RICHArD GrOSS

MEDICINE
& NAnCY KInnISOn

for Nurses and Health Professionals

Psychology

PsychologY
Psychology
for Nurses and Health Professionals

Psychology for Nurses and Health Professional,,s, Se,c,ond

edition is an accessible guide providing comprehensive

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Psychology
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for Nurses and Health Professionals

Second edition
for Nurses and Health Professionals

Second edition

RICHARD GROSS
NANCY KINNISON

Boca Raton London New York

CRC Press is an imprint of the

Taylor & Francis Group, an informa business
CRC Press
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 To Libbey Starr, granddaughter number five, as adorable and
beautiful as the other four. What a fortunate Poppa I am!

Richard Gross

To Theresa and Michael and their families, who light up my life.

Nancy Kinnison
Contents

Prefaceix
Acknowledgementsxi
Authorsxiii
Table of diary extracts xv

1. What is psychology? 1
2. Theoretical approaches 21
3. Psychological aspects of illness 41
4. Stress: Definitions and causes 75
5. Stress: Effects and methods of coping 101
6. Attitudes and attitude change 127
7. Prejudice and discrimination 145
8. Conformity and group influence 171
9. Obedience 187
10. Social cognition and health behaviour 215
11.  Neuropsychological and genetic aspects of illness 247
12.  Substance use and abuse 275
13. Death and dying 297
14. Early experience and social development 325
15. Cognitive development 349
16. Development of the self-concept 367
17.  Adolescence 385
18. Adulthood 403
19. Late adulthood 419

Glossary439
References457
Index497

vii
Preface

The basic approach that we adopted in the first edition of Psychology for Nurses
and Health Professionals has been retained: psychological theory and research
is interpreted and digested through the eyes of an imaginary student, Surena,
whose ‘From my diary’ extracts (indicated by the pen icon in the margin) pro-
vide the scenarios that relate to the chapter. Surena does not make her ‘appear-
ance’ until Chapter 3, when she begins to use the book to help her understand
her experiences in her placements. As in your own practice, these do not follow
the sequence of the chapters. To help you find your way around the book, we
have provided a ‘map’ in the form of a grid on page xv that shows how Surena’s
placements and the chapters are related.
Throughout each chapter, Surena makes notes indicated by the notebook
icon in the margin. In keeping with the increased emphasis on reflective prac-
tice (RP) in higher education, in this edition Surena refers more to RP theories
to help her structure and analyse her own. Sometimes she reflects on her feel-
ings about and behaviour towards her patients or applies the psychological
material to the patients’ and her own behaviour. As she gains experience, she
comments on or evaluates the psychological material itself or reflects on ethi-
cal and social issues.
Note that in all chapters the psychology content includes critical evalua-
tion of theory and research, which shows the additional higher level academic
skills you are expected to develop during your course. To that end, a recurring
feature is the ‘Time for Reflection...’ breaks. These are designed to encourage
you to think about the text that follows and to have questions (if not always
answers) in your mind to help you understand and digest the studies and theo-
ries that you read about. So, instead of just reading in a rather passive way, you
will adopt a more critical approach, equipped with some idea of what to expect
and what to look out for.
Sometimes the questions are quite specific, and the answers are given
directly in the text that immediately follows. At other times, the questions are
more general and abstract, and the answers unfold throughout the next few
paragraphs. Another kind of question will require you to reflect on your own
experiences and views on a particular issue; in these cases, of course, there is
no ‘correct answer’.
Occasionally, these ‘Time for Reflection...’ breaks appear as ‘Research
Questions...’; here, you are asked to think about methodological issues arising
from a particular piece of research described in the text.
Frequent references are made to Psychology: The Science of Mind and
Behaviour (2010), written by one of us (Richard Gross), pointing you in the

ix
x Preface

direction of more detailed discussion of a particular theory or study or dis-

cussion of something that space does not allow in the present text at all.
Other features include ‘Key Study’ and ‘Critical Discussion’ boxes. Every
chapter opens with an introduction and overview, which tells you what is cov-
ered in the chapter and sets the scene, and ends with a comprehensive sum-
mary, useful for revision.
Based on reviewers’ comments, we have changed the number and order
of chapters as they appeared in the first edition. We believe the order is more
logical and gives the book greater overall coherence. While dropping three
chapters from the first edition, much of the material has been moved into other
chapters. In addition, there is a brand new chapter on neuropsychological and
genetic aspects of illness and a substantial amount of updating and reordering
of material – both within and between chapters.
Finally, Richard Gross has produced an easily accessible Web site. This
includes additional material to complement the textbook as well as ways of
assessing your knowledge and understanding.
It seems self-evident that to provide holistic care for patients, all health pro-
fessionals need to have a theoretical knowledge and understanding of psychol-
ogy. Knowing how to apply it is less obvious, and, of course, there is no one
best or correct way to do it. We believe that our approach is supremely relevant
to the evolving demands of patient care and hope that you will find it both
useful and enjoyable. The ‘for’ in the title explicitly relates to nurses and allied
health professionals in their different roles; implicitly, and as demonstrated
throughout the book, it also relates to you as an individual.

Richard Gross and Nancy Kinnison

Free web resources

PowerPoint chapter summaries, MCQs and extension material are available
to download from the CRC Press website: [Link]
isbn/9781444179927.
Acknowledgements

The authors thank Naomi Wilkinson for commissioning this second edition
while still at Hodder Education and for taking the project with her when she
moved to Taylor & Francis (United Kingdom). They also thank Ed Curtis,
project editor at Taylor & Francis (Florida), for his support and guidance, as
well as Dennis Troutman at diacriTech in New Hampshire and Paul Abraham
and Dhayanidhi Karunanidhi at diacriTech in Chennai, India.
As with the first edition, Richard thanks Nancy for providing what he could
not – the essential ability to ‘translate’ psychological theory into the language
of nursing practice.
Nancy’s thanks extend further to Alison and Michael Stuckey for their
enduring support, to Laura-Jane Harris for her collaboration on the scenarios
and to the care practitioners and patients for sharing so generously with me
their thoughts, experiences and feelings on which they are based. For reasons
of confidentiality you must remain anonymous – but you know who you are...
Nancy owes a very special debt of gratitude to Richard for his general text-
book (an unrivalled reference throughout my teaching career) and for his
patient guidance and encouragement during our further work on this edition.
Again, it has been a privilege and a pleasure.

xi
Authors

Richard Gross studied psychology and philosophy at Nottingham University,

followed by a master’s degree in the sociology of education and mass commu-
nications at Leicester University School of Education. After completing a post-
graduate certificate in education, he taught psychology for more than 25 years
on a variety of further and higher education courses, including ‘A’ level, access
to higher education, and nursing diploma and degree courses. He has published
a number of psychology textbooks, including Psychology: The Science of Mind
and Behaviour (1st edition 1987, now in its 6th edition [2010]), Key Studies in
Psychology (6th edition, 2012), Themes, Issues and Debates in Psychology (3rd
edition, 2009), and Being Human: Psychological and Philosophical Perspectives
(2012).
Nancy Kinnison worked as a staff nurse in Cornwall following her general
training at the Royal Devon and Exeter Hospital. Her experience included
gynaecology, dermatology and children’s wards and casualty. During this
time, she obtained the diploma in nursing (Part A–theory) and then became a
night sister at the Royal Cornwall Hospital (Treliske). Following her divorce,
she obtained a degree in sociology and social administration (health care)
at Southampton University and then a postgraduate teaching certificate at
Garnett College in London. Throughout this time she was an ‘agency nurse’
working in hospitals in Cornwall, Southampton and Roehampton (London).
While teaching in London (where she was fortunate to meet Richard Gross),
she taught sociology, psychology and health education and also piloted and
managed the new BTEC National Diploma in Health Studies. Later, she moved
to Bath College of Further Education to take a position that included teaching
psychology on the postgraduate diploma in nursing, run in collaboration with
Bath Royal United Hospital.

xiii
Table of diary extracts
Diary entry Title Page Chapter no. and title
1. Year 1/Community/District 41   3. Psychological aspects of illness
Nurse
2. Year 1/Community/District 216 10. Social cognition and health
Nurse behaviour
3. Year 1/Community/District 297 13. Death and dying
Nurse
4. Year 1/Community (Health 326 14. Early experience and social
Visitor) development
5a. Year 1/Community (Health 349 15. Cognitive development
Visitor)
5b. Year 1/Children’s Ward 353 15. Cognitive development
6. Year 1/Orthopaedic Ward 172   8. Conformity and group influence
7. Year 1/Orthopaedic Ward 188   9. Obedience
8. Year 2/Surgical Ward 386 17. Adolescence
9. Year 2/Surgical Ward 367 16. Development of the self-concept
10. Year 2/Surgical Ward 128   6. Attitudes and attitude change
11. Year 3/Medical Ward 76   4. Stress: Definitions and causes
12. Year 2/Medical Ward 276 12. Substance use and abuse
13. Year 2/Medical Ward 404 18. Adulthood
14. Year 2/Elderly Care Ward 146   7. Prejudice and discrimination
15. Year 3/Elderly Care Ward 248 11. Neuropsychological and genetic
aspects of illness
16. Year 3/Elderly Care Ward 102   5. Stress: Effects and methods of
coping
17. Year 2/Teaching Block 420 19. Late adulthood

xv
1 What is psychology?

Introduction and overview

The opening chapter in any textbook is intended to ‘set the scene’ for what
­follows, and this normally involves defining the subject or discipline. In most
disciplines, this is usually a fairly simple task. With psychology, however, it is
far from straightforward. Definitions of psychology have changed frequently
during its relatively short history as a separate field of study. This reflects dif-
ferent, and sometimes conflicting, theoretical views regarding the nature
of human beings and the most appropriate methods for investigating them.
While most psychologists would consider themselves to be scientists, they
disagree about exactly what science involves and the appropriateness of using
certain scientific methods to study human behaviour.

A brief history
The word ‘psychology’ is derived from the Greek words psyche (mind, soul or
spirit) and logos (knowledge, discourse or study). Literally, then, psychology is
the ‘study of the mind’.
The emergence of psychology as a separate discipline is generally dated at
1879, when Wilhelm Wundt opened the first psychological laboratory at the
University of Leipzig in Germany. Wundt and his co-workers were attempt-
ing to investigate ‘the mind’ through introspection to analyse conscious
thought into its basic elements, much as chemists analyse compounds into ele-
ments. This attempt to identify the structure of conscious thought is called
structuralism.
Wundt and his co-workers recorded and measured the results of their
introspections under controlled conditions, using the same physical surround-
ings, the same ‘stimulus’ (such as a clicking metronome), the same verbal
instructions to each participant and so on. This emphasis on measurement

1
2 What is psychology?

and control marked the separation of the ‘new psychology’ from its parent
discipline of philosophy.

In Greek mythology, Psyche

And logos
was represented by a
means “knowledge”,
butterfly. She became the
“study”: like
wife of Eros, the god of love
all “ologies”!
(renamed Cupid by the
Romans).

Philosophers had discussed ‘the mind’ for thousands of years. For the first
time, scientists (Wundt was a physiologist by training) applied some of scien-
tific investigation’s basic methods to the study of mental processes. This was
reflected in James’s (1890) definition of psychology as

the Science of Mental Life, both of its phenomena and

of their conditions … The Phenomena are such things
as we call feelings, desires, cognition, reasoning, deci-
sions and the like.

However, by the early twentieth century, the validity and usefulness of

introspection were being seriously questioned, particularly by American psy-
chologist John B. Watson. Watson believed that the results of introspection
could never be proved or disproved, since if one person’s introspection pro-
duced different results from another’s, how could we ever decide which was
correct? Objectively, of course, this is impossible: we cannot ‘get behind’ an
introspective report to check its accuracy. Introspection is subjective, and only
the individual can observe his/her own mental processes.
Consequently, Watson (1913) proposed that psychologists should confine
themselves to studying behaviour, since only this is measurable and observable
by more than one person. Watson’s form of psychology was known as behav-
iourism, which claimed that the only way psychology could make any claim
 A brief history 3

to being scientific was to emulate the natural sciences (physics and chemistry)
and adopt its own objective methods. Watson (1919) defined psychology as

that division of Natural Science which takes human

behaviour – the doings and sayings, both learned and
unlearned – as its subject matter.

Especially in America, behaviourism (in one form or another) remained

the dominant force in psychology up until the late 1950s. The emphasis on the
role of learning (in the form of conditioning) was to make that topic one of the
central areas of psychological research as a whole (see Box 2.2).
In the late 1950s, many British and American psychologists began looking
to the work of computer scientists to try to understand more complex behav-
iours that, they felt, had been either neglected altogether or greatly oversimpli-
fied by learning theory (conditioning). These complex behaviours were what
Wundt, James and other early scientific psychologists had called mind or men-
tal processes. They are now called cognition or cognitive processes, including
perception, attention, memory, problem-solving, decision-making, language
and thinking in general.
Cognitive psychologists see people as information-processors, and cogni-
tive psychology has been heavily influenced by computer science, with human
cognitive processes being compared with the operation of computer programs
(the computer analogy). Cognitive psychology now forms part of cognitive sci-
ence, which emerged in the late 1970s (see Figure 1.1).
Despite the fact that cognitive processes can only be inferred from what
a person does (they cannot be observed literally or directly), they are now
accepted as valid subject matter for psychology, provided they can be made
‘public’ (as in memory tests or problem-solving tasks). What people say and do

Psychoanalytic theory and Gestalt psychology

●● In 1900, Sigmund Freud, a neurologist living in Vienna, first published his psychoana-
lytic theory of personality in which the unconscious mind played a crucial role. In paral-
lel with this theory, he developed a form of psychotherapy called psychoanalysis. Freud’s
theory (which forms the basis of the psychodynamic approach) represented a challenge
and a major alternative to behaviourism (see Chapter 2).
●● A reaction against both structuralism and behaviourism came from the Gestalt school
of psychology, which emerged in the 1920s in Austria and Germany. Gestalt psycholo-
gists were mainly interested in perception, which they believed could not be broken
down in the way that Wundt proposed, and behaviourists advocated for behaviour.
Gestalt psychologists identified several ‘laws’ or principles of perceptual organisation
(such as ‘the whole is greater than the sum of its parts’), which have made a lasting
contribution to our understanding of the perceptual process (see Gross, 2010, for a
detailed discussion).
4 What is psychology?

Figure 1.1 The relationship between psychology and other scientific disciplines.

Biology
Science of living things
(a) human beings and other
(non-human) animals
(b) physiology (c) genetics

Biological bases of behaviour

Heredity and environment
Comparative psychology

Psychiatry Psychology Sociology

Clinical psychology Social Scientific
Branch of Scientific study
of behaviour psychology study of
medicine Abnormal psychology
dealing with and experience society
psychological Learning theory
illness Anthropology
(psychopathology) Personality theory

Intelligence
Cognitive Philosophy
Psychotherapy science
e.g., Developmental psychology Cognitive The scientific study
psychoanalysis psychology of cognition Linguistics

Artificial intelligence Neuroscience

(part of computer science)

informs us about their cognitive processes; however, the processes themselves

remain inaccessible to the observer.
The influence of both behaviourism and cognitive psychology is reflected in
Clark and Miller’s (1970) definition of psychology as

the scientific study of behaviour. Its subject matter

includes behavioural processes that are observable,
such as gestures, speech and physiological changes,
and processes that can only be inferred, such as
thoughts and dreams.

Similarly, Zimbardo (1992) states that ‘Psychology is formally defined as

the scientific study of the behaviour of individuals and their mental processes’.

Classifying the work that psychologists do

Despite behaviourist and cognitive psychology’s influence on psychology’s
general direction in the past 90 years or so, much more goes on within psychol-
ogy than has been outlined so far. There are other theoretical approaches or
 Classifying the work that psychologists do 5

orientations, other aspects of human (and non-human) activity that ­constitute

the special focus of study and different kinds of work that different psycholo-
gists do.
A useful, but not hard and fast, distinction can be made between the aca-
demic and applied branches of psychology. Academic psychologists carry out
research and are attached to a university or research establishment, where they
will also teach undergraduates and supervise the research of postgraduates.
Research is both pure (done for its own sake and intended, primarily, to increase
our knowledge and understanding) and applied (aimed at solving a particu-
lar problem). Applied research is usually funded by a government institution
like the Home Office, National Health Service (NHS) or the Department for
Children, Schools and Families or by some commercial or industrial institution.
The range of topics that may be investigated is as wide as psychology itself, but
they can be classified as focusing either on the processes or mechanisms under-
lying various aspects of behaviour or more directly on the person (Legge, 1975).

Process approach
The process approach is divided into three main areas: physiological, cognitive
and comparative psychology.

Physiological (or bio)psychology (Chapters 3–5 and 11)

Physiological (or bio)psychologists are interested in the physical basis of behav-
iour, how the functions of the nervous system (in particular the brain) and the
endocrine (hormonal) system are related to and influence behaviour and men-
tal processes. For example, are there parts of the brain specifically concerned
with particular behaviours and abilities (localisation of brain function)? What
role do hormones play in the experience of emotion and how are these linked
to brain processes?
A fundamentally important biological process with important implica-
tions for psychology is genetic transmission. The heredity and environment (or
nature–nurture) issue draws on what geneticists have discovered about the
characteristics that can be passed from parents to offspring, how this takes
place and how genetic factors interact with environmental ones (see Gross,
2010). Other topics within physiological psychology include motivation and
stress (an important topic within health psychology).

Cognitive psychology
As seen earlier (page 3), cognitive (or mental) processes include attention,
memory, ­ perception, language, thinking, problem-solving, decision-making,
reasoning and concept-formation (‘higher-order’ mental activities). Social
psychology (classified here as belonging to the person approach) is heavily
cognitive in flavour: for example, many social psychologists study the mental
processes we use when trying to explain people’s behaviour (for social cog-
nition, see Chapter 10). Also, Piaget’s theory (again, belonging to the person
approach) is ­concerned with cognitive development (see Chapter 15).
6 What is psychology?

Comparative psychology
Comparative psychology is the study of the behaviour of non-human ­animals,
aimed at identifying similarities and differences between species. It also
involves studying non-human animal behaviour to gain a better understand-
ing of human behaviour. The basis of comparative psychology is evolutionary
theory. Research areas include classical and operant conditioning (see Box 2.2)
and evolutionary explanations of human behaviour (see Gross, 2010).

Person approach
Social psychology (Chapters 6–9)
Some psychologists would claim that ‘all psychology is social psychology’,
because all behaviour – public and private – take place within a social context.
However, other people usually have a more immediate and direct influence on
us when we are actually in their presence (as in conformity and obedience –
see Chapters 8 and 9). Social psychology is also concerned with attitudes and
attitude change (see Chapter 6), and prejudice and discrimination (Chapter 7).

Developmental psychology (Chapters 14–19)

Developmental psychologists study the biological, cognitive, social and emo-
tional changes that occur in people over time. One significant change within
developmental psychology during the past 30 years or so is the recognition
that development is not confined to childhood and adolescence, but is a life-
long process (the lifespan approach). It is now generally accepted that develop-
ment continues beyond childhood and adolescence into adulthood and late
adulthood (see Figure 1.2).

Figure 1.2 Three generations of the same family.

 Areas of applied psychology 7

Individual differences
This is concerned with the ways in which people can differ from one another,
including personality (see Chapter 5), intelligence and psychological abnormal-
ity. Major mental disorders include dementia (see Chapter 11), schizophrenia,
depression, anxiety disorders and eating disorders. Abnormal psychology is
closely linked with clinical psychology, one of the major applied areas of psy-
chology (see discussion in page 9). Psychologists who study abnormality and
clinical psychologists are also concerned with the effectiveness of different
forms of treatment and therapy. Each major theoretical approach has contrib-
uted to both the explanation and treatment of mental disorders (see Chapter 2).

Comparing the process and person approaches

In practice, it is very difficult to separate the two approaches. However, there
are important relative differences between them.

Some important differences between the process and person

approaches
●● The process approach is typically confined to the laboratory (where experiments are
the method of choice). It makes far greater experimental use of non-human animals
and assumes that psychological processes (particularly learning) are essentially the
same in all species and that any differences between species are only quantitative
(­differences of degree).
●● The person approach makes much greater use of field studies (such as observing behav-
iour in its natural environment) and of non-experimental methods (e.g. correlational
studies, see Chapter 3). Typically, human participants are studied and it is assumed that
there are qualitative differences (differences in kind) between humans and non-humans.

Areas of applied psychology

Discussion of the person/process approaches has been largely concerned with
the academic branch of psychology. Since the various areas of applied psychol-
ogy are all concerned with people, they can be thought of as the applied aspects
of the person approach.
According to Hartley and Branthwaite (1997), most applied psychologists
work in four main areas: clinical, educational and occupational psychology and
government service (such as forensic [or criminological] psychologists). In addi-
tion, Coolican et al. (2007) identify counselling, sport, health and environmen-
tal psychologists. Hartley and Branthwaite argue that the work psychologists
do in these different areas has much in common: it is the subject matter of their
jobs that differs, rather than the skills they employ. Consequently, they con-
sider an applied psychologist to be a person who can deploy specialised skills
appropriately in different situations (see Box 1.1).
8 What is psychology?

Box 1.1 Seven major skills (or roles) used by applied

­psychologists.
●● The psychologist as counsellor: Helping people to talk openly, express their feelings,
explore problems more deeply and see these problems from different perspectives.
Problems may include school phobia, marriage crises and traumatic experiences (such
as being the victim of a hijacking), and the counsellor can adopt a more or less direc-
tive approach (see Chapter 2, page 31).
●● The psychologist as colleague: Working as a member of a team and bringing a par-
ticular perspective to a task, namely drawing attention to the human issues, such as
the point of view of the individual end user (be it a product or a service of some kind).
●● The psychologist as expert: Drawing upon psychologists’ specialised knowledge, ideas,
theories and practical knowledge to advise on issues ranging from incentive schemes
in industry to appearing as an ‘expert witness’ in a court case.
●● The psychologist as toolmaker: Using and developing appropriate measures and tech-
niques to help in the analysis and assessment of problems. These include question-
naire and interview schedules, computer-based ability and aptitude tests and other
psychometric tests (mental measurement) (see Chapter 6).
●● The psychologist as detached investigator: Many applied psychologists carry out evalu-
ation studies to assess the evidence for and against a particular point of view. This
reflects the view of psychology as an objective science, which should use controlled
experimentation whenever possible (see pages 12–15).
●● The psychologist as theoretician: Theories try to explain observed phenomena, sug-
gesting possible underlying mechanisms or processes. They can suggest where to look
for causes and how to design specific studies that will produce evidence for or against
a particular point of view. Results from applied psychology can influence theoretical
psychology and vice versa.
●● The psychologist as agent for change: Applied psychologists are involved in helping
people, institutions and organisations, based on the belief that their work will change
people and society for the better. However, some changes are much more controver-
sial than others, such as the use of psychometric tests to determine educational and
occupational opportunities and the use of behaviour therapy and modification tech-
niques to change abnormal behaviour (see Chapters 2 and 5).
Source: Based on Hartley, J., Branthwaite, A., The Applied P
­sychologist, Open University Press,
­Buckingham, 2000.

TIME FOR REFLECTION …

●● Which, if any, of the skills identified by Hartley and Branthwaite do you
consider to be relevant to nursing (or allied health professions)?
●● How do they apply (it might be useful to think in terms of whether they
apply formally or informally, implicitly or explicitly)?
●● Are there any major skills that are used in nursing (or allied health pro-
fessions) that are not included by Hartley and Branthwaite?
 Areas of applied psychology 9

The major functions of the clinical psychologist

The functions of a clinical psychologist include the following:
●● Assessing people with learning difficulties, administering psychological tests to brain-
damaged patients, devising rehabilitation programmes for long-term psychiatric patients
and assessing elderly people for their fitness to live independently (see Chapter 11).
●● Planning and carrying out programmes of therapy, usually behaviour therapy/modifica-
tion or psychotherapy (group or individual) in preference to, or in addition to, behav-
ioural techniques (see Chapter 2).
●● Carrying out research into abnormal psychology, including the effectiveness of different
treatment methods (‘outcome’ studies); patients are usually adults, many of whom will be
elderly, in psychiatric hospitals, psychiatric wards in general hospitals and psychiatric clinics.
●● Involvement in community care, as psychiatric care in general moves out of the large
psychiatric hospitals.
●● Teaching other groups of professionals, such as nurses, psychiatrists and social workers.

Clinical psychology
Clinical psychologists are the largest single group of psychologists, both in the
United Kingdom (Coolican et al., 2007) and in the United States (Atkinson
et al., 1990). A related group is ‘counselling psychologists’, who tend to work
with younger clients in colleges and universities rather than in hospitals.
Clinical psychologists work largely in health and social care settings, including
hospitals, health centres, community mental health teams, child and adolescent
mental health services and social services. They usually work as part of a team
with, for example, social workers, medical practitioners and other health profes-
sionals. Most work in the NHS, but some work in private practice (see Figure 1.3).
Psychotherapy is usually carried out by psychiatrists (medically ­qualified
doctors specialising in psychological medicine) or psychotherapists (who have

Figure 1.3 Assessing elderly clients in a residential setting.

10 What is psychology?

undergone special training, including their own psychotherapy). In all

its ­
various forms, psychotherapy is derived from Freud’s psychoanalysis
(see  Chapter  2) and  is distinguished both from behavioural treatments and
from physical (somatic) treatments (those based on the medical model – see
Chapter 3 and Gross, 2010).

Forensic psychology
This is a branch of psychology that attempts to apply psychological principles
to the criminal justice system. Areas of research interest include jury selec-
tion, the presentation of evidence, eyewitness testimony, improving the recall
of child witnesses, false memory syndrome and recovered memory, offender
profiling, stalking, crime prevention, devising treatment programmes (such as
anger management) and assessing the risk of releasing prisoners.

Educational psychology
Educational psychologists are mostly employed by local education authorities,
working in schools, colleges, child and family centre teams (previously called
‘child guidance’), the School Psychological Service, hospitals, day nurseries,
nursery schools, special schools (day and residential) and residential children’s
homes. Their functions include the following:
●● Administering psychometric tests (particularly intelligence/IQ tests)
●● Planning and supervising remedial teaching
●● Planning educational programmes for children and adolescents with spe-
cial educational needs (including the visually impaired and autistic)
●● Advising parents and teachers how to deal with children and adolescents
with behaviour problems and/or learning difficulties

Occupational (work or organisational) psychology

Occupational psychologists are involved in the selection and training of indi-
viduals for jobs and vocational guidance, including administration of aptitude
tests and tests of interest. (This overlaps with the work of those trained in per-
sonnel management.)

Health psychology
This is one of the newer fields of applied psychology.
Health psychologists work in various settings such as hospitals, academic
health research units, health authorities and university departments. They
may deal with problems identified by health care agencies, including NHS
trusts and health authorities, health professionals (such as general practitio-
ners, nurses and rehabilitation therapists) and employers outside the health
care system.
 Language of psychology 11

The breadth of health psychology

●● The use of psychological theories and interventions to prevent damaging behaviours
(such as smoking, drug abuse and poor diet) and to change health-related behaviour
in community and workplace settings.
●● Promoting and protecting health by encouraging behaviours such as exercise, healthy
diet and health checks/self-examination.
●● Health-related cognitions: Investigating the processes that can explain, predict and
change health and illness behaviours (see Chapter 3).
●● The nature and effects of communication between health care practitioners and
patients, including interventions to facilitate adherence (such as taking medica-
tion), preparing patients for stressful medical procedures and so on (see Chapters 3
and 9).
●● Psychological aspects of illness: Looking at the psychological impact of acute and
chronic illness on individuals, families and carers (see Chapters 3 and 4).

Language of psychology

TIME FOR REFLECTION …

●● What, if anything, has come as a surprise to you regarding what goes on
in the name of ‘psychology’?

As in all sciences, there is a special set of technical terms (jargon) to get used
to, and this is generally accepted as an unavoidable feature of studying the sub-
ject. But over and above this jargon, psychologists use words that are familiar
to us from everyday speech in a technical way, and it is in these instances that
‘doing psychology’ can become a little confusing.
Some examples of this are ‘behaviour’ and ‘personality’. For a parent to tell
a child to ‘behave yourself’ is meaningless to a psychologist’s ears: behaving is
something we are all doing all the time (even when we are asleep). Similarly, to
say that someone ‘has no personality’ is meaningless because, as personality
refers to what makes a person unique and different from others, you cannot
help but have one!
Some of the technical terms used throughout the book are defined in the
Glossary (pages 439–456).

Formal versus informal psychology

Legge (1975) and others distinguish between formal and informal psychology
(or professional versus amateur, scientific versus non-scientific).
12 What is psychology?

Our common-sense, intuitive or ‘natural’ understanding is unsystematic

and does not constitute a body of knowledge. This makes it very difficult to
‘check’ an individual’s ‘theory’ about human nature, as does the fact that each
individual has to learn from his/her own experience. So part of the aim of for-
mal psychology is to provide such a systematic body of knowledge.
However, rather than negating or invalidating our everyday, common-
sense understanding, Legge (1975) believes that most psychological research
should be aimed at demonstrating ‘what we know already’, and then going
one step further. Only the methods of science, he believes, can provide us with
the public, communicable body of knowledge that we are seeking. According
to Allport (1947), the aim of science is ‘understanding, prediction and con-
trol above the levels achieved by unaided common sense’, and this is meant to
apply to psychology as much as to the natural sciences.

What do we mean by ‘science’?

TIME FOR REFLECTION …

●● What do you understand by the term ‘science’?
●● What makes a science different from non-science?
●● Are there different kinds of science and, if so, what do they have in
common?

Asking this question is a necessary first step for considering the appropriate-
ness of attempting to scientifically study human behaviour.

Major features of science

Most psychologists and philosophers of science would probably agree that for
a discipline to be called a science, it must possess certain characteristics. These
are summarised in Figure 1.4.

What is ‘scientific method’?

The account shown in Figure 1.4 of what constitutes a science is non-­
controversial. However, it fails to tell us how the scientific process takes place,
the sequence of ‘events’ involved (such as where the theory comes from in
the first place and how it is related to observation of the subject matter) or the
exact relationship between theory construction, hypothesis testing and data
collection.
Collectively, these ‘events’ and relationships are referred to as (the) scientific
method. Table 1.1 summarises some common beliefs about both science and
scientific method, together with some alternative views.
 What do we mean by ‘science’? 13

Figure 1.4 A summary of the major features of a science.

A
science
must
involve

Subject matter
There must be a definable
What is it about?
subject matter (the range of
objects or phenomena it studies)

Theory construction Explanation:

A theory is a complex set of How can we account for what
inter-related statements which we observe?
attempts to explain observed Why does it happen?
phenomena

Hypothesis testing
Discovery
A hypothesis is a testable
Prediction: of
statement, derived from a theory,
Given our general
which makes a prediction about
theory, what laws
what will happen under certain
will happen if…? or
specified conditions
principles

Evidence:
Use of empirical methods Have our predictions
been supported?

1. Experiments Laboratory
Field How are the data collected?
2. Observation Natural
(a) naturalistic
(b) controlled
(c) participant

3. Tests
(a) standardised/objective
(b) projective

4. Surveys and questionnaires

5. Case studies
14 What is psychology?

Table 1.1 Some common beliefs and alternative views about ‘science’ and ‘scientific method’.

Common beliefs Alternative views

λ Scientific discovery begins with λ There is no such thing as ‘unbiased’
simple, unbiased, unprejudiced or ‘unprejudiced’ observation.
observation: the scientist simply Observation is always selective,
‘samples’ the world without any interpretative, prestructured and
preconceptions, expectations or directed: we must have at least some
predetermined theories idea of what we are looking for,
otherwise we cannot know when we
have found it. Goldberg (2000) cites
a philosophy professor who asserted
that what we call ‘data’ (that which is
given) should more accurately be
called ‘capta’ (that which is taken)
ν From the resulting sensory evidence ν ‘Data’ do not constitute ‘facts’:
(‘data’/sense data), generalised evidence usually implies measure­
statements of fact will take shape: we ments, numbers and recordings,
gradually build up a picture of what which need to be interpreted in the
the world is like based on a number light of a theory. Facts do not exist
of separate ‘samples’ objectively and cannot be discovered
through ‘pure observation’
‘Fact’ = data + theory (Deese, 1972)
σ The essential feature of scientific σ Despite the central role of data
activity is the use of empirical collection, data alone do not make a
methods, through which the sensory science. Theory is just as crucial,
evidence is gathered: what distin­ because without it data have no
guishes science from non-science is meaning (see preceding point)
performing experiments and so on
τ The truth about the world (the τ Scientific theory and research reflect
objective nature of things, what the the biases, prejudices, values and
world is ‘really like’) can be assumptions of the individual scientist
established through properly as well as of the scientific community
controlled experiments and other s/he belongs to. Science is not
ways of collecting ‘facts’: science can value-free (see Gross, 2010)
tell us about reality as it is
independent of the scientist or the
activity of observing it
 Scientific study of human behaviour 15

Table 1.1 (Continued) Some common beliefs and alternative views about ‘science’ and ‘scientific method’.

Common beliefs Alternative views

υ Science involves the steady υ Science involves an endless succession
accumulation of knowledge: each of long, peaceful periods (‘normal
generation of scientists adds to the science’) and ‘scientific revolutions’
discoveries of previous generations (Kuhn, 1962; see Table 2.1)
ι Science has a warm, human,
exciting, argumentative, creative
‘face’ (Collins, 1994)
Source: Based on Medawar, P.B., The Art of the Soluble, Penguin Books, Harmondsworth, 1963; Popper,
K., Objective Knowledge: An Evolutionary Approach, Oxford University Press, Oxford, 1972.

Scientific study of human behaviour

Social nature of science: The problem of objectivity
‘Doing science’ is part of human behaviour. When psychologists study what
people do, they are engaging in some of the very same behaviours they are try-
ing to understand (such as thinking, perceiving, problem-solving and explain-
ing). This is what is meant by the statement that psychologists are part of their
own subject matter, which makes it even more difficult for them to be objective
than other scientists.
According to Richards (1996), it may be impossible for any scientist to
achieve complete objectivity. One reason for this relates to the social nature of
scientific activity. As Rose (1997) says,

How biologists, or any scientists, perceive the world

is not the result of simply holding a true reflecting
mirror up to nature: it is shaped by the history of our
subject, by dominant social expectations and by the
patterns of research funding.

According to Richardson (1991), science is a very social business. Research

must be qualified and quantified to enable others to replicate it: in this way, the
procedures, instruments and measures become standardised, so that scientists
anywhere in the world can check the truth of reported observations and find-
ings. This implies the need for universally agreed conventions for reporting
these observations and findings.
However, even if there are widely accepted ways of ‘doing science’, ‘good sci-
ence’ does not necessarily mean ‘good psychology’. Is it valid to study human
behaviour and experience as part of the natural world, or is a different kind of
16 What is psychology?

approach needed altogether? After all, it is not just psychologists who observe,
experiment and theorise (Heather, 1976).

The Psychology experiment as a social situation

To regard empirical research in general, and the experiment in particular, as
objective involves two related assumptions:
1. Researchers influence the participant’s behaviour (the outcome of the
experiment) only to the extent that they decide what hypothesis to test, how
the variables are to be operationalised (defined in a way that allows them to
be measured), what design to use (e.g. randomly allocating each participant
to one experimental condition or testing every participant under each con-
dition) and so on.
2. The only factors influencing the participant’s performance are the ­objectively
defined variables manipulated by the experimenter.

TIME FOR REFLECTION …

●● Try to formulate some arguments against these two assumptions.
●● What do the experimenter and participant bring with them to the exper-
imental situation that is not directly related to the experiment, and how
may this (and other factors) influence what goes on in the experimental
situation (see Gross, 2010)?

Experimenters are people too: The problem of experimenter bias

Some examples of experimenter bias

●● According to Valentine (1992), experimenter bias has been demonstrated in various
experiments, including reaction time, animal learning, verbal conditioning, person-
ality assessment, person perception, learning and ability as well as in everyday life
situations.
●● What these experiments consistently show is that if one group of experimenters has
one hypothesis about what it expects to find and another group has the opposite
hypothesis, both groups will obtain results that support their respective hypotheses.
The results are not due to the mishandling of data by biased experimenters: the experi-
menters’ bias somehow creates a changed environment, in which participants actually
behave differently.
●● In a natural classroom situation, children whose teachers were told they would show
academic ‘promise’ during the next academic year showed significantly greater IQ
gains than children for whom such predictions were not made (although this latter
group also made substantial improvements). In fact, the children were randomly allo-
cated to the two conditions. But the teachers’ expectations actually produced the pre-
dicted improvements in the ‘academic promise’ group, demonstrating a self-fulfilling
prophecy (Rosenthal and Jacobson, 1968).
 Scientific study of human behaviour 17

TIME FOR REFLECTION …

●● Try to explain the findings from the studies described in Box ‘Some
examples of experimenter bias’.
●● How could experimenter expectations actually bring about the different
performances of the two groups of children?

Participants are psychologists too: Demand characteristics

Instead of seeing the person being studied as a passive responder to whom
things are done (‘subject’), Orne (1962) stresses what the person does, imply-
ing a far more active role. Participants’ performance in an experiment could
be thought of as a form of problem-solving behaviour. At some level, they see
the task as working out the true purpose of the experiment and responding in
a way that will support the hypothesis being tested.
In this context, the cues that convey the experimental hypothesis to participants
represent important influences on their behaviour, and the sum total of those cues
are called the demand characteristics of the experimental situation. These cues
include all explicit and implicit communications during the actual experiment
(Orne, 1962). This tendency to identify the demand characteristics is related to the
tendency to play the role of a ‘good’ (or ‘bad’) experimental participant.
Not only is the experiment a social situation, but science itself is a culture-
related phenomenon. This represents another respect in which science cannot
claim complete objectivity (Moghaddam et al., 1993).

Problem of representativeness
Traditional, mainstream experimental psychology adopts a nomothetic (‘law-
like’) approach. This involves generalisation from limited samples of partici-
pants to ‘people in general’, as part of the attempt to establish general ‘laws’ or
principles of behaviour.

TIME FOR REFLECTION …

●● The photograph below captures a fairly typical scene as far as participant
­characteristics in mainstream psychological research are concerned. It
depicts one of Asch’s famous conformity experiments (see Chapter 8,
pages 174–177).
●● What are the most apparent characteristics of the experimental partici-
pants, and how are they similar to/different from those of Asch (who is
pictured furthest right)?
18 What is psychology?

Despite the fact that Asch’s experiments were carried out in the early 1950s,
very little has changed as far as participant samples are concerned. In American
psychology at least, the typical participant is a psychology undergraduate, who
is obliged to take part in a certain number of studies as a course requirement
and who receives ‘course credits’ for doing so (Krupat and Garonzik, 1994).
Mainstream British and American psychology has implicitly equated
‘human being’ with ‘member of Western culture’. Despite the fact that the vast
majority of research participants are members of Western societies, the result-
ing findings and theories have been applied to ‘human beings’, as if culture
made no difference (they are ‘culture-bound and culture-blind’) (Sinha, 1997).
This Anglocentric or Eurocentric bias (a form of ethnocentrism) is matched by
the androcentric or masculinist bias (a form of sexism), according to which the
behaviours and experiences of men are taken as the standard against which
women are judged (see Gross, 2009).
In both cases, while the bias remains implicit and goes unrecognised (and is
reinforced by psychology’s claim to be objective and value-free), research find-
ings are taken as providing us with an objective, scientifically valid account of
what ‘women/people in general are like’. Once we realise that scientists, like all
human beings, have prejudices, biases and values, their research and theories
begin to look less objective, reliable and valid than they did before.

Problem of artificiality
Criticisms of traditional empirical methods (especially the labora-
tory experiment) have focused on their artificiality, including the often
unusual and bizarre tasks that people are asked to perform in the name of
science. Yet, we cannot be sure that the way people behave in the labora-
tory is an accurate indication of how they are likely to behave outside it
(Heather, 1976).
What makes the laboratory experiment such an unnatural and artificial
situation is the fact that it is almost totally structured by one ‘participant’ –
the experimenter. This relates to power differences between experimenters and
their ‘subjects’, which is as much an ethical as a practical issue (see Gross, 2009).
Traditionally, participants have been referred to as ‘subjects’, implying
something less than a person, a dehumanised and depersonalised ‘object’.
According to Heather (1976), it is a small step from reducing the person to a
mere thing or object (or experimental ‘subject’) to seeing people as machines
or machine-like (‘mechanism’ = ‘machine-ism’ = mechanistic view of people).
This way of thinking about people is reflected in the popular definition of psy-
chology as the study of ‘what makes people tick’.

Problem of internal versus external validity

If the experimental setting (and task) is seen as similar or relevant enough
to everyday situations to allow us to generalise the results, we say that the
study has high external or ecological validity. But what about internal valid-
ity? Modelling itself on natural science, psychology attempts to overcome the
 Conclusions 19

Box 1.2 Some difficulties with the notion of experimental control

●● While it is relatively easy to control the more obvious situational variables, this is more
difficult with participant variables, either for practical reasons (such as the availability
of these groups) or because it is not always obvious exactly what the relevant variables
are. Ultimately, it is down to the experimenter’s judgement and intuition: what she/he
believes it is important (and possible) to control (Deese, 1972).
●● If judgement and intuition are involved, then control and objectivity are matters of
degree, whether in psychology or physics (see Table 1.1).
●● It is the variability/heterogeneity of human beings that makes them so much more dif-
ficult to study than, say, chemicals. Chemists do not usually have to worry about how
two samples of a particular chemical might differ from each other, but psychologists
need to allow for individual differences between participants.
●● We cannot just assume that the IV (or ‘stimulus’ or ‘input’) is identical for every partici-
pant, definable in some objective way, independent of the participant and exerting a
standard effect on everyone.
●● Complete control would mean that the IV alone was responsible for the DV, so that
experimenter bias and the effect of demand characteristics were irrelevant. But even if
complete control were possible (even if we could guarantee the internal validity of the
experiment), a fundamental dilemma would remain. The greater the degree of control
over the experimental situation, the more different it becomes from real-life situations
(the more artificial it gets and the lower its external validity).

problem of the complexity of human behaviour by using experimental con-

trol. This involves isolating an independent variable (IV) and ensuring that
extraneous variables (variables other than the IV likely to affect the dependent
variable [DV]) do not affect the outcome (see Coolican, 2004). But this begs the
crucial question: how do we know when all the relevant extraneous variables
have been controlled? (See Box 1.2).
To discover the relationships between variables (necessary for understand-
ing human behaviour in natural, real-life situations), psychologists must
‘bring’ the behaviour into a specially created environment (the laboratory),
where the relevant variables can be controlled in a way that is impossible in
naturally occurring settings. However, in doing so, they construct an artificial
environment and the resulting behaviour is similarly artificial – it is no longer
the behaviour they were trying to understand!

Conclusions
During the course of its life as a separate discipline, definitions of psychology
have changed quite fundamentally, reflecting the influence of different theo-
retical approaches. Initially through the influence of behaviourism, psychol-
ogy has taken the natural sciences as its model (scientism). In this chapter,
20 What is psychology?

we have highlighted some of the major implications of adopting methods of

­investigating the natural world and applying them to the study of human
behaviour and experience. Ultimately, whatever a particular science may
claim to have discovered about the phenomena it studies, scientific activity
remains just one more aspect of human behaviour.

CHAPTER SUMMARY
●● Early psychologists, such as Wundt, attempted to study the mind through
introspection under controlled conditions, aiming to analyse conscious
thought into its basic elements (structuralism).
●● Watson rejected introspectionism’s subjectivity and replaced it with
behaviourism. Only by using the methods of natural science and study-
ing observable behaviour could psychology become a true science.
●● Gestalt psychologists criticised both structuralism and behaviourism,
advocating that ‘the whole is greater than the sum of its parts’. Freud’s
psychoanalytic theory was another major alternative to behaviourism.
●● Cognitive psychologists see people as information processors, based on the
computer analogy. Cognitive processes, such as perception and memory,
are an acceptable part of psychology’s subject matter.
●● Academic psychologists are mainly concerned with conducting research
(pure or applied), which may focus on underlying processes/mechanisms
or on the person.
●● The process approach consists of physiological, cognitive and compara-
tive psychology, while the person approach covers developmental and
social psychology and individual differences.
●● Most applied psychologists work in clinical, counselling, forensic, educational
or occupational psychology. Newer fields include health and sport psychology.
●● A distinction is commonly made between informal/common-sense and
formal/scientific psychology. The latter aims to go beyond common-sense
understanding and to provide a public, communicable body of knowledge.
●● A science must possess a definable subject matter, involve theory con-
struction and hypothesis testing and use empirical methods for data
collection. However, these characteristics fail to describe the scientific
process or scientific method.
●● Science is a very social activity and consensus among the scientific com-
munity is paramount. This detracts from psychology’s claim (or that of
any other science) to objectivity.
●● Environmental changes are somehow produced by experimenters’ expec-
tations (experimenter bias), and demand characteristics influence partici-
pants’ behaviours by helping to convey the experimental hypothesis. The
experiment is a social situation and science itself is culture related.
●● The artificiality of laboratory experiments is largely due to their being
totally structured by experimenters. Also, the higher an experiment’s
internal validity, the lower its external validity becomes.
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