Tag Archives: belonging

Social support as a psychological stressor, implications for Rep. Gabrielle Giffords

Rep. Gabrielle Giffords was shot in the head at a political rally in January

By Kevin R. Betts

Some of you will remember my post back in January about Jared Loughner, the 22 year old who shot and killed six people and wounded 14 others at a political rally in Arizona. Rep. Gabrielle Giffords was seriously wounded in the shooting by a shot to the head. The story of Giffords has since received extensive attention by major news agencies. Colleagues, political supporters, and perhaps most of all, her husband, have eagerly awaited Gifford’s recovery and hoped for her successful future in politics.  The impact of social support on recovery from such hardships has been studied extensively by social and health psychologists. What effect, if any, might social support have on recovery efforts like those of Giffords?

The intuitive assumption of many laypersons—that social support aids recovery—is not completely accurate. To be sure, recipients of social support often gain strength from the social support they receive during hardships. Yet, social support can also hinder recovery efforts if administered inappropriately. Researchers Rafaeli and Gleason (2009) find that social support can undermine the recipient’s sense of self-efficacy, focus the recipient’s attention on the stressor, and make the recipient feel indebted to the provider. The combination of these factors and others may lead recipients to perceive social support as an additional stressor. Rafaeli and Gleason (2009) emphasize that social support can promote positive health outcomes, but only when the right type of support is provided at the right time. For instance, reassuring a recipient that she is capable of overcoming some stressor may be stressful if she is already confident in her abilities (because it could undermine her sense of self-efficacy). It might make more sense in such cases to speak of the positive outcomes that will result once the stressor is “inevitably” overcome.

Findings like these may be especially relevant to Giffords’ recovery efforts. Supporters of Giffords would like to see her make a complete recovery that allows her to continue work in public office. At a fundraiser in March, supporters raised $125,000 in pledges to sustain her 2012 reelection campaign. The support that Giffords has received from supporters is profound. Yet, expectations set for her may be unrealistic. Neurosurgeon Dr. Dong Kim asks, “If somebody has a severe brain injury, are they ever going to be like they were before? The answer is no.” Given limits to how fast one can recover from such a serious injury, Giffords may perceive these support behaviors as stress inducing. Giffords still has a lot of recovering left to do before returning to office can even be considered. If we wish to see Giffords make the fastest recovery possible, it may be wise for the public to set our expectations aside for a while and just let her recover.

Read more:

What’s really going on with Gabby Giffords? (Newsweek)

Rafaeli, E., & Gleason, M.E.J. (2009). Skilled support within intimate relationships.  Journal of Family Theory and Review, 1, 20-37.

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Does isolation reduce violent behavior among psychiatric inpatients?

By Kevin R. Betts

The Joint Commission, an independent health care oversight group, recently expressed alarm over violence in U.S. hospitals. Russell L. Colling, a consultant who advised the Joint Commission said, “The reality is, there is violence every day in the emergency department.” On inpatient units in psychiatric hospitals, violent behavior among patients is often met with forced isolation. A primary goal of isolating these patients is to ensure their safety, as well as that of other patients and staff. However, isolation is also thought by many to act as a deterrent for potential future acts of violence. Having been directly involved in this process as a mental health technician, I often pondered the effectiveness of isolation as a way to combat violent behavior among patients.

Perhaps counterintuitively, research on social ostracism suggests that isolation may promote later aggressive acts (Williams, 2007). In order to understand why this may be the case, imagine yourself in the position of a patient involuntarily committed to an inpatient unit at a local psychiatric hospital. Disagreeing with your involuntary admission, you verbally express your anger to the staff. Told that you may not leave, you become even angrier, perhaps trying to access locked doors. You feel an utter lack of control over your situation. Making matters worse, the staff expresses concern that you may become violent as a result of your distress and “for your safety,” escorts you to a locked room so that “you may reflect on your acting out behavior.” You are in isolation. Your anger further increases and you find yourself behaving in ways you could not previously imagine, yelling “let me out” and banging on the only door in a windowless room. You think to yourself, “They will regret this once they let me out of here.” What you (and many other patients placed in similar situations) are experiencing is an impaired sense of belonging, self-esteem, control, and meaningful existence―direct consequences associated with social ostracism (Williams, 2007). In the eyes of an isolated patient, these needs may wrongly be perceived as restorable through aggressive means.

If isolation can promote violent behavior, what should be done to combat violence among distressed psychiatric inpatients? Solutions that prevent violent behavior in the first place may be most successful. Listening to patient complaints in a timely manner is essential. Empathizing with these complaints, helping patients manage their distress, and ensuring patients that their distress is temporary should also be effective.

Read more:

http://www.businessweek.com/lifestyle/content/healthday/639936.htmlViolence on the rise at U.S. health care centers (Businessweek)

http://www3.interscience.wiley.com/journal/120185263/abstractWilliams, K.D. (2007). Ostracism: The kiss of social death. Social and Personality Psychology Compass, 1, 236-347.

View other posts by Kevin R. Betts

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