburgh: Edinburgh University Press.
A famous and highly entertaining account of self-
presentation.
PFP _ S 279
Trower, P., Bryant, B. and Argyle, M. (1978). Social Skills

and Mental Health. London: Methuen.
An account of social skills training with neurotics,
with full details of procedures.
Z80
II
The Adult: A Review of His
Memory
E. N. Dunkin
Introduction The first reaction to seeing yet another global word at the
beginning of a chapter is probably 'What are we talking
about this time?', and the direct answer has to be that
no one is very sure what is meant by 'memory'. Like the rest
of the world, we have a good idea of what contributes to
memory and when we find it useful. But looking at the histo-
rical record of psychology, we seem to be in much the same
state now, when it comes to defining memory, as they were
in the heyday of the Greek and Roman orators. We know a
few ways of using memory reliably, but we have not been all
that successful in deciding just what it is and how to make
it more efficient ALL the time, whatever IT is. Perhaps our
inability to make it more reliable stems from not having a
clear idea of what it is. We can describe the items and
processes that contribute to it, but we do not make a very
good job of adding up the parts and deciding what it is that
we have been assembling.
People have very stubborn ideas about their own memory.
Either they are seriously prejudiced about the best way to
use it as a servant, or they reject it because it is not a
good servant. They seem to have no idea how to get it under
control and quite often it is not even there when they want
it. The more anxious the possessor of a so-called 'bad
memory' becomes, the less adequately it serves him.
The average person is perplexed by the thing, partly
because it does not have a real identity and partly because
it seems to behave without due deference to the ownership of
the person who says he has it. Psychologists over the years
seem to have reacted in much the same way. From time to
time they have become intrigued by its puzzles and by their
own dilemma; or they have found apparently brilliant ways of
dictating to this elusive part of the 'mind' so that it will
hand over its stock of information accurately and rapidly.
Then they have (encouraged by their moderate but surprising
success) thought about the whole thing, tried to constrain
their observations into a theory, and the will-o'-the-wisp
thing has disappeared just as they were coming to terms with
it. Memory seems to be somewhat like a soap bubble, pro-
mising and temporarily attractive, but held together by a
questionable set of forces, a surface tension that is so
unstable that it is likely to burst as soon as it comes
281
The adult: a review of his memory
into contact with anything else. Yet its surface tension and
the air currents in the environment combine to give the
bubble its intrinsic and colour ful limi ts, the swirling
patterns that fascinate the observer. It is the interaction
between memory and the immediate environment that has
absorbed those who have tried to analyse it.
It is interesting that we commonly use another analogy
when we speak of memory, although it is quite probable that
we are not conscious of the analogy most of the time. We
use the phrase 'committing things to memory', as though we
are sentencing a criminal to incarceration in jail. Perhaps
this common usage represents a deep-rooted belief that our
chances of getting anything out again are remote, or that
once in memory (or prison) there is little chance of any-
thing getting lost. From what we know about the way
memory is used by human beings, it seems that each of
these interpretations of the fate of things stored in
memory corresponds with the actual alternatives.
Historical background
Ebbinghaus was the first psychologist since the time of
Simonides (500 Be) who really settled down to precise in-
vestigation of this thing we call memory. He was intrigued
with the problems of discovering an identity for memory by
establishing its limits and clarifying, amongst other
things, what it was not. It is worth noting that this
approach is similar to the one used by Wundt and the early
psychologists who explored perception. They gradually col-
lected evidence of the limits of sensitivity that a creature
had to all the sources of stimulation in its total environ-
ment. Ebbinghaus debated the whole question of memory and
came to the conclusion that human beings regularly relied on
tricks and chance events to help them store their impres-
sions of verbal information and to retrieve them on demand.
This being the case, he set about devising some pseudo-
verbal material which intrinsically had none of the usual
aids to memory. The items he made up looked like short
words on casual inspection. They were made up of three
letters: each had a consonant, followed by a vowel and then
a second consonant. The vowel made it possible for anyone
to pronounce the 'syllable', but the consonants were selec-
ted and combined so that each syllable had no semantic
value (no meaning to the user of normal English). Probably
because he was the only person he knew who would tolerate
such 'nonsense syllables', and because he wanted to find out
personally whether he could obey the rules he set up for
committing long lists of the nonsense to memory, the greater
part of his early studies relied on using himself as the
experimental subject. His method consisted of reading the
nonsense syllables at the rate of 150 syllables per minute.
(This rate is five times greater than the one used for
presenting nonsense syllables in modern verbal learning
experiments.) Lists 0 f the syllables were repeated until
Ebbinghaus could recite a list without error of sequence or
282
of syllable form. He reported his reactions to the task and

was thoroughly honest about any intruding activity that he
detected, such as imposing a pseudo-meaning on a syllable,
under the bracket of 'it sounds like' a real word, or
linking it to a coincidental change in his surroundings,
such as the sun coming out and shining on the list he was
holding as he happened to be saying a syllable. Ebbinghaus
was also careful to hold constant as many external factors
as possible. He carried out his learning sessions at the
same time each day and reduced environmental differences
to a minimum. The results of his work were analysed
statistically.
Using this precise system and tightly controlled mat-
erial, Ebbinghaus worked out the limits of his own ability
to memorize. He published his findings as early as 1885, but
the world at large and most of the psychologists in parti-
cular only marvelled at his persistence and left him to his
demanding studies. Some psychologists obj ected to the highly
artificial nature of the tasks he had designed and claimed
that he had so altered the process of memorizing that his
findings were trivial, and made no real contribution to the
understanding of the phenomenon of human memory. They may
have had a sneaking regard for his single-minded determi-
nation to take up a challenge when the rest of the psycho-
logical world was either avoiding it or denying its very
existence. Certainly he was not joined by a vast number of
fellow workers trying to extend his findings or to disprove
their validity.
There is a distinct gap in the history from the late
nineteenth century until 1932, when Bartlett made a serious
and appealing argument against the Ebbinghaus approach to
memory studies. He said, in essence, that the material
Ebbinghaus had used was so foreign, so unlike the usual
things that people remember, that the task of memorizing
that material was a dual one. Because of its unusual nature
the material. imposed a preceding task of inventing meaning
for the syllables, or else of finding a device for linking
separate items by using one of several 'support manoeuvres'.
These manoeuvres had been known for many centuries and
included the chaining of visual images, presumably by tying
a time or sequence association to the material to be re-
called. Images could depend on rhyming properties ('sounds
like' qualities), high discriminability by sensory proper-
ties (colour, touch, smell, or a mixture of these) or
bizarre settings. Taken in groups, individual sounds could
be combined by tone and rhythm factors, so that a very long
routine would have a quality rather like that of a musical
tune. These tricks or manoeuvres were the very ones that
Ebbinghaus himself struggled to suppress as he rehearsed his
lists, but for Bartlett they typified the reality of human
memory. He coined the phrase 'effort after meaning' to
explain what people are doing when they try to memorize
anything, and he devised a series of experiments to demon-
strate how meaningful verbal material is managed by a
283
person's memory. His book (Bartlett, 1932) gives explicit

details of the stories he used in his experiments. One of
the best known of his examples is based on a Red Indian folk
tale which was read by a subject. Some time later, that
subject was asked to tell the story in as much detail as he
could recall. The story reveals strange superstitions that
are part of the Red Indian culture and it is full of vivid
descriptions, offering high imagery possibilities. Bartlett
recorded each version of the tale that his subjects gave him
on different occasions: these records were precise verbatim
reports of the subjects' words. The records showed some of
the characteristic mutations that occurred in the original
material when a human memorizer 'had a go at it'. But each
of the condensations or distortions tallied with Bartlett's
basic premise that human learners consistently strive to
impose a meaning on any material they are trying to learn,
whether they are sorting and checking a relatively simple
sensory input for perceptual purposes or looking for a
personal summary of a mass of verbal material.
So, against a backdrop of relative blankness and dearth
of alternative ideas, the work of Ebbinghaus and of Bartlett
show up in strong contrast to each other. Once these dia-
metrically-opposed approaches to memory studies had been
made, it was possible to examine them for common features.
The net result of such a comparison was a general opinion
that each of them was artificial in its own way. Ebbinghaus
had stripped sounds of their significance as words and so
given any language-reliant person a task that was unsuitable
for revealing his usual memorizing behaviour. And Bartlett
had, by asking his subjects to carry out repeated recitals
of grossly similar story material, contaminated the situ-
ation so that it was impossible to decide whether a third
version of the Red Indian tale demonstrated increasing dis-
tortion and decay of the original material as time went by,
or a pattern of serial errors that depended on the person's
recall of the second error-bound recital. It was impossible
to decide anything about the true remnants of the experi-
ence of the original version. Despite a considerable debate
at the time, Bartlett's work was not extensively followed
up. It is interesting to note that, although many psycho-
logists continued to refer to memory while they were concen-
trating on learning, very few tackled the matter directly.
There were others gnawing away at the edges of the problem
but not many took up the central dispute. It is also worth
noticing that whenever any studies came closer to tackling
the memory concept, they reflected either Ebbinghaus's ex-
perimental and strictly controlled methods, or Bartlett's
emphasis on meaningful material.
More recently, and with the increasing knowledge avail-
able about the chemistry, electrical activity and structural
adjustments that go on in the brain, there have been many
attempts to adopt models that can serve as a framework
in which to explain the way we use memory. As might be
expected, some of these models also call on analogies that
284
are available in other scientific fields dealing with infor-

mation management, storage and retrieval. Computers have
been accepted as adminstrative servants, high-speed calcu-
lators and agents for augmenting human memory. This has
biassed the style of the models and influenced some of the
alternative ways for discussing memory. It is beyond our
scope to consider all the current models but the common
features of some of them are introduced. Suggestions for
further reading are listed at the end of the section. In
each case, the books are very readable and the whole subject
is fascinating. It is also very important for those people
who are working with the fallible memories of real people
such as ourselves and our patients.
Memory as a storage After that historical interlude, we must return to the

system problem of sorting out what memory is or, perhaps more
realistically, what it is not. After years of struggling
with the idea that it ought to have a single identity (and
if it had, surely definition would be an easy task?),
psychologists have come to the conclusion that it is more
fruitful to accept that it takes in a range of activi-
ties. Memory seems to be a word which assembles a range of
human abilities that somehow link the past with the present
and create the impression that the link will persist well
into the future. So it is not surprising that there is a
time relationship built into the ideas and terminology we
use in describing these activities. At a very simple level,
memory is held to have three parts: '
"'.
experience (linked to basic learning)
retentIon
~vived experience (linked to recall,

recognition, remembering)
As a corollary to this simple division, forgetting is the

temporary or permanent failure to revive experience on
demand.
The first of these parts, experience, has received a
lot of experimental attention, and careful investigation of
the third part, revived experience, has led to inferences
about the amount of remembering and forgetting people do.
The conditions that favour learning and remembering have
been scrutinized, together with others that are associated
with various degrees of forgetting. From all of these
studies, some general findings have emerged:
* retention is impossible without initial learning;
2.85
* retaining and forgetting are not commensurate in all

cases: forgetting can happen without any impairment of
the function of retention, but where retention is lost,
forgetting is bound to occur;
* remembering can be demonstrated to have at least three
guises: these are recollection, recognition and relative
ease of re-learning.
If we make a serial comparison of the three forms of remem-

bering, we come to the conclusion that they vary in diffi-
culty. It is easier to re-Iearn than to recognize, and
easier to recognize than to recall. We may be reminded of
the old adage on economy of effort that advises one and all
'never stand when you can sit, never sit when you can lie
down'. Unfortunately, at a practical level, it is rarely
possible to put the easiest task in front of people. In the
pressure of everyday life, the efficient person is the one
who 'knows' the facts or techniques and can recall them
without being given the basic experience again so that it
can either be recognized before being put to use, or re-
learned.
Most of the studies dealing with revived experience have
eventually run into difficulties because it cannot be ass-
umed that a person is a sufficiently reliable reporter of
his own ability to remember. Once these reports are seen
as less than accurate, any interpretation of them begins to
move into the sphere of speculation. However, the area
that is completely speCUlative (although it is almost worth
laying odds that the next breakthrough in brain physiology
will bring speculation into line with facts) is the central
one of retention. And perhaps that is really the crux of the
matter. After all our wanderings through the vagaries of
memory, have we come to the conclusion that we are really
trying to find out about the way human beings retain infor-
mation (verbal and non-verbal), and how they manage to re-
vive it on demand? A facetious answer to the second part
of that question might be 'Not too well!', since there are
plenty of indications that people are not very efficient
when it comes to deliberately searching their retained
information (their memory store) for particular things.
Grappling with the discrepancies between retention and
availability of learned material has been a practical
problem for teachers and instructors over the centuries.
Perhaps it is the REUAmUTY of computers that has at-
tracted everyone. Under careful instruction, they will
retrieve everything that has ever been loaded into their
memory store. There are certainly many popular models of
human memory based on both computer dynamics and infor-
mation theory. These are in hot competition with the neuro-
physiological models. Setting aside the emotive elements in
the debate, there seems to be no particular reason for
thinking that the major styles of model are incompatible,
especially if we take the neurons of the human brain and
the wiring of compu ters and telephones as analogous.
Z86
Geaeral OIItline of model characteristics

Most of the models concentrate on subdividing the machinery
for committing verbal, or other, experiences to memory. They
emphasize the processes by which a person works on these
experiences and on his own 'apparatus' so that he has a
permanent record of the events. The first step seems to be
an immediate ability to 'bold' an image of the sensory input
long enough to reach a perceptual decision, followed by a
further but very short period in which some record of the
perception is available. This can be illustrated by the
ability to recall a short series of numbers, such as a six-
digit telephone number, while we set about the job of
dialling the sequence. Unless a further effort is made to
record the number for future use, or if something prevents
us from dialling the number immediately, the series of
digits is unlikely to be available to recall after one-and-
a-half to two seconds. It is possible to 'bang on' to the
series by chanting it (rehearsing it) repeatedly while we
deal with a competing activity such as answering the door-
bell or turning off a boiling kettle, but we have to be
deliberately concentrating on the digit sequence during the
intervening period. If we know that we are going to need the
telephone number in the more distant future, we can either
write it down in a special list or 'do something' so that we
will be able to recall it whenever we want it in the future.
The real debate is on the nature of this 'something' that is
done. It is generally agreed that verbal, numerical or other
material is moved to a long-term store, but there are many
different ways of explaining what is going on in order to
achieve this transfer. Everybody seems to be searching for
a 'memory trace' of some sort but no exact evidence of a
physical counterpart for the stored material has yet been
found.
To summarize, the basis of memory rests on some iU-
defined process of storing material, with varying degrees of
accessibility, for retrieval. The storing process can be
characterized as having three stages, as shown below.
* Perceptual or immediate storage lasting one or two

seconds. During this time an image of the sensory input
survives, decaying rapidly, but its survival can be
prolonged by active rehearsal.
* Short-term or primary storage which is a holding process
lasting approximately five seconds. It is presumed that
this holding allows a person enough time to decide
whether all or part of the information is worthy of
transfer to long-term memory. Items judged as trivial
seem to be released, having survived only a few seconds
beyond the original experience.
* Long-term or permanent storage from which material
can be revived at any time after its admission. Most
theories support the idea that the accessibility of
material in long-term storage depends on factors that
are so variable that it is almost wiser to regard them
287
as idiosyncratic. Ignoring the wisdom of this, some

general conditions affecting recall, recognition and
ease of re-learning have been suggested.
Perceptual store
This is sometimes referred to as iconic or echoic, with the
implication that people translate their experiences of all
sorts into visual or auditory images. The assumption is that
words and the way they look or sound may be attached to the
original sensory input as part of the perceptual process,
but that prior to that, people have the ability to repeat
internally the electrical or chemical events that were
caused by the sensory stimulation in the first place. It is
interesting that the images of hearing survive slightly
longer than those of sight. Perhaps this is because things
we hear happen one at a time while things we see have masses
of information occurring all at the same time. Sperling
devoted a great deal of study to this particular aspect of
memory and came to the conclusion that there was a surviving
but swiftly decaying 'trace' of the sensory experience that
could be 'inspected' at this preliminary stage. He carried
out detailed experiments with five subjects and confirmed
the general impression that most people can only remember
part of the wealth of information they are aware of seeing,
when the time allowed for looking at an object or scene is
restricted (his work is described in Sperling, 1960). Sub-
sequent findings with expansion of his theories can be found
in Norman (1970).
Short-term memory
There is some debate on the question that this is distinct
from the immediate or perceptual holding that we were dis-
cussing above, with a counter-argument being that it is a
continuation of the same process. Certainly, the time limit
for short-term memory is not a great deal more, being
reckoned in seconds and being quoted as five to seven
seconds. There seems to be a need for items to be 'dealt
with' at this stage before a person can take in any more.
Things that are not processed adequately before the person
is bombarded with new experiences will fade and not enter
long-term storage. This has been nicely demonstrated in
experiments which oblige the subjects to carry out a further
activity within the five- to seven-second interval following
a particular visual or audi tory display. Results have shown
that if attention is forced away from the experimental
display at this time, recall of the display is impossible
and attempts at recognition are unreliable. The inference
from this is that the transfer of the data to long-term
memory has been prevented.
There are several theories on the events taking place
when no competing activities disturb the person's normal
processing of new material. These range from the idea that
rehearsal of the original sensory events is repeated many
times until some permanent trace has been developed, to
exact hypotheses about the neurophysiological activities
288
going on inside the brain. The concept of repetition is

common to both of these explanations but the latter one
is explicit, since it relates the idea of repetition to a
locus: that is, to the area between particular neurons. As
early as the 1930s, Thorndike put forward the idea that
connections or bonds could be developed between cells of the
cerebrum. During the short-term memory period, it would be
necessary to 'use' the particular neurons and synapses many
times so that firm 'bonds' could be made, thus ensuring
permanent survival of this pathway. He made the general
assumption that the brain cells of children were peculiarly
effective as they were totally available at first for the
establishment of such memory traces. Children could be
expected to learn a great deal and to remember their exper-
iences. With increasing age, the capacity of the brain cells
to be re-combined in alternative memory traces would be
limi ted, while in the elderly, de teriora tion of the brain
and consequent cell loss would account for the failing
memory that people expected from the aged.
Some 30 years later, Hebb took up these ideas and ela-
borated them into a precise theory of 'cell assemblies'.
These were described as closed loop circuits, in which acti-
vation persisted for long enough to allow structural changes
to take place at the synapses in use. When more than one
of these cell assemblies happened to be active at the same
time, the development of systems could occur. Repeated use
of such systems would make their subsequent use easier and
more likely to occur. Unfortunately, a full description of
these carefully proposed theories, and others of similar
precision but different explanatory mechanisms, such as
those of Deutsch, are beyond our scope, but the reader is
urged to follow up the additional reading lists.
At the same time that neurophysiological theories have
been put forward to explain the elusive memory trace, other
models of the underlying processes have been offered. Broad-
bent structured his explanation in terms of information
theory concepts, expressing the difficulties that people
have in being efficient memorizers of one task while they
are busy carrying out another, as a problem of competition
between channels and inefficiency of filter systems. His
theory cannot be carried through to a complete solution of
the memory dilemma because no one knows the details of the
coding system human brains impose on the raw input
materials.
Yet another analogy is made by some theorists who see
human memory as comparable with computer memories. The
arguments in this case have a persuasive character, espe-
cially as the binary digit principle of machine 'language'
tallies nicely with the all-or-none activity of neurons. It
is very reasonable to equate the 1 or 0 property of a com-
puter component with the 'on' or 'off' state of individual
neurons, and many psychologists accept computer-based
models as a realistic way to approach the investigation of
memory. Most of us are impressed by the speed and accuracy
of computers and we are relatively resigned to the fact that
2.89
the memory banks of a computer take up a lot of space.

Compared to the human brain, the space costs of a computer
are appallingly high, but the computer wins every time when
it comes to reliability of retrieval of stored material. In
fact, it is the discrepancies between the total remembering
of computers and the unpredictable forgetting which afflicts
human beings that have set off some of the recent investi-
gations on the reasons for memory failure. These, in turn,
suggest at least some of the ways in which conditions of
learning can be altered, or personal efforts can be modi-
fied, so that people with faulty memories or high memory-
requirements can improve their abili ty to remember.
Reascma for low It is difficult to avoid seeing a hierarchical structure

reliability of recall linking the reasons. They can be considered in two main
groups, each having two subdivisions, which are in turn
divisible, viz:
* storage problems: (i) factors affecting short-term

memory (overloading and failure); and (ii) factors
affecting long-term memory (interference and tissue
loss) ;
* retrieval problems: (i) lack of access due to inadequate
labell:ng; and (ii) inhibition of recall by subconscious
repression.
Factors affecting short-term memory

These can be summarized as inefficiency due to overloading
of one type or another, or as total absence due to organic
disorders.
1. IN OVERLOADING, the complexity of stimulus materiai

may exceed the discriminating ability of the person, so that
he does not make a suitable selection of the stimuli for
perceptual and short-term management. The number of items
given at once may exceed the limit of short-term memory
span. Simultaneous presentation of items, or rapid sequence
of presentation of new material, will cause competition for
attention, so that temporary traces decay before they can be
processed and transferred to long-term memory. Retroactive
inhibition can occur, with current material being so similar
to recently learned material that it 'scrambles' the PRE-
VIOUS MEMORY TRACES. Another form of interference is
called proactive inhibition: in this case, the more recently
presented material is not readily LEARNED because it is so
similar to previously learned material.
Anxiety or other emotional states may raise the level
of arousal so that the person fails to concentrate on the
information available in a sensory experience.
2. FAILURE of short-term memory can be found in cases

of brain injury involving concussion and in chronic dis-
orders such as Korsakoff's psychosis. Where concussion has
290
occurred, there is a period of life immediately before the

blow on the head for which the person has no memory. This
blank patch is known as a period of retrograde amnesia, and
the length of the amnesic interval varies directly with the
severity of the injury. It seems that the sensory input from
the activities and events immediately before the blow on the
head received no central processing because the person was
unconscious at the time when the perceptual trace should
have been available for inspection. In Korsakoff's psycho-
sis, it is considered that parts of the limbic system and
hippocampus have become incompetent and unable to contri-
bute to the normal management of sensory input.
Methods of improving efficiency despite overloadiDg

A considerable amount of study has been made of the question
of the span of short-term memory, with the most stimulating
and appealing theory being put forward by George Miller
(1956). He discllsses the whole process by which it is
possible to grollp items that are presented for memorizing
into manageable 'chunks' of information. As long as a person
finishes up with about seven 'chunks', he can hold these in
his immediate memory and make use of them: for instance,
by recalling the things in the 'chunks' on request. It is
possible to make up packages of assorted information, such
as series of numbers, names of objects, etc., and these
packages can either be achieved by visual images or by
translation into codes. It is the organization that gives
material a very high chance of being recalled every time it
is wanted. This sort of organization has often been written
off as trickery in the past. People have been aware of
mnemonics for centuries but it has become unfashionable to
use them. Those who do are criticized or belittled for using
tricks and it is difficult to find out whether this is a re-
action of envy or of superstitious fear. Normal people
do not remember everything they want to, so total recall
must be the work of the devil! Certainly there has been an
educational reaction against rote learning: that is, the
committing of masses of facts to memory without fully un-
derstanding the ideas behind them or the inter-relationships
between them, so it is probable that one of the ways of
reliably recalling memorized facts fell into disrepute
because it was seen as an accessory after the fact.
But it is really not necessary to go to the lengths of
detailed studies of the limits of the span of short-term
memory to uncover the effects of grouping in reducing the
difficulty of memorizing tasks. Most people cannot recite in
the correct sequence a set of more than seven letters, but
they can repeat a whole sentence, comprising as many as 40
letters, with no difficulty at all immediately after hearing
that sentence for the first time. In this example, the sen-
tence has a meaning and individual words have a known set
of letters: in Miller's chunks of information, the person
who makes up the groups of information simultaneously gives
the group a coded meaning. We learn the common codes of
291
language in childhood: it takes an extra effort to make up

and use special codes for unusual memorizing tasks.
Training in selection of information, known as dis-
crimination training, can also help to combat the problem
of overloading of short-term memory when complicated
objective situations have to be analysed and recalled.
Factors affecting long-term memory

These are generally linked to deterioration, either of the
memory trace itself - which may become obliterated by
successive traces using the same areas of the brain - or of
the neurons. It is an accepted fact that people lose brain
cells gradually but relentlessly as they become older. This
is seen as an underlying cause of the decreasing reliability
of memory in the elderly. However, it is difficult to re-
concile this general comment with the facts: not all old
people have feeble memories and those who have some diffi-
culties with recall of recent events often have amazing and
vivid memories of their early life. The arguments for disuse
atrophy, progressive organic loss and the effects of inter-
ference do not deal satisfactorily with the variety of abi-
lities we can observe in elderly people, nor can all cases
of forgetfulness be explained by arteriosclerotic changes,
trauma or chronic neurological disorders. It is more useful
in many cases to reconsider the whole matter of short-term
memory and the preparation of material for transfer to long-
term memory, as many old people just do not manage these
areas too well without help. We return to this matter later.
Lack of access due to inadequate labelliDg

Although this is firmly listed as a problem of retrieval, it
turns out to be the result of yet another deficiency associ-
ated with the initial experience and short-term memory. Many
of the things that are stowed away in our long-term memories
are virtually lost because we make such a poor job of the
storing in the first place. The possessor of a so-called bad
memory behaves rather like a householder who regards the
attic of his house as a place to dump anything for which
there is no immediate demand. He manages to take himself
and the temporarily unwanted clutter up the stairs to the
attic but heaves the things into the space with gay abandon
and without paying any attention to where he has put them.
It is not surprising that when he subsequently searches for
them he has no idea where they are, can find no clues to
their location and often retreats from the search pro-
claiming that they are not there at all. In contrast, a
computer behaves like a very orderly householder who labels
every item before it is taken to the attic and actually
keeps a detailed record of the packing of the attic, so that
he can find every article at any time, provided that he uses
the system he has developed. Although it is unlikely that
anyone can be counselled so well that he adopts all the
reliability and accuracy of a computer, it is definitely
possible to help people to do a better job of labelling the
292
things that reach their long-term memories. It is evident

that recall depends on the wealth or paucity of cues, or
associations, that people make. Since the late 1960s there
has been considerable interest in this and it is generally
agreed that minimal cueing causes low accessibility, while
multiple cueing gives high accessibility, of experimental
material.
In addition to the chaos induced by haphazard transfer
of facts to long-term memory, there is another factor that
leads to poor retrieval. This is not so much a lack of
organization or system as an over-zealous use of a sorting
activity. It results in material being put into discrete
compartments and strongly resists any cross-referencing be-
tween one compartment and another. The compartments, or
'pigeon-holes', usually have limits that coincide with the
context in which the learner originally came across the
information. It is very restricting in its extreme form,
making it almost impossible for quite well-known facts to be
recalled in a different context. It is a source of common
complaint from teachers: their pupils behave as though they
have never been taught anything about English, except in the
lessons that are actually called 'English language lessons'.
Whatever the teacher has managed to pass on to them about
the structure and use of the English language is formally
ignored in all other scholastic subjects where verbal
expression is required.
We can collect further information about retrieval if we
watch the things that someone does when he is having diffi-
culty in recalling something, although he is convinced that
the wanted information 'is there somewhere'. He hunts for
key words, follows up ideas such as 'it sounds like ••• ' or
'I am sure it starts with a "T" , as he searches for audi-
tory cues. 'It looks like .•• ' or 'I know it was someone
with fair hair ••• ' indicates that he is searching for
visual cues. While all this struggling is going on, the
person has a subjective experience of unrest, frustration or
anxiety. If the search is unproductive, he may decide it
would be better to make a determined effort to forget the
whole thing, to 'put it out of his thoughts', and some time
later when he has managed to do so, 10 and behold out pops
the wanted name or word or identification. This illustrates
one final comment on retrieval, that it may be inhibited by
the general emotional state of a person or by the very
activity of trying to retrieve a specific piece of
information.
Inhibition of recall by subconscious repression

The majority of interpretations of this mechanism are allied
to the Freudian theories of conflict between our acceptable
or 'conscious' selves and our primitive desires or 'uncon-
scious' selves. The repression of memories about traumatic
experiences in the past or events associated with desires
that are unacceptable to our conscious selves is seen as
the underlying barrier to recovery in some emotional and
293
psychia tric states. The use of analytical techniques, hyp-

nosis, and chemotherapy can reveal the existence of clear
memories that resist any voluntary efforts on the part of
the person to recall them. The problems due to this special
form of forgetting can be solved if the original cause of
conflict, unhappiness or fear can be examined and accepted
by the patient. Chapter 13 considers this matter in greater
detail. It is mentioned here to make the list of retrieval
problems complete.
SuggestiODS for better use of memory

From the review of memory in this chapter, it is possible to
assemble some ideas that can be used to help those who need
to improve their ability to leam and remember. These
include:
* training in analysing complicated situations and in

discriminating important features from unimportant
ones;
* practice in reducing the load on short-term memory by
grouping and coding new information;
* practice in associating purposeful labels with material
that is to be remembered (this may be in the form of
adding mnemonic devices to the original material or it
may simply be in terms of emphasizing key aspects of the
material itself);
* practice in finding and making firm associations between
related materials: that is, setting up cross-references
within the material to be remembered;
* obligation to use and re-use the details and principles
of what is learned so that the meaning is clear.
In all of these, there is an underlying stress on active

review of the material that is to be remembered, whether
that active review is inevitable because the information is
being organized and reorganized for storage, or withdrawn
from storage for repeated use. Adequate labelling and re-
petition must be given to the material by the person hoping
to remember it in the future, but his efforts will be even
more successful if the things he has to learn are presented
with clarity, simplicity and brevity.
References Bartlett, F.e. (193Z)

Remembering: A study in experimental and social
psychology. Cambridge: Cambridge University Press.
Miller, G. (1956)
The magical number seven, plus or minus two: some limits
on our capacity for processing information.
Psychological Review, 60, 81-87.
Norman, D.A. (1970)
Models of Human Memory. New York: Academic Press.
Sperling, G. (1960)
The information available in brief visual presentations.
Washington, DC: American Psychological Association.
Z94
QuestiODS 1. Identify and explain four reasons for low reliability of

recall from memory.
2.. Think of examples of your own use of grouping and coding
information for easier management of things you are
learning in everyday activities or in studying. Can you
suggest ways to improve the success of your subsequent
recall?
3. What is meant by overlearning? Why is it a valuable
technique?
4. How would you advise a fellow student or a patient so
that 'cross-referencing' of learned material is more
likely to occur (i.e. how can compartmentalization of
information be counteracted in order to improve
reliabili ty of recall)?
5. Why is keen observation of on-going experience essential
to later remembering?
6. Suggest some of the reasons for a person having a 'bad
memory'. What advice can be given to such a person so
that his memory can be more useful in the future?
7. Define short-term memory and explain the differences
between this and long-term memory. How can transfer
from short-term memory to long-term memory be (a)
inhibited, (b) facilitated?
8. How would you ensure that your instructions to an
elderly hemiplegic patient for standing up from a seated
position were as clear as possible?
9. The section dealing with memory suggested ways of
increasing the chances of remembering information. Give
examples of the way you would use these recommendations
in the management of treatment of (a) an elderly patient
needing walking practice following hip replacement sur-
gery, (b) a diabetic patient learning to use a wheel-
chair following lower limb amputation, (c) a brain-
damaged (spastic), five years old, learning to crawl?
10. Why is it important to explain to patients the value and
purpose of the exercises that you ask them to do?
AImotated reading Baddeley, A.D. (1976) The Psychology of Memory. New York:
Basic Books Inc.
This book is very easy to read. It offers broad coverage
of the current state of knowledge about memory, and
relates this to historical aspects and to applied
situations.
Broadbent, D.E. (1958) Perception and Communication. London:

Pergamon Press.
This deals with hearing and perception as the bases of
communication, surveys the experimental work and
discusses the value of auditory studies. It is written
in a clear style and stresses that people must be
appreciated as 'whole' beings as well as offering a
variety of separate senses that are amenable to special
study.
PFP _ T 2.95
Hunter, I.M.L. (1973) Memory. Harmondsworth: Penguin.

Despite its relatively early date of publication, this
book remains a classic: it surveys the available data on
the potential and limitations of human memory and
emphasizes those enquiries that have given most
information on the basic activities of memory.
Mace, C.A. (1976) The Psychology of Study. Harmondsworth:

Penguin.
This is a useful text: recommended to students
interested in improving study habits.
Norman, D.A. (1970) Models of Human Memory. New York:

Academic Press.
A series of articles by investigators who are
authori ties in this field.
Richter, D. (1966) Aspects of Learning and Memory. London:

Heinemann.
Another collection of papers by individual scientists
working in different fields. The first three chapters
deal with problems of human memory and the remaind~r
of the book considers memory in terms of physiology,
biochemistry and animal behaviour.
296
12
Ageing and Social Factors
Peter G. Coleman
0peniDg remarks This chapter, dealing with ageing and its social problems,
E.N.DUNKIN is the last one in Part ill about the individual moving
through the time and social dimensions of his life. It deals
with the general patterns that come sooner or later to be
characteristic of older people, but it stresses that losses
and changes in skills do not affect everybody in the same
way.
In our earlier discussion on memory and related activi-
ties, we have hinted that some alterations in the ability to
recall recent events or periods of past experience can be
expected in people who have arteriosclerotic or other forms
of brain damage. The incidence of cerebral ischaemia and
loss of nervous tissue becomes greater with advancing years,
so it is reasonable to expect some loss of memory in the
elderly, although this is not invariable. In this section,
Peter Coleman makes a point of advising people who work with
the elderly to ensure that all advice or instructions are
given as clearly and briefly as possible to counteract any
tendency towards confusion and to maximize the chances of
accurate recall.
The changes in social activity that appear in the latter
part of an individual's life are explained in terms of a
reduction in the arousal-seeking, or extraversion, charac-
teristics of personality that were introduced in chapters 6
and 7. In addition, this chapter considers changes in the
motivation of older people, seeing some of the alterations
as suitable modifications that match reduced physical abi-
lities to reasonable goals. But it also draws attention to
the need for external motivation in some cases to make sure
that elderly people stay as close as possible to their maxi-
mum efficiency and independence for as long as possible.
It includes a brief discussion of the effects of bereave-
ment, and of the proximity of their own death, on old
people. This subj ect is covp.red more fully in the final
chapter of the book.
What is it to be old? The study of ageing and problems associated with it are now
PETER G. COLEMAN recognized as important. This is not surprising, for older
people have become the major clients of the health and
social services. They also have a lot of free time at their
297
Ageing and social factors
disposal. If there is to be an expansion in adult education

and opportunities for creative leisure activities, the
benefits should go especially to retired people.
What is surprising is that it has taken so long for the
social sciences to pay attention to ageing and old age. This
is not true in the novel or in the theatre, where issues to
do with growing old have often brought out the best in
writers; yet sociology, and even more so psychology, have
neglected ageing.
This is a matter of great regret. So many young pro-
fessionals are called on to devote their attention to the
needs of people at the other end of the life span, yet they
are likely to have received little in the way of stimulating
material about the distinctive psychological features of old
age. This chapter is a small attempt to put that right. But
such a chapter can only be as good as the sources on which
it is based, and we have a long way to go before we can be
proud of our knowledge of the psychology of ageing.
Professional people do nevertheless have to be intro-
duced to the subject of ageing, and it is interesting to
note how that introduction has come to take on certain
standard forms over the last ten years. There are two very
popular, almost obligatory ways, it seems, to begin talking
or writing about ageing. The first way is to present the
demographic data about the increasing numbers of elderly
people in the population. The second way is to discuss the
negative attitudes people have about working with the el-
derly. The latter is favoured by those who feel they need to
confront their audience straight away with the problems of
finding enough interested and dedicated people to man our
welfare services for the elderly. The former approach is the
more typical and gentle way into the subject.
The CClIIIIDCID iDtrodoctiOD to agejDg

In important respects old age as we know it today is a
relatively modern phenomenon. Though there may have been
individual societies in the past where a comparably large
part of the population was old, it is clear that there has
been a dramatic change in developed countries since the turn
of the century. At that time those over the age of 65 in
Britain constituted one in 20 of the population; today they
constitute one in seven. Of course, to have reached the age
of 65 is a very crude indicator of being old. Some people
are physically worn out long before that age, and that was
probably much more true of past eras. On the other hand,
many people in their sixties, seventies and even eighties do
not have characteristics that we associate with old age.
In recent years much more use is being made of the
statistic 'over the age of 75', since it has become clear
that this is the group in the population which makes the
largest demands on the health and social services. This has
highlighted the worrying news for service planners in a time
of economic constraints that, while the total number of
those over 65 will not increase very much in the coming
Z98
years, the population of those over 75 has already passed 5

per cent of the total population and will reach 6 per cent
by the end of the 1980s.
However, expressing concern simply at the number of
elderly people in the population is misleading. Why, after
all, should it be a problem that 15 per cent rather than,
say, 10 per cent or 5 per cent of the population is over the
age of 65, or that 6 per cent rather than 4 per cent or 2
per cent is over the age of 75? A lot of the issues have to
do with economics. The state must find the means to continue
paying adequate and maybe even improved pensions, and to
provide welfare services for larger numbers of people.
But perhaps the more fundamental issues are the avail-
ability and willingness of people, whether relatives, neigh-
bours, professionals or volunteers, to give assistance to
large numbers of disabled people in the population. For
ageing, as any introduction to the subject makes abundantly
clear, is associated with an increasing likelihood of deve-
loping chronic disability. A number of recent surveys and
epidemiological studies have given us a good picture of the
incidence of physical and mental disability in old age.
For example, the proportion of people living at home who
are unable to go out of doors on their own is 12 per cent in
the population over 65, rising from 4 per cent in the 65-69
age group to nearly 50 per cent in the over 85 age group.
The proportion of people living at home who are markedly
mentally deteri0rated is judged to be 6 per cent in all
people over the age of 65 rising to 13 per cent in those
over 75 and 20 per cent in those over 80.
Global estimates of disabili ty in daily living (in get-
ting around the house and providing for oneself) indicate
that need of assistance is present in 15-20 per cent of the
age group 65-74, rising to 35-40 per cent in the 75-84 age
group and over 60 per cent in those above 85. If one adds
the number of people living in institutions (hospitals and
old people's homes) which is about 4-5 per cent of the total
elderly population, one can conclude that above 30 per cent,
or nearly one in three of all people over the age of 65, are
disabled and in need of help.
Of course, the other side of the coin is equally true
and equally worth stating. Among those people reckoned to
be elderly, 70 per cent are NOT disabled and NOT in need
of help. These people should also be borne in mind when we
think about the nature of old age and of the provision
society should be making for its older population.
A typical introduction to ageing then goes on to present
further numerical data on the social position of the elder-
ly. Almost one-third of people over 65 have been found to
live alone and this number is much higher in the older age
groups. In an Age Concern survey published in 1978, 35 per
cent of those over 75 were found to have no living offspring
and 45 per cent of those living alone who did have children
said they would like more frequent visits. Over one-half of
men, and one-third of women living alone agreed that they
299
had never dreamed that they could be so lonely. But again

one has to be careful in presenting this information to
describe the other side; the majority of elderly people are
not isolated and are not lonely.
Still, the overall picture is of a great social problem,
of a vast number of elderly people living in wretched cir-
cumstances. Moreover, physical and social disadvantages are
not independent of one another and are also closely related
to other environment'll and psychological factors. Physical
and mental breakdown can have as much to do with bad housing
and lack of social stimulation as with specific medical con-
ditions. The necessity of a multi-disciplinary perspective
is clear from even a brief examination of the disabilities
and disadvantages of old age.
The need for a lif~an perspectige

Such is a typical introduction to discussion on policy and
provision for the elderly. But in our view it is inadequate
even as an introduction, for there are vitally important
perspectives missing. No wonder indeed that we should be
concerned with attitudes, with finding enough people pre-
pared to work with the elderly, enough geriatricians, enough
nurses, enough social workers and so on, when the only
image we present of old age is a negative one. If the only
perspective we emphasize is one of endless problems, often
insoluble because of irremediable physical and mental
deterioration, we cannot expect many people to have the
courage to become involved. Few people would be inclined
to say they they had hit on an interesting and challenging
field of work.
And yet ageing and the related problems of elderly
people are interesting and challenging fields of work, and
psychology has a vital contribution to make to this under-
standing. This is not, however, a psychology that is just
based on a model of deterioration: a mapping out and ana-
lysis of declining abilities. That has been the main contri-
bution from psychology up to now. This is not to deny that
a lot of valuable work has been done and is still being done
in this tradition, but there is a far more important
contribution to be made.
Old people are like the rest of us. What is special
about them is not that they may be mentally deteriorated,
disabled or isolated. The majority, after all, is none of
these things and many people reach the end of their lives
without suffering any disadvantages. What is special about
old people is that they have lived a long time. They have
had all the kinds of experiences we have had and many, many
more. They are moving towards the end of life, it is true,
but surely it is every bit as important how one ends one's
life as how one begins it.
Some people are inclined to say not only that often
little can be done to improve the lot of an individual
elderly person, but that somehow it is not worth the effort
because that person will soon be dead anyway; but that is a
300
reason for making a greater effort, for trying to put things

right before the end. For some people their lives may not
have been so happy and they themselves may be grappling with
that fact, trying to come to some sort of resolution. Old
age is the last opportunity. Who would say that the last
chapter of a book is unimportant? Some people are tempted
to skip chapters to reach it first.
The perspective on ageing which is needed is one which
takes into account the whole life span. The discovery any
student of old age has to make is not only that old people
have a long life history behind them, but that their present
lives, their needs and wishes cannot be understood without
an appreciation of that life history.
If we really talk to old people all this will become
evident. But how often to we do this? A most eloquent test-
imony of our neglect is a poem (88 lines long) that was
found in the hospital locker of a geriatric patient. (It can
be found in full, quoted in the preface of the recent Open
University Text, Carver, V. and Liddiard, P., 1978, 'An
Ageing Population', Hodder & Stoughton.)
What do you see nurses

What do you see?
Are you thinking
When you are looking at me
A crabbit old woman
Not very wise,
Uncertain of habit
With far-away eyes
Then open your eyes nurse,

You're not looking at me.
The writer emphasizes the continuity between her identity as

an old person and her identities at previous stages in the
life cycle. She is still the small child of ten with a large
family around her, still the 16 year old full of hopes and
expectations, still the bride she was at 20 and the young
woman of 30 with her children growing up fast. At 40 her
children are leaving home, and she and her husband are on
their own again. But then there are grandchildren for her to
take an interest in. Years pass and she has lost her husband
and must learn to live alone. She is all of these people.
But the nurse does not see them.
How do we begin to develop a life-span view of elderly
people? Perhaps if we stop to think about our own lives, we
will realize how much we too have been influenced by the
experiences we have had and how much they still live within
us. How much more experience an elderly person has had!
Short IIUIDIDaJ'Y
In beginning any consideration of old age, therefore, it is
insufficient merely to focus on the problems arising from
the large numbers of elderly people in the population. The
301
chances of developing physical or mental disabili ty increase

with age, as also do problems of isolation and loneliness.
But the essential feature of old age is that it is both the
last and a vital part of the life cycle. If we are to under-
stand and help old people we need to see them in the context
of their individual life histories. The aim of giving ser-
vice to any age group should be to facilitate individual
self-fulfilment. We should also seek to allow old people to
live out their lives in ways that they find befitting.
Psychological changes It is only proper to admit at the outset that the main acti-
with age vity of psychologists interested in ageing, with some ex-
ceptions, has not been a life-span perspective. Their work
has mainly been concerned with trying to establish what
psychological changes, usually changes of deterioration,
occur with advancing age, with understanding the bases of
such changes and finding ways of compensating for them.
These are obviously important questions.
However, it is necessary to issue a warning about such
research. We run the danger of attributing too much impor-
tance to age itself. People of the same age, at any age,
show enormous variation in their capacities and performance.
How they behave is often not so much a function of their age
but of particular physical, psychological, environmental and
social factors (including what society 'expects' of older
people). It is of limited interest to find out the capa-
bilities of the average person of a certain age in a
particular society and at a particular point in history.
What is much more interesting is to try to uncover the fac-
tors underlying a person's behaviour at any age, time or
place.
This point is easy to illustrate from some of the earli-
est research on the performance of different age groups on
intelligence tests. It was found that people in older age
groups tended to do much worse than younger ones, and these
results were interpreted as demonstrating a marked decline
in intellectual ability with age. Subsequent studies have
shown how misleading such cross-sectional comparisons can
be. The differences were due almost entirely to the differ-
ent backgrounds of the groups being tested. In particular
the younger generations had received much more extensive
formal education and this was the main reason for their
better performance on the intelligence tests.
For this reason longitudinal studies which follow the
same people over a number of years are preferable to cross-
sectional studies which look at different people of dif-
ferent ages. However, longitudinal studies are also not
without their problems. It may be very difficult to follow
up the same people over a long period of time. Some may
refuse their co-operation, some may die. As a result, the
group at the end of the study may not be representative of
the original group.
302
Copiti.e cleterioratiClll
It would be wishful thinking to deny that there is any
deterioration with age. Physical ageing is a fact which is
easy to observe, though it may occur at different rates in
different people. Performance in everyday tasks in which we
have to use our cognitive ability to register things we see
or hear, remember them and think about them also deterior-
ates. Absent-mindedness is one of the most common complaints
of older people in everyday life.
In more recent cross-sectional studies of the perfor-
mance of different age groups on experimental tasks, psycho-
logists have tried their best to control for obvious factors
which might produce differences in their own right, like
education, illness, sensory impairment and willingness to
carry out the tasks in question. Of r.ourse, some question
marks remain over differences in attitude and perceived
role; for instance, whether older people see the purpose of
such tasks in the same way as younger people. Nevertheless,
certain conclusions can be drawn about the abilities which
seem to change the most as one grows older. In the first
place, older people taite much longer to carry out tasks, and
this is not only because their limb movements are slower. In
tasks in which they have to divide their attention ('try to
do two things at once') decline with age is very marked and
is already evident in those over 30. Ability to remember
things we have seen or heard declines, as does also the
ability to hold associations in mind.
On the other hand, if they are given sufficient time
and can make use of mnemonic devices, like wri ting down
information to be remembered (e.g. keeping a diary), older
people can compensate to a great extent for declining
cognitive abilities. The value of such studies is also that
they should make us aware that when we are dealing with
older people, it may be especially advantageous to present
information succinctly and explicitly, and to allow more
time for material to be taken in.
However, in some older people decline is not evident
at all. Particular experiences, for example particular
occ11pational backgrounds, may develop certain abilities in
an individual to such an extent that they remain well deve-
loped throughout old age. Retired telephone operators who
have no difficulty in dividing their attention between a
number of messages are a case in point. The prominence of
so many older people in public life where they reap the
fruit of years of experience in political dealings is also
an obvious illustration. Moreover, it seems to be true that
in some old people deterioration does not, in fact, occur.
There are studies which indicate that the cognitive ability
of a sizeable minority of elderly people, perhaps as many as
one in ten, cannot be distinguished from that of younger
people.
This, then, is evidence that age itself is not the im-
portant thing. Indeed, it seems better to view age simply as
a vector along which to measure the things that happen to
303
people. Some things that happen with age are universal. They
occur at different times, but they are unavoidable. These
things we can, if we like, describe as 'age' changes. But a
lot of the things we associate with old age are not due to
ageing processes and are not universal. There is a great
variation in the extent to which people are hit by physical
and social losses as they grow old. Some people are
fortunate, some people are unfortunate.
From the point of view of cognitive ability, the most
unlucky are those people who suffer from the various forms
of brain diseases which lead to a progressive deterioration
in mental functioning. But it is worth noting that there is
a much broader relationship between the occurrence of dif-
ferent diseases and poor performance on intellectual and
memory tasks. It is well recognized how certain infections
can bring on temporary confusional states. Some individuals
have an inborn tendency to react to infection in this way,
especially in extreme youth and old age. Chronic disease
also takes its toll. Perhaps the most telling study was one
carried out by Birren and colleagues nearly 20 years ago
(reported in Kimmel, 1974), which found a connection between
impairment in cognitive performance and mild disease in a
group of elderly people who had been positively selected for
their good health.
Yet health is by no means the only extrinsic factor
influencing mental state in old age. A lot of research has
been done recently on the psychological effects of such
brain-washing treatments as isolation and sensory depriva-
tion. Disorientation and confusion are common results, but
we are often slow to recognize that old people may be living
in circumstances where, by any ordinary standards, they are
extremely isolated and deprived of stimulation. No one calls
to see them, to engage them in conversation, to remind them
of their names, roles and relationships. Disorientation in
time and space, and confusion about identity and relation-
ships with others can be a natural result. From our own
experience we know how time can lose its meaning after one
has been ill in bed for a day or two, away from the normal
daily routine.
Other social and psychological factors playa part too.
Motivation to recover or maintain abilities is obviously
crucial, and studies have continued to emphasize the point
made at the beginning of this section, namely that the
amount of education remains one of the major factors in
cognitive ability and performance throughout life.
Has ageing itself then no significance for cognitive
functioning? There does seem to be a case for postulating,
independently of changes related to extrinsic factors, a
slowing down of brain activity with age. This is the 'age'
change which shows up especially on performance on speeded
tasks. However, perhaps such a distinction is misleading.
As alrl"ady mentioned, we do not know whether these changes
apply to everyone and in the long run they may be inter-
pretableas the result of 'disease'.
304
On the other hand, we do have to accept that suscep-

tibility to certain diseases is itself a ch'lracteristic of
ageing and a number of these diseases, especially arterio-
sclerosis and senile dementia, have very grave consequences
for cognitive functioning. But an important point to bear in
mind as well is that mental deterioration and even apparent
dementia can also be the result of social and environmental
trauma. We need to pay attention to social as well as physi-
cal causes if we are to reduce cognitive decline in old age.
Personality and life style

Scientific work on personality and style of life in old age
does not match the amount that has been done on cognitive
functioning. The evid~nce we do have, however, relates both
to change and stability.
One clear finding from research is that introversion or
interiority increases with age. This means that as people
grow old they become more preoccupied with their own selves,
their own thoughts and feelings, and less with the outside
world. This change is only relative, of course, but it is
evident both from responses to questionnaires and also from
projective tests, where people are asked to describe or
react to stimuli they are presented with, such as pictures
of family and social situations.
The term disengagement has been used to describe such
a change in orientation, meaning a decreased concern with
interacting with others and being involved in the outside
world, and an increased satisfaction with one's own world of
memories and immediate surroundings. However, critics have
been quick to point out the dangers of exaggerating the
extent to which disengagement is a 'natural' development in
old age. Most of the decreased interaction and involvement
of older people is forced upon them by undesired physical
and social changes: disability, bereavement, loss of occupa-
tional roles and so on. Moreover, there is also clear f'vi-
dence that old people are happier when there is a good deal
of continuity between their past and present activities.
It would be wrong to label any decreased invobement in
the outside world that a particular elderly person may show
as a natural development of ageing, and nor should we plan
special facilities for elderly pE'ople like shelter~d housing
on the periphery of towns because this is supposed to fit in
with their needs for 'disengagement'. This is an important
point to make because such things do happen.
Nevertheless, there does seem to be truth in the claim
that there is some intrinsic movement towards a more intro-
verted state with age. Some of the most sensitive studies
have shown a trend towards introversion from the age of 40
onwards, which is a period of life when the physical and
social losses associated with ageing are usually not yet
being strongly felt. A number of psychodynamic theorists,
most notably Jung, have vividly described the inner changes
which characterize the onset of the second part of life, for
instance a critical stock-taking of the life one has led so
305
far, and we refer to these again in the last part of this

section.
It is worth mentioning that there have also been at-
tempts to link some of the 'disengagement' changes with age
to major theories in general psychology. For instance, there
is an important strand of work in the study of motivation
which suggests that individuals seek optimum levels of
arousal at which they are comfortable and also most effec-
tive. It is conceivable that this optimum level changes with
age. One thesis postulates that a number of psychological
changes of old age, such as disengagement and preference
for simple and familiar situations, are evidence of a basic
change in the organism from a primarily arousal-seeking to
a less arousal-seeking state (Dibner, 1975). This change may
come about as the result of a need to conserve energy with
a decline in efficiency of energy systems, reflected in
basal metabolism rate, respiratory function, and cardiac
output. Certainly it is commonly observed that, when re-
covering from challenges like sickness and external stress,
older people noticeably lack energy for other things.
Whether this theory applies more generally has not really
been investigated.
Another consideration is that disengagement could also
be the result of failings in sensory acuity and cognitive
capacities. We all know how uncertain situations make us
feel agitated. Ultimately we are inclined to avoid such
situations. A good example of this phenomenon is the old
person with failing hearing who avoids conversations with
others because he finds them too difficult to cope with.
Certainly this is a perspective on motivation with practical
implications. We should make sure that the situations in
which we place elderly people are not over-arousing. Of
course, they also should not be under-arousing.
At the same time it needs to be stressed that, in
general, changes with age in personality are not large ones.
The stability people show in their characteristics and style
of life over age is far more striking. Longitudinal studies
show that people continue to enjoy the same interests and
activities. When striking negative changes occur in a per-
son's interests or familiar mode of activities or ways of
coping with life in old age, for no obvious reason, this is
often a sign of psychiatric illness, especially depression.
Indeed, some of the most valuable studies on personality
in old age are those which have shown how important it is
to take into reckoning a person's 'life style~ for in-
stance, in explaining why people react differently to
changes and losses such as retirement, bereavement and
living alone, or a move to a residential home. Any research
finding about old people usually has to be qualified by a
reference to life style. For example, one American study
demonstrated the advantages to be found in grouped housing
for the elderly in allowing for more contact with people of
similar ages and interests. But it was careful to point out
that this did not apply to those with a life style exclu-
sively orientated to family or those who could be classified
306
as inveterate 'outsiders'. The implication is that WP. should

take much more notice of a person's personality and life
style than we usually do. This is mentioned again later when
talking about the reaction of people to environmental
change.
A greater awareness of old people as individuals would
also make lIS more sensitive to their true needs. We are
often too keen to apply objective norms to their situation,
or too little interested in listening to their own accounts
of their lives. If we considered their life history more we
would have a better appreciation of their present attitudes
and concerns. If a study of personality is of any value it
should at least teach us to respect individual differences.
If anything, old people, far from being more alike one
another, are more different from one another than young
people. This is understandable after all: they have had more
time to grow different from each other.
Growth and development

Old age and ageing have been neglected themes in psycho-
logical research. The major work that has been done has been
strongly related to the biological model of decline and de-
terioration. There has been analysis of negative changes,
but little attention to positive developments. Deterioration
is an obvious fact of old age and it is a priority to under-
stand it better if we are to do something to ameliorate it.
But it is not the only perspective on old age.
Certainly in literature old age has been treated much
more generously. The works of Nobel prize winners such as
Patrick White ('The Eye of the Storm', 1973), Saul Bellow
('Mr Sammler's Planet', 1969) and Ernest Hemingway ('The
Old Man and The Sea', 1952), present vivid and compelling
pictures of old age that, like King Lear, have to do with
deterioration and change, but also with growth in
understanding and the values of existence.
Indeed, a characteristic theme in li terature is of old
age as a time of questioning; of one's own achievements, of
the meaning of one's life, of the values one lived by and of
what is of lasting value. It is as if an old person, freed
from the strait-jacket of society, suffering losses in his
ability to function and in his social position - perhaps
precisely because of them - is somehow let free to question
life. Here we can understand how disengagement in old age
can be both an intrinsic process and one that is related to
external circumstances.
Thinking and talking about the past is indeed one aspect
of old age that has been given some attention by psycho-
logists interested in ageing. Reminiscing, of course, can
take on many forms and can have different functions. The
reminiscer may use it to draw lessons for himself or for his
listeners; it may be of help in maintaining a person's sense
of identity in trying circumstances; it may be a consolation
to someone in dreary moments. But perhaps the most signi-
ficant use of memory is in achieving a creative reconsid-
eration of the past, one that throws new light on life and
307
experience. Self-assessment is no doubt an important goal at

all stages of life, but in old age it is especially salient
because of the awareness of the closeness of death. Psychi-
atrists have pointed to the significance of 'life reviewing'
in older people, and in research by Coleman it has been
shown that such a level of critical and exploratory consi-
deration of one's past life and actions does seem to be of
significance in letting elderly people with unsatisfactory
past lives come to terms with them.
Jung is probably the major thinker in our time who has
devoted attention to creative inner processes in later life.
Erikson too has delineated the achievement of a sense of
'integrity' as the last major task of life, 'the acceptance
of one's one and only life cycle as something that had to be
and that, by necessity, permitted of no substitutions'. Such
wri ters acknowledge that a process of inner conflict often
precedes the achievement of such states of being. But we
also need to face up to the fact that the conflict raised by
the questioning of old age may not always be resolvable.
Some people die in protest or in despair, and who is to say
that is not fitting?
On a lighter note, perhaps these thoughts also give us
a clue as to some of the advantages of working with elderly
people. In many ways older people are easier to talk to than
younger people. They appear more open about themselves, less
inhibited and less defensive. The explanation would seem to
be that they are less likely to feel threatened about show-
ing their real selves or worried about showing their emo-
tions. There is no point for them in being false any more.
Short SlIII1I!IiIpY
A look at the scientific literature shows that the psycho-
logy of ageing has been neglected. Most of the work has been
concentrated on cognitive ability. From this it is clear
that 'age' itself is less important than is usually thought.
The major determinants of cognitive deterioration are the
diseases which characterize a large number of, but certainly
not all, old people. Psychological and social factors also
influence the mental status of the elderly, just as they do
younger age groups. What evidence there is about persona-
lity and life style indicates a good deal of stability in
people's interests throughout the latter part of life.
Change is more often than not due to physical or social
trauma. Little consideration has been given to the distinc-
tive features that old age may have: for instance, life
reviewing, changing attitudes to life and the development of
a sense of integrity.
AdaptatiOD to loss in From what has already been said it should be clear that old
old age age is a time of great inequality. It is a time when losses
occur. loss of physical and mental abilities, loss of people
who were close to one, loss of roles and loss of activities.
These losses are not inevi table; they do not occur in the
308
same degree to everyone. But they are sufficiently universal

for us to recognize merit in the analogy between old age and
the season of winter. The analogy is a useful one. Winter
can be very harsh but it can also be very beautiful.
Any caring society which deserves that description has
the duty to mitigate the harshness where it can, and the
kinds of provision society makes will be considered in the
next section. But first of all we must remember that all
people, young and old, do have resources of their own to
call on. We are not simply the passive victims of fate. We
make positive adaptations to the events that come upon us.
The ability to adapt and the ways in which we cope with
circumstances are personal characteristics. They also owe a
lot to the society we are brought up in. They are necessary
for survival in a world that is often cruel.
Gerontologists have paid quite a lot of attention to the
concept of adaptation in old age, and have sought a measure
of the extent to which an elderly person appeared to be
adapted to his or her current circumstances. These have
variously been called measures of adjustment, life satis-
faction, morale, well-being and so forth. Principally they
reflect the need researchers have felt for measures by which
they could assess the impact of the losses of old age, of
the provisions made for elderly people - such as special
housing developments and recreational facilities - of the
success of interventions made by professional people, and
also of the individual's own ability to cope.
In this section we shall consider briefly some of the
losses of old age and the way we find old people reacting
to them. But first we would do well to examine our own
assumptions as to how old people should react to events.
Is adaptation, for instance, necessarily always the most
appropriate reaction? Protest may be more to the point.
Acceptance of some situations may be impossible or, more
simply, undesirable. One should not have to learn to like
what is bad. The situation itself must be changed, not the
individual made to conform. Even when faced with the in-
evitable, compliance may not always be or seem to be the
fitting reaction, as in Dylan Thomas' plea to his father to
'rage against the dying of the light'. Perhaps it is best to
begin by looking at loss and reaction to it in old age as
objectively as we can.
Adjustment to re1ocatiOD
It is one of the misfortunes of old age that people can find
themselves being obliged to move, sometimes quite unexpec-
tedly and against their will, to different environments,
particularly institutional settings, where they often have
to remain for the rest of their lives. Although this is
usually done to them 'for their own good' (they are judged
incapable of looking after themselves in their own homes) ,
the end result may be much worse than leaving them alone:
for example, further deterioration and loss of interest in
life.
309
There has been growing realization of the extent to

which environmental changes can contribute to physical ill-
ness and psychiatric disorders. Even where it is voluntarily
undertaken and has otherwise favourable effects, there are
indications that rehousing can undermine a person's health.
There is also a great deal of variation between individuals
in their reactions, so it is important to discover which
factors might predict the ability to adjust easily to new
surroundings.
Among psychological factors, cognitive abili ty is
clearly crucial. There appear to be two major reasons why
cognitively impaired old people react worse to relocation.
In the first place their lack of ability to anticipate and
prepare means that they experience more stress on making
the move. Second, because of their poor short -term memory
and orientation abili ties it may take them a long while to
understand their new surroundings.
Personality is important too. We are not sufficiently
sensitive to the fact that the institutional environments we
provide may be fine for one kind of elderly person but not
for another. American studies have shown the importance, for
instance, of rebellious and aggressive traits, as opposed to
passive and compliant ones, in predicting survival and lack
of deterioration after relocation to institutional settings.
It is not an unusual experience for visitors to residential
homes in Great Britain to find that particular lounges have
become the preserve of certain domineering individuals. Yet
we do not think twice about sending people, who all their
lives might have lived very 'privately', to spend their last
days in such a setting.
Certainly not to be neglected are attitudinal factors
concerned with what the move means to the person, whether
he wants to go, and how he sees his own future in the new
setting. American research has demonstrated that charac-
teristics often supposed to be descriptive of individuals
after they have come to live in residential homes, like
withdrawal, depression and anxiety, can in fact be just as
characteristic of people about to enter. This does not mean
that relocation is unimportant, for it is likely that the
effects of having to move to an institution are already
evident in those on the waiting list. From Dutch studies by
Coleman and others, it is clear that waiting to move is a
very stressful experience. Older people in such situations
may well need much more support than they usually get.
Attitudes to health aDd well-being

Severe disability is one of the major losses of old age and
its central importance in shaping the rest of an indivi-
dual's life is one of the most common findings to emerge
from investigations on social aspects of ageing. People who
are disabled have more problems in maintaining their desired
styles of life and are more dissatisfied than people who are
not disabled. This is not surprising.
What is more surprising, or at least not logically to be
expected, is the fact that, in general, levels of well-being
310
do not decline with age. This is despite the fact that the
incidence and severity of disability tend to increase with
age and have a great influence on well-being. All the
evidence from survey research indicates that although a
sizeable minority of the elderly population suffers from
depression, the general level of expressed satisfaction with
life is as high or even higher than in the younger age
groups. Even within the older age group itself the survey
evidence does not support the view that age carries with it
a declining chance of happiness.
The key to understanding this apparent contradiction
between decline in physical health and maintenance of well-
being is to appreciate the importance of the concept of
subjective health. Feeling well is an important aspect of
health, one that a doctor cannot afford to neglect. If an
old person thinks he is sick, if he does not want to live
independently, if he thinks he should be looked after, he is
going to make a demand on services. Though subjective and
objective health are usually closely associated, this is not
always the case. A person may feel physically unwell as a
result of the circumstances he lives in more than because of
any particular health condition. For example, in the Dutch
studies it emerged that elderly people who had applied for,
but been refused, admission to residential homes felt as bad
or even worse about their health than those who had applied
and been accepted. The latter group objectively were less
healthy and more disabled. That is why they were accepted.
But there were other circumstances in the lives of those who
were not accepted, pernaps loneliness and bad living circwn-
stances, which made them feel just as unwell. (It should be
mentioned that Dutch residential homes are more frequent and
superior in quality to their counterparts in Great Britain.
For instance, individuals usually have a room of their own
in which they can place their own furniture.)
The clear evidence from both longi tudinal and cross-
sectional studies is that whereas objective health and
physical functioning of elderly people tend to deteriorate
with age, the same is not true in regard to how they feel
about their health. The most likely explanation has to do
with expectations. People expect to become somewhat more
disabled with old age. If they do, they accept it. But if
their physical functioning remains stable, they may in fact
experience this as a bonus and feel better as a result. Only
if their health deteriorates beyond the expected norm are
they likely to feel badly about it.
This argument applies strictly only to feeling well, but
it has wider implications for well-being generally and for
reactions to other losses in old age. Expectation is a very
important aspect of reaction to loss. It is what people ex-
pect and what people find normal that determines how they
react to things, and how satisfied they feel with their
situation. This kind of consideration also leads one to
reflect how different things could be if old people's
expectations changed. This is, in fact, not so unlikely.
Future generations of elderly people may be far less
PFP _ U 311
accepting of lower standards of health and also, for

instance, of income. They may expect things to be a good
deal better for them. And if things are not going to be
better they are going to be less happy as a result.
SeH-esteem and its sources the lynchpin of adjustment?

Disability and environmental change have been picked out for
consideration as two of the negative changes associated with
old age. There are others, of course. Bereavement requires
a major adjustment which seems to follow certain definite
stages. Grieving is a normal healthy part of the process and
the support and understanding of those around in allowing
the bereaved to express themselves may be very important to
it. Nevertheless, the gradual loss of people of the same
generation takes away major supports from a person's way of
life. Loss of occupational role with retirement is another
big change. Indeed, adjustment to it is often thought of in
the same terms as adjustment to the old age role itself.
Most people make good adaptations, but not all, and retire-
ment can be a major precipitating factor in the onset of
la te life depression. Then again, a very significant loss
for many people as they grow older is that of income. They
must adapt to making do with less. There has been almost no
psychological investigation of this kind of adaptation. From
what one can see, it would seem that a lot of old people
positively take pride in stretching their money. This, of
course, may also have a lot to do with their experience of
deprivation in the past.
Clearly, in all these adaptations much depends on the
characteristics of the individual person involved, and one
is led to ask whether there are any general ways in which
one can conceptualize how a person adapts to the various
losses and changes that occur with old age. Some authors
talk in terms of the individual possessing particular quali-
ties, for instance 'coping ability'. In our view, the most
valuable index of adjustment in old age is that of self-
esteem.
Loss of self-esteem appears as one of the characteristic
symptoms in depression in old age, itself one of the major
negative outcomes of being old. As a psychiatric condition,
it has been claimed to occur in as many as one in four of
all elderly people. A lot of this depression is associated
with the stresses of old age and consequent loss of self-
esteem.
Maintenance of positive attitudes to oneself seems to be
one of the key issues in old age. An especially important
component of self-image is a sense of being in control of
one's own life. Development in childhood and adulthood is
associated with an increasing sense of effectiveness and of
impact on the external world. In old age this sense may well
be taken away. The population of old people living in insti-
tutions, for example, has been found to have generally a
lower level of self -esteem than old people living in the
community.
31Z
Intrinsic to this conception of self-identity is the

notion that it must have roots outside itself. Therefore, if
an individual is to maintain his self-esteem he has a con-
tinuing need of sources from which he can define an accept-
able image of himself to himself. For some people these
sources can exist in past relationships and achievements or
in an inner conviction about the kind of people they are,
but in the main they depend on the present external cir-
cumstances of their lives; their roles in the family, in
relation to other people, in work and in other activities.
When these circumstances change, as they often do in
old age, a person may have to find alternative sources to
maintain a positive view of himself. Here again it is vital
to understand a person's life history. A person whose sense
of self has been based on one particular kind of source, for
instance relationships with members of his close family, is
going to suffer especially if he loses such family contacts
through death.
Little research has been done directly on the topic of
sources of self -esteem in the elderly, but there are avail-
able some interesting illustrations of this point of view.
American studies have shown, for instance, how sources per-
tinent to an old person's definition of self alter when they
enter a residential home. The staff often view the old per-
son in quite a different way from that to which they are
accustomed. For instance, they may not see a particular old
lady as a mother or someone who was house-proud but simply
as a lame person who needs to be helped in walking to the
dining table and so on. In such circumstances it is easy to
see how people can lose their old sense of self or, as other
studies have shown, be unable when asked to illustrate how
they really feel about themselves. It is a good institution
which tries to find out what kind of person the resident is
and to help them continue to be that person, for instance by
encouraging them to help in the kitchen and lay the table.
Studies on elderly people living in different kinds of
housing schemes both in the Netherlands and Britain have
supported our conviction that self-esteem is important and
that it is crucial to provide adequate sources of self-
esteem. Self-esteem seems to be the central dimension in
well-being in old age. If one analyses different indices of
well-being they all tend to be related together. For ins-
tance, if someone is lonely he is more likely to be worried,
feel badly about his health or have a negative attitude
to old age. But all such indices are particularly closely
related to self-esteem. It is the best index of a general
level of well-being.
One way to investigate sources of self-esteem is to ask
people directly what makes them say that, for instance, they
feel useful or feel useless. Not surprisingly, lack of in-
firmity and contact with other people including the family
emerge as the major sources of self-esteem. Especially in
disabled people, being able to do things for oneself, and in
particular to get around, appear to be key factors. Also,
313
being a source of help and encouragement to others is very

important.
In this context it is worth putting in a good word for
residential care and other types of grouped housing schemes.
In a previous part of this section it was indicated that a
move to an institutional setting can be damaging for certain
types of individual, but a good institutional setting can
also be of great benefit to certain people. This is possible
when sources of self-esteem are likely to be strengthened
rather than weakened by the move.
For instance, some people could be said to be 'living
independently in the community'. But in reality they may be
extremely isolated and totally dependent on the services
being brought to them. Once they have moved to a genuine
communal setting the burden of infirmity and the conscious-
ness of being alone can be diminished. Precisely because
they are better able to cope for themselves in the new en-
vironment and to be of importance to others, they may gain
a new lease of life.
Studies in the Netherlands have confirmed American find-
ings that self-esteem and well-being generally are lower in
elderly people living in institutions, but they also show
self-esteem to be at a particularly low ebb in elderly
people on the waiting list for residential care. Actually
moving into the new setting can, therefore, improve self-
esteem and well-being. Nevertheless, as already emphasized,
relocation in old age remains a risky business. Having a
well-established sense of self-esteem indeed is itself a
good predictor of the success of the move, whereas people
with low self-esteem seem to be at particular risk of
deterioration and death.
Short 8Imggary
A person's individual characteristics help determine how
he will react to the losses of old age. These losses, of
physical and mental ability, of people close to one, of
social role and even of customary living space, are not
peculiar to old age, but they are typical of it. They occur
with greater frequency and they occur cumulatively. To some
extent they are expected and that helps the adaptation. But
not all changes that occur in old age are unavoidable. Some
can and should be resisted. Whether a person resists or
adapts to change, a crucial factor in his well-being appears
to be his capacity to experience continuity between his past
and present sense of self.
Be1piDg old. people Not all the loss and trauma of old age can be countered from
an individual's own resources. The modern welfare state pro-
vides a range of services for the elderly; housing, health
and social services. These are, of course, limited, subject
to decisions about what level of services the country can
'afford'. We do not know what a perfect service for the
elderly would be like, but we certainly do know that what
314
we provide at present falls a long way short of it. Indivi-

dual initiatives, special schemes and innovations show
glimpses of what the future could bring. Voluntary organi-
zations in particular have had a good record in pioneering
services to people in need, which later have come to be
recognized by the general public as services which ought to
be provided universally by the state and local authorities.
However, the achievement of the present level of ser-
vices needs to be respected if we are to develop further,
and it is important that people in the various caring pro-
fessions who carry out these services remember their respon-
sibilities. One of the dangers is taking the operation of a
service for granted and then applying it automatically or
mindlessly. The people on the receiving end then cease to be
considered as individuals.
Welfare services are sometimes handed out in a 'conveyor
belt' fashion according to crude objective indicators of
need. For instance, elderly people may be classified by
their degree of disability and potential help available and
then given accordingly 'home help two mornings a week' or
'meals on wheels five days a week' or 'two weeks' relief
admission in a residential home or hospital'. The pressures
of work are great and the need to develop efficient service
delivery is obvious. But the temptations to lose consider-
ation of individuality in the process are equally great.
A key element, it would seem, in any work with elderly
people is the individual assessment; and it is here that the
psychological perspective has a vital role. We need a good
assessment not only of people's physical condition and
capabilities and of their social situations, but also of
their individual needs, their abilities and interests, which
should include a good picture of how they used to be.
'Needs' is a difficult term. Perhaps we should be more
circumspect when we use the word. Certainly agencies should
be more honest about their pretensions to be meeting needs.
They are providing services, but not necessarily meeting
needs. Going into a residential home may satisfy the local
authority's requirement to provide care and attention for
those they judge to be in need of it, but what about a
person's other needs? The total needs that any person has
are very individual, subtle and dynamic. To assess them
realistically requires a degree of acquaintance with the
person, a know ledge of his life and past history, and the
preparedness of the person to speak about himself.
This is true of all people, of course, but especially
true of elderly people. They have a long life behind them
and as a consequence may well be more 'individual'. Yet it
often seems that there is less time for professional people
to talk with elderly people than with younger people, al-
though more time is essential. Old people 'need' time to
think about their situation, to make a considered judgement
about what is best for them, and they often benefit from
having someone with whom they can talk it over.
Besides helping in assessment, psychology can also play
a role in the actual provision of therapeutic interventions
315
both to old people themselves and to those around them.

Applied psychology should be able to show the best way, for
example, to help recover abilities that seemed to be lost,
or to mend social relationships that had become tense. There
is a lot of work here for psychologists to apply themselves
to, but for the rest of this section we briefly consider
first the question of maintenance of interest, activities
and functioning of elderly people, particularly those living
in institutional settings, and second, issues to do with
relationships between elderly people and family members
who are supporting them.
MaiDtaiDiDg of interests, actiYities aacl fuactiODiDg

One of the most tragic images we have of old age is that of
an old person with shoulders sunk, sitting collapsed in a
chair, totally uninvolved in the world around. In a previous
section we have already raised the question of 'disengage-
ment' in old age, and we repeat the point made there that,
although some decline in activity may be an intrinsic part
of growing old, most of such decline is the result of
physical disabili ty and environmental trauma.
When there is a dramatic decline in a person's activi-
ties for no obvious reason, we need to alert ourselves to
the possibility that the person may be depressed. Loss of
well-established habits and activities and lack of interest
or anxiety about trying to regain them may be symptoms of
the kind of depression which will respond to treatment, even
though the person may not admit to having depressed
feelings.
Depression in old age can respond remarkably well to
medical treatment, which indeed may appear to be the only
way of getting somebody out of the vicious circle of lack of
interest and initiative in which he finds himself. But, of
course, there also has to be some activity and interest for
the person to go back ta particularly if someone is dis-
abled there may be few possibili ties open to him. The person
is then likely to decline again. It is also quite clear that
prolonged inactivity has deleterious effects both on physi-
cal and psychological functioning. Skills that are not
practised will tend to atrophy.
In recent years a lot of new initiatives have been
taken in geriatric hospitals in providing opportunities for
patients to engage in different types of activity: arts and
crafts, music discussion and so on. Generally, staff report
improvements in elderly people who do take part in such
activities, which can be seen in their personal appearance,
in their physical and mental functioning and in their con-
tact with others. Moreover, this improvement is not only
confined to those actually taking part in a given activity,
but seems to extend to other patients who are not able or
do not wish to take part. Even just to see something going
on is valuable stimulation. We need to know a lot more about
the kinds of activities that are useful and which eleIllents
are crucial (e.g. activity itself, interacting with others,
316
receiving personal affection, achieving new skills and so

on) •
The situation in residential homes also needs attention.
Visitors remark on the absence of activity in the lounges of
residential homes, but it is hard to see what people could
be doing when the environment does not offer any real pos-
sibilities for activity. Investigators have shown that the
level of activity in such a situation can be increased
dramatically by bringing in recreational materials. Though
it is important to introduce the materials involved and to
encourage the elderly people to use them, the amount of
staff involvement need not be that great. Yet such is the
pressure to carry out actual care and cleaning work in
residential homes that staff often seem to have little time
to help in getting such recreational activities off the
ground.
Volunteers seem to have an important role to play here,
as do instructors in adult education institutions. There
must be a role too for community, educational and clinical
psychologists in guiding their efforts, not only in setting
up such activities but also generally in seeking out ways of
encouraging patients and residents in institutions to con-
tinue to take an active interest in life, and also to parti-
cipate in the running of the institution. Of course, similar
consideration must be given to elderly people living in the
community too, particularly those who are disabled and
isolated.
An even greater challenge is offered by people who are
mentally deteriorated. In the first place it is very impor-
tant to distinguish elderly people who really have irret-
rievable brain disease from those who only appear to have
because they are depressed. Indeed, it may be symptomatic
of someone's depression that he thinks his brain is rotting.
It may be no easy matter to distinguish this, because it is
difficult to motivate someone who is depressed to actually
demonstrate his abilities. Memory for everyday events is a
good guide, though, and some psychological tests, like
remembering word associations and remembering patterns that
have been presented, can be helpful. With the right treat-
ment and support depressed people can be encouraged to
regain their old abilities. But elderly people who clearly
are deteriorating mentally should not be abandoned to their
fate. Tests have shown that such people, given encouragement
and help, can still acquire and retain new information and
maintain skills, but the effort needed from outside is
great. A good example is the use of so-called 'reality
orientation', where people around the elderly person, either
informally throughout the day or in concentrated formal
classes, systematically try to help remind the person of
time, place and season, of names of people, of objects, of
activities and so on. It is valuable in this to maintain a
lif e history perspective, too, considering the things that
have been important to individuals in their lives; sights,
sounds, tastes, smells and sensations.
317
Psychologists have a lot to do with applying findings

from the study of learning and memory to help old people.
The trouble at present is that such people are often left
alone, and this only exacerbates their condition. Dementia
is a progressive illness, but what happens between its onset
and death is important. If in the future we find medical
means of slowing down its progress, it will become an even
more urgent matter to find means as well to allow people to
maintain their optimum potentialities in the time that is
left to them.
Family relatiOllllbi,.
Another vital issue is the relationship between disabled
elderly people and their families. Many more of such people
are supported by their families than live in institutions
for the elderly. For instance, in the case of severe de-
mentia, there are four to five times as many suffering from
such a condition living in the community as live in resi-
dential homes or hospitals. Yet often families who are doing
the caring get pitifully little in the way of support
services.
If they become overburdened by the stress of their in-
volvement, both they and their elderly relatives suffer. The
old person's mental condition may well be aggravated by
tired and irritable relatives, and if there is a breakdown
in care and there is no alternative but to take the old
person into an institution, the family members are likely to
suffer greatly from feelings of guilt. They often want to
care for a relative till that person dies, but need help in
carrying it out.
It is an important principle to accept that work with
families is an integral part of work with elderly people.
Family ties after all usually form a substantial part of an
individual's identity. If those ties are damaged, so is the
person's identity. The physical and mental deterioration
that happens to many people as they grow older and their
ensuing state of dependency can put a strain on many rela-
tionships. Men, for instance, usually do not expect to
outlive their wives. They can encounter great problems if
they find instead that they have to spend their old age
looking after a physically or mentally deteriorated wife,
especially if in the past it was the wife who ran the
household. Children, too, often find difficulty in taking
over responsibility for ailing parents.
The actual symptoms, particularly of mental disturbance
in old age, can be very disturbing. In some forms of demen-
tia (probably dependent on the part of the brain that has
been affected) the behavioural changes that can occur, car-
icaturing the original personality, increasing aggression or
leading to a loss in standards of cleanliness, can be very
painful for relatives to bear. It may be difficult for them
to accept that the patient is not simply being difficult or
unreasonable. Families need counselling about the nature of
the illness and, in the case of dementia, of its progressive
318
nature, and preferably promise of continued practical sup-

port as well. Group meetings held for relatives of different
patients by doctors, social workers or other professionals
can also be useful in allowing relatives to share common
experiences and problems. Groups for the bereaved, parti-
cularly husbands or wives, can also play their part. The
last years of their lives may have revolved around the care
of a sick spouse and they must now find new meaning in
life.
Short: """"""Y
In attempting to help old people, therefore, we must con-
sider not only the needs of individual old people but also
of those around them. Everybody lives within a social con-
text and for most, ties with the family and other signifi-
cant people are important to their sense of identity. The
traumas of old age can put severe strain on even the best
of relationships and a high priority should be given to re-
lieving this strain where possible. For those elderly people
who are isolated or living in institutional settings, the
main aim must be to preserve interest in life. Maintenance
of activity and functioning is a vital principle. With
imagination a lot more could be done to involve elderly
people in the world around them.
The futun In discussing ageing and social problems it may seem strange
to end with a note about the future. But from what has been
said it should be obvious that great improvements need to
take place both in society's provision for the elderly and
in the attitudes of each and everyone of us to the elderly
people we live among.
For most people old age is not a particularly unhappy
time, though for some it is. In part that may be, as we
have suggested, because old people have low expectations.
They quietly accept a society that treats them meanly and
as somehow less important. In the future that may all
change. We may see new generations of elderly people,
foreshadowed in today's Grey Panthers in America, who will
mobilize their potential power as a numerically important
part of the electorate and pressurize society to give them a
better deal.
On the other hand, old people may continue to remain
on the sidelines. They may refuse to see their own material
and other interests as being of central importance to
society, in which case the rest of the population must see
they are not forgotten.
The most important changes, indeed, are the attitudinal
ones. We must recognize that old people are ourselves. They
are our future selves. There is a continuity in life both
between their past and present and between our present and
future.
Old people remain the same people they were. Indeed,
if we really want to know about a person's needs and wants
319
and how they could be satisfied, the best introduction would

be to let him tell us about his life history. Whatever new
steps are taken in the future must follow on from this and
make sense in relation to it.
Better provision would follow from such a recognition.
If we really respected people's individuality, we would
provide them with some choice about the circumstances and
activities with which they end their days, not just enforce
certain standard solutions. In short, we must allow people
to grow old in ways that suit them, perhaps to explore new
avenues of development, and to make the most of the years
that remain. Also, when we consider those who need our help,
who suffer in old age and perhaps are dependent upon us, we
should not forget these wider perspectives.
Bibliography Birrell, J .K. aDd Schaie, K. W. (eds) (1977)

Handbook of the Psychology of Ageing. London: Van
Nostrand Reinhold.
Brearley, C.P. (1975)
Social Work, Ageing and Society. London: Routledge lit
Kegan Paul.
Bromley, D.B. (1974)
The Psychology of Human Ageing (2nd edn). Harmondsworth:
Penguin.
Carver, V. and Liddiard, P. (eds) (1978)
An Ageing Population (Open University text). Sevenoaks:
Hodder lit Stoughton.
Chown, S.M. (ed.) (1972)
Human Ageing. Harmondsworth: Penguin.
Di1mer, A.S. (1975)
The psychology of normal ageing. In M.G. Spencer and
C.J. Dorr (eds), Understanding Ageing: A multi-
disciplinary approach. New York: Appleton-Century-
Crofts.
Gray, B. and 1IIaacs, B. (1979)
Care of the Elderly Mentally Infirm. London: Tavistock.
Kastenbaum, R. (1979)
Growing Old - Years of Fulfilment. London: Harper lit
Row.
Kimmel, D.C. (1974)
Adulthood and Ageing. An interdisciplinary developmental
view. Chichester: Wiley.
Miller, K. (1977)
Abnormal Ageing. The psychology of senile and presenile
dementia. Chichester: Wiley.
Neugarten, B. aDd associates (1964)
Personality in Middle and Later Life. New York:
Atherton Press.
1. Discuss the view that old people do not differ from

young people except in the number of years they have
lived.
320
2. Should the study of the psychology of ageing be part

of developmental psychology or a separate field of study
altogether?
3. 'Deterioration in function is the main psychological
characteristic of old age.' Do you agree?
4. What factors influence mental performance in old age?
What evidence do we have on their relative importance?
5. Is there more truth in 'disengagement' theory as a
sociological or psychological theory of ageing changes?
6. What explanations are there for the decline in
activities that some people show as they grow older?
7. How important is a knowledge of life style or
personality type to understanding how people react to
change and stress in old age?
8. Are the changes we observe in old people's behaviour
related more to the physical and social losses they
incur or more to intrinsic processes of ageing?
9. Do old people show genuine developmental changes as well
as changes of deterioration?
10. Analyse the relationship between well-being and health
in old age with particular regard to increasing
occurrence of disease and disabili ty.
11. Which psychological factors predict the success or
failure of relocation to new forms of housing (e.g. old
people's home, sheltered housing)? What are the implica-
tions for practice of professional people involved?
12. Discuss the role of 'expectations' in adaptation to loss
in old age.
13. Write an essay on self-esteem and sources of self-esteem
in old age. How is self-esteem nourished, and how is it
threa tened?
14. Under what circumstances is a move to a residential
home or other institutional environment likely to be
success ful/unsuccess ful?
15. Has the psychologist a role to play in community welfare
services for the elderly, for example in primary medical
care or social services agencies?
16. What behavioural and other psychological techn~ques are
there available to help people to recover interests and
customary activities that they may have lost in old age?
17. Which psychological factors are related to the onset of
and recovery from depression?
18. Do any therapies exist that might be helpful to people
suffering from mental impairment in old age?
19. Discuss the problems that can arise in a family as a
result of the disabilities of old age and the relevance
of a psychological perspective in helping to resolve
them.
20. 'Social and psychological factors are more responsible
for mental deterioration in old age than are physical
disorders of the brain.' Discuss.
21. What methods can we use in studying psychological
changes with age? What are their respective strengths
and weaknesses?
321
22. 'The psychology of ageing cannot be considered in

isolation from the medical or sociological study of
ageing.' Do you agree?
23. 'Too many of our views on the psychology of ageing are
restricted by the limits of our own society.' Discuss
the value of a cross-cultural approach to the psychology
of ageing.
24. Which psychological research and theories are of value
in the design of long-stay environments for the
elderly?
25. It has been said that both doctors and social workers
are dominated by a 'disease' model which they use
excessively in 'labelling' old people's behaviour. How
can a psychological perspective help towards a better
understanding?
26. The problems of old age are more a function of society's
attitude to ageing than of ageing itself.' Do you
agree?
27. 'Old age, far from being the least important, is the
most important period of life. It is the last
opportunity an individual has to achieve identity and
self fulfilment and develop a sense of integrity.'
Discuss this view and its implications for the way we
treat elderly people.
Aunotated reading Brearley, C.P. (1975) Social Work, Ageing and Society.
London: Routledge & Kegan Paul.
A book written for social workers but bringing together
a wide range of material from medicine, psychology and
sociology.
Bromley, D.B. (1974) The Psychology of Human Ageing (2nd

edn). Harmondsworth: Penguin.
Written by a British psychologist, it gives a very
thorough coverage of subjects such as changes in
performance and cognitive skills with age, and is good
on the methodological issues involved in doing research
on ageing.
Carver, V. and Liddiard, P. (eds) (1978) An Ageing

Population (Open University text). Sevenoaks: Hodder &
Stoughton.
A collection of readings prepared for the Open
University course. The papers have been drawn from a
variety of sources to provide a multidisciplinary
perspective on the needs and circumstances of the
elderly.
Gray, B. and Isaacs, B. (1979) Care of the Elderly Mentally

Infirm. London: Tavistock.
A more specialized book on the elderly mentally infirm
than Brearley's, also intended for social workers,
written jointly by a geriatrician and a social worker.
322
Kastenbaum, R. (1979) Growing Old - Years of Fulfilment.

London: Harper & Row.
An introduction to the subject written by an American
psychologist. He presents a balanced approach to old
age, giving due weight to positive perspectives. The
book is also attractively illustrated.
323
Part four
The Individual Crisis
3Z5
13
Crisis, Stress and the Sick Role
D. A. Shapiro
Opening remarks The last part of this book breaks with the pattern of
E. N. DUNKIN introducing each contributed section separately and deals
in general with the question of crises that happen in a
person's life. Before the final three chapters, on psycho-
pathology, management of pain and the problems of bereave-
ment and death, there is a section in which we look again
at some of the ideas that have been offered earlier in the
book and relate these to the onset and resolution of
physical and mental disorders.
So far we have presented a human being as having the dignity

of an identity that makes him distinct from his environment
and we have agreed that he has an effect on his environment
as well as being affected by it. This interaction can be
seen as an inevitable dialogue which we have 'interrupted'
with our series of questions 'What, why, when and how does
anyone do things?' The dialogue began at birth and continued
throughout life with definite periodicity and in different
settings. Our human being grew up surrounded by the acti-
vities of education, work and recreation. In Part m we had
a deliberate scheme of time and social periods and we saw
the healthy individual as he developed within the home,
school and employment settings, where he made more and
more social relationships.
Given that the whole popUlation is not healthy all the
time, where does the hospital or clinic and the concept of
the 'sick' person fit into our scheme? Although some refer-
ences have been made to abnormal reactions from time to
time, we have not really considered the sick person nor all
the other settings that are associated with hila surgeries,
clinics, hospitals, nursing homes and the like. How does a
healthy individual become a 'sick person'? And what dif-
ferences does illness make to the patterns created by the
person/environment interactions?
We would be misrepresenting life and psychology if we
failed to acknowledge and consider that an individual's
progress through time is also marked by crises of varying
severity. Before we go any further, it would be as well to
agree what is meant by crisis. Referring to a standard dic-
tionary definition, we find that it is a 'turning point, a
moment or brief period of danger or suspense'. This promptly
PFP _ Y
3Z7
Crisis, stress and the sick role
invites each one of us to judge what is dangerous and to

find out where the corners are, so that we can give the
definition a real meaning for ourselves. It draws attention
to the fact that the quality of crisis is linked inextri-
cably with such personal interpretations; what is critical
and threatening for one person may be seen as of no conse-
quence to another, depending on the previous experience and
personality of the individual. But we must make some value
judgements or we will be unable to pursue the matter any
further.
Perhaps it is reasonable to talk about some of the
consequences of crisis. In most cases, a crisis alters the
immediate environment of the person in terms of health,
social or economic prospects. Someone facing a health crisis
is aware of mental or physical symptoms {often including
'pain' or 'discomfort'}, and these tend to bring him into
contact with a different set of people such as doctors,
nurses and other members of the caring professions. Usually,
this change in human environment is matched by changes in
the non-human environment: at the simplest level, this may
mean confinement within the home at an unusual time of day,
and may include being in bed for much longer than usual. A
more serious health crisis may cause more extreme disruption
of his environment, with the individual finishing up in the
ward of a hospital. Other forms of crisis {such as loss of
employment, breakdown of a marriage, financial gain in a
lottery, or sudden death of a close relative} will bring
parallel but different invasions of the person's life style
and social surroundings.
Training ground for It would be illogical to follow the interpretation of

crisis management 'crisis' too far into the realms of disaster without pausing
to consider that there are 'turning points' throughout life
that do not put people under medical care. We could go back
to our earlier discussions in chapters 8 and 9 and pick out
examples of periods in which the child faced the necessity
of deciding how to deal with a novel situation, trying the
solution he selected and then judging the results. Each of
these experiences is bound to make its mark on the child who
learns as much about his accuracy in predicting his ability
to manage himself and his environment as he does about the
quality of his world. On reflection, it seems that people
progress through their lives meeting and managing one
problem after another. The more often they are pleased with
the outcome, the higher is the chance that they will become
confident in their ability to deal with the unexpected as
well as with the expected. However, not all people find
their efforts or the results of those efforts particularly
rewarding, and those who have repeated experiences of being
defeated by problems have a tendency to become discouraged.
They do not develop a normal amount of self-reliance and
they become preoccupied with their own inadequacy, so we
have a picture of two alternatives. The crises of develop-
ment may be met, managed and mastered, leaving the person
3Z8
more mature in independence, self-esteem and appreciation

of others (and better able to deal with future problems), or
they may be met, mismanaged and abandoned, leaving the
person essentially weakened by the evidence that he is in-
competent. This gives us an excellent sample of positive
feedback, that is, the observed tendency for the incidence
of one outcome to promote more and more outcomes of the
same sort. If a house were fitted with a positive feedback
control unit, rather than a normal thermostat that works on
the negative feedback principle, the occupants of the house
would be cooked instead of being protected in a comfortable
thermal environment! With or without this analogy to help
us, the effect of positive feedback on the person's adaptive
behaviour is clear and we can see how many of the differ-
ences between people happen if we have access to their
individual histories. We have already noticed in Piaget's
theory of cognitive development that positive feedback can
account for the growth of intellectual ability of children.
The skills mastered in each successive stage of development
are available thereafter and each achievement promotes the
next advance. This means that the child has an increasing
set of skills, including the earliest and the latest to
develop, when he faces the challenges of any situation.
The fact that we have returned to our study of childhood
illustrates one of the characteristics of many thoughtful
peopl~ the western world has a tendency to watch matura-
tion with interest and with close attention to detail, and
then to abandon the individual when he reaches adult life.
Rightly or wrongly, there is a popular belief that we have
an obvious training obligation to growing creatures but that
our responsibilities in that area fall off sharply once the
person is 'big enough to take care of himself'. This de-
flects attention from crises that are more accidental than
developmental, and frequently gives too little thought to
folk whose size is no indication of their ability to manage
their own lives, regardless of the circumstances. Since too
little attention is paid to the matter in general, it is by
no means certain that people are given the most appropriate
help, even when help is forthcoming.
So what of adult crises? How does the young adult learn
to be a middle-aged adult, or to be a young adult with no
chance to walk again after a spinal fracture? How does the
middle-aged person learn to meet and master the changes that
come with retirement, the failing health that arrives with
age and the ultimate prospect of dying? Even if people have
become very independent by the time they are in their thir-
ties, what preparation does life give them for the abrupt
change in their value in the eyes of the working community,
or of their family, when they lose their jobs and the eco-
nomic situation denies them the chance of starting again?
Redundancy has been a concept linked to exact sciences and
discussions related to the properties of intricate non-human
systems for many years, but now it is a familiar and well
understood word, an excuse for consigning unwanted workers
to the scrap heap of the unemployed. Its emotive properties
3Z9
are enhanced by the fact that the present economic climate

has a hardening tendency to translate 'unemployed' into
'unemployable'. Politically and economically, civilized
communities arp. under increasing obligation to find ways of
dealing with some adult crises. Governments are taking stock
of their facilities for looking after the elderly members of
the population because the life expectancy for the indivi-
dual is still rising. Ideally, each person should have the
chance to deal with every personal crisis on the basis of
his own choice: he has been apprenticed to do just that
throughout his early experience, but the realistic limits of
personal choice are often too great. Socio-economic or
health factors may lead the individual to find a 'way out',
or they may impose such an alternative on him. One of the
results of this is the 'sick person' we mentioned earlier.
We would do well to remember two things about illness:
* it is not always, or more correctly not ever, confined

to the physical part of the person;
* many sick people need help; the apprenticeship of
development has not been sufficient.
How do we find out who needs more than a medical diagnosis

and corresponding physical measures of treatment?
From this brief discussion and from comments made in
earlier chapters (e.g. chapter 5), there seems to be a case
for regarding stress as an interactive combination of for-
midable odds pitted against limited resources. If the odds
are not seen as insurmountable or the resources are not felt
to be limited, or both of these things, then stress does not
even exist, however severe the situation may be in the opi-
nion of an outside observer. The stalemate of the immovable
object and the irresistible force is seen as a challenge and
the person finds a way round the problem with no evidence
of stress in the process. Someone with a less robust person-
ality may show signs of increasing anxiety and tension: he
is not convinced that he can deal with the problem, or he
may over-estimate his competence and under-estimate the
opposition, thinking that he can manage instead of knowing
when he has no chance of success. In either of these two
lattp.r cases, the effects of stress may be shown in irri-
tabili ty, reduced tolerance for trivial interruptions and
inability to make simple decisions. These psychological
signs may be accompanied, or replaced, by physical signs and
symptoms such as indigestion, palpitations, headaches or
skin disorders. When this happens we see evidence of the
development of a 'psychosomatic disorder'.
Reactions to crises When they are involved in stressful situations that cannot
when stress occurs be resolved immediately, people may become physically or
mentally unwell. Where sudden disasters occur (such as
tragic illness of a member of the family, serious accident
to close friends or oneself), a pattern of psychological
disturbance can be seen. The first part of the pattern is
330
one of acute distress. The person is confused, very anxious

and has a feeling of helplessness or panic. At this time,
people seem almost incapable of making any decisions and
will accept any help and advice they are offered. Later, the
level of anxiety falls and there is an improvement in judge-
ment. People cannot live on the edge of an emotional pre-
cipice indefinitely and the intensity of grief passes with
time. It is difficult to give an absolute time scale, but
the period of intense grief may last anything from one to
six weeks. In this time, either something else may have
happened to alter the situation or else -the person is
exhausted. Extreme prolonged distress seems to be self-
limiting: perhaps the individual manages a 'pretence' of
recovery which is really a defence mechanism that denies the
existence of grief. This process is not fully understood,
although it is known that people no longer respond to coun-
selling, and attempts to help them have minimal success once
this 'cover' has developed. If there is only partial resolu-
tion of the crisis, the person may become susceptible to
ever-growing numbers of similar experiences and develop a
corresponding inability to deal with them.
SolutiODS to crises Having been to great lengths to emphasize differences be-

tween individuals, there is an element of contradiction in
trying to summarize their responses to crises. With the
appropriate reservations to allow for personal variation,
the scope of available solutions can be given as:
* the person recovers from his initial collapse, having

marshalled his personal resources, returns to the fight
and manages the situation successfully;
* the person gives evidence of stress and so finds enough
collateral support to make it possible to carryon his
normal life in spite of the disaster;
* the person seeks exemption from his responsibilities in
the sanctuary of illness.
In the first case, the problems are fully resolved and the
person comes out of the fray as a better manager of crises.
Later, the crisis may be seen as trivial. If that happens,
and it is an understatement of the original problem, it can
lead to subsequent under-estimation of difficult situations,
making the person insensitive. By way of example, we may
see that acceptance of the serious accidents coming through
a city casualty department as a realistic part of daily life
may provide a nurse with the resilience to tragedy that she
needs to allow her to carryon her work. In this case the
devaluation of the crisis is adaptive and has a positive
quality. In contrast, tolerance for the brutal murders that
occur in feuds and vendettas is a grotesque acceptance that
is maladaptive to the needs of society.
In the second case, evidence of distress (notice that
the word 'stress' is embedded in the term) may call forth
responses from the spouse, entire family, and close friends.
331
Their help may be enough to tide the person over the worst
of the problems.
In the third case, if this does not work, the evidence
of stress will be directed at and probably noticed by the
general practitioner, social worker, lawyer, psychiatrist,
or marriage counsellor. By this time, the life style of the
person is disrupted and further adaptation to the situation
is impossible. He finds that he cannot go on within the
normal limits of acceptable behaviour. It is at this point
that he may exchange his normal role for that of the 'sick
person'.
Who knows about personal crises?

From what we have said so far, it is clear that the numbers
and sorts of people aware of the crises of their fellows
varies with the type of crisis. Problems may arise in edu-
cational, vocational, familial or recreational settings and
they may have social, economic or health consequences or
causes. There is no sure way of knowing who will be seen
by the patient as the best person to be 'told' about the
difficulties. There is also no way of knowing that the
person himself will even recognize the true details of the
problem.
Against this uncertain background, diagnosis is not just
a matter of giving a name to the condition and some pills to
the patient: it involves looking beyond to the reasons for
the presenting symptoms.
The sick role: illness as a state of the person

By definition, illness is a socially accepted excuse for
giving up responsibili ties, at least on a temporary basis.
It is one of the few forms of 'deviance' that is granted
respectabili ty by the society. Man has a peculiar habit of
minding everyone else's business. He appears to see himself
as 'his brother's keeper' and is forever judging his own and
other people's behaviour against the standards that are
tacitly or explicitly agreed by society. In the midst of all
this, illness in seen as something THAT HAPPENS TO people:
it is an unfortunate attack of fate on a fellow human being,
and there is a tendency for people to close ranks around the
sufferer. Emotionally, the first reaction is to support the
poor soul who is under attack. This reaction guarantees
empathy for the sick person immediately but the empathy
slides to sympathy and beyond that to pity, eventually be-
coming irritation and loss of patience if the sickness does
not depart, or if the sick person is not coming up with a
suitably rapid recovery. The pattern for what continues to
justify sickness is well drawn and woe to the invalid who
fails to meet the demands of his role!
If the first place, he is expected to consult an expert
to put matters right. This expert may be his general prac-
titioner, or consultant, or psychiatrist, etc. If he does
not make a start on his part of the contract by agreeing
that he has a problem and looking for help, there is a good
332
chance that the family and friends will reject the illness
and the person who has it. Provided that the person keeps to
the rules, the sick role is allowed to take precedence over
all other normal roles, such as those of parent, spouse,
manager, supervisor, etc. But the individual may not be
prepared to give up all responsibilities in some of these
and frequently sees it necessary to advise his substitute
from his sick bed. Parsons (1951) summarizes the sick role
in terms of two privileges granted to the sick person which
are offset by two obligations on his part. These are out-
lined below.
* Society grants him exemption from those social respon-

sibilities that are incompatible with his illness. The
more serious the disorder, the more responsibili ties are
excused. Society agrees that he cannot be expected to
cure himself and that he must be looked after by other
people.
* In return the sick person must show willing. He must
have motivation to get well: he must agree that illness
is undesirable and must want to get better. The sick
person is obliged to find the right people to help him
and he must co-operate with them (take the advice of
the doctor, etc.).
In other words, he cannot expect the benefits of sickness if

he does not pay the costs.
All these social contracts about illness apply to west-
ern civilization and within that, they are most formalized
amongst the middle-class members of the community. We are
led to the conclusion that illness behaviour is socially
learned; it is a carefully laid down and meticulously fol-
lowed prescription for the privilege of extra care from
other people. It seems that middle-class people have two
advantages when it comes to adopting the right role. They
are fluent in their own descriptive language so they make a
good job of reporting their symptoms when they go to the
doctor, and they usually start off with more information
about their bodily functions than the lower-class person.
The latter is often more reliant on old-fashioned ideas
about health and bodily fllnction~ the liver is cited as the
reason for a wide range of disorders, and the general solu-
tion for all ills lies in evacuating the entire contents of
the gut, preferably all in one drastic effort. If the former
explanation or the latter remedy does not happen to coincide
with spontaneous recovery, he is likely to resort to taking
patent medicines. It is impossible to decide whether the
medicine or the faith of the people that take it is the
cause of many recoveries, and these are then recalled to
justify using it on the next occasion.
Reactioas to illness that cause concern to medical aDd

paramedical personnel
Once a person has asked for medical advice, he becomes a
333
patient. Then there are four ways in which he can respond

to his illness
* he may adopt the illness and give it up completely when

he recovers;
* he may reject the idea of the illness or manage to avoid
the sick role;
* he may adopt the illness readily and be very reluctant
to give it up;
* he may do his best to avoid it, then finally give in and
cling to residual symptoms long after the underlying
condition has passed.
The first of these is seen as an appropriate (or adaptive)

response and the other three represent maladaptive responses
leading to difficulties in managing the case. The last two
set the stage for prolonged invalidism which may be resis-
tant to all attempts to re-motivate the person so that he
will take up normal responsibilities.
Three styles of behaviour are often seen within the
maladaptive responses these are regression, overdependency
and denial. Regression and overdependency often occur to-
gether. Any limitation of activities leads to the person
becoming preoccupied with himself. This usually makes the
person co-operative with the people looking after him at
first, but if it persists it causes progressive isolation of
the person from 'real' events and can complicate recovery.
People who have been deprived of attention, who have a real
or imagined unpopularity, and who have had few satisfying
social relationships react to the extra attention that
illness brings by becoming too reliant on the people who are
looking after them and the security of that care. It may be
the first time that they can recall being important and they
are reluctant to return to their perceived role in which
they are alone, rejected and undervalued.
In the case of denial, the person cannot accept that he
is ill, or he cannot accept the reasons that the doctor has
given him for the signs and symptoms. This may be because
illness destroys his self-image and he cannot reconcile his
shattered self with the need to go on living from day to
day. Or he may be afraid of the inevitable outcome of his
disease and in some way believe that if he ignores it, and
refuses to admit its existence, it will go away. Fear and
denial often delay the crucial visit to the doctor when
people think that they may be told that they have cancer.
Sadly, this leads to less chance of a radical surgical cure
when their suspicions are confirmed and to years of unneces-
sary anxiety and suffering when they have no malignant
condition at all. Denial may cause a patient to refuse
treatment and to show hostility and rejection towards the
doctor who gives the diagnosis. This may be followed by a
fruitless search for another opinion that will reverse the
first verdict.
334
Psychoeomatic medic:me, In a general or orthopaedic hospital, physiotherapists are

psychiatry DId the familiar with patients who are very anxious about them-
physiotherapist selves. This is not because no one can tell them what is the
matter but because they have been told, and they have a
heightened appreciation of the long-term prospects of their
complaint. For example, it has not reduced their anxiety at
all to be told that they have osteoarthrosist they have a
very real fear of the word 'arthritis' and detect an ominous
similarity between this and 'osteoarthrosis'. Folk-lore has
it that arthritis is incurable and severely crippling. Left
with a vague idea about rheumatism, many people with joint
pain and decreasing functional range of movement manage to
maintain a cheerful attitude to life. Once they BELIEVE
that they face progressive deterioration and serious dis-
ability, they may become anxious or depressed. Their pessi-
mistic interpretation may be true in the long term, but
anxiety about this can undermine the efficiency of their
treatment in the short term. It is not possible to reverse
permanent joint damage, but it is possible to improve joint
stability when non-weight bearing exercises promote stronger
muscles and better support for the affected joint. Excessive
anxiety on the part of the patient is likely to mitigate
against the relative success of the exercise routine because
the patient is not putting his best effort into the
exercises.
Most physiotherapists are also aware of the patients
whose signs and symptoms defy diagnosis. There does not seem
to be any organic pathology to explain them and the unsolved
problem may eventually lead to family and friends dismissing
them as 'neurotic'. In terms of our recent discussion, they
are judged as abusers of the sick role because no one can
come up with a reason for their troubles. Under these con-
ditions, patients are seen as answerable for their own
problemst they can no longer be blamed on providential bad
luck. The patients are expected to take up their responsi-
bilities with alacrity or suffer the consequences of the
stigma of malingering. Although we may think that this is
a harsh decision, it may have some positive value, as the
rejection may force a reappraisal of the situation. Coming
from frustrated relatives, a protest may not be effective,
but reported by a member of the professional treatment team
(presumed to be detached from the family and the immediate
environment of the patient), it is likely to lead to action,
possibly in the form of a case conference on the patient.
Reconsideration and adjusted thinking may give greater
awareness of the psychological and emotional aspects of the
patient's condition. The problem may be recla<;sified as
'psychosomatic'. In itself, this reclassification has no
curative properties but it is likely to redirect the aims of
treatment. From narrow emphasis on reducing physical signs
and symptoms, the whole purpose of treatment may be revised
and the team members may concentrate on finding and reducing
the inner conflicts.
335
Psychosomatic medicine
To talk of psychosomatic medicine shows a concern for the
co-variability of mental and physical health. In its widest
sense it is really a way of considering illness and not a
neat categorization for a special set of disorders that are
difficult to explain in purely physical terms, because
their aetiology seems to be linked with stress. A more
limited meaning of 'psychosomatic' is often coupled with a
short list of common conditions such as rheumatoid arthri-
tis, asthma and peptic ulceration. There is a pattern of
physiological changes, associated with over-activity of the
sympathetic division of the autonomic nervous system, which
occurs in the signs of these conditions. They were mentioned
earlier and include:
* increased metabolic rate and raised blood sugar level;

* increased rate and force of the heart beat, plus raised
blood pressure;
* increased potential for blood clotting.
The majority of these states have a detrimental effect on

the cardio-vascular system if they are maintained over long
periods of time. They aggravate the problems of heart and
blood vessels when arteriosclerosis and atheroma are already
present. This leads to myocardial hypertrophy with the final
result of cardiac failure when no further compensation is
possible. All of these changes are characteristic of in-
creased arousal and while they are maintained more catecho-
lamine is produced. This in turn leads to reduced breakdown
of fibrin, increased breakdown of fats, increased levels of
fatty acid in the blood stream and consequent rise in the
clotting tendencies of the blood.
The respiratory system is primarily affected in asthma,
hay fever and rhinitis. In these conditions, either the mu-
cous membrane of the tract shows an excessive inflammatory
response or the muscular walls of the bronchi and bronchi-
oles go into spasm. The mucosa of the digestive tract may
be ulcerated in the stomach, the duodenum or the colon
without any logical organic explanation, since the acid
levels of digestive juices sampled from different cases do
not show an invariable relationship to the regional inci-
dence of ulcers nor to the severity of the condition. In
rheumatoid arthritis, the vulnerable material is the colla-
gen in periarthritic and intra-arthritic structures. It is
suspected that the immune response of the body is stimulated
by the damaged collagen and that this leads to progressive
destruction of the articular surfaces and distortion of the
ligaments.
As biochemical explorations of the body continue, it is
possible that all these tissue changes may be explained in
terms of altered levels of such chemica.ls as histamine and
acetylcholine. So far, high levels of both chemicals have
been observed in most of the disorders we have been dis-
cussing, but there is nothing to justify regarding them as
anything more than co-existent with the conditions. At this
336
stage, it cannot be proved that the chemicals increase in

quantity before the onset of the condition, or vice versa.
And even if future research shows that biochemical imbalance
is causative, this may still be less useful to the world
than the more general awareness of mind{body linkage that
such disorders illustrate. The availabililty of corrective
chemical dosages may only give us the chance to counteract
the signs and symptoms as they arise; it will not neces-
sarily offer any greater accuracy in identifying and
removing the cause of the problems.
Right at the beginning of the book the sad dichotomy of
mind and body was mentioned and the need for understanding
people in their entirety was stressed. It is encouraging
that the caring professions and scientists are moving to-
wards uniting their ideas about people and their needs.
There is an increasing awareness of the psychological needs
of people who have been diagnosed as having physical dis-
orders, and an equivalent recognition of the physical needs
of people who are primarily under treatment for personality
or behaviour disorders which make it difficult or impossible
for them to to live normal lives in the community.
Payc:hiatry and physiotherapy

Physiotherapists are now seen as valuable and necessary in
psychiatric treatment situations. It is recognized that the
general physical condition of people declines when they are
mentally unwell, whether they are treated at home or in
hospital. They have a tendency to be less active and liable
to circulatory stasis if they have depressive reactions, or
overactive and physically exhausted in anxiety states. In
either case, patients can benefit from physiotherapy. Gen-
eral class exercises, sui ted to the age and comprehension
of the patients, have a stimulating effect on circulation
and may offer the necessary group support for trying to
improve the posture of each patient. In the many conditions
that are characterized by learned tension and anxiety, re-
laxation is initially a means of reducing the tension during
the instruction sessions. Given enough training, many of the
acutely involved patients can be taught to control their
level of tension by purposeful relaxation under their own
direction.
Certain treatments, such as continuous narcosis, carry a
risk of respiratory complications unless adequate attention
is given to breathing exercises, postural drainage and
training in coughing during the brief waking periods of the
Z4-hour regime.
The main concern of physiotherapists in a psychiatric
hospital will be the physical state of the patients, but
they must also be aware of the patients' social, emotional
and economic needs. They have an excellent opportunity for
observing the mood and reactions of their patients and of
reporting these to other members of the treatment team. The
changes they see may indicate a primary response to treat-
ment, a complication developing as a sequel to chemotherapy
337
or other treatment, or spontaneous alteration in the psycho-

logical state due to improvement or decline in the under-
lying disorder. Any of these may have a very real bearing on
the immediate and long-term treatment requirements and
information about them is of use to the psychiatrist.
As a footnote, it is worth mentioning that some pre-
cautions must be observed in using electrotherapy when
patients are on particular drug regimes as sensitivity to
heat and light is intensified; for example, ultra-violet
light treatments are contra-indicated if a patient is being
given chlorpromazine; heat and light sensitivity are
increased if a patient is taking anti-depressant drugs.
In the following section, David Shapiro gives a clear
account of psychopathology by focussing attention on the
alternative ways that exist for explaining and treating
psychological disorders. As you work through the section,
the new material will be seen in what must now be the fami-
liar general organization of this book. Information is
marshalled under medical, statistical, cognitive, psycho-
dynamic and socio-cultural headings. You will find that many
of the ideas that were originally put forward in chapter 5
are reiterated in the context of abnormal cognitive and
emotional functions, with the recently discussed effects of
stress on the individual (chapter 12) taking their place in
the total scheme.
Psychopathology 'Psychopathology', literally defined, is the study of dis-

D. A. SHAPIRO ease of the mind. Our society entrusts most of the care
of individuals whose behaviour and experience are prob-
lematic or distressing to medical specialists (psychiat-
rists). Being medically trained, psychiatrists see their
work as requiring diagnosis and treatment of 'patients'.
Psychologists, on the other hand, have sought alternative
means of understanding abnormal behaviour, and the aim of
this chapter is to outline the progress that has been made
in this direction.
The varieties of A good way to appreciate the great variety of problems we

psychopathology are concerned with is to examine the system of classifi-
cation used by psychiatrists, summarized in table 1. Readers
requiring more detailed descriptions of these should consult
a psychiatric textbook. In the NEUROSES, the personality
and perception of reality are fundamentally intact, although
emotional disturbances of one kind or another, usually in-
volving ANXIETY or its presumed effects, can make life
very difficult for the individual. The PSYCHOSES, on the
other hand, are characterized by gross impairments in per-
ception, memory, thinking and language functions, and the
individual is fundamentally disorganized, rather than merely
emotionally disturbed. However, there is no clear-cut brain
disease, and so the disorder cannot be explained in purely
biomedical terms. The layman's conception of 'madness' is
338
based on the symptoms of schizophrenia, including delusions

(unshakeable, false beliefs), hallucinations (such as hear-
ing 'voices') and thought disorder (manifested in 'garbled'
speech). The third category of table 1, PERSONALITY
DISORDERS, comprises deeply ingrained, motivational and
social maladjustments. Table 1 also includes ORGANIC
SYNDROMES, which are behaviour disorders associated with
identified brain disease. Not included in the table are the
important group of PSYCHOSOMATIC illnesses. These are
characterized by physical symptoms whose origins are in part
psychological (emotional). They include asthma, high blood
pressure, gastric and du denal ulcers. More generally,
psychological stress is increasingly implicated in many
physical illnesses.
The medical model of Before describing psychological approaches to behaviour

psychopathology disorder, it is necessary to examine critically the
predominant medical approach. This makes three major
assumptions, which are considered in turn.
The diagnostic system

The first assumption of the medical model is that the
various kinds of abnormal behaviour can be classified, by
DIAGNOSIS, into SYNDROMES, or constellations of
SYMPTOMS regularly occurring together. This diagnostic
system has already been summarized in table 1. It has a
number of disadvantages. First, some disorders appear to cut
across the boundaries of the system. Thus an individual
whose severe anxiety is associated with fears of delusional
intensity may defy classification as 'neurotic' or 'psycho-
tic'. Second, scientific studies of the ability of psychi-
atrists to agree on the diagnosis of individuals have
suggested that the process is rather unreliable, with
agreement ranging from about 50 per cent to 80 per cent
depending upon the circumstances (Beck et aI, 1962). Third,
research also suggests that the diagnosis given to an indi-
vidual may bear little relationship to the symptoms the
individual has (Zigler and Philips, 1961). Fourth, the
diagnosis of psychiatric disorder is much more subjective
and reflective of cultural attitudes than is the diagnosis
of physical illness; one culture's schizophrenic might be
another's shaman; similar acts of violence might be deemed
heroic in battle but psychopathic in peacetime. Careful
comparisons of American and British psychiatrists have shown
that the two groups use different diagnostic criteria and
hence classify patients differently.
Despite these limitations, the psychiatric classifica-
tion persists. This is largely because no better descrip-
tive system has been developed, whilst improvements have
been obtained in the usefulness of the system by refining it
in the light of earlier criticisms. For example, agreement
between psychiatrists has been improved by standardization
of the questions asked in diagnostic interviews and the use
339
Crisis, st.-ess and the sick role
Table 1
Major Neuroses (milder disturbances)

category
Illustrative Anxiety Obsessive- Phobias Conversion Neurotic

syndromes state compulsive reactions depression
- -- - -- - - - -- - - - - - - - - -- - - - - -
disorders
Charac- Palpita tion, Intrusive Irrational Physical Hopelessness

teristic tires thoughts, fears of symptoms, dejection
symptoms easily, urges to specific lacking
breathless- acts or objects or organic
ness, ner- rituals situations cause
vousness
anxiety
Major Psychoses (severe Personali ty disorders Organic syndromes

category Non-organic (antisocial
disturbances disturbances)
Illus- Affective Schizo- Psycho- Alcoholism Epilepsy Severe

trative disorders phrenia pathic and drug mental
syndromes persona- dependence handicap
lity
- - -- - - - - -- - - -- - -- - -
Charac- Distur- Reality Lack of Physical Increased Extremely
teristic bances of distor- conscience or psycho- suscepti- low intelli-
symptoms mood, tion, logical bility to gence, social
energy social dependence convulsions impairments
and withdrawal,
activity disorga-
patterns nization
of thought,
perception
and emotion
of standard decision-rules for assigning diagnoses to

constellations of symptoms. But it is still necessary to
bear in mind that the diagnostic system is not infallible
and the 'labels' it gives individuals should not be
uncritically accepted.
Phyaiological buia of ~thology

The second assumption of the medical model is that the
symptoms reflect an underlying disease process, physio-
logical in nature like those involved in all illnesses,
causing the symptoms. Three kinds of evidence are offered
in support of this. First, the influence of hereditary
340
factors has been assessed by examining the rates of disorder

among the relatives of sufferers. To the extent that a
disorder is heritable, its origins are considered biological
in nature. For example, comparison between the dizygotic
(non-identical) and monozygotic (identical) twins of suf-
ferers suggests that there is some hereditary involvement
in schizophrenia, anxiety-related disorders, depression and
antisocial disorders, with the evidence strongest in the
case of schizophrenia (Gottesman and Shields, 1973). Studies
of children adopted at birth also suggest that the offspring
of schizophrenic parents are more liable to suffer from
schizophrenia than other adopted children, despite having no
contact with the biological parent. On the other hand, the
evidence also shows that hereditary factors alone cannot
fully account for schizophrenia or any other psychological
disorder. Even amongst the identical twins of schizo-
phrenics, many do not develop the disorder. Both hereditary
and environmental influences are important.
The second line of evidence for a 'disease' basis of
psychopathology concerns the biochemistry of the brain. This
is a vastly complex subject, and one whose present methods
of investigation are almost certainly too crude to give
other than an approximate picture of what is going on. Over
the years, a succession of biochemical factors have been
suggested as causes for different forms of psychopathology.
Unfortunately, the evidence is not conclusive, as bio-
chemical factors found in sufferers may be consequences
rather than causes. Hospital diets, activity patterns or
characteristic emotional responses may influence the brain
biochemistry of disordered individuals.
Despite these problems, there are some promising lines
of biochemical research. For example, it has been suggested
that schizophrenia may be caused by excess activity of dopa-
mine, one of the neurotransmitters (substances with which
neurons stimulate one another: see Snyder et aI, 1974).
This suggestion is supported by the similarity in molecular
structure between dopamine and the phenothiazine drugs which
are used to alleviate schizophrenia, suggesting that these
drugs block the reception of dopamine by taking its place at
receptors which normally receive it. These drugs also cause
side effects resembling the symptoms of Parkinson's disease,
which is associated with dopamine deficiency. Although this
and other evidence support the dopamine theory of schizo-
phrenia, some research has failed to support it, and so the
theory has yet to be universally accepted. In sum, bio-
chemical evidence is suggestive, and consistent with pre-
sumed physiological origins of psychopathology, but it is
not conclusive, nor can such evidence make a psychological
explanation redundant. It is best seen as an important part
of our understanding of psychopathology, whose causal
significance varies from disorder to disorder.
The third line of evidence for the physiological basis
of psychopathology concerns disorders with clear organic
causes. Disease or damage to the brain can result in severe
341
disturbance of behaviour. A classic example of this is

'general paresis 0 f the insane', whose widespread physical
and mental impairments were discovered in the last century
to be due to the syphilis spirochete. This discovery en-
couraged medical scientists to seek clear-cut organic causes
for other psychological abnormalities. A large number of
ORGANIC BRAIN SYNDROMES have been established, in
which widespread cognitive and emotional deficits are
associated with damage to the brain by disease, infection,
or injury. EPILEPSY, in which the individual is unusually
susceptible to seizures or convulsions, is associated with
abnormal patterns of brain activity measured by the electro-
encephalogram (EEG) even between seizures. Many indivi-
duals with severe MENTAL HANDICAP (Clarke and Clarke,
1974), who attain very low scores on tests of general in-
telligence and show minimal adaptation to social require-
ments and expectations, suffer from clear-cut organic
pathology, often accompanied by severe physical
abnormali ties.
On the other hand, all of these disorders are affected
by the person's individuality, experience and environment.
For example, similar brain injuries result in very different
symptoms in different individuals. Those suffering from
epileptic seizures can make use of their past experience to
avoid circumstances (including diet and environmental sti-
muli) which tend to trigger their convulsions. Most mentally
handicapped people do not have clearly identifiable organic
illnesses. Even amongst those who do, the environment can
make a big difference to the person's ability to learn the
skills of everyday living. Psychologists have found that
special training can help mentally handicapped people who
might otherwise appear incapable of learning.
Medical treatment of psychopathology

The third assumption of the medical model concerns how
psychopatholog"y should be managed. Physical treatments are
offered in hospitals and clinics to persons designated
'patients'. It is beyond our l present scope to describe the
extensive evidence supporting the effectiveness of drugs and
electro-convulsive therapy (ECT), the major physical treat-
ments currently employed. However, there are several reasons
why psychologists are often inclined to question the support
this evidence gives to the medical model. First, individuals
differ in their responsiveness to physical treatments, and
nobody really understands why some individuals are not
helped. Second, the fact that abnormal behaviour can be
controlled by physical means does not prove that its origins
are physical. Third, the physical treatments often lack a
convincing scientific rationale to explain their effects.
The medical model: conclusioas

In sum, the medical model gains some support from the
evidence, but is sufficiently defective and incomplete to
warrant the development of alternative and complementary
342
approaches. Although the diagnostic system is of some value,

it must be used with caution. Although hereditary influ-
ences, biochemical abnormalities and organic pathology have
a part to play in our understanding of psychopathology, they
cannot explain its origins without reference to environ-
mental and psychological factors. The apparent efficacy of
physical treatment does not establish the physical origins
of what they treat. The remainder of this chapter is
concerned with five alternative approaches developed by
psychologists and social scientists, and assesses their
contribution with respect to some of the most important
kinds of psychopathology. The evidence presented is, of
necessity, very selective, and a full appreciation of these
approaches can only follow more extensive study. It should
also be borne in mind that the present emphasis on origins
of disorder entails a relative neglect of research on
treatment.
The statistical model The statistical model identifies individuals whose behaviour
or reported experience is sufficiently unusual to warrant
attention on that basis alone. Abnormal individuals are
those who greatly differ from the average with respect to
some attribute (such as intelligence or amount of subjective
anxiety experienced). For example, according to Eysenck
(1970), people who score highly on dimensions known as
'neuroticism' (very readily roused to emotion) and 'intro-
version' (quick in learning conditioned responses and asso-
ciations) are likely to show what the psychiatrist calls
'anxiety neurosis'. Although this approach is commendably
objective, it is not very helpful alone. Not all unusual
behaviour is regarded as pathological. Exceptionally gifted
people are an obvious case in point. Some statistically
abnormal behaviours are obviously more relevant to psycho-
pathology than are others, and we need more than a statis-
tical theory to tell us which to consider, and why. But the
model is of value for its suggestion that 'normal' and
'abnormal' behaviour may differ only in degree, in contrast
to the medical model's implication of a sharp division
between them.
The psychodynamic The psychodynamic model is very difficult to summarize,

model based as it is on theories developed early in the century by
Freud, and revised and elaborated by him and subsequent
workers within a broad tradition (Ellenberger, 1970). Like
the medical model, it seeks an underlying cause for psycho-
pathology, but this is a psychological cause, namely,
unconscious conflicts arising from childhood experiences.
Freudians have developed a general theory of personality
from their study of psychopathology. Freud viewed the per-
sonality as comprising the conscious EGO, the unconscious
ID (source of primitive impulses) and partly conscious,
partly unconscious SUPER-EGO (conscience). The ego is
held to protect itself from threat by several defence
343
mechanisms. These are a commonplace feature of everyone's

adjustment, but are used in an exaggerated or excessively
rigid manner by neurotic individuals, and are overstretched
to the point of collapse in the case of psychotic
indi viduals.
For example, neurotic anxiety is learned by a child
punished for being impulsive, whereupon the conflict between
wanting something and fearing the consequences of that
desire is driven from consciousness (this is an example of
the defence mechanism known as REPRESSION). According
to this theory, pervasive anxiety is due to fear of the
person's ever-present id impulses, and phobic objects, such
as insects or animals, are seen as symbolic representations
of objects of the repressed id impulses. Dynamic theory
views depression as a reaction to loss in individuals who
are excessively dependent upon other people for the main-
tenance of self-esteem. The loss may be actual (as in
bereavement) or symbolic (as in the misinterpretation of a
rejection as a total loss of love). The depressed person
expresses a child-like need for approval and affection to
restore self-esteem. In psychotic disorders such as schizo-
phrenia, the collapse of the defence mechanisms leads to the
predominance of primitive 'primary process' thinking.
Despite its considerable impact upon the ways in which
we understand human motivation and psychopathology, psycho-
dynamic theory has remained controversial. Most of the
evidence in its favour comes from clinical case material, as
recounted by practising psychoanalysts, whose work is based
on the belief that unconscious conflicts must be brought to
the surface for the patient to recover from the symptoms
they have engendered. Whilst this method often yields com-
pelling material which is difficult to explain in other
terms (Malan, 1979), it is open to criticism as insuf-
ficiently objective to yield scientific evidence. It is all
too easy for the psychoanalyst unwittingly to influence
the material produced by his patient, and the essential
distinction between observations and the investigator's
interpretations of them is difficult to sustain in the
psychoanalytic consulting-room. The abstract and complex
formulations of psychodynamic theory are difficult to prove
or disprove by the clear-cut scientific methods favoured by
psychologists, and the patients studied, whether in Freud's
Vienna or present-day London or New York, are somewhat
unrepresentative.
There is some scientific evidence which is broadly
consistent with psychodynamic theory; for example, the
defects in thinking found in schizophrenia are compatible
with the dynamic concept of ego impairment, and loss events
of the kind implicated by dynamic theory are associated with
the onset of depression. Although psychologists hostile to
dynamic theory can explain these findings in other terms,
there is little doubt that the theory has been fruitful,
contributing to psychology such essential concepts as
unconscious conflict and defence mechanism.
344
The learning model The learning model views psychopathology as arising from
faulty learning in early life, and conceptualizes this
process in terms of principles of learning drawn from
laboratory studies of animals and humans. The most basic
principles are those of Pavlovian or 'classical' condi-
tioning (in which two stimuli are presented together until
the response to one stimulus is also evoked by the other) ,
and 'operant' conditioning (whereby behaviour with favour-
able consequences becomes more frequent). According to
proponents of the learning model, the symptoms of psycho-
pathology are nothing more than faulty habits acquired
through these two types of learning. The 'underlying patho-
logy' posited by the medical and psychodynamic models is
dismissed as unfounded myth.
For example, it is suggested that phobias are acquired
by a two-stage learning process; first, fear is aroused in
response to a previously neutral stimulus when this stimulus
occurs in conjunction with an unpleasant stimulus; then the
person learns to avoid the situation evoking the fear,
because behaviour taking the person away from the situation
is rewarded by a reduction in fear. Another learning theory
is that schizophrenic patients receive more attention and
other rewards from other people, such as hospital staff,
when they behave in 'crazy' ways, thereby increasing the
frequency of this behaviour. Again, depressed people are
seen as failing to exercise sufficient skill and effort to
'earn' rewards from situations and from other people; a
vicious circle develops and activity reduces still further
in the absence of such rewards.
In general, the learning model provides a powerful set
of principles governing the acquisition of problem beha-
viour. But it has severe limitations. For example, the fact
that fears and phobias can be established by processes of
conditioning in the laboratory does not prove that this is
how they come about naturally. The theory cannot readily
explain how people acquire behaviours which lead to such
distress (it is hardly 'rewarding' to suffer the agonies of
depression or anxiety, and learning theorists acknowledge
their difficulty over this fact by referring to it as the
'neurotic paradox'). Recently, learning theorists have
examined the important process of imitative learning or
modelling, whereby the behaviour of observers is influenced
by another's actions and their consequences. Fear and
aggression can be aroused in this way, with obvious impli-
cations for the transmission of psychopathology from one
person (such as a parent) to another. But human thinking
is considered by many psychologists too complex to be
understood in terms of these relatively simple learning
theories. Hence the development of the cognitive approach,
to which we now turn.
The cognitive model The cognitive model focusses upon thinking processes and
their possible dysfunctions. 'Neurotic' problems are seen as
345
due to relatively minor errors in reasoning processes,

whilst 'psychotic' disorders are held to reflect profound
disturbances in cognitive function and organization.
For example, it is well known that depressed people
hold negative attitudes towards themselves, their experien-
ces and their future. According to cognitive theory, these
attitudes give rise to the feelings of depression (Beck,
1967). Although an episode of depression may be triggered
by external events, it is the person's perception of the
event which makes it set off depressed feelings. Experiments
in which negative beliefs about the self are induced in non-
depressed subjects have shown that a depressed mood does
indeed follow. But whether similar processes account for
the more severe and lasting depressive feelings of clinical
patients is another matter, although the promising results
of 'cognitive therapy', in which the attitudes of depressed
patients are modified directly, may be taken as indirect
evidence for the theory.
Cognitive theory also embraces people's beliefs about
the causation of events (known as ATTRIBUTIONS). For
example, it has been suggested that the attributions one
makes concerning unpleasant experiences will determine the
impact of those experiences upon one's subsequent beliefs
about oneself; thus, if a woman is rejected by a man, this
is much more damaging to her self -esteem if she believes
that the main cause of the event is her own inadequacy, than
if she attributes the event to the man's own passing mood.
An attributional approach suggests that failure experiences
are most damaging if the individual attributes them to wide-
ranging and enduring factors within himself. Consistent with
this, depressed people have been found to attribute bad
outcomes to wide-ranging and enduring factors within them-
selves, whilst they attribute good outcomes to changeable
factors outside their control.
Psychologists have devoted considerable efforts to
precise descriptions of the cognitive deficits of schizo-
phrenic patients through controlled laboratory experiments.
For example, schizophrenics have difficulty performing tasks
requiring selective attention to relevant information and
the exclusion from attention of irrelevant information.
Schizophrenics are highly distractable. This may help to
explain how irrelevant features of a situation acquire
disproportionate importance and become interpreted as part
of their delusional systems of false beliefs, or how speech
is disorganized by the shifting of attention to irrelevant
thoughts and mental images which other people manage to
ignore.
The cognitive approach is of great interest because it
combines the systematic and objective methods of experi-
mental psychology with a thoroughgoing interest in an
important aspect of human mentality. It is a very active
'growth area' of current research, and shows considerable
promise. It is perhaps too soon to evaluate many of its
specific theories, however, and it does carry the risk of
neglecting other aspects of human behaviour.
346
The socio-cultural The final model to be considered attributes psychopathology

JDOdel to social and cultural factors. It focusses upon malfunc-
tioning of the social or cultural group rather than of an
individual within that group.
In terms of the socio-cultural model schizophrenia, for
example, has been considered both in relation to the quality
of family life and to larger socio-economic forces. Within
the family, behaviour labelled schizophrenic is seen as a
response to self-contradictory emotional demands ('double
binds') from other family members, notably parents, to which
no sane response is possible. Although graphic accounts have
been offered of such patterns in the family life of schizo-
phrenic patients, there is no evidence that these are
peculiar to such families. If anything, the research evi-
dence suggests that abnormalities of communication within
the families of schizophrenics arise in response to the
behaviour of the patient, rather than causing the disorder.
Looking beyond the family, the higher incidence of schizo-
phrenia amongst the lowest socio-economic class, especially
in inner city areas, is attributed to the multiple depriva-
tions suffered by this group. Episodes of schizophrenia are
triggered by stressful life events, some of which are more
common, or less offset by social and material supports,
amongst lower-class people. On the other hand, cause and
effect could be the other way round, with persons developing
schizophrenia 'drifting' into poverty-ridden areas of the
city. Indeed, schizophrenic patients tend to achieve a lower
socio-economic status than did their parents.
The socio-cultural approach is of undoubted value as a
critical challenge to orthodox views, and has generated
useful research into social and cultural factors in psycho-
pathology. Its proponents have also made valuable contri-
butions by bringing a greater humanistic respect for the
personal predicament of troubled individuals, and to the
development of 'therapeutic communities' and family therapy
as alternatives to individually-centred treatments. However,
many of its propositions concerning cause-effect relation-
ships have not stood the test of empirical research.
It is well known that certain physical illnesses are related

to psychological factors. These 'psychosomatic disorders'
include ulcerative coli tis, bronchial asthma and hyper-
tension. It is not so widely appreciated, however, that
psychological factors may be involved in ANY physical
illness. This is because the physiological changes
associated with stress (for instance, the release of the
'stress hormones' such as adrenalin) can suppress immune
responses and so increase the individual's susceptibility to
many diseases, ranging from the common cold to cancer
(Rogers et aI, 1979). Many aspects of a person's life have
been implicated in ill-health, presumably because of their
effects on such physiological mechanisms. These include
physical stresses such as noise, highly demanding and/or
repetitive jobs (whether physical or mental), catastrophic
347
life events (such as accidents, illness or bereavement) and

major emotional difficulties (such as marital discord) •
However, for physical illness as for psychopathology,
the cause-effect relationship is not simple. Some indivi-
duals are more constitutionally stress-prone than others, it
appears. Some people live in congenial and supportive
surroundings, enabling them to withstand pressures which
might otherwise lead to illness. Most of the events impli-
cated in psychological distress and ill-health are in part
the results of the individual's own state and behaviour. For
example, marital conflict may reflect prior strains felt by
the individuals involved. Furthermore, the impact of a
stressful event or circumstance depends on the individual's
appraisal of it. For example, noise is less distressing if
we know we can silence it should it become unbearable. Thus
consideration of psychological factors in ill-health demon-
strates clearly the interaction between features of indivi-
duals and of their surroundings. For physical illness as for
psychopathology, we must realize that there are many inter-
acting causes rather than imagine that anyone factor is
alone responsible for the problem at issue.
Ccmc:lusiaas Each of the approaches surveyed has contributed to our

understanding of psychopathology. The evidence presented for
each can only illustrate the massive amounts of research
which have been carried out. Nonetheless, several clear
themes emerge which have profound implications for our
present and future knowledge of psychopathology.
First, the system of classification is inadequate, and
research shows that different people within the same broad
diagnostic group (such as schizophrenia) behave very dif-
ferently; it therefore follows that different causes may be
found for the difficulties experienced by these sub-groups
of people.
Second, the different approaches could profitably be
integrated rather more than they have been in the past.
For example, elements of the medical, statistical, socio-
cultural and cognitive approaches have been combined in
recent work on schizophrenia, in wnich the vulnerability
of an individual to the disorder is seen as reflecting both
heredity and environment; this vulnerability determines
whether or not a person experiences schizophrenia when he
faces stresses which are too much for him to cope with
(Zubin and Spring, 1977). The fact that psychopathology
generally has multiple causes lends particular urgency to
the need to construct broad theories incorporating the facts
which were hitherto regarded as supporting one or another
of the competing approaches.
Third, the different approaches have more in common
than is often acknowledged. In relation to schizophrenia,
for example, the breakdown of ego functioning described by
psychodynamic theory resembles the inability to process
information identified by cognitive theory.
348
Fourth, the limitations of existing models have encour-

aged the growth of alternative approaches. For example,
the 'transactional' approach emphasizes the importance of
the individual's active part in bringing about apparently
external stressful events and pressures (Cox, 1978). This
approach views the individual as neither a passive victim of
circumstances, nor as irrevocably programmed from birth to
respond in a particular way. Person and environment are seen
as in continuous interaction, so that one-way cause-effect
analysis is inappropriate. For example, harassed executives
and mothers of small children bring some of the stress they
suffer upon themselves as they respond sharply to colleagues
or children and thus contribute to a climate of irritation
or conflict. Research using this approach has only recently
begun, but it holds considerable hope for the future.
Finally, what can this psychological study of psycho-
pathology offer the professional? There are as yet no
certain answers to such simple questions as 'What causes
schizophrenia?' or 'Why does Mrs Jones stay indoors all the
time?' If and when such answers become available, they will
not be simple. They will involve many interacting factors.
Meanwhile, the psychological approach teaches us a healthy
respect for the complexity of the human predicament, and is
a valuable corrective to any tendency to offer simplistic or
unsympathetic explanations of human distress. Furthermore,
professionals will often find it illuminating to apply some
of the approaches outlined here to help understand dis-
tressed individuals they encounter in their daily work.
References Beck, A.T. (1967)

Depression: Clinical, experimental and theoretical
aspects. New York: Harper & Row.
Beck, A.T., Ward, C.B., Mendleson, M., Mock, J.E. and
ErIbaugh, J. (1962)
Reliabili ty of psychiatric diagnosis IT: a study of
consistency of clinical judgements and ratings. American
Journal of Psychiatry, 119, 351-357.
Clarke, A.M. and Clarke, A.D.B. (1974)
Mental Deficiency: The changing outlook (3rd edn).
London: Methuen.
Cox, T. (1978)
Stress. London: Macmillan.
Ellenberger, B.F. (1970)
The Discovery of the Unconscious. London: Allen Lane/
Penguin.
Eysenck, B.J. (1970)
The Structure of Human Personality (3rd edn). London:
Methuen.
Gottesman, 1.1. and Shields, J. (1973)
Genetic theorising and schizophrenia. British Journal of
Psychiatry, 122, 15-30.
Malan, D.B. (1979)
Individual Psychotherapy and the Science of
Psychodynamics. London: Tavistock.
349
Rogers, M.P., Dubey, D. and Reich, P. (1979)

The influence of the psyche and the brain on immunity
and disease susceptibility: a critical review.
Psychosomatic Medicine, 41, 147-164.
Snyder, S.H., Banerjee, S.P., Yamamura, H.I. and
Greenberg, D. (1974)
Drugs, neurotransmitters and schizophrenia. Science,
184, 12.43-1253.
Zigler, E. and Philips, L. (1961)
Psychia tric diagnosis and symptomalogy. Journal of
Abnormal and Social Psychology, 63, 69-75.
Zubin, J. andSpriDg, B. (1977)
Vulnerability - a new view of schizophrenia. Journal of
Abnormal Psychology, 86, 103-126.
Questions 1. Outline the psychiatric system of classification.

2. What problems are raised by the diagnostic system used
by psychiatrists? Can it be improved?
3. What can the study of twins tell us about
psychopathology?
4. Outline the evidence for a biochemical basis for
schizophrenia.
5. Give an example of psychopathology with a known organic
cause, and explain what this cause is. Do environmental
factors play any part in the disorder you have
described?
6. How useful is the medical model of psychopathology? Does
it have any disadvantages?
7. Outline the statistical approach to psychopathology,
indicating its value and limitations.
8. What are defence mechanisms, and how are they involved
in psychopathology?
9. Compare and contrast the explanations of phobias offered
by psychodynamic and learning theories.
10. What is wrong with psychoanalysis as a scientific method
of investigating psychopathology?
11. Outline some differences between neurotic and psychotic
disorders.
12. How might you recognize depression in a client or
patient you encountered in the course of your
professional work?
13. Is psychopathology simply behaviour which has been
learned because it produces rewards?
14. What is the importance of self-esteem in
psychopa thology?
15. How can family life affect well-being and
psychopathology?
16. Which of the models of psychopathology do you prefer?
Give your reasons.
17. How can psychological factors affect susceptibility to
physical illness?
18. 'The child is father to the man.' Does this statement
gain support from psychological research into
psychopathology?
350
19. Sometimes people confuse 'mental illness' and 'mental

handicap'. How would you explain the difference to a
colleague or student?
ZOo Which forms of psychopathology would be particularly
disabling to a person employed in your profession, and
why?
AImotated readiDg Bannister, D. and Fransella, F. (1971) Inquiring Man.

A persuasive account of George Kelly's personal
construct approach to psychology and psychopathology,
written by two of its leading exponents.
Davison, G.C. and Neale, J.M. (1977) Abnormal

Psychology: An experimental clinical approach (Znd edn).
Chichester: Wiley.
The chapter can provide no more than an introduction to
psychopathology. This is the best of the textbooks
available: it is readable, comprehensive and, in
general, accurate. It is useful in teaching, and has
been drawn upon extensively for drafting the chapter. If
you want to follow up any aspect of the chapter in more
detail, look up the topic in the Index of this book.
Hilgard, E.R., Atkinson, R.L. and Atkinson, R.C.

(1979) Introduction to Psychology (7th edn). New York:
Harcourt Brace Jovanovich (chapters 14, 15 and 16).
Intermediate in length between the present chapter and
the Davison and Neale book, this group of chapters gives
a good general account. Chapter 14 reviews conflict and
stress in terms of both experimental and psychoanalytic
work; chapter 15 gives a good outline of much of the
ground covered in this chapter; and chapter 16 discusses
methods of treatment.
Inechen, B. (1979) Mental Illness. London: Longman.

This reviews the field from a sociological viewpoint,
and covers a good deal of research on social factors in
psychopathology •
Seligman, M.E.P. (1975) Helplessness: On depression,

development and death. New York: Freeman.
Seligman presents his theory of learned helplessness in
a very stimulating and engaging book. Although the
theory was based on laboratory studies with animals,
Seligman has injected a great deal of 'human interest'
into this account. Students who are especially
interested in the theory of depression should note,
however, that Seligman's ideas have moved on since the
book was written to incorporate attributional concepts.
Spielberger, C. (1979) Understanding Stress and Anxiety.

New York: Harper & Row.
A very readable and well-illustrated introduction to
351
experimental and clinical work on stress and anxiety,

recommended for the student wishing to look further into
these aspects.
Stafford-Clark, D. and Smith, A.C. (1979) Psychiatry for

Students (5th edn). London: Allen & Unwin.
The present chapter does not attempt to do full justice
to psychiatry. This is the most readable of the general
textbooks on psychiatry, written for students rather
than for practitioners. It is a good source for more
details of psychiatric symptoms, disorders and
treatments.
352
14
The Management of Pain
Colette Ray
0peuiDg remarks Colette Ray's chapter on the management of pain continues

E.N.DUNKIN the theme of the importance of PERSONAL perception of all
stimulation including any that is judged harmful, painful or
unpleasant. She draws attention to the possibility of sum-
marizing individual diffp.rences in pain responses by linking
them to the personality measures of neuroticism and extra-
version (see chapters 6 and 7) and to racial attitudes
towards pain. The Skinnerian principles of reinforcement are
used to show how pain behaviours start, and how they become
modified in a social setting.
You may find it necessary to revise details of the ana-
tomy and physiology of the brain, spinal cord and peripheral
nervous system in order to make the best use of this section
and we heartily endorse the recommendation to read Melzack
(1973). For those who are not used to the terminology of
zoology and comparative psychology, the term 'neocortex'
refers to the cortical area of the cerebrum (or forebrain).
And for those who have not met it before, here is a brief
summary of the submaximal tourniquet technique that features
in the following section as one of the experimental ways to
elicit pain.
Sub"ullrim.) tourDiquet teclmique

The experimental subject lies on his back, with one upper
limb raised towards the ceiling. Venous blood is drained out
of the limb using an Esmarch bandage from finger tips to
axilla. A blood pressure cuff is placed round the top of the
arm and pumped up to Z50mm Hg. pressure before the Esmarch
bandage is removed. The arm is lowered to the person's side
while a one-minute pause is taken before a period of exer-
cise is given to the muscles of the forearm. The subject
squeezes a hand spring exerciser ZO times, taking two
seconds for each squeeze followed by two seconds rest. A
complete rest period follows, with the tourniquet still
inflated, until the subject says that the increasing pain in
his arm is 'unbearable' and the experimenter deflates the
tourniquet.
What is pain? Pain may be defined as an unpleasant sensation which is

COLETTE RAY focussed upon the body, and is often but not always
353
The management of pain
associated with tissue damage. While it may be generally

true that physical injury produces pain and that pain occurs
as a result of injury, this is by no means always the case.
There are many syndromes for which a somatic explanation
is not easily available, and the source of the disorder can
be attributed either to an abnormality in the way in which
normal sensory inputs are processed or to psychological
factors. Similarly, people may meet with injury but fail to
experience pain as a consequence. This will sometimes happen
if the damage occurs suddenly in a compelling situation,
such as in battle or on the sportsfield, where attention and
emotions are directed elsewhere. It is difficult, therefore,
to determine in a priori terms when pain should and should
not be experienced, and we must rely primarily upon the
individual's own self-report to indicate whether it is pre-
sent or absent and the intensity of his feelings. Given a
similar degree of pain, however, any two people will react
to this in different ways. They may vary in their evaluation
of the symptom's significance; in their emotional reactions
and expression of these; in the extent to which they com-
plain verbally about the pain and the kinds of remedies they
seek; and in the effect that the pain has upon their family,
occupational and social activities. Such reactions to symp-
toms are distinct from the symptoms themselves and are
generally ::eferred to as 'illness behaviour' (Mechanic and
Volkart, 1960). A number of factors will influence these
behaviours, including the individual's personality and
cultural background and the rewards and expectations
associated with pain.
Penouality and culture It has been widely argued that pain will in some cases have
a psychodynamic significance: that is, a psychological
meaning and function. Freud regarded it as a common con-
version syndrome, representing the transformation of a re-
pressed drive into physical symptoms; the pain need not be
created to achieve this end, but may be selected from a
background of 'possible' pain as that which best fulfils a
specific symbolic function. A state of emotional disturbance
can also influence pain in a less specific way, if the per-
son fails to recognize the true nature of the disturbance
and seeks instead an explanation in terms of everyday physi-
cal symptoms which might otherwise be ignored. An individual
who is generally over-preoccupied with physical concerns
would be most likely to misattribute psychological distress
to somatic symptoms in this manner. Engel (1959) has sug-
gested that there is a 'pain prone personality', character-
ized by feelings of guilt which can be in part relieved by
pain; other relevant characteristics he lists are a family
history of violence and punishment, a personal history of
suffering and defeat, a state of anger and hostility which
is turned inwards rather than outwards and conflict over
sexual impulses. The immediate 'trigger' for pain in the
case of such a personality may be the loss of someone
354
valued, and several writers have seen physical pain as a

symbol of real or imagined loss.
People show consistency in their response to pain over
time, while there are distinct differences between people.
Generally speaking, women are more responsive than men,
and the young more than the old. The relationship between
pain responses and personality traits has been extensively
studied, particularly with respect to neuroticism and
extraversion. There is some tendency for the former to be
related to pain proneness, but many inconsistent findings
have been obtained both in the laboratory and in natural
settings. Extraverts under some conditions tolerate pain
better than introverts, but may in some situations report
more pain because of a greater readiness to brave the pos-
sibility of social disapproval. Many studies have looked
at pain in psychiatric patients, and at the personality
profiles of pain patients compared with those of control
samples. A relatively high incidence of pain is found in
psychiatric groups and pain patients have a more 'neurotic'
profile than control groups (see Sternbach, 1974). It is,
however, unclear to what extent personality disturbance
predisposes to pain and to what extent the experience of
pain causes emotional difficulties. The relative importance
of these two different effects will· depend upon whether the
context is that of psychiatric patients who experience pain,
or pain patients without a psychiatric history; in the for-
mer case maladjustment is likely to give rise to physical
pain rather than the reverse, while in the latter emotional
difficulties will generally be a consequence, rather than a
cause, of pain.
Responses to pain differ not only between individuals
and groups within a society, but also between cultures. All
groups develop norms or expectations of how one should per-
ceive and react to any particular situation, and individuals
will adopt these to the extent that they are part of or
identify with the group. Some norms are prescriptive: that
is, there is a certain pressure upon the individual to
conform with expectations in this respect, and deviation
will meet with disapproval. An example of such a norm
relevant to pain behaviour would be the expectation that
one should not evade one's obligations by faking or 'maling-
ering'. Descriptive norms, in contrast, do not imply an
obligation to conform, but merely describe the behaviour
which is characteristic or typical of the group. Cultural
stereotypes suggest the existence of differences between
nationalities in their expression of pain, and there is
empirical evidence for such differences. Zborowski (1969)
studied a group of American male patients and compared
reactions for those of Jewish, Irish, Italian and Old
American descent. Both Old Americans and Irish Americans
were inhibited in the expression of pain, while the Italians
and Jewish patients were more reactive. These latter groups
both sought to draw attention to their pain by this expres-
sive behaviour, but their underlying aims were different.
355
The Italians were primarily concerned with obtaining relief

from pain, while for the Jewish patients the primary concern
was to discover the cause of the symptom. These cultural
differences appear quite reliable, since Zborowski's find-
ings were supported by those of a study in which the res-
ponses of similar groups were compared, but in a very
different laboratory setting (Sternbach and Tursky, 1965).
Rewards and expectations Learning theorists make a distinction between a respondent

behaviour which is closely linked with the occurrence of a
particular stimulus or si tuation and does not require any
other support for its establishment or maintenance, and an
operant behaviour which is not directly elicited by the
stimulus but can become associated with it given appropriate
conditions of reinforcement. Reinforcement is defined as any
event which strengthens a behaviour; rewards will generally
operate as reinforcers, as will the termination of an aver-
sive stimulus, while punishment generally weakens behaviour.
This kind of analysis may be applied to pain behaviour
(Fordyce et aI, 1968). We can assume that certain responses
to pain will be directly elicited by the experience, with-
drawal or crying for example, while others may be prompted
by the experience but depend effectively upon the outcomes
which they produce. An individual may thus adopt and main-
tain a number of pain behaviours because they bring rewards
such as sympathy and nurturance, and enable him to avoid
activities or obligations which he finds unpleasant.
Behaviour will not only be influenced by the rewards
associated with different kinds of response, but also by an
awareness of how other people react in a similar situation.
The experience of pain may involve considerable uncertainty,
and when faced with uncertainty people often look to others
as guides to determine both how the experience should be
interpreted and the norms governing behaviour in that situ-
ation. This process has been described as one of 'social
comparison' (Festinger, 1954). We compare our own inter-
pretations and reactions with those of others to decide
whether or not they are valid or appropriate in the cir-
cumstances, and may seek a lead from another before making
our own interpretation and response. Thus the presence of a
calm individual to act as a model may reduce the response
to a painful stimulus, and the presence of one who appears
distressed may intensify the response. Such effects have
been demonstrated in the laboratory, in studies where the
experimenter recruits a confederate who supposedly under-
goes electric shocks similar to those to which the subject
is indeed exposed, and instructs him to react to these with
or without expression of pain and distress. Both 'tolerant'
and 'intolerant' models in such studies can change subjects'
reports of the intensity of the pain they experience and
their willingness to tolerate shocks of various intensities.
Similar effects can be observed in clinical settings; pa-
tients with problems or treatments in common will observe
356
each other, develop expectations about pain intensity and

the course of recovery, and learn the norms of pain ex-
pression within that group. Modelling processes will occur
within the family but over a longer period of time. Child-
ren's reactions to pain will be influenced by their obser-
vations of their parents' behaviour, and the child whose
parents focus upon his or their own pain symptoms and react
strongly to these may come to react in the same way. This
effect would initially operate with respect to specific
situations but could then generalize to pain behaviour in
general.
Theory and research Early theories regarded pain as arising from the relatively
direct transmission of signals from 'nociceptors' to pain
centres in the brain, and the receptors, pathways and
centres involved were thought to be specific to pain. The
assumption of specificity does not, however, seem justified,
and this simple model cannot account for many common pain
phenomena, including the known effects of psychological
factors such as experience, motivation, attention and emo-
tionality. A recent theory which has attracted much interest
is the gate-control theory (see Melzack, 1973). The gate
referred to is a hypothetical mechanism at the level of the
spinal cord, which is assumed to modulate signals from the
periphery before they are centrally processed. It is sug-
gested that this mechanism is situated in the substantia
gelatinosa and has its effect by inhibiting or facilitating
the transmission of signals from the dorsal horns to the
adrenolateral pathways of the spinal cord. Activity in
peripheral fibres will not only influence the transmission
of pain signals directly but also affects the operation of
the gate, as can central brain processes. Three distinct
psychological dimensions of the pain experience have been
related to these neurophysiological concepts. These are the
sensory-discriminative, the motivational-affective and the
cognitive-evaluative dimensions respectively. The first is
associated with the rapidly conducting spinal systems pro-
jecting to the thalamus, the second with reticular and
limbic structures, and the third with neocortical processes.
The model is a complex and dynamic one, and can hence
explain many diverse phenomena.
Some areas of research focus upon physiological aspects
of pain, while others are more directly concerned with
identifying those factors which can modify the experience.
These investigations are carried out both in laboratory and
in clinical settings. Experimental laboratory studies may be
criticized on the grounds that the kinds of pain that can be
induced and the conditions in which it is experienced are
rather different from those that apply under natural condi-
tions. They do, however, allow the researcher to control and
monitor carefully the variables under study. Various methods
of inducing pain have been developed for this purpose. These
include application of heat or pressure; administration of
357
electric shocks; the cold pressor test for which the subject
has to immerse his hand in ice-cold water; and the sub-
maximal tourniquet technique which produces ischaemic pain.
Using such methods experimenters can study the effects of
various manipulations upon pain measures such as the
threshold, or the point at which the subject first reports
pain, and tolerance level or the point at which he requests
that the painful stimulus be terminated. Threshold and
tolerance levels are not appropriate for use in the context
of naturally occurring pain, and measures in clinical situ-
ations are primarily concerned with the assessment of
subjective intensity. Estimates of this may be obtained by
asking the patient to rate the symptom on a scale which is
gradated by numbers or by verbal descriptions representing
different levels of pain from mild to severe. The experience
of pain does, however, vary in quality as well as in degree.
Melzack and Torgerson (1971) have thus developed a ques-
tionnaire which enables patients to describe their symptoms
in terms of a wide range of adjectives such as sharp, tug-
ging, aching, piercing, nagging and so on. These descrip-
tions can be related to the three dimensions of pain
described earlier.
Somatic therapies The chemical agents used in the treatment of pain are
numerous and varied in their nature. They include, first,
narcotic drugs such as opium, morphine and their deriva-
tives; these act centrally and produce both pain relief and
a state of tranquillity. There is, however, a risk of estab-
lishing a dependency and this obviously places constraints
on the way in which they may be employed. A second category
comprises the psychotropic drugs or minor tranquillizers and
anti-depressants; these are directed at the reduction of
emotional distress rather than the pain experience per se.
Third, there are agents which act peripherally and not
centrally; examples are the salicyclates and analine deriva-
tives, including aspirin and phenacetin. These have anti-
pyretic and anti-inflammatory properties which can reduce
pain, although not as effectively as the narcotic agents.
They can have physical side effects if taken in large
quantities or over long periods of time. Recent develop-
ments in the study of the brain's chemistry may provide new
directions in the psychopharmacological treatment of pain.
Opiate-binding sites have been discovered in the dorsal
horns and in the central nervous system, and there is much
interest currently in substances such as encephalin and the
endomorphins which are naturally occurring morphine-like
peptides. It seems that morphine and similar substances may
produce their effects by mimicking the action of these
endogenous peptides. However, we are still far from fully
understanding the properties of these compounds and the
way in which they interact with the complex anatomical
structures involved in the transmission of pain.
358
In many cases chemical therapies provide insufficient

relief, or cannot be used in the quantities required for
adequate relief because of their side effects, and other
forms of physical treatment may then be demanded. Surgical
procedures designed to interrupt the nervous system's
transmission of pain signals have been carried out at many
different sites from the periphery to the centre, but the
general effectiveness of such procedures is disappointing.
There have been some encouraging results, but in many cases
where relief is obtained it may only be temporary. This
outcome, in the context of the irreversibility of the pro-
cedures employed, has focussed attention on less drastic
forms of treatment. One of these is to 'block' sensory input
by injecting alcohol or a local anaesthetic agent such as
procaine into the nerve root. Another is to increase this
input by peripheral stimulation. This practice is concep-
tually similar to the 'counter-irritation techniques' that
have been commonly used throughout history. These have
included hot fomentations, vigorous massage, and the raising
of blisters and dry cupping. For the latter a cupping glass,
with the air partly withdrawn from it by means of an air
pump or flame, was drawn across the skin, thus raising a
painful red weal. Both nerve blocks and peripheral stimu-
lation can be very effective in the treatment of appropriate
syndromes. Not only may they have an immediate effect
through restoring normal sensory inputs, but they can dis-
rupt abnormal patterns of central nervous system activity
and thus permanently affect the way in which pain is
processed.
A method that may comprise important psychological
as well as physical factors is acupuncture. This has only
recently been applied to the control of pain and is most
often used in the context of surgery. The procedure involves
inserting needles into one or several skin areas, and these
needles are then stimulated either manually or electrically.
The successes claimed may be in part attributable to effects
associated with peripheral stimulation, but Chaves and
Barber (1974) have proposed a number of psychological bases
for its apparent efficacy. These include the fact that a low
level of anxiety is looked for in those selected for treat-
ment by this method; the expectation among these patients
that the experience will be pain free; a thorough prepara-
tion before surgery with a strong suggestion of pain relief,
and exposure to models who have successfully undergone the
experience; and the distractions associated with the general
procedure which should draw attention away from the opera-
tion itself. These authors also suggest that the pain of
surgery may be generally exaggerated, and point out that
acupuncture is not generally used in isolation but in com-
bination with sedatives and analgesics. The apparent success
of acupuncture may then depend upon the existence of such
physical and psychological supports, but as yet the relative
contribution of these factors and of any direct somatic
effects of the technique is unknown.
PFP _ X 359
Psychological approaches We cannot have direct access to another's experience and

to therapy must make inferences about this on the basis of overt
behaviours, such as motor activity, autonomic reactions,
verbal descriptions, and so forth. Some psychologists argue
from this that any distinction between experience and
behaviour will be lmproductive, and that the psychological
analysis of pain and treatments for its relief should be
directed at the behavioural level (Fordyce et aI, 1973).
With respect to therapy, typical goals would then be the
reduction of help-seeking and dependent behaviour, a de-
crease in the medications taken, and an increase in physi-
cal and social activity. The therapist would first identify
those behaviours thought to be undesirable within this
framework, and would then seek the co-operation of the
individual's family and friends in withdrawing the presu-
mably rewarding conditions which serve to maintain these.
For example, they might be advised to meet unreasonable
requests for assistance with disapproval and reluctance, and
to respond to legitimate demands or complaints helpfully but
without the accompanying expressions of sympathy and concern
which serve to reinforce these. At the same time, alter-
native desirable behaviours would be met with attention,
approval and encouragement. This approach is most obviously
appropriate where changes have occurred as a response to
suffering, and have been maintained in spite of the removal
of the pain source because they are found to fulfil other
needs. It may also help in cases where the underlying con-
dition cannot be alleviated, in this context by motivating
the individual to lead as normal a life as possible in the
circumstances, and to avoid the temptation of making a
'career of suffering'. A behavioural approach may not alter
the intensity of the pain experienced, and pain may even
intensify during therapy as physical activity increases.
Nevertheless, a change at this level can have a positive
impact on emotional adjustment and can improve the general
quality of life for both the individual and his family.
Other psychological therapies attempt to modify the
underlying experience of pain rather than the behaviours
associated with this. One such approach is to provide
training in the use of cognitive strategies which either
direct attention away from pain or restructure the experi-
ence so that it is no longer distressing. The sufferer may
be instructed to counter the pain when it occurs by atten-
ding to distractions in the environment rather than to his
sensations, or by constructing fantasies and concentrating
on thoughts which are incompatible with these. He may,
alternatively, be advised to acknowledge the painful sen-
sations but to reinterpret them in imagination as something
less worrying or take a 'clinical' attitude which distances
him emotionally. There have been many attempts to study the
effectiveness of these strategies in laboratory experiments,
but with suprisingly inconsistent results. One reason for
the failure of some studies to demonstrate a positive effect
may be the difficulty of ensuring that subjects follow the
360
instructions faithfully. Those in the experimental group

will sometimes reject the strategy suggested to them and
substitute their own, while the control group may sponta-
neously employ strategies even though not instructed to do
so (Scott, 1978). The very nature of the problem suggests
that cognitive strategies in general play an important role
in coping with pain, but it presents considerable methodo-
logical difficulties in establishing the effectiveness of a
given strategy, either in absolute terms or in comparison
with another strategy.
A third clearly psychological approach to pain therapy
is that of hypnosis. Here the aim is to m;mipulate the
experience directly by means of suggestion. There has been
much discussion about the nature of hypnosis. Some have
thought of it as a special state of consciousness or trance
which is distinct from other experiences, but others have
argued that it is an example of complete or almost complete
absorption in a particular role and conformity with the
expectations associated with this (Sarbin and Anderson,
1964). The subject has faith in the hypnotist's power to
influence him, and is prepared to accept such influence to
the extent that not only his outward behaviour but also his
subjective experience will be modified. Hypnotic suggestion
has been used for pain relief in surgery, dentistry, ter-
minal care and obstetrics (Hilgard and Hilgard, 1975).
Verbal reports of pain are affected by hypnosis, but in-
voluntary physiological responses such as heart rate or
galvanic skin responses are not generally affected. This
indicates that there is still some sense in w ltich the pain
is present, and it has been suggested that the absence of
the subjective experience of pain under hypnosis is a form
of dissociation, with pain being processed at a precon-
scious, but not at a conscious, level. In one study subjects
were trained to make two reports of pain simultaneously, one
using a key press and another by verbal description, and the
results supported the dissociation hypothesis. The key press
response indicated more pain than the verbal report, al-
though less pain than that reported verbally under
comparable conditions but in a normal 'waking' state.
Hypnosis is not itself a means of preventing or allevi-
ating pain, but a method for increasing the potency of the
suggestion of analgesia made to the subject while in this
state. Suggestion can have a powerful effect outside the
context of hypnosis merely by creating the expectation of
pain relief, and this is the basis of the well-known placebo
effect. A placebo drug is a neutral substance which has a
positive influence because of the expectations created by
the context in which it is administered, and all treatments
can be assumed to have some placebo element given that the
subject is aware of their intended purpose. Substances which
are known to be pharmacologically inert are thus used for
comparison purposes in drug trials, rather than no treat-
ment, in order to control for the anticipation of relief and
provide a true baseline for evaluating the active and
361
specific influence of the drug on trial. It is estimated

that placebo treatments can alleviate surgical pain in about
one-third of patients; laboratory studies produce lower
estimates, but a significant proportion of subjects are
still found to benefit. The effectiveness of a placebo will
vary with the situation in which it is administered and with
the status and manner of the person who administers it,
since effectiveness will depend on expectations and the
latter will be influenced by these factors. It will vary
also with the individual to whom it is administered, and
people can be grouped as either 'reactors' or 'nonreactors';
the former are not only more responsive to placebos, but are
less differentially responsive to active drugs. While from a
methodological viewpoint placebo effects may often be regar-
ded as 'mock' effects for which controls must be introduced,
from an applied perspective it is evident that the patient's
expectations can be construed as powerful and legitimate
agents of change. Their general influence will be added to
that produced by the specific nature of any physical or
psychological manipulation which is, with the patient's
awareness, diverted at the treatment of pain, and can
significantly enhance the therapeutic impact of these.
Psychological preparation The occurrence of pain may sometimes be anticipated before

for pain the event: for example, if a patient is scheduled for an
unpleasant medical examination. Many of the treatments re-
ferred to earlier may be used as a form of preparation for
a painful experience as distinct from an agent for relief
once pain has occurred, but particular attention has re-
cently been given to psychological preparation with an
emphasis on those forms which enhance 'cognitive control'.
These involve the provision of information which enables the
individual to predict accurately what will happen in the
situation and the nature of his experience, and instructions
in strategies which may be employed to maximize the chances
of successful coping. A number of laboratory studies have
investigated the effect of the former, 'informational con-
trol', and have found that the stressfulness of electric
shock and similarly noxious stimuli is reduced if subjects
are made aware in advance of the timing and intensity of
these and the fact that there is no danger of actual in-
jury. The potential of the second kind of manipulation,
'strategic control', is demonstrated by the work of Turk
(1978) who has developed a procedure for enhancing subjects'
ability to control their response to painful stimuli, hence
increasing their resistance to stress and tolerance for
pain. The training procedure is quite complex. First, the
subjects are given general instruction in the nature of
pain; it is not considered essential that the explanation
should be theoretically valid, but merely that it should
provide a framework within which the experience may be
conceptualized and the recommendations for coping presen-
ted. In the second stage of the procedure the subjects are
362
trained to relax physically and mentally, and are provided

with a selection of varied cognitive strategies with which
to confront and control the pain. These strategies are
similar to those described earlier, comprising methods both
for redirecting attention and reinterpreting the experience.
In this context, however, they are presented as a 'package'
from which the subjects will select those suited to their
personal needs. At this stage they will also be asked to
generate feedback statements that can later be used to
foster a feeling of control while in the painful situation
and provide self-reinforcement. The final stage is that of
rehearsal, where the subjects imagine the painful situation
and their reactions, and subsequently play the role of a
teacher instructing someone else in the procedure. This
training has been found to increase pain endurance consi-
derably in a cold pressor task. Subjects were able to extend
the time during which they kept their hand in ice-cold water
by 75 per cent, from before to after training, and this com-
pared with a 10 per cent improvement for a 'placebo' group
who had been given attention and encouragement but no in-
struction in specific cognitive techniques. The experimental
group also showed a significant decrease in pain ratings.
It might be argued that many of the laboratory studies
that have investigated informational control have involved
highly structured and artificial tasks, and that the results
might not be applicable to patients' experiences in clinical
settings. It might also be pointed out that the cognitive
training described above is highly complex; it has several
components and stages and is orientated towards the parti-
cular personality and needs of each individual. It thus
requires some investment of time and effort on the part of
both the trainer a.'1d trainee, and such elaborate procedures
might not be practicable in most naturally occurring situ-
ations. Similar, positive effects of preparation have,
however, been found both under hospital conditions and in
laboratory studies which have simulated these closely in
terms of the nature of the painful procedures employed and
the complexity of the preparation attempted.
Some of the most influential studies carried out in this
area have been those conducted by Johnson and her colleagues
(Johnson, 1975). In one of the first of these, male subjects
were exposed to ischaemic pain in the laboratory and were
either told what physical sensations they might expect as a
result of the procedure, or the procedure itself was des-
cribed without elaborating the sensations associated with
it. It was found that the former preparation reduced dis-
tress, but the latter was ineffective in comparison with
a control group. The intensity of the sensations experienced
by the two information groups was the same, and the results
could not be accounted for by group differences in either
the degree of attention paid to these sensations or the
anticipation of possible harm. It seemed, then, that this
effect must have been due to the expectations held by sub-
jects about what they were to experience, with more accurate
363
expectations being associated with lower levels of distress.

Further studies have used patients undergoing a variety of
stressful medical examinations or treatments, including
gastroendoscopy, cast removal and gynaecological exami-
nation. These too point to the conclusion that providing
information about what to expect reduces stress and un-
pleasantness, especially if this focusses upon what the
subject will experience rather than the objective nature of
the procedure.
The effects of psychological preparation have also been
extensively studied within the context of surgery. This will
be a stressful experience for most patients, and the anti-
cipation and experience of pain will contribute to this dis-
tress. The kinds of preparation attempted in these studies
have varied quite widely. Most have taken a broad approach,
providing information about procedures and sensations,
offering reassurance and emotional support and advising on
how to cope with physical discomfort and difficulty. The
effects of these interventions are consistently positive,
with both reductions in subjective distress and improvement
in post-operative measures of recovery. Two such studies
which have focussed on pain are those of Egbert and col-
leagues (1964) and Hayward (1975). Wherever preparation
comprises a number of different components it is difficult
to determine which of these are responsible or necessary for
the effectiveness of the whole. Some research has thus at-
tempted to isolate and compare different kinds of prepara-
tion. It seems, for example, that providing instructions on
how to cope with physical difficulties is not in itself very
helpful, but is beneficial when presented against a back-
ground of accurate expectations (Johnson et aI, 1978). Only
one study has attempted any detailed training in cognitive
strategies and looked systematically at the impact of this
training. Langer and colleagues (1975) encouraged the
development of coping devices, such as the reappraisal
of threatening events, reassuring self-talk and selective
attention, and showed a significant and independent effect
of this instruction.
There is, then, evidence from a number of studies that
the distress associated with an unpleasant procedure can be
reduced by making the individual aware of what this involves
from his point of view. It is, however, important to recog-
nize that such information can only be expected to have a
beneficial effect if it is presented in a reassuring way:
creating an expectation of pain, whether accurate or not,
can of course alarm the patient and counteract any positive
effects of informational control. Instructions or training
which help the individual to cope with physical or psycho-
logical stresses also have a role in the preparation for
pain, and will enhance the effects of accurate expectations.
FiDal comments The experience of pain depends upon a complex signalling

system whose functions are determined by neurophysiological
364
and biochemical influences which are not yet understood but

are acted upon by physical and psychological factors of
which we have some knowledge. These influences are many
and varied, and provide a relatively broad scope for treat-
ment. Some cases may call for one form of therapy rather
than another, but for many a combination of physical and
psychological approaches will present the most productive
strategy.
A number of writers have called attention to the impor-
tance of the doctor-patient relationship in the treatment of
pain. Szasz (1968) and Sternbach (1974) have pointed to
motives which can cause the latter to resist abandoning his
symptoms, and show how the physician may play a comple-
mentary role which facilitates these efforts: the patient
who wishes to maintain his invalid status will have this
claim effectively legitimized by the doctor who continues to
treat him as though he were ill. Another common theme of
doctor-patient interaction is an attempt by the patient to
place responsibili ty for the outcome of treatment on the
physician's shoulders, with the latter accepting this res-
ponsibility because of an eagerness to help and a reluc-
tance to admit to the limitations of his professional skill.
Such attitudes have been criticized as maladaptive. It has
been argued that doctors should discourage passivity and
helplessness, and cultivate a co-operative and problem-
orientated relationship in which the patient takes an active
role. This will involve confronting any undesirable atti-
tudes he holds towards the pain, and emphasizing that the
outcome of treatment will be determined as much by his
own efforts as by what can be done for him. Sympathy and
reassurance can reinforce pain behaviour and can foster a
dependency which discourages self-help and the development
of strategies for coping.
On the other hand, the total care of the pain patient
should be concerned not only with the relief of pain but
also with the psychological stress to which this suffering
can give rise. The danger of emotionally isolating the
patient is as real as that of over-protecting him. The
attitude of family, friends and even professional helpers
may be complex and emotionally charged, reflecting both an
altruistic concern for the victim's welfare and personal
fears and conflicts associated with suffering. The distress
of the person in pain will in itself be distressing, parti-
cularly where it seems that there is little hope of pro-
viding immediate relief, and this can prompt either physical
withdrawal or psychological distancing to prevent or defend
against emotional upset. Moreover, pain is greatly feared,
both for its own sake and because of its association with
illness, injury and death, and contact with suffering can
elicit anxiety about one's own vulnerability in this res-
pect. This, too, can lead to avoidance or a reluctance to
become practically and emotionally involved. Finally, while
suffering is often unmerited, the recognition of this is
disquieting, since it reminds us of the injustice of the
365
world and our powerlessness in the face of events. Experi-

mental studies have found that blameless victims are some-
times perceived as responsible for their fate, or are
derogated so that this fate appears to be less unjust. We
can predict from these studies that feelings towards the
pain victim in real life might sometimes have a hostile
element, and bear the implication that he is in some way to
blame for his situation whether or not this is the case.
Few would dispute the importance of emotional support
in alleviating immediate distress, and the availability of
social support is a key factor in protecting an individual
under stress from long-term maladjustment. It is therefore
important to adopt a balanced approach in the care and
management of the person in pain, helping him to help him-
self while at the same time providing the sympathy and
reassurance to reduce anxiety and prevent despair.
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Information: A prescription against pain. London: Royal
College of Nursing.
Hilgard, E.L. and Hilgard, J.R. (1975)
Hypnosis in the Relief of Pain. Los Altos: Kaufmann.
Johnson, J.E. (1975)
Stress reduction through sensation information. In I.
G. Sarason and C.D. Spielberger (eds) , Stress and
Anxiety: Volume II. Washington, DC: Hemisphere.
Johnson, J .E., Rice, V .H., Fuller, S.S. and Endress,
M.P. (1978)
Sensory information, instruction in a coping strategy,
and recovery from surgery. Research in Nursing and
Health, 1, 4-17.
366
Lauger, E.L., Jama, I.J. uacl Wolfer, J.A. (1975)

Reduction of psychological stress in surgical patients.
Joumal of Experimental Social Psychology, 11, 155-165.
Meclumic, D. uacl Volkart, E.R. (1960)
Illness behaviour and medical diagnosis. Journal of
Health and Human Behaviour, 1, 86-94.
Melzack, R. (1973)
• The Puzzle of Pain. Harmondsworth: Penguin.
Melzack, R. uacl T-.ncm, W.S. (1971)
On the language of pain. Anaesthesiology, 34, 50-59.
Sarbin, T .R. uacl ADdencm, M.L. (1964)
Role-theoretical analysis of hypnotic behavior. In J.
Gordon (ed.), Handbook of Hypnosis. New York:
Macmillan.
Scott, D.S. (1978)
Experimenter-suggested cognitions and pain control:
problem of spontaneous strategies. Psychological
Reports, 43, 156-158.
Stembach, R.A. (1974)
Pain Patients: Traits and treatment. New York: Academic
Press.
Sternbach, R.A. uacl Tunky, B. (1965)
Ethnic differences among housewives in psychophysical
and skin potential responses to electric shock.
Psychophysiology, 1, 241-246.
Szaa, T.S. (1968)
The psychology of persistent pain: a portrait of l'homme
douloureux. In A. Soulairac, J. Cahn and J. Charpentier
(eds) , Pain. New York: Academic Press.
Turk, D.C. (1978)
Application of coping-skills training to the treatment
of pain. In I.G. Sarason and C.D. Spielberger (eds) ,
Stress and Anxiety: Volume V. Washington, DC:
Hemisphere.
Zborowaki, M. (969)
People in Pain. San Francisco: Jossey-Bass.
1. What cues might we use in determining whether a person

is in pain and the degree of pain experienced?
z. Describe the range of chemical and physical therapies
available for the treatment of pain.
3. Can pain be treated using psychological methods alone?
4. Write a short essay on the use of hypnosis and
acupuncture in the treatment of pain.
5. What is a placebo effect? What role can it play in the
treatment of pain?
6. How do factors such as personality and culture influence
pain behaviour?
7. In what sense can it be said that pain is 'learned'?
8. What criteria might be employed in selecting one form
of pain treatment rather than another?
9. What psychological preparation would you recommend for
an adult who has to undergo an unpleasant medical
examination or treatment?
367
10. What psychological preparation would you recommend for

a child who has to undergo an unpleasant medical
examination or treatment?
11. Discuss the possible disadvantages of being either too
'soft' or too 'hard' in one's attitude toward the pain
patient.
lZ. Does pain have a biological function?
13. Describe and discuss examples of cases where pain can
occur in the absence of physical injury.
14. Describe and discuss examples of situations in which
injury may be sustained without a corresponding
experience of pain.
15. Write an essay on The definition of pain'.
16. How important is an understanding of the neurophysio-
logical and chemical mechanisms underlying pain for its
effective treatment?
17. Write an essay on the experimental induction of pain..
What methods have been used and to what extent are they
justified?
18. Critically assess the relevance of experimental
laboratory research on pain for the understanding and
treatment of pain in real-life settings.
19. Compare and contrast two or more methods for measuring
pain.
AImotatecl readiDg Fagerhaugh, S. and Strauss, A. (1977) Pain Management:

Staff-patient interaction. Reading, Mass.: Addison-Wesley.
Hayward, J.C. (1975) Information: A prescription against

pain. Royal College of Nursing.
McCaffery, M. (197Z) NurSing Management of the Patient

with Pain. Philadelphia: Lippincott.
These three books focus applied aspects on pain,
relating theoretical knowledge to problems of patient
care. The text by J. C. Hayward describes a study
concerned with the psychological preparation of surgical
patients.
Melzack, R. (1973) The Puzzle of Pain. Harmondsworth:

Penguin Education.
Sternbach, R.A. (1974) Pain Patients: Traits and treatment.

New York: Academic Press.
Both of these books provide a broad introduction to
physiological, psychological and social aspects of pain
and its treatment.
Sternbach, R.A. (ed.) (1976) The Psychology of Pain.

New York: Raven.
Weisenberg, M. and Tursky, B. (eds) (1976) Pain: New

perspectives in therapy and research. London: Plenum.
368
These are collections of papers, recommended for

students who wish to consider issues and controversies
within the area in greater detail than that provided by
the introductory texts.
369
15
Dying and Bereavement
A. T. Carr
0peDiDg remarks In the analogy of life as a dialogue between the individual

E.N.DUNKIN and his environment, this chapter moves towards the one-
sided conversation that happens when the individual's effect
on the environment is declining as the sick role can no
longer be set aside, despite the combined efforts of the
individual and the caring people who are supporting him.
Terminal illness is a special case, with only one ultimate
end. Preserving the quality of life in its final phases is
the prime concern. The chapter presents a realistic and
inevitable end to our explorations and after reading it, we
hope you will have a sense of the natural fulfilment of life
rather than one of anticlimax and futility. To put the whole
topic into perspective, you will need to summon up all the
observations made throughout the book.
Demographic trends If you had been born at the beginning of this century, your
A.T.CARR life expectancy at birth would have been 44 years if you
were male or 48 years if you were female. If you were born
today, your initial life expectancy would be 70 years or 76
years respectively. These figures reflect an ageing of the
population that has occurred in all western industrial
societies over the past 80 years. Although we all will die,
most of us will do so at a relatively advanced age. Although
we all will be bereaved, most of us will not suffer this
until we are young adults or until we are in our middle
years.
The fatal conditions of the present day, once hidden by
the mass diseases, are those associated with longevity. In
1978, almost 590,000 people died in England and Wales and
85 per cent of these deaths were attributable to only three
categories of illness: diseases of the circulatory system
(heart and blood circulation), neoplasms (cancer) and dis-
eases of the respiratory system (OpeS, 1979). Also, more
than two people in every three now die in institutions of
one form or another.
In the absence of any radical changes of events, the
vast majority of us will die aged 65 years or over, in an
institution of some sort and as a result of a disease of our
circulatory system, or respiratory system, or of cancer.
This underlines an important feature of dying and death at
370
Dying and bereavement
the present time: they have become unfamiliar events that

take place in unfamiliar surroundings, watched over by
unfamiliar people. We all know that we will die and that we
may be bereaved, yet we have very little relevant experience
upon which to develop our construing or anticipation of
these events and states.
Telling The majority of fatally ill people realize, at some point,

that they will not recover, even if they have not been
informed of the nature of their illness. However, it would
appear that only about half of all fatally ill people appre-
ciate their condition before significant changes in health
force the conclusion 'I am dying'. This is almost certainly
an under-estimate: there will be some people who know that
they will not recover but who do not communicate this.
Although about one-half of terminally ill people appear
to appreciate the seriousness of their illness, this aware-
ness is usually achieved independently, informally and
indirectly. No more than 15 per cent of terminally ill
cancer patients are told of their prognosis either by their
general practitioner or by a hospital doctor (Cartwright et
aI, 1973). This contrasts markedly with the experiences of
their close relatives. Almost 90 per cent of the close
relatives of terminally ill patients are aware that the
patient's illness is terminal and most of them are informed
of this by a general practitioner or by a hospital doctor.
There are several implications of these data, the two most
obvious being that fatally ill people and their principal
carers often do not share the same information about the
illness, and that doctors usually are unwilling to tell
patients when they have a disease that will kill them.
Perhaps the most serious consequence is that one or more
of the familial participants has to cope with the demands
of this most stressful period without adequate support.
It is remarkable how Ii ttle emphasis is placed upon the
wishes of the patient. Most people, including doctors,
whether they are young or old, ill or well, say they would
want to know if they had a fatal illness or that they are
glad they do know. Several studies have examined this issue
and the results are consistent in showing that more than 70
per cent of all the samples used say they would want to be
informed if they had a terminal disease. It is clear that
most people say they would want to be informed of the
seriousness of their illness, most doctors say that they
would want to be told, and yet the majority of fatally ill
patients are not told. Also, the existence of a real threat
to life does not reduce the very high proportion of people
who want to know if they have a fatal illness.
In general, leaming that one has a fatal illness is
followed by a period of disquiet, even grief, although the
emotional response may be concealed from others. It is worth
noting that some patients do not 'hear' or at least appear
not to remember, what they have been told regarding their
371
prognosis. Although it has been proposed that the defence

mechanism of denial is a ubiquitous response to learning of
a fatal prognosis (Kubler-Ross, 1969), there are other more
mundane possibilities. The first is the use of terminology
that may have very precise meanings for a professional but
which may mean nothing, or something very different, to the
patient. To inform a patient of 'malignant lymphoma' or
'secondary metastases' may not constitute communication.
Even when the words that are used are understood reasonably
well, they may not convey what was intended. For some
individuals, the knowledge of their impending death will be
extremely distressing; in such cases the person may be quite
unable to accept what is plain to everybody else. They may
become distraught as their bodies show increasing signs of
impending death while they continue to deny that they are
dying. Such extreme responses, as a terminal illness
progresses, correspond to denial as elucidated by Kubler-
Ross (1969). However, it would be inappropriate to regard
as denial a person's failure to comprehend or to recall
initial statements of his prognosis. Quite apart from the
communication problems mentioned above, if a person has no
prior suspicions that his condition may be terminal it is
probable that he will be unable to accept a fatal diagnosis.
It is not that be refuses to accept such information, but
he is unable to accept it. It demands it. radical revision of
a person's view of the world and such a major psychological
adjustment takes time. Initially, such news is not dis-
believed, but on the other hand, it cannot be fitted into a
person's perception of the world: it cannot be accommodated.
The revised view of the world will need to be tested,
amended and confirmed in the light of further information.
The person will seek such information in what people say,
how they behave and how his body feels. It is only when the
revised view of the world 'fits', in the sense that it is
not violated by new observations or new information, that
the person is able fully to accommodate the 'truths' that
have been offered. An individual who has prior suspicions
about the seriousness of his illness has already construc-
ted, at least in part, a view of his world that includes
himself as a dying person.
Our aim must be to maintain dignity, to alleviate
suffering and to help the person live as fully as possible
for as long as he is able: he should be told what he is
prepared to hear at a time when he is prepared to listen.
The same principle might be kept in mind when dealing with
relatives. There are indications that those who are told
with care show improved family relationships, less tension
and less desperation during their terminal illnesses than
those who are not (Gerle et aI, 1960). Helping a person
towards fuller awareness of, and adjustment to, a fatal
prognosis is the beginning of a communication process which
is itself an integral part of caring for the terminally ill.
TenaiDality aDd dyiDg The two words terminality and dying are being used to draw
37Z
a distinction that can have important implications for the

way in which fatally ill people are managed and treated. The
main implication is that of regarding someone as terminally
ill, but nevertheless living and with some valuable life
remaining, rather than regarding him as dying with all the
negative attitudes this provokes. Once an illness has been
diagnosed as terminal we need to regard the patient as
living and possibly living more intensely than the rest of
us, until he clearly is dying. Terminality, then, begins
when a terminal diagnosis is made but dying starts later,
usually when death is much closer and when the person is
prepared to relinquish his biological life in the absence of
valuable, functional life.
Sources of disUess
Effective and appropriate care of the fatally ill requires
an awareness of potential sources of distress so that dis-
tress can be anticipated and thus be avoided or alleviated.
Of course, distress is not confined to the patient: effec-
tive care and support for those who are close to the patient
is merited not only on humanitarian grounds, but also
because of the exacerbation of the patient's suffering that
can result from the distress of relatives and friends. Table
1 summarizes some of the most common sources of distress
for the patient and those who are close to him.
The listing contained in table 1 is by no means
exhaustive, but it illustrates a number of points. First,
given some capacity for empathy on the part of the
survivor(s) there is little that the terminally ill person
must endure that the survivor can avoid. This commonality
of the sources of distress argues strongly for the need to
attend to the welfare of survivors before they become
bereaved. Second, it is clear that almost all the potential
sources of distress are psychological in nature. Even some
of the physical symptoms such as incontinence or smells are
distreSSing because of our values and expectations. Also,
pain itself is an experience that is subject to psycho-
logical factors rather than a sensation that is elicited by
an appropriate stimulus.
Although we cannot examine in detail the physical dis-
tress of terminal illness, our discussion would be incom-
plete without a summary of this. Cartwright et al (1973) and
Ward (1974) identified retrospectively the physical symptoms
experienced by their samples of terminal cancer patients,
215 and 264 individuals respectively. These data are
summarized in table 2.
It is striking that the rank order of symptoms is the
same for both samples and a significant proportion of
patients in each sample experienced each of the symptoms
listed. Other common physical symptoms were breathing
difficulties, 52 per cent; coughing, 48 per cent (Ward); and
sleeplessness, 17 per cent (Cartwright et al).
Distress and copiDg

An examination of tables 1 and 2 points to a number of
3'j'3
Table 1
Commcm sources of distress
Fatally ill person (P) Those who love P
Awareness of impending death Awareness of impending

bereavement
Anticipation of loss Anticipation of loss
Physical sequelae of disease Empathic concern,

process, e.g. tumours, lesions, aversion, etc.
nausea, incontinence,
breathlessness, unpleasant
smells
Frustration and help- Frustration and help-

lessness as disease lessness as disease
progresses progresses
Uncertainty about the Uncertainty about the

future welfare of the future welfare of the
family family
Anticipation of pain
Empathic concern Caring for P,

night-sitting,
tiredness, etc.
Changes in roles with Changes in roles with

family, friends, etc. family, friends, etc
Changes in abilities as Empathic concern

illness progresses
Changes in appearance as Empathic concern,

illness progresses aversion, etc.
Uncertainties about dying Empathic concern
Dying Empathic concern
Discovery of death,
directly or indirectly
Practicali ties,
funeral, etc.
Grief
Role changes
Reconstruction of life
374
Table 2
Symptoms suffered by terminal cancer patients
Per cent in sample of Per cent in sample

Symptom Cartwright et al of Ward
Pain 87 62
Anorexia 76 61
Vomiting 54 38
Urinary
incontinence 38 28
Faecal
incontinence 37 20
Bedsores 24 l3
psychological processes that predispose people to react with

depression and anxiety during a terminal illness. Current
approaches to depression emphasize the role of loss and
helplessness as aetiological factors. Loss refers to the
real or imagined loss of a valued object, role, activity,
relationship, etc. The individual relevance of the concept
of loss lies in the individual differences of our value
systems. For example, a person who highly values physical
abili ties, physical appearance, etc., is likely to be more
at risk for depression as a result of physical debility,
tiredness and deterioration in appearance, than someone for
whom such attributes are low in his hierarchy of values.
Helplessness describes a state that is characterized by
an awareness that one's behaviour is unrelated to the events
which impinge upon oneself. When a person is subjected to
aversive events whose occurrence, intensity, duration, etc.,
is quite independent of behaviour, a characteristic state
may ensue. This state, which occurs in the majority of
subjects tested, is known as learned helplessness. There are
individual differences in susceptibility to learned help-
lessness, but the more aversive the events and the more
frequently they are experienced as independent of behaviour
the more likely it is to develop. It is a generalized state
characterized by apathy, dysphoric mood, psychomotor retar-
dation (i.e. slowness in thought and action), and feelings
of hopelessness. Many clinical depressions are explained
most fully in terms of the development of helplessness and
there is evidence that sudden death is not an uncommon
consequence of learned helplessness in laboratory animals.
There can be Ii ttle doubt about the relevance and importance
of helplessness to our consideration of the welfare of the
terminally ill.
PFP _ Y 375
Let us now return to the sources of distress summarized

in tables 1 and 2. It is clear that some of these are
intrinskally uncontrollable, and others duplicate the
procedures that are used in experimental work to induce
helplessness in that they are aversive, uncontrollable and
repeated: for instance, urinary incontinence and vomiting.
Furthermore, many patients undergo physical investigations
and treatments that they do not understand, that they find
unpleasant or painful and about which they feel they have
li ttle choice other than to accept them passively. It is not
surprising to find that depression is commonly encountered
in the terminally ill. A significant minority of fatally ill
people and their next-of-kin become moderately or severely
depressed (about one in five people in each group). Those
most at risk are adolescents, young parents with dependents,
those who have many physical symptoms and those who
experience lengthy hospitalization.
The reciprocal interaction of physical and psychological
processes must not be overlooked. We have already considered
the depressive role of repeated, unpleasant physical symp-
toms. However, the interaction also proceeds in the other
direction: adverse emotional states such as depression and
anxiety augment pain and other physical discomforts. The
essential point is that pain is not a simple response to an
appropriate physical stimulus such as tissue damage: it is
an experience that is compounded of the stimulation and the
person's response to that stimulation. The motivational and
emotional state of the person acts, as it were, to colour
the sensation and to produce the experience we call pain.
Without such 'colouring' and evaluation the sensation may be
perceived but not experienced as painful.
It is the experience of most who work in terminal care
that the relief of anxiety or depression through appropriate
support, communication and practical help reduces the pain
of patients and, not insignificantly, reduces the need for
medication. The point is not that attention to the psycho-
logical state of the patient removes the need for relevant
medication but that it reduces the dosages that may be
required to bring relief. There are many obvious advantages
that derive from this, not the least of which is the ability
to alleviate pain without resorting to medications that
render the patient confused, drowsy or comatose.
Anxiety arises when a future event is appraised as
threatening . This appraisal is the evaluation of an event in
terms of its harmful implications for the individual, harm
being the extent to which continued physical and psycho-
logical functioning is endangered. Threat appraisal is a
highly subjective process that depends upon the subjective
likelihood of an event - that is, how probable the person
feels the event to be - and the degree of harm that will
result, this again being subjectively assessed. So a ter-
minally ill person is anxious to the extent that the events
that he anticipates are both likely and harmful in his own
terms: if they are not perceived as likely or harmful then
they will not provoke anxiety.
376
Anxiety is an essentially adaptive emotion, in that it

motivates us to initiate behaviours that prevent the anti-
cipated harm being realized. To the extent that a person
accepts that he is dying and is unable to reduce or eli-
minate the harmful consequences of this process, he is
liable to remain anxious. An inspection of tables 1 and 2
reminds us that there are many potential types of harm that
the fatally ill person is motivated, by anxiety, to alle-
viate. It is reassuring to note that the intense pa.11ic that
is such a common feature of clinical anxiety states occurs
rarely in terminal illness except, perhaps, in those who
continue to deny the imminence of death as the end ap-
proaches and those for whom breathing is difficult. However,
moderate anxiety is by no means uncommon in the terminally
ill. This is not only an extra burden of suffering for the
person but it also exacerbates other discomforts including
pain.
There are few systematic reports of anxiety in terminal
illness but from the data that do exist it is clear that
moderate anxiety is experienced by between one-quarter and
one-half of patients. The anxiety may be readily discerned
in those people who are able to verbalize their fears, and
who are given the opportunity to do so, but it may be less
obvious in those who communicate less 'well verbally. How-
ever, the physiological and behavioural concomitants of
anxiety are good indicators of the presence of unspoken
fear. Often it is difficult to distinguish between physio-
logical signs of anxiety such as gastric upset, nausea,
diarrhoea, muscular pains, etc., and symptoms of the dis-
ease process or side effects of treatment. Nevertheless, the
possibility that a patient might be persistently anxious
should not be overlooked.
Given the subjective nature of threat appraisal, the
causes of an individual's anxiety can be surprisingly idio-
syncratic, but there are a few consistencies that may pro-
vide some clues. Younger adults expect to be distressed by
pain and parting from the people they love, whereas the
elderly fear becoming dependent and losing control of bowel
and bladder functioning. Hinton (1972) reports that almost
two-thirds of his patients who died aged 50 years or less
were clearly anxious but this was true of only one-third of
those aged 60 years and over. There is a clear and under-
standable trend for young parents of dependent children to
be more anxious than other groups. Perhaps it is not insig-
nificant that younger patients also tend to experience more
physical discomfort during their terminal illnesses.
According to Hinton (1963), anxiety is more common in
people with a lengthy terminal illness. He found more than
50 per cent of those who had been ill for more than one year
to be clearly anxious, but only 20 per cent of those who had
been ill for less than three months showed similar levels
of anxiety. Although anxiety levels fluctuate during a
patient's terminal illness, there is no general trend for
anxiety to increase as the person draws closer to death.
Some people become more apprehensive as their illnesses
377
progress, but others become more calm during the last stages
of their lives.
Some specific experiences of illness may be potent
sources of anxiety. Prior episodes of intolerable pain can
provoke great anxiety when they are recalled or when their
return is anticipated. Difficulties in breathing are com-
monly associated with anxiety and a tendency to panic. Also,
in the context of a mortal illness there are a number of
sources of distress that are intrinsically uncontrollable
and uncertain, such as the final process of dying, death and
the nature of the world in which one's dependent survivors
will be living. When anticipated harm remains and the person
perceives it as beyond his abili ty to influence, he becomes
liable to the state of helplessness. If this is severe he
may become depressed, as we have discussed: if less severe,
then he may exhibit the resignation that has been termed
'acceptance' (Kubler-Ross, 1969). If he persists in his
attempts to control and influence events that are beyond his
reach he is likely to remain anxious and even to become more
anxious as he approaches death.
For the fatally ill child under five or six years of
age, anxiety takes the form of separation anxiety, lone-
liness and fears of being abandoned. The young child does
not appear to fear death and its implications, but his fears
are aroused by those aspects of illness and hospitalization
which elicit fear in most ill children who require hospital
treatment.
Between the ages of six and ten or eleven years, sepa-
ration fears persist, but the child is increasingly prone to
anxiety over painful treatments and bodily intrusions. Such
fears of mutilation and physical harm are intensified in the
absence of familiar, trusted adults. Some children in this
age group, because of differing prior experiences or more
advanced cognitive development, are also aware of the
cessation of awareness and bodily functioning consequent
upon death.
Although there is some dispute as to whether the child
under ten years of age is aware of his impending death at a
conceptual level, there is little doubt that many young
children perceive that their illness is no ordinary ill-
ness. This is a frequent clinical observation and there is a
good deal of evidence that it is so whether or not the
diagnosis is discussed with the child (Spinetta, 1974). Of
course there are many cues that may indicate to the child
tha t something very serious and threatening is happening,
quite apart from his numerous tests, treatments and visits
to hospital. Most children are finely tuned to detect
meaningful and subtle signs in the verbal and non-verbal
behaviour of adults: the things that are not talked about,
tone of voice, eye contact, posture, etc. Also, there are
many cues that the child would find it hard to overlook:
whispered conversations, unusually frequent and intense
bodily contact, unusual generosity and freedom of choice
with regard to presents and treats, and so on.
378
Parents and others usually begin to grieve for the

fatally ill child soon after they accept the prognosis.
Their ability to cope with this grief is an important
determinant of their effectiveness in supporting the child.
Since familiar adults and siblings are likely to be the
child's greatest potential source of comfort and reassur-
ance, it is important that time and attention is devoted to
these significant others for the sake of the child's wel-
fare. There are indications of a high incidence of psycho-
logical difficulties in family members, particularly sib-
lings, during the terminal illness of a child. Clearly
parents, who are themselves struggling with their own
emotions, may have difficulty sustaining the other child-
ren in the family, let alone in providing comfort and
reassurance to the one who is ill.
Adolescents and some younger children will be aware of
the finality of death. Although dependent upon adults in a
functional sense, they may perceive themselves as having
important roles to play in the welfare of others and thus
be subject to fears for the well-being of their survivors in
much the same way as adults with dependents. The very
young child may endure a terminal illness with striking
calmness and acceptance of his lot, provided that his sepa-
ration fears are allayed, but once he is past the age of six
or seven years he becomes prone to a wide range of fears
that exceed those of his 'normally ill' counterpart with
severe, chronic, but non-fatal illness. Although children
may be reluctant to express their fears, or may express them
unclearly and indirectly, they should be anticipated in all
aspects of care.
We have examined the range of potential sources of
distress in terminal illness and the most common types of
distress that result from these. Pain, anxiety and depres-
sion are sufficiently frequent and severe to merit attention
when services are being planned and delivered. However, a
majority of fatally ill people do not become severely
anxious, deeply depressed or suffer from unrelieved pain.
This does not minimize the awful suffering of the large
minority or the pressing need for improvements in care to
which this suffering testifies. It indicates only that, with
whatever help they receive, most people who endure a ter-
minal illness cope reasonably well, keeping their levels of
distress within limits that are acceptable to themselves and
to those who care for them.
The responses of people who are faced with impending
death show sufficient uniformity to enable observers to
write of stages, phases and patterns of coping (e.g. Kubler-
Ross, 1969; Falek and Britton, 1974). Quite apart from
doubts about the uniformity and progressive nature of stages
of coping in terminal illness (e.g. Schulz and Aderman,
1974), it cannot be assumed that any particular individual
NEEDS to negotiate these stages in order to cope most
effectively with his impending death. The emotional res-
ponses and their dependent behaviours are indicators of the
379
difficulties, and triumphs, experienced by people in their

attempts to cope. The absence of a specific emotion does not
mean that the person has omitted a necessary stage of the
'normal' coping pattern and that this omission detracts from
his adjustment. Provided we do not equate typical with ideal
or necessary, an awareness of the emotional stages or phases
that are commonly encountered in terminal patients can help
us to understand the problems they face, to provide the
types of help and support that might be beneficial and to
improve our ability to cope with the emotions that their
behaviours arouse in relatives and in ourselves.
However, there are a number of general points that can
be made about a stage model of terminal illness. The res-
ponses de linea ted, including denial, anger, bargaining,
depression and acceptance (Kubler-Ross, 1969} , are not
specific to people who are facing death; they have been
observed in many other stressful situations that involve
loss and uncontrollable harm, such as bereavement, amputa-
tion and imprisonment. The generality evidenced by these
observations does not confirm the progression of the stage
model: it highlights the normality of disbelief, anger,
sadness, etc., in the face of irretrievable and severe
loss.
Often it is difficult to decide which stage or phase a
person is in. Without reasonable certainty in the identifi-
cation of stages, the predictive value of a stage model is
severely impaired. This predictive aspect of the model is
also reduced if the stages are not Ubiquitous and if they
a~ not successive. Clinical observation suggests that the
emotion displayed by a person is responsive to many internal
and external events. Perhaps all that can be said with any
certainty is that some responses, when they occur, are
likely to predominate earlier in a terminal illness, for
example denial, and some are more likely to appear later,
for example depression and acceptance.
We must take care not to lose sight of the individual
in anticipating responses to a terminal illness. The fatal-
ly ill person brings with him his own particular view of
himself, his family, his future, doctors, death, etc. The
importance of individual differences during the terminal
phase of life is well illustrated by the work of Kastenbaum
and Weisman (l97Z). They found that their patients could be
divided into two broad groups, both of which were aware of
the imminence of death but which differed markedly in their
behavioural styles. One group gradually withdrew from their
usual activities and social contacts, remaining inactive
until their final illness. The other group was characterized
by involvement: patients in this group remained busily
engaged in everyday activities until death occurred as an
interruption in their living.
Dying
The relationship between a patient's reactions to a terminal
illness and his dying is not only that these are the psycho-
logical context within which the final process occurs, but
380
also there are increasing indications that they influence

the timing of death (see Achterberg and Lawlis, 1977).
Whereas blood chemistries reflect on-going or current
disease status, psychological factors are predictive of
subsequent disease status and longevity. Poorer prognosis
and shorter survival occurs in patients who, typically, show
great dependence upon others, who deny the severity of their
conditions, who have a history of poor social relationships
and who do not have access to, or do not utilize, supportive
social relationships during their illnesses. These patients
tend to become more withdrawn, pessimistic and depressed as
their illness progresses. Longer survival is associated with
patients who maintain good personal and social relationships
in the context of an existing network of such relationships.
They can be assertive without hostility, asking for and
receiving much medical and emotional support. They may be
concerned about dying alone and seek to deter others from
withdrawing from them without their needs being met. These
patients also experience less pain, or at least complain
less about pain and discomfort.
Dying is a process rather than an event that occurs at
one point in time. This final process that constitutes the
transition from life to death is usually of short duration,
a matter of hours or days. For the vast majority of people
it is not dramatic. Most people, both ill and well, express
a desire to die peacefully or to die in their sleep. There
is little doubt that this wish is fulfilled in most cases.
Although there are a few people for whom pain or breath-
lessness may increase near the end, most slip knowingly or
unawares into the unconsciousness that continues until their
dying is finished.
After a terminal illness lasting some months, most
patients are tired and wearied by their experiences. During
his last days, apart from having his needs tended, a patient
may wish to be alone or to avoid news and problems of the
'outside world'. He may well become less talkative and pre-
fer shorter visits. Communication tends to shift increas-
ingly towards the non-verbal. In terms of interaction he may
want little more than somebody to sit with him in silence,
perhaps holding his hand. It is clear from those who wish
to talk briefly in their last hours of life that there is an
experience of 'distance' from life. As Saunders (1978) so
aptly puts it, 'They were not frightened nor unwilling to
go, for by then they were too far away to want to come back.
They were conscious of leaving weakness and exhaustion
rather than life and its activities. They rarely had any
pain but felt intensely weary. They wanted to say good-bye
to those they loved but were not torn with longing to stay
with them.'
Euthanasia Euthanasia, meaning a gentle and easy death and the act of
bringing this about, has been a source of discussion and
controversy for many years. The level of current interest is
evidenced by the large number of recent publications on the
381
topic in the professional li terature and the increasing

support of the public for such organizations as the Volun-
tary Euthanasia Society in the UK and the Euthanasia Edu-
cation Council in the USA.
The public support for euthanasia is probably based upon
an expectation that death will come as a result of a lengthy
illness, an illness that may well be prolonged unduly by the
application of current medical knowledge and techniques. It
is based upon fears of the physical and psychological incom-
petence, dependence, indignity and pain that may result from
a chronic or terminal illness. Even those professionals who
oppose euthanasia on ethical, religious or practical grounds
readily concede that such fears are not unjustified for many
people. We have already examined the potential distress of
terminal illness but, for many people, support for eutha-
nasia is prompted by thoughts of an unwanted, useless exis-
tence where biological life is maintained artificially and
against their wishes in a hospital, nursing home or geri-
atric ward. Sadly, such thoughts are all too often re-
inforced by cases that Saunders (1977) rightly describes
as 'truly horrendous'. As a society we cannot escape the
reality that far too many elderly people end their days
in loneliness, isolation and degradation. Even when the
physical care provided is good, the psychological distress
can be great. The prima facie case for euthanasia appears
to be strong.
The many logical, philosophical and ethical arguments
relating to the legalization of voluntary euthanasia, both
active and passive, have been well stated several times
(e.g. Rachels, 1975; Foot, 1978), and space precludes their
consideration here. However, these arguments frequently
take little account of relevant practical and psychologi-
cal issues. In drawing up the necessary guidelines for the
legalization of volunt;u-y euthanasia there are major prob-
lems in guarding against error and potential abuse, both by
relatives and professionals. Nevertheless, many of these
problems could be surmounted by the use and recognition of
the Living Will. This document, as distributed by the Eutha-
nasia Educational Council, is signed and witnessed when the
person is in good health. Its aim is to avoid an existence
in dependence, deterioration, indignity and hopeless pain.
Doctors spend their lives preserving the lives of others
and alleviating their suffering. It can be argued that, in
recent years, the pendulum has swung too far in the direc-
tion of the maintenance of life at the expense of the relief
of distress, but the activities of doctors make demands upon
their energies and their personal time that few other pro-
fessions would tolerate. This degree of commitment is con-
sistent with, and continually reinforces, a value system
that places a very high priority upon the preservation of
life and actions that serve this end. For an individual in
whom such values relate closely to his self-concept, the
active termination of a patient's life may be damaging to
his self-regard and to his concept of his own worth as a
382
person. Although there is little difference between active

and passive euthanasia on moral and logical grounds, for an
individual doctor the difference may be vast and unbridge-
able in terms of his own psychology. It would be quite
unjustifiable to place such men in a position where society
expected them to implement active euthanasia.
From the patient's point of view, the avail abili ty of
euthanasia has a wider potential than the avoidance of
further suffering. People who are given control over
aversive and painful stimulation, by having the facility to
terminate, reduce or avoid it in some way, are better able
to cope with the experience. Even though the available
control is rarely exercised, the aversive stimulation is
better tolerated and provokes less distress. Provided that
the patient is quite sure that his life can be terminated
when he wishes, and only when he wishes, he is likely to
cope better with the effects of his illness or condition and
to be less distressed by them.
To allow a patient to die in order to release him from
hopelessness and irreducible suffering, while continuing to
treat his current distress, is thoroughly compatible with
the humanitarian principle of care. Whether or not one
wishes to describe this as passive, voluntary euthanasia is
a matter of personal choice. There are grounds for a more
widespread recognition of this compatibility and for more
weight to be given to the wishes of patients and their
families. Of course, the same grounds demand that more
effort, time and resources should be devoted to improving
the quality of care that is offered. All such improvements
weaken the case for regarding death as a desirable release
from suffering, as a release that is needed so frequently
that its use should be regularized. In the long term, and
certainly in the shorter term, there are likely to be some
people for whom death is the preferred option. It is a prob-
lem that will become more acute as our society continues
to age and as the life-preserving techniques of medicine
continue to develop.
Bereavement Bereavement is a state characterized by loss. The main focus

of interest is upon the loss occasioned by the death of a
significant person but people are bereaved by other losses
such as loss of role, loss of status, separation and ampu-
tation. The state of loss serves as the stimulus for the
bereavement response, a response that is manifested cultur-
ally and individually. The cultural response constitutes
mourning and is a pattern of behaviour that is learned from
and supported by one's immediate culture as appropriate
following bereavement. Grief is the individual response and
is the main area of concern for researchers and clinicians
alike. In that grief typically follows a reasonably consis-
tent course over time, ending ultimately in its resolution,
it can be regarded as an individual process that occurs in
response to individual loss.
383
The uature of grief

Although the major features of grief are known to most of
us either intuitively or through personal experience, the
chief findings of the many descriptive studies can be
summarized broadly as follows:
* grief is a complex but stereotyped response pattern that

includes such physical and psychological 'symptoms' as
withdrawal, fatigue, sleep disturbance, anxiety and loss
of appetite;
* it is elicited by a rather well-defined stimulus
situation, namely the real or imagined loss of a valued
object or role, and it is resolved when new object
relations are established;
* it is a ubiquitous phenomenon among human beings and
appears in other social species, especially higher
primates;
* it is an extremely stressful response both physically
and psychologically, but grief-related behaviour is
often antithetical to the establishment of new object
relations and hence to the alleviation of the stress.
For example, fatigue and withdrawal make it much more
difficult for the bereaved person to develop new roles
and new personal relationships in place of those lost
through bereavement.
The complexity and stress of grief is readily appreciated

when the number and nature of its components are consi-
dered. Hinton's (197Z) description of grief adumbrates the
most commonly observed characteristics: shock, denial,
anxiety, depression, guilt, anger and a wide variety of
somatic signs of anxiety. Other components include searching
behaviour, suicidal thoughts, idealization of the lost per-
son, panic, a heightened vulnerability to physical illness
and to psychological disorders.
The nature of grief as a process is emphasized by the
designation of stages by many observers and authors. Al-
though there is a sequential character to the process it
would be incorrect to anticipate an orderly progression
through the stages in all people. As with the notion of
stages in dying that was discussed earlier, the component
responses of the various stages overlap and merge into one
another. Also, there are frequent 'regressions' to earlier
stages. Again, it is better to think in terms of components,
some of which will predominate earlier in the process and
others that will predominate later. In general, three stages
or phases have been delineated and labelled according to
inclination: perhaps the best descriptive labels are shock,
despair and recovery.
Initially there may be a period of numbness and detach-
ment depending, to some extent, on the unexpectedness of
the news of the death. During this immediate response the
person may appear stoical and calm. Normal routines may
be maintained especially where domestic or other factors
384
structure the si tuation. Alternatively, the person may

appear dazed and quite unable to comprehend the reality of
the news; he may be unresponsive to his environment and in
need of care and support during this period. Whatever the
specific initial reaction in a particular instance, it can
last from a few minutes to two weeks or so, with the sto-
ical reaction being the more likely to persist longer. The
bereaved person is less able than the terminally ill to deny
successfully the reality of the situation: sooner or later,
and in many different ways, powerful and pointed signs of
the reality of loss occur, such as the empty place at table,
the empty bed or chair, the funeral or the silent house when
friends and relatives depart. As with the news of terminal
diagnosis, people need time to assimilate and to accommodate
to a new state of the world. Whether the period of shock and
disbelief is long or short, a sense of unreality or even
disbelief is likely to return periodically for several
months.
As awareness of the loss develops the person may express
anger at himself, at staff or at God for not preventing the
death. Whether or not anger is present, the phase of acute
grieving or despair is the most painful. Lindemann (1944),
in his pioneering study of bereavement, observed the follow-
ing 'symptoms' as common to all individuals suffering acute
grief: somatic distress lasting between 20 minutes and one
hour at a time, feelings of tightness in the throat, choking
with shortness of breath, muscular weakness and intense sub-
jective distress described as tension or psychological pain.
This specific response, which appears to be unique to be-
reavement, occurs against a background of stress, anxiety
and sadness or depression, together with the somatic
concomitants of these emotions.
Behaviourally, the grieving person may be unable to
maintain goal-directed activity, appearing disorganized and
unable to make plans. He may be restless, moving about in
an aimless fashion and constantly searching for something to
do. He may find himself going, unwittingly, to the places
where the dead person might be found if he were alive. A
preoccupation with the lost person creates a perceptual set
that leads to misinterpretations of ambiguous sights and
sounds as indicative of his being alive. Some grieving
people report seeing the dead person with a clarity that
goes beyond illusion and misperception. Such experiences
can occur long after the phase of acute grieving is past.
Obviously, the physical and psychological demands of this
period are heavy and it is not surprising that irritability
is common, especially when the person is eating and sleeping
poorly. Anger, frustration and resentment may be directed
at friends and neighbours irrespective of merit. Such feel-
ings may also be directed against the dead person for aban-
doning the survivor.
The intense anguish of the despair phase can be unremit-
ting, rising to peaks of distress with thoughts of the loved
one who has died. Most bereaved people seem unable to
385
prevent themselves from thinking and talking about the one

who has died even though this usually exacerbates their dis-
tress. Whether this is conceptualized as 'grief-work' or as
repeated exposure leading to habituation, it appears to be
necessary to recovery from grief. A reduction in the fre-
quency and intensity of periods of peak distress may be
the first sign that the process of recovery is beginning.
Although estimates vary, the acute despair phase of grief
typically lasts for three to ten weeks.
The process of recovery from grief is a process of
reconstruction. Although some aspects of the person's
private and public 'self' may survive bereavement relatively
unchanged, it is necessary to develop new roles, new beha-
viours and new relationships with others. Whatever else may
or may not be changed by bereavement, the survivor must
live without one important and potentially crucial personal
relationship that had existed previously: the loss of this
relationship is the loss of the psychological and practical
advantages, and disadvantages, that it conferred. Socially,
the survivor is now a widow or a widower rather than one
of a married couple: he is now a boy without a father, or
she is now a mother without a child, etc. Apart from the
direct, personal impact of such changes, they also influence
the way survivors are viewed and treated socially. The be-
reaved person has to develop a new private and public self
that enables him to live in a changed world.
Although a reduction in the frequency and intensi ty of
periods of extreme distress may herald the process of
recovery, it cannot begin in earnest until the person has
periods in which he is not overwhelmed with despair nor
preoccupied with thoughts of the one who has died. Many
bereaved people recall with clarity the moment when they
realized that they had not been preoccupied with their loss:
when, for a brief period at least, their thoughts had been
directed elsewhere and their emotions had been less nega-
tive, even positive. These moments of 'spontaneous forget-
ting', together with improvements in sleeping and appetite,
provide the person with some opportunity to reconstrue and
to reconstruct himself and his future. With less exhaustion
and a lightening of mood, decisions and actions become more
feasible and the person can begin the active process of
reviving previous relationships and activities, perhaps in a
modified form, and of developing new ones. This period of
active readjustment may never be complete, especially in the
elderly, but it usually lasts for between six and 18 months
after the phase of acute grief and despair.
Determinants of grief
Strictly speaking, it is inaccurate to talk of determinants
of grief for the available data do not allow us to identify
the causative factors that lead to variations in the res-
ponse to bereavement. However, it makes intuitive sense to
talk of determinants and is in keeping with other literature
on the topic. Parkes (1972) groups the factors of potential
386
importance according to their temporal relationship to the

event of death, that is, antecedent, concurrent and subse-
quent determinants. Among antecedent factors, the most
influential appear to be life stresses prior to bereavement,
relationship with the deceased and mode of death. On
the whole, an atypical grief response with associated
psychological problems is more likely when bereavement
occurs as one of a series of life crises, when the death is
sudden, unanticipated and untimely, and when the relation-
ship with the deceased had been one of strong attachment,
reliance or ambivalence.
A number of demographic variables (concurrent) relate
to the nature of grief. In particular, being young, female
and married to the deceased increases the likelihood of
problems arising after bereavement. Of course, these factors
are not unrelated to such antecedent factors as strong at-
tachment, reliance and untimely death. Other concurrent
factors with adverse implications are susceptibility to
grief, as evidenced by previous episodes of depression, an
inability to express emotions, lower socio-economic status
and the absence of a genuine religious faith.
The presence of religious faith might be placed more
appropriately with subsequent determinants, for its role is
likely to be one of supporting the bereaved person during
the stressful period of grief. Also, someone with an active
belief system probably will be associated with a supportive
social group, and there is little doubt that a network of
supportive social relationships is the most advantageous of
the subsequent determinants. Other subsequent factors that
have positive implications are the absence of secondary
stresses during the period of grief and the development of
new life opportunities at work and in interpersonal rela-
tionships, for instance. Again, these are more probable when
a good network of supportive social relationships exists. It
is worth recalling our earlier conclusion about the value of
such relationships in a person's adjustment to impending
death.
Among the wide range of factors that have implications
for a person's reaction to bereavement, there is most con-
troversy about the importance of anticipatory grief. As the
term implies, this refers to grief that occurs in antici-
pation of an expected death, particularly the death of a
child or a spouse. Overall, it can be concluded that younger
widows experience more intense grief, with associated
problems, than those aged 46 years or over. Sudden death
exacerbates the severity of the grief response for young
widows but not for the middle-aged or the elderly. For the
latter two groups there appears to be a small effect in the
opposite direction: that is, some symptoms of grief, espe-
cially irritabili ty, are greater after a prolonged illness
prior to death. It should be noted that the potentially
beneficial effects of anticipatory grief are not confined to
conjugal bereavement but also mitigate the response to other
losses, such as that of a child. Also, it seems possible
387
that there is an optimum period for the anticipation of

death, perhaps up to six months, after which the lengthy
dur'ltion of illness may increase stress and exhaustion and
increase the likelihood of adverse reactions in subsequent
grief.
Dlness and death after bereavement

There are clear data that reveal an elevated mortality risk
after bereavement. At all ages, bereaved persons experience
a higher risk of dying than married people of corresponding
sex and age. The increase in risk is greater for bereaved
males than females, and for both sexes, the increase is
greater at younger ages.
The elevated risk of death is concentrated particularly
in the first six months after bereavement especially for
widowers, with a further rise in the second year for widows.
The predominant causes of death are coronary thrombosis and
other arteriosclerotic or degenerative heart diseases. Most
of these causes can be seen as a result of continued stress
and a lack of self-care. In general, when the data from
replicated studies in the UK and the USA are taken together,
the risk of dying is at least doubled for widows and
widowers at all ages for a great variety of diseases.
Having briefly examined the possible psychological and
physical consequences of bereavement, and having considered
relevant predictive factors, it is important to remember
that we are talking only of probabilities. A person may be
at great risk of problems following bereavement, in the
statistical sense, and yet survive the experience well.
Another person with only favourable indicators may suffer
badly and experience severe physical or psychological
problems.
The vast majority of bereaved people, with a little help
from their friends, cope well with the experience and recon-
struct lives that are worth while in their own terms. There
are no persuasive grounds for considering the provision of
professional services for the bereaved. The most useful
strategy is to maintain some form of non-intrusive follow-up
after bereavement with ready access to an informal support
group if this should be necessary. The bereaved need some-
body who will listen when they want to talk, somebody who
will not try to push them into things before they are ready:
somebody who will support them emotionally and practically
when appropriate and just by showing that they care. This
demands an informal response rather than a professional one.
However, professional care and concern should not end with
the death of a patient: the newly bereaved person still has
a long way to go and every effort should be made to ensure
that they will have acce,s to whatever social support may be
needed.
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Falek, A. aDd Britton, S. (1974)
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Foot, P. (1978)
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Dying they live. In H. Feifel (ed.), New Meanings of
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Care of the dying. In V. Carver and P. Liddiard (eds) ,
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Ouestioas 1. How has the pattern of dying changed in the UK since the
tum of the century? What has caused these changes and
what are their consequences?
389
Z. Who should be informed of a patient's fatal prognosis?

Give reasons for your answer.
3. Summarize the most common sources of distress of the
terminally ill and their families: what are the impli-
cations of these?
4. Why do terminally ill people become depressed and how
large a problem is this?
5. How common is anxiety in terminal illness and why does
it arise?
6. What psychological problems might arise for a fatally
ill six-year-old child and his family? What steps could
be taken to mitigate these problems?
7. Why should there be growing public support for the
legalization of voluntary euthanasia and why is this not
reflected in professional attitudes?
8. What is the bereavement response and what causes it?
9. What factors are important in influencing the nature of
grief?
10. Construct a stereotypic, but detailed, character sketch
of the person most likely to cope badly with a terminal
illness: do the same for the person most likely to cope
well. Justify your answer.
11. How would you respond to a 40-year-old dentist, with
two children, who is suffering with terminal cancer,
when he asks you 'What will it be like?' What points
would you hope to cover in this and subsequent conver-
sations, and why do you consider these important?
Amlotated reading General

Kastenbaum, R.J. (1977) Death, Society and Human
Experience. St Louis, Mo.: Mosby.
Written by a psychologist, but for a general readership,
this book provides broad coverage of the psychological
and social aspects of death at a level that is readily
understood, without being unduly simplistic. Relevant
data are cited together with many illustrative examples.
A good deal of space is given to concepts of death, from
childhood to old age, and there are sections on bereave-
ment and suicide. A few exercises for students are also
included.
TermiDal illnesa and dyiDg

Hinton, J. (1972) Dying. Harmondsworth: Penguin.
This is an eminently readable book by a psychiatrist
with much practical experience of caring for the ter-
minally ill and the dying. This experience enables
Hinton to write with some authority on practical con-
siderations and to place research findings in perspec-
tive. Relevant data are cited appropriately throughout
the text and the book contains a good deal of useful
information. The best sections are upon dying and the
care of the dying and there is a concluding section on
bereavement.
390
Doyle, D. (ed.) (1979) Terminal Care. Edinburgh: Churchill-

Livingstone.
This is a collection of papers arising from a multi-
disciplinary conference. Accordingly, it provides useful
reading for a wide range of health-care professionals
including nurses, social workers and ministers of
religion. In addition to examining the roles of differ-
ent professions there are chapters on grief, domiciliary
care and primary care.
Euthanasia
Glover, J. (1977) Causing Death and Saving Lives.
This is a clear and concise consideration of the ethical
and practical problems associated with most aspects of
taking life, from abortion to euthanasia. For those who
want a brief but careful consideration of euthanasia and
those who are seeking to place euthanasia in a wider
context, this is a most valuable book.
Russell, R.O. (1977) Freedom to Die. New York: Human

Sciences Press.
Although the author examines arguments for and against
the legalization of voluntary euthanasia, the tone of
the volume is clearly in favour of this. The value of
the book lies in its uncomplicated style, broad coverage
and extensive appendices. In addition to examining the
relevant arguments, the author traces the development
of public awareness of euthanasia and attempts that have
been made to promote the practice. The appendices
include an example of the Living Will and various
legislative proposals and bills that have been proposed
in the UK and USA.
Bel'eavement
Parkes, C.M. (1972,) Bereavement. London: Tavistock.
This volume appeared in Pelican Books in 1975 and,
although it is now beginning to age, it is probably the
best single source of information on bereavement. The
reader is taken progressively through the response to
bereavement in its many manifestations and is provided
with a clear account of grief, the factors that influ-
ence this and the nature of recovery. Illustrative
examples and research findings are used throughout the
text and the book concludes with a substantial section
on helping tht:: bereaved.
Smith, K. (1978) Helping the Bereaved. London: Duckworth.

This is a short and unpretentious book aimed at a
general readership. It is valuable for its reliance on
the statements of bereaved people to convey powerfully
the experience of grief and the range of emotions and
events that commonly occur. The examples help one more
accurately to empathize with the bereaved.
PFP _ Z 391
Epilogue
E. N. Dunkin
Epilogue Man and his friendly psychologist share similar needs and
E.N.DUNKIN behaviour repertoires, with the need to explore having high
priority. While the general curiosity of Man has led him to
discover more and more about his surroundings, the psycho-
logist's curiosity has made him spend a lot of time studying
the scope of the behaviour repertoires he shares with his
fellows.
The effective growth and improvement of any profession
partly depends on the contribution of individual skilled
practitioners and partly on the ability of its teachers to
do a good job of training the newcomers. People whose daily
work is intricately involved with the behaviour of others,
and with social skills, need the pool of information on
learning, motivation, teaching and social interactions that
psychologists have amassed. The teachers and trainers of
the caring professions must use this information to give
their attempts at teaching a reasonable chance of success.
Skill in teaching must be matched with skill in planning
the training: this depends on selecting the most helpful
items from the mass of available information and on reducing
an unrealistic (if idealistic) syllabus to manageable pro-
portions. It also calls for skill in guiding the student
towards sources of existing knowledge that bear on the main
requirements of the profession.
It is impractical to leave the student to discover which
are the pertinent facts by an independent and slow pro-
gression of trial and error. It takes too long for each
learner to become a reliable practitioner, and it is not
compatible with the general way that people pass on the
accumulated knowledge in this world. If a twentieth-century
engineer sets out to overcome transport problems, he does so
equipped with the background know ledge 0 f kinetics, physics,
metallurgy, etc. He does not have to invent the wheel for
himself and find out its value in constructing a mobile
machine before he can design an improved wheel!
Given that we accept certain media of treatment (the
use of exercise in all its guises, the use of electrother-
apy, passive movements, traction, manipulation, wax baths
and hydrotherapy), we also accept that the student physio-
therapist must acquire the skills and technology associated
with these.
392
Epilogue
Given that the clients or patients referred to physio-

therapy have signs and symptoms of physical disorder, the
student physiotherapist must learn initially about the nor-
mal structures and function of the human body in order to
understand the diseases that commonly afflict the human
frame. These two needs have been agreed for a long time as
the basic requirements for professional training in physio-
therapy. However, in the early days of the profession, there
was little awareness of the emotional and social needs of
the patients. Immersed in solving the physical problems of
their patients, medical and paramedical people lost sight of
the person who had the problems in the first place. Or per-
haps they assumed that human beings were more alike than
different when it came to their psychological reactions.
Clearly this was not a considered or wise judgement. Perhaps
there was a prevailing idea that being sick or unwell acted
as a leveller and ironed out the differences between people.
Whatever the erroneous thinking or lack of thought in the
past, it is obvious that the caring professions must take up
the question of what motivates people, sick or well, and of
what reactions people make to changes in their circumstan-
ces. In physiotherapy we now see these sharing importance
with the traditional questions about the body and its
physical state.
Integration is a popular word: people are busy putting
things together in many walks of life and physiotherapists
are not alone in their re-appraisal of the basic needs of
their training. Their appreciation of the totality of people
could have caused serious overcrowding of training pro-
grammes that were already heavily committed to the physical
description of human beings, their organic disturbances and
physical means of treatment. It is only with improved
sampling techniques that such overcrowding can be avoided.
This book has had the goal of arousing your interest in
the questions to be answered. We hope it has shown you a
little of the available wealth and faScinating opportunities
for further exploration within psychology. With luck, it has
been more inviting than daunting.
393
Index
Ability tests 159 and illness 330

Abnormal behaviour 338- 352 as a motive 44,51 - 54
Abnormality and pain 354 Aphasia 141
Accents 246 - 247 Aptitude tests I 59
Accommodation 249 Arousal 52, 127 - 128, 13 I ,
Achievement motivation 44, 132, 154, 336
47-51,75 Arthritis 336
Actions, two-phase 91 - 92 Assertiveness 265
Acts, verbal 262 Assessment 25 - 26
Acupuncture 359 of the elderly 315
Adaptive behaviour 122, of learning 18 - 20
209 - 21 0,308 - 309 Assimilation 249
Adolescence 254- 257 Asthma 143,336,339,347
Adoption 21 2, 222 Attention and perception
Adult intelligence tests 104 112-113,123,140
Affective factors 72 - 74,83 Attitudes 8, 163 - 164, 261,
Ageing, demographic data on 264, 269
296- 297 Attributions 113 - 114, 346
and learning 72, 75 - 77, 276, Authoritarian behaviour 261
292 Autobiography, as psychological
and social problems 297 - 323 material 174, 185, 186
Aggression 124, 138 Autonomic nervous system
Alcoholics, and social skills 128,144
training 274 Avoidance behaviour 57
Altruism 261
Amnesia 290, 291
Anger 132,384,385 Backwardness 244 - 246
Anorexia 375 Bales' categories of social acts
Anxiety 123, 127, 130, 132, 262,263
142,145,170,269,271, Battered babies 205, 209
338,340,343,358,366, Biofeedback 145
375,376,378,379,384,385 Biography, as psychological
and age 310 material 174,185- 187
395
Index
Biological bases of behaviour Communication, with patients

121-148 230 - 232, 275 - 276
Birth abnormalities 222 - 223 and scientific methodology
Behaviour, accounts of 21 - 22 13,14, .16
biological bases of 121 - 148 Computer memory 286
Behaviourism 42-44,68 Computer models of memory
Bereavement 297,305,348, 289-290
370-371 Conation 7, 8
Blindness I 14 Concept formation 125
Blood-bond 21 I - 212 Condition 42,56, 123,
Blood pressure 339 129-131,134-135,192,
Brain, chemistry of 341, 358 233,345
evolution of I 22, 124 - 126 Concrete operations 76
and personality 132 Conformity and adolescence
Brain cell activity 122, 257
284-285,288-289 Consciousness, problem of 177
Brain-damage I 14 - liS, Construct theory 191
297 - 298, 303, 317 - 318, Controlled experiments
338,342 27-28,36
Brain research 138 - 139 Convergent thinking I 04 - I 06
Brain surgery 28 Conversational model of self 189
Coronary heart disease
Cancer 373, 375 Cortex, arousal of 127, 132
and smoking 24 lesions of 140
Cattell's theories of personality Creativity I 04 - I 06
154 Crisis and sick role 327 - 352
Cause and effect 22, 23, 25 Curiosity as a motivator 74
Central nervous system 5, 112
Change, motivation for 41, 61 Data collection 19 - 21, 30,
Child - child interaction 33-36
215-216 Death 131,370- 391
Child development 197 - 228 Deductive method 18
Child rearing 205, 21 I - 218 Defence mechanism 344
Children, fatally ill 378 - 379 Delinquency 205, 224, 274
language development of Demographic data on ageing
229-253 298-299,370
Class, social 269 Depression 132, 139,214,269,
Classroom strategies 69 310,312,316-317,341,
Cognition 7,81-84,144, 344,345,375,378,379,
267 - 268, 345 - 346 384,385
and development 206 Desensitization 273
and learning 68 Despair 385 - 386
and pain 357,360,361 Diagnosis of psychopathology
Cognitive constructs 265 339 - 340
Cognitive deficits 139, Dialects 246 - 247
303- 305 Disadvantaged children
Colour blindness I 14 206-207
Common-sense knowledge 18, Discovery method of learning
132 87-88
Commitment 270 Disease, and motor skills 94
396
Index
Disengagement and ageing Eysenck's theories of personality

305- 306 153- 154
Distress 373 - 380
Factor analysis and personality
Divergent thinking 104 - 106 169-171
Divorce 205, 224
Failure, fear of 41, 49 - 50, 72
Doctors, and patients 365
Family, and bereavement 371,
and social skills 274
372
Double bind 34 7
and the elderly 318 - JI9
Drives 4,43, 54
Fatally ill child 378 - 379
Dyadic interaction 260
Fathers, as parents 212 - 213
Dying 372-373,380-381
Fear, biochemical changes and
122
offailure 41, 49 - 50, 72
Education and self-knowledge
as a motive 56 - 57
178
Feedback 86,91-92,235,259,
EEG 144- 145
262,271,272,329
Ego 343,348
Feeding habits 6, 40 - 41
Egocentric thinking 20 I, 204,
Freudian theories, of
261
development 198
Electro-convulsive therapy 342
of motivation 62 - 63
Emotion 123,128-129,131,
of personality 150
132,261,264,266,376
of the unconscious I 77 - 178
and arousal 55 - 56
Friendship 268 - 270
and pain 354
Empathy 170, 373, 374 Gastric ulcers 142, 143
Empirical knowledge 17 Gate-control theory of pain 357
Environment I 08, I 23, I 3 I , Gaze, role of 259 - 261
180,211-217,268 Gene/behaviour interaction 146
and ageing 3 I0 - 3 I I Gestalt theory of perception
- inheritance debate 121 108- 109
and intelligence 106, 168 Goals of behaviour 258 - 260,
and learning 68 266- 267,385
and memory 283 Grammatical errors 232
and motivation 57 Grief 331,374,384- 386
and performance 55 Guilt 188,354,384
and schizophrenia 341 Guttman scale 163
and stress 135 - 137
Epilepsy 342 Handicapped children 222 - 223
Ethology I 23, 146 'Headstart' 206 - 207
Euthanasia 381 - 383 Helplessness 374,375, 378
Event-related potential 144 Hippocampus 140
Evolution, of the brain 122, Hoplelessness 383
124-126 Hospitals, children in 219
Expectations 44, 356 Hostility 187 - 188
of physiotherapists 66 Hypertension 142,143
Experience 21 - 22 Hypnosis, and memory 294
and memory 285, 286 and pain 361
Experiments, controlled 27 - 28 Hypothesis testing 34 - 35
Extraversion 73 - 74, 133, 153, Iconic systems 71 - 72, 76
169, 170, 265, 353 Id 177
397
Index
Illness, after bereavement 386 Learning, and neural activity 140

denial of 334, 372, 384 and teaching 66 - 100, I 23
and stress 330 - 333 theories of 233, 237
Illusions in perception I I I - I I 2 Lesions 141 - 142
Imagination 3 Lexis 232, 238
Incentive motivation 44,48 Life crisis 387
Individual differences 22,23, 34, Life events and illness 347 - 348
132-134,159-164 Life expectancy 370
Inductive method 18 Life-span perspective 300 - 30 I
Inheritance/environment Likert scales 163
debate 121 Linguistic structure 233
of intelligence 106 Literature and achievement 5 I
and schizophrenia 341 Lobectomy 141
Injury and motor skills 94 Long-term memory 287,
Instincts 4 292- 294
Institutions, children in Loss 372, 373, 381, 383
219- 221 in old age 308 - 309,314
and the elderly 309 - 310,
316-317 Malingering 355
Instrumental conceptualism Managers and social skills training
70-72 274
Intellectual development 207 Maslow's hierarchy of needs 44,
Intelligence 123, 265 45-47
and perception 101 - I I 7 Maternal deprivation 21 3 - 214,
Intelligence tests 101 - 104, 218
133-134,159,164-169 Maturation and learning 68
Interaction, social 125, 261, Medical model of
266, 268 - 269 psychopathology 339 - 343
Interest, as motivator 74 Medicine, psychosomatic
Interest tests 162 - 163 336- 337
Intonation 249 Memory 77 -79, 123,
Introspection 3, 106 - 108, 122, 140- 141,287,294
131 and ageing 303
Introversion 73 - 74, 133, 153 and perception 108
and ageing 305 Mental abilities 103
Intuitive beliefs 17 - 18, 20, 36 Mental handicap 342
Methodology 13 - 39
Jungian theories of personality Modelling 233, 234, 240, 272
152-153 Models, use of 35 - 37
Mood tests 161 - 162
Morphemes 237,239,250
Knowledge, nature of 80 - 84
Mortality risk after bereavement
of results 92-93
388
Korsakoff's psychosis 290 - 291
Mother - child interaction
207 - 21 I, 221 - 222, 239
Laboratory, social skills training Mothers, depression in 214
272 Motivation 4,40-65,74-75,
Language, development of 200, 86-87,129,260,376
207,229- 253 and learning 72,94, 140
Learned helplessness 375 tests of 161 - 162
398
Index
Motor skills, deficits in 231 - 232 Perception and intelligence

development of 67,90-96, 101-117
259-260 Perceptual store 288
Multiple choice questions 85, 86 Performance, and anxiety
Muscle power 93,94 51-52
and environment 55
Nature/nurture debate Performative utterances 261
125-126 Personal construct theory
Need for achievement 47 - 51, 155-156,176,181
62, 75 Personality 123, 132,
Neonatal development 199, 149- 173, 182-184
222 and ageing 305 - 307, 310
Nervous tissue, physiology of and learning 73
122 measurement of 133,
Neuromuscular damage 94 153-154,160
Neuron, transmission in 93 - 94 and pain 354 - 356
Neurophysiology, of memory Person perception 258,
288-289 265-266
of pain 357 Persuasion 258, 261
Neurosurgery 138 Phobias 41,56-57,134,344,
Neuroticism 133,153,169, 345
170,338,340,343,345 Phonology 232,237,248,250
and pain 353 Physical attractiveness 269
and social skills training 273 Physical cues 265
Non-verbal communication 125, Physical development and learning
231, 235, 244, 260 - 262, 68
264,266,269,271,276, Physical illness and stress 339
378,381 PhYSiological psychology 5,
Non-verbal memory 286 140- 142
Non-verbal tests of intelligence PhYSiology, and behaviour
165 137-138
and phobias 56
Objective behaviour 3 Physique and personality
Objective tests 85, 86 151-152
Observation and scientific Piagetian theories 66,
methodology 15 - 16 198-203,257
Operant conditioning 69 - 70, Play 124
89 - 90,203,233,260 Practice and skill acquisition
Outcomes. educational 81 - 82 90-91,93,96
Pragmatics 232, 250
Pain 41, 107, 130 - 132, Prediction, social 187 - 188
333 - 369,374,378,379, Predictive power of theories 46
381,385 Predictive validity of tests I 58
Paired-associate learning 53 Prisoners, social skills and training
Parenthood 123, 21 3 - 217 274
Passive movement and motor Private psychology 21 - 22
skills 95 Proactive interference 78 - 79
Patients, communication with Programmed learning 89 - 90
231, 275 - 276 Projective tests of personality
Pattern categorization I 08 47-48,50, ISS, 161
399
Index
Proprioceptive loss I 14 Rewards 79

Psychiatric illness 133, 355 and pain 356
Psychiatry, and physiotherapy and punishment 233 - 235, 260
335 Role and person 184 - 185,
Psychodynamic theory 188,190-191,267
343 - 344, 348, 354 Role playing 258, 262,
Psycholinguistics 250 271- 274
Psychological approaches to pain Routines, social 262
360- 364 Rules, of behaviour 258,
Psychology, definition of I - 7 258- 261
Psychometric models 171 - 172 of social situations 267
Psychopathology 338 - 352
Psychophysiology 143 - 145 Scaling 27
Psycosomatic medicine Schizophrenia 145, 339, 341,
142-143,145,336-337 345, 347 - 349
Psychosomaticproblems 123,339 Schools, social skills training in
and physiotherapy 335 274
Psychotherapy 46, 178, Scientific methodology 13 - 39
185-186,273- 274 Self-disclosure 270
Psychoticism 133, 153, 169, Self-esteem 6,46, 73, 75, 76,
170,338 269,342,345
and memory 290 - 291 and ageing 3 12 - 314
and social skills training 273 and crisis management 329
Pyschotropic drugs 358 Self-fulfilling prophecy 32
Public psychology 21 - 22 Self knowledge 6,83,
Punishment 58,354 174-194,258,382,383
Semantics 232, 248, 250
Quantification 19
Semiotic structure 267
'Received Pronunciation' Seriation I 08
246- 247 Sensitivity of perception 107
Redundancy 329 - 330 Sensitivity training 46
Reflective questions 88 Sensori-motor ability 90
Reflexes I 24 Sensory input, and ageing 304
Regression and illness 334 deficient I 14
Rehearsal and memory 283, and pain 354, 357
284, 287 Sex, and learning 72, 75 - 77
Reinforcement 43,45,57 - 61, Sexual behaviour 256 - 257,
68,70,79,91-92,234, 264, 270
260,269,356 Shock 384, 385
Reliability of psychological tests Short-term memory 140,
26,156-157 287 - 292
Relocation and ageing 309 - 310 Sick role 327 - 352
Repertory grid techniques Single-parent families 213, 224
185-186 Situational factors 131, 267
Repression 293 - 294,344 Skills 8
Research procedures 29 - 33 children's acquisition of
Results, knowledge of 92 - 93 185-186
Retroactive interference 78, 80 limits of 93 - 94
Reversal and perception 112 -113 social 258 - 280
Revision 80 Sleep - waking cycle 128
400
Index
Small group research 258 Surgical procedures for pain 359

Smoking and cancer 24,29 Symbolic function of pain 354
Social comparison 356 Symbolic mode of thinking
Social development 204, 71-72,76
206-211 Syndrome 339
Social factors and learning Syntax 232,234,238,251
75-77
Social function of language Teaching, and learning 66 - 100
236- 237 and social skills training 274
Social prediction 187 - 188 Temperament tests 160 - 161
Social problems and ageing Terminal illness 370- 391
297 - 323 Testing 26,158-159
Social relationships, T-groups 273
supportive 387 Theory, role of 20 - 21, 32 - 33
Social skills 258 - 280 Thurstone scales 163
Socio-cultural model of Tissue damage 354
psychopathology 347 Training, motor skills 260
Sociolinguistics 233, 251 and physiotherapists 95 - 96
Somatic therapy for pain social skills 258 - 280
358- 359 Trait Psychology 54, 179 - 180,
Speech formation I 25 182
Speech therapists 230 Trial and error solutions 43
Springboard questions 88, 90 Two-phase actions 91 - 92
Stage model of terminal illness
Ulcers I, 336
380
Unconscious processes 23, 36,
Standard English 246 - 247
62-63,177-178
Statistics 33 - 35
Utterances 261
and personality 153 - 154
and psychopathology 343 Validity 26 - 27,31 - 33,
Status and scientific methodology 157-158
14 Verbal behaviour 3, 83, 144,
Stereotypes 149 - ISO, 269 231,260,261,264,274,378
Stimulation 6,107, 108 Verbal guidance and motor skills
and ageing 306, 307 95
and child development 209 Verbal knowledge of results 92
Stimulus effects 108 - 109 Verbal learning experiments
Stimulus - response behaviour 282- 283
42,44,68,70-71,93-94 Verbal memory 283,284,286
Stress 123, 135 - 137, Verbal tests of intelligence 164
142-143,144 Violence 354
of bereavement 371 Visual perception problems
and illness 327 - 352 107 - 108
Study habits 79 - 80
Subjective behaviour 3 Walking, learning how to
Submaximal tourniquet technique 91-92
353 Wechsler Intelligence Scale 164
Suicidal thoughts 384 Well-being and age 310- 311,
Super-ego 177, 343 314
Surgery, cognitive strategies and Welfare for elderly 314
363, 364 Welfare system 126 - 127
401

Psychology For Physiotherapy

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Psychology For Physiotherapy

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Psychology for Professional Groups

Psychology for Physiotherapists

Series Editors: Antony J. Chapman and Anthony Gale

Psychology for Professional Groups is a new series of major

PnNisbecl with this hook

Softcover reprint ofthe hardcover 1st edition 1981

All rights reserved. No part of this publication may be

First published 1981 by THE BRITISH PSYCHOLOGICAL SOCIETY

ISBN 978-0-333-31884-3 ISBN 978-1-349-16600-8 (eBook)

The paperback version of this book is sold subject to the

Note: throughout these texts, the masculine pronouns have

The conclusions drawn and opinions expressed are those of

Throughout their training and professional life, physio-

* discuss these questions with other people;

At the same time, it is hoped that these two activities

Acknowledgement I am glad to have this opportunity of thanking Miss Jennifer

This book is one of a series, the principal aims of which

In search of a def"mition Discussions centred on psychology tend to attract general

own ideas about the meaning of the word 'psychology'. It is

America than it was in Europe, where a proportion of psycho-

Three f1Jndamental If it is difficult to set the limits of psychology and

* WHAT can a creature do?

stronger than his recollection? How could fantasy be dis-

with human beings, and they have controlled the tendency to

scope) of the medical sphere. The purpose of our studies,

* by changing the environment so that the usual time

Essentially this puts the animal and the changes in its

* general statement (WHY?): 'A creature will eat food to

If feeding is studied and the general statement on why an

modern tendency amongst psychologists to call a spade a

* cognition: action or faculty of knowledge including

From the welter of terms and areas available in psychology,

If we add to these some of the problems that human beings

Historically, psychology began as a branch of philosophy and

Nevertheless, there must be some analysis of all complex

0peaiDg remarb Scientific achievement is a phrase that has attracted grow-

Values of scieatific methodology in physiotherapy

* a standard way to evaluate the contribution made by the

* an effective means of improving self-knowledge for the

In this world, where the pursuit of science is a compelling

Need for int~fessiODal cOJllllllDrieation

treatment plan. They also need to understand the principles

ObMnatiOll aDd accurate ft:CardiDIf a necaury habit

is expressed in equivalent accuracy in recording, analysis

Scientific methodology and the student

'beginning as we mean to go on' and therefore to place an

* Is there any justification for striving for order and

Introduction Two fundamental questions that are central to all disci-

Intuitive belief contributes hugely to our views about

on how to plan observations so that the data collected are

undisciplined guidance of intuitive belief. A more construc-

The role of theory

supposed to be c!iaracterized by the careful accumulation of

Public .... pri.ate~_

some physical object under scrutiny. The potential for

human terms, one responds to the perceived meaning of an

Stages in adftDciDg kDo_ledge

possibility that data will be tainted by the theoretical

absolute certainty, this explanation can be dismissed with-

FinctiDg out Psychological enquiries have to proceed along a rather

appointing a person to a job. One most important aspect of

with them. If, however, they predict something about an

more sophisticated experimental designs, several variables