Wednesday, 30 September 2015
Recently the Guardian reported that NHS staff have been advised to apologise to patients for medical blunders. Prompted by the Mid Staffordshire care scandal, new guidance issued by the General Medical Council says that doctors, nurses and midwives must now offer a prompt apology and explanation to those injured by mistakes during treatment. But will the simple act of saying “sorry” increase public trust of NHS staff?
Thanks to social science research there is now sound, evidence-based advice on how best to deliver a successful apology. One study looked no further than newspapers for its source of information. Famous people are forever issuing public apologies in the hope of maintaining their elevated status and so researchers at Rutgers University, New Brunswick, analyzed 183 celebrity apologies issued through the media. Apologies that included elements of denial (not my fault!) and evasion (it was complicated!) did not wash well with the public. On the other hand apologies containing elements of corrective action (I’ll never do it again!) and mortification (I am ashamed of myself!) received a more favourable reception. In the wake of the Monica Lewinsky scandal, President Clinton’s admission of “personal failure” and “regret” garnered support in public polls despite mass calls for his impeachment by over 70 major media outlets including the New York Times. But when the Tea Party activist and Republican Party member Marilyn Davenport got caught emailing a racist image depicting President Obama and his parents as chimpanzees, her apology fared less well. Starting with “Fellow Americans and everyone else who has seen this email” was fine because it centred on those offended by her actions. However, her evasive ending, “I didn’t stop to think about the historic implications”, shed any credibility that had might have begun to be re-earned.
Still, the drawback in studying celebrity apologies is the difficulty in gauguing how the popularity of the person in question might have influenced the public reaction. Researchers at Germany’s Catholic University Eichstaett-Ingolstadt instead looked at how people would rate apologies for bad service delivered by an anonymous restaurant waitress. Volunteers watched a film depicting a couple visiting a hotel restaurant. As the meal unfolded it became apparent that this particular establishment was more Fawlty Towers than Claridge’s. The service got ever-slower and when food did eventually make it onto the table it was burned beyond recognition. Different versions of the film showed the waitress returning and apologising but with subtle alterations in how she expressed it. The apology was sometimes more and sometimes less intense (“I’m really sorry”, as opposed to “I’m sorry”), more or less empathic (adding or leaving out “I feel very uncomfortable about it”) and more or less timely (apologising the moment the problem occurred compared with at the end of the meal). In some instances there was no apology at all. Satisfaction was rated higher for apologies that were more intense, empathic and timely. Apologies that were lackadaisical, unsympathetic and late garnered lower levels of satisfaction, and indeed these weak efforts were equivalent to no apology at all. Where apologies are concerned it’s not what you do it’s the way that you do it.
Together these studies show that if NHS staff understand how to construct an effective apology then this could be a good way to increase rapport with patients. Apologies that profer regret, promise corrective action, and are delivered early, with intensity and genuine sympathy can make amends for mistakes and other problems encountered by health service users. But why stop there?
A fascinating Harvard Business School study has shown that apologising for things that aren’t your fault (known as a superfluous apology) can also be an excellent means of garnering trust. This study entailed a researcher in a busy train station asking members of the public if he could borrow their mobile phone. It was a wet November day and on some occasions he began by saying “I’m so sorry about the rain”. When the request began with the superfluous apology 47% of people approached handed over their phones compared with just 9% when asked outright without mentioning the inclement weather. Apologising for something for which they were not responsible made many people trust a stranger sufficiently so that they would hand over an expensive personal item to him. Saying sorry about the rain acknowledges and expresses regret for the other person’s adverse perspective (being made uncomfortable by getting wet) even when the person speaking those words was in no way responsible for that adversity.
Based on these studies the NHS could benefit from directing its staff to apologise not just for their own mistakes but for all manner of things – the weather, the government, diesel car emissions – literally anything. Expressed with conviction, empathy and in good time Bevan’s National Health Service could apologise itself to an assured and sustainable future. Oh hang on, sorry, have I taken this too far?
Tuesday, 21 January 2014
John Calvin Coolidge Jr. was the 30th United States president, holding office from 1923 to 1929. He came to prominence as the Governor of Massachusetts when he ended the 1919 Boston police strike by publicly supporting his Police Commissioner’s orders for three quarters of the police force to be sacked. Coolidge's presidency steered the US through the period of unprecedented economic growth that became known as the roaring twenties. A renowned leader whose reputation has remained strong to this day, one of Coolidge's more obscure legacies was the lending of his name to a psycho-biological phenomenon – thanks to a singularly trivial event.
The story goes that President Coolidge and his wife were being shown around a farm. For some reason they became separated, viewing different parts of the farm at different times. At the chicken yard, Mrs Coolidge observed a rooster mating very actively and asked how often this occurred. She was surprised to hear it was dozens of times a day and joked that the staff should tell the president when he came by. When the president's party later arrived, the farm staff duly recounted his wife's observations concerning the rooster. President Coolidge demonstrated a keen sharpness of mind when he asked the simple but revealing question of whether the cock was mating with the same hen every time. On hearing to the contrary the President suggested the staff might mention that to Mrs. Coolidge.
The Coolidge Effect, named after the 30th President of the United States, is concerned not with industrial relations, economics or outstanding leadership. Rather, it concerns an aspect of sexual behaviour. Specifically speaking, it denotes the observation, which holds for many species, that males will be more eager to mate with a new female, as opposed to one that is familiar. In technical terms, males have been found to display a shorter refractory period (that is, the time between one copulating session and the next) if a new partner becomes available. The research underlying the Coolidge Effect was written up by scientists from the University of California in a paper published in 1963.
The study falls fairly and squarely in the field of experimental psychology, such that several similar scenarios were set up and different behaviours were observed, counted and compared across these different conditions. The particular behaviour under observation was rats having sex. Male rats were required to pass a simple test in order to be selected for the study. They were placed with a female on heat for half an hour and those that copulated to ejaculation a minimum of two times were chosen. Interestingly, how the researchers were able to detect the occurrence of a rat ejaculation I can scarcely imagine, and sadly the paper doesn't explain. Maybe a reader of this blog could enlighten the rest of us!
For the main experiment male rats were paired up with females on heat and allowed to mate until they stopped for at least 30 minutes, at which point they were declared to be sexually exhausted. Then the female was removed. Next, some of the males were introduced to a new on-heat female while others were re-introduced to the same on-heat female that they had reached sexual exhaustion with. Sexual activity during the re-introduction phase was measured, in particular the number of times the female was mounted and the percentage of male rats achieving first and second ejaculations.
At first nothing in the rats’ behaviour was untoward. The number of mountings and first ejaculations was similar whether or not a new female was reintroduced. However, none of the rats re-introduced to the original partner ejaculated for a second time, whereas several of the rats with new partners did enjoy what might be termed a "second coming". In addition, three male rats that were not at all interested in a re-introduced familiar female changed their tune and were seen to copulate with a new partner introduced later in an additional phase of the experiment. Final evidence for the Coolidge effect was an observation made among rats that copulated in a further re-introduction phase. When the partner was new 86% of males achieved ejaculation, a much higher proportion than the 33% managing this when the same partner was reintroduced.
So there is the evidence for the Coolidge Effect. It was based on the finding that male rats become more interested in sex with a new partner rather than an existing mate. But what does it mean? Why might it exist? It is probably easiest to understand from the perspective of evolution, that is, by considering the benefits to the continuation of the species. The evolutionary advantage of the Coolidge Effect is that it encourages a wider circle of copulation partners, so increasing the chances of pregnancy and procreation. Think of it as Nature's way of guarding against putting all your eggs in the same basket, as the old saying goes.
This paper is a worthy addition to the Cool Psychology Blog for several reasons. For one thing, it’s cool for rat ejaculations to be used as a variable in a psychology experiment. It just is. Also this would have been a fascinating experiment to run on a day-to-day basis – for instance, I wonder if any of the rats gained particular reputations for their prowess (or lack of). It's fairly well known that psychologists are fascinated by many different aspects of behaviour but who knew this stretched to an interest in rats having sex? On the other hand, you could say that the research is somewhat sexist. In the narrative only the males seem to be active participants in the mounting, copulating and ejaculating. It takes two to tango so it is likely that the females were more active than portrayed.
This line of research is still ongoing, but has grown in sophistication. A Mexican team published a Coolidge Effect paper in 2012 that measured sperm count and erection occurrence as well as the number of mounts and ejaculations. While evidence for the Coolidge Effect was apparent, still this recent paper doesn’t reflect societal trends towards sexual equality – it is still all about the males, with the female rats considered as passive sexual partners. On the other hand, a paper from the mid-1980s did show evidence of a Coolidge Effect in female hamsters re-introduced to the same or a new male partner.
The reference to the original research described in this blog that lead to the coining of the term “The Coolidge Effect” is included below. Unfortunately the article is copyright protected and so only available at libraries that pay to subscribe to it – for example university libraries. This link takes you to the paper’s official web page where you can read a short summary.
Lester, G.L. & Gorzalka, B.B. (1988). Effect of novel and familiar mating partners on the duration of sexual receptivity in the female hamster. Behavioral & Neural Biology 49, 398-405.
Tlachi-Lópeza, J.L., Eguibarb, J.R., Fernández-Guastic, A. & Luciod, R.A. (2012). Copulation and ejaculation in male rats under sexual satiety and the Coolidge effect. Physiology & Behavior 106, 626–630.
Wilson, J.R., Kuehn, R.E. & Beach, F.A. (1963). Modification in the sexual behavior of male rats produced by changing the stimulus female. Journal of Comparative and Physiological Psychology 56, 636-644.
Tuesday, 2 July 2013
Happiness is defined by psychologists as the frequent experience of positive emotions, such as joy, interest and pride (see Lyubomirsky, King & Diener, 2005, listed below). A series of studies carried out by psychologists has assessed the popular belief that the weather can affect happiness and mood. These studies arose from everyday observations of people declaring how depressing they find the weather on a rainy day, or how uplifted they feel during a sustained spell of sunshine. Psychologists have applied a scientific approach to the investigation of how weather and mood might be related. To be scientific requires taking objective measurements of people’s mood and mapping that against an accurate record of the meteorological conditions at the time. When such an approach is taken, the relationship between weather conditions and happiness is rather a weak one.
A typical study was carried out recently by some Dutch psychologists (see Klimstra and colleagues, 2011, listed below). The happiness of over 800 volunteers was measured by having them rate three statements about their mood, e.g. “I feel content”, on a scale from “not at all” to “very much”. They did this several times over a 17 month period. For each day on which a questionnaire was completed, information was obtained from the Royal Netherlands Meteorological Institute on average temperature, hours of rainfall and hours of sunshine.
When the questionnaire responses were compared with the meteorological data, there was little correspondence between them. For half the participants, happiness was completely unaffected by sunshine, rainfall and temperature. For the other half of participants the relationships were more complicated, with some people being found to be more happy in typically summery weather, but others being found to be less happy in the same conditions. Even here, though, the relationships were not that strong with the greatest amount to which the weather influenced happiness being no more than 15%.
These findings, and similar ones from other studies, suggest that the relationship between the weather and our happiness is much less important than people think. Why might this be? One explanation is that a “focussing illusion” occurs (see Schkade & Kahneman, 1998, listed below). The illusion is such that in the depths of winter we imagine an idealised hot sunny day and focus on the differences, e.g. warmth rather than cold, and sunlight rather than cloud. In focussing on these differences we forget that a real-life hot summer day might include negative as well as positive features - such as having to go to work, child supervision, feeling too hot, and so on. Focussing on ideal examples rather than realistic ones makes us overestimate the extent to which warm sunny days will make us feel happy.
The generally held belief of a strong association between summer weather and happiness does not stand up to scientific scrutiny. Nevertheless, many people believe such a link exists, and therefore the connection between summer weather and happiness is a powerful psychological idea. The potency of such ideas should not be underestimated. After all, the placebo pill contains no drug and yet has been seen to be an effective treatment for a range of medical conditions (Eccles, 2002). A summer mind-set is likely to be a far more valuable asset in the pursuit of positive mood and happiness than summer weather itself.
Eccles, R. (2002). The powerful placebo in cough studies? Pulmonary Pharmacology & Therapeutics 15; 303-308.
Klimstra, T.A., Frijns, T., Keijsers, L., Denissen, J.J.A., Raaijmakers, Q.A.W., van Aken, M.A.G., Koot, H.M., van Lier, P.A.C. & Meeus, W.H.J. (2011). Come rain or come shine: Individual differences in how weather affects mood. Emotion 11, 1495-1499.
Lyubomirsky, S, King, L. & Diener, E. (2005). The benefits of frequent positive affect: Does happiness lead to success? Bulletin 131, 803-855.