Through Grandpa’s Eyes, Term Paper Example

Introduction

A number of psychosocial theories have been formulated to attempt to predict, explain, and deal with health-related behavior.  These psychosocial theories are categorized into two groups: (1) social cognition models and (2) stage models. Social cognition models deal with the separate or integrated effects of cognition and affect (i.e. emotion or attitude) whilst stage models (most famously Erickson’s psychosocial theory) specify and describe the developmental stages necessary for traversing in order to achieve mental health.

This essay will focus on psychosocial social cognition models using Patricia MacLachlan’s (1980) book  “Through grandpa’s eyes” as base.  In the book:

 “John’s grandpa is blind, but grandpa has his own way of seeing. And for John this makes a day spent with Grandpa an adventure – of new sounds and smells and ways of doing every day things” (MacLachlan, 1980; book jacket).

As elaboration on social cognition models they are categorized into five distinct theories, closely similar yet distinct in specific particularities. The five models that have been used most widely by health behavior researchers in recent years are: the Health Belief Model, Protection Motivation Theory, Self-Efficacy Theory, the Theory of Reasoned Action, and the Theory of Planned Behavior.

The Health Belief Model (HBM; Becker, 1974) was developed in the1950s by researchers who were seeking to explain why some reject health services such as immunization and screening.  In short, using a subjective expected utility model of decision evaluation (where person evaluates and weighs outcomes of expectancies and values), patient’s judgment of high susceptibility to disease, high severity of disease, high benefit in regards to using service, and low barriers involved in using service would all configure in decision making model regarding whether or not to adopt a possible course of health action.

Protection Motivation Theory (PMT; Rogers 1983): A person will be more motivated to seek and/ or adopt required health action according to the extent that the person believes the threat will continue if she persists in her current course of action, according to whether the recommend action is perceived affective in reducing or eliminating threat, and if she is able to carry out the recommended action.

Self-Efficacy Theory (SET; Bandura, 1986).  The two key determinants of behavior are perceived self-efficacy and outcome expectancies. In other words, the extent to which the person feels able to actualize/ implement behavior, and the consequences (both negative and positive) of performing the behavior.

Theory of Reasoned Action (TRA; Azjen & Fishbein, 1980) assumes that most behaviors (including that of health) are rationally and arbitrarily determined and that a person’s intention to implement that behavior is a function of two basic determinants: his attitude towards the behavior, and subjective norm (i.e. the perceived expectations of important others with regard to the individual performing that behavior).

Finally, the Theory of Planned Behavior (TPB; Ajzen, 1991) is an elaboration of TRA to include also those behaviors that are not entirely under one’s control, such as any of the numerous sorts of addiction.  Here Ajzen added a variable called perceived behavioral control, which, essentially, uses personal past experience as a measure to gauge one’s ability in overcoming or gaining desired behavior.   An individual with higher perceived behavioral control is likely to try harder and to persevere for longer than an individual who has lower perceived control.

This essay will take specific concepts and, connecting them to the five psychosocial models mentioned above, will draw upon examples from McLachlan’s book to illustrate the theories.

Concept 1: Mindfulness

If there is any one concept that resonates through this book, it is mindfulness.

“Grandpa is blind. He doesn’t see the house the way I do. He has his own way of seeing” (MacLachlan, 1980). And it is this special way of seeing, the particular habit of moment by moment focusing on, utterly absorbing himself in whatever he is doing, smelling, tasting, encountering – that enables Grandpa to convert his disability into an adventure for himself and into an excitement for his grandson.

Mindfulness has been recommended as a technique to help people manage stress, anxiety, and pain. Davidson (Davidson et al., 2003) discovered that during mindfulness mediation, the left frontal lobe of the brain becomes more active and the right less so, indicating an increase in the experience of positive emotions.  Later, a meta-analysis of mindfulness-based stress reduction (Grossman, Nieman, Schmidt, & Walach, 2004) showed that this approach was effective for a wide variety of people and for several stress- and pain-related problems.  The analysis also indicated that mindfulness meditation can help not only people with stress-related and anxiety disorders but also people who do not have clinical problems but are seeking a way to manage the stresses in their lives.

The term mindfulness is derived from an English translation of the ancient Pati word sati, which connotes awareness, attention, and remembering. Mindfulness meditation has been defined as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally” (Segal, Williams, & Teasdale, 2002, p.121).  It is believed to nurture greater awareness, clarity, and acceptance of present-moment reality, and is unique from other forms of meditation in that the focus is on the acceptance of present moment experience (Segal et al., 2002).  Let’s take Grandpa for an example. He is aware of everything. Closely able to distinguish the sound of birds (they are a red winged black bird, and a song sparrow, he insists. And he is right). Slow and deliberate in his movements converting a mere piece of wood into a ‘thinking wood’ merely by his stroking his hand back and forth against it, aware of the gurgling in the rain gutter, feeling the nuances of the winds.

Mindfulness has been described as “keeping one’s consciousness alive to the present reality” (Hanh, 1976, p11).  It has been further described as “the clear and single-minded awareness of the what actually happens to us and in us at the successive moments of perception” (Nyanaponika, 1972, p5). Therefore, the psychological process of being mindful necessitates that one bring awareness to her present internal and external experience. It is an open or receptive awareness and attention which emphasizes an open, undivided observation of what is occurring both internally and externally, rather than a particular cognitive approach to external stimuli.  Proponents of mindfulness laud this capability, assuring us that learning the ability to be mindful enhances one’s “attentional control” (Segal et al., 2002).  Grandpa’s characteristic of mindfulness is a pointer of self-efficacy theory. Feeling efficacious about himself – believing that he can work through his challenges – Grandpa diffuses a certain enthusiasm about his limitations and this, in turn, helps him surmount them.  More so, as per the Theory of Reasoned Action (closely connected to the Theory of Reasoned Behavior): “a person who believes that performing a given behavior will lead to mostly positive personal consequences will hold a favorable attitude towards the behavior” (Sutton, 2002). Grandpa evidently enjoyed his ‘game’. The fact that he so patently succeeded, reinforces consistent studies that find that increasing one’s ability to be fully engaged in the present, positively affects the tenor of our health.  With Grandpa’s mindfulness, the world is a different place.  Nana’s voice smiles to him, and when John closes his eyes in order to test this assumption, “Grandpa is right. Her voice smiles” to him too. How is that? “Because I am looking through Grandpas eyes” (MacLachlan, 1980). Since mindfulness leads to an increase in the experience of positive emotions, in turn granting Grandpa (in this case) the delight of living in the present and an inordinate sensation of self-control which is likely to enable him to persevere for longer than an individual who lower perceived self-control.

Concept 2: Mental Schemas.

One’s formative culture leaves enduring effect on the personality and cognition of an individual (as social theorists say) resulting in a person thinking that an attitude is ‘correct’, ‘ valid’ and ‘proper’ to the extent that it is anchored in a group of people with similar beliefs, opinions, and attitudes.  Such opinions effect judgment, hence actions, and are automatic. Automaticity is difficult if not impossible to prevent (Macrae & Bodenhausen, 2000).  In its negative form, it results in attitudes such as prejudice, stereotyping, conformity, and the like. Therefore, it is important to be aware of and to impede automaticity, but society and socialization being what it is like, we are often unable to do so.

Blindness is one form of stereotype.  People, unfortunately, feel threatened by its existence. Oedipus punished himself by gouging out his eyes, and the Chorus pitied him, seeing him as effectively ending his life. The sages in the Talmud assert that a blind man is as though he were dead.   We are mentally programmed, social psychologists theorized, according to schemas that originate from cultural and geo-historical conditioning (Nisbett & Ross, 1980; MacCrae & Bodenhausen, 2000), and these schemas – otherwise known as mental abstractions – automatically compel us to categorize facets of our environment such as objects, personality traits, self, social roles, and social groups in a subjective manner, consequently driving our response.  Colloquially, we know this as stereotyping.  Stereotyping is natural, it is neither bad nor good, and can possibly even be advantageous, considering that it frees up cognitive resources (e.g., Fazio & Williams, 1986). Its problem, however, is that it ignores particular instances, often resulting in erroneous judgments, and, when negative, consequents in prejudice. Grandpa is blind; however he is far from dead in the Talmudic sense of the word. Vibrant with life, he is able to recognize sensation to an extent that living people are deterred from doing. He has integrated himself with minute nuances of life and has therefore absorbed a living that has permeated itself into his very essence and makes himself come so alive for his grandson that his grandson has absorbed different mental schemas of the category called ‘blindness’. For his grandson, blindness is a game, an odyssey, a sport.

“I smell flowers,” says Grandpa.

“What flowers?” I ask.

He smiles. He loves guessing games.

…

“Carnations!” I cry. I love guessing games. (MacLachlan, 1980)

John closes his eyes in order to guess his breakfast.  He makes his plate of food a clock too and eats through Grandpas’ eyes. He attempts to play cello through grandpa’s eyes. Grandpa teaches him how to recognize the features of a sculpture by passing his fingers over them in a certain manner. For the boy, the Grandpa’s special abilities seem magic, and in a way the grandfather is certainly able to attach himself to reality far more than ‘ordinary’ seeing people can.

In short, whereas people are generally threatened by blindness, many perceiving it as a loss of life, Grandpa’s abilities to inject a favorable attitude in his disease passes on a positive schema of blindness to his grandson. For him, seeing a blind person would automatically inspire a positive response.

Stereotypes are like that: they can be negative or positive, and they almost always – because they generalize – provide one with an erroneous picture. Some outgroups, for instance, elderly, disabled, housewives, are pitied and disrespected for their perceived incompetence, whilst the outliers, homeless, drug addicts, and the very poor, are, perceived as manipulative, condemned as disreputable and exploitative (Fiske, 2002). Yet not everyone is like that.  Deindividuation, a cognitive method, that originated from models of impression formation produced by Bower (1998) and Fiske and Neuberg (1990), theorized that individuals categorize (or at least initially categorize (Fiske & Neuberg, 1990)) rather than personalize. Bower (1998) and Fiske and Neuberg (1990), therefore, recommended that perceivers should engage themselves in aggregating an individualized impression. Rather then automatically accepting that blindness denotes a limited or oblique existence, one should, they recommended, zone in on the individual, and study his case.  The adjectives used in conjunction with Grandpa are that  ‘he smiles’, “he laughs”. “The sun wakes Grandpa differently form the way it wakes me. He says it touches him, warming him” (MacLachlan, 1980). This blind man is not dead. He lives. And it is precisely this fact that enables him to impart different schemas – positive schemas about blindness – to his grandson.

Concept 3: Empathy

Empathy is the concept where one utterly sympathizes with the other. In a psychotherapeutic context, “this means that the therapist must understand the client’s world from the client’s point of view” (Weiten, 2007). Technically, anyone, can be a therapist. What a therapist implies, particularly in the humanistic framework, is the ability to provide a supportive emotional climate so that healing changes can occur in the other.  In a way, therefore, John acts as therapist for his grandfather. He enters his grandfather’s world in a way that few others can, and seems to have merged with his grandfather in his experiences of that world.

“Where’s Nana?” I ask him.

“Don’t you know?” he says, bending and stretching. “Close your eyes, John, and look through my eyes.” (MacLachlan, 1980)

By so doing, he accentuates his grandfather’s positive attitude towards his disability. The psychosocial Theory of Reasoned Action holds that the perceived expectations of important others in that individual’s life is a basic determinant of the individual’s performing the behavior in question.  In other words, people will have strong intentions to perform a given action if they evaluate it positively, and if they believe that important others think they should perform it.  By entering his grandfather’s world – practicing empathy to an inordinate degree, John helps his grandfather evaluate his behavior positively. More so, the grandfather feels a type of pressure to comply with his grandson’s expectations, which reinforces his salient behavioral beliefs. TRA states that intention to perform the behavior is determined by two determinants: attitude towards the behavior and subjective norm (namely the way significant others in that person’s life perceive the behavior). Each factor feeds into the other. By ‘attitude’, a person who believes that performing a given behavior will lead to mostly positive consequences will hold a favorable attitude towards that behavior. In Grandpa’s life, the significant people in his environment – namely Nana and John – endorse his behavior, and, by so doing, they served as a referent to Grandpa so that he weighted by that additional motivation to comply with that referent. John and Nana are, therefore, healers who, due to their ‘seeing through Grandpa’s eyes’, are granted acuity into the workings of their ‘patient’s’ mind.

‘Empathy’, however, when taken to its literal fullest implications is philosophically debatable since it is ontologically unachievable. A therapist has to listen to the patient and reference the patient’s words through his own images. He has a particular perspective – we all have, and he processes all observations and utterances through that biased perception.  He cannot escape that processing, neither can he escape the influence of prior knowledge on cognition and human judgment (Chater and Oaksford, 2001).

In Leibniz’s ‘Monadology”, Leibniz describes monads in the following way:

All is bound up together so that each body acts on every other body proportionately according to the distance, and everything is affected relatively, so it comes about that each monad is a living mirror, a mirror endowed with internal action, representative of the universe according to its point of view. (Leibniz, 1965, p. 276)

Humans are also bound up one with the other, thereby invariably and inextricably influencing the other. John cannot help but influence his grandfather, and simultaneously too, grandfather’s behavior cannot help but influence John. Each is affected relatively, each acts a living mirror of the other, and yet, at the end of the day, “each monad is a living mirror … representative of the universe according to its point of view” (Leibniz, 1962). John can never literally step into his grandfather world for he, John, is not blind. He can enter his grandfather’s world to the fullest of his ability, and yet will always miss the same degree of sensation for his experiences necessarily differ. An individual perceives his world through transparent patterns (or templates) which he creates, and then attempts to fit reality over that template. Carl Rogers lauded empathy and passed it on as a necessary component for the psychotherapeutic relationship. Yet, even Rogerian empathy is a mere translating of the other’s predicament into the therapist’s own experience, and, therefore, one can say, inherently limited.

What we essentially have, then, is the equivalence of two Liebnizian monads who are existentially apart, each sampling their own mirror image of the world but unable to impart their sensations to the other, and so, therefore, empathy in its understood context may be a misnomer.

Most patients significantly stress that it is the act of talking with someone about their problems that helps them (which is why counseling is called the ‘talking cure’; the one irreducible factor of all 490 plus psychotherapies (Feiffel & Eels, cited in Tennov, 1975). In that way, too, the grandson was probably the best therapist for the grandfather.

According to Beck, psychologists often lead us to believe that we can’t work out our problems on our own (Aaron Beck in Seligman, 1991) “The troubled person is led to believe that he can’t help himself and must seek out a professional healer when confronted with distress related to everyday problems of living.” Most perniciously, “this subtle indoctrination inhibits him from using his own judgment in analyzing and solving his problems” (M. Seligman, quoted in Dawes, 1994, pp.202). It is being with the other – this sort of empathy –whilst realizing that one can never utterly enter the other’s world that grants the other a haven of acceptance and reinforce his sense of efficacy in performing his behavior.

Empathy in its literal sense may, perhaps, be unobtainable, but John has, indeed, managed to look through his grandfather’s eyes to a remarkable extent, and, by doing so, has accentuated his grandfather’s emotional and mental healthy mindset.

Conceptual framework

The concepts mentioned above were mindfulness, empathy, and stereotypes of blindness.  Each in their own way, as pointed out, can be significant factors in psychosocial healing, and each are interrelated.

The grandfather’s focus on mindfulness enables him to continue, moment by moment, in a blind world and to gain a sort of contentment from a situation that many others would consider unendurable and beyond their control.  In fact, it is the grandfather’s attitude towards his disability that injects a certain cognitive schema in the boy’s perception towards blindness as a concept.  Whereas blindness is popularly perceived as tragic, the grandfather sees it as vital, life giving, and life exalting and infuses the boy with a marvel of the disability. It becomes a game: to guess the words, to guess the smell, to discover the food through the taste, the identity through the touch; in all, to challenge his grandfather, to close his eyes and live the world through his grandfather’s experience.

As we walk back towards the house, Grandpa stops suddenly. He bends his head to one side listening. He points his finger upwards.

“Honkers,” he whispers.

….

“Canada geese,” I tell him.

“Honkers,” he insists. And we both laugh. (MacLachlan, 1980)

It becomes an amazement, a wonder, fun! The grandfather’s attitude of mindfulness, in other words, a spirit that transcends acceptance – that goes to the source of his handicap and manipulates it for all that it is worth – causes the concept ‘blindness’ to achieve a magical, seductive aura in an otherwise threatening, off-putting term.  ‘Laugh’ is a common expression through the book. Nana laughs; Grandpa laughs; John laughs.  This blind man is able to disperse joy through the way that he takes his disability, and, in so doing, makes his limitations a wonder. The boy is enthralled with his grandfather’s sightlessness. And it is this enthralling wonder, that, in turn, makes him so empathetic to his grandfather’s situation that, in turn, serves as referent for the grandfather to try harder and to persevere in his attitude and behaviors. Had the boy shown negative indications such as fear or revulsion, the grandfather might have been more muted in his demonstrations, aside from which social attitudes overlap in their ramifications. It was due to the very fact that the boy was so enthralled and excited by his grandfather’s feats that the grandfather was driven on to produce even more ‘magic’, to stretch out the excitement of this dark new world.  Empathy helped him persevere, create, and recreate, and as such was a beneficial tool in helping him maintain his health behavior. As the expectancy model predicts, social expectancies will factor in a person’s choice whether or not to adopt a certain behavior. It can hardly be doubted that the boy’s enthusiasm for his grandfather’s tricks stimulated the grandfather to generate enjoyment from his handicap and to perceive it in a uniquely courageous fashion.  The fact that he did so, indubitably, contributed to the fact that he seemed to take his blindness in such an extraordinary healthy manner. Effervescent and spunky, the grandfather epitomized self-efficiency to the latter of the word. He threw himself into a challenged existence and made it live for him to the fullest. Sights, sounds, smells –each and every minutiae of existence- resounded and thrilled on a far mightier platform than it ordinarily does for individuals lesser ‘gifted’ than he. The self-efficacy of mindfulness and the ability to cope with his disease, reinforced by his grandson’s admiration for his coping abilities, enabled the grandfather to persevere.

Finally, the grandfather’s attitude  – his remarkable ways of dealing with his disability – was responsible in preventing any potential fears of blindness from forming in the boy’s head. On the contrary, an unusually positive schema of blindness formed and the boy associated sightlessness with adventure. Blindness seems to result in mostly positive consequences, and the result is that Grandpa, Nana, John, and reader accrue a favorable attitude towards Grandpa’s challenges and to his ways of dealing with those challenges. Mindfulness, empathy, and mental schemas intertwine, since one’s person’s behaviors and attitude invariably influence another and, consequently, modify or reinforce existing cognitive perceptions that, in turn, drive behavior. Through the construct of self-efficacy, Grandpa was able to influence the subjective norm towards his incapacity and, by so doing, reinforced his own attitude towards his limitations. His perceived self-efficacy    successfully helped him perform the recommended actions, thus reducing the existence of the vulnerability of his situation and severity of the threat.

Conclusion

The five social cognition models – the health belief model, protection motivation theory, self-efficacy theory, the theory of reasoned action, and the theory of planned behavior –  possess similarities and differences.  Some constructs are common to more than one model, for instance perceived susceptibility to disease and threat of disease are manifest in both the health belief model and in the theory of planned behavior. Perceived behavioral control and self-efficacy are two other elements that appear common to all.

All the models assume that individuals are future oriented, and that they weigh up the costs and benefits of possible future costs of action. In this way, they all incorporate to a lesser or greater degree the expectancy-value principle as epitomized in the normative model of judgment and decision-making. In other words, humans chose their attitudes and behaviors by multiplicatively combining their expectations and values.

Psychosocial cognitive models are sometimes criticized for being static, for being placed at one moment in time whereas a human’s behavior it is said is ongoing, comprised of various factors, and generally fluctuating. This criticism is unfounded (Sutton, 2002), since social cognition models summarize dynamic causal process. Although seemingly static, self-efficacy for instance is a dynamic causal process. As indicated in this essay, the grandfather’s perception of self-efficacy, caused individuals in his environment to respond in kind, which, in turn, reinforced his positive health behavior. Had significant others reacted differently, their evaluations might have produced changes in his attitude, which, in turn, would have led to changes in intention, which would have, ultimately, produced changes in his behavior, consequently affecting others.

Psychosocial models differ in the degree to which they empathize one construct over another. For instance, the Health Belief model focuses on the individual’s perception of the disease as a threat, whereas the theory of Reasoned Action, for instance, refers to the individual’s perception of possible courses of action that may attenuate that threat.

The models also differ in regards to their scope of application.  Key constructs in the HBM and PMT attach themselves to a given health threat, whereas the other three models are general theories that can be applied to any domain or behavior.

Finally, one focus of current interest in psychosocial discussion is the ‘intention-behavior gap’ where the individual may, for instance, intend to diet or exercise yet repeatedly fail to follow through. Researchers are baffled by this phenomenon; particularly since some individuals deeply desire to curb their negative habits or procure healthy ones, yet, somehow, seem unable to maintain their resolution. Some have posited Gollwitzer’s (1993) concept of implementation intentions and related ideas to explain why some people who have strong intentions to achieve a goal succeed whereas others fails. Grandpa is an excellent representative of Gollwitzer’s implementation intentions. Through converting his disability into a game by practicing mindfulness, he converts it into a positive mental schema in his grandson’s perspective, thus securing the empathy of his grandson and a vicious cycle ensue whereby he accomplishes an admirable existence of health.  ‘Through Grandpa’s eyes’ can be used as model for anyone in order to achieve personal or other health behavior interventions.

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