Physiology of Anger

Posted on May 24, 2013. Filed under: anger, Court Mandated Anger Management, emotion, therapy | Tags: , , , , |



Like other emotions, anger is experienced in our bodies as well as in our minds. In fact, there is a complex series of physiological (body) events that occurs as we become angry.

Emotions more or less begin inside two almond-shaped structures in our brains which are called the amygdala. The amygdala is the part of the brain responsible for identifying threats to our well-being, and for sending out an alarm when threats are identified that results in us taking steps to protect ourselves. The amygdala is so efficient at warning us about threats, that it gets us reacting before the cortex (the part of the brain responsible for thought and judgment) is able to check on the reasonableness of our reaction. In other words, our brains are wired in such a way as to influence us to act before we can properly consider the consequences of our actions. This is not an excuse for behaving badly – people can and do control their aggressive impulses and you can too with some practice. Instead, it means that learning to manage anger properly is a skill that has to be learned, instead of something we are born knowing how to do instinctually.

As you become angry your body’s muscles tense up. Inside your brain, neurotransmitter chemicals known as catecholamines are released causing you to experience a burst of energy lasting up to several minutes. This burst of energy is behind the common angry desire to take immediate protective action. At the same time your heart rate accelerates, your blood pressure rises, and your rate of breathing increases. Your face may flush as increased blood flow enters your limbs and extremities in preparation for physical action. Your attention narrows and becomes locked onto the target of your anger. Soon you can pay attention to nothing else. In quick succession, additional brain neurotransmitters and hormones (among them adrenaline and noradrenaline) are released which trigger a lasting state of arousal. You’re now ready to fight.

Although it is possible for your emotions to rage out of control, the prefrontal cortex of your brain, which is located just behind your forehead, can keep your emotions in proportion. If the amygdala handles emotion, the prefrontal cortex handles judgment. The left prefrontal cortex can switch off your emotions. It serves in an executive role to keep things under control. Getting control over your anger means learning ways to help your prefrontal cortex get the upper hand over your amygdala so that you have control over how you react to anger feelings. Among the many ways to make this happen are relaxation techniques (which reduce your arousal and decrease your amygdala activity) and the use of cognitive control techniques which help you practice using your judgment to override your emotional reactions.

If anger has a physiological preparation phase during which our resources are mobilized for a fight, it also has a wind-down phase as well. We start to relax back towards our resting state when the target of our anger is no longer accessible or an immediate threat. It is difficult to relax from an angry state, however. The adrenaline-caused arousal that occurs during anger lasts a very long time (many hours, sometimes days), and lowers our anger threshold, making it easier for us to get angry again later on. Though we do calm down, it takes a very long time for us to return to our resting state. During this slow cool-down period we are more likely to get very angry in response to minor irritations that normally would not bother us.

The same lingering arousal that keeps us primed for more anger also can interfere with our ability to clearly remember details of our angry outburst. Arousal is vital for efficient remembering. As any student knows, it is difficult to learn new material while sleepy. Moderate arousal levels help the brain to learn and enhance memory, concentration, and performance. There is an optimum level of arousal that benefits memory, however, and when arousal exceeds that optimum level, it makes it more difficult for new memories to be formed. High levels of arousal (such as are present when we are angry) significantly decrease your ability to concentrate. This is why it is difficult to remember details of really explosive arguments.

http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=5805&cn=116

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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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Predicting violence

Posted on January 5, 2013. Filed under: article, biology, blame, Health, life, Psychology, violence | Tags: , , , , , |

After every act of incomprehensible violence, the world asks whether the killer could have been identified ahead of time. It’s as automatic as the call for more gun control and better mental health services.

Psychologists and psychiatrists have been working for decades to try to figure out whether there’s a link between mental illness and violence, and if so, which people are likely to act. Using an ever-changing tool kit of theories and questionnaires, they’ve made some progress.

It’s now fairly clear, for example, that people with severe mental illness, such as schizophrenia, bipolar disorder and some personality disorders, are more likely to commit violent acts than others. But the risk is small. The vast majority of mentally ill people won’t commit assault, rape, arson or homicide, although the risk rises sharply among those who abuse drugs and alcohol.

These insights are proving useful to psychiatrists, psychologists, judges, school administrators and others who must decide whether someone seems too dangerous to be left alone. But they aren’t good enough to identify an Adam Lanza, the young man who killed 28 people, including himself, in Newtown, Conn., last month. (Lanza’s mother told friends that he had Asperger syndrome, a developmental disorder, but no evidence has emerged that Lanza was diagnosed as mentally ill.)

“There is no instrument that is specifically useful or validated for identifying potential school shooters or mass murderers,” said Stephen D. Hart, a psychologist at Simon Fraser University in Vancouver who is the co-author of a widely used evaluation tool. “There are many things in life where we have an inadequate evidence base, and this is one of them.”

Even when someone has a history of threatening behavior, the killing of innocent people can’t necessarily be prevented.

The woman accused of pushing a man to his death in front of a New York subway train on Dec. 27 had been arrested several times for assault and treated in the psychiatric wards of two hospitals. The man who fatally shot two firefighters and himself in Webster, N.Y., on Christmas Eve had killed his 92-year-old grandmother three decades earlier.

The task of identifying violence-prone individuals is even trickier with young people, who have shorter histories and whose normal development often includes a period of antisocial behavior.

The prospect that the most recent massacre, or the next one, could lead to efforts to find young men contemplating the killing of strangers worries many people. Among those expressing concern are some psychologists and former patients forcibly swept into the mental health system and treated against their will.

“I think people are going toward wanting all their kids to be screened in high school for mental illness and violence risk — and that’s a bad idea,” said Gina M. Vincent, a forensic psychologist at the University of Massachusetts Medical School. “That’s my biggest fear of what’s going to come out of this.”

“We can’t go out and lock up all the socially awkward young men in the world,” said Jeffrey W. Swanson, a professor of psychiatry and behavioral sciences at Duke University. “But we have to try to prevent the unpredicted.”

Aggravating factors

The best-known attempt to measure violence in mental patients found that mental illness by itself didn’t predict an above-average risk of being violent. People released from psychiatric wards were more violent than their neighbors only if they also had drug and alcohol problems, according to the MacArthur Violence Risk Assessment Study, which tracked almost 1,000 former patients in the early 1990s.

Other research has found a link — although not a particularly strong one — between mental illness and violence.

In a 2001 study funded by the National Institutes of Health, researchers asked 35,000 adults whether they had been diagnosed with a mental illness anytime in their lives and in the previous year. They also asked a long list of questions about the subjects’ personal histories and behaviors. Re-interviews were conducted three years later, asking about violent events in the intervening period.

People who reported that they’d had both “severe mental illness” and substance abuse problems in the year before the first interview had the highest rate of violence; 9.4 percent had committed a violent act. The next most violent were people with other types of mental illness (mostly antisocial personality disorder) accompanied by substance abuse — 7.2 percent of them reported violent behavior.

Groups with lower rates of violence included people suffering only from severe mental illness, 2.9 percent of whom reported having been violent; those only with substance abuse problems (2.5 percent); and those with other mental illnesses alone (1.4 percent). People without any of these problems had just a 0.8 percent rate of violence.

Over the years, researchers have made a particular effort to study violence and schizophrenia, a disorder that emerges in young adults and often includes paranoid thoughts.

An analysis of 20 studies published three years ago found that schizophrenia increased the risk of acting violently fourfold in men and even more in women. The risk of schizophrenics committing homicide was 0.3 percent — more than 10 times greater than the average citizen.

The evidence suggests that “there’s a modest relative risk” for violent behavior in people diagnosed with a serious mental illness, said Swanson, the Duke researcher.

Risk assessment

If some of the mentally ill are dangerous, can they be found?

Over the years, studies have shown that psychiatrists’ accuracy in identifying patients who would become violent was slightly better than chance — “obviously not good enough, given what’s at stake for public safety as well as for civil liberties,” said John Monahan, a University of Virginia psychologist who helped direct the MacArthur study.

So Monahan and many others came up with a constellation of “risk factors” and “protective factors” for violent behavior — analogous to the risk factors for heart disease, such as age, blood pressure, smoking and cholesterol — and included them in questionnaires.

Some of those instruments rely heavily on adding up scores. Others put more emphasis on the interviewer’s clinical judgment. The most popular current strategy combines both approaches; it forces the evaluator to include any pertinent issue.

All of the approaches consider the presence of a mental disorder as only a small contributor to risk, outweighed by other factors such as age, previous violent acts, alcohol use, impulsivity, gang membership and lack of family support.

There have been numerous efforts to test these violence-predicting tools in recent decades. For example, Monahan and his colleagues incorporated 106 risk factors into a software interview program and administered it to patients being discharged from psychiatric units in Massachusetts and Pennsylvania. Of those judged to be low-risk by this tool, 90 percent committed no violence over the next six months. Of those judged to be high-risk, 49 percent committed violent acts.

“From our research, we could quickly distinguish between a patient whose chance of being violent was 1-in-10 from one whose was 1-in-2,” he said.

Last summer, a large study published in the British Medical Journal found much the same thing.

It analyzed the findings of 68 studies that involved about 25,000 people in psychiatric hospitals, prisons or court-ordered detention. (The studies used a variety of assessment tools.) Of the people predicted to “violently offend,” 41 percent did. Of those predicted to be nonviolent, 91 percent were. In practical terms, that meant that if authorities used the tools for the purposes of public health, they’d have to detain two people to prevent one from becoming violent.

The authors of the analysis concluded that “risk assessment tools in their current form can only be used to roughly classify individuals at the group level, and not to safely determine criminal prognosis in an individual case.”

Most of this research has been conducted on populations already “enriched” with the potential for violence: psychiatric patients, drug users, binge drinkers, people who have been arrested. But some mass shooters don’t fall into any of those categories.

For the general public, there’s no screening tool for violence, and nobody expects that there ever will be.

Increased awareness

Is what’s known about the relationship between mental illness and violence of any use after events like the mass shooting in Connecticut?

People who study and provide mental health treatment generally say, “Yes.” However, that’s not because people prone to violence can be found and stopped. It’s because if psychiatrists, psychologists and judges become more aware of the relationship between social circumstance, behavior and risk factors for violence, then they might be able to exert influence long before a killer’s plans are made.

At least that’s the current thinking.

“Most people who are thinking about violence are ambivalent about it,” said Hart of Simon Fraser University. “Our job is to find people who are ambivalent and convince them that violence is a bad idea.”

He cited the recent case in Vancouver of a college student who told a friend she was thinking of killing a homeless man. The friend notified authorities; the student was detained and evaluated with an assessment tool called the HCR-20. She had a “death kit” of tools in her possession and had killed a cat and dog for pleasure. She was convicted of animal cruelty but will soon be released on probation, with close supervision.

But some people warn that a more aggressive mental health system would pose its own dangers.

James B. Gottstein, a lawyer in Anchorage and head of the Law Project for Psychiatric Rights, has won four cases in his state’s Supreme Court supporting patients’ rights to refuse to take psychiatric medicines, limiting conditions for involuntary commitment and other issues. He learned firsthand what it’s like to be forcibly drugged and stigmatized by psychiatric treatment.

In June 1982, he had a manic episode that he attributes to sleep deprivation. He was working hard, suffering from jet lag after returning from Europe and living in a place where the sun didn’t set at night. He was taken by the police to a mental hospital, where he spent a month.

“One of the problems that happens when you become a psychiatric patient is that everything that you do or say can be labeled as a psychiatric symptom,” said Gottstein, 59, a graduate of Harvard Law School.

“If the police knock down your door and haul you off and you get upset, you get labeled as ‘hostile’ and ‘labile.’ If you decide that you’re not going to react to these provocations, you get labeled as having ‘a flat affect.’ If you think something is funny and you laugh to yourself, then they write down ‘responding to internal stimuli,’ ” he said.

It’s not that people don’t want help, Gottstein said, but that “the system basically forces things on them that they don’t want.” He thinks it is “entirely possible to create a system where things are voluntary.”

Essential are peer counselors — people once similarly diagnosed who might be able to connect with the mentally ill when the professionals can’t. There’s a largely unknown movement trying that approach. But he’s quite sure that’s not what people calling for “greater access to mental health services” these days are talking about.

And that worries him.

http://www.washingtonpost.com/national/health-science/predicting-violence-is-a-work-in-progress/2013/01/03/2e8955b8-5371-11e2-a613-ec8d394535c6_story.html?hpid=z2

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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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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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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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We grow accustomed to what is familiar

Posted on December 2, 2012. Filed under: attention, biology, choice, Conflict, control, emotion, fear, happy, Health, learning, life | Tags: , , , , , , , |

We need only to do something once to know we are capable of doing it, the more we do it the better we get, each time we do it, we gain confidence and are more capable, less fearful. The doubts we possess prevent us from trying and push our comfort zone, to step beyond what we are capable of achieving. What is familiar is comfortable, and we like to stick with what provides us comfort, but what is familiar is not always what’s better. Anything worth having in life takes some degree of effort, change is inevitable and what was once novel soon becomes familiar. We adapt to just about anything and are able to endure. We grow accustomed to what is familiar and in it we find security. We cannot necessarily control what is happening but we can adjust to the world around us, we are great at dealing with change we change our clothes, our hair, as you read this the hand on the clock are moving, the lights grow dimmer the sun sets, we cannot control the wind but we can adjust our sails. Yet we feel as powerless as a car without an engine to alter our environment, but we can be a role model to others to be an example of how we would like to be treated. If what I’m doing isn’t working, I need to change direction and find what I can alter, that being yourself, rather then fight what I cannot control.

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how the brain makes moral decisions

Posted on November 21, 2012. Filed under: article, attention, Conflict, emotion, fairness, probem solving, Psychology, thinking, thoughts | Tags: , , , , , , , , , |

When we think about morality, many of us think about religion or what our parents taught us when we were young. Those influences are powerful, but many scientists now think of the brain as a more basic source for our moral instincts.

The tools scientists use to study how the brain makes moral decisions are often stories, said Joshua Greene, a Harvard psychologist,citing one well-known example: “A trolley is headed toward five people, and the only way you can save them is to hit a switch that will turn the trolley away from the five and onto a side track, but if you turn it onto the side track, it will run over one person.”

It’s a moral dilemma. Greene and other researchers have presented this dilemma to research volunteers.

Most people say they would flip the switch and divert the trolley. They say they don’t want to kill someone, but one innocent person dead is better than five innocent people dead.

What this shows is that people resolve the moral dilemma by doing a cost-benefit analysis. Greene says they look at the consequences of each choice, and pick the choice that does the least harm.

In other words, people are what philosophers would call utilitarians. Except, Greene tells me, sometimes they aren’t.

He asked me to visualize another well-known dilemma:

“This time, you’re on a footbridge, in between the oncoming trolley and the five people. And next to you is a big person wearing a big backpack. And the only way you can save those five people is to push this big guy off of the footbridge so that he lands on the tracks. And he’ll get squashed by the train; you sort of use him as a trolley stopper. But you can save the five people.”

Would you push the big guy to his death? More important, do you feel this moral dilemma is identical to the earlier one?

“In a certain sense, they’re identical,” Greene said. “Trade one life to save five. But psychologically, they’re very different.”

Pushing someone to their death feels very different from pushing a switch. When Greene gives people this dilemma, most people don’t choose to push the big guy to his death.

In other words, people use utilitarian, cost-benefit calculations — sometimes. But other times, they make an emotional decision.

“There are certain lines that are drawn in the moral sand,” Green said. “Some things are inherently wrong, or some things inherently must be done.”

There’s another dimension here that’s interesting: If you watched yourself during the first dilemma, you may have noticed you had to think about whether you’d push that switch. In the footbridge dilemma, you probably didn’t have to think — you just knew that pushing someone to his death is wrong.

Greene says we really have two completely different moral circuits in our brain.

When you listen to a dilemma, the two circuits literally have a fight inside your brain. Part of your brain says, slow down, think rationally — make a cost-benefit analysis. Another says, no, don’t think about it. This is just wrong!

“These responses compete in a part of the brain called the ventromedial prefrontal cortex, which is a kind of place where different types of values can be weighed against each other to produce an all-things-considered decision,” Greene said.

So what makes the ventromedial prefrontal cortex go with the rational mode sometimes, and the emotional mode other times?

Greene and a colleague, Elinor Amit, thought closely about what was happening to people as they tipped from rational mode to an emotional mode. In new research they’ve just published in the journal Psychological Science, these psychologists say they have the answer.

“Emotional responses don’t just pop out of nowhere,” Greene said. “They have to be triggered by something. And one possibility is that you hear the words describing some event, you picture that event in your mind, and then you respond emotionally to that picture.”

That’s the key: Some dilemmas produce vivid images in our heads. And we’re wired to respond emotionally to pictures. Take away the pictures — the brain goes into rational, calculation mode.

Here’s how they found that out: Greene and Amit set up an experiment. They presented people with moral dilemmas that evoked strong visual images. As expected, the volunteers made emotional moral judgments. Then the psychologists made it difficult for volunteers to visualize the dilemma. They distracted them by making them visualize something else instead.

When that happened, the volunteers stopped making emotional decisions. Not having pictures of the moral dilemma in their head prompted them into rational, cost-benefit mode.

In another experiment, Greene and Amit also found that people who think visually make more emotional moral judgments. Verbal people make more rational calculations.

Amit says people don’t realize how images tip the brain one way or another. And that can create biases we aren’t even aware of.

She laid out a scenario to think about: “Imagine a horrible scenario in which a terrorist takes an ax and starts slaughtering people in a bus,” she said. “I’m coming from Israel, so these are the examples that I have in my mind.”

The story produces a movie in our heads. We can see blood everywhere. We can hear people screaming. We don’t have to think at all. It feels terribly wrong.

Then Amit presented another kind of news event: A drone strike that sends a missile hurtling toward a target. At the center of the cross-hairs, an explosion. There’s dust billowing everywhere.

“So if you learn about these events from television or from pictures in a newspaper, which one [would you] judge as more horrible?” Amit asked. “The person with the ax that killed maybe two people but the scene looks horrible and extremely violent, or the picture of the drone that killed 100 people but looks relatively clean and nice?”

To be sure, the events Amit describes are completely different. One’s a terrorist attack, the other is a military action. But it’s true the ax murderer instantly sends the brain into emotional mode.

The drone strike has less vivid imagery. You can’t see, up close, what the missile does. So most people go into utilitarian mode — they start to think about the costs and benefits.

Amit’s point is not that one mode is better than the other. It’s something much more disturbing. As you listen to the news everyday, hidden circuits in your brain are literally changing the ground rules by which you judge events.

You think you’re making consistent moral choices when, really, the movies playing in your head might be making your choices for you.

http://www.npr.org/2012/09/20/161440292/why-pictures-can-sway-your-moral-judgment

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Babies teach us right from wrong

Posted on November 19, 2012. Filed under: article, Children, fairness, family, kids, learning, Parenting, school, teen, thinking, thoughts | Tags: , , , , , , , , , |

The following script is from “The Baby Lab” which aired on 60 minutes..Nov. 18, 2012.

It’s a question people have asked for as long as there have been people: are human beings inherently good? Are we born with a sense of morality or do we arrive blank slates, waiting for the world to teach us right from wrong? Or could it be worse: do we start out nasty, selfish devils, who need our parents, teachers, and religions to whip us into shape?

The only way to know for sure, of course, is to ask a baby. But until recently, it’s been hard to persuade them to open up and share their secrets. Enter the baby lab.

This is the creature at the center of the greatest philosophical, moral, and religious debates about the nature of man: the human baby. They don’t do much, can’t talk, can’t write, can’t expound at length about their moral philosophies. But does that mean they don’t have one? The philosopher Rousseau considered babies “perfect idiots…Knowing nothing,” and Yale psychologist Karen Wynn, director of the Infant Cognition Center here, the baby lab, says for most of its history, her field agreed.

Lesley Stahl: Didn’t we just think that these creatures at three months and even six months were basically just little blobs?

Karen Wynn: Oh, sure. I mean, if you look at them, they–

Lesley Stahl: Yeah.

Karen Wynn: They kinda look like little, I mean, cute little blobs. But they can’t do all the things that an older child can. They can’t even do the things that a dog or a pigeon or a rat can.

No pulling levers for treats or running mazes for these study subjects. But they can watch puppet shows. And Wynn is part of a new wave of researchers who have discovered seemingly simple ways to probe what’s really going on in those adorable little heads. We watched as Wynn and her team asked a question that 20 years ago might have gotten her laughed out of her field. Does Wesley here, at the ripe old age of 5 months, know the difference between right and wrong?

Wesley watches as the puppet in the center struggles to open up a box with a toy inside. The puppy in the yellow shirt comes over and lends a hand. Then the scene repeats itself, but this time the puppy in the blue shirt comes and slams the box shut. Nice behavior…mean behavior…at least to our eyes. But is that how a 5-month-old sees it, and does he have a preference?

Annie: Wesley, do you remember these guys from the show?

To find out, a researcher who doesn’t know which puppet was nice and which was mean, offers Wesley a choice.

Annie: Who do you like?

He can’t answer, but he can reach… (reaches for nice puppet)

Annie: That one?

Wesley chose the good guy and he wasn’t alone.

More than three fourths of the babies tested reached for the nice puppet. Wynn tried it out on even younger babies, 3 month olds, who can’t control their arms enough to reach. But they can vote with their eyes, since research has shown that even very young babies look longer at things they like. Daisy here looked at the mean puppet for 5 seconds; then switched to the nice one for 33.

Karen Wynn: Babies, even at three months, looked towards the nice character and looked hardly at all, much, much, much shorter times, towards the unhelpful character.

Lesley Stahl: So basically as young as three months old, we human beings show a preference for nice people over mean people.

Karen Wynn: Study after study after study, the results are always consistently babies feeling positively towards helpful individuals in the world. And disapproving, disliking, maybe condemning individuals who are antisocial towards others.

Lesley Stahl: It’s astonishing.

Wynn and her team first published their findings about baby morality in the journal “Nature” in 2007, and they’ve continued to publish follow-up studies in other peer-reviewed journals ever since — for instance on this experiment.

They showed babies like James here a puppet behaving badly — instead of rolling the ball back to the puppet in the middle, this green-shirted bunny keeps the other puppet’s ball, and runs away.

Then James is shown a second show — this time the bunny who he just saw steal the ball, tries to open up the box to get the toy. Will James still prefer the puppet who helps out? Or will he now prefer the one who slams the box shut?

[Annie: Who do you like? That one.]

He chose the one who slammed it shut, as did 81 percent of babies tested. The study’s conclusion: babies seem to view the ball thief “as deserving punishment.”

Lesley Stahl: So do you think that babies, therefore, are born with an innate sense of justice?

Karen Wynn: At a very elemental level, I think so.

Paul Bloom: We think we see here the foundations for morality.

Paul Bloom is also a professor of psychology at Yale, with his own lab. He’s collaborated with Wynn on many of her baby studies, and he also happens to be her husband.

Paul Bloom: I feel we’re making discoveries. I feel like we’re– we’re discovering that what seems to be one way really isn’t. What seems to be an ignorant and unknowing baby is actually a creature with this alarming sophistication, this subtle knowledge.

And he says discovering this in babies who can’t walk, talk, or even crawl yet, suggests it has to come built in.

Lesley Stahl: So, remember B.F. Skinner, who said that we had to teach our children everything through conditioning. So, does this just wipe him off the map?

Paul Bloom: What we’re finding in the baby lab, is that there’s more to it than that — that there’s a universal moral core that all humans share. The seeds of our understanding of justice, our understanding of right and wrong, are part of our biological nature.

Wait a minute, if babies are born with a basic sense of right and wrong, a universal moral core, where does all the evil in the world come from? Is that all learned? Well maybe not. Take a look at this new series of discoveries in the Yale baby lab…

[Annie: Would you like a snack?]

In offering babies this seemingly small, innocuous choice — graham crackers or Cheerios — Wynn is probing something big: the origins of bias. The tendency to prefer others who are similar to ourselves.

Karen Wynn: Adults will like others who share even really absolutely trivial similarities with them.

So will Nate, who chose Cheerios over graham crackers, prefer this orange cat, who also likes Cheerios — over the grey cat who likes graham crackers instead?

Apparently so. But if babies have positive feelings for the similar puppet, do they actually have negative feelings for the one who’s different? To find out, Wynn showed babies the grey cat — the one who liked the opposite food, struggling to open up the box to get a toy. Will Gregory here want to see the graham cracker eater treated well? Or does he want him treated badly?

[Annie: Which one do you like? That one.]

Gregory seemed to want the different puppet treated badly.

Lesley Stahl: That is amazing. So he went with his bias in a way.

And so did Nate and 87 percent of the other babies tested. From this Wynn concludes that infants prefer those “who harm… others” who are unlike them.

Paul Bloom: What could be more arbitrary than whether you like graham crackers or Cheerios?

Lesley Stahl: Nothing.

Paul Bloom: Nothing. But it matters. It matters to the young baby. We are predisposed to break the world up into different human groups based on the most subtle and seemingly irrelevant cues, and that, to some extent, is the dark side of morality.

Lesley Stahl: We want the other to be punished?

Karen Wynn: In our studies, babies seem as if they do want the other to be punished.

Lesley Stahl: We used to think that we’re taught to hate. I think there was a song like that. This is suggesting that we’re not taught to hate, we’re born to hate.

Karen Wynn: I think, we are built to, you know, at the drop of a hat, create us and them.

Paul Bloom: And that’s why we’re not that moral. We have an initial moral sense that is in some ways very impressive, and in some ways, really depressing — that we see some of the worst biases in adults reflected in the minds and in the behaviors of young babies.

But Bloom says understanding our earliest instincts can help…

Paul Bloom: If you want to eradicate racism, for instance, you really are going to want to know to what extent are babies little bigots, to what extent is racism a natural part of humanity.

Lesley Stahl: Sounds to me like the experiment show they are little bigots.

Paul Bloom: I think to some extent, a bias to favor the self, where the self could be people who look like me, people who act like me, people who have the same taste as me, is a very strong human bias. It’s what one would expect from a creature like us who evolved from natural selection, but it has terrible consequences.

He says it makes sense that evolution would predispose us to be wary of “the other” for survival, so we need society and parental nurturing to intervene. He showed us one last series of experiments being done in his lab — not with babies, but with older children of different ages. The kids get to decide how many tokens they’ll get, versus how many will go to another child they’re told will come in later. They’re told the tokens can be traded in for prizes.

[Mark: So you can say green, and if you say green, then you get this one and the other girl doesn't get any; or you can say blue, and if you say blue, then you get these two, and the other girl gets these two. So green or--

Rebecca: Green!]

The youngest kids in the study will routinely choose to get fewer prizes for themselves just to get more than the other kid –

[Ainsley: I'll pick green.]

– in some cases, a lot more.

Paul Bloom: The youngest children in the studies are obsessed with social comparison.

[Mark: So you get these seven. She doesn't get any.

Kendall: Yay!]

Paul Bloom: They don’t care about fairness. What they want is they want relatively more.

But a funny thing happens as kids get older. Around age 8, they start choosing the equal, fair option more and more. And by 9 or 10, we saw kids doing something really crazy –

[Abby: Green.]

– deliberately giving the other kid more.

Mark: Green or blue?

Maeve: Green.

They become generous. Chalk one up to society.

Lesley Stahl: They’ve already been educated?

Paul Bloom: They’ve been educated, they’ve been inculturated, they have their heads stuffed full of the virtues that we might want to have their heads stuffed with.

So we can learn to temper some of those nasty tendencies we’re wired for — the selfishness, the bias — but he says the instinct is still there.

Paul Bloom: When we have these findings with the kids, the kids who choose this and not this, the kids in the baby studies who favor the one who is similar to them, the same taste and everything– none of this goes away. I think as adults we can always see these and kind of nod.

Lesley Stahl: Yeah. It’s still in us. We’re fighting it.

Paul Bloom: And the truth is, when we’re under pressure, when life is difficult, we regress to our younger selves and all of this elaborate stuff we have on top disappears.

But of course adversity can bring out the best in us too — heroism, selfless sacrifice for strangers — all of which may have its roots right here.

Paul Bloom: Great kindness, great altruism, a magnificent sense of impartial justice, have their seeds in the baby’s mind. Both aspects of us, the good and the bad are the product I think of biological evolution.

And so it seems we’re left where we all began: with a mix of altruism, selfishness, justice, bigotry, kindness. A lot more than any of us expected to discover in a blob.

Lesley Stahl: Well, I end my conversation with you with far more respect for babies. Who knew?

http://www.cbsnews.com/8301-18560_162-57551557/babies-help-unlock-the-origins-of-morality/

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Explosive Rage and Brain Damage

Posted on October 26, 2012. Filed under: anger, article, frustration, Health, life, Psychology | Tags: , , , , , , , , , , , , |

”HE was a scientist, but he was acting strangely,” said Dr. Stuart Yudofsky, a psychiatrist who consulted on the man’s case. ”At work, when something didn’t go right, he would scream and threaten his co-workers. At home, if his 4-year-old spilled some food at the table, he’d get so mad at her, he’d punch holes in the walls with his fist. It was completely out of character.” For several years the scientist was treated by a series of psychotherapists, who urged him to examine his childhood for deep-seated conflicts that might explain his rages. Then a psychiatrist prescribed a sedative. Nothing helped.

Finally the scientist was referred to a neurologist, who traced the beginning of the violent outbursts to an auto accident in which the scientist had received a severe head injury. When the scientist was treated with propanolol, a medication used to control blood pressure, his rages stopped.

The scientist’s case exemplifies a new advance in understanding explosive anger: that the most common cause is brain injury or neurological disease, and that there are now medications that can control it far more effectively than can the approaches most commonly used by psychiatrists.

But researchers say that despite the advance in understanding the causes of violent rage, too little attention is being paid to people who suffer from such attacks, and that as a result they receive inadequate care.

”The brain basis for violent rage often goes unrecognized, and a great many patients with the problem are being given improper care,” said Dr. Yudofsy, chairman of the department of psychiatry at the University of Chicago Medical School. ”This has been a huge unsolved problem for psychiatry.”

The rage resulting from neurological impairment is distinct from ordinary anger. It is a sudden and unpredictable storm of overwhelming fury that is triggered by a trivial event and that builds into an explosion in an instant. It serves no purpose for the person who is swept away and typically leaves remorse and embarrassment in its wake.

The work on rage bears great significance for several groups, like the estimated four million people in the United States with Alzheimer’s disease. Studies have found that about a third of Alzheimer’s patients have uncontrollable rages. Inability to handle the patients’ outbursts of rage is the single most common reason given by families of Alzheimer’s patients for sending them to nursing homes or hospitals.

Apart from those with Alzheimer’s disease, one million people suffer brain injuries each year from strokes, tumors or blows to the head; 180,000 of them are injured in auto accidents. Some degree of constant irritability or explosive aggression occurs in as many as 70 percent of those who suffer serious brain injury, studies have shown. For those working with such patients in hospitals, dealing with outbursts of anger is troubling and frightening.

Insights on Criminal Violence

The research may also offer insights into some criminal violence: two studies involving a total of 29 murderers on death row in at least four states found that almost all had a serious brain injury that may have triggered their violence.

”Explosive rage is very common, since it can be a symptom of any malady that destroys brain cells,” said Dr. Yudofsky. ”And I suspect brain damage is, by far, the most frequent cause of these violent outbursts, though no one has exact numbers.”

The new treatments may mean a fresh start on life for people who have suffered from the attacks of rage.

Other experts caution that there are many cases of explosive rage that cannot be explained by brain damage. ”There are a large group of people with brain damage who do not have explosive rage, and a sizable group of people with rage who have no brain injury,” said Dr. Gary Tucker, chairman of the psychiatry department at the University of Washington medical school.

Even so, brain damage is increasingly being recognized as a cause of the problem. Dr. Louis J. West, chairman of the psychiatry department at the medical school of the University of California at Los Angeles, said, ”The number of cases where brain damage explains an explosive rage is not so small as we used to think.”

In some studies, up to 70 percent of those with outbursts of rage were found to have neurological damage. A University of Pennsylvania study of 286 psychiatric patients prone to unprovoked attacks of rage found that 94 percent had some kind of brain damage. The cause ranged from head injuries and stroke to encephalitis and Alzheimer’s disease.

Factors Found on Death Row

Like violent psychiatric patients, violent criminals have also been found to have a disproportionate share of brain injuries. For example, of the 29 death row inmates all were found from hospital records or neurological tests to have had a head trauma, ranging from falls from trees in childhood to regular beatings.

”There is no question that much violent crime can be traced, in part, to brain injury, especially in criminals who are repeatedly violent,” said Dr. Dorothy Otnow Lewis, a psychiatrist at New York University Medical School, who conducted the research on death row inmates.

But Dr. Lewis says that brain injury alone is not likely to provoke such intense violence. ”The most lethal combination is a history of neurological damage and abuse in childhood,” said Dr. Lewis. ”When you have a kid who has some organic vulnerability, like a brain injury, and you add being raised in a violent household, then you create a very, very violent person.”

Her conclusions stem from a study of 95 boys who were studied at a Connecticut correctional school in the late 1970′s, then were tracked seven years later using records of their subsequent arrests maintained by states and the Federal Bureau of Investigation.

Those who, as teen-agers, showed no sign of neurological problems or childhood abuse had not committed a violent crime as adults. Those who had some brain impairment, or who had been abused in childhood, committed an average of two violent offenses.

But those who had both brain impairment and an abusive family history had committed an average of five violent crimes. Nine who had been convicted of murder were in this category. Avenue for Criminals? Experts in law and psychiatry doubt that the findings suggest an avenue for criminals to evade punishment for violent crimes. ”Being swept away by emotion does not mean one did not know right from wrong,” said Dr. Park Dietz, a psychiatrist in Newport Beach, Calif., and formerly a professor of law and psychiatry at the University of Virginia.

Nevertheless, he said, ”it is legitimate to bring up a brain impairment at sentencing to mitigate the blame for the defendant and so get a lesser sentence.” And, he said, it was becoming increasingly common for defense lawyers to raise neurological problems in their client as a defense of last resort when there is no other sign of mental illness.

Injuries to certain parts of the brain, such as the frontal areas of the cortex, are the most likely to result in attacks of rage, researchers say. According to one theory, these brain areas ordinarily control aggressive impulses that originate in lower brain centers. When the controlling areas are damaged, the inhibitions disappear, allowing rage to be expressed freely.

For that reason, a new diagnosis, a ”disinhibited type” of dementia, has been proposed for inclusion in the next edition of the official psychiatric diagnostic manual.

”There is good evidence that explosive rage is one sign of a disinhibition syndrome,” said Dr. Tucker, who heads the committee studying such new diagnoses.

”But we see rage attacks as one example of a more general category of inappropriate emotional behavior due to brain trauma. It can take many forms, such as exposing oneself, or swings from crying to laughing.”

Unique Psychiatric Syndrome

Dr. Yudofsky, on the other hand, leads a group of psychiatrists who argue that explosive rage marks a unique psychiatric syndrome in itself and that a specific treatment is now available for it.

Dr. Yudofsky said that most patients treated for explosive rage were being given the wrong medications. ”The majority of these patients are prescribed sedatives like heavy tranquilizers or antipsychotic medication,” he said. ”You see patients in hospitals looking like zombies. They’ve been oversedated to keep them under control.”

One of the most promising new treatments for rage is propanolol, a beta-blocker more commonly used to treat hypertension that has none of the debilitating side effects of the sedatives.

In a study published in the spring issue of The Journal of Neuropsychiatry and Clinical Neurosciences, Dr. Yudofsky and colleagues showed that the drug was highly effective in calming rage in white rats.

The researchers first made lesions in the rats’ brains in a procedure that ”creates a very violent rat,” Dr. Yudofsky said. The researchers then put the rats on a device that delivered a shock to their feet.

When the rats were paired, they attacked each other four out of five times when the shock was applied. But after they were given injections of propanolol, they attacked only about one in five times, or at the same rate as before the operation.

Drug’s Usefulness

A number of studies in humans also suggest the usefulness of propanolol. One of the most recent, reported at the meeting of the American Psychiatric Association in May, was conducted by Dr. Jonathan Silver, director of neuropsychiatry at Columbia Presbyterian Medical Center in New York City.

That study used a group that is among the hardest to treat: 21 patients whose violence has kept them in the locked ward of a psychiatric hospital for an average of 10 years. Overall, there was a 50 percent reduction in the number of angry outbursts, from an average of one incident a day, to one every other day. In seven patients the reduction was greater than 75 percent.

In addition to propanolol, other medications have shown promise for controlling rage. Most mute the activity of catecholamines or serotonin, brain chemicals involved in emotions like anger.

The other medications include lithium, used to treat manic-depression; buspirone, used to treat anxiety; and carbamazepine, used to control seizures.

It was this last drug that was of crucial help to Paul Streicker, president of an advertising and public relations agency from Providence, R.I., who had attacks of rage following a severe brain injury from an auto accident.

”As I was recovering, I was highly irritable,” Mr. Streicker said. ”Once in the hospital I threw a can of soda at my dietitian. At home, I’d have fits of rage where I’d take a swing at a lamp and yell.”

But when Mr. Streicker began taking carbemazapine, his emotions were tamed.

Experts say learning not to feel guilty or embarrassed about outbursts can help prevent self-reproach and depression.

”People can also relearn some emotional controls,” Dr. Yudofsky said. ”Drug treatment should be in tandem with psychotherapy and family therapy.”

http://www.nytimes.com/1990/08/07/science/when-rage-explodes-brain-damage-may-be-the-cause.html?pagewanted=all&src=pm

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