Bonding over bullying

I've been meaning to post about this Invisibilia episode for ages, and also saw this comment from a somewhat recent post that made me want to post it again, and finally have gotten around to it.

So the Invisibilia episode is worth listening to fully, at least the first half of it. It talks about a woman who has always been treated badly, bullied, and even villified, and she had no idea why. She's high functioning -- a doctor -- but she found social interactions to be very difficult. She describes the worst of many similar episodes of bullying:

The worst thing that ever happened was, I was at summer camp, and I don't know what I did. I have no idea. But they actually bound and gagged me and took me out of the cabin at night in the rain and put me outside, and it was just awful.

Here's why: "Kim's brain is not great at seeing emotion. When she looks out at the world, she physically sees all the things that most people see. It's just that much of the emotion is subtracted. Though for most of her life, she didn't realize that, and so her interactions with other kids could be difficult."

She undergoes TMS, transcranial magnetic stimulation, which some of you may remember from Wisdom of Psychopaths: "Basically in TMS you take this very fancy magnet, hold it to the scalp and send pulses through the skull to get brain cells to activate in a different way. They typically change for a very short period of time - between 15 and 40 minutes."

During TMS, she experiences for the first time an awareness of the emotional world, and realizes that this whole time she has been missing out on millions of emotional cues from the people around her. She says that she would have otherwise had no idea that such a world existed before, because she had always just believed that the way she saw the world was the way the world actually was (sound familiar to all of you out there?).

I thought the hosts had an interesting reaction to her realization that the world was different than she thought it was -- as if maybe she would have been better off not knowing. But she doesn't see it that way at all:

But even though TMS has not changed Kim's ability to see long-term, she says she's still happy she got it. She says she thinks a lot about one of the videos she was shown. In it, two employees were saying mean things to a fellow employee named Frank. And Kim says the first time she watched it before the TMS, she couldn't answer any of the questions the researchers were asking about it. But afterwards, she understood not only the video but also one of the big mysteries that had dominated much of her life.

KIM: It never made any sense to me as to why people would be mean to somebody else. Why would you be mean to somebody? And what I saw is that when the two employees were there and were talking together and then were giving Frank a hard time, the primary thing was not that they were trying to be mean to Frank.

The primary thing is that they were bonding, building a bond between the two of them. And it was simply the means to do it was to be nasty to Frank. And then I was like, oh, maybe that's what these kids were doing when they were bullying me.

SPIEGEL: It's much easier to live in a world which makes sense, where people are mean not just for fun but because they, like everyone else, want to belong and feel safe. Now that's the world that Kim lives in. 

This same phenomenon of bonding over bullying was referenced in the comment I mentioned above:

But I also made the experience, that the team spirit in a group is rising if there is a common "enemy/victim". Well it's at the victims expense but for the rest of the group and their friendships it is something positive... Anyway, I don't know if this phenomenon is also visible in a group consisting of various sociopaths.

The point of the podcast was that everyone has blindspots -- everyone has a certain viewpoint that by its very nature is limited. As much as Kim was blind to emotions and sociopaths are blind to morality, empaths are also blind to the random things they get up to -- like bonding over bullying. The key is to have just a little bit of intellectual humility to admit the possibility that the way you see the world may not be 100% accurate. 

Neurofeedback

I have been putting off writing about this because I wish that I knew more and could tell you more, but I also feel like better something than nothing. This past summer I did a round of 15 sessions of neurofeedback along with a friend who really wanted to try it and wanted sort of a buddy in the process, but also because I have always struggled to fall asleep and stay asleep and this was recommended to me as a potential help. I don't really want to try to describe the process completely or even my experience with it (nor give the impression that I endorse it) but I do want to relate a little of my experience with it.

I first started with a QEEG mapping of my brain, essentially (and forgive my ignorance) where they put a cap on your head are tracking your brain waives with all of these nodes placed in different areas of the scalp. This UCLA professor kind of describes its use in neurofeedback here. One thing that I found incredibly credible about the results was that knowing nothing about me (I never told him about my diagnoses of anything), my practitioner told me, in this very cautious way, "I don't want to alarm you or anything, and this is definitely something that we can see in the "normal" population but it is much more common in the autism spectrum, but your empathy and emotional processing regions have abnormally low functioning. Do you ever feel like you are disconnected from your emotions or other people?"

So even though my primary focus was on sleep, brain efficiency, and perhaps increased creativity (if any of these were possible and I was just making a wishlist), my practitioner became pretty fixated on working on the emotional processing. Sometimes he wouldn't tell me outright that was what he was doing for that particular session, I could just tell from the types of questions he would ask me. Sometimes he told me but said that he thought it was necessary to get that up and running before we targeted other things on my wishlist.

Things I appreciated about the experience:

1. It was a little validating to hear that my brain actually is demonstrably mapped out to be crapped out (at least according to these metrics) when it comes to empathy. 
2. Making the little green boat move with my brain waves while keeping the red and yellow boats still in the little electronic regatta made me realize: (1) my thought patterns are a lot more fixed and beyond my control than I realize and (2) because I consciously process so much information as it comes into my brain, I am less open minded. By the latter I mean that my very mechanism of trying to consciously process as much information as I can rather than letting the subconscious deal with it requires me to quickly categorize the data as being interesting or important or not, and always according to my pre-existing criteria. I've always thought that this made me function higher cognitively because less is getting past me, but I realized that it also has the weird but predictable effect of making me search for familiar patterns and thus be closed minded to truly new things, concepts, or types of information. 
3. Certain sessions (again forgive my ignorance) where he wasn't tracking my brain waves but feeding my brain certain waves could be an absolute trip. Once I felt for all the world like I was on an opiate.
4. I slept really soundly and deeply after almost every session in what felt like deep, restorative sleep. 
5. I did sometimes feel waves of affection or other very strong emotional moments of truth, either during the sessions or in the days between the sessions, that suggested that there is still (for me) a capacity for less muted emotions. 

I didn't continue after 15 sessions because my talk therapist suggested that the problem with the neurofeedback technology and techniques are that the brain changes are there, but that they don't last. Again, I did not do any research to verify that claim, so forgive my ignorance.

Even if the effects did not last, there were certain realizations I made during the process that have lasted. I understand better how my brain takes in raw information and that my most efficient brain processing is not to try to earmark or categorize everything as it is coming in (as I naturally default too now), but rather to try to passively let the information come to me in whatever form it chooses to take -- as if there is a direct tunnel of information from the source straight to my brain and I just need to keep that tunnel clear, not force anything. I realized that I do have strong attachments to my loved ones, even if that feeling of attachment or love does not always seem very accessible to me. My practitioner was also a dabbler in dream interpretations, and I learned that whether or not dreams actually have meaning, there was sometimes useful information to glean from the analysis of my dreams. Maybe I will discuss one particularly clear example in a future post. 

Child sociopath: Early intervention as treatment

Sociopathic children represent a unique quandary for people who love children and hate sociopaths. They are also the most impressionable, which some see as an invitation to target them with attempts at early intervention. From Fox News:

Criminologist Nathalie Fontaine of Indiana University studies the tendency toward being callous and unemotional (CU) in children between 7 and 12 years old. Children with these traits have been shown to have a higher risk of becoming psychopaths as adults.

"We're not suggesting that some children are psychopaths, but CU traits can be used to identify a subgroup of children who are at risk," Fontaine said.

Yet her research showed that these traits aren't fixed, and can change in children as they grow. So if psychologists identify children with these risk factors early on, it may not be too late.

"We can still help them," Fontaine said. "We can implement intervention to support and help children and their families, and we should."

Neuroscientists' understanding of the plasticity, or flexibility, of the brain called neurogenesis supports the idea that many of these brain differences are not fixed.

"Brain research is showing us that neurogenesis can occur even into adulthood," said psychologist Patricia Brennan of Emory University in Atlanta. "Biology isn’t destiny. There are many, many places you can intervene along that developmental pathway to change what's happening in these children."

How do you accomplish this early intervention?

"You don’t have to do direct brain surgery to change the way the brain functions," Brennan said. "You can do social interventions to change that."

Fontaine's studies, for example, suggest that kids who display callous and unemotional traits don't respond as well to traditional parenting and punishment methods such as time-outs. Instead of punishing bad behavior, programs that emphasize rewarding good behavior with positive reinforcement seem to work better.

Raine and his colleagues are also testing whether children who take supplemental pills of omega-3 fatty acids — also known as fish oil — can show improvement. Because this nutrient is thought to be used in cell growth, neuroscientists suspect it can help brain cells grow larger, increase the size of axons (the part of neurons that conducts electrical impulses), and regulate brain cell function.

"We are brain scanning children before and after treatment with omega-3," Raine said. "We are studying kids to see if it can reduce aggressive behavior and improve impaired brain areas. It's a biological treatment, but it's a relatively benign treatment that most people would accept."

I'm conflicted about this news. On the one hand I am reminded of very well-meaning attempts at early intervention for children of first generation immigrants, Romani children, aboriginal children, native children, and other efforts at forced integration and assimilation into the "norm." On the other hand some sociopaths really do suffer immensely. To the extent that these efforts demonstrate society's increasing awareness of sociopaths and desire to cater more carefully to sociopathic needs, e.g. using very consistent incentive schemes instead of punishment to achieve desired behavior, I see it as a step in the right direction.

James Fallon's Life as a Nonviolent Psychopath

I've been meaning to do a post on the Atlantic's interview with James Fallon (Life as a Nonviolent Psychopath) about his new book, "The Psychopath Inside: A Neuroscientist's Personal Journey into the Dark Side of the Brain." Both the book and the article are worth reading in their entirety.

My favorite part in the article was Professor Fallon describing his relationship with his close associates, wife and sister:

I started with simple things of how I interact with my wife, my sister, and my mother. Even though they’ve always been close to me, I don't treat them all that well. I treat strangers pretty well—really well, and people tend to like me when they meet me—but I treat my family the same way, like they're just somebody at a bar. I treat them well, but I don't treat them in a special way. That’s the big problem.

I asked them this—it's not something a person will tell you spontaneously—but they said, "I give you everything. I give you all this love and you really don’t give it back." They all said it, and that sure bothered me. So I wanted to see if I could change. I don't believe it, but I'm going to try.

In order to do that, every time I started to do something, I had to think about it, look at it, and go: No. Don’t do the selfish thing or the self-serving thing. Step-by-step, that's what I’ve been doing for about a year and a half and they all like it. Their basic response is: We know you don’t really mean it, but we still like it.

I told them, "You’ve got to be kidding me. You accept this? It’s phony!" And they said, "No, it’s okay. If you treat people better it means you care enough to try." It blew me away then and still blows me away now. 

My second favorite part was on the possibility of change:

I think people can change if they devote their whole life to the one thing and stop all the other parts of their life, but that's what people can't do. You can have behavioral plasticity and maybe change behavior with parallel brain circuitry, but the number of times this happens is really rare.

Interestingly, I've felt like with my life being somewhat ruined by publishing the book, I have plenty of time now to do this very thing. I'm curious where it will take me.

Other topics include how sociopaths have a Zen Buddhist perspective, the difference between someone who becomes a violent sociopath and someone who does not, how and why treatment of infants and small children is critical to their development, and why sociopathic traits might not really "mature" until the adult brain has matured.

The adaptable brain

If you believe that there is at least some genetic component to sociopathy, is it possible to find a workaround? This recent Oliver Sacks article from the New York Times discusses the incredible adaptability of the brain:

While some areas of the brain are hard-wired from birth or early childhood, other areas — especially in the cerebral cortex, which is central to higher cognitive powers like language and thought, as well as sensory and motor functions — can be, to a remarkable extent, rewired as we grow older. In fact, the brain has an astonishing ability to rebound from damage — even from something as devastating as the loss of sight or hearing. As a physician who treats patients with neurological conditions, I see this happen all the time.

For example, one patient of mine who had been deafened by scarlet fever at the age of 9, was so adept at lip-reading that it was easy to forget she was deaf. Once, without thinking, I turned away from her as I was speaking. “I can no longer hear you,” she said sharply.

“You mean you can no longer see me,” I said.

“You may call it seeing,” she answered, “but I experience it as hearing.”

Lip-reading, seeing mouth movements, was immediately transformed for this patient into “hearing” the sounds of speech in her mind. Her brain was converting one mode of sensation into another.

In a similar way, blind people often find ways of “seeing.” Some areas of the brain, if not stimulated, will atrophy and die. (“Use it or lose it,” neurologists often say.) But the visual areas of the brain, even in someone born blind, do not entirely disappear; instead, they are redeployed for other senses. We have all heard of blind people with unusually acute hearing, but other senses may be heightened, too.
***
The writer Ved Mehta, also blind since early childhood, navigates in large part by using “facial vision” — the ability to sense objects by the way they reflect sounds, or subtly shift the air currents that reach his face. Ben Underwood, a remarkable boy who lost his sight at 3 and died at 16 in 2009, developed an effective, dolphin-like strategy of emitting regular clicks with his mouth and reading the resulting echoes from nearby objects. He was so skilled at this that he could ride a bike and play sports and even video games.

People like Ben Underwood and Ved Mehta, who had some early visual experience but then lost their sight, seem to instantly convert the information they receive from touch or sound into a visual image — “seeing” the dots, for instance, as they read Braille with a finger. Researchers using functional brain imagery have confirmed that in such situations the blind person activates not only the parts of the cortex devoted to touch, but parts of the visual cortex as well.

One does not have to be blind or deaf to tap into the brain’s mysterious and extraordinary power to learn, adapt and grow. I have seen hundreds of patients with various deficits — strokes, Parkinson’s and even dementia — learn to do things in new ways, whether consciously or unconsciously, to work around those deficits.

That the brain is capable of such radical adaptation raises deep questions. To what extent are we shaped by, and to what degree do we shape, our own brains? And can the brain’s ability to change be harnessed to give us greater cognitive powers? The experiences of many people suggest that it can.

Can my brain adapt too?