The development of perceived control
Frank J. Infurna, Charles J. Infurna, in Personality Development Across the Lifespan, 2017
What is perceived control?
Constructs encompassing perceptions of control range from locus of control to constraints, fatalism, mastery, agency, competence, learned helplessness, and self-efficacy. This set of constructs represents an integral general-purpose belief system that has diverse effects across the lifespan. Perceived control in this chapter is considered a catch-all term that encompasses many different constructs relating to control, such as locus of control [Rotter, 1966], self-efficacy [Bandura, 1997], learned helplessness [Seligman, 1975], constraints [Lachman & Weaver, 1998], and mastery [Pearlin & Schooler, 1978]. At the very heart of the various definitions and constructs of perceived control are competence and contingency. Competence is defined as ones ability or capacity to interact effectively with its environment and effectiveness in carrying out goals [White, 1959]. Contingency refers to the belief that performing a particular behavior will then lead to the desired outcome or belief that there are obstacles or factors beyond ones control that interfere with reaching goals [Skinner, 1996]. Generally speaking, the collective measures of perceived control can be broadly defined as [1] the belief that ones own actions, efforts, and choices can exert influence over and shape life circumstances and [2] ones ability to attain desired outcomes [Infurna & Mayer, 2015; Krause, 2003; Levenson, 1981; Pearlin & Schooler, 1978; Skinner, 1996].
More broadly, we believe that perceived control can be construed as ones orientation toward life circumstances. That is, perceived control refers to how individuals orient themselves with their life circumstances; do individuals believe they have the means and abilities for attaining desired outcomes or do they view their life as being determined by external factors [fatalistically ruled], to which their actions have no way of attaining desired outcomes? Also, does ones orientation function to assist in adaptation by protection against the adverse effects of stressors through soliciting support from their social network or engaging in the wrong goals, leading to negative outcomes? In sum, perceived control is a general-purpose belief system that consists of a toolbox for success, which has downstream effects on key outcomes across the lifespan.
As this is a chapter on the development of perceived control, we strongly believe that perceived control does not reflect innate attributes that are fixed in personality, but instead are malleable or have the capacity to change. The construct of perceived control should be considered as a flexible set of interrelated beliefs that are organized around interpretations of prior interactions in specific domains or learned appraisals of ones capabilities [Pearlin, 2010; Skinner, 1995].
Fig. 15.1 graphically illustrates data from the Americans Changing Lives [ACL] study showing the developmental trajectory of perceived control across the adult lifespan [for details on the measure of perceived control in this study, see Infurna & Okun, 2015; Infurna, Ram, & Gerstorf, 2013]. The ACL study consists of four assessments, spanning 16 years on individuals ranging in age from 24 to 100. In Fig. 15.1, data are shown for a subset of 250 participants [gray lines] and the solid black line is the model implied trajectory from a multilevel model [see Grimm, Ram, & Estabrook, 2016; Singer & Willett, 2003] examining change in perceived control across chronological age. We observe that, on average, the developmental trajectory of perceived control is one of stability in young adulthood and midlife, but declines in old age. However, the raw data from individuals in the study [gray lines] indicate that there is a great deal of heterogeneity in the extent to which perceived control changes across the adult lifespan. As shown, from the wave-to-wave data, some participants show stability, whereas others show substantial increases or decreases. This chapter focuses on reasons why perceived control changes across the adult lifespan, or put differently, what are the possible reasons why some individuals show substantial changes in perceived control? The emphasis is on examining developmental change across different time metrics and how antecedents likely differ by ones stage in the lifespan. Before doing so, we next discuss the numerous beneficial effects that have been observed of perceived control across the lifespan.
Figure 15.1. Developmental change in perceived control across the adult lifespan. Perceived control shows a curvilinear trend across the adult lifespan, showing relative stability in young adulthood and midlife and declines in old age. Data are taken from the Americans Changing Lives Study and a multilevel model with linear and quadratic components were applied to four assessments of perceived control that cover 16 years of time.
Modernity
D. Linehan, in International Encyclopedia of Human Geography, 2009
Modernity, Knowledge, and Geography
For many observers, the intellectual foundations of modernity lie in the transformations in the production of knowledge between the Renaissance and the Enlightenment. This historical period was characterized by the rising dominance of individualism and, in contrast to the fatalism of the medieval period, tended to promote an optimistic outlook on the potential of humankind. Based broadly upon the rediscovery of knowledge from classical antiquity and the Arab world made during the Renaissance, the cultural and technological innovations of the Enlightenment enabled the creation of a scientific worldview that ushered in new regimes of order, progress, and rationality. The Enlightenment is sometimes portrayed as a rupture in the history of human development, following which people in the West increasingly imagined themselves in novel ways. This development established a new and powerful social imaginary whereby it was assumed that modern society was on a progressive trajectory, and through rational, scientific endeavor, was destined to transcend its limitations and rise to a higher stage of human development. In contrast to the premodern individual who may have viewed herself and the world through the lens of myth or religious belief, the modern person increasingly drew upon the tenets of humanism and science, and in time, would be asked to become more reflexive and self-conscious in outlook. This new sensibility was well reflected in the literature and art from this period onward. The rise of portraiture, the proliferation of personal diaries, or the self-conscious hero in William Shakespeare's Hamlet [written in 1600] who asks himself to be or not to be can all be regarded as cultural artifacts generated among some of the new spaces of modernity which proliferated from this time onward spaces such as the art gallery, the coffee-house, and the theater.
Geographical ideas also changed radically during the Enlightenment, and concepts of nature, time, and space were fundamentally re-ordered and reflected strongly the impulse of modernity. The Enlightenment worldview helped naturalize the essentially representational category of geometric space as fact. This awarded new powers to the abstractions of the mapmaker, the surveyor, and the architect, whose work could be used to powerfully envision the state of the world [Figure 1]. Developments in geographic science, notably in new techniques and theory in navigation, surveying and mapping, became a key way to both perform and represent a modern worldview. Through, for example, the consumption of globes, atlases, or travelogs, geographical knowledge enabled literate Western individuals and societies to see themselves as modern and distinguish themselves from the so-called primitive others [Figure 2]. Geographical science also provided a set of techniques to plan and implement the conquest and reorganization of terrestrial resources. For instance, by calculating and measuring landholdings, topographical surveying underwrote the legal appropriation of the commons and the transformation of communal and ancestral land into private property. Geographical science also enabled European exploration, moderated the risks in global sea travel, and in innumerable ways supported the appropriation of resources and peoples exploited by colonialism. In this regard, it can be said that modernity became closely associated with a spatial logic that informed the organization of resources and investment and played a key role in the distribution of land.
Figure 1. Plan of the city of Philadelphia [1683]. Devised by William Penn, this conception for Philadelphia is among the earliest examples of utopian city planning. As illustrated here, one of the most explicit expressions of Enlightenment thinking was in the use of grids to organize urban development and human settlement. Grids appeared frequently in colonial contexts, underwriting the distribution of land and urbanization in Australia, North America, and Africa.
Figure 2. One of the several large globes made for Louis XIV of France by the Italian geographer and cartographer, Vincenzo Coronelli, in 1683.
More broadly, within modernity, the creation and application of knowledge became instrumental to the rational organization of society. Consequently, ideas of progress and the use of scientific knowledge were foundational attributes of most forms of planned urban transformation in the nineteenth and the twentieth centuries. From Thomas More's Utopia to urban plans devised by Ebenezer Howard or Le Corbusier, Enlightenment values have had an enduring effect on shaping space and society [Figure 3]. These ideals became impressed into the planning of cities like Vienna, Paris, and Barcelona, which in the eighteenth and nineteenth centuries laid out new systems of streets, promenades, boulevards, and park networks. These new modern spaces were intended to reflect the civilized and modernized outlook of their populations and more particularly, the modernizing impulse of their political elites. The spatial signature of this progressive culture can still be seen in the symbolic cores of many European cities, such as Paris, Madrid, and St Petersburg, crowded with monumental architecture, spectacular landscapes, and progressive urban institutions such as galleries, exhibition halls, and museums, all committed to the heroic celebration of human endeavor and creativity, core humanist attributes.
Figure 3. Illustration from Garden Cities of To-Morrow [London, 1902]. Ebenezer Howard's diagrammatic illustrations of how a model garden city should be planned were always understood to be idealizations, but nevertheless, were enthralled by Enlightenment and Utopian thinking. These geometric designs embraced the problems and potential of modernity, and presented new visions of order. Howard offered a workable plan for a progressive urban society, which through spatial planning would address the alienation of human society from nature by integrating cities into the surrounding environment.
However in line with the ambiguous and contradictory qualities of modernity, it has been observed that the pursuit of order has often involved profound social disruption. Modernity was often achieved with severe costs to liberty, life, and ecological sustainability. In spite of its claim to progress, modernity held within it, the seeds of barbarism. In his lectures on physical geography, the Enlightenment philosopher and geographer, Immanuel Kant concurred with another pillar of Enlightenment thinking, David Hume, that white Europeans were superior in racial characteristics to Asians and Africans. Both these key thinkers declared that Africans were incapable of rational thought, cultural expression, and were to all extents outside humanity. These kinds of positions embedded inside the Enlightenment project helped underwrite European arguments for the acquisition of colonial lands and ensured slavery was maintained until the mid-nineteenth century as the basis for the commercial exploitation of resources in the so called New Worlds. As such, the utopian promises of the Enlightenment were rarely attained. Indeed, they were often distorted, as, for example, in the civilizing but more often than not, racist mission of European colonialists in Asia and Africa in the nineteenth century, or the rational but brutal organization of concentration camps during the twentieth century. Consequently, modernity in particular, how it represented by Enlightenment thinking and its inheritors may be understood as a duplicitous event, promising stability and progress, but often presenting a stressful, destabilizing, and precarious experience. This was particularly the case for the peasantry, the poor, and indigenous peoples, exploited by colonialism, harmed by racism, and excluded from the comfortable orbit of bourgeois protection and social life.
Modernity
Denis Linehan, in International Encyclopedia of Human Geography [Second Edition], 2009
Modernity, Knowledge, and Geography
For many observers, the intellectual foundations of modernity lie in the transformations in the production of knowledge between the Renaissance and the Enlightenment. This historical period was characterized by the rising dominance of individualism and, in contrast to the fatalism of the medieval period, tended to promote an optimistic outlook on the potential of humankind. Based broadly upon the rediscovery of knowledge from classical antiquity and the Arab world made during the Renaissance, the cultural and technological innovations of the Enlightenment enabled the creation of a scientific worldview that ushered in new regimes of order, progress, and rationality. The Enlightenment is sometimes portrayed as a rupture in the history of human development, following which people in the West increasingly imagined themselves in novel ways. This development established a new and powerful social imaginary whereby it was assumed that modern society was on a progressive trajectory, and through rational, scientific endeavor, was destined to transcend its limitations and rise to a higher stage of human development. In contrast to the premodern individual who may have viewed herself and the world through the lens of myth or religious belief, the modern person increasingly drew upon the tenets of humanism and science, and in time, would be asked to become more reflexive and self-conscious in outlook. This new sensibility was well reflected in the literature and art from this period onward. The rise of portraiture, the proliferation of personal diaries, or the self-conscious hero in William Shakespeare's Hamlet [written in 1600] who asks himself to be or not to be can all be regarded as cultural artifacts generated among some of the new spaces of modernity which proliferated from this time onwardspaces such as the art gallery, the coffeehouse, and the theater.
Geographical ideas also changed radically during the Enlightenment, and concepts of nature, time, and space were fundamentally reordered and reflected strongly the impulse of modernity. The Enlightenment worldview helped naturalize the essentially representational category of geometric space as fact. This worldview awarded new powers to the abstractions of the mapmaker, the surveyor, and the architect, whose work could be used powerfully to envision the state of the world [Fig.1]. Developments in geographic science, notably in new techniques and theory in navigation, surveying and mapping, became a key way both to perform and to represent a modern worldview. Through, for example, the consumption of globes, atlases, or travelogs, geographical knowledge enabled literate Western individuals and societies to see themselves as modern and to distinguish themselves from the so-called primitive Others [Fig.2]. Geographical science also provided a set of techniques to plan and implement the conquest and reorganization of terrestrial resources. For instance, by calculating and measuring landholdings, topographical surveying underwrote the legal appropriation of the commons and the transformation of communal and ancestral land into private property. Geographical science also enabled European exploration, moderated the risks in global sea travel, and in innumerable ways supported the appropriation of resources and peoples exploited by colonialism. In this regard, it can be said that modernity became closely associated with a spatial logic that informed the organization of resources, and investment and played a key role in the distribution of land.
Figure1. Plan of the city of Philadelphia [1683]. Devised by William Penn, this conception for Philadelphia is among the earliest examples of utopian city planning. As illustrated here, one of the most explicit expressions of Enlightenment thinking was in the use of grids to organize urban development and human settlement. Grids appeared frequently in colonial contexts, underwriting the distribution of land and urbanization in Australia, North America, and Africa.
Figure2. One of the several large globes made for Louis XIV of France by the Italian geographer and cartographer, Vincenzo Coronelli, in 1683.
More broadly, within modernity, the creation and application of knowledge became instrumental to the rational organization of society. Consequently, ideas of progress and the use of scientific knowledge were foundational attributes of most forms of planned urban transformation in the 19th and the 20th centuries. From Thomas More's Utopia to urban plans devised by Ebenezer Howard or Le Corbusier, Enlightenment values have had an enduring effect on shaping space and society [Fig.3]. These ideals became impressed into the planning of cities like Vienna, Paris, and Barcelona, which in the 18th and 19th centuries laid out new systems of streets, promenades, boulevards, and park networks. These new modern spaces were intended to reflect the civilized and modernized outlook of their populations and more particularly, the modernizing impulse of their political elites. The spatial signature of this progressive culture can still be seen in the symbolic cores of many European cities, such as Paris, Madrid, and St Petersburg, crowded with monumental architecture, spectacular landscapes, and progressive urban institutions such as galleries, exhibition halls, and museums, all committed to the heroic celebration of human endeavor and creativity, core humanist attributes.
Figure3. Illustration from Garden Cities of To-Morrow [London, 1902]. Ebenezer Howard's diagrammatic illustrations of how a model garden city should be planned were always understood to be idealizations, but nevertheless, were enthralled by Enlightenment and Utopian thinking. These geometric designs embraced the problems and potential of modernity and presented new visions of order. Howard offered a workable plan for a progressive urban society, which through spatial planning would address the alienation of human society from nature by integrating cities into the surrounding environment.
In line with the ambiguous and contradictory qualities of modernity, it has been observed that the pursuit of order has often involved profound social disruption. Modernity was often achieved with severe costs to liberty, life, and ecological sustainability. In spite of its claim to progress, modernity held within it the seeds of barbarism. In his lectures on physical geography, the Enlightenment philosopher and geographer, Immanuel Kant, concurred with another pillar of Enlightenment thinker, David Hume, that white Europeans were superior in racial characteristics to Asians and Africans. Both these key thinkers declared that Africans were incapable of rational thought, cultural expression, and were to all extents outside humanity. These kinds of positions embedded inside the Enlightenment project helped underwrite European arguments for the acquisition of colonial lands and ensured slavery was maintained until the mid-19th Century as the basis for the commercial exploitation of resources in the so called New Worlds. As such, the utopian promises of the Enlightenment were rarely attained. Indeed, they were often distorted, as, for example, in purportedly civilizing, but more often than not, racist mission of European colonialists in Asia and Africa in the 19th Century, or the rational but brutal organization of concentration camps during the 20th Century. Consequently, modernityin particular, how it is represented by Enlightenment thinking and its inheritorsmay be understood as a duplicitous event, promising stability and progress, but often presenting a stressful, destabilizing, and precarious experience. Such was particularly the case for the peasantry, the poor, and Indigenous peoples, exploited by colonialism, harmed by racism, and excluded from the comfortable orbit of bourgeois protection and social life.
Health Psychology
Clare Bradley, ... Christel Hendrieckx, in Comprehensive Clinical Psychology, 1998
8.11.7.5 Patient Empowerment
With diabetes, as much if not more than with other chronic disorders, optimal management can only be achieved by means of complex behavioral changes on the part of the patient. It is not enough for the clinician merely to give instructions. Health professionals are increasingly working towards holistic approaches to treatment, which include an emphasis on providing the education, support, and encouragement to enable patients, where possible, to manage their own diabetes. Indeed, the second edition of the St. Vincent Declaration Action Programme to improve diabetes care in Europe [Krans et al., 1995] now includes specific guidelines to facilitate patient empowerment.
The construct of empowerment has been in use in other domains of psychology for some time, and has at times been both ill-defined and misunderstood. In the context of diabetes care, a useful overview of patient empowerment has been provided by Anderson [1995].
The empowerment of individual patients is a complex goal. It requires first that patients have a level of authority and responsibility to be able to make decisions and manage their own treatment. Second, it requires that they be willing to accept that responsibility and to achieve the necessary skills and knowledge to make them capable of managing their diabetes. Third, the environment of care needs to be such that policies and practices facilitate self-management of diabetes care. Central to the achievement of each of these elements is the healthcare professional. They must accept patients as active and responsible self-carers, educate them both in knowledge of diabetes and self-care choices, and facilitate the setting of individual goals of self-care through an assessment of individual preferences. Patently, this becomes even more vital in an age of technologically advanced healthcare systems, where the tendency may be to alienate patients from active participation in their own medical treatment [Stabler, 1993].
Whilst numerous accounts of research into patient empowerment may be found, the literature specific to diabetes care is limited, but growing [Anderson, 1995; Anderson, Funnell, Barr, Dedrick, & Davis, 1991; Anderson et al., 1995; Doherty, Hall, James, & Roberts, 1996; Feste, 1992; Kinmonth et al., 1996]. In looking to the future for a more widespread adoption of attitudes and practices which facilitate patient empowerment, it is clear that certain barriers need to be overcome. Some patients may be reluctant to accept responsibility for their own diabetes management, and need to be encouraged with the knowledge that they are best placed to make decisions which impact on the day to day running of their lives. They then need access to professional support, education in the knowledge of their condition, self-care skills, and choices available to them. Healthcare professionals may also misunderstand patient empowerment. They may see this as an unethical suggestion that they should abdicate responsibility for care and relinquish clinical control and decision making. At the other end of the spectrum, some may see patient empowerment as a license to divest themselves of the more intractable problems associated with diabetes care. In reality, however, patient empowerment involves active participation of the health professional in the role of facilitator, enabling patients to set individual goals for diabetes management and to achieve optimal outcomes in both medical and psychosocial health.
There is early evidence for the success of patient empowerment interventions. Anderson [1995] reported a randomized waiting-list control group trial of patient empowerment education. Despite some problems associated with drop-out rates and the combination of data from randomized and nonrandomized participants for analysis, the results suggested a modest improvement in blood glucose control, along with gains in self-efficacy and attitudes toward diabetes.
Greenhalgh, Chowdhury, and Helman [1996] evaluated a patient empowerment model with a sample of British Bangladeshis with diabetes, 295 and identified a variety of culturally related factors which may create obstacles to patient empowerment including ignorance about diabetes and available services, poverty, fatalism, and religious convictions. These findings underline the need for individual patient focus in empowerment programs if those programs are to be appropriate to patients needs. Quatromoni et al. [1994] described a study which used focus groups to explore culture-specific information that could be useful in empowerment interventions with Caribbean Latinos with NIDDM. Amongst the issues they identified were
feelings of social isolation, little understanding of long-term consequences of diabetes, fatalism regarding the course of the disease, barriers to diet and exercise interventions, skepticism regarding the value of preventive health behaviors, and a clear need for culturally-sensitive health-care provision. [Quatromoni et al., p. 869]
Similarly, the Haida Gwaii Diabetes Project [Herbert, 1996] described an approach which uses community-based research to identify a culturally sensitive approach to diabetes prevention and management. Outcomes suggest an empowerment benefit to individuals with diabetes, their families, and community. Moreover, there were reported benefits to healthcare professionals, in that they also felt empowered to implement diabetes care in ways which were more pertinent to patients.
Evidence suggests that patient empowerment offers a promising way forward in diabetes care. It is perhaps worthwhile, however, to sound a cautionary note. Should empowerment interventions fail to show significant benefits in the future, it may be that the interventions themselves have not been adequate to the task, either in that health professionals did not receive adequate training to enable them to move to more participative care, or that the empowerment goals were not focused sufficiently on the cultural or individual needs of patients.
Disaster Models
David Etkin, in Disaster Theory, 2016
6.4 Philosophical Approaches
The philosophical approaches that underlie disaster models relate mainly to: [1] our understanding of cause and effect, and [2] ethics and values.
6.4.1 Cause and Effect
Over time there has been a conceptual evolution of how we understand disasters in terms of cause and effect. Historically, there was a strong tendency to view such events as things that happen to us, placing people in a victim role with little or no power. From this worldview, disasters were the result of Fate [Figure 6.4], God, or Nature. In fact, the very word disaster comes from Greek roots meaning an ill-favored [dis] star [aster]. Faith-based perspectives on disaster continue to play a large role in how people from some cultures perceive these events.5 Within these systems, sin, guilt, and punishment often play a predominant role. For example, some people believe that the 2005 Tsunami in Indonesia was sent by God to punish people for their evil ways,6 or that earthquakes are caused by womens sin.7 It is difficult to overestimate the importance of this issue, since it largely determines the degree to which many people will engage in mitigation and prevention activities.
Figure 6.4. The three fates, attributed to Jacob Matham. Print, Engraving.
Source: collection of the Los Angeles county museum of art. //commons.wikimedia.org/wiki/Los_Angeles_County_Museum_of_Art.Recent models of disasters are based on the notion that we have the ability and capacity to determine our experiences, and view such events as being within our locus of control. Such a positivist, engineering approach to mitigation is embedded in a belief that nature is predictable and controllable by human beings, the roots of which lie in the seventeenth and eighteenth century paradigms of Newton, Descartes, and other rationalist thinkers, and can be traced back to Plato.8 I do not mean to imply that notions of people managing their environment to be safer do not predate thisthey do. Consider, for example the Babylonian Code of Hammurabi, dating back to 1772 BC In part, this approach assumes that science can understand, predict, and perfectly [or almost so] engineer the natural world. It is also based on a belief that it is humankinds natural right to control nature, a perspective that places us above the natural world.9
Perspectives on the degree of control that humans have over complex systems have shifted from classical notions as a result of the development of ecological theory [Section 6.5.7] and chaos theory [Chapter 5]. Chaotic systems, although bounded, can be highly unpredictable and can exhibit surprising emergent properties. This has led to a shift from management approaches that are deterministic to ones that are adaptive and that recognize limitations to the degree to which humans can control parts of their environment. There is a large and interesting literature on adaptive management10 that is beyond the scope of this chapter.
John Adams discussion of the four myths of nature11 inspired me to think more about the degree of power and control that we have over many of the worlds risky systems. This is becoming an increasingly important question as technology increases its potential for destruction. Certainly we have the power to change the surface of the planet, alter genetic codes, and destroy other species, but how much control do we have, in the sense of deterministically creating desired outcomes? The answer varies depending on circumstances; sometimes we have a great deal of control and other times our sense of control is illusory. Depending on how you view these two factors, one would choose very different disaster management strategies. To illustrate the difference between power and control, consider the following: an army may be able to defeat another nation militarily, but may not be able to win their hearts and minds and reduce terrorism.
Consider the four quadrants in Figure 6.5. A traditional engineering approach [based on high power and high control] will lie in the upper right hand quadrant. This approach can be very effective for well-defined systems with low complexity that are well understood and for which broad stakeholder agreement exists. This is where traditional top-down risk management strategies are effective. Strategies to increase resilience or ones that use the application of the precautionary principle fit well in the lower right quadrant, where systems are more complex and less well understood, and outcomes are less predictable.
Figure 6.5. A conceptual framework for managing disaster, based on degrees.
Where would a world view of fatalism lie on Figure 6.5?
What are your thoughts about fatalism as a disaster management strategy?
Student Exercise
Place the following on Figure 6.5 [in terms of humans ability to manage these systems]. Explain your choices:
[A] nuclear energy plants
[B] climate change
[C] earthquakes
[D] tornadoes
[E] broken fire hydrant
[F] terrorism
[G] hormone-driven teenagers.
6.4.2 Ethics and Values
This topic will be explored in more detail in Chapter 9. The classic ethical tension in the disaster field is between utilitarian and Kantian arguments [Figure 6.6]that is, should the greater good be emphasized, or should peoples rights trump consequentialist thinking? Other ethical approaches that are important include Virtue Ethics and Social Contract Theory. Environmental ethics is beginning to play a larger role in disaster models, largely because of climate change and environmental destruction, and how these trends affect disaster risk. Ethical issues are explored explicitly in the following publications; Ethical Land Use: Principles of Policy and Planning by Beatley and Ethics for Disaster by Zack, and play a large role in The Gendered Terrain of Disaster: Through Womens Eyes by Enarson and Morrow and A New Species of Trouble by Erikson.
Figure 6.6. Emmanual Kant.
Source: Wikipedia.The International Association of Emergency Managers has addressed this issue by developing a code of ethics and professional conduct based on the three qualities of respect, commitment, and professionalism. Similarly, they developed a set of principlesthat emergency management must be comprehensive, progressive, risk driven, integrated, collaborative, coordinated, flexible, and professional. Their definition of collaborativethat emergency managers create and sustain broad and sincere relationships among individuals and organizations to encourage trust, advocate a team atmosphere, build consensus, and facilitate communication certainly recognizes the importance of human relationships and implies the need for moral behavior, even if it is not stated explicitly. The Chaplain Network of Nebraska has developed a Disaster Chaplain Code of Ethics and Guiding Principles that shows a keen awareness of duties and rights. Some government agencies have ethics guides, although they are often legalistic and generally do not include human relationship issues. For example, FEMA, along with many other U.S. government agencies, has published an ethics guide for their employees that covers ethics prohibitions, travel issues, and when to accept gifts. It is worth noting that some professions have given this issue prominencesee, for example, the Canadian Code of Ethics for Psychologists.
It is not unusual for people to be faced with ethical dilemmas, which are situations in which there is a conflict between different moral imperatives. How these are resolved is important. Ethics and values do not appear explicitly in any of the disaster models discussed in Section 6.5, but nevertheless underlie them in important ways. Their inclusion would only serve to make these models more relevant.
Student Exercise
List three ethical dilemmas, related to:
Land use planning
Response
Recovery
How would you go about resolving them?
New Technologies: Ethics of Genomics
J.M. Street, in International Encyclopedia of Public Health, 2008
The Geneticization of Health and Illness
The rise of personalized medicine brings with it the potential danger of the geneticization [Lippman, 1991] of health such that the contribution of environmental factors in health and disease is downplayed. Although genomics permits high-risk individuals with a genetic predisposition to complex disorders to take action to minimize their risk, such knowledge may be counterproductive. Fatalism arising from a belief in genetic determinism may result in a failure to undertake appropriate preventive measures. Alternatively, individuals may be falsely reassured by negative genetic information and may engage in risky behavior as a result. Changing behavior requires considerable personal resources and there is increasing evidence that genetic knowledge may not be a sufficient motivator. In the past, most genetic testing has revolved around inherited disorders with a high certainty of future disease. In contrast, genomics will in many cases predict marginal increased risk which, when applied across populations, may have significant implications for public health but may be more difficult to communicate to the individual patient or the public at large.
Practicing Behavioral Strengthening
Wei-chin Hwang, in Culturally Adapting Psychotherapy for Asian Heritage Populations, 2016
Chapter Goal #1: Continue to Consolidate Gains Through the Use of Weekly Take-Home Exercises and Practice
Weekly Check-In and Review of Take-Home Exercises
Inquiring about your clients week and continuing to check in on your clients take-home exercises are important for helping clients feel like you care about their lives and emphasizes your continued expectation that doing take-home exercises is important and beneficial. This is especially important since this is only the third time that clients are asked to complete the climbing the mountain exercise, which is repeatedly used throughout the treatment program. However, in this session, the emphasis for the climbing the mountain exercise is developing and strengthening effective communication skills or wise communication, rather than wise action.
Trying to encourage clients who are reluctant to complete take-home exercises can be frustrating for therapists if the client continually shows up to session empty-handed. Struggles with completing take-home exercises affected both the culturally adapted cognitive-behavioral therapy [CBT] and nonadapted CBT treatment conditions of the clinical trial. Therapists in the nonadapted CBT condition talked about difficulties getting the client to do homework and discussed how Chinese Americans clients didnt want to complete the homework and only wanted to come in to session and complain about their problems. Therapists in the culturally adapted condition also had difficulty getting clients to complete take-home assignments, but had less difficulty because they were not framed as homework, but rather as practice and exercise.
At first glance, getting clients to complete homework exercises may seem like a nonculture-related compliance issue that may also be associated with a number of factors including severity of clinical issues. Nevertheless, there are a number of cultural issues that may influence homework compliance. These include the cultural beliefs of fatalism in many Asian heritage populations, as well as the notion of ethnocultural transference and countertransference. In Asian culture, fatalism is associated with beliefs imbued by different religions and historical practices. Fatalism is related to concepts of karma, reincarnation, and other spiritual beliefs. Although the belief itself may not be problematic, when those who are suffering with mental illness rigidly internalize such beliefs, it often reinforces a cycle of learned helplessness and inaction, which in turn reinforces the symptoms of various psychiatric disorders such as motivation in depression and avoidance in posttraumatic stress disorder.
Clients may fall into despair, feeling as if nothing could be done to change their life circumstances and that nothing they do can take away their pain. This experience is fairly common among low-income Asian heritage populations who have very few cognitive, social, emotional, financial, and housing resources. Clients who become attached to fatalism may even distort religious teachings that are meant to help normalize life difficulties and help clients with acceptance. For example, the quote life is suffering is one of the hallmark teachings of Buddhism. It helps people develop perspective and emotional distance when faced with and while interpreting stressful life experiences. Although Buddha did say life is suffering, he never followed up with theres nothing you can do about it, so dont even bother trying. Therapists need to be aware of these cultural-religious beliefs, so they can culturally adapt and address these issues in treatment.
Understanding this issue can also help therapists become less frustrated and be aware of ethnocultural transference and countertransference issues in treatment [ie, cultural influences on the traditional notions of transference and countertransference] [Comas-Diaz & Jacobsen, 1991]. Although at face value some of these processes may not seem obviously cultural, they are a salient part of working with diverse populations that culturally competent therapists need to be aware of. Moreover, addressing ethnocultural transference and countertransference is extremely important because they can significantly influence the clienttherapist working alliance, which in turn affects treatment outcomes. Examples of more obvious ethnocultural transference and countertransference were provided in chapter Understanding Cultural Influences on Mental Health.
A more subtle example is homework noncompliance. Although clients from all cultures can struggle with homework noncompliance and develop learned helplessness when it comes to motivation to take action, these issues are more likely to affect individuals from cultures that place a heavier emphasis on fatalism and superstitious beliefs. Consequently, many clients from Asian heritage backgrounds may feel hopeless and believe that no matter what they do, nothing will help. Compliance with take-home exercises becomes collateral damage, and instead, clients may come into treatment in a complaining mode. This ethnocultural transferential issue is then experienced by the therapist, who needs to be aware of their own ethnocultural countertransference [eg, I wish my client would stop complaining and there is no point in trying to get Asian heritage clients to do their homework because they simply wont do it].
If this situation arises in supervision, it is important for the supervisor to address and understand both the culture-universal [etic] and culture-specific [emic] processes occurring. Specifically, homework noncompliance can affect people from all cultural backgrounds. However, when working with Asian heritage populations, culture-specific issues of fatalism, problematic interpretations of cultural-religious beliefs, and the tendency to complain to others [which is more heavily emphasized in collectivistic cultures when seeking support] need to be addressed. Otherwise, the therapist may also fall into a parallel process of learned helplessness, and despair takes over. Therapists may feel that no matter what they do, they cannot get their clients to take responsibility for their own lives and mental health. They can even become critical of their clients for not taking action and only wanting to dump their problems on the therapist. This process can become insidious and may even affect the supervisor, where the parallel process continues and they feel like there is nothing they can do to get their Asian heritage therapist to get their clients to do their homework. Supervisors can highlight these parallel processes, and help therapists take a step back and reframe the issues with cultural understanding [eg, highlighting fatalism, cultural-religious beliefs, and ethnocultural transference and countertransference].
In addition, supervisors can highlight culture-universal processes that may also be affecting homework compliance. Specifically, a major symptom of depression is lack of motivation. Therefore, as a function of having this disorder, it is normative for clients to have difficulties completing their take-home assignments. Addressing and highlighting clinical issues that affect motivation in the client and therapist is an important first step to addressing the problem. Underscoring the therapists role and responsibility of engaging the client and troubleshooting noncompliance, despite clinical and cultural barriers, can help normalize the problem and provide hope that they can be effectively overcome. Since this problem is culturally common, it is also important not to blame the clients or the therapist for becoming frustrated, hopeless, or noncooperative. Rather, a culturally adapted and responsive approach to understanding how culture permeates and qualitatively affects therapy processes and impacts problem resolution is needed. This helps the therapist develop more emotional empathy, resilience, and perspective when addressing client problems. Moreover, it also helps the therapists to continue setting the precedence and expectation that take-home practice exercises are a critical part of the treatment process.
What are scenarios?
Steve O'Connor, Peter Sidorko, in Imagine Your Library's Future, 2010
Change of attitudes toward the future
In so far as it is possible, we need to shape our future, rather than letting the future happen to us. It is apparent that we have many possible futures open to us but the difficulty lies in identifying those futures and in choosing wisely amongst them. In more optimistic times people believe that resources inevitably follow to support growth. Today, there is a widespread pessimism, even fatalism, about the state of the worlds environment which, couched with the severe economic downturn, is making people blind to positive opportunities. It is once again worthwhile remembering the Chinese word Wei Ji meaning danger and opportunity. They go hand-in-hand. The scenario planning methodologies aim to assist and direct thinking in a constructive sense, even through emerging darker resource moods. In times of dark moods toward the future, the first thing that has to change is how we allow ourselves to think about the future. If we allow ourselves to begin to think about solutions, then the methodologies taught in this book will greatly open the possibilities and/or opportunities.
Peace Organizations, Non-Governmental
Keith Suter, in Encyclopedia of Violence, Peace, & Conflict [Second Edition], 2008
Similarities of the Organizations
First, all nongovernmental peace organizations are seeking a reform of some kind. They are protesting against an existing political principle, such as the overall use of war as an instrument of national policy, or a particular war [e.g., Iraq] or a weapon system [e.g., the Campaign to Abolish Landmines, which won the 1997 Nobel Peace Prize].
Second, they all believe that peace [however defined] is possible. Their members have not succumbed to a sense of fatalism that war is inevitable and that nothing can be done to stop it.
Third, all the organizations manifest, to differing extents, five common qualities: optimism [a belief that it is possible to work for a better situation]; activism [a belief that it is better to be proactive rather than just sitting around and letting things happen]; populism [a belief that the mass of ordinary people ought to be involved in political change and not just leaving decision making to an elite]; holistic vision [a belief that life consists of subtle interconnections with one component affecting others]; and that the individual can make a difference.
Finally all the organizations have required resilience: the ability to keep going despite all the adverse developments. For example, hundreds of thousands of people, if not millions, were involved in demonstrations in 2003 against an attack on Iraq. Despite the marches etc., the governments of the US, UK, and Australia went ahead. Subsequent events [not least the protracted nature of the violent conflict] vindicated the views of the protesters. But many people would have been disillusioned at the time.