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Wish you were here? Christian Jarrett on the psychology of holidays

Incorporating Psychologist Appointments ÂŁ5 or free to members of The British Psychological Society

letters 558 big picture centre careers 610 looking back 622

deception in psychological research 580 coach your cortex 586 working on an acute medical ward 592 interview with Alex Haslam 596


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The British Psychological Society Contact The British Psychological Society St Andrews House 48 Princess Road East Leicester LE1 7DR tel 0116 254 9568 fax 0116 227 1314

Welcome to The Psychologist, the monthly publication of The British Psychological Society. It provides a forum for communication, discussion and controversy among all members of the Society, and aims to fulfil the main object of the Royal Charter, ‘to promote the advancement and diffusion of a knowledge of psychology pure and applied’. It is supported by www.thepsychologist.org.uk, where you can view this month’s issue, search the archive, listen, debate, contribute, subscribe, advertise, and more.

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Associate Editors Articles Vaughan Bell, Kate Cavanagh, Harriet Gross, Marc Jones, Rebecca Knibb, Charlie Lewis, Wendy Morgan, Tom Stafford, Miles Thomas, Monica Whitty, Jill Wilkinson, Barry Winter Conferences Sarah Haywood International Nigel Foreman, Asifa Majid Interviews Nigel Hunt, Lance Workman History of Psychology Julie Perks

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psychologist vol 24 no 8

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letters 558 the media; counselling psychology; benevolent sexism; Little Albert; and more

THE ISSUE

news and digest 566 the Society’s response to DSM-5; working memory ‘side-effects’; challenging public scepticism of science; nuggets from the Research Digest; and more

Are holidays worth it? This might seem like a strange question to pose as many of you prepare for those short spells of solace you have toiled, scrimped and saved for over the last year. But are they really fun? Do they do us good? Pack some psychology in your suitcase and you can find some surprising answers. Turn to p.574 to find out more, including the reason why my breaks since first reading Christian Jarrett’s article tend to have involved me thrusting ice-creams at my kids, imploring them, ‘Eat it! Eat the icecream!’ Elsewhere, don’t miss a ‘One on one’ with Julie Stokes, and Jim Horne in ‘Looking back’, with probably the goriest article ever to feature in The Psychologist. This section, dealing with the history of psychology and the psychology of history, has been an important part of the publication since 2008, and there are some great articles collected at www.bps.org.uk/ lookback. But as with all corners of The Psychologist, we need your help to ensure it continues. Do get in touch with your ideas. Enjoy your holidays, and take us with you. Dr Jon Sutton

media Kairen Cullen on a silver lining from the cloud of Boys and Girls Alone

Wish you were here? Christian Jarrett examines the psychology of holidays

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Deception in psychological research – a necessary evil? Allan Kimmel offers recommendations in a controversial area

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Coach your cortex Dan Hackley on ‘brain training’ – sales con or evidence-based exercise?

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Taking the medicine James Anderson argues that the profession needs to examine its view of the self

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Free from the shackles Alex Haslam talks to Lance Workman about glass cliffs, higher education and Zimbardo

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book reviews 598 questions of religion and spirituality; a case for educational change; strategies for helping the shy child; and more society

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a guest column from Robert Roe, President of the European Federation of Psychologists’ Associations; President’s Award; special educational needs; bipolar disorder; the connected baby; and more

careers and psychologist appointments

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Victor Thompson talks about working in sports and clinical psychology; two British clinical psychologists exchange views on their moves to the USA new voices

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Claire McAndrew on communication, paradigm shifts, sandpits and more in our series on first-time Psychologist authors looking back

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Jim Horne with what must surely be the goriest article in the history of The Psychologist one on one

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…with Julie Stokes

read discuss contribute at www.thepsychologist.org.uk

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BIG PICTURE

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An emotional snapshot Photo by the Queen’s University Belfast emotion team. If your work lends itself to a striking visual image, get in touch on jon.sutton@bps.org.uk This snapshot of dynamic emotion shows a powerfully negative reaction to a loud noise, which was followed within a second by laughter. It’s all part of research led by Dr Ian Sneddon (Queen's University Belfast) and published recently in PLoS ONE (tinyurl.com/3clkqfx), which indicates that people in different cultures perceive the same universal patterns of emotional expression, but that they differ in the intensity at which they rate that emotion. Dr Gary McKeown, another researcher on the study, suggests that this is due to the differing levels of emotion commonly expressed in different cultures. ‘If you live in a country where people around you typically have a low level of emotional expression, like the UK, then you will rate a given instance of emotional display as denoting a higher level of underlying emotion than if you lived in a country where people are typically more emotionally expressive, such as the

Mediterranean countries. We are in the middle of a research programme to test this idea and we are collecting emotional expressions from people in different countries.’ Whereas previous research has largely been based on still photographs of emotion, the Queen’s University Belfast team have used video stimuli. ‘Much emotional information is carried in the movement and transitions between facial expressions. Even taking a still picture from a dynamic sequence can give a misleading impression about the overall emotional situation.’ These cross-cultural examples of dynamic emotional expression in response to stimuli – such as disgust in response to unknowingly placing a hand in a bowl of cold spaghetti – have been collected into a database available to the research community. To access the Belfast Induced Natural Emotion Database, see www.psych.qub.ac.uk/BINED.

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DIGEST

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What colour is your breast-stroke? People with synaesthesia experience odd sensations that make it seem as though their neural wires are crossed. A certain word might always come served with the same particular taste, or a letter or numeral might reliably evoke the same particular colour. But an emerging view among experts is that synaesthesia is grounded in concepts, not crossed senses. By this account, it’s certain ideas, regardless of which sense perceives them, that trigger a particular concurrent experience. The latest evidence for this comes from Danko Nikolic and his colleagues at the Max-Planck Institute for Brain Research. They’ve documented two synaesthetes, HT and UJ, who experience different swimming strokes, whether performing them, watching them or merely thinking about them, as always being a certain colour. HT and UJ, both now aged 24, began swimming competitively at an early age, and the sport continues to be an important part of their lives. The first test that Nikolic’s team performed was to present the pair with four black and white close-up photos of different swimming strokes and have them say which colour the strokes triggered using a book of 5500 colour shades. This was repeated four weeks later for HT and three weeks later for UJ. Three nonsynaesthete control participants, all swimmers, were recruited for comparison. They similarly reported which colours the photos made them think of and they repeated the exercise after just a two-week gap. The clear finding was that the difference from the first test to the second test in the precise colours chosen for each stroke by the synaesthetes was eight times smaller than the test-retest difference shown by the controls, thus supporting the synaesthetes’ claim that different strokes always provoke the same colours. Next the researchers administered a version of the Stroop test: the synaesthetes and controls were presented with the same swimming In the July issue of Cortex stroke photos as before, but this time they were shown with different coloured tones, for example in blue or yellow. The participants’ task was to name the colour. If certain swimming strokes really do evoke particular colours for the synaesthetes then their colour naming ought to have been affected by the precise stroke/colour pairing on any given trial, such that you’d expect them to be quicker if the photo’s colour matched the colour evoked by the stroke shown in the image. That’s exactly what was found – UJ, for example, was 101ms slower when naming incongruent colours versus congruent ones. No such effect was observed for two control participants. According to the classic view of synaesthesia as cross-wiring between senses, you’d think that swimming-style synaesthesia would require the act of swimming (via proprioception) to evoke a concurrent experience, but this study suggested it was enough to merely activate the concept of the different swim strokes by looking at pictures. This is consonant with past research showing, for example, that letter/number-colour synaesthesia can be triggered merely by imagining the necessary letter or number. Other research has documented synaeshetic experiences devoid of any particular sensory element, including so-called time-unit-space synaesthesia, in which units of time are experienced as existing in particular locations relative to the body. ‘Hence, the original name of the presently investigated phenomenon syn + aesthesia (Greek for union of senses) may turn out to be misleading in respect of its true nature,’ the researchers said. ‘The term ideaesthesia (Greek for sensing concepts) may describe the phenomenon much more accurately.’ For more detailed discussion of how, when and why synaesthetic triggers and concurrent experiences are acquired, it’s worth checking out the full article (tinyurl.com/5sykudw).

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Feeling lonely? – Have a bath In the May issue of Emotion Wallowing in the bath, immersed in soothing warm water, the benefits are more than sensuous, they’re social too. That’s according to John Bargh and Idit Shalev, researchers at Yale University, whose new research shows that physical warmth can compensate for social isolation. Indeed, their study suggests that people subconsciously self-comfort against loneliness through the use of warm baths and showers. Among 51 undergrads, those who reported being more lonely also tended to bath or shower more often, to do so for longer and with warmer water. Overall, 33.5 per cent of the variation in these measures was accounted for by loneliness. A similar result was found for a community sample. Perhaps lonely people simply have more time to take baths because they go out less, but the association with preferring warmer water is harder to explain away. A second study confirmed the causal role that physical temperature can play in people’s sense of social warmth. Students conducted what they thought was a product test of a small therapeutic pack, which was either warm or cold. Those who evaluated the cold pack, holding it in their palm, subsequently reported feeling more lonely than those who tested a warm version of the pack. What about a direct test of the therapeutic benefit of physical warmth? Another study had students recall a time

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they’d felt socially excluded, then they went on to perform the same product test of a warm or cold pack used before. Recalling being excluded had the expected effect of making students desire friendly company and comforting activities like shopping. But this effect was eradicated if they’d product tested the warm pack. ‘Warm physical experiences were found to significantly reduce the distress of social exclusion,’ the researchers said. Our recognition of the link between physical and social warmth is reflected in our language – ‘a warm smile’, ‘a cold shoulder’ – and has been for centuries. Yet Bargh and Shalev think this understanding remains largely unconscious. Indeed, they found that participants rated a character in a short story as no more lonely if she took a bath and shower in the same day as those who read the version without the extra bathing. These findings add to past research suggesting a specific link between physical and social/emotional warmth, and build on the embodied cognition literature, which has shown the effects of physical states on our thoughts and behaviour, and vice versa. But this new study is the first to provide causal evidence that physical warmth can ameliorate feelings of exclusion. Bargh and Shalev speculated their findings could even have practical applications: ‘…the physical-social warmth association may be a boon to the therapeutic treatment of syndromes that are mainly disorders of emotion regulation, such as Borderline Personality Disorder,’ they said.

Toddlers won’t bother learning from you if you’re daft In the April issue of Infant Behavior and Development Infants of just 14 months already have a nonsense-detector that alerts them to unreliable people, from whom they’ll no longer bother taking lessons. Diane Poulin-Dubois demonstrated this in a study with 60 infants. In one ‘reliable’ condition, the researcher smiled and exclaimed with delight on discovering a toy in a container, before then passing it to the infant to inspect. In the other ‘unreliable’ condition, the researcher similarly expressed delight but there was in fact no toy. This was repeated several times. Next, the same researcher produced a touch-on light, placed it on the desk and switched it on by leaning forwards and using her forehead. She repeated this three times then passed the light to the infant. The key finding is that infants in the ‘unreliable’ condition were far less likely to bother imitating the

researcher by switching on the light with their own forehead. Across two attempts, 34 per cent of infants in the unreliable condition used their forehead to turn the light on, compared with 61 per cent of infants in the reliable condition. ‘Infants seem to perceive reliable adults as capable of rational action, whose novel, unfamiliar behaviour is worth imitating,’ the researchers said. ‘In contrast, the same behaviour performed by a previously unreliable adult is interpreted as irrational or inefficient, thus not worthy of imitating.’ Other explanations for the finding were ruled out. For example, infants in both the reliable and unreliable conditions were equally attentive to the researcher’s demonstration with the light, so it’s not the case that they’d simply lost interest. The new finding adds to a growing body of research

showing children’s selectivity in who they choose to learn from. For example, children prefer to learn from adults as opposed to their peers, and they prefer to learn from people they are familiar with and who appear more certain, confident and knowledgeable. Prior research with infants found they were less likely to follow the gaze of an unreliable adult who’d earlier expressed delight at an empty container. ‘These results add to a growing body of literature that suggests that infants are adept at generalising their knowledge about the reliability of other people across varying contexts,’ the researchers said. ‘The unique contribution of the present study shows that, similar to older children, infants are able to keep track of an individual’s history of being accurate or inaccurate and use this information to guide their subsequent learning.’

‘My colleagues regularly comment on how valuable they have found the Digest in its various forms and how much more confident they feel about being up to date with research, not just in their field but across the full breadth of psychology.’ Dr Catherine Loveday, Principal Lecturer in Cognitive Neuroscience, University of Westminster

The Society’s free Research Digest service, at www.researchdigest.org.uk/blog and edited by psychologist and journalist Dr Christian Jarrett, won ‘best psychology blog’ in the 2010 international Research Blogging Awards. Visit now to see why.

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FEATURE

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Wish you were here? Christian Jarrett examines the psychology of holidays

‘A momentous but until then overlooked fact was making its first appearance: that I had inadvertently brought myself with me to the island.’ Alain de Botton, The Art of Travel

T

he torrent of travel TV shows, newspaper supplements and guidebooks says it all. In life’s layers of daily drudgery, holidays provide the elusive seams of golden experience – the chance to forge cherished memories, to live freely, unshackled from the constraints of work and stress. Mere fantasy perhaps, but intuition tells us that these escapes from the quotidian grind must do us good, that a change of scene surely revitalises. What does psychology have to say? Do we actually enjoy our holidays once we get around to them? Are they beneficial? Strap yourself in for a tour of the field and some surprising answers.

Are holidays fun?

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If you approach people who are holidaying and ask them what kind of mood they are in, it’s likely you’ll get a positive answer. At least that’s what tourism scholar Jeroen Nawijn based at NHTV Breda University of Applied Sciences found when he interviewed hundreds of international tourists in the Netherlands over a 19-day period in the spring of 2008, and hundreds more over 13 days in 2009. Overall, with nearly 96 per cent of the first sample reporting a positive mood, Nawijn

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Braun-LaTour, K.A., Grinley, M.J. & Loftus, E.F. (2006). Tourist memory distortion. Journal of Travel Research, 44, 360–367. de Bloom, J. Geurts, S.A.E., Taris, T.W. et al. (2010). Effects of vacation from work on health and well-being: Lots of fun, quickly gone. Work and Stress, 24, 196–216. de Bloom, J., Kompier, M., Geurts, S. et al. (2009). Do we recover from

concluded that holiday misery as portrayed by the media scare stories is a myth. Moreover, holiday happiness levels were unrelated to people’s age or socioeconomic background. ‘Enjoying a holiday trip is universal,’ says Nawijn. ‘This is not surprising as holidaymaking is a voluntary activity, for adults anyway. If you don't like to take a vacation, then don’t. Certainly there are trips that turn into a nightmare, but these are really exceptions rather than the rule.’ Based on the way that people’s feelings varied according to the stage of holiday they were at, Nawijn has proposed a ‘holiday happiness curve’: people in the first 10 per cent of their holiday were generally in lower mood (what he calls the ‘travel phase’); those between 10 per cent and 80 per cent into the trip (the ‘core phase’) were in high mood; those at the period between 80 to 90 per cent of the trip were in lower mood (a ‘decline phase’); and finally, those in the final tenth of the holiday once again reported higher mood (a ‘rejuvenation phase’). Nawijn believes this last phase is where people have left behind the worries of packing and the frustration of the trip coming to an end. ‘They are able to enjoy their trip again,’ he says, ‘and possibly also look forward to coming home.’

vacation? Meta-analysis of vacation effects on health and well-being. Journal of Occupational Health, 51, 13–25. Fritz, C. & Sonnentag, S. (2006). Recovery, well-being, and performance-related outcomes: The role of workload and vacation experiences. Journal of Applied Psychology, 91, 936–945. Gram, M. (2005). Family holidays. A

Surprisingly perhaps, the type of holiday, and the activities engaged in that day, were not related to people’s self-reported happiness levels. Maybe most of us have a good sense of the kind of holidays we enjoy and stick to those? Factors that were associated with selfreported happiness were weather (no surprises there), stress levels, attitude towards one’s companions, and length of stay: people on mid-length holidays of between three to six days tended to report more positive mood than those on shorter or longer trips. ‘Possibly a two- to six-day holiday trip is long enough to enjoy (unlike a two-day trip),’ Nawijn surmised, ‘but short enough to minimise arguments with partner, family or friends.’ When it comes to the enjoyment of much longer holidays, say from two months to a year, the research simply hasn’t been done. ‘If someone takes such a long journey, one can only speculate as to the reasons why,’ says Nawijn. ‘Perhaps it’s a phase of life, leaving school, before entering college, or perhaps a midlife

qualitative analysis of family holiday experiences. Scandinavian Journal of Hospitality and Tourism, 5, 222. Gump, B.B. & Matthews, K.A. (2000). Are vacations good for your health? The 9–year mortality experience after the multiple risk factor intervention trial. Psychosomatic Medicine, 62, 608–612. Kemp, S., Burt, C.D.B. & Furneaux, L. (2008). A test of the peak-end rule

with extended autobiographical events. Memory and Cognition, 36, 132–138. Kop, W.J., Vingerhoets, A.J.J.M., Kruithof, G-J. & Gottdiener, J.S. (2003). Risk factors for myocardial infarction during vacation travel. Psychosomatic Medicine, 65, 396–401. Kühnel. J. & Sonnentag, S. (2011). How long do you benefit from vacation? A closer look at the fade-out of vacation

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crisis or really a true desire to travel and discover. Who knows? But it would certainly be interesting to study the effect of these different motivations for lengthy travels on one’s sense of wellbeing.’

The good times What constitutes the good times on holiday – those moments you wish you could bottle up and savour for ever? Malene Gram at Aalborg University in Denmark addressed this question in the context of family holidays. She interviewed 26 German and Danish families for a paper published in 2005, finding that the answer depended to a large extent on whether you ask children or parents. For kids, it was moments of activity and absorption, such as roller-coaster rides, and sensory experiences, such as the leatherlike feel of a giraffe’s tongue, that were most cherished. For parents, by contrast, relaxation was vital, as was knowing that their children were having a good time. Some parents also recalled fond memories of rediscovering their own inner child. Moments of togetherness were particularly savoured – a factor that clashed somewhat with the adults’ need for quiet periods of relaxation away from their kids. Ice-cream was a recurring theme: when families sat down together to enjoy an ice-cream (some of them reported doing this several times a day) this seemed to act as a bonding activity and also provided a rich sensory memory for the children. ‘The ice-cream situation seems to be a very harmonic moment,’ Gram wrote. ‘Wow!’ situations were also mentioned – one six-year-old boy recalled the time that a killer whale splashed water, soaking the audience. A mother reminisced fondly about the time on a ferry ride when some passengers erupted into song, playing their musical instruments spontaneously. How do parents gauge the success of a holiday? One mother said that on the way back, if the kids ‘fall asleep in the car right away, then we know it has been good’. For parents hoping to foster some golden moments on holiday, Gram says it’s important to be realistic about how we spend time together: ‘Enjoy intense moments of togetherness,’ she advises, ‘but make sure to give every family member time and space to be themselves and do whatever is important in the construction of their holiday, too.’

The ‘rosy-view effect’ So far the results seem promising enough, but the picture gets a little more complicated thanks to a curious phenomenon – ‘the rosy-view effect’ – documented in the late nineties by Terence Mitchell at the University of Washington and his colleagues. Based on surveys of three groups of participants before, during and after a 12-day tour of Europe, a five-day Thanksgiving vacation and a three-week bicycle trip across California, the researchers concluded that people generally anticipate and recall enjoying holidays far more than they really do enjoy them at the time (although, consistent with Nawijn’s research, the participants’ in-the-moment experiences were generally positive). The principal reason for the mismatch, based on participants’ diary records, seemed to be that the holiday experiences were peppered with let-downs, quickly forgotten on return. Another factor was minor distractions, the potholes of daily existence, which detracted from enjoyment during the holiday, but which were also quickly forgotten when reminiscing. The rosy-view effect poses a quasiphilosophical problem – so long as we expect to enjoy our holidays and we recall an inflated enjoyment of them once we get back, does it matter what the

effects. Journal of Organizational Behavior, 32, 125–143. Maddux, W. & Galinsky, A. (2009). Cultural borders and mental barriers: The relationship between living abroad and creativity. Journal of Personality and Social Psychology, 96, 1047–1061 Mitchell, T.R., Thompson, L., Peterson, E. & Cronk, R. (1997). Temporal adjustments in the evaluation of

experience was really like? In at least one practical sense, likely to be of particular interest to the travel industry, it seems it’s our memories that matter more than our true experience. In 2003 Derrick Wirtz and his colleagues at the University of Illinois at Urbana-Champaign gauged the expected, actual and remembered enjoyment of 41 students taking their spring break, including trips to Florida, Europe and Kentucky. Consistent with the rosy-view

events: The ‘Rosy View’. Journal of Experimental Social Psychology, 33, 421–448. Nawijn, J. (2010). The holiday happiness curve: A preliminary investigation into mood during a holiday abroad. International Journal of Tourism Research, 12, 281–290. Nawijn, J. (2011). Determinants of daily happiness of vacation. Journal of Travel Research. Online pre-print.

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effect, the students anticipated and recalled experiencing more positive emotions than they actually reported during their holiday. Contrary to the rosyview effect, a similar pattern was also found for negative emotions, prompting the researchers to speculate that maybe it’s the intensity of emotion, good and bad, that’s overestimated before and after a holiday. Crucially, when Wirtz’s team asked the students whether they planned to go on the same holiday again, it was

Redelmeier, D.A. & Kahneman, D. (1996). Patients’ memories of painful medical treatments: Real-time and retrospective evaluations of two minimally invasive procedures. Pain, 66, 3–8. Van Heck, G.L. & Vingerhoets, A.J.J.M. (2007). Leisure sickness: A Biopsychosocial perspective. Psychological Topics, 16, 187–200. Vingerhoets, A.J.J.M., Van Huijgevoort, M.

& Van Heck, G.L. (2002). Leisure sickness: A pilot study on its prevalence, phenomenology, and background. Psychotherapy and Psychosomatics, 71, 311–317. Wirtz, D., Kruger, J., Scollon, C.N. & Diener, E. (2003). What to do on Spring Break? The role of predicted, on-line, and remembered experience in future choice. Psychological Science, 14, 520–524.

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their remembered affective experience, rather than their actual experience, that predicted their stated decision. This finding is all the more consequential in light of a later paper by Elizabeth Loftus, the University of California-Irvine doyenne of false memory research, in which she demonstrated the ease with which people’s holiday memories could be distorted. Together with her colleagues, Kathryn Braun-LaTour and Melissa Grinley, Loftus had half of 129 participants look at a Disneyland picture advert featuring the Warner Bros character Bugs Bunny, while the others saw a standard Disneyland ad. The participants, all of whom had themselves been to Disneyland, then read other people’s reminiscences about a holiday to the theme park. These were written in a style you might expect to find on an internet travel site, and critically, the same

participants who saw the Bugs version of the advert read a reminiscence in which the narrator recalled meeting Bugs Bunny, among other characters, at Disneyland (an impossibility given Bugs Bunny’s Warner Bros origins). The disconcerting finding is that when asked to recall their own Disneyland trip, the participants exposed to the misleading ad and narrative were significantly more likely (36 per cent vs. 8.7 per cent) to say erroneously that they too had met Bugs Bunny when they went to Disneyland. Replace the Bugs Bunny trick with misleading references about food or facilities on internet review sites and the profound implications of this study begin to register. The lessons for the travel industry, Loftus and her team concluded, ‘…are huge. The most precious after-effect of a tourist’s experience is his or her memories, and through this and other

research we now know that these are not sacrosanct. They can be distorted from the use of marketing, competition, Listservs, TV programs, etc.’ ‘These sorts of manipulations of our autobiography are probably routinely occurring in real life,’ says Loftus, ‘and we’re not even aware that they have influenced us. We may have to get used to the idea that some of our memories may not really be our own.’ One final point in relation to holiday memories: if they play such an important role in our holiday-based feelings and decisions, then perhaps some lessons could be learned from the broader literature on hedonic experiences involving shorter events? In particular, research by Nobel winner Daniel Kahneman and his colleagues identified something called ‘the peak-end rule’ – that is, people’s overall memories of an experience showed a strong association

The bad times People long for the rhythmic sound of lazy waves, the squidge of warm sand between their toes (or substitute your own holiday fantasy). Yet all too often, having reached their destination, illness strikes: lethargy, a sore throat perhaps, or a thumping pain in the temples. Psychologists call this ‘leisure sickness’. Most of what we know about this concept is anecdotal, but a 2002 pilot study by Ad Vingerhoets and his colleagues at Tilburg University suggested leisure sickness is fairly common – of 1128 men and women surveyed, around 3 to 4 per cent said they suffered from illnesses more on holidays and at weekends than when at work. Just what causes leisure sickness is largely speculative at the moment. In a 2007 commentary, Guus Van Heck and Vingerhoets outlined various possible causes including: changes to lifestyle (many people drink more/less coffee or alcohol on holiday than at home; sleep patterns may also be different); a change of focus (without the distraction of work, people may become more

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aware of their bodily states); and stressrelated processes (the body may balance out the effects of chronic stress at work, and once that source of stress is removed suddenly, the immune system is left out of kilter). Some people may be more prone to leisure sickness than others. The 2002 pilot study suggested that people who are particularly committed to their work, who are perfectionists and who find it difficult to relax, may be especially at risk. Highly extravert characters may also suffer from a loss of stimulation and challenge that can manifest as boredominduced illness. Given the established benefits of an illness-free holiday, Vingerhoets says managers and doctors should take leisure sickness more seriously and provide those who suffer from it with useful guidelines. ‘Perhaps a work-out demarcating and emphasising the transition from work to nonwork may be helpful to “unwind” the body and better adjust to a the demand-free state,’ he says.

On a related note, although epidemiological research suggests holidays help reduce the risk of heart problems longterm, unfortunately for some people with a pre-existing problem, it seems holidays and holiday travel can be the trigger for a heart attack. Willem Kop (now also at Tilburg University) and colleagues in a 2003 study found that risk was greatest during the first two days, car travel was a particular risk, as was staying in a tent or mobile home rather than a hotel. Traffic jams and proximity to irritating travel companions were the obvious adverse factors relevant to these situations. ‘High-risk patients need to be alerted to the unique physical and mental activities specific to vacation travel that can act as triggers of acute coronary syndromes during their vacation,’ the researchers concluded. However, Vingerhoets, a co-author, points out that since most of these patients were highrisk, ‘it’s very likely that they would also have developed these heart problems in the home or work setting’.

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with the average of the peak level of emotional feeling and the final level of emotion at the end of the experience. For example, a 1996 study found patients’ recall of colonoscopy was predicted by the peak-end rule rather than by the duration of the procedure. Applying this rule to our holidays would suggest we need to try to obtain as high a peak of enjoyment as we can, and to end on a high note. The rest might not matter so much. Simon Kemp and his colleagues at the University of Canterbury in New Zealand investigated this very issue in a 2008 paper involving 49 holidaying participants who were surveyed before, every day during, and after their trip. The main finding was that although holiday duration didn’t make a difference to recalled happiness, the peak-end rule wasn’t that accurate either. Instead, overall recalled happiness on holiday was most strongly associated with participants’ happiness during their most memorable or unusual 24-hour period of the holiday. ‘One implication’, says Kemp, ‘is that if you want to have a memorable holiday then it helps to include one experience that is likely to be memorable – and much better if it is memorably good rather than memorably bad! Another is that the length of the holiday probably doesn’t matter too much for how you think about it afterwards – although it might from the point of view of relaxation.’ Kemp’s team further predicted that what constitutes the most memorable or unusual period of the holiday could be prone to change as time passes, meaning that the factors affecting our recalled happiness may well change from one week to the next. ‘More important,’ Kemp says, ‘they are likely to vary with what is otherwise occupying your mind at the time you are recalling.’

Are holidays beneficial? Aside from the hoped-for pleasures they bring whilst we’re on them and the treasured memories they provide afterwards, many of us go on holidays in the belief that the experience will do us good, in terms of our health and wellbeing. Our employers too no doubt expect us to return revitalised and ready to tackle our work with renewed vigour. There’s certainly some evidence that overseas travel can spur creativity. For

example, William Maddux at INSEAD and Adam Galinsky at the Kellogg School of Management found that students who’d spent more time abroad were more likely to solve a creativity problem. Also, an epidemiological study published in 2000 involving thousands of men at risk of heart problems found that the more holidays they took, the more likely they were to survive the study’s nine-year follow-up period. ‘Vacations may not only be enjoyable but also health promoting,’ stated Brooks Gump and Karen Matthews at the University of Pittsburgh (findings like this should be a worry to US workers who have no statutory holiday entitlement – their average number of paid days leave is about 10. In contrast, full-time European workers are guaranteed at least 20 days paid leave a year). These observations on creativity and longevity aside, quality research in the field of occupational psychology looking at the benefits of holidays is surprisingly thin on the ground. When Jessica de Bloom at Radboud University, Nijmegen and her colleagues performed a metaanalysis of the topic in 2009 they identified just seven suitable papers in the literature. Broadly speaking they were looking for studies that involved healthy participants and provided a pre- to post-

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comparison of well-being and other health factors. Between them, these seven studies featured hundreds of participants in a variety of different occupations. The main message was that going on holiday had a small but significant positive effect on the workers’ well-being (the effect size was 0.43) when comparing ratings taken just after a holiday with a few days or weeks before. The disappointing news is how brief these benefits appeared to be. Two to four weeks after returning, participants lapsed back to their pre-holiday wellbeing levels – a phenomenon that researchers in the field call the ‘fade out effect’. ‘I think that the fade out effect is a natural phenomenon whereby people feel the same way if they are in the same environment,’ says de Bloom. ‘After returning home, vacationers are back at the normal work environment and accordingly also feel as they normally feel during working times: not bad, but not as positive as during times of more control, freedom and new experiences, i.e. the situation on holiday.’ Beyond this main finding, de Bloom and her team frowned collectively at how little we know about the psychological effects of holidays. The potentially contrasting effects of different holiday

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types and activities remains unknown and there were even too few studies in the meta-analysis to check the effect of different holiday lengths. A reliance on self-report also means no research group has yet looked objectively at actual work performance to see if this improves after a holiday. ‘We are currently busy investigating important issues regarding the effect of different types and durations of holidays and the role of vacation activities and experiences,’ de Bloom says. ‘The answer to these questions will hopefully lead to a number of practical implications that can help people to plan their vacations in order to achieve maximal recovery, experience pleasure of looking forward to a vacation, savour the experience of a vacation and prolong its positive effects.’ As well as being limited in scope, existing studies in the field are also scuppered by a methodological problem – the risk that observed effects presumed to be caused by the holiday experience could in fact be mere sideeffects. Consider how the rush to meet deadlines before going away could adversely affect people’s well-being preholiday. In a pre- versus post-holiday design this would therefore inflate the apparent benefit of a holiday. Contrarily, measures taken on return could be skewed by the stress of coming back to a pile of work: this could have the effect of concealing true benefits garnered from having a vacation. De Bloom and her colleagues made a start attempting to address this problem in a study of their own conducted last year, involving 96 Dutch workers employed in a range of different industries from IT to healthcare. A first baseline measure of well-being was taken two weeks before the participants’ winter sports holiday (average length was nine days), hopefully well before any potential adverse effects of rushing to get away. Also, measures were taken during the holiday using specially prepared mobile phones, and again once a week for several weeks on return, so that a more detailed picture of the fade out effect could be observed. The good news is the in-holiday measures once again revealed evidence of a benefit – the workers felt in a better mood compared with their pre-holiday baseline, more energised and healthier. The bad news was that these benefits were all eradicated during the very first week back at work. The one anomaly in this regard was fatigue – the participants showed no benefits on this measure during their trips, perhaps because of the

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active nature of the holiday, but they did show a reduction in fatigue during their first week home. Disappointingly, this benefit was gone within two weeks.

Are they worth it? The rapid fading out of holiday benefits may be a little demoralising, but fortunately some new research is beginning to provide clues for how to extend your post-holiday glow. For a 2006 paper, Charlotte Fritz at the Technical University of Braunschweig and Sabine Sonnentag at the University of Konstanz surveyed hundreds of non-academic university employees before, during and after a holiday. Participants generally reported feeling healthier after the holiday and experiencing work tasks as less effortful. As usual, this benefit faded quickly, but it was prolonged for those who didn’t face an accumulation of work on their return. So if you can find a way to avoid your work mounting up whilst your away, this could help prolong the benefits of a break. Avoiding negative thoughts about work while away was also associated with better outcomes post-holiday. Another paper published just this year by Jana Kühnel and Sabine Sonnentag involved a survey of 131 German teachers before and three times after they took a two-week Easter vacation. Once again, a holiday benefit was found, in terms of reduced emotional exhaustion and increased work engagement, and yet

again this was short-lived, fading out entirely within one month. Crucially, though, it faded out more slowly for teachers who used spare time in the evenings and weekends post-holiday to relax. ‘Why is relaxation important?’ Sonnentag asks. ‘Relaxation should help to reduce the strains accumulated during the working days.’ That one nugget is the good news, the bad news is that continuing a relaxation regimen after a holiday only delayed the inevitable. The fade out was slowed down for the first two weeks only. Findings like this beg the question – are holidays worth all the hassle and expense? Is it worth digging for those seams of gold? Sonnentag believes holidays are definitely worth it. ‘Although the beneficial effects fade out quickly, not having any holidays/vacations would probably be very problematic because the strain would accumulate over time,’ she says. De Bloom agrees emphatically: ‘Vacations give people the opportunity to (re)connect to family, partner and friends,’ she says. ‘They help us to “refill our batteries”, remain productive and perform on high levels. The fact that the aftereffects are short-lived only emphasises that we should go on a vacation more frequently in order to keep our levels of health and well-being high.’ Who could possibly disagree with that? I Dr Christian Jarrett is The Psychologist’s staff journalist. chrber@bps.org.uk

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18–20 April Grand Connaught Rooms London

Bringing together Division of Sport and Exercise Psychology Division for Teachers and Researchers in Psychology Qualitative Methods in Psychology

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LOOKING BACK

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Blasts from the past Jim Horne with what must surely be the goriest article in the history of The Psychologist

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references

uch has been written in The Psychologist (eg. Macmillan, 2008) and elsewhere about Phineas Gage. Many of us know how, as a result of a railroad accident in 1848, Gage lost part of the frontal area of his brain, and lived a different but reasonable life until his death 12 years later, following a series of fits. However, few readers will be aware of many rather similar accounts of this era – even much earlier – of people (all men) surviving with little apparent ill effect, after losing significant portions of the same brain region. Many of the injured were soldiers who had been hit by musket balls, or who were victims of their own musket breech backfiring into the forehead after aiming and firing. The British Medical Journal (BMJ) has quite a selection of these remarkable accounts. For example, in the ‘Case of recovery after compound fracture of the frontal bone and loss of cerebral substance’, George Mallet MD (BMJ, 15 July 1853, p.610), describes how Mr R. Booth, a 60-year-old stonemason, was struck on the head by the handle of a rapidly rotating windlass. After being knocked out, and then carried by his fellow labourers back to his house, his situation was considered hopeless by a passing ‘medical gentleman’. Surprisingly, the next day he was still alive, and his GP (Dr Mallet), was called, to find that Booth was still ‘insensible’, having sustained a compound fracture of the entire breadth of frontal bone, with a large piece driven into the brain, ‘a very considerable quantity of the cerebral matter was adherent to the adjoining parts… the quantity of the brain lost could not be

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Harlow, J.M. (1868). Recovery from the passage of an iron bar through the head. Publications of the Massachusetts Medical Society, 2, 327–347. Macmillan, M. (2008). Phineas Gage – unravelling the myth. The Psychologist, 21, 828–831. See www.bps.org.uk/gage

accurately estimated, but it was not thought not be less than from one to two tablespoonfuls’. Assisted by a medical friend, Dr Mallet proceeded to remove 12 bone fragments deeply embedded into the cortex, and, ‘still the man remained quite insensible to our operations; but on the extraction of the thirteenth, the last, which was a larger piece and more deeply imbedded than the others, he started up in bed and uttered – no doubt from his accustomed habit, and quite unconscious of what had been going on – an oath’. Dressings were applied, and Booth was left until the next morning, when Dr Mallet found him ‘quite sensible and exhibiting no unfavourable symptoms’. The only medication he subsequently received was castor oil, for his bowels. Three months later Dr Mallet reported that Booth had walked three miles to the surgery, and that ‘pulsations of the brain were seen immediately under the newly formed skin… his intellect, as far as I could judge, was unimpaired; and the muscular power not at all paralysed. I never saw him afterwards’. An extraordinary report by P. Blaikie Smith MD, again in the BMJ (7 September 1892, p.627–629), entitled, ‘Revolver wound of the brain; lodgment of the bullet; recovery’, was of ‘a young gentleman in the best of health and spirits [who] accidentally shot himself with his revolver’. ‘…Blood and cerebral matter issued slowly from a wound in his forehead…over the right eyebrow.’ How he survived what happened next can only be a tribute to the seemingly pointless but

extraordinary dexterity of Dr Smith, who ‘inserted a director into the wound …the instrument was slowly and carefully passed onwards for its whole length into the brain… gradually assuming an upward direction… ending not far from the upper extremity of the fissure of Rolando’. Thankfully, ‘no resistance to the progress of the director was experienced and no trace of the bullet could be discovered upon careful searching… towards the vault of the cranium’. His patient remained conscious but drowsy, could speak slowly in monosyllables, and had ‘very slight paralysis of the left side of his face chiefly in the vicinity of the mouth… but the left arm and leg were completely paralysed’. For those interested, Dr Smith kindly provides a drawing of the track the bullet took through the brain (see picture below). The patient occasionally complained of a headache, and after four days some slight improvement was noted, and the facial paralysis had disappeared, but he ‘always lay as if he were asleep… and indeed did sleep a great deal – yet he could easily be roused, and when he spoke his articulation was faster and his replies more prompt than before’. He recognised the voices of others but kept his eyes mostly closed, ‘and on several occasions inquired about the pursuits of

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his brothers, and showed an interest in Journal of April 1822 (p.199), of a 15lawn tennis’. Over the next three weeks year-old soldier who was wounded by the left hemiplegia improved somewhat, the bursting breech of an overloaded and ‘his progress continued to be most small cannon. Shrapnel blew through his satisfactory’, although there was a forehead, resulting in the loss of a piece temporary relapse with high fever and of frontal bone measuring 2½ x 1¼ headache, diagnosed as ‘meningitis’, inches together with 32 other pieces of treated by mercury and ice to the head, bone and metal that were removed from it subsided over another week. Steady the frontal part of his brain, together recovery continued to be maintained over with, ‘more than a tablespoon of cerebral the next two months, with the hemiplegia substance… portions of brain were also ‘greatly diminished… could walk for an discharged at three dressings’. The hour and was quite free of headache’. account went on to say, ‘at no period Although having no recollection of the were there any symptoms referable to this event itself, his memory by now was injury… during the time that the brain ‘nothing abnormal’. Moreover, ‘his other was discharged he is reported as giving faculties seemed unaffected… reasoning correct answers to questions put to him, and imagination and as being unimpaired... conversation perfectly rational’. easy and natural… nothing By three months “pulsations of the brain were to indicate that he had the wound had been the subject of a closed, and ‘he was seen immediately under the serious cerebral injury’. Six reported in perfect newly formed skin” months later he was health, and having ‘perfectly well… two arms suffered no of equal power… walked derangement of his naturally… apart from the scar on his mental capacities’. forehead and an exaggerated left knee In 1827 came a report by a Dr Rogers jerk’. There was no epilepsy. Dr Smith in the Medico-Chirurgical Transactions, ends by noting that treatment consisted where a young man received a frontal chiefly of ‘rest, quiet, good nursing and impact, again from a breech explosion. suitable diet’, and directed the reader to It was not until another three weeks, another case ‘wonderfully like that of my when the soldier, ‘discovered a piece of patient’ of an American boy who, the year iron lodged within the head in the bottom before, had also accidentally shot himself of the wound from which a considerable in the forehead, and after some extradural quantity of bone had come away… it surgery had fully recovered with in a year, proved to be the breech pin of the gun and had become ‘expert in riding a three inches in length and three ounces bicycle’. in weight’. Four months later he was There are many earlier cases of battle ‘perfectly cured’. Another case, here, was injuries, and a comprehensive account of an exploding breech pin penetrating can be found in a lengthy editorial the 1½ inches into the brain, making a hole British Medical Journal of 1853 (29 April, ¾ inch in diameter, resulting in an ‘escape pp.375–376), entitled, ‘Cases of recovery of cerebral substance’. But ‘no severe after loss of portions of the brain’. The symptoms occurred, and recovery took earliest reference was to a ‘small work’ place in less than 24 days’. written by Dr James Younge, entitled A Dr De Barbe reported in an 1853 ‘Wounds of the Brain Proved Curable’ issue of the Gazette des Hôspitaux published in 1682, where the latter had Chaumes on a soldier hit by pieces of the amassed opinions of 60 other authors breech that penetrated ‘above the centre covering over 100 observations, even of the left eyebrow’. Nevertheless, for including those of Galen. More specific whatever reason, ‘he was able to search accounts, in this editorial, of frontal for the fragments of the gun and walk trauma, begin with one from the Battle some distance to the hospital. When the of Waterloo (1815) when a ball entered piece of the gun was removed, a spoonful a soldier’s left frontal bone and lodged of cerebral matter escaped’. Moreover, within his brain. He developed left side ‘there was no disturbance of intellect, nor hemiplegia and ‘loss of memory of proper of the senses, nor of speech throughout names, and of some names of objects’. the progress of the case. On the twelfth However, he fully recovered from these day the patient was discharged, cured.’ symptoms, rejoined the army and lived In the next issue of the same Gazette, for another 12 years, eventually dying more cases were described whereby of TB. ‘injuries to the brain are not only less The next case, a few years later, was fatal than commonly supposed, but less based on a report by Dr John Edmonson, frequently followed by severe symptoms’. in the Edinburgh Medical and Surgical One advantage of gunpowder is that it

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is also a strong antiseptic, which soldiers would sprinkle on battle wounds. As the foreheads of these victims were probably fortuitously coated with gunpowder dust, before penetration by what would have been a sterile piece of breech, the risk of infection was reduced. Fortunately, with the introduction of the rifle and all-metal cartridges, around 1860, most of these injuries disappeared, as did the musket. The apparently benign outcomes of these cases seems to contrast with that of Phineas Gage, whose personality apparently markedly changed, his behaviour becoming risqué, bawdy and uninhibited, which might well be due to his having a more extensive (orbito) frontal trauma. Of course, as Macmillan (2008) noted, this might not have been as great as is thought: much of what we know about Gage comes from his physician Dr John Martyn Harlow, who enjoyed much fame and fortune as a result of Gage’s accident, culminating in a 20-page paper, eight years after Gage’s death (Harlow, 1868). On the other hand, maybe the physicians treating these other cases I’ve mentioned might not have been familiar enough with their patients to spot more subtle changes in behaviour, given the usual deference and respect that would usually have been paid to their doctors. The horrifying thought of a piece of metal being violently projected into the frontal cortex of these hapless individuals needs to be tempered with the scene, of around a hundred years later, set by Dr Walter Freeman. In 1946 Freeman invented the ‘ice pick lobotomy’; a procedure requiring only a kitchen ‘ice pick’ and a rubber mallet. Often only using a mild tranquilliser on his patients, Freeman would niftily hammer the ice pick through the thin area of skull, just above the tear duct, and then sweep the pick back and forth to sever connections in his ‘trans-orbital procedure’. With no apparent scars, his technique was seen as a great neurosurgical advance, able to be performed in mental hospitals lacking surgical facilities. Such was Freeman’s zeal that he traversed the USA in his own van, which he called his ‘lobotomobile’, demonstrating the procedure at numerous medical centres, even in hotel rooms. Thankfully, he eventually lost his licence to practise having previously incapacitated President Kennedy’ sister, Rosemary, and killing a patient who was seeing him for her third transorbital procedure. I Jim Horne is Director, Sleep Research Centre, Loughborough University j.a.horne@lboro.ac.uk

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The Psychologist August 2011  

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