WHEN I set out to write this piece, it seemed so obvious from a purely psychological perspective that ‘face coverings’ were a bad idea that I believed my principal question would be: ‘How come we got saddled with the practice?’ There were psychologists on the Scientific Pandemic Insights Group on Behaviour (SPI-B) reporting to the Covid-19 Sage Committee and my assumption was that their technical advice had somehow been overturned or ignored. I was wrong for two reasons: first, their terms of reference meant they were unlikely ever to be asked such a question; second, if they were asked, the composition of the committee meant any response would be pitched at completely the wrong level.
A good place to begin an assessment of the nature (as distinct from the content) of the psychological advice provided by SPI-B on face coverings is an article entitled ‘Staying ‘Covid-safe’: Proposals for embedding behaviours that protect against Covid-19 transmission in the UK’. This sets out a programme requiring changes to the ‘financial, social, and physical infrastructure’ of all sections of society. Impressive stuff, but well above the pay-grade of a mere psychologist; what I wanted to know was the exact form of advice about the psychological effects of ‘face coverings’. There is none, apart from the assumption that they should be worn (at least, in enclosed spaces). Indeed, this is seen as so far self-evident that the paper demands efforts to ‘embed’ the behaviour, so that, for example, ‘when I enter a crowded indoor space, I will wear a face covering’ becomes part of my social identity.
And that appears to be that: the discipline of psychology is relevant to this issue only inasmuch as it comments on the symbolic, social and political function not of masks, but of ‘mask behaviour’. This is made plain in a 2021 opinion piece in the British Medical Journal by two psychologists, one a member of SPI-B. ‘Messaging about the importance of masks as an efficacious means of stopping infections [sic] is critical,’ particularly when the public might be showing signs of ‘mask fatigue’. Face masks represent ‘a highly salient public sign that defines the identity of the wearer (or non-wearer). They have intense symbolic value and hence the meanings attributed to mask wearing become of critical importance to whether masks are worn. We choose to wear masks (or not) because of what we want to say about ourselves and also what others will assume about us’. The piece concludes with some decidedly tendentious political observations: ‘In an era of resurgent populism, the right have used masks as a core symbol of elite oppression. Masks become muzzles. The requirement to wear masks becomes an act of silencing. The success of this narrative is reflected in the way that use of masks associates negatively with Trump voting in the US and with Brexit voting in the UK.’
I must say I find all this bizarre in the extreme. You hardly need a psychologist to explain that the first and most potent visual stimulus we all encounter is our mother’s face. There have been well over 5,000 papers published on the topic of mother-infant visual interaction; you can make a case that they form the bedrock of developmental psychology. Even from first principles, disruption to the visibility of the mother’s face is highly likely to have significant adverse developmental consequences. Why did nobody say this, or at least whisper it?
In fact, we can do far better than simply guess: research by David Lewkowicz and colleagues on the topic was published more than ten years ago and is consistent with a body of work going back for decades. For the first few months of life, infants look predominantly at their mother’s eyes – a bright glittering stimulus that moves independently of the face in which it is embedded. However, as babies begin to babble, their visual attention shifts to the mother’s mouth as she responds with speech. Psychologists have known for many years that the infant brain makes use of this information to model the device (mouth, lips, tongue) the mother is using to produce her native language. This is an automatic process, part of our genetic endowment and a key element in language acquisition. The infant brain needs this information and there are consequences of not getting it, and (ominously) almost certainly consequences of not getting it at the right time.
Knowing even that much, what would your advice be faced with the suggestion to cover the mother’s mouth?
This article is an expanded version of the December 2020 entry on Professor Kennedy’s Covid Diary blog.