How to use this Page

Cassie, Publicity

Anthony Scioli is Professor of Clinical Psychology at Keene State College. Henry Biller is Professor of Clinical Psychology at the University of Rhode Island. Their new book, Hope in the Age of Anxiety, is a look at how we can be happy and healthy in a world filled with economic collapse, natural disasters, poverty, and the constant threat of terrorism. In this excerpt, they look at how finding meaning can positively affect your health.

What is meaning in life? Many lengthy philosophical essays have been written on this topic, but one of the most compelling descriptions can be found in a pithy five-page article written by philosopher Robert Baird. In Meaning in Life: Created or Discovered, Baird reduced the meaning-making process to three essential life tasks: cultivating depth and quality in your relationships, committing yourself to projects and goals, and fashioning stories that place your life in an ultimate context. Note that, once again, the big things in life come down to attachment, mastery, and survival, or in other words, hope. Perhaps this is why theologian Emil Brunner proclaimed: “What oxygen is to the lungs, such is hope to the meaning of life.”

Meaning in life is both a destination and a vehicle. As a destination, a meaningful life can be viewed as a desired end state or goal: every human being has a need to lead a life that makes sense to him or her on a personal level. As a vehicle, meaning making can pave the way to better health: being fully engaged in the flow of life and having a deep sense of purpose can make you more resistant to illness and extend your life. In both senses, the personal meaning in one’s life, like a potentially effective exercise program, usually requires some adjustment if it is to be sustained over time, and for many, that adjustment includes the incorporation of established traditions such as religious faith. But regardless, the meaning that one finds in life supports health because it solidifies hope.

Meaning as a health destination. Meaning is hardly a luxury item for a social animal endowed with prominent frontal lobes and a keen sense of future survival. Meaning is basic to human life. No amount of money or power can take its place. If these earthly gains sufficed, we would never see many of those who have them in spades destroy themselves with drugs, eating disorders, or other self-destructive behaviors. Horace Greeley put it well, “Fame is a vapor, popularity an accident . . . riches take wings.”

Meaning as a vehicle to better health. Individuals infused with meaning are well anchored. They have strong relationships, a potent sense of mastery, and an unwavering sense of purpose. In short, they are brimming with hope. What are the health benefits of such deep centeredness? Psychiatrist Viktor Frankl observed that those of his fellow prisoners at Auschwitz who were able to sustain some sense of purpose were less likely to succumb to illness. More than even food or medical care, a meaning-oriented outlook preserved the immune systems of these survivors.

Psychologist Carol Ryff has been among those who believe that meaning and purpose in life reduces allostatic load, the wear and tear of biological reactivity to stress. To the extent that spiritual beliefs impart meaning, this may be why high religious involvement tends to be associated with fewer cardiovascular crises and greater longevity. In a sense, the meaning-centered individual is less likely to be tossed adrift by what Shakespeare dubbed the “slings and arrows of outrageous fortune.”

Ryff and her colleagues tested the meaning hypothesis by studying 134 women, ages 61 to 91. They assessed both hedonic (joy and happiness) and eudaimonic well-being (meaning and purpose). Greater meaning and purpose, rather than more joy and happiness, emerged as the better health predictor. Specifically, those who reported greater eudaimonic well-being had lower levels of stress hormones and inflammatory cytokines as well as higher levels of HDL (”good” cholesterol). They also had a healthier body mass index.

The ability to derive meaning is also important for those already diagnosed with a serious illness. Denise Bowes of Dalhousie University in Nova Scotia and her colleagues conducted detailed interviews of nine women diagnosed with ovarian cancer. “Hope” and “finding meaning” were the two most important factors that determined perceived well-being. As one woman put it, “If you don’t have hope, then you don’t have anything really.”

The role of meaning as an illness buffer seems to be especially important for older individuals. One of us (A. S.), in collaboration with psychologist David McClelland, explored the impact of derived meaning, chronic illness, and age on reported morale in 80 younger (25 to 40) and 80 older (65 to 80) adults. The findings were fascinating. Older individuals were better able to derive meaning from experiences with illness than their younger counterparts. In addition, despite reporting twice as many chronic illnesses as the younger group, the older adults had significantly higher levels of morale. What accounted for this surprising finding? It appeared to be derived meaning. Among older adults, meaning was the strongest predictor of morale, exceeding by a factor of ten to one both the importance of age and the number or severity of chronic illnesses.

Baroness Mary Warnock is a philosopher renowned for her writing on moral issues. Previously a Fellow and Tutor in Philosophy at St Hugh’s College, Oxford, and Mistress of Girton College, Cambridge, she is now an Independent Life Peer in the House of Lords, and a writer and broadcaster. Elisabeth Macdonald has spent her career working in cancer medicine in the UK as well as periods as a Consultant Oncologist in France and in research at Stanford University, California. Their book, Easeful Death: Is There a Case for Assisted Dying?, is publishing in paperback in March, and you can read their previous blog post here. The following is an excerpt about the medical perspective of assisted death.

Doctors in general are of a conservative turn of mind when contemplating decisions involving their patients. Medicine is a discipline in which taking risks with patient welfare is almost never justified and doctors, even those trained to model their care on the latest evidence-based research, are not easily persuaded to change a long established policy. It is not surprising that the contemplation of such profoundly serious changes of practice as assisted suicide and euthanasia has led to controversy, disagreement, and fierce professional debate. Doctors are currently forbidden, like every other citizen, to end human life. There is no legal indulgence conferred by a medical or nursing qualification.

So what attitudes do these professionals express when discussing the interests of patients in grave distress who seek medical aid to end their lives? In medical ethics much discussion centres on the difference between ‘killing’ and ‘letting die’. For many people it seems important to distinguish between killing and letting die and to prohibit the former while authorizing the latter in certain cases. In the past the distinction was sometimes, not very helpfully, referred to as that between ‘active’ and ‘passive’ euthanasia. In recent years, however, the distinction between killing and letting die has become blurred. For example, switching off a respiratory-support machine could be interpreted as actively terminating a patient’s life. Alternatively this act may be seen as withdrawing the artificial means maintaining a life which is already unsustainable by the individual alone. In other words this act discontinues an artificial circulation in a patient who is actually already dead (letting die).

We would contend that there is no morally relevant difference between killing someone and allowing him to die. A well-known example cited in medical ethics describes two young men, each of whom want their 6-year-old cousin to die in order that they can gain a large inheritance. Smith drowns his cousin while the boy is taking a bath. Jones plans to drown his cousin, but as he enters the bathroom he sees the boy slip and hit his head: Jones stands by doing nothing while the boy drowns.

Smith killed his cousin: Jones merely allowed his cousin to die. Both of these acts are clearly reprehensible but do demonstrate that the distinction between killing and letting die is morally irrelevant. Moreover, someone who starves another person to death is as guilty of murder as someone who poisons that person. The person who allows a fellow human being to die of hunger is as morally guilty as someone who acts to poison him. The difference lies in the more obvious and direct causal implications of the verb ‘to kill’. Killing, like pushing or pulling, kicking or smashing, is manifestly doing something to produce a certain effect. John Stuart Mill insisted that a cause is not necessarily an ‘active intervention’. The failure of the guards to patrol the walls may cause the fall of the city. Yet people may still instinctively feel that failing to do something is less causal than killing them. It is less ‘hands on’. It is after all doing nothing, and may therefore seem to be incapable of producing any effect. Ex nihilo nihil fit. Moreover, ‘to kill’ is a verb that contains a record of its own success. If I kill you, you are dead; whereas if I, say, fail to feed you, there is room for another event to come along either to save or to dispatch you. There is space for what the lawyers call novus actus interveniens.

A case that illustrates the medical abhorrence of active intervention to bring about death was that of a 40-year-old woman known only as Ms B. In 2001 she suffered a burst blood vessel in her neck and became totally paralysed. She was kept alive on a ventilator for a year, her brain unaffected. When the year was up, she asked that she might get someone to switch off the ventilator at a time of her choice, when she felt she had had enough. The hospital authorities refused, and one of the doctors involved was reported as saying: ‘She is asking us to kill her, and this we would not like to do’. Ms B appealed to the courts, and a court was convened round her bed. The judge, Lady Butler-Sloss found that she was suffering from no mental incapacity, and that it would be lawful for the hospital to grant her request. They still repeated that they could not kill her, even if it would be a lawful act. So Ms B was moved to another, less squeamish hospital, where in due course she asked for the ventilator to be switched off and she died.

Thus, doctors are profoundly suspicious of any action which may be classified as killing; and this is partly, we believe, because of the emotive violence contained within the very word ‘killing’. This word carries with it images of battlefields or grisly car accidents. These images are far removed from the scene of calm, caring, easeful, and timely death that is the ideal we would all wish eventually for ourselves.

Max Fink, M.D., is Professor of Psychiatry and Neurology Emeritus at State University of New York at Stony Brook. He is the author of Electroconvulsive Therapy: A Guide for Professionals and Their Patients, the latest guide to ECT. It carefully explains where in the course of an illness ECT is best considered, what will take place, the necessity of voluntary consent, and how the treatment works. In this post, Dr. Fink looks at why electroconvulsive therapy is making a comeback.

Soon to celebrate its 75th birthday, electroconvulsive therapy (ECT, electroshock) is undergoing world-wide revival despite its negative image. Its efficacy in treating medication treatment failures, especially in patients with melancholic depression, bipolar disorder, psychosis, and suicide risk encourages its use. It also helps that the present ECT methods are safe and that scientists have developed a better understanding of its mechanism.

Developed in the 1930s, electroshock therapy was widely used and was effective in reducing the thousands of patients hospitalized in the state asylums throughout America. The medications introduced in the 1950s curtailed usage of ECT, but as more and more patients failed to improve and “therapy resistance” became a watchword in clinical practice, interest in ECT revived.

Much has changed in the clinical practice from the treatment without anesthesia, oxygen, and muscle relaxation that mark present practice. Permanent losses of personal memories are no longer a feature of modern practice. Indeed, the treatment is widely endorsed and a review shows that it meets the standards of ethical medical care.

Many have argued that doctors should not be applying a treatment whose mechanism is unknown. The patients who respond best are those with abnormal endocrine physiology. We now understand that ECT liberates brain hormones that regulate the body functions that are abnormal—sleep, appetite, mood, thought, motor activity—and these releases are essential to effective treatment.

The limitations of medication treatments for depression, mania, and schizophrenia demonstrated in recent large scale governmental studies and the reports of efficacy of ECT support this revival. The increased interest is world-wide and has broken some national barriers that restricted the use of ECT in some countries.

Max Fink, M.D., is Professor of Psychiatry and Neurology Emeritus at State University of New York at Stony Brook. He is the author of Electroconvulsive Therapy: A Guide for Professionals and Their Patients. The book tackles such questions as: For whom is electroshock effective? How is it administered? What are its risks? How long does the treatment take? Is it a cure? In this post, Dr. Fink explains what, exactly, electroconvulsive therapy is.

Long a mystery among psychiatric treatments, electroconvulsive therapy (ECT, electroshock) has revealed some of its features to science. Interest in ECT revived after its denigration in the 1970s and 1980s by its continuing success in relieving melancholic depression and bipolar disorder, especially in the large numbers of “medication resistant” patients who suffer chronic debilitation despite extensive courses of medications and psychotherapy. In such patients ECT is effective and safe, especially with present methods of treatment, oxygenation, and muscle relaxation.

The patients successfully treated with ECT are those with severe mood disorder, loss of appetite, weight, and sleep, a preoccupation with death, hopelessness, helplessness, and motor retardation, agitation or catatonia. These symptoms are understood as a failure in the body’s hormone regulatory system, especially in the functions of the thyroid, adrenal, and sex glands. Interestingly, the control of these glands resides the brain’s central glands of hypothalamus and pituitary, structures in the middle of the brain.

ECT stimulates the brain’s central glands directly, either by electricity or chemicals, that produce brain seizures (similar to spontaneous epileptic seizures). Electricity alone, without the seizure, is not clinically useful although occasionally recommended as “brain stimulation” without seizures.

With the seizure the brain’s glands release their hormones into the brain’s own circulating system and into the blood stream, effectively stimulating all the glands of the body. The hormone systems are temporarily normalized. To achieve a long lasting effect, the treatments must be repeated over many weeks, and occasionally over months.

Craig Anderson, Distinguished Professor of Psychology at Iowa State University, is well known for his research on the effects of media violence. His research on aggression, media violence, depression, and social judgment has had a profound influence on psychological theory and modern society. Karen Dill is Associate Professor of Psychology at Lenoir-Rhyne College, and has the honor of having a car named after her in Grand Theft Auto IV. Here, they talk about the effects of video game violence on children and adolescents.

Transcript after the jump.
Lori Handleman (OUP Editor): I’d like to welcome Dr. Craig Anderson and Dr. Karen Dill to the podcast. Craig is distinguished professor of psychology at Iowa State University, and is widely regarded as the foremost expert on the effects of violent video games. He is the author of Violent Video Game Effects on Children and Adolescents, published by Oxford University Press in 2007.

Karen is associate professor of psychology at Lenoir-Rhyne in Hickory, North Carolina. Her dissertation, co-authored with Craig, is the single most-cited research paper on the effects of video game violence. Karen is currently writing a book for Oxford University Press on the social psychology of the mass media, titled When Fantasy Becomes Reality. Craig, Karen, welcome.

ANDERSON: Thank you.

DILL: Thanks Lori. Hi Craig.

ANDERSON: Hi Karen, good to talk to you.

DILL: Good to talk to you too. I thought I would begin with just telling a little story about how we know each other.

ANDERSON: Sure

DILL: When I was 19, if you’ll recall, way back in those days (of course it was only a couple years ago), I first met Craig. He was teaching social psychology at the University of Missouri, and I started doing some research work with you as you remember on temperature and aggression. And I recall that my good friend called me across the hall into her dorm room and showed me her social psychology book and said “Hey, that guy you’re working for, he’s famous!” So I thought, oh, really? But now I know it’s true. I know we want to have a sort of broader conversation about media psychology today, so I thought I’d start with a question about that.

ANDERSON: Sure, okay.

DILL: As a media psychologist, there are a lot of people out there, and I know I encounter them all the time, as do you, who are really resistant to believing that media violence even can cause aggression. Can you talk about why you think that might be true?

ANDERSON: Yes, I think there are a number of reasons. The media industry themselves, of course, have a huge profit motive, and that certainly plays a big role in their attempts to discredit the research. You know, gamers themselves, I think there are a number of things that enter into their resistance. First of all, people in general don’t like to believe they can be affected by anything, especially anything as trivial as TV shows, or movies, or video games. So there’s just a general resistance to belief that we’re being affected by outside forces. Then I guess there’s one other sort of overriding thing that influences parents as well as people in the media industries, the people who create violent games or violent media, people who distribute them and sell them, and it’s actually a kind of cognitive dissonance kind of thing. You know, most people think of themselves and they think, “I’m a good person, I don’t do things to harm children,” yet they’re producing these violent games, or they’re selling them or renting them to kids. So there’s this other sort of cognition floating around of gee, if it’s true that these things are harmful, then I’ve harmed children, and that’s very, very uncomfortable. The easy way out of that discomfort is to decide that the research is wrong and that there aren’t harmful effects, and I’m still a good person even though I’m selling these bloody things to children all the time.

DILL: Yeah, absolutely. And that makes our jobs, as media psychologists, difficult, and I want to talk about that more a little bit later. I’m sure you and I have both sat in audiences with teenage boys glaring at us, not enjoying our talks in any way.

ANDERSON: Right.

DILL: People do try to deny it, but it is there for those who can see it. Do you think there’s any way to convince somebody who’s resistant to believing in the research that media violence affects are real?

ANDERSON: Yeah, that’s a good question. I’ve had an email exchange, fairly recently, with a die-hard gamer. I usually don’t get into these exchanges because they’re usually pretty pointless. This one had an interesting twist to it; this young man, he’s in his late teens. After some initial sort of give and take on the email, he apparently set up either a video camera or a webcam, he didn’t say which, but basically recorded himself while he was playing one of his favorite violent games, and then went back and watched the recording. He said “I had no idea I was swearing that much at the game,” and he said “my facial expressions, I looked incredibly angry, I had no perception while I was playing the game, that this is what I was doing.”

DILL: That’s such a rare person. When people do that, I’m always impressed because it’s hard to get over all those barriers that you mentioned.

ANDERSON: Exactly. And I found that kind of interesting. But you know, for the more general kind of resistance, certainly I think there are going to be people who just can’t possibly accept that there might be harmful effects. That’s unfortunate, but you know, that’s the way it is.

DILL: I want to talk a little about some broader media issues. I know that you do a lot of work on media violence, but I’m curious to hear you talk a little bit about what might be some fundamental and important ways people are just affected by exposure to the mass media in general.

ANDERSON: Well, I think most people underestimate how big an impact mass media in general have. If you look at how many hours a week most people spend watching television or movies or playing video games or, more recently, just on the internet. I mean, that’s where we get our information, is from the mass media, and when the messages tend to be very similar, that is there’s an awful lot of violence, and of course in the United States and I think in most modern countries as well, an awful lot of consumer messages out there, those tend to shape our values, our beliefs about what’s possible, our beliefs about what’s appropriate. And I think that has implications for society in general.

DILL: Sometimes I think about these reality shows, and I think that if someone taped a reality show of your average American, it would just be someone sitting on the sofa or looking at their computer screen. It wouldn’t be very interesting.

ANDERSON: That’s true, that’s true.

DILL: Do you think scientists should try to advocate for the positions suggested by their research? Should we get more involved in the policy making?

ANDERSON: That’s a good question. I know psychologists have wrestled with that periodically. I guess my feeling at this point is that we have a responsibility to provide, as clearly as possible, factual information gained from our research studies. We should provide that information to any group, any individual, who seeks it out, who wants it. In terms of actually becoming an advocate for specific policies, I personally have tried to stay away from that aspect. In part because I’m not really a public policy person, and in part because I’m afraid that if I start advocating for a particular policy, that that will somehow detract from my ability, my perceived ability, to act as a scientific expert. I think we do have a responsibility to society in general to say “Okay, here’s what the research says. Here’s what the research doesn’t say. Here’s where we need more research in order to be able to answer questions that are of importance to modern society.”

DILL: There’s a lot of myths that people do believe about media violence that are going around out there, and I think that these are used to make those kinds of arguments. Can you tell us about some of the myths and talk about why they are myths?

ANDERSON: Yes, yes. I’m sure both of us have heard many of the same ones over and over in different contexts. Some of the more common ones are, for example: only some kids are affected. That comes out in several forms: only boys are affected, or only children, young children, are affected, or only those who are already aggressive, only aggressive kids are affected by media violence. And I’ve even heard the extreme version—only those sick psychopathic few are affected. And of course, that’s just not true. As you well know, the research evidence seems to indicate that basically every group, any kind of categorization scheme you can come up with seems to suffer some harmful effects of exposure to media violence. There’s certainly considerable debate within the field about whether some groups might be more harmed than others, and there’s some reason to think that might be true, but there’s certainly no evidence that only a few are affected. I think that’s one of the real big ones. And you hear that a lot from parents too, I’m sure you do as well. “Well, my kid isn’t going to be affected.” Along those same lines is the myth that if your child or adolescent or even adult is at a cognitive stage where they can distinguish fantasy from reality, that they know it’s a game, that it won’t have a negative impact on them. We also know that that’s a myth. It’s just not true.

DILL: What are some of the most common reactions you get when you’re speaking? And I know it differs depending on who the audience is that we’re talking about here, but could you talk a little bit about that?

ANDERSON: Well, for some, basically for non-gamers, I get two kinds of shock reactions. One is they’re shocked at the content. I show them brief clips from modern games and they’re just appalled. They had no idea what is out there and what is commonly being played by children and adolescents.

DILL: Yes, I’ve seen whole rooms of people turn kind of ghostly white after seeing some of those game scenes.

ANDERSON: Yes, exactly. In fact, I’ve started warning my audience on occasion and started scanning my audiences to be sure there aren’t underage kids in there before I show some of the clips that are common from games. The other form of shock I get, especially from people who aren’t gamers, is they’re shocked at how strong the research data are. They had no idea about how many studies have been done and how consistent the results are across different kinds of studies, across different countries. It’s like they sort of expected gee, if the research is that clear, they would have seen it in the news. And they haven’t seen it in the news. That’s a fairly common reaction. And the gamers in the audience, and of course a larger and larger portion of the audiences now are gamers. So for example, I recently gave a couple talks that were largely undergraduate students in the audience, and a lot of the gamers in that audience first of all seemed panicked by this. You know, they’re very threatened by the idea that there might be some harmful affects and they immediately engage in this alternative search for explanations, and they’re usually the same alternative explanations that we’ve ruled out again and again.

DILL: That really shows just how motivated people are, that there’s a powerful psychology going on there. It’s just not the one that they think. Now, I know we have a time limit here and I’m enjoying this conversation and wish it could on longer but I have one more question for you. This is not easy to do in a short program like this, but if you had some parting words for the parents out there, because I know that there are a lot of parents who are concerned when they hear these things and they want to know well, what should good parents do in this situation. Do you have some advice?

ANDERSON: Yes, what I’ve been telling parents recently is first of all, young children, if they’re say two years or younger, shouldn’t have any screen time at all, whether it’s TV, video games, movies, whether it’s non violent. There is growing research literature suggesting that screen time for kids that young may well be associated later with attention deficit problems and school performance problems. They shouldn’t have any screen time. Another thing I’d tell people is there shouldn’t be any TV, computer, video games that kind of stuff in the child’s bedroom. The reason for that is if it’s in the bedroom, it’s very hard for parents to monitor how long a child watching TV, for example, or playing video games, as well as it’s very hard to monitor the content. So the TVs, video games, all that should be in public space, where it’s relatively easy for a parent, while they’re doing other things around the house, just to walk by. A third thing I tell people is that you really need to control your child’s media diet in the same way that you would control their food diet. We really don’t want children growing up on potato chips and soda, so why would you want them growing up on sort of junk media? You need to be actively involved in your child’s media choices and media use. You need to talk to them about what kind of behaviors are appropriate or inappropriate, so if they are watching a TV show or playing a game that has some violence in it, if a parent talks to them about how those are unrealistic portrayals, and this is not really the way we solve problems—all this has to be age appropriate of course—but those kinds of discussions seem to help. And then finally I suggest a simple thing, but one that takes time, is, you know, reading to kids is really very good for them, and as they get a little bit older, having them read to you is good for them in multiple ways. So I guess that’s my parting advice: more reading, less screen time, and what screen time they have should be carefully monitored and controlled by the parents.

DILL: That’s great advice.

Lori: Well, thank you so much, Craig and Karen, for such a fascinating discussion. I know our podcast listeners are going to enjoy this and take a great deal of information away. We look forward to reading and hearing more about your important work in the future.

DILL, ANDERSON: Thank you.

ShareThis