Teen Driving Risks
I have been very concerned about the burgeoning evidence of the dangers of being distracted while driving.
My concerns have been buttressed by a new report.
A national survey
of more than 5,600 high school students conducted by an alliance
between The Children’s Hospital of Philadelphia and State Farm
Insurance Companies indicates that high school students are routinely driving under highly
dangerous conditions.
Teens who participated in the study say they routinely drive while fatigued and while talking on cell
phones, and that they let strong emotions cloud their judgment. Many also admitted that they are not wearing seatbelts.
The National Teen Driver Survey represents 10.6 million 9th, 10th, and 11th grade students in U.S. public high schools.
The survey results are available as a downloadable report on Keeping Young Drivers Safe,
a new Web site for parents and educators from the Children’s Hospital
of Philadelphia/State Farm alliance. The site is packed with practical
information on developing a plan that will enable new drivers to
develop the skills and habits they need to stay safe.
You can also visit the site at www.chop.edu/youngdrivers, where you will find information on working with a new driver to set goals and
rules; developing a timeline for parent-guided driving lessons; and
developing a parent/teen driving agreement.
Why is Laughter Infectious?
When I was a very young student Monty Python’s Flying Circus was being shown on TV for the first time. The TV room in the halls of residence would normally be home to one or two sleeping stalwarts. But on Monty P. nights we would have seventy or eighty of us crammed into a small room: the sharing of laughter made the whole show ten times funnier.
I think that we’ve all had the experience of infectious laughter. It’s easy enough to see that it can be a social lubricant. But how does it work?
We have known for some time that when we are talking to someone, we often mirror their behavior, copying the words they use and mimicking their gestures. You may know that deliberately copying other people is a technique that we use when we are trying to influence others. It has seemed likely that the same applies to laughter.
Researchers at University College and Imperial College in London have shown that positive sounds such as laughter or a rousing and triumphant “woo hoo!” trigger a response in the listener’s brain. This response occurs in the regions of the brain that are activated when we smile, as though preparing our facial muscles to laugh. The research, funded by the Wellcome Trust, Action Medical Research and the Barnwood House Trust, is published in the Journal of Neuroscience.
The research team played a series sounds to volunteers whilst measuring their brain’s response using an fMRI scanner. Some of the sounds were positive, such as laughter or the triumphant woo hoo’s, while others were distinctly unpleasant, such as screaming or retching. All of the sounds triggered a response in the volunteer’s brain in the region of the premotor cortex. This is part of the brain that prepares the facial muscles to respond to emotion. The response was greater for positive sounds, suggesting that these were more contagious than negative sounds. The researchers believe that this explains why we respond to laughter or cheering with an involuntary smile.
When we are in a group and encounter positive emotions, the brain responds by automatically priming us to smile or laugh. This gives us a way of mirroring the behavior of others, which in turn helps our social interactions. Presumably it plays an important role in building strong bonds between individuals in a group.
There is a global movement which started in India called the laughter clubs, in which people get together to have a really good belly laugh. It has been claimed that these group giggles reduce the chance of developing depression. The data is not good, but there’s one thing for sure: it’s unlikely to cause you much harm.
“Laugh and the world laughs with you; cry and you cry alone.”
–Horace (a.k.a. Quintus Horatius Flaccus, Roman Poet and Satirist, 65-8 B.C.E.)
“What a force is laughter.”
–Alexander Solzhenitsyn (Russian Writer and, in 1970, Winner of the Nobel Prize in Literature, 1918-)
“The arrival in town of a good clown is of more benefit to the people than the arrival of 20 asses laden with medicine.”
–Thomas Sydenham (English Physician and a Founder of Modern Clinical Medicine and Epidemiology, 1624-1689)
The Seat of the Emotions and the Gateway to Reason
“If passion drives, let reason hold the reins.”
–Benjamin Franklin (American Author, Inventor and Diplomat, 1706-1790)
For many centuries reason and emotion have usually been held to be two poles of a magnet, the North and South of the psyche. Every now and then someone has proposed some other psychological lodestone, but most have finally devolved into this simple binary model.
Yet a moment’s introspection shows us that reason and emotion are inextricably linked. We know from people with alexithymia and a dizzying array of “personality disorders,” that a real-life Mr. Spock would be a hobbled creature. Yet we also know that simple binary models of pleasure and pain as the drivers or behavior are over simplified. It appears that one of the great attainments of many mammalian species – and who knows how many others – is an ability to be moved by more complex considerations of loyalty, propriety and even morality.
There is an important study in this month’s issue of the Journal of Neuroscience. The amygdala is a central processing station in the brain for emotions and is involved in laying down emotional memories. A shock or extreme pleasure may both leave their traces in the amygdala, so it plays a key role in survival.
But this new research shows that the amygdala also plays a role in working memory, a higher cognitive function that is critical for reasoning and problem solving. If you ask someone for a telephone number and you instantly dial the number and then forget it, that is working memory in action. If you choose to remember the number for later, it moves out of working memory into longer term memory stores. In some senses working “memory” is a little bit of a misnomer: it is a function that enables us to manipulate information extremely rapidly.
In two different functional magnetic resonance imaging (fMRI) studies with a total of 74 participants, individual differences in amygdala activity predicted behavioral performance on a working memory task. The experimental subjects were asked to look either at words, such as rooster, elbow, and steel, or faces of attractive men and women. Then they were asked to indicate whether or not the current word or image matched the one they saw three frames earlier. Try it for yourself, and you will see that this is quite challenging. The subjects’ brains were scanned while completing the tasks.
People with stronger amygdala responses during the working memory task also had faster response times.
This is exceptionally important for anyone interested in thinking and learning: it shows that a region of the brain thought to be involved primarily, or perhaps even exclusively, in processing emotions is also involved in higher cognition, even when there is no emotional content.
I think it most likely that the amygdala may be involved in vigilance, perhaps preparing people to better cope with challenging situations and also improving their ability to sort information according to its relevance to the current situation. This is something that people with poor resilience find hard to do, so it may be that the amygdala is involved in developing and maintaining resilience.
This study helps to prove the total inter-relatedness of emotion and cognition and supports learning strategies that are based upon integrating emotion with facts. One of the ways in which health care students are able to remember enormous numbers of facts is by attaching them to patients with whom they have worked. Emotion, interest and empathy can dramatically accelerate learning.
Alexithymia
There is an important psychological symptom that can cause a great deal of distress, particularly in relationships. It is called alexithymia.
The Harvard psychiatrist Peter Sifneos originally coined the term in 1972 to describe people who had extreme difficulty in emotional cognition. The word “alexithymia” literally means “no words for mood.” People with this problem lacked the ability to understanding, processing or describing their feelings verbally. As a result, most people who have the problem are largely unaware of their own feelings or what they signify. As a result they only rarely talk about their emotions or their emotional preferences, and they are largely unable to use their feelings or imagination to focus and fuel their drives and motivations.
People with alexithymia seem unable to fantasize and many report multiple somatic symptoms. However, alexithymia is also associated with a number of other complaints, such as hypertension, irritable bowel syndrome, substance use disorders, and some anxiety disorders. Their speech is often concrete, mundane and closely tied to external events. So they will describe physical symptoms rather than emotions, and don’t understand that their bodily sensations are signals of emotional distress.
Alexithymia lies on spectrum: regular readers will remember some of our discussions about categorical and dimensional diagnoses. For some people it is little more than an inability to get in touch with their emotions. But at the other end of the spectrum are a number of illnesses in which alexithymia may occur, including schizoid personality disorder, posttraumatic stress disorder, anorexia nervosa or Asperger’s syndrome. It is also much more common in victims of trauma.
Much has been written about alexithymia: a literature search earlier today generated over 8,500 publications.
It is still not clear what causes alexithymia. But this much is clear: in some people, there is a strong inborn predisposition to developing it, while in others it can develop in response to life events such as being raised in a low socioeconomic group with little social stimulation, trauma or chronic stress. For this reason we often talk about primary and secondary alexithymia.
Some neuropsychological studies have indicated that alexithymia may be due to a disturbance to the right hemisphere of the brain, which usually plays a predominant role in processing emotions. Other studies show evidence that there may be a deficit in the transmission of information between the hemispheres of the brain, with emotional information from the right hemisphere not being properly transferred to the language regions in the left hemisphere. Other studies have suggested that alexithymia may be related to a dysfunction of the anterior cingulate cortex a region of the brain involved in the control of attention, empathy, emotion and the anticipation of rewards.
Alexithymia can have some serious consequences. Apart from making relationships very difficult, it is more common in people who have near-fatal asthma attacks or have poor diabetic control. People with a history of alcohol abuse who have alexithymia are more likely to relapse. Alexithymia may predispose people to developing the insulin resistance syndrome.
As you can see, alexithymia can be dangerous: we have to have words for our feelings, or the feelings will express themselves though our bodies. It can predispose us to just about every stress-related illness, and even some illnesses that we don’t normally think of as stress-related. Since alexithymia is all about an ability to express emotions, it can be thought of as a social or informational disease. If we cannot inform others about our wants and needs, and if our minds cannot send us signals to say that something is going wrong, there could be a catastrophe lying in wait for us.
People with extreme forms of alexithymia can be very difficult to help using conventional medicine.
However, many people have minor degrees of alexithymia, and these can be helped by therapies designed to help them express emotions:
- First is to become aware of the problem: I’ve had good success with asking people to keep an emotions “log book:” if they are having odd symptoms, how good are they about having appropriate emotions? I ask them to keep a note of their emotions in response to normal interactions with other people, or while watching television or a movie. If the person feels nothing while watching something really emotional, that can help him or her see that there is a problem. Simply learning to be more expressive can help mild cases: there are an array of forms of psychotherapy that can help.
- In mild cases, we have had some good results with flower essences. There’s not a shred of scientific proof that they help, but clinically they often do. The same goes for two other helpful approaches:
- Homeopathy: there are over a dozen remedies that may help
- Tapping therapies
Attention Deficit Disorder and Executive Functioning
“Not to have control over the senses is like sailing in a rudderless ship, bound to break to pieces on coming in contact with the very first rock.”
–Mahatma Gandhi (Indian Nationalist and World Teacher, 1869-1948)
The Mahatma’s statement could apply to most people stuggling with attention deficit disorder.
There is an important idea in neurology and psychology called “Executive functioning.” This refers to our ability to be able to make and carry out plans, direct our attention, focus and also to control our internal states: our impulses and emotions and to be able to switch from one task to another. In other words it is a key part of our ability to self-regulate our behavior, mind and emotions.
Most evidence now indicates that executive function is mediated by the regions of the dorsolateral prefrontal cortex. It happens that these same regions are amongst those that seem to undergo beneficial changes in people who practice meditation.
For people interested in attention deficit disorder, I’d like to recommend a book, “Attention Deficit Disorder: The Unfocused Mind in Children and Adults,” by Thomas E. Brown. In the book he encapsulates some up-to-date research indicating that one way of conceptualizing some of the difficulties faced by people with attention deficit disorder, is to break them down into the six major “domains” of executive functioning:
- Activation: Organizing, prioritizing and getting to school or work
- Focus: Tuning in, maintaining focus and shifting attention
- Effort: Sustaining effort, regulating alertness and adjusting processing speed
- Emotions: Modulating emotions and managing frustration
- Memory: Holding and manipulating information and retrieving memories
- Action: Monitoring and regulating actions
It can be very helpful for people to understand why they face the problems that they do, and how each may be amenable to a different type of help.
What we have done below is to re-draw and slightly simplify an extremely helpful diagram from Dr. Brown’s book, that will make it easier for you to see that kind of problems you or a loved one may be facing, and how treatment and coping strategies will be directed toward whichever of these is causing the most trouble in a person’s life.
(You can click on the diagram to see a large version of it.)
Women, Asthma and the Brain
There’s been a longstanding puzzle in medicine. Well actually there are lots of them, but here’s one that may be a puzzle no more.
For many years now, it’s been known that asthma is more common in women, and also that psychological stress can cause flare ups of asthma.
Many women experience “menstrual flaring:” a worsening of asthma around the time of their menstrual period. There is also a strange paradox: some women with asthma wheeze less if they take an oral contraceptive, while some non-asthmatic women begin to wheeze when they take it. In some women pregnancy makes asthma worse, and in others it affords months of relief of symptoms. Women who are obese are more likely to get asthma, presumably because their intra-abdominal fat stores are churning out inflammatory mediators.
Researchers from the University of Wisconsin have shed some important light on this link between asthma and the brain. In research published in the Proceedings of the National Academy of Sciences. In the study, six patients with mild asthma were exposed to ragweed or dust-mite extracts. The subjects were shown three different categories of words: asthma-related (e.g., "wheeze"), non-asthma negative ("loneliness") or neutral ("curtains").
Using functional magnetic resonance imaging, they showed that activity in two regions, known as the anterior cingulate cortex and the insula showed increased activity when the asthma-related words were heard compared with the other types. What is more, this enhanced activity was specifically linked to physiologic signals from the ragweed and dust-mite extracts. So being exposed to asthma-relevant emotional stimuli is associated with markers of inflammation and airway obstruction in asthmatic people exposed to an asthma-producing antigen.
In people with asthma and other stress-related conditions, these brain regions may be hyper-responsive to disease-specific emotional and physiologic signals. Taken together, these could contribute to problems that worsen the asthma, such as inflammation.
And one of the ways of making these regions of the brain hyper-responsive? Bathe them in estrogen.
That still does not explain why pregnancy and the oral contraceptive makes some women’s asthma better, and does the opposite in others. But it may just have to do with the “set point” of the cells in these regions of the brain. In the same way that we might set the thermostat in out house. An already hyper-responsive brain might be normalized and an under-active one stimulated to be over-active.
We need to do some more experiments, but these are a great start.
If you ever wheeze, have a look to see if there are stressors or hormonal events that trigger you. Whether you are being treated with homeopathy, herbals or conventional therapy, knowing when to expect trouble gives you the power to adapt you treatment when you are entering a risky time in your life.
Cutting and Self-injury
There’s an extremely disturbing trend: ever-increasing numbers of young people who are cutting themselves. Once rare, and something usually seen only in people with serious psychiatric illness, many school children encourage and goad each other into doing it, and there are websites dedicated to cutting, on which young people compare notes and even give each other advice on how to conceal what they are doing, by cutting themselves in places like the lower back.
We have been offered a great many explanations for this worrying development, but not much in the way of evidence. We know that most people who cut themselves are female adolescents or young adults, and apart from the obvious physical dangers, there is evidence that this behavior may lead to a more serious psychological condition called Borderline Personality Disorder. This can be a serious problem that carries a high risk of suicide. It is also of some theoretical interest, because there seem to be genuine cultural differences in borderline personality disorder. An estimated 5.8 million to 8.7 million Americans, mostly women, suffer from it, but it is far less common in most of Western Europe and Australia. Research over the last decade has indicated that the condition is becoming more common in these regions. People with the borderline personality disorder have a wide spectrum of difficulties that are marked by emotional instability, difficulty in maintaining close relationships, eating disorders, impulsivity, chronic uncertainty about life goals and addictive behaviors such as using drugs and alcohol. They also have major impact on the medical system by being among the highest users of emergency and in-patient medical services. Glen Close’s character Alex Forrest in the movie Fatal Attraction, had some of the features that we might expect in some with borderline personality disorder.
Researchers from the University of Washington in Seattle have reported that adolescent girls who engage in cutting behavior have lower levels of the chemical transmitter serotonin in their blood. They also have reduced levels of activity in the parasympathetic nervous system as measured by what is called respiratory sinus arrhythmia, a measure of the ebb and flow of heart rate as we breath. Low levels of this measure are typically found in people who are anxious or depressed. The study included 23 girls aged 14 to 18, who engaged in what psychologists call “parasuicidal” behavior. Participants were included if they had engaged in three or more self-harming behaviors in the previous six months or five or more such behaviors in their lifetime. The comparison group consisted of an equal number of girls of the same ages who did not engage in this behavior.
In line with previous research, the adolescents in the parasuicide group reported far more incidents of self-harming behavior than did their parents.
The findings of low serotonin and low parasympathetic activity support the idea that the inability to regulate emotions and impulsivity can trigger self-harming behavior. The primary problem is an inability to manage their emotions: the people who cut themselves have excessively strong emotional reactions and they have extreme difficulty in controlling those emotions. Their self-harming behavior may serve to distract them from these emotions.
A characteristic feature of borderline personality disorder is not just self-injurious behavior but also stress-induced reduction of pain perception. Reduced pain sensitivity has been experimentally confirmed in patients with the condition. The increasing incidence of the condition in Europe is attracting many European investigators and colleagues from Mannheim in Germany have recently traced the neurological circuits involved in this stress-induced reduced pain perception.
There is good evidence that people who cut themselves are more likely to have been victims of sexual abuse or violence as children, though that obviously does not mean that every person who harms themselves has had something bad happen to them in childhood. Sadly the research has become more complex because of the numbers of people who have been given false memories of abuse by well-meaning psychologists.
Treating people who cut themselves, whether or not they have borderline personality disorder can be very challenging. The first thing is to treat any underlying mood or anxiety disorder. A combination of medications and psychotherapy is normally used, with people making claims for the value of different types of therapy. Many therapists also say that they have helped people who cut themselves with tapping therapies, acupuncture, homeopathy and qigong. I’ve not been able to find any credible research evidence to support the use of those therapies, though I’ve also seen some success stories.
We also have the puzzle about why cutting and borderline personality disorder seems to have been less common in other parts of the world and are now increasing. There is research to show that it’s not just a matter of recognition or of calling the illness something else in Europe. I have a friend who is a senior academic at an Ivy League University, and an expert on borderline personality disorder. During a sabbatical in Scotland some 15 years ago, he could not find a single case. This matters, because if we can identify what’s changed, we may have some clues about treatment. There are hundreds of candidates, including environmental stress, diet and toxins.
There’s an important new study in which 13 children with autism showed marked improvement in some of their challenging behaviors when they were given 1.5gms of omega-3 fatty acids each day. This was only a six week study, but it needs to be replicated using larger numbers. It is also important to be alert to the possibility that some makes of omega-3 fatty acids on the market contain mercury. The one that we have found best so far has been OmegaBrite. http://www.omegabrite.com/ It will also be useful to see if dietary supplementation will help self-injurious behavior in other types of people.
Here is a list of some of the better information sites about self-harm.
The key to success with helping complex problems, as I point out in great detail in Healing, Meaning and Purpose, is a comprehensive approach:
Combinations are Key
Heroes and Villains
“Nothing is as infectious as example.”
–François Duc de la Rochefoucauld (French Writer and Moralist, 1613-1680)
I was just expecting to learn something about what’s been going on in the world today, when I came across this excellent blog item by Chess Grandmaster Susan Polgar.
Just have a look at this extraordinary video.
What amazed me just as much as the video, was that one of the commentators on Susan’s blog defended the action of the adult, on the grounds that the assaulted child had played a foul, saying, "As a parent, how easy would you find it to stand by if that happened to your kid?"
The answer to that should be, "Very easy indeed."
Adults are supposed to have some modicum of self-control.
Adults also have a responsibility to model good behavior, not just for their own children, but for all other children as well.
It reminded me of the quotation:
"If you can’t be a good example, then you’ll just have to be a horrible warning."
–Catherine Aird (a.k.a. Kinn Hamilton McIntosh, English Writer and Creator of “Inspector Sloan”, 1930-)
I’ve been involved in competitive games for most of my life, and of course they can inflame emotions. But it is how we act on those emotions that matters. I used to have an excellent chess coach named Craig Jones. He has done a lot for scholastic chess, and I remember being horrified by the antics of some parents at chess tournaments. Those scenes from the movie Searching for Bobby Fischer are not an exaggeration.
Being a victim of your emotions is bad enough. Being a lousy role model is the worst kind of irresponsibility.
I actually prefer another term to "role models." I call them heroes. And the opposite of a hero is, I suppose, a villain.
“Young people need models, not critics…”
–John Wooden (American Basketball Coach, 1910-_
Re-Writing Our Life Stories and Developing Resilience
“Every man’s story is important, eternal and sacred.”
–Herman Hesse (German-born Swiss Novelist, Poet and, in 1946, Winner of the Nobel Prize for Literature, 1877-1962)
In Healing, Meaning and Purpose, I spend a lot of time discussing the nature of memory – that it does not work like a video recorder, but is a dynamic process – and the value of re-writing your life story. This is a remarkably powerful technique.
What is particularly interesting and useful is to uncover events in our lives that have had two characteristics. First, is that they had a strong subjective impact. And second, that they generated meaning. Breaking up with a partner might generate a lot of emotion and lead you to believe that you are not good in relationships or it could make you think that the other person didn’t appreciate you. Losing a game of football may be painful, but will likely not generate much meaning. Unless your team is on a thirty game losing streak….
A recent study from Quebec published in the Journal of Personality, studied events that we use to define ourselves. Researchers looked at the subjective impact and the meaning-making effect of these self-defining events. This is what they found. When we remember events in our lives that we feel had a major impact on our life story or on our sense of identity, we tend to downplay the negative and emphasize the positive.
When we are asked to think back to those events, we tend to report less sadness and more pride than we actually felt at the time. For positive memories, people reported equally intense positive emotions – for example love – and less negative emotions – such as fear – compared with how they recalled feeling at the time.
What this means is that in the face of change, adversity and opportunity, we are always trying to maintain a positive and coherent sense of self. This is a component of psychological resilience. Someone with clinical depression loses the ability to maintain this positive and coherent sense of self.
This work is also important for people trying to fashion a more positive view of him or herself. While it is usually a good idea to cultivate a positive mental attitude, there are some people for whom such an approach can be disastrous: they are the ones who thrive on negativity. Which one are you?
Simply deciding to change your view of yourself will likely have only a very short-term effect unless you identify and work with cardinal life events. Some forms of psychotherapy revolve around trying to identify the key events that have fashioned our sense of self and that have contributed to our identity. You can begin that process for yourself.
But that is only one part of the equation.
Any long-term change will also involve the attitudes and expectations of other people: none of us lives in a vacuum. I have known countless supremely self-confident musicians, artists and even scientists, whose careers have never got started, because nobody agreed with their evaluation of themselves.
There are a number of ways of presenting yourself in a way that will inspire confidence in other people, and I shall discuss some of those in one of my future programs.
“Every story can be told in different ways.”
–Greek Proverb
Technorati tags: Memory Resilience Story
