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Long term impact of Bullying and Victims

Posted on February 21, 2013. Filed under: Children, Health, kids, learning, life, News, Parenting, relationships, stress, teen, vicitm, violence | Tags: , , , , , , , , , |

A significant study from Duke, out today, provides the best evidence we’ve had thus far that bullying in childhood is linked to a higher risk of psychological disorders in adulthood. The results came as a surprise to the research team. “I was a skeptic going into this,” lead author and Duke psychiatry professor William E. Copeland told me over the phone, about the claim that bullying does measurable long-term psychological harm. “To be honest, I was completely surprised by the strength of the findings. It has certainly given me pause. This is something that stays with people.”

I’m less surprised, because earlier research has shown that bullying increases the risk for many problems, including low academic performance in school and depression (for both bullies and victims) and criminal activity later in life (bullies). But the Duke study is important because it lasted for 20 years and followed 1,270 North Carolina children into adulthood. Beginning at the ages of 9, 11, and 13, the kids were interviewed annually until the age of 16, along with their parents, and then multiple times over the years following.

Based on the findings, Copeland and his team divided their subjects into three groups: People who were victims as children, people who were bullies, and people who were both. The third group is known as bully-victims. These are the people who tend to have the most serious psychological problems as kids, and in the Duke study, they also showed up with higher levels of anxiety, depressive disorders, and suicidal thinking as adults. The people who had only experienced being victims were also at heightened risk for depression and anxiety. And the bullies were more likely to have an antisocial personality disorder.

The researchers also checked to see if the variation among the groups could be attributed to differences in socio-economic status, or family dysfunction/instability, or maltreatment (which they defined as physical or sexual abuse). All three groups—the victims, the bullies, and the bully-victims—had higher rates of some type of family hardship than the kids who didn’t experience bullying at all. For the victims, the risk of anxiety disorders remained strong even when taking into account family problems, though the risk of depression did not (it dropped just below statistical significance if the victims came from a stable home, Copeland said). For bully-victims, the risk of both anxiety and depression held, and for bullies, the risk of antisocial personality disorder did as well. In other words, these results suggest that bullying scars people whether they grow up in a home with two functional parents or with frequent arguing, not much parental supervision, divorce, separation, or downright abuse or neglect. It’s a finding that’s in line with other work, for example by Judith Rich Harris, who in her book The Nurture Assumption, shows that kids are very much influenced and affected by their peers.

Why does bullying have such far-reaching impact? Copeland and his team suggest the experience may change kids’ physiological response to stress, and their ability to cope. This looked especially stark for the bully-victims. “It was definitely the case that chronic bullying led to worse outcomes, but much more the case that being a bully-victim was associated with really significant problems,” Copeland said. The biggest cry for help is coming from that group. Fortunately, it’s a smaller number than victims overall.” Bully-victims, Copeland and others have found, have more problems at home and the most trouble with impulse control and aggression. Sometimes they do the dirty work for popular kids who bully to curry favor with them. “I don’t think things are working out socially for them in a lot of ways,” Copeland said.

It’s important to point out that Copeland and other researchers don’t define bullying broadly, in a way that encompasses a lot of mutual conflict among kids, or one-time fighting. Bullying is physical or verbal harassment that takes place repeatedly and involves a power imbalance—one kid, or group of kids, making another kid miserable by lording power over him. As Dan Olweus, the Scandinavian psychologist who launched the field of bullying studies in the 1960s, has been arguing for many years, this is a particular form of harmful aggression. And so the effort to prevent bullying isn’t about pretending that kids will always be nice to each other, or that they don’t have to learn to weather some adversity.

If the results of this study are dismaying because they indicate that bullying is permanently scarring, the findings also strengthen the argument for prevention. Copeland underscores this idea. “Consider me a reluctant convert, but I’m starting to view bullying the same way I do abuse in the home,” he said. “I honestly think the affects we’re observing here are just as potent. And that’s definitely not the way American researchers look at things. They want to know all about what parents are doing at home. Peers aren’t considered a priority. But these days, with all the time they spend on the Internet, kids are spending even more time with their peers, and that’s a factor we need to pay more attention to.”

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hardwired to express our emotions

Posted on January 6, 2013. Filed under: biology, Conflict, emotion, frustration, learning, life, Psychology, relationships | Tags: , , , , , , , , , |

Our brains and bodies are naturally designed to express a range of emotions and
to respond to the emotions of others. The emotions of fear, shame, and anger
serve us in the most dangerous situations we may have to face. The fear and
anger not only energize us to run or fight, but also communicate our emotional
state to those close enough to respond. Our anger lets others know we are
energized to attack and they had better respect that. Fear communicates to
others that there is something dangerous nearby, and they might want to get
ready to run, too. Shame also communicates. It communicate surrender so that our
foe will not continue to attack.

We are also hardwired to express joy, distress, and surprise. The expression of joy communicates our relief at being safe among friends, while distress communicates our need for help and comfort.Surprise seems designed to help us assess the situation when something unexpected happens. It focuses our attention and opens our eyes.

We also come equipped with the ability to recognize these basic emotional states in others. Mirroring structures in the brain help us to respond to others actions and emotions automatically. Very young babies understand the difference between a smile and a frown, a lullaby and a scolding and they respond automatically.

Direct uninhibited emotional response between two people is called intimacy, and babies are natural at it, which is why we often find relationships with babies so rewarding. Babies are not ashamed to show their feelings, whether they are distress, frustration, delight, fear, or shame itself. And when we are with them, we are not ashamed to mimic them with goo goos and gah gahs of baby talk that we would be embarassed to see on video, absent the baby context. We are free to be responsive to a baby’s distress or frustration. We are rewarded by the good feelings of intimacy.

So what goes wrong later?

Somewhere along the line, we learn to try to hide our feelings because our own feelings scare us or we are ashamed of them. Expressing our feelings becomes associated with feeling vulnerablebecause others may make fun of us or try to use our feelings against us. So we work very hard to hide our feelings behind a mask of some kind, and in order to do this we work to suppress the emotions. We can get so good at this that we hide the feelings even from ourselves and feel horrified at the possibility that others could know about our distress, shame, or frustration. Some of us drink, binge, purge, or work long hours in order to numb ourselves and make it easier to suppress the emotions rather than express them. And we lose the freedom and delight of intimacy in a habit of hiding behind our mask. We substitute sex for intimacy and busy routines for friendship.

Underneath the masks, the busy routines, and the defensive habits, we are still hardwired to express our emotions and respond to others, still hardwired for intimacy if we can let go of the habits we have developed to protect ourselves. We can escape the trap of these new defensive habits, but we often have to have help to overcome the fear and shame that keep us stuck behind our masks.

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From Teasing to Violence

Posted on January 5, 2013. Filed under: anger, Children, Conflict, control, Depression, family, friendship, kids, learning, life, Parenting, relationships, vicitm, violence | Tags: , , , , , , , , , , |

With all the violence in suburban schools, there has been increased curiosity about the sources of social ostracism among youth,  painful facts of life about the healthiest and, we presume, happiest of our  kids. The focus of this article is on teasing, an almost universal experience  with implications far beyond the attention we generally give to it.

Most of us can sympathize with the child who complains miserably of being teased or bullied. Our advice is usually simplistic: “Try to ignore it,” on the theory  that the teaser will get bored and drop it when the victim does not react.  But this discounts the reactions of the other participants, the onlookers or the audience for whom the bully is performing and who reward the scene with their attention. Besides, none of us is good at ignoring our  own feelings, and the feelings that can be triggered by teasing are more powerful and painful than we like to admit, perhaps because we feel powerless to protect our children from this kind of an attack, ubiquitous as it is. The two primary feelings involved are often topics of discussion in the therapy session: shame and anger, or in their extreme: humiliation and rage.

Looking back on it, it seems to me that the relationship between shame and rage should be obvious. When something or someone  makes you feel powerless, terribly hopelessly powerless, the thing  you crave most is something that will help you feel powerful, or at least  safe. We don’t like to talk about these disturbing feelings. Shame is something we hide, or minimize, because exposing our shame only seems to make it worse. So the impact and consequences of teasing, shaming and excessive
criticism remain obscure for many of us. And the resulting rage catches us by surprise.

Many things can make us feel powerless. Whenever we experience animportant loss or disappointment, we feel powerless. When we are shamed, teased, criticized or bullied, we feel powerless. When we are ignored, we may feel powerless. When we are sick, tired, or hungry and as a result, confused, we may feel powerless.

When a young child craves power, there are only a few options. He can reach out for the loving protection of a comparatively powerful parent or caretaker. He can practice those few things that give him a child’s sense of mastery and control. He can exercise power over someone or something smaller or weaker. He can imagine fantasy  scenarios of power, or revenge.

Babies are good at reaching out for protection. Though some may be fussier than others, most babies have a powerful way of making most adults feel nurturing and protective toward  them.

A toddler is experimenting with a growing repertoire of
movement and communication skills that offer a sense of mastery and control over a small part of his universe. But if you speak sharply to  a toddler, you will see the downcast eyes that represent the classic posture and facial expression of the primary affect of shame. Some anguished sobbing will usually follow, and it is not unusual for
the anguish to be followed by rage, as the toddler regroups and assaults you with the worst insult in his vocabulary.

The surge of aggression following the shame of defeat is part of our emotional evolutionary heritage. The two feelings are hard wired together, the sequence normal and unavoidable. But we do have some choice in what to think and how to act in response to the feelings, and these choices are learnable and therefore teachable.

The parent who finds a toddler’s tantrum cute and laughs at it, or the parent who finds it intolerable and punishes it, will see the child’s shame and rage reenacted immediately. With a few repetitions of this scene, the child soon develops a memory for the experience of  helpless rage. Another alternative for the parent in this situation is to  help the child release the shame and rage, and to begin to learn how that is  done. By listening seriously, and labeling the feeling, the parent can accept the expression of emotion, while firmly limiting any dangerous or destructive behavior. Understanding, accepting, and labeling the shame and anger (and predicting that it will soon pass) reassures the child of continued respect and love; these responses help the child learn to get past the feelings of helplessness sooner, an important emotional skill to learn.

A five-year-old entering school is suddenly faced with a much larger world full of dangers and chances to feel powerless. What has he learned about this painful and confusing feeling and what to do about it?  If he has not learned how to recover from shame and rage fairly quickly, he  may be in for a crash course. Before long, he will encounter a disapproving adult or a competitive peer who will trigger feelings of shame and helplessness, followed by some feelings of aggression or rage. He will  practice one or more strategies for dealing with this situation and choose one as his favorite. He may try to bury the rage by taking it out on himself in a damaging flurry of self-criticism. He may fantasize about revenge, and even plan and execute some form of retaliation. He may take his aggression out on someone else, seeking a way to restore status by teasing or harassing another, or by shifting blame. Or he may find a supportive listener with whom to work out this problem, though this requires skill and sensitive communication from the child and the listener. There are so many such episodes in his young life, that a preference for one of the strategies is soon established. It may work well enough in the short term to hide the helplessness and take the shame inside, or to gain back a sense of power. But often it may result in some unreleased shame or anger that grows into a chronic expectation of social danger.

The adolescent lives in a world in which the option of reaching out for protection from a loving adult becomes enormously more complicated and difficult. Even the need to seek understanding and help from an adult can be the source of embarrassment or shame when the primary psychological task is establishing  independence. Competition for status within the all-important peer group often takes the form of teasing or hazing, where one youngster seeks to make himself the center of attention by making fun of another. It is a universal game, and within limits, can be a healthy kind of flexing of social  muscles. But the limits are not well known, and therefore easy to cross. The young person who is the butt of the joke is in a poor position to define the rules of this game. Shame and hurt rule in silence, and the inevitable anger soon begins to grow. The young person may direct this anger at any of a number of targets. He may define himself as a loser and experience anger
at himself, eroding his self-esteem. He may become angry with the adults  of the world for not protecting him, or with the “winners’ of the game for their cruelty or insensitivity. This anger is difficult to express, especially toward the teasers who provoked it. So it is more likely to be turned inward and become the stuff of self-hatred or angry fantasies of  revenge. Fortunately, many kids find some way through this minefield without significant scars. But many others do not. Eating disorders, adolescent depression, and oppositional disorders all share a chronic expectation of criticism or shame, with chronic anger focused either on the self or the outside world or both. For some the anger fuels constant fantasies of getting even. Their angry demeanor subtly repels some of their peers, leaving them more isolated, and angrier. They find sympathy with angry lyrics in songs, angry images in movies, and a  few angry friends, their fellow misfits. Academic and social failure and isolation add to the shame, and to the rage. Emotion “motivates” us to act. And rage motivates angry or violent behavior, toward oneself or the outside world.

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Parents can teach assertiveness

Posted on January 4, 2013. Filed under: Children, family, kids, learning, Parenting | Tags: , , , , , , , , , , , , |

I like to define assertiveness as the art of asking for what you want in a way that makes it easy for the other person to give it to you.   If you think of it as a skill that can be learned by anyone, and can be learned easily by children at an early age when they are learning all kinds of communications skills, I can explain how it is preferable to the other ways of getting what you want.

The other ways of getting what you want that are available even to small children are: crying or whining, demanding, and suffering silently or pouting.  We were all born knowing how to cry and whine to alert the big people that we are unhappy and something needs to change. Crying or whining works for babies and very small children who can’t communicate their needs very specifically.  It is irritating or distressing, so it gets our attention and motivates us to do something to stop the crying.  When parents respond appropriately and the baby is comforted, she stops crying and parents feel better.
Demanding attention with an aggressive tone is also possible, even for very small children.  Like whining, it is irritating, but it can be effective because the squeaky wheel often does get the grease.  But it can also generate resistance because of a sense of a power struggle, and sometimes parents begin to say no automatically to a lot of requests when they feel that they are burdensome demands.
Quite a few young children learn that they can make others uncomfortable in a quiet way by pouting or suffering silently without making a noisy fuss.  This works in some relationships, but also tends to generate irritation or resistance.
By contrast to these behaviors, asking clearly for what you want is more effective.  It is respectful of the other because it gives them a choice to say yes or no, where as whining or demanding or pouting are manipulative.  Asking politely generates less resistance because it is less irritating or aggressive.  When the assertive individual is specific and clear about what he is asking for, it does not force the other to guess what is needed.  Crying or pouting often leaves it up to the other to guess how to resolve the problem.  Finally, asking gives the other a chance to feel good when they grant your request and you thank them for it.
Assertive asking is an Emotional Intelligence skill that toddlers can learn and it can benefit them greatly later in life as well as making family life for parents much more pleasant.  Unfortunately, many of us never master this skill.  You don’t have to look very far to find bosses who only know how to demand and criticize or friends who only seem to know how to manipulate, coerce, pout, or threaten to get what they want.

Parents can teach assertive asking in two simple ways:

1)      Simply ask your toddler, calmly and persistently, to rephrase their whiny demand as an assertive request.   When they do it, reward them as often as practical by granting their request.   When you have to say no, first praise them for their assertiveness then cushion your denial with some offer of an alternative.
2)      Demonstrate assertive asking in communications between adults and between adults and older children in the family.  Enlist older siblings in teaching assertiveness.  Calm persistence and repetition are just as effective in teaching the skill of assertiveness as they are in teaching language skills and other social skills.
The hardest thing about assertiveness lies in knowing what you need so that you can ask for it clearly.  The request must be specific, and realistic.  Sometimes this requires some problem solving skills that young children don’t yet have, and parents can help by making some suggestions about what they might ask for.  “Do you think you are tired and need someone to read you a story?”  “Can you ask for that?”

The next most important thing in assertiveness is timing, which requires some empathy for the other person so that your request can be heard.  Children shouldn’t have to be too sensitive to their parents’ needs, though they often are acutely aware and can be quite naturally empathic.  Parents can help the child develop this skill by coaching them:  “I can’t read you a story right now, because I am fixing dinner, but if you remind me after dinner, I would be happy to.”

The final key to effective assertiveness is persistence.  Children rarely have difficulty with this, but adults often give up after asking once and not getting what they want.  You have to know that lots of people respond negatively at first, but will be able to hear your request and respond positively if you are persistent.  And when their positive response is rewarded with your gratitude, mutual cooperation is enhanced.
Children stop asking and revert to whining, demanding, pouting, or sneaking if they are intimidated or denied too often and too harshly.  They need to know that asking is alright and that it works.  This undermines the shame and anger that can develop in an environment where it is not ok to ask.
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how much does your personality change?

Posted on January 4, 2013. Filed under: article, happy, learning, life, Psychology | Tags: , , , , , , , |

No matter how old people are, they seem to believe that who they are today is essentially who they’ll be tomorrow.

That’s according to fresh research that suggests that people generally fail to appreciate how much their personality and values will change in the years ahead — even though they recognize that they have changed in the past.

Daniel Gilbert, a psychology researcher at Harvard University who did this study with two colleagues, says that he’s no exception to this rule.

“I have this deep sense that although I will physically age — I’ll have even less hair than I do and probably a few more pounds — that by and large the core of me, my identity, my values, my personality, my deepest preferences, are not going to change from here on out,” says Gilbert, who is 55.

He realized that this feeling was kind of odd, given that he knows he’s changed in the past. He wondered if this feeling was an illusion, and if it was one that other people shared: “Is it really the case that we all think that development is a process that’s brought us to this particular moment in time, but now we’re pretty much done?”

Gilbert says that he and his colleagues wanted to investigate this idea, but first they had to figure out how. The most straightforward way would be to ask people to predict how much they’d change in the next decade, then wait around to see if they were right. “The problem with that is, it takes 10 years,” says Gilbert.

So the researchers took a much quicker approach. They got more than 19,000 people to take some surveys. There were questions about their personality traits, their core values and preferences. Some people were asked to look back on how they changed over the past 10 years. Others were asked to predict how they thought they would change in the next decade.

Then the scientists crunched the data. “We’re able to determine whether, for example, 40-year-olds looking backwards remember changing more than 30-year-olds looking forwards predict that they will change,” Gilbert explains.

They found that people underestimated how much they will change in the future. People just didn’t recognize how much their seemingly essential selves would shift and grow.

And this was true whether they were in their teen years or middle-aged.

“Life is a process of growing and changing, and what our results suggest is that growth and change really never stops,” says Gilbert, “despite the fact that at every age from 18 to 68, we think it’s pretty much come to a close.”

Personality changes do take place faster when people are younger, says Gilbert, so “a person who says I’ve changed more in the past decade than I expect to change in the future is not wrong.”

But that doesn’t mean they fully understand what’s still to come. “Their estimates of how much they’ll change in the future are underestimates,” says Gilbert. “They are going to change more than they realize. Change does slow; it just doesn’t slow as much as we think it will.”

The studies, reported in the journal Science, impressed Nicholas Epley, a psychology researcher at the University of Chicago. “I think the finding that comes out of it is a really fundamentally interesting one, and in some ways, a really ironic one as well,” says Epley.

He says everyone seemed to remember change in the past just fine. “What was bad, though, was what they predicted for the future,” says Epley.

He notes that if you want to know what your next 10 years will be like, it’s probably good to look at what your past 10 years were like — even though we seem not to want to do that.

Gilbert says he doesn’t yet know why people have what he and his colleagues call the “end of history illusion.”

One possibility is that it’s just really, really hard to imagine a different, future version of yourself. Or maybe people just like themselves the way they are now, and don’t like the idea of some unknown change to come.

http://www.npr.org/blogs/health/2013/01/03/168567019/you-cant-see-it-but-youll-be-a-different-person-in-10-years

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Why do we shout?

Posted on January 2, 2013. Filed under: anger, Conflict, control, emotion, forgiveness, happy, hate, hostility, learning, life, love | Tags: , , , , , , , |

A master asked his disciples: ‘Why do we shout in anger? Why do people shout at each other when they are upset?’

The disciples thought for a while, and one of them said ‘Because we lose our calm, we shout for that.’ ‘But, why to shout when the other person is just next to you? ‘Isn’t it possible to speak to him or her with a soft voice? Why do you shout at a person when you’re angry?’ The disciples gave him some other answers but none satisfied the master.

Finally he explained: ‘When two people are angry at each other, their hearts distance a lot. To cover that distance they must shout to be able to hear each other. The angrier they are, the stronger they will have to shout to hear each other through that great distance.’

Then the master asked: ‘What happens when two people fall in love? They don’t shout at each other but talk softly, why? Because their hearts are very close. The distance between them is very small…’

And he concluded: ‘When they love each other even more, what happens? ‘They do not speak, only whisper and they get even closer to each other in their love.

‘Finally they even need not whisper, they only look at each other and that’s all. That is how close two people are when they love each other.’

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acts of kindness increase happiness

Posted on January 1, 2013. Filed under: Children, choice, family, happy, Health, kids, learning, life, love, Parenting, Psychology | Tags: , , , , , , , |

In the aftermath of Christmas, a parent could be forgiven for thinking that materialism has trumped human kindness.

Take heart. Children can easily become kinder and more helpful. And that behavior makes them more positive, more accepting and more popular.

At least that’s how it worked for fourth- and fifth-graders in Vancouver, Canada. Researchers there have been studying empathy and altruism in schoolchildren for decades.

“How do we decrease bullying, increase empathy and caring for others?” says Kimberly Schonert-Reichl, an applied developmental psychologist at the University of British Columbia who helped lead the experiment.

They wanted to see how performing random acts of kindness would influence that. But one measurement thrown into the mix almost as an afterthought — being liked by peers — was the quality most improved by helpful acts.

The researchers asked 9- to 11-year-olds in 19 classrooms to either perform three acts of kindness or visit three places each week (the tourists were the control group).

The acts of kindness were simple. The children gave mom a hug when she was stressed out, shared their lunches, or vacuumed the floor.

After four weeks, the researchers tested the kids and compared the results with tests they’d taken before. All the children had more positive emotions, and were slightly happier.

But the children who performed acts of kindness were much more likely to be accepting of their peers, naming more classmates as children they’d like to spend time with.

“I do think we’re on to something,” Schonert-Reichl tells Shots. The children were at an age when bullying can be more extreme, she says, and children become more self-conscious. So an increase in peer acceptance could benefit in the classroom and in social life. The study was published online in the journal PLOS One.

Being part of the experiment made kindness intentional. The children had to plan their acts of kindness, and remember to do them. Similar experiments in adults have shown that being actively kind increases happiness, and happier people then become more likely to help others.

Parents don’t have to have a Ph.D. to encourage these sorts of simple acts of kindness in children – or in themselves.

“I think of ways to start the New Year, and people making resolutions,” says Schonert-Reichl, a former middle school teacher and mother of two boys.” Can I do an act of kindness for someone every day?”

Harried parents would feel better, she says, and their children would, too. “They start helping, and they start feeling this is nice.” Seeing themselves as the kind of person who helps others could be an identity that then stays with them for the rest of their lives.

http://www.npr.org/blogs/health/2012/12/27/168128084/random-acts-of-kindness-can-make-kids-more-popular

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A Man with an Angry Brain

Posted on December 28, 2012. Filed under: anger, article, biology, Court Mandated Anger Management, Depression, emotion, frustration, hostility, learning, life, mood swings, Psychology, stress | Tags: , , , , , , , , , , , , , , , , |

Over the past 30 years, I’ve spent nearly 25,000 hours counseling angry men, and until about two years ago, my enthusiasm was beginning to wane. If you’ve worked with angry male clients, you can understand why. These men are generally highly reluctant clients, who are often in your office only because they’ve gotten “the ultimatum” from their wives or girlfriends or bosses or sometimes court judges: “Get therapy for your anger or get out / you’re fired / you’ll go to jail.” Many, considered by everyone who knows them to have an “anger problem,” arrive in your office convinced that they don’t have an anger problem: the real problem is their stupid coworkers, annoying girlfriends, demanding spouses, spoiled kids, or unfair probation officers. However, they arrive at your office with a shotgun at their backs, so to speak, and know they have no choice. They hate the entire situation because it makes them feel powerless.

No wonder they feel powerless: they’re being coerced to lay down their anger, the only weapon they’ve ever had against feelings of powerlessness. They often trace their reliance upon anger to a childhood history of danger, trauma, shaming, and pain. Anger is the emotion they can trust, the one that might keep danger at bay. As they grew up, they continued to use anger to make people they regard as dangerous back away. By the time you see them, they regard just about every person in their lives as “dangerous,” including loved ones. These men have become habitually angry. I liken their condition to the default option on a computer: their anger goes on automatically unless they consciously turn it off.

Of course, it isn’t easy to turn off the default option when the way to do so is hidden deep within the machine’s (our brain’s) control panel. Furthermore, men for whom anger is a default emotional response to life’s vicissitudes are often relatively untrained in experiencing and communicating other emotions. For example, one of my clients “went off”–screaming and threatening bodily harm against his father’s doctors–when his father died, to the point the police had to be summoned, because he couldn’t handle his grief. Anger was the only emotion he could call upon in time of need. Not surprisingly, when these men come to therapy, whether as individuals or in couples or groups, they’re frequently defensive, argumentative, passive-aggressive, protective of their right to be angry, and doubtful about my competence to understand or help them in any way.

It’d be misleading to say that my most difficult clients are unmotivated. More accurately, they’re antimotivated, committed to undermining any behavioral programs or specific anger management tactics I offer. Meaningful change takes many repetitions: “Practice, practice, practice” is a hallmark of anger-management training. For example, taking the time to put a problem into perspective (“On a 1-10 point scale, Joe, how important is it for your teenage daughter to get home every night by 8 p.m.?”) works well, but only if the client is motivated enough to practice putting things into proper perspective perhaps as often as several times a day. It stands to reason that trying to argue such men out of their commitment to anger is pointless. I long ago realized I couldn’t beat them in face-to-face combat; they’re better at in-your-face challenges and making contemptuous remarks than I’ll ever be. I needed a tool that allowed me to sidestep their oppositionality and create a therapeutic alliance.

At a deeper level, chronically angry people have become lifelong victims of what’s sometimes called negative neuroplasticity. They’ve unintentionally trained their brains so well, through countless repetitions of undesired behavior (at least, undesired by the rest of the world), that they’re primed to think, feel, and say things that increase their own anger. For example, Joe may well think that if his daughter gets home after 8 p.m. it means she’s probably having sex with some male punk. That kind of thought pattern is automatic.

So now we have two major concerns. First, some of my clients enter treatment antimotivated. Second, their brains have been programmed to react automatically with anger and hostility to a wide variety of situations. What kind of therapeutic intervention can address these issues?

Focusing on the Brain to Increase Motivation

About six years ago, I stumbled across the answer when I attended a session about the brain at the Networker Symposium in Washington, D.C. The controversial brain researcher Daniel Amen was just beginning his lecture when he mentioned in passing that he’d been browsing through the books on anger in the sales area. “None of them said anything about the brain,” he noted somewhat dismissively. Now many of those anger books he was trashing were my books, so at first I was defensive. But by the end of the talk, I realized he was right, at least about the books I’d authored. I hadn’t mentioned anything about brain processes for a simple reason: I didn’t know anything about them. That led me to immerse myself in the subject of the brain, and as I did so, my enthusiasm for working with angry clients increased exponentially.

How can learning about the brain–particularly the angry brain and how it got that way–possibly influence clients who have a hard time taking in therapy or sticking with anger-management techniques? Aren’t concepts drawn from brain research simply too abstruse, too abstract, and apparently unrelated to daily life to make much difference to them? In fact, what I’ve found is just the reverse: these men are fascinated by information about how anger develops in the brain and why it’s so hard to control, and they consider it far more relevant to their lives than many standard therapy concepts. Getting to understand a bit of what happens “inside their heads” when they get angry resonates deeply with them. In one way, they can cling to their defensiveness and denial systems, since they certainly can’t be accused of deliberately messing up their minds. Sidestepping their defensiveness and emphasizing their opportunity to do something right that will retrain their brains gives them a positive direction and a possible source for well-earned personal pride. Furthermore, hearing me explain how, by regular, committed behavioral practice of various anger-management techniques, they can literally change their own brain circuits, stimulates both hope that they can change and desire to begin. For the first time in their lives, they feel they might be capable of literally using their own brains tochange their brains. It is a real revelation to many angry men.

My own enthusiasm for brain science and my belief in angry men’s inherent capacity to reorganize their own neural circuitry are probably another key to revving up their motivation to try. My “brain talk” to them isn’t just a lecture about applied neurophysiology, but in truth a kind of triggering mechanism arousing their own curiosity and interest. Clearly, my enthusiasm evokes–in their brains–a mirroring enthusiasm for this process. It may well be that my sheer enthusiasm for this endeavor, my joy and excitement about the brain, triggers left-hemisphere mirror neuronal activity that bypasses right-hemisphere negativity and cynicism.

Devron Johnson is a 40-year-old male who’s been divorced for 10 years, partly because of his anger problems. An intelligent but not highly educated man, he works as a heating and cooling technician. He has two adolescent sons, with whom he barely converses and seldom visits. He’s now in a new relationship with Sheila, a 36-year-old mother of three younger children who live with them. Although Devron has never been physically violent with the children, he often frightens them with his angry outbursts.

This man grew up in a tough part of Detroit, where survival was the name of the game. His parents separated and reconnected several times during his childhood. The family atmosphere was markedly hostile–full of negativity, accusations, and occasional violence. Devron said he hated his father because he was never there for him, not even when he became a star athlete on his high school’s baseball team.

Devron sought therapy because Sheila had threatened to end their relationship unless he became much nicer to her kids. He added that he was also in trouble at work because “I gave the finger to my boss once too often.”

Here’s how Devron described his anger: “Man, I had a bad attitude in school. I beat people up if they looked at me wrong. But I gave that up. I don’t hit nobody anymore. But Sheila says I still have a bad attitude. She says I look for problems with her kids. Then I blow because I have a really short fuse. And I have a hard time letting go of my anger, too. Once I get pissed at someone, they stay my enemy forever.” Still, Devron does want to change. He loves Sheila and even grudgingly admits he likes her children. He doesn’t want to lose them. However, he doubts whether I, or anybody else, can help him. A few years ago, he attended an anger-management program for about 10 weeks, but says, “I didn’t get nothing useful from it.”

Like many angry clients, Devron came to counseling under duress–the “get help, or get out” final call. This isn’t a formula for success, since such clients often arrive for counseling thinking that they’ll more or less passively go through the motions to get the wife/boss/law off their backs, and then they’ll be free to revert to previous behavior. By contrast, Devron was directly skeptical and dismissive–derisive, in fact. Instead of pretending to buy the package, he openly challenged me to prove I had something new to offer. It’s uncomfortable to be sneered at by your client, but I’ve learned to recognize an open challenge as a positive indicator for success. Devron’s disdain was a sign of energy that might be used in counseling, if I could develop an alliance with him.

“Actually, Devron, I do have something to offer you that you probably haven’t run into before,” I told him, “I can help you change your brain.” I proceeded to explain with the enthusiasm and energy I usually feel when talking about the brain that he was actually capable of making fundamental, long-term changes in the way he thinks. “Devron, all it takes is commitment and persistence. I know you’re capable of both of those things because you’ve told me how much you love Sheila and the kids–that’s commitment–and how you’ve stuck it out with them when it would have been easier to walk away–that’s persistence.” I emphasized to him that he’d developed lifelong habits of anger that had become deeply rooted in his brain. But I assured him that he and he alone could make changes in those habits if he so desired. However, I cautioned him that real brain change doesn’t come easy. I said he’d need to make a strong commitment to practice new behavior for at least several months, so he could build, improve, and expand new circuitry inside his brain while reducing the power of his negative brain circuits. I briefly mentioned such concepts as neuroplasticity and myleinization, but only as a tactical move, to assure him that I did, in fact, know what I was talking about. I told him I didn’t just believe this brain stuff might work, I was absolutely convinced because I’ve seen many other angry people change their brains in just this way, and because I myself had changed my brain to become much more optimistic and generous.

As I spoke, I watched Devron’s “show me” expression change to hope and wonder. “You mean I can really change the way I think?” he asked. It turned out that Devron’s oppositionality obscured a deep sense of pessimism and hopelessness. He’d believed that change was impossible, in effect dooming him to a lifelong anger career. But now, maybe because of my own sense of conviction, he began to see possibilities. We talked a little more before the hour ended, and I asked him to think about how much he wanted to change his brain and in which ways. I also asked him what positive goals he wanted to pursue–for example, what other emotions he might be willing to experience if his brain wasn’t dominated by anger. A positive goal is important with all clients, of course, but especially with angry clients, who often mistakenly set only the negative goal of being less angry. I explained to Devron that only setting a negative goal like quitting being angry was like deciding that a car that currently could only go in reverse would be just fine if you could get it to stay in neutral. The idea is to move forward in life, to get that car moving ahead. Of course this same idea applies to only quitting drinking (instead of leading a sober lifestyle) or stopping being critical (instead of giving praise).

Finally, I cautioned Devron again that real brain change doesn’t come easy. I told him he’d need to make a strong commitment to practice new behavior for at least several months so he could build, improve, and expand new circuitry inside his brain while reducing the power of his negative brain circuits. I then sent him home with two pages of examples of possible brain change plans he could implement. One example was converting criticism and pessimism to praise and optimism. Another was to convert resentment into forgiveness. A third was to look for the good in people (and himself) instead of the bad.

When Devron returned a week later, he said he’d thought a lot about changing his brain and his life. He’d discussed it with Sheila, who’d told him she’d stick around for a while if she saw him really working to change his behavior. Now he was eager to make a six-month commitment to brain change. I then gave him some handouts I’ve created to help him name his brain-change plan. A person with a good brain plan has given it a name that means something at an emotional level, includes specific initial behaviors to maximize the opportunity for immediate success, and at least speculates about longer-term improvements and additions, and how achieving these changes might affect him or her. I also gave Devron the chapter on neuroplastic change from my book to reinforce the idea that changing his brain was realistic, if and only if he’d make a strong commitment to it.

Devron returned the next week in a quandary. He told me that he and Sheila had had a big disagreement about what his brain-change plan should include. She wanted him to be nicer to her children. Devron told me that he wanted to be nicer to them, but that his first concern was quitting thinking so pessimistically about the world. “If I can’t quit thinking that everyone is out to screw me over, I don’t think my changes will last,” he said. I thought Devron had hit upon a clear understanding of how he needed to change at an existential level. Brain-change plans aren’t simple behavioral alterations: they really change your brain, and in doing so, ultimately affect your connections with yourself, those you love, and the universe. So I affirmed Devron’s insight. However, I did point out that his goal and Sheila’s weren’t contradictory. Being nicer to the kids could well become one way that he altered his mindset of hostility and suspiciousness. After all, deeply held beliefs don’t change completely on their own. Devron needed to try out new behavior and receive positive rewards for doing so in order to give his brain the opportunity to be transformed.

I’d like to offer a side comment here. We often expect our angry clients to act as if they were living in a safe world, a world in which people are pleasant, trustworthy, loving, and consistent. This false belief on our part sets clients up to fail. Devron’s siblings, for instance, regularly engaged in felonious behaviors, such as drug dealing and robbery, and expected him to join them as he often had in the past. He told me during therapy that he’d begun declining these invitations. When I asked him if he’d practiced being assertive with them, he laughed. “I guess if telling my brother to go to hell when he attacked me for not going along with some scam he was into, then yes, I was very assertive.” The result of his new “good” behavior was that his family ostracized him for several months. Fortunately though, Sheila and her children were dependably in his corner, so that Devron could practice new, prosocial behavior around them without being criticized or ridiculed.

Devron named his plan “Learning to Trust.” I was tempted to add “and take in love,” but Devron would have labeled that phrase unmanly. When I asked him how he planned to begin this plan, he suggested he could go to his father to see if he could learn to trust the man he most distrusted in the world. Needless to say, this was a palpably rotten idea: in all likelihood, his father would once again have demonstrated his complete untrustworthiness, potentially undermining everything Devron was trying to do. I talked him out of it with some difficulty by pointing out that he was betting his whole stake on one roll of the dice. “Besides, it’s a bad bet,” I said. “You’d be better off investing in a smaller stake, like letting yourself trust Sheila more.” That reminded him of his real priorities.

He decided to open up emotionally a little more to both his family and a few trusted coworkers. For example, he told some of his history to two of his coworkers, the ones he felt most comfortable with, and they responded positively with their own self-disclosures. Then he took a bigger chance by admitting to Sheila that he had cheated on his first wife. Much to his shock, she told him she’d known about it for a long time–his ex-wife had thoughtfully given Sheila that information when she’d begun dating Devron–but she’d chosen not to mention it and trust that he’d be faithful to her.

Shiela’s disclosure and assertion of trust brought him to tears. At that very moment, his brain-change plan spontaneously expanded to include being trustworthy to others. Since Devron had a long history of lying by omission (“Oh, I must have forgotten to tell you that”) this expansion was quite significant. It had proved harder for him than the initial goal because he’d had to retrain himself not to leave out some of the truth “so nobody could pin me down.” He kept expanding from his core commitment to develop trust. He realized along the way that he’d been mean to Sheila’s children because he didn’t want to get close to them and then lose them. But Sheila came through by rewarding his obvious changes with reassurance that she’d stay with him.

I regularly review a client’s brain-change plan with him or her, rather than just assume it’s working fine. It’s important to challenge clients quickly if they’re letting their plan drift.

The final addition to Devron’s plan was learning how to be more empathetic. Devron acknowledged that empathy was strange territory for him: “Frankly, I never gave a damn what anybody else felt.” But now that he felt safer, he could do what safe people do: care about and take a real interest in others. Like many angry people, he has some difficulty being empathic. Empathy partly depends on automatic attunement processes usually learned in infancy through parent–infant synchronic movement. He experienced few such experiences as a child. We talked together about this deficit, a deficit he was determined to challenge. He immediately made a real effort to put himself in the shoes of others. It’s just that he had trouble first taking off his own shoes. For instance, he told his 12-year-old daughter, Amy, who was being teased by classmates, that he knew exactly how she felt, even though he’d been the bully, not the victim, when he’d been in school. But here again, the principles of neuroplasticity apply. Devron realized he’d misunderstood the situation when his daughter got mad at his reply. He then consciously took the time to listen better. Gradually, this behavior was becoming faster, smoother, and more automatic.

Devron’s plan, then, began with developing some basic trust in the world, which led to being trustworthy himself, which morphed into increased empathy and actually caring about others. He quit working with me after approximately nine months. Our last session included Sheila, who affirmed that Devron had become much less angry, more caring, and far more present in their lives. She’d previously doubted his changes would endure, “But he’s only becoming nicer,” she admitted. “I don’t doubt him any longer.” Devron added that he now felt deep inside his soul that he could trust Sheila. He felt safe in a relationship for the first time in his life. “So now I have no reason to be mad all the time.” Of course, he and Sheila still argue from time to time, as do almost all couples. But Devron controls his initial burst of anger far better than before, calms down quicker, and lets go of his anger sooner.

http://www.alternet.org/personal-health/angry-brain-how-help-men-uncontrollable-tempers?paging=off

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school shooting: probabilities and possibilities

Posted on December 28, 2012. Filed under: article, Children, fairness, Health, kids, learning, life, News, Parenting, Psychology, thinking, thoughts, violence | Tags: , , , , , |

About a month ago, Declan Procaccini’s 10-year-old son woke him early in the morning in a fright.

“He came into my bedroom and said, ‘Dad, I had a horrible, horrible dream!’ ” Procaccini says. “He was really shaken up. I said, ‘Tell me about it,’ and he told me he’d had a dream that a teenager came into his classroom at his school and shot all the kids in front of him.”

Procaccini’s son is a sensitive kid, frequently anxious, so Procaccini did what he often does when his son crawls into his bed with a fear or anxiety: He explained why the fear wasn’t rational by simply laying out the math.

“The chance of that happening here are 1 in a zillion,” Procaccini told his son, and then continued with a lesson about probabilities and possibilities. “You know, it’s possible that Godzilla could right now come through the trees? Yes. But is it probable? No. I think we both know that it’s not probable.”

This discussion seemed to calm his son down a bit. He shook off his dream and returned to life as usual.

“That worked out for a little while,” Procaccini says.

And then Procaccini’s community became the “1″ in “1 in a zillion.”

‘I’m Going To Need Help For A Long Time’

The day Adam Lanza shot his way through Sandy Hook Elementary School, Procaccini’s 8-year-old daughter was in a reading room just down the hall from the principal’s office.

She had walked herself to her class early and was sitting there with two teachers when the three of them heard the sound of gunfire coming from outside.

“They grabbed my daughter by the arm and threw her into the bathroom,” Procaccini says. “There’s a little bathroom off the reading room, I think it’s a single-person … and the three of them just sat in there, quiet, ’cause he came into the room.”

Apparently, Lanza didn’t hear them because he left, and everyone in the tiny bathroom survived.

In the days after the shootings, though, one of the teachers who had been at the school and knew Procaccini well reached out to him and his wife, Lisa. She wanted them to know just how terrifying their daughter’s experience had been.

You need to get your daughter help, she told the family. Procaccini recalls her saying, “I was literally in the same area as your daughter, and I know what she saw and I know what she heard, and I’m going to need help for a long time. You need to get her help.”

But since the shootings, Procaccini’s daughter has barely talked about what happened, barely registered any emotional distress at all.

“I don’t know if she’s just disassociated. I don’t know if it’s her defense mechanism. Or I don’t know if she just doesn’t get it. I truly don’t,” Procaccini says.

His 10-year-old son, however, has been struggling. Procaccini’s son graduated from Sandy Hook Elementary last year and now attends Reed Intermediate School, which went into lockdown during the shooting, so the boy had no idea what was happening until Procaccini picked him up and told him about it. Immediately, Procaccini says, his son started crying. “I mean, he was crying like a little baby. I haven’t seen him cry like that, you know? He was so scared.”

And as soon as they got home, Procaccini says, his son made a decision: no more school for him. “I’m not going!” he insisted over and over again.

But when Procaccini’s family went to see a therapist the next day, one of the things the therapist made clear was that staying away from school was a bad idea. The more school his son missed, she told Procaccini, the harder it would be to get him to go back.

And so on Tuesday of last week, when Reed went back into session, Procaccini tried to persuade his son to go.

“I said, ‘Come on, I’ll walk you in, I’ll show you!’ And he just snapped. And it was crying and screaming, ‘I’m not going! I’m not going! You’re not leaving me!’ “

For the rest of the week, Procaccini and his son simply drove to the school and walked together through the halls for hours, Procaccini’s car keys safely tucked into his son’s coat pocket so that Procaccini couldn’t drive away by himself.

This procedure was supposed to convince his son that school really was a safe place, but his son doesn’t seem to be buying it, and Procaccini is worried about what will happen after the holiday break.

“I don’t have a plan, really,” he says.

Since the shootings, Procaccini’s son hasn’t had another dream, but Procaccini is certain that if he does, there will be at least one difference in the way that Procaccini responds. Procaccini won’t talk about probabilities and possibilities again. That argument suddenly doesn’t make any sense.

‘Something Somewhere Will Happen’

Zhihong Yang, another parent of a Sandy Hook student, lives two miles away. Yang tells me to call her Jen, and when I walk in, there’s a small pile of papers spread over the table in her kitchen, handouts for Sandy Hook Elementary parents distributed at a conference the night before.

Yang’s son Jerry is in the third grade and was at Sandy Hook during the shooting. Unlike some of the other kids who were at the school, he genuinely seems to be doing OK. But for her part, Yang finds herself thinking about things she had never considered before.

“Yesterday I went to Costco and I can’t help but think: If there was a shooter here, what do you do? I went to the supermarket: If something happened there, what do you do?” she says.

This makes sense, since death is all around Yang. Take her drive to school. Her usual seven-minute route is now lined with families affected by the tragedy. “At least four families that had victims in that accident,” she says, “and when I drive by I feel the pain and I do cry.”

Yang is from China. She says that in college there, she studied math, and then suddenly — totally without prompting — I find myself in another conversation about possibilities and probabilities. Yang, it turns out, specialized in statistics, and since the shooting has been thinking a lot about possibilities and probabilities, reconsidering her original feelings about them.

Yang tells me that she had always assumed that she was safe because the chance of a shooting happening to her specifically was very small. But since the shooting she’s been focused on this one rule of statistics she learned in college, which she calls the “large number certainty theorem.”

“If the base is big enough,” she explains, “even though the probability is small, things will happen with certainty.”

By Yang’s reckoning, this is how the large number certainty theorem applies.

We know that many people have guns, and we know that a certain number of people have disordered minds or bad intentions, and we also know that this is a huge country. In other words, the base is big.

“So, you know, mathematically, something somewhere will happen with certainty,” she says.

And so though Yang previously depended on the idea that school shootings were so rare they would probably happen to someone else, the shooting has taught her that “we should not wait until it actually happens to us to take action.”

Yang has decided to get more involved with fighting for gun control. This, to her, seems like the logical thing to do.

Still, the logic of many parts of all this are not clear to her at all.

“You can safely predict that this will happen, but why it particularly happened to that class? To that teacher’s room? That particular family?” she says.

This obviously is not a question that math can answer. Math can tell us only that something will happen — not when, not to whom.

And so, Yang reasons, morally she should not distinguish between its happening to someone else and its happening to her. Probabilities just aren’t improbable enough for that.

http://www.npr.org/blogs/health/2012/12/27/168152215/shootings-leave-sandy-hook-survivors-rethinking-the-odds

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Empathy and the brain: When kids are cruel

Posted on December 17, 2012. Filed under: article, biology, Children, Conflict, emotion, family, frustration, Health, kids, learning, life, Parenting, teen | Tags: , , , , , , , , , , , , |

Human empathy depends on the ability to share the emotions of others—to “feel” what other people feel. It is regarded by many people as the foundation of moral behavior. But to some, the concept seems rather airy-fairy. What does it mean to say “I feel your pain”? Isn’t that just a fanciful flight of the imagination?

Well, not really. For one thing, it turns out nonhuman animals—-even rodents-—show evidence of empathy. For another, it appears that empathy has a neurological basis.

The same brain regions that process our first-hand experiences of pain are also activated when we observe other people in pain. Moreover, when we observe the emotional signals of others, we recruit brain regions associated with theory of mind, the mechanism that permits us to take the perspective of another person. This theory of mind mechanism-—along with the ability to keep our own emotional reactions under control-—may be of crucial importance for showing empathic concern, or sympathy.

A person who lacked theory of mind or the ability to self-regulate emotions might focus solely on her own emotional reactions to another person’s plight. She might respond aversively to the victim, or–absorbed by her own emotional agitation–she might even become aggressive. Empathy, then, involves a package of abilities. Here’s a quick guide to the biology of empathy, including information about the development of empathy in children.

In one experiment, 15 rhesus monkeys were trained to get food by pulling chains. Monkeys quickly learned that one chain delivered twice as much food than the other. But then the rules changed. If a monkey pulled the chain associated with the bigger reward, another “bystander” monkey received an electric shock. After seeing their conspecific get a shock, 10 of the monkeys switched their preferences to the chain associated with the lesser food reward. Two other monkeys stopped pulling either chain—preferring to starve rather than see another monkey in pain.

Mice, too, respond to the display of pain by their companions. Researchers at McGill University put pairs of mice together and injected one or both of them with a substance that induces mild stomach ache. Mice reacted to the pain by wriggling and stretching their legs. But the intensity of the reaction depended on social cues. Mice wriggled and stretched more when their companions were also in pain. Moreover, mice exposed to the sight of a suffering cage mate were quicker to back away from an unpleasant heat source—suggesting that witnessing their companion’s discomfort made mice more sensitive to their own pain.

So there is nothing particularly human about finding the painful experiences of others unpleasant. But why is “second-hand” pain unpleasant or upsetting?

New research by neuroscientist Jean Decety suggests a fascinating neurological link between our own, first-hand experience of pain and our perception of pain in other people. When typically developing kids (aged 7 to 12 years) were presented with images of people getting hurt, the kids experienced more activity in the same neural circuits that process first-hand experiences of pain. This automatic response–termed “mirroring”—has also been documented in adults. The phenomenon may reflect the activation of mirror neurons, nerve cells that fire both when a person performs an action and he sees that action being performed by others. To date, researchers have identified specific neurons involved in the mirroring of hand movements. No one yet has isolated specific mirror neurons for pain or emotion.

Mirror neurons may explain how we can experience “second-hand” pain or emotion. But to respond with empathic concern, we need other information, too. We need to understand the perspectives of other people. We also need to overcome our own negative reactions to the display of another person’s pain or distress.

Brain-imaging research seems to confirm this link between theory of mind and empathy. For instance, when people have been asked to evaluate the emotional facial expressions of others, they showed activation in the brain regions associated with theory of mind tasks. And theory of mind is probably important in other ways. For instance, Jean Decety and his colleagues have investigated how the brain distinguishes between the victims of accidents and victims of aggression.

To better understand how theory of mind contributes to the perception of “second hand” pain, Decety’s team showed kids two sets of images. One set depicted people experiencing painful accidents. The other set showed people who were being victimized by aggressors. In both scenarios, functional magnetic resonance imaging (fMRI) revealed that merely looking at images activated brain regions associated with the first-hand experience of pain. But when kids watched images of one person deliberately inflicting pain on another person, additional brain regions (in the orbital medial frontal cortex and the paracingulate cortex) were activated.

Brain imaging research and studies of brain-damaged patients suggest that these regions are associated with social interaction, emotional self-control, and moral reasoning. Were the additional brain regions activated because the kids were engaged in social and moral thinking? It seems very plausible.

The activation wasn’t caused by the mere presence of multiple people in the images, because researchers controlled for that. And, when kids were debriefed at the end of the experiment, most of them commented on the unfairness with which the victims had been treated.

The study mentioned above measured the responses of normally-developing kids. What about kids who show a cruel streak? Decety’s group conducted a similar fMRI study on teenage boys with conduct disorder, or CD.

This disorder is a serious psychiatric condition linked with behaviors like physical aggression, manipulative lying, sexual assault, cruelty to animals, vandalism, and bullying. It’s also a precursor to antisocial personality disorder in adulthood (Lahey et al 2005). Researchers screened boys (aged 16-18) for CD, and showed them the same types of images of accidents and assaults mentioned above.

The results were very interesting. I feel your pain…and it makes me lash out

In some respects, the boys with CD responded like boys in the control group. In particular, the mirror neuron system for pain was activated in both groups.

But there were dramatic differences.

First, the boys with conduct disorder experienced less activation in brain regions associated with self-regulation, theory of mind, and moral reasoning.

Second, the boys with CD actually exhibited a stronger “mirror” response to accidentally-caused pain.

And, unlike controls, the boys with conduct disorder experienced strong, bilateral activation in the amygdala and striatum.

What does this mean? It’s not clear. The amygdala processes emotion. And the striatum is activated by strong stimuli—both pleasurable and aversive. So there are at least two possibilities.

The aggressive boys might have gotten a pleasurable “kick” out of viewing the pain of others.

But given that their own pain centers were strongly activated, it’s also possible that observing second-hand pain triggered negative emotions—emotions that make the boys behave more aggressively. As Decety and his colleagues point out, negative emotions—particularly in people with poor emotional control—can cause agitation and outbursts of aggression (Berkowitz 2003). This effect may be magnified in kids who have trouble distinguishing their own first-hand pain from the pain of others.

Decety and colleagues speculate that boys with conduct disorder may experience high levels of agitation or distress when they experience second-hand pain. When this distress is combined with poor self-regulation of emotion, they lash out. But whether second-hand pain makes aggressive kids feel good or irritable, one thing seems pretty certain:

The brains of boys with conduct disorder responded more intensely to images of other people experiencing pain. And this intensity was linked with the boys’ aggressive tendencies. The more strongly a boy’s brain responded to second-hand pain, the more highly he scored on measures of daring and sadism.

Animal studies and brain scan research might make us wonder if feeling empathy is a purely automatic process. But, as noted above, empathy is really a package of abilities, and there is evidence that empathy and empathic concern can be shaped by experience.

Moral Development

http://www.jaapl.org/content/40/2/191.full

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