As a clinical psychologist, my job involves, literally, trying to change other people’s minds.
The circumstances a person might be struggling with are frequently, in themselves, not subject to direct influence, but how a person perceives and interprets the circumstances, how they feel about it, and how they think about themselves, can change.
Sometimes, the changes can be profound. Life-altering.
At times, life-saving.
We know that, with some individuals, if we establish a rapport, a bond of trust, they become more receptive to considering alternatives. We call that cognitive flexibility:
Demystifying cognitive flexibility: Implications for clinical and developmental neuroscience
Trends in Neuroscience (2015)
Cognitive flexibility is the ability to appropriately adjust one’s behavior according to a changing environment [1, 2]... Cognitive flexibility enables an individual to work efficiently to disengage from a previous task, reconfigure a new response set, and implement this new response set to the task at hand. Greater cognitive flexibility is associated with favorable outcomes throughout the lifespan such as better reading abilities in childhood [3], higher resilience to negative life events and stress in adulthood [4], higher levels of creativity in adulthood [5], and better quality of life in older individuals [6].
The building of rapport and trust is, in my field, referred to as the therapeutic alliance, or alternately, the working alliance. The therapeutic alliance has been shown in research spanning decades to be the single most important factor in producing positive outcomes in therapy.
But the fact that rapport and trust is crucial in psychotherapy to be effective, does not mean that it is always possible to establish rapport and trust with every person we encounter. How we approach the interaction matters greatly, but it is a two-way street. Not every person is interested in, or receptive to, our efforts to establish a positive relationship.
Good intentions, and a genuine interest in establishing rapport and trust, will not, by themselves, prompt a person to consider alternative perspectives.
This is true in psychotherapy, and it is true in public discourse of political matters, and pressing societal concerns (like, for example, a highly contagious, potentially fatal viral pandemic).
In a diary from 2017, I highlighted research of personality features that consistently distinguish individuals who align with the political right from the political left:
I’ve written before about the particular personality features consistently displayed by conservatives, including authoritarian attitudes and preference for social dominance hierarchies, tendency to evaluate situations and people according to the emotions fear and disgust (which in turn correlates with a high degree of xenophobia), and compared to progressives, show low propensity for Openness to Experience, a specific psychological trait identified in the Five Factor Model of personality, which is characterized by active imagination, aesthetic sensitivity, attentiveness to inner feelings, preference for variety, and intellectual curiosity (these are personality features progressive tend to exhibit more of, and conservatives considerably less, which is reflected in progressives’ acceptance of, and conservatives aversion to, cultural diversity).
DKos contributor BrainWrap has done exemplary work crunching the numbers, demonstrating that vaccination rates correlate strongly with voting patterns across the country. (Short version- vote Biden, more vaccinated; vote for a vile, deranged moronic pathologically lying serial sexual predator fascist, less vaccinated.)
Now, we need to remember that nothing we deal with can be reduced to ‘just politics’.
Everything is political, and a person brings their politics with them everywhere they go, and to everything they do.
Ideology is an element of a person’s worldview, and worldview involves a number of psychological factors (which I have previously described at some length in previous diaries here, here, here and here).
What can we identify as psychological characteristics of people who refuse vaccination?
Results from a study conducted in the UK and Ireland found the following:
Murphy, J., et. al (2021) Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom. Nature Communications 12: 29
"The psychological profile of COVID-19 vaccine hesitant and resistant people
Interestingly, while vaccine hesitant and resistant individuals in Ireland and the UK varied in relation to their social, economic, cultural, political, and geographical characteristics, both populations shared similar psychological profiles. Specifically, COVID-19 vaccine hesitant or resistant persons were distinguished from their vaccine accepting counterparts by being more self-interested, more distrusting of experts and authority figures (i.e. scientists, health care professionals, the state), more likely to hold strong religious beliefs (possibly because these kinds of beliefs are associated with distrust of the scientific worldview) and also conspiratorial and paranoid beliefs (which reflect lack of trust in the intentions of others). They were also more likely to believe that their lives are primarily under their own control, to have a preference for societies that are hierarchically structured and authoritarian, and to be more intolerant of migrants in society (attitudes that have been previously hypothesised to be consistent with, and understandable in the context of, evolved responses to the threat of pathogens)
56. They were also more impulsive in their thinking style, and had a personality characterised by being more disagreeable, more emotionally unstable, and less conscientious."
Similar findings
were reported in a study conducted last year in the US:
Lin, F.Y. and Wang, C.H. (2020)
Personality and individual attitudes toward vaccination: a nationally representative survey in the United States BMC Public Health 20, Article number: 1759"This study provides concrete evidence on the relationships between personality traits and individual attitudes toward vaccination. Specifically, agreeableness and emotional stability exert significant positive effects on individual attitudes toward health benefits of vaccination, whereas conscientiousness has a significant positive influence on individual attitudes toward health benefits of vaccination and support for school vaccination. That is, people high in agreeableness, conscientiousness and emotional stability are more likely to perceive vaccination as beneficial, whereas those high in conscientiousness are also more likely to favor school-based vaccine requirement."
Finally, from Italy, a study identified the importance of 'locus of control' as an influence on attitudes towards vaccination:
Giuliani, M. et. al. (2021) Who Is Willing to Get Vaccinated? A Study into the Psychological, Socio-Demographic, and Cultural Determinants of COVID-19 Vaccination Intentions Vaccines (9) 810
"Particularly interesting are the results concerning health locus of control. In line with Olagoke et al. [29], higher “chance externality” health locus of control (i.e., assuming that one’s health depends on fate or case) was directly and associated with hesitant or negative vaccination intentions. This is arguably explained by the fact that believing that one’s health does not depend on one’s actions and behaviors is likely to lead one to dismiss COVID-19 vaccination as a useful resource. This result is also in line with another study showing that a higher “chance externality” locus of control was associated with vaccine hesitant/resistant parental attitudes toward child vaccinations [15]. “Chance externality” locus of control had also negative indirect effects on the willingness to get the COVID-19 vaccination, mediated by: (1) trust in science and healthcare institutions, and (2) the belief that COVID-19 can be more severe than the common flu. Again, this might be due to the fact that believing that one’s health depends more on fate than on one’s own actions will lead one to consider healthcare institutions’ advice as irrelevant to deal with COVID-19. The negative association between chance externality locus of control and the belief that COVID-19 can be more severe than the common flu, on the other hand, may be related to a poor health literacy, as suggested by a previous study [30]. Finally, the fact that negative/hesitant vaccination intentions were associated both with conspiracist beliefs about the human origin of the pandemic and with a higher “chance externality” health locus of control is in line with many previous studies that highlighted a close connection between conspiratorial thinking and high external locus of control in general [31,32]."
And what might we observe about the psychological features of militant anti-mask protestors?
Here’s what a recent study tells us:
A phenomenon called psychological reactance might help explain the mindset of anti-maskers
A new study published in PLOS One sheds light on the core beliefs that characterize people who refuse to wear face masks during the pandemic. The findings suggest that anti-maskers endorse a core belief that masks are ineffective against the virus, coupled with a psychological reactance to mask wearing that likely strengthens their anti-mask attitudes.
Behavioral scientists invest themselves in understanding the underlying thought processes that characterize people’s behavior. In the context of a global pandemic, understanding why certain people refuse to wear face masks is crucial for protecting public health.
Study authors Steven Taylor and Gordon J. G. Asmundson suggest that the refusal to wear masks during the pandemic may be partially motivated by a phenomenon called psychological reactance. Psychological reactance (PR) is the unpleasant arousal that a person experiences when they are asked to follow orders that they believe to infringe on their personal choices. People high in PR tend to react to attempts at persuasion with hostility and counter-arguments, believing that they are defending their freedom.
The upshot?
The configuration of psychological characteristics of people who refuse vaccination and those who are hostile to mask-wearing-- their personality, and the worldview they hold-- do not permit reasoned discourse, nor appeals to morality or common interest.
Talking nicer to them, in a way they so often demand of the rest of us (the very people they are harming) will avail is nothing.
What is this costing us?
Among other things, it is costing the rest of us access to medical care we would otherwise have available to us, but for the vaccine refusers and anti-mask militants:
Physicians make decisions to decline and discontinue care every day, out of necessity, including whether appropriate care is available for the medical condition a person presents with. Exactly the scenario described in the article above.
For many medical conditions (e.g., organ transplantation, experimental treatment and trauma surgery), it is decidedly NOT first come, first serve.
And even with ‘non-emergency’ situations, like an ankle or wrist fracture, the potential for life-threatening complications is present.
That CoVid patients have been given priority, to the point of displacing others who may die, is based on a triage model not formulated for a pandemic.
The associated ethical consideration is the exhaustion of medical resources on behalf of individuals who have undermined efforts to address the public health crisis.
“We do not yet have any great treatments for severe disease, but we do have great prevention with vaccines. Unfortunately, many have declined to take the vaccine, and some end up severely ill or dead. I cannot and will not force anyone to take the vaccine, but I also cannot continue to watch my patients suffer and die from an eminently preventable disease,” the letter stated, according to the newspaper. “Therefore, as of October 1st, 2021, I will no longer see patients that have not been vaccinated against COVID-19. If you wish to keep me as your physician, documentation of your vaccination will suffice. If you wish to choose another physician, we will be happy to transfer your records.”
The simplistic framing- ‘they’re in need of emergency care, and they got here first’- has never been the sole formula for deciding how to prioritize care, and judgements about whom care is offered to has never been limited to mythical standards of objectivity. The decisions, however they are arrived at, are always arbitrary, socially conditioned, and morally fraught. And always will be.
The vaccine refusers and anti-mask militants are also costing the rest of us access to the tax-payer funded services— like schools our children can attend safely.
This story was first brought to my attention by DKos member FoundingFatherDAR:
CDC study shows unvaccinated teacher started delta COVID outbreak at Marin school
The report, released Friday, emphasizes the significance of vaccination and "strict adherence to multiple nonpharmaceutical prevention strategies, including masking" in ensuring the safety of students and teachers now that in-person learning is the norm at Bay Area schools.
The outbreak began in late May, when a teacher at an unnamed Marin County pre-K-8 school received a positive test result just two days after first experiencing a stuffy nose and fatigue...
But in between those two days, the teacher continued to work after attributing their sickness to allergies — leading to infections among their class.
A majority of those infected sat in the front rows of the teacher's class — a staggering 80 percent of the students sitting in the front two rows tested positive. Twenty-one percent of the rest of the class tested positive.
While both students and teachers wore masks inside the classroom, the teacher allegedly took off their mask while reading aloud to the class.
Vaccine refusers and anti-mask militants are costing us staggering sums of money, which is desperately needed to effectively address, well, every other problem we’re facing right now:
Of course, vaccine refusers and anti-mask militants, more than anything else, are costing us too many lives:
Pro-Trump youth group TPUSA deleted a tweet mocking protective masks after its cofounder died of the coronavirus
Jul 30, 2020
The conservative youth group Turning Point USA deleted a tweet mocking protective masks after its cofounder Bill Montgomery died at 80 of complications related to COVID-19.
Two friends of Montgomery confirmed his death to Politico on Wednesday. In a tweet on Tuesday evening, Charlie Kirk, the group's chairman, paid tribute to him, describing him as an "American hero."
"He touched the lives of thousands of young Americans and I will miss him greatly," Kirk wrote.
The group, established by Kirk and Montgomery in 2012, has criticized public-safety measures designed to slow the spread of the disease, such as wearing masks.
