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Nurturing Our Better Nature: A Proposal for Cognitive Integrity as a Foundation for Autonomous Living

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Abstract

As we account for the genetic and environmental influences on morally-relevant character traits like intellectual honesty, industriousness, and self-control, do we risk becoming ever less accountable to ourselves? Behavioral genetic research suggests that about half the variance in such character traits is likely attributable to heredity, and a small fraction to the shared family environment. The remaining 40-60% is explained by neither genes nor family upbringing. This raises the question: how active a role can individuals play in shaping their own character? What, if anything, can and should one do to take responsibility for the kind of person one becomes? This paper sketches a novel theoretical proposal for addressing these questions, by drawing on several previously disparate lines of research within behavior genetics, philosophy, and experimental psychology. Our core proposal concerns the metacognitive capacity to engage in active, reality-based cognition, as opposed to passive, stimulus-driven processing or an active pretense at cognition (i.e., self-deception). We review arguments and evidence indicating that human beings both can and should exercise this capacity, which we have termed “cognitive integrity.” We argue that doing so can in a certain sense “set us free” of our genetic and environmental influences—not by rendering them irrelevant, but by giving us the awareness and motivation to manage them more responsibly. This perspective has important implications for guiding the development of psychosocial interventions, and for informing how we direct ourselves more generally, both as individuals and as a society.
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Behavior Genetics
https://doi.org/10.1007/s10519-018-9919-x
ORIGINAL RESEARCH
Nurturing Our Better Nature: AProposal forCognitive Integrity
asaFoundation forAutonomous Living
EugeniaI.Gorlin1 · ReinierSchuur2
Received: 21 November 2017 / Accepted: 6 August 2018
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract
As we account for the genetic and environmental influences on morally-relevant character traits like intellectual honesty,
industriousness, and self-control, do we risk becoming ever less accountable to ourselves? Behavioral genetic research sug-
gests that about half the variance in such character traits is likely attributable to heredity, and a small fraction to the shared
family environment. The remaining 40–60% is explained by neither genes nor family upbringing. This raises the question:
how active a role can individuals play in shaping their own character? What, if anything, can and should one do to take
responsibility for the kind of person one becomes? This paper sketches a novel theoretical proposal for addressing these
questions, by drawing on several previously disparate lines of research within behavior genetics, philosophy, and experi-
mental psychology. Our core proposal concerns the metacognitive capacity to engage in active, reality-based cognition, as
opposed to passive, stimulus-driven processing or an active pretense at cognition (i.e., self-deception). We review arguments
and evidence indicating that human beings both can and should exercise this capacity, which we have termed “cognitive
integrity.” We argue that doing so can in a certain sense “set us free” of our genetic and environmental influences—not by
rendering them irrelevant, but by giving us the awareness and motivation to manage them more responsibly. This perspec-
tive has important implications for guiding the development of psychosocial interventions, and for informing how we direct
ourselves more generally, both as individuals and as a society.
Keywords Moral development· Heritability· Free will· Cognitive control· Metacognition· Moral identity
Introduction: behavior genetics
andthequestion ofhuman agency
Can we take responsibility for shaping our own character?
And if so, when and how should we do so?
According to what Dar-Nimrod and Heine (2011) termed
“genetic essentialism”—the increasingly common view that
our genetic makeup determines everything about us—the
answer to the first question is, of course, that we cannot. The
second question, then, is moot.
Dar-Nimrod and Heine (2011) indict genetic essential-
ism as a scientifically implausible belief that people rou-
tinely adopt in response to being told that a given trait is
“heritable.” A range of evidence is reviewed for the unde-
sirable consequences of adopting this belief: For instance,
experimental studies show that genetic essentialist beliefs
make people more likely to endorse racial and gender ste-
reotypes, stigmatize individuals with mental illness, and
decrease their own self-control efforts with respect to
unhealthy eating behaviors (Dar-Nimrod and Heine 2011).
These findings dovetail with the broader psychological lit-
erature on the negative behavioral and psychological con-
sequences of endorsing determinist versus free will beliefs:
People who endorse determinism are more likely to get or
stay addicted to alcohol (Vonasch etal. 2017); experience
more stress, poorer work performance, and lower overall life
satisfaction (Baumeister and Brewer 2012); engage in more
dishonest behavior (Vohs and Schooler 2008) and conform-
ity (Alquist etal. 2013); and exhibit more impulsive and
antisocial tendencies (Rigoni etal. 2012).
The implications of these findings are particularly stark
for those faced with the prospect of changing a relatively
fundamental but problematic aspect of themselves—e.g.,
* Eugenia I. Gorlin
gena.gorlin@gmail.com
1 Ferkauf Graduate School ofPsychology, Yeshiva University,
Bronx, NY, USA
2 Department ofPhilosophy, University ofBirmingham,
Birmingham, UK
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overcoming a drug or alcohol addiction, reversing a lifelong
pattern of aggressive or self-injurious behavior, or becom-
ing an assertive communicator in the face of longstanding
social anxiety.
Yet such are the changes that people are routinely called
upon to make in the course of psychotherapy. Perhaps unsur-
prisingly, the people who come in with the highest levels
of self-efficacy and motivation—i.e., beliefs that one can
change and that the change is worth making—are the ones
most likely to benefit from various forms of psychotherapy
(e.g., Adamson etal. 2009; Gordon etal. 2011; Powers
etal. 2008). This is notable given that only about 60% of all
patients benefit from even our most rigorously tested and
refined psychotherapies, largely due to poor adherence and
high dropout rates (e.g., Franklin and Foa 1998; see also;
Hofmann etal. 2012, for a review of meta-analyses).
People’s beliefs about agency and moral responsibility
clearly matter, and these beliefs are largely shaped by what
we, as a scholarly community, have to say on the subject
(Dar-Nimrod and Heine 2011). So, what do we have to say?
Unfortunately, the answers given by modern scholars have
inspired little confidence. Indeed, recent media coverage of
the “science of free will” has ranged from vague and con-
fusing to downright demoralizing (e.g., Bear 2016; Chivers
2010; Griffin 2016).
Accordingly, in his commentary on Dar-Nimrod and
Heine’s (2011) review, Turkheimer (2011) agrees that
genetic essentialism is untenable, but notes the need for an
alternative account of how the heritability of human behav-
ior does or does not constrain human agency. In developing
such an account, he argues that more attention should be
paid to the so-called “nonshared environment”—that is, the
unexplained variance left over after accounting for all the
shared genetic and environmental factors that make twins
similar rather than different on a given trait. He acknowl-
edges that some portion of this leftover component reflects
measurement error, and some further portion reflects the
influence of exogenous environmental factors not shared by
two twins raised together (e.g., classroom assignment or dif-
ferential parenting approaches). Nonetheless, he notes, these
explanations together can account for only a small fraction
of the 40–60% of variance in complex behavioral traits (e.g.,
self-control, impulsivity, conscientiousness) that is “left
over” once genes and shared environment are accounted for.
Indeed, a quantitative review by Turkheimer and Waldron
(2000) concluded that “measured nonshared environmental
variables do not account for a substantial portion of the non-
shared variability posited by biometric studies of behavior.”
This core finding that about half the variance in most human
behavioral traits cannot be explained by either genetic or
shared environmental factors, Turkheimer (2011) argues, is
consistent with our experienced sense of exercising at least
some agency over who we become. Indeed, he even goes so
far as to claim that “the nonshared environment, in a phrase,
is free will.”
Of course, the fact that so much of the variance in our
behavior cannot currently be accounted for by genes or fam-
ily environment does not “prove” that we are responsible
for the rest; nor does it tell us what it would look like for us
to wield that responsibility. It merely tells us that our genes
and family environment do not explain everything about us,
thus leaving room for whatever it is that “free will” turns out
to be. As Turkheimer (2011) states in his commentary, “we
can leave it to the philosophers to work out all the details in
a theory of what it means to have a choice about our behav-
ior and therefore to be morally culpable for it…” In fact, of
course, philosophers have been discussing and debating the
nature of free will for several millennia. According to the
Stanford Encyclopedia of Philosophy, “free will” generally
refers to “a particular sort of capacity of rational agents to
choose a course of action from among various alternatives,”
which philosophers generally agree is “very closely con-
nected to the concept of moral responsibility” (O’Connor
2016). However, there is substantial disagreement about
what this “capacity” amounts to, and whether it exists at all.
Philosophical positions on this issue broadly cluster into the
following categories:
(1) Hard determinism, which denies the existence of free
will on the premise that it is incompatible with a deter-
ministic universe (e.g., Pereboom 2005, 2008; Strawson
1994). This is the view most closely aligned with the
“genetic essentialist” and “determinist” beliefs that led
to the various negative psychological and behavioral
consequences discussed above. Of note, the “naïve
environmentalist” view that Turkheimer (2011) identi-
fies as the “mirror image” of genetic essentialism—i.e.,
that people are entirely determined by their environ-
ment—also presumably falls into this category.
(2) Compatibilism, which asserts that free will exists and
can ultimately be explained by deterministic causes
(whether genetic, environmental, or some complex
interaction of the two) (e.g., Dennett 1984, 2003; Fis-
cher and Ravizza 1998; Frankfurt 1969, 1982).
(3) Libertarianism, which asserts that free will exists and
is not reducible to deterministic physical causes, but
rather is subject to a different sort of explanatory mech-
anism. Theorists differ in the specific mechanisms they
posit, with the most prominent accounts being agent-
causal (e.g., Reid 1983/1788; Chisholm 1964, 1976;
Binswanger 1991; Griffith 2010; Rheins 2016), event-
causal (e.g., Mele 1990; Searle 2010), and noncausal
(e.g., Ginet 2014, 2016).
Although it clearly falls outside the scope of the current
paper to resolve this longstanding ontological debate, we
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will be assuming the view that is common to the compati-
bilist and libertarian positions: namely, that free will exists
and involves the experienced capacity to deliberate between
alternative futures when selecting a course of action. This
capacity, in turn, is thought to be a crucial prerequisite to
taking moral responsibility for one’s actions. Of note, we
do not presume at this stage that free will is reducible to
what behavior geneticists refer to as the “nonshared environ-
ment,” given that this term already embeds the compatibil-
ist assumption that all human behavior can be explained in
terms of either genetic and/or environmental causes. Rather,
we refer to the variance left over after accounting for genes
and shared environment simply as “unexplained variance,”
thereby avoiding any ontological commitments that we are
not ready to make.
Indeed, even setting aside the ontological debate, we sub-
mit that there is still much work to be done to understand
the loci and consequences of choice as it is experienced by
human beings. For instance, there is a need to identify and
characterize the specific choices or chosen modes of func-
tioning involved in the development of human character, in
a way that yields therapeutic interventions and actionable
guidance for living. Toward this end, we suspect it will be
especially valuable to identify categories of choices that are
fundamental to other choices involved in the development of
stable character traits. Once we have identified and validated
the causes of human behavior at this more proximal, expe-
riential level of analysis, we may be in a better position to
inquire into how much these proximal causes, in turn, can be
explained by relatively distal genetic and/or environmental
factors.
Thus, the current paper seeks to sketch out a philosophi-
cally and psychologically informed response to both the
can and should questions posed above, proceeding from
this “experienced choice” level of analysis. Based on our
critical review of the relevant literatures, we will advance
the thesis that a major locus of agency lies in a specific way
that we can we direct our thinking. That is:
Barring severe brain damage or disability, human
beings can choose to engage in active, reality-oriented
cognition—i.e., to exercise cognitive integrity. Exer-
cising and habituating to cognitive integrity, in turn,
increases one’s agency with respect to more down-
stream character traits.
Existing philosophical perspectives
onepistemic agency
A small but growing body of philosophical work has
stressed the respects in which we can be said to control
our thinking and beliefs, even if it does not make sense to
say we directly choose the content of our beliefs as such
(Heil 1983; Audi 2001; Steup 2011; Salmieri and Bayer
2014; Paul 2015). Some philosophers have even argued
that this freedom over our thought processes is the source
and prerequisite of our moral agency (Clifford 1877/1999;
Ghate 2016; Salmieri and Bayer 2014). After all, if we
cannot choose how—and whether—to think, how respon-
sible can we be for the actions we take on the basis of our
thinking (or non-thinking)?
The idea that the locus of human agency is fundamen-
tally cognitive rather than behavioral can be traced back
to the third century critic of the Stoics, Alexander of Aph-
rodisias. Alexander claimed that we are responsible for
our actions in virtue of a choice to deliberate or not (see
Sharples 2007). Elements of this idea can be found later in
Thomas Reid (1983/1785), but the more explicit emphasis
on cognitive control as the primary locus of free will did
not come until more recently, as in the work of William
James, who identified free will as an ability to exercise
attention or not (1914), and Binswanger (1991, 2014), who
identified free will as an ability to raise or lower the level
of one’s conscious awareness or not. In these accounts,
free will refers not to any particular cognitive capacity as
such, but to the metacognitive capacity to exert control
over our own cognitive processes or not. These accounts
align well with modern theories of virtue epistemology
and epistemic responsibility (e.g., Code 1987; Montmar-
quet 1992; Zagzebski 1996), which conceptualize mental
processes like attentiveness to facts and openness to new
ideas as voluntary “acts of intellectual virtue” (Zagzebski
1996) that become increasingly habitual with practice.
Even if one grants that psychologically healthy indi-
viduals are capable of controlling their own thought
processes, there is a question of whether such agency is
retained in the context of “compulsive” mental health
disorders such as addiction. According to the widely
held “disease” model of addictive disorders, substance
dependence robs afflicted individuals of their capacity for
rational deliberation, at least in the context of decisions
about whether to use (e.g., Mele 1990; Levy 2011; Elliott
2002). On the other hand, some philosophers (e.g., Pickard
2013) point to the contradiction between such non-agen-
tic views of addiction and the inherently choice-centric,
autonomy-promoting therapeutic interventions—e.g., cog-
nitive-behavioral therapy, contingency management, and
motivational interviewing—that have been shown effective
in treating these disorders (see Pickard 2013). In making
a case for the role of choice in addiction, Pickard (2013,
2016) highlights the role of motivated cognitive processes
such as denial and rationalization in maintaining addic-
tive disorders and other forms of psychopathology, and
the modification of these processes as a key pathway to
recovery.
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Introducing cognitive integrity
asamoral‑epistemic norm: conceptual
distinctions andclarications
Building on these accounts of epistemic agency as it
manifests in both healthy and psychologically disordered
individuals, we propose that the metacognitive choice to
engage in active, reality-oriented cognition is our fun-
damental locus of control over our own morally-relevant
behaviors and character traits. We refer to this deliberate
engagement in active, reality-oriented cognition as cogni-
tive integrity. This state of active, reality-oriented cogni-
tion is to be contrasted with two other ways of using one’s
cognitive faculties: passive processing and active pretense,
i.e. self-deception.
We regard the term cognitive integrity as describing
both a present-moment state of mental activity and a more
trait-like disposition to engage in such mental activity (just
as the term “honesty” may describe either a discrete act
performed in a given situation, or a trait-like disposition
of a given individual).
The remainder of this section fleshes out and explicates
cognitive integrity and its contrasts.
Cognitive integrity asactive (versus passive)
Cognitive integrity is a state of being engaged in an active
as opposed to a passive mental process. We conceptual-
ize active processing here as any mental process that is
directed by the agent’s conscious intention, versus being
driven by an unconsciously activated intention or by
whatever associative stimuli happen to be salient in the
moment. Put another way, engaging in active processing
literally means exercising agency over one’s mind, that
is, making goal-directed choices about how and where to
direct one’s awareness. Sometimes this may require greater
effort, as when deliberating on a decision about where to
attend graduate school, and other times this may mean
resting one’s mind and purposefully letting one’s thoughts
wander (see Seli etal. 2016, on the dissociable proper-
ties of intentional versus unintentional mind-wandering).
Here we draw on Barghs (1994) conceptualization of the
“four horsemen” of strategic versus automatic process-
ing, which identifies four mutually dissociable processing
features: awareness, intentionality, effort, and controlla-
bility (i.e., ease of disengaging). Accordingly, we regard
a mental process as active if it is initiated and maintained
consciously and intentionally, regardless of how much
effort it involves or how easy or difficult it would be to
stop, per se. Thus, we would regard depressive rumina-
tion—or dwelling on one’s problems in an unintentional,
stimulus-driven manner—as a passive process (see Nolen-
Hoeksema etal. 1993), no matter how seemingly effortful
or draining it may be. This conceptualization also aligns
with research suggesting that successful goal-directed task
performance may sometimes be associated with lesser
rather than greater expenditure of cognitive resources,
possibly due to more efficient metacognitive management
of those resources (e.g., Bogler etal. 2017).
Cognitive integrity asreality‑oriented (versus
self‑deceptive)
We take the term “cognition” or “cognizing” here to refer to
the set of mental processes whose common goal is knowl-
edge (as implied by their Latin predecessor, cognoscere
“to get to know, recognize”). In this regard, the “reality-
oriented” modifier in our definition of cognitive integrity is
arguably redundant, as “cognizing” in the proper sense is
inherently aimed at apprehension of reality. However, we
also recognize that the human cognitive apparatus can and
often does get hijacked in the service of other, non-cognitive
ends, such as relieving emotional discomfort or avoiding the
need for effort. We refer to these non-cognitive uses of our
cognitive apparatus as a pretense at cognition, because their
“success” depends on the individual’s conviction that they
are, in fact, accurately describing reality. For example, the
common rationalization that “I’m too tired to be productive
right now, I’ll work on this paper tomorrow” is only effec-
tive at relieving the guilt of procrastination if one at least
partially believes it. Yet anyone who has ever procrastinated
knows there is a qualitative difference between (1) genuinely
believing one is too tired to be productive (which may well
be true, or at least aligned with the available evidence), and
(2) telling oneself one is too tired as an excuse for avoid-
ing the work. There is an inherent pretense of reality-based
cognition involved in the latter case.
One challenge that can be raised against this or any other
account of self-deception is that it seems paradoxical to sup-
pose that the same individual can both believe and disbelieve
a given claim simultaneously (e.g., Borge 2003; Mele 2001).
However, this alleged paradox largely rests on the premise
that people’s epistemic agency begins with the adoption or
rejection of certain belief contents (e.g., Ginet 2001). If this
were the case, then it would indeed make no sense to say
that a person can both adopt and reject a given belief at the
same time. By contrast, however, we subscribe to Salmieri
and Bayer’s (2014) view that the locus of epistemic agency
is not the adoption or rejection of certain belief contents, but
rather the engagement or non-engagement in certain meta-
cognitive processes (e.g., directed attention, logical inquiry,
fact-checking, etc.) that in turn foster the development and
validation of reality-oriented beliefs (see also Audi 2001;
Hieronymi 2006; Wu 2015).
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On this view, self-deception does not consist in the
explicit rejection of some claim one explicitly regards as
true. Rather, the choice to self-deceive arises much earlier
in the epistemic process, when one first becomes aware of
some to-be-processed information that one implicitly senses
to be uncomfortable or threatening. At this stage, one can
choose to (1) engage in active cognition aimed at increas-
ing one’s awareness and understanding of the information
(i.e., practice cognitive integrity); (2) disengage from further
active processing of the information (i.e., default to passive,
stimulus-driven processing); or (3) engage in active pretense
at cognition, with the aim of reducing or obfuscating one’s
awareness of the information (i.e., self-deceive).
We propose that this pretense at cognition can utilize any
of the processes normally involved in cognition, includ-
ing (but not limited to) attention, elaboration, and memory
recall. Of note, each of these processes can also occur pas-
sively when activated by some external or internal stimu-
lus, or they can be actively deployed in the pursuit of actual
knowledge. What distinguishes the self-deceptive deploy-
ment of these processes, as noted earlier, is the passing
awareness of some potentially uncomfortable stimulus and
the corresponding intention to reduce or distort that aware-
ness. These features of experience are inherently difficult to
assess in the laboratory, but there is some indirect experi-
mental evidence that people sometimes engage in this type
of intentional distortion of objects in awareness. For exam-
ple, students who knowingly cheated on a math test, and
thus were aware of the reason for their artificially inflated
score, later proceeded to overestimate their performance on a
similar test—despite the fact that their predictive errors cost
them money (Chance etal. 2011). The authors concluded
that these participants must have convinced themselves that
their original high scores were due to their ability rather
than their cheating. Indeed, this tendency toward overesti-
mation after cheating was stronger among individuals who
scored higher on a questionnaire purportedly assessing “self-
deceptive denial” (via virtuous-sounding items that no one
is expected to endorse unless they self-deceive; e.g., “I have
never done anything that I’m ashamed of”; Paulhus and Reid
1991).
Further evidence for the existence and maladaptive nature
of self-deceptive processing comes from the extensive litera-
ture on cognitive processing biases in mental health disor-
ders. Contrary to early research on the so-called “depressive
realism” hypothesis (Alloy and Abramson 1988), depressed
versus non-depressed individuals make more negatively
distorted self-assessments (Whitton etal. 2008), make less
accurate causal attributions for personal life events (Moore
and Fresco 2007), and display more false memories for
negatively valenced information (Joormann etal. 2009).
Similar biases have been reported in individuals with anxi-
ety disorders (see Craske and Pontillo 2001, for a review).
Notably, even though these cognitive distortions often cast
the patient in an overly negative rather than an overly posi-
tive light, they may share the common self-deceptive goal
of reducing or removing perceived responsibility for action.
For example, a patient may attribute global and unchange-
able negative traits to oneself, akin to the genetic essen-
tialist beliefs described earlier (e.g., “I can’t really help my
depressed and antisocial nature, since it’s in my genes”). On
the other hand, patients may externalize blame to their envi-
ronment and thereby protect their own positive self-image
while insulating themselves from the need for change (e.g.,
by telling themselves “Of course I’m angry all the time; it’s
how my parents raised me”). This latter strategy is similar
to self-protective processes hypothesized for individuals
with narcissistic personality disorder (see Beck etal. 2004,
pp.254–255).
Again, the presence of biased cognitive processes does
not in itself provide evidence of self-deception, given that
such biases often occur without the individual’s awareness
or intention. However, the research on self-handicapping
strategies and their positive associations with depression
(e.g., Sahranc 2011; Weary and Williams 1990) as well as
anxiety (Prapavessis etal. 2003; Sahranc 2011) provides
indirect evidence that there may be a strategic element to
some of these disorder-related cognitive biases. Negative
preservative thought processes like rumination and worry
have also been posited to serve an avoidant function in anx-
ious and depressed individuals (e.g., Newman and Llera
2011; Moulds etal. 2007).
Implicit capacity versusexplicit metacognitive
choice
We do not regard the choice to exercise cognitive integrity
as being equally accessible in every waking moment of a
person’s existence. Rather, we regard it as a kind of implicit
capacity for self-reflection and metacognitive oversight that
is available to anyone with a basically intact human brain
(we do not claim to know precisely what neural circuitry is
required in order to support this capacity, although the pre-
frontal cortex is likely involved; e.g., Dogan etal. 2016). In
this regard, the capacity for cognitive integrity is analogous
to other, more specific mental capacities that most human
beings possess but may not always be explicitly aware of
possessing. For example, most people have the capacity to
look out the window and notice their surroundings while
riding a bus to work, assuming they have intact eyesight
and neck mobility. But they do not necessarily experience
themselves as actively choosing not to look out the window
if they are absorbed in their own thoughts and the option
simply does not occur to them. On the other hand, if some-
one or something brings this option to their awareness—
e.g., another passenger remarks on the beautiful view, or
Behavior Genetics
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they remember something interesting they had seen during
their previous bus ride—suddenly they do have an explicit
metacognitive choice to make. If they decide to look out the
window, this now opens up a new set of choices: how far out
do they look? Do they focus on the buildings, or the clouds
overhead, or the people in the street? How diligently and in
what level of detail do they describe to themselves what they
are seeing? Likewise, if they choose instead to stay focused
on their own train of thought, this no doubt opens up its own
series of more downstream choices, such as whether to keep
thinking about the same topic or switch to a new concern.
Similarly, the capacity to exercise cognitive integrity
presents itself as an explicit metacognitive choice insofar
as a person has some conscious awareness of an alternative
between engaging in an active, reality-oriented thought pro-
cess or not. For instance, suppose that you notice you have
been passively mind-wandering for the past 5min instead
of taking in the content of this article. Upon noticing this,
you would become explicitly aware of a choice that had been
implicitly available all along, namely: do you take back the
reins of your mind and actively reassess what you want to
be doing right now (perhaps deciding to return to the arti-
cle, or perhaps deciding to switch to another task)? Or do
you not take the reins, rather letting your mind continue to
drift without a consciously set intention? Notice that only
the former choice puts you in a position to identify further,
more downstream choices that were not already salient to
you, such as switching to a different task or asking a differ-
ent set of questions about the article. These alternatives are
not likely to present themselves if you choose to remain in
passive autopilot mode.
To illustrate the issue further, suppose you catch your-
self fishing for excuses to stay home instead of going to the
gym as you had planned. Once you become even fleetingly
aware of this pretense at cognition in which you are engaged,
you are presented with a metacognitive choice: do you shift
into active, honest thinking, working to identify the realistic
costs and benefits of going to the gym so you can make an
informed decision? Do you instead double down on your
excuses, working to convince yourself that they were sincere
all along? Or do you not give it much thought either way,
passively going in whatever direction you feel most strongly
pushed by your emotions (whether this means going to the
gym out of guilt, or not going to the gym out of laziness)?
Again, it is apparent that the first of these three alternatives
opens up a wider, more flexible range of downstream choices
than the latter two. Once you are actively probing your
knowledge and, if need-be, seeking out new data to inform
your cost-benefit analysis, you gain access to a variety of
paths to consider: you might realize that there are other,
more rewarding ways to get your exercise tonight, such as by
going out dancing or joining your friends for frisbee; or you
might decide to modify your gym workout based on your
changing physique and priorities; or you might realize that
you have already gotten all the exercise you need today, and
your guilt at not going to the gym is based on internalized
cultural norms that you no longer endorse. None of these
possibilities are likely to occur to you if you get passively
buffeted about by, and/or actively distort the data to fit with,
your current emotions.
Of note, we expect that various genetic and environmental
factors may influence how frequently the choice to exercise
cognitive integrity explicitly presents itself and how easy or
hard it is to motivate. For instance, attention deficit / hyper-
activity disorder (ADHD) is a highly heritable neurocogni-
tive condition (with genetic factors explaining ~ 88% of the
variance; Larsson etal. 2014) that is associated with more
frequent distraction and unaware mind-wandering (e.g.,
Franklin etal. 2016). As such, individuals with ADHD may
be more prone to slipping into a passive, stimulus-driven
processing mode without metacognitive awareness of doing
so. As to more canonically environmental influences, indi-
viduals who have experienced significant trauma may feel
intense fear and, in severe cases, may even automatically
dissociate from reality when confronted with certain trauma-
related cues (e.g., Lanius 2015). It may be extremely dif-
ficult, if not altogether impossible, for them to engage in
active, reality-oriented cognizing in such moments, given
how excruciatingly painful or even dangerous reality can
seem. Nonetheless, individuals with ADHD and those with
post-traumatic stress disorder (PTSD) often do benefit from
interventions that call upon them to engage in some form
of active, reality-oriented cognition, as will be discussed in
Evidence from clinical and social/personality psychology
section below.
Habituating tocognitive integrity: avirtue ethical
perspective
Of course, engaging in active, reality-oriented cognition
does not guarantee that one will never reach erroneous con-
clusions or choose a poor course of action. There are many
ways that even an active, reality-oriented reasoning process
can go wrong, and one will not always have sufficient knowl-
edge or reasoning skills to know what the consequences of
a given course of action will be, or even to recognize that
one is uncertain. Insofar as one is actively directing one’s
thought processes, however, one gains enormous flexibil-
ity in drawing upon the sum of whatever knowledge and
evidence one does have available, rather than being buf-
feted along by whatever heuristic stimuli or emotional cues
happen to be salient in the moment (e.g., Pollock 1991;
Stanovich 2002). Additionally, insofar as one is directing
one’s thought process with the goal of apprehending reality,
one is inherently more motivated to notice and correct any
errors or contradictions one does become aware of—versus
Behavior Genetics
1 3
rationalizing them away in order to reduce the momentary
discomfort of being wrong. As such, people who consist-
ently practice cognitive integrity likely experience a sense
of increasing efficacy and self-credibility over time (akin to
the psychological construct of “self-congruence” described
by Rogers 1957).
By contrast, habitually engaging in self-deceptive pro-
cessing, or pretense at cognition, as we have termed it, leads
to an increasingly biased and contradictory dataset, just as
the policy of selectively doctoring or removing “undesir-
able” findings would increasingly distort a scientific data-
set. In this manner, self-deception undermines agency by
obscuring one’s knowledge of the determinants and conse-
quences of one’s behavior, thus impairing one’s ability to
make informed, autonomous decisions about how to behave
in the future. For example, if a person cannot remember
what happened or how she felt in past instances of asking
someone out on a date, she will have little experience-based
guidance in deciding whether to pursue her current crush.
Moreover, given that one is never fully deceived by one’s
own pretense at cognition (at least at the time one engages
in it), we further posit that people who engage in frequent
self-deception harbor an increasing sense of insecurity about
their own beliefs and decisions, sensing as they do that those
beliefs and decisions rest on an unreliable dataset.
In this light, we posit that the repeated exercise of active,
reality-based thinking fosters the habituation of cognitive
integrity as a trait-like virtue (see Kraut 2012, for a summary
of Aristotle’s account of virtue habituation; see also Badh-
war 2014, for a more modern account).1 We expect that this
habituation would occur through two mutually reinforcing
mechanisms: (1) the experience of increasing efficacy and
self-credibility arising from active, reality-oriented think-
ing would make future acts of cognitive integrity easier
to motivate, given the accruing evidence of its value; and
(2) the skills involved in active, reality-oriented thinking
would also increase and become more chronically accessi-
ble with practice, such that the conscious choice to practice
cognitive integrity more readily presents itself (see Stichter
2013, for an account of virtues—including epistemic vir-
tues—as skills). Through these joint mechanisms, we expect
that practicing cognitive integrity not only increases one’s
agency with respect to more downstream choices, but also
increases one’s awareness and motivation with respect to the
ongoing exercise of cognitive integrity itself.
Thus, we propose, by engaging in active, reality-oriented
cognition whenever presented with the choice to do so, we
lay the groundwork for more informed and flexible—i.e.,
autonomous—character development. Below, we review
experimental evidence from psychology that further sup-
ports this thesis.
Evidence fromclinical andsocial/personality
psychology
Some of the best evidence that people can choose to engage
in active, reality-oriented cognition comes from psychologi-
cal interventions that call upon people to do so. For example,
mindfulness-based interventions (Kabat-Zinn 1982, 1990;
see also; Bishop etal. 2004) involve the practice of con-
sciously and intentionally attending to some aspect of one’s
present-moment reality, whether internal or external (e.g.,
the sensations of breathing, the sounds in the room, or one’s
own emotional states). In the course of this practice, one is
typically instructed to redirect one’s attention back to the
chosen object of awareness whenever one becomes aware
that one’s mind has drifted from it. One is also typically
instructed to observe the object of awareness “just as it is,
without evaluation or judgment (e.g., Segal etal. 2002). This
practice of directing and redirecting one’s attention, on pur-
pose, to present-moment reality is the core constituent of
any mindfulness training intervention; there is no prereq-
uisite knowledge or technique one needs to learn in order
to begin doing it. Indeed, mindfulness-based interventions
have been successfully implemented with individuals who
suffer from wide-ranging cognitive and emotional impair-
ments: for instance, individuals with ADHD (e.g., Mitchell
etal. 2015), PTSD (Boyd etal. 2018), drug addiction (e.g.,
Marcus and Zgierska 2009), and even currently psychotic
patients with schizophrenia (e.g., Chadwick 2014). The
more one practices directing and redirecting one’s attention
in this voluntary manner, in turn, the better a decision-maker
one becomes. For instance, individuals who received brief
training in mindfulness meditation (versus a mind-wander-
ing control condition) were more effective at overcoming
the sunk-cost fallacy—a common reasoning bias—during
a decision-making task (Hafenbrack etal. 2014). Likewise,
mindfulness-based interventions have been shown to reduce
symptoms and improve overall functioning in individuals
with clinically impaired decision-making, such as, again,
those with ADHD and substance use disorders (Mitchell
etal. 2015; Marcus and Zgierska 2009).
Similarly, most forms of cognitive-behavioral therapy
(CBT) call upon patients to do at least some amount of
(active) self-monitoring and (reality-based) reappraisal
in order to challenge their disorder-maintaining beliefs
and biases (e.g., Beck 1976, 1991). CBT has now been
1 Note that the term “habituation” as it is used here has an entirely
different meaning than the term “habituation” as it is typically used
by behavioral psychologists, wherein it refers to the gradual decrease
in perceptual or emotional responding to a frequently repeated stimu-
lus. Our usage of this term derives from the Aristotelian virtue ethi-
cal tradition in philosophy, which famously regards virtuous character
traits as learned action habits (see Kraut 2012).
Behavior Genetics
1 3
established as efficacious in treating large subsets of indi-
viduals with wide-ranging pathologies, including depres-
sion and anxiety (see Hofmann etal. 2012), PTSD (see
Kar 2011), substance use disorders (McHugh etal. 2010),
and schizophrenia (see Dickerson 2004, for a review).
Meanwhile, motivational interviewing (MI; Miller and
Rollnick 1991) involves realistically weighing the pros and
cons of maintaining an addictive or otherwise unhealthy
behavior. MI has shown similar benefits for wide-ranging
health and behavioral outcomes, usually accompanied by
decreases in patient defensiveness and increases in self-
efficacy and readiness for change (e.g., Handmaker etal.
1999). Each of these interventions depends on a patient’s
willingness to (1) exert active self-control in the face of
habitual thought patterns and behavioral urges, and (2)
face at least some uncomfortable truths—e.g., that their
drug use or depression or social anxiety has stalled their
lives, and often has caused significant misery to them and
their loved ones; and that they bear some responsibility for
their behavior, and thus can also take some responsibility
for changing it. Thus, the sheer fact that so many clini-
cally diagnosed individuals do successfully complete and
benefit from these treatments offers indirect evidence that
one can, in principle, choose to become actively honest
with oneself, even when doing so is incredibly painful or
difficult.
There is also more direct experimental evidence that peo-
ple can willingly shift out of passive and/or self-deceptive
processing into a more active, reality-oriented mode when
prompted or inspired to do so. For instance, numerous stud-
ies have shown that a brief self-affirmation exercise, which
typically involves writing about an important personal value,
can increase an individual’s willingness to engage honestly
with reality despite the presence of conflicting motivational
cues (e.g., failure feedback, cognitive depletion, or oppor-
tunities to win money by cheating) (Cohen etal. 2000; Shu
etal. 2011; Sherman and Kim 2002; etc.). This increased
willingness, in turn, has been shown to improve health-rel-
evant behavioral outcomes, such as safe sex practices (Sher-
man etal. 2000), and to reduce maladaptive post-failure
rumination (Koole etal. 1999). Similarly, several lines of
research suggest that actively reflecting on a given moral
value, such as “honesty,” leads to greater personal identifica-
tion with that value (Ryan and Deci 2000; Sheldon and Elliot
1998; Sheldon and Schachtman 2007; Street etal. 2001).
This greater personal identification with moral values, in
turn, attenuates the influence of poor self-control—a moder-
ately heritable personality trait—on cheating behavior (Gino
etal. 2011). Thus it is plausible that the practice and habitua-
tion of cognitive integrity, which presumably increases one’s
personal identification with active reflection itself, leads to
greater agency with respect to the development of other
moral character traits.
Implications forclinical intervention
If we are right about the foundational role of active, reality-
oriented cognition in autonomous character development
and change, this has powerful implications for therapeu-
tic treatment. This will be relevant when we return to the
question of how cognitive integrity can increase our agency
with respect to highly heritable traits, First, it can provide
a framework for highly targeted differential diagnosis and
treatment matching, depending on whether a patient presents
with deficits in active cognition, reality-oriented cognition,
or both. As we have argued elsewhere (e.g., Gorlin and
Teachman 2014, 2015), interventions that strengthen active,
controlled information processing without also targeting a
patient’s motivation to avoid uncomfortable stimuli can seri-
ously backfire in the long run, insofar as they only empower
the patient to avoid reality more aggressively.
Second, this framework yields several novel clinical
recommendations, which we are currently in the process of
developing and testing (see Gorlin and Lombrozo 2018a,
b). These recommendations primarily target self-deceptive
processing, given that few existing interventions explicitly
address this behavior, whereas there are already numerous
interventions that train active attention and metacognitive
control (e.g., Hoorelbeke and Koster 2017; Houben and
Jansen 2011; Tang and Posner 2009).
What, then, would be the ingredients of an intervention
that promotes cognitive integrity as an antidote to self-
deception? Our proposed approach, described in greater
detail elsewhere (see Gorlin and Lombrozo 2018a; Gorlin
and Otto 2018), draws upon existing intervention techniques
that have shown promise in shifting habituated beliefs and
metacognitive habits. The explicit goal of our proposed
intervention, however, is to aid patients in internalizing
the thesis of this paper: that they are capable of exercis-
ing cognitive integrity, and that doing so is good. In line
with standard cognitive-behavioral procedures for adopting
and internalizing new beliefs (e.g., Beck 1991; Barlow etal.
2004), we first provide a rationale for the value of active,
honest thinking, and then encourage patients to test out this
value through repeated practice. Preliminary qualitative
results suggest that patients find this intervention technique
both palatable and useful, though further research is needed
(Gorlin and Lombrozo 2018a, b).
Implications forbehavior genetics
Returning now to Turkheimer’s (2011) observation that
about half of the variance in complex human behav-
ior traits is unexplained by either genes or shared
Behavior Genetics
1 3
environment, how might our cognitive integrity construct
eventually help shed light on the remaining variance? Pro-
ceeding from the “experienced choice” level of analysis
as we have done, let us consider some of the agentic pro-
cesses that might lead two identical twins to diverge in
their paths from one another, despite sharing the same
genes and family environment.
One way this might happen is through sheer “dumb
luck”—one twin gets assigned to the bullying teacher while
the other gets the nice one; one twin gets in a terrible acci-
dent while the other does not, etc. But this is unlikely to be
the whole explanation, given that even identical twins who
share the same teacher and classroom report experiencing
their teacher and peer interactions differently—with these
differential experiences, in turn, predicting differences in the
twins’ academic achievement (Asbury etal. 2008). What,
then, might be the kinds of choices that lead to such different
experiences over time?
Let us imagine two identical 13-year-old twins—we will
call them Mary and Jane—who are growing up in the same
violent, hostile home environment, and moreover have inher-
ited their parents’ genetic predisposition toward aggressive
behavior. Imagine now that each twin finds herself being
unfairly singled out by a bullying teacher, Mrs. Smith. Per-
haps Mary and Jane both initially feel tempted to lash out at
the teacher in anger, given their shared heredity and home
environment. But suppose also that, having been in quite
a few similar situations before, Mary and Jane both have a
vague inkling that this situation will not turn out well for
them if they lash out.
Now suppose that Mary decides to ignore this inkling and
act on her anger, cursing loudly at Mrs. Smith. At this point
Mary will likely get sent to the principal’s office, which will
further intensify her anger and aggressive urges. Fearing her
parents’ explosive reaction, Mary might now be tempted to
rationalize her behavior to them and even to herself, insisting
that she “couldn’t help it” and that it was “all Mrs. Smith’s
fault.” Given her parents’ propensities, they will likely not
give Mary the benefit of the doubt when they hear this story;
instead they will yell at her or worse, making Mary feel even
more attacked and even more inclined to lash out. At each
of these junctures, Mary retains the capacity to pause for a
moment and actively, honestly reflect on her alternatives,
which in turn would increase the likelihood that she would
choose a calmer, more rational response. But to make this
choice, Mary would now have to face the embarrassment of
admitting she had acted wrongly in the first place, in addi-
tion to the uncomfortable strain of holding back her aggres-
sive urges in the face of increasingly hostile interactions with
her parents and teachers. Each time Mary either passively
acts on her angry impulses or actively rationalizes the choice
to do so, she makes it even harder on herself to choose the
actively honest route on the next occasion.
Suppose that Jane, on the other hand, decides to pause
and reflect for a moment, giving words to her initial ink-
ling: “Ugh, Mrs. Smith is being so unfair, but will it really
help my case if I lash out and get sent to the principal’s
office like I did the last 2 times?” Perhaps she would even
think, as young people with abusive or alcoholic parents
sometimes do (see Kendler 2013), “lashing out is what
mom or dad would do in this situation. I really hate it when
they do that. Plus it never ends well for them.” At this
point, Jane might decide to stay quietly attentive through
the rest of class, still feeling her anger but delaying her
reaction until she has had some time to think it through.
Later that evening, Jane might actually get some positive
feedback from her parents for once when she tells them
the story of how she bided her time with the bullying
teacher. Moreover, her parents will likely feel angry on
Jane’s behalf, perhaps channeling their anger into a firmly
worded email to Mrs. Smith. Jane will presumably feel
proud and satisfied with how she handled this situation,
which will make her all the more likely to deploy the same
active, honest thinking approach the next time around.
Thus we can see how choosing to engage in an active,
reality-oriented thought process versus to “act now and
rationalize later” can set in motion two distinct chains
of environmental events and further choices, with each
choice reinforcing and biasing (though not fully determin-
ing) the next. If both twins continue along these respective
paths, their shared genetic predisposition toward aggres-
sive behavior will likely exert a much heavier influence
on Mary’s moral phenotype than on Jane’s. For instance,
Mary will probably seek out friends who share and fur-
ther encourage her aggressive coping style, whereas Jane
may deliberately shy away from such people because she
notices that they bring out the worst in her. This would be
in line with Kendler’s (2013) argument that human deci-
sion-making processes can intervene on and sometimes
even completely reverse the effects of genes on behavior.
For instance, he cites findings showing that children who
are at increased genetic risk of alcohol use disorders, and
who grow up observing their parents’ problematic alco-
hol use, are more likely to become teetotalers as adults
(Harburg etal. 1982, 1990). We share Kendler’s conclu-
sions, but further suggest that the power to intervene on
the expression of one’s genetic tendencies depends on the
choice to engage in such active, reality-oriented decision-
making in as he describes.
By the same token, insofar as our hypothetical twins also
share a genetic predisposition toward such adaptive traits
as planfulness, cognitive flexibility, and/or conscientious-
ness, for example, Jane will likely capitalize on these natural
tendencies to a greater extent than Mary will—largely by
selecting environments for herself that nurture and support
those tendencies.
Behavior Genetics
1 3
With enough time and repetition, both Mary’s and Jane’s
behavioral patterns will presumably get canalized into stable
character traits. The more canalized they get, the harder it
will get, presumably, to break free of them. Notably, how-
ever, Mary still retains the capacity to reflect actively and
honestly on her aggressive tendencies, and if she does, she
may well decide—like Jane did in the original scenario—
that her behavior is worth changing. Indeed, suppose we
now fast-forward 30years and imagine Mary feeling
tempted to hit one of her own children again in an angry
rage. Does Mary have a choice about whether to act on this
inclination? We would argue that she does—if she makes
the metacognitive choice to exercise cognitive integrity. To
appreciate the courage she would need to muster in order
to make this choice, consider what facts she would need to
grapple with in the course of her active, honest reflection:
that she has committed physical abuse against her child in
the past, and that she could have stopped herself; that her
children might not be safe with her, which means there is
a chance she might have to give them up; that she has been
inflicting on her children the same kind of misery that her
parents had once inflicted on her; that she may now need to
do a lot of work, and invest a lot of resources, to push back
against her aggressive tendencies and the damage they have
caused. This may mean getting therapy for herself and her
children, attending anger management courses, apologizing
to the children and anyone else she has hurt, and so on.
The moment her reflections lead her to glimpse any one of
these uncomfortable implications, she will be tempted to
turn away from the awareness and default to her usual ration-
alizations (e.g., “I can’t help it, this is just who I am”). But
the choice to persist in active, honest thinking will remain.
And if she does persist, she will have a fighting chance of
breaking the cycle of violence that has gotten passed down
through the generations (e.g., Black etal. 2010).
What this example illustrates is that taking responsibility
for our character fundamentally means taking responsibil-
ity for our thinking. The choice to engage in active, reality-
oriented cognition, as we have argued, is the locus of human
agency, and it is only to the extent that we engage in this
process that we can meaningfully direct our own lives and
character.
We have only sought here to establish this claim at the
level of experienced actions and choices, using Turkheimer’s
(2011) proposal regarding the unexplained variance in
human behavior traits as inspiration for a broader inquiry
into the metacognitive processes that underpin human
agency. However, our claim about cognitive integrity as a
locus of agentic control does yield testable hypotheses about
the genetics of morally-relevant character traits: for instance,
our hypothetical example of Mary and Jane suggests that
the unexplained variance in a maladaptive trait like aggres-
sion or excess alcohol use should be larger among those
individuals who engage in more active, reality-oriented
thinking. While this hypothesis has never been directly
tested to our knowledge, there is some indirect evidence sug-
gesting its plausibility: for example, academic achievement
has been found to moderate the heritability of adolescents’
alcohol use behavior, such that the behavior is less heritable,
with more unexplained variance, among higher-achieving
students (Benner etal. 2014). Based on findings such as
this one, recommendations can be made for overriding
one’s genetic susceptibility to alcohol use by approaching
schoolwork in an active, reality-oriented manner. Indeed,
research has shown that “mental contrasting” strategies,
which involve actively imagining a desired future and com-
paring it to the current reality, help children improve their
academic performance, especially when combined with stra-
tegic “if-then” planning statements (Gawrilow etal. 2013).
These strategies proved especially effective among students
at high risk for ADHD (Gawrilow etal. 2013). These and
similar findings suggest that the choice to implement active,
reality-oriented cognitive strategies may help compensate
for highly heritable behavioral deficits.
Such findings also raise the intriguing possibility that
reflecting actively and honestly on one’s predispositions
can itself inform one’s choice of self-regulatory strategies.
Indeed, this may even inform one’s choice of strategies for
increasing one’s own awareness and motivation to practice
active, honest thinking in the future. A temperamentally
disinhibited, impulsive individual may benefit more from
a strategy that makes her less likely to “forget” her com-
mitment to active, honest thinking when confronted with
distractions or temptations—such as a strategy that increases
the mental “stickiness” of preexisting goal commitments, or
one that improves the mental filtering of irrelevant thought
contents. By contrast, a temperamentally inhibited, risk-
averse person may benefit more from a strategy that pro-
motes greatest openness and spontaneity of thought, so that
she does not interpret her goal commitment too rigidly and
fail to notice new or non-obvious applications (e.g., being
actively honest with herself about her current emotional
states).
Pending future research to test these hypotheses, the novel
framework described here suggests a promising pathway for
shaping and, if need-be, reshaping our own character. By
nurturing the foundational virtue of cognitive integrity in
ourselves, even the most “volitionally impaired” among us
may be able to break the chains of heredity and happen-
stance to choose the kind of person we become.
Acknowledgements This research was funded by the Templeton Foun-
dation via a Genetics and Human Agency junior investigator award to
Dr. Gorlin. We also wish to thank associate editor Dr. Peter Zachar and
two anonymous reviewers for their valuable feedback, and Dr. Eric
Turkheimer for heading the Genetics and Human Agency initiative.
We are also grateful to Drs. Colin DeYoung and Jonathan Livengood
Behavior Genetics
1 3
for their helpful comments on a conference presentation that preceded
this manuscript, and to Drs. Benjamin Bayer, Matthew Bateman, Boris
Hanin, and others who have lent their insights and general moral sup-
port to this project.
Funding This study was funded by the Templeton Foundation (via a
Genetics and Human Agency junior investigator award).
Compliance with ethical standards
Conflict of interest Authors Gorlin and Schuur both declare that they
have no conflicts of interest.
Human and Animal Rights and Informed consent This article does not
contain any studies with human participants or animals performed by
any of the authors.
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... As one of us has argued elsewhere (Gorlin & Schuur, 2019), distinguishing between these fundamentally different metacognitive functions can help clarify why some of our most sophisticated cognitive capacities sometimes work to undermine rather than promote our long-term thriving. According to this framework, the overarching aim of "knowledge-constructive" processes is to help us build and maintain a streamlined, up-todate knowledge base that can effectively guide us in navigating the world and pursuing our valued goals. ...
... In this light, we would caution the authors to attend more carefully both to what is being forgotten and why before celebrating the virtue of forgetting as such. Pending a fuller theoretical and empirical inquiry into our proposed framework (see Gorlin & Schuur, 2019), we might instead suggest celebrating the honest, courageous quest for practical wisdom-even when it hurts in the short-term. ...
... Specifically, the mechanisms for increasing awareness (exploration, attention, reflection, and application) are all themselves agential processes. Exploring, attending, reflecting, and acting in pursuit of new knowledge requires effort and willingness, and thus is hard work (see Gorlin and Schuur, 2019). As such, we refer to the process of increasing awareness in psychotherapy as itself an agential process. ...
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Emotions shape the landscape of our mental and social lives. Like geological upheavals in a landscape, they mark our lives as uneven, uncertain and prone to reversal. Are they simply, as some have claimed, animal energies or impulses with no connection to our thoughts? Or are they rather suffused with intelligence and discernment, and thus a source of deep awareness and understanding? In this compelling book, Martha C. Nussbaum presents a powerful argument for treating emotions not as alien forces but as highly discriminating responses to what is of value and importance. She explores and illuminates the structure of a wide range of emotions, in particular compassion and love, showing that there can be no adequate ethical theory without an adequate theory of the emotions. This involves understanding their cultural sources, their history in infancy and childhood, and their sometimes unpredictable and disorderly operations in our daily lives.
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Mindfulness-based treatments for posttraumatic stress disorder (PTSD) have emerged as promising adjunctive or alternative intervention approaches. A scoping review of the literature on PTSD treatment studies, including approaches such as mindfulness-based stress reduction, mindfulness-based cognitive therapy and metta mindfulness, reveals low attrition with medium to large effect sizes. We review the convergence between neurobiological models of PTSD and neuroimaging findings in the mindfulness literature, where mindfulness interventions may target emotional under- and overmodulation, both of which are critical features of PTSD symptomatology. Recent emerging work indicates that mindfulness-based treatments may also be effective in restoring connectivity between large-scale brain networks among individuals with PTSD, including connectivity between the default mode network and the central executive and salience networks. Future directions, including further identification of the neurobiological mechanisms of mindfulness interventions in patients with PTSD and direct comparison of these interventions to first-line treatments for PTSD are discussed.
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Background: Cognitive control impairments may place remitted depressed (RMD) patients at increased risk for developing future depressive symptomatology by disrupting emotion regulation processes. Research has shown that directly targeting cognitive control has beneficial effects on high trait ruminators and clinically depressed patients. The current study tested whether internet-delivered cognitive control training (CCT) can be used as an intervention to increase resilience to depression in RMD patients. Method: Effects of CCT were assessed using a double-blind randomized controlled design. RMD patients performed 10 sessions of a working memory-based CCT (N = 34) or a low cognitive load training (N = 34; active control condition) over a period of 14 days. Assessments took place prior to training, immediately following 2 weeks of training, and at 3 months follow-up. Brooding and depressive symptomatology were selected as primary outcome measures, alternative indicators for emotion regulation and residual symptomatology were selected as secondary outcome measures, along with indicators of functioning. Results: Compared to an active control condition, CCT demonstrated beneficial effects on a cognitive transfer task, brooding, depressive symptomatology, residual complaints, self-reported use of general maladaptive emotion regulation strategies, and resilience after controlling for intention to treat. Furthermore, completers of the CCT reported a reduction in experienced disability and cognitive complaints. However, no beneficial effects were found for self-reported use of adaptive emotion regulation strategies. Conclusions: These findings demonstrate the effectiveness of CCT as an intervention to reduce cognitive vulnerability, residual symptomatology, and foster resilience following recovery from depression. CCT thus holds potential as a preventive intervention for RMD patients.