The other night I was evaluated at a sleep clinic. My snoring has been driving my wife crazy, and she reports that I often snort and gasp myself awake – indicative of sleep apnea, I suppose. So after some considerable foot dragging that went on for years, I succumbed and made an appointment with the help of my primary care physician.

I enjoy a certain amount of fascination regarding medical and health procedures. I am comfortable with visits to my doctor, and I make sure that I get my money’s worth by asking all kinds of questions – some of which have little if anything to do with me or my health. The MD perspective is rather unique and I enjoy picking his or her brain. This sleep clinic experience was going to be uncharted territory for me, and I anticipated storing up nuggets of information.

As luck would have it, I was the only patient that night. The technician was a young guy named Eric, and he was friendly and eager to talk about the process and his work. I knew a fair amount about sleep disorders from my own work, but I quizzed Eric on his experience with sleep walking (I did that a lot in my twenties), sleep terrors (not my experience), sleep paralysis (ditto, and evidently quite terrifying for those who experience it), people who act out their dreams (e.g., start hitting their sleeping partners or try jumping out windows) and the other mundane sleep problems. Turns out that the sleep clinic serves children to people in the 90s. The “average” patient is in his or her 40s or 50s, although anecdotally Eric has been noticing an increase in folks in their 60s and 70s.

I wish I kept track of the number of electrodes attached to me. There had to be twenty of them, and they were attached to my scalp, forehead, near my eyes, on my jaw, neck, behind the ears, and even my legs (to monitor restless leg syndrome). I also had two straps around my chest for measuring heartbeat and breathing. With the exception of these straps that were attached by Velcro, the electrodes involved this gooey paste-like substance. When Eric was done attaching everything to me – and the process took twenty minutes – I looked like something from a science fiction movie.

By Eric finished, the time was approaching 11:00 PM and I was getting pretty tired. Eric asked me to start the night sleeping on my back. Snoring and issues with sleep apnea are more likely to occur when someone is sleeping on his or her back. When you fall asleep, everything relaxes, including your throat and tongue, so there is a tendency for these things (including that thing that hangs down the back of your throat) to collapse. For those individuals who are prone to sleep apnea, the throat collapses entirely – and you stop breathing. At that point, your brain has to make a decision, either remain sleeping or wake up and breathe. The resumption of breathing is the default option, so the sleeper is jolted awake, often with a (loud) snort. The most common patient with sleep apnea is obese with poor health habits, but I don’t fit that description. I’m 6’2” and 170 pounds, and I work out 4-plus days a week. However, my problems seem to be structural… I don’t have much of a chin so stuff is rather tight in that area to begin with. When I doze off, it doesn’t take much for the inner structures to relax and close.

Anyway, I digress. Sleeping on my back, as per Eric’s request, was not going to be a problem. I often start out in that position anyway, so this was no big deal. So, lights out.

I couldn’t fall asleep.

Surprising as it sounds, the wires were not a problem. Rather, I kept thinking I’ve got to fall asleep. If I don’t I’ll screw up the data. So, I talked myself into a mini-frenzy. I wanted to “do well”. I wanted answers. The only way to get answers would be to fall asleep.

The other factor adding to the pressure was that if I met criteria for sleep apnea, Eric would try out a CPAP unit on me. CPAP stands for continuous positive airway pressure. The unit keeps a relaxed airway open by providing a constant flow of air pressure. And, I wanted to see if that would be beneficial for me.

Finally, I feel asleep, but only after turning slightly to my side. Sometime later, Eric asked me via an intercom to turn to my back. I complied, but couldn’t fall asleep again.

This was getting crazy.

Finally, I said the hell with it, and turned to my side, and fell asleep.

There was no clock in the room, so I couldn’t tell the time, but sometime later I vaguely remember Eric appearing and putting a CPAP unit on me. I was thankful, because this meant my breathing data suggested something. I could sense the slightest pressure opening my airway, and I recall thinking the experience was remarkable.

Morning came, and more staff was on duty, including a woman with blue hair. People started giving me feedback about my results, which was surprising given that Eric told me the night before that he couldn’t provide any information. The doctor would be doing that next week.

Suddenly, I hear Eric say, “Okay, Tony, time to wake up.”

I did when he pulled the drapes open slightly to let some light in. He told me it was 6:15 AM. No one else was in the room. No young woman with blue hair. I had been dreaming that part of the whole thing. It was just Eric and me.

I asked him when he came in to put the CPAP on me. He stopped and stared.

“I didn’t.”

I brought my hand to my face. Sure enough, there was nothing there beyond the numerous wires from the night before. I was stunned. I thought I was getting a great CPAP experience.

“You had a very difficult time sleeping on your back.”

I was disappointed. That meant that the results might be inconclusive. My breathing didn’t justify putting on a CPAP. But maybe that was because I didn’t sleep well on my back, and I really had sleep apnea – but they won’t know because I wasn’t a “good” subject. Would they have any answers for me? I don’t know. I won’t meet with the physician later next week.

My poor wife may have to live with a loudly snoring, non-sleep apnea husband. Sigh.

Bullying and The Cold Spot, Part 3

I am continuing my comments on bullying with this blog – but first a thanks to The Cold Spot by J.G. Faherty – the ghost story about bullying which got the whole thing started in the first place.

Some practitioners are troubled with the proliferation of bullying programs in our schools (for instance, see Bully Nation by Susan Eva Porter). Their argument is interesting: we’ve adopted a bully-victim mindset that makes the problem worse and not better. According to this viewpoint, labeling one kid a bully and the other a victim has unfortunate consequences. First, the “bully language” is overly simplified and doesn’t address the nuance of the situation and the kids involved. Second, by being labeled, the kids are assigned and seen as fitting the role – which is very hard to escape. As a result, they are either demonized or pitied, and they cannot learn from experiences and grow from the experiences. For the “victim”, this produces victimhood and does not promote resilience. For the “bully”, there is no chance to reinvent him or herself. Third, labels make all kids the enemy – they are pitted against one another (when really, this is an adult problem in terms of how we should structure environments and deal with problematic behavior). Finally, developing anti-bullying programs, which often have zero-tolerance policies, sets up kids to fail – because kids, being kids, are bound to make mistakes in the future.

The folks who see anti-bullying programs as problematic would like to see the bully-victim language discarded. Instead, the emphasis should be on helping kids who are on the receiving end (I’m trying to avoid the “v-word”) develop resilience. Teaching and developing resilience would involve helping kids learn how to deal with unpleasant situations, develop coping skills, assertiveness skills, social support and communication skills, etc. – anything that would lead to personal growth. For the kids who perpetrate the unwanted behavior (avoiding the “b-word”), a pattern of responding should be set up which insures safety first (for all kids) and includes swift consequences for misbehavior – and consequences which “fit the crime” (this includes clarity of expectations – kids need to know ahead of time what is expected of them, and they need to know that consequences will be applied consistently).  In all cases, adults are there to support the kids, remain calm, and model and demonstrate appropriate problem solving behavior.

The advocates to eliminate or move away from anti-bullying programs raise some interesting points. The methods for dealing with the behavior seem on target to me. I don’t know how well their approach would work in a truly dangerous or intimidating environment, especially with older teenagers. I can report on a case with which I am familiar where a therapist took such an approach in helping a child who was bullied unmercifully. The therapist worked with the child to develop coping skills and resilience skills to address the painful distress and isolation of being a target. The results were phenomenal. This kid came out of the counseling with a stronger sense of self, an awareness of personal strength, an awareness of how to deal with unpleasant people, and a renewed sense of assertiveness. This is not to say that the experience became a “piece of cake”. The kid had to deal with some very difficult things – but that kid dealt with them and matured as a result.  While this success was remarkable, I am not convinced that we should move away from anti-bullying programs. For me, the jury is still out.

All of these thoughts as a result of a horror novella called The Cold Spot… I hope Mr. Faherty is pleased that his work generated these thoughts. Bullying is a very sad and frustrating problem, and he captures the issue in a unique way – within a ghost story and then some.  Whatever the form of the narrative, we need to be constantly reminded of how kids are hurt – and in some cases very deeply – on a daily basis from peers while right under the noses of adults.

Okay, I am continuing my comments on bullying with this blog – but first a thanks to The Cold Spot by J.G. Faherty – the ghost story about bullying which got the whole thing started in the first place.

A number of factors related to bullying often come as a surprise to people. First, kids who do the bullying are not the stereotypical antisocial hoodlums. Very often these kids can move among various roles: bully, popular kid, smart kid, jock, etc. They can be members of multiple groups. Second, they do not bully all of the time, so they have friends and social groups – and, this is interesting, they often report having been bullied as well. Third, while boys tend to engage in more physical bullying than girls, girls are masters at relational aggression (e.g., spreading rumors, excluding a girl from the group, withdrawing friendship).  The intent of this social manipulation is to cause damage to another kid’s social standing or self esteem. When you include both physical and relational aggression into the mix, gender differences between bullying in boys and girls disappears. Regardless, bullying of both forms indicates forms of aggressive behavior that occur within a context of an imbalance of power, are intentionally harmful, and occur repetitively.

The consequences of bullying are tremendous for victims: higher rates of depression, stress, isolation, anxiety, and in some cases suicidal ideation. Peer relationships are disrupted, and the disruption can persist into adulthood with these individuals having difficulty developing and maintaining relationships and trusting others.

Interventions to decrease bullying in school settings generally involve: arranging or altering the environment to minimize the circumstances which allow bullying to occur (this could be as simple as having teachers standing at their classroom doors during class transitions to monitor the hallways), training teachers and other school personnel how to identify and respond quickly if they observe bullying, establishing rules and specific consequences for certain forms of misbehavior or problem behavior which are consistently applied,  and developing a solution-oriented mindset where teachers and staff can share solutions that they have found successful in reducing the problem behavior.

I will continue with how The Cold Spot got me thinking about bullying in the next blog…

We’ve seen some startling examples of the negative impact of bullying on victims: media reports of suicide and attempted suicide by children, adolescents, and young adults in college. In addition, many personal accounts of misery and depression of those victims reach us seemingly daily. Yet, the issue persists, despite many attempts to change the way our schools operate and efforts to change our very cultural attitudes toward bullying.

I was reminded again about the topic of bullying after my recent read of The Cold Spot by J.G. Faherty. I found his use of bullying as a device for framing his horror novel to be rather unique and I enjoyed it immensely. As a psychologist and a professor, I am used to addressing bullying from those professional perspectives. I teach a graduate level course entitled Counseling Children and Adolescents, and one of the favorite topics is bullying. The reason, of course, is that the graduate students in our counseling program who are placed in settings (schools and clinics) where they work with kids often come face to face with this issue. Dealing with bullying is difficult. Circumstances vary across incidents, the situations and kids involved are often quite complex, and people (that is, adults) often don’t know how to address it.

I will continue with a discussion on bullying prompted by reading The Cold Spot in the next blog… 

If you’ve been reading the two previous blogs, I’ve been trying to summarize an article by Mathias Clasen entitled “Monsters Evolve: A Biocultural Approach to Horror Stories” which was published in the Review of General Psychology in 2012. According to Clasen, “Horror stories trigger the evolved danger management systems.” Put another way, Clasen indicates that

“horror fiction capitalizes on cognitive and physiological machinery that is a product of natural selection”

The question remains why many people continue to like horror stories? If horror triggers our danger management systems unnecessarily, why do we seek them out?

Well, here is where it gets a little tricky. More importantly, at least as far as I am concerned, here is where psychology begins to play a huge role. There are two potential explanations:

1.      We can loosely categorize this along demographic lines: Target audiences for horror. In talking demographics, we also end up considering gender roles. The main target of horror movies and the biggest consumers are adolescent boys. Beyond the obvious fact that this group is a little on the goofy end of things to begin with, male adolescents often engage in behavior that has been considered rites of passage. Some of this is culturally sanctioned, other rituals are more informal. Regardless, going to scary movies together and surviving the horror together can be considered a male bonding experience (according to Clasen). “Hey, dude, we survived and we did it together” (although teen boys probably wouldn’t report it in this manner). At the same time, girls tend not to be the market audience, but are often taken to these movies by their dates (the guys who love them – the movies in this case, and maybe the girls). Now, according to Professor Clasen, teen girls like boys who are brave and boys like to reciprocate by being brave (that is, gender appropriate reactions to horror movies). If everything goes according to plan, both parties get their wish – and boys also get to watch a cool movie to boot. According to Clasen, this is known as the snuggle theory of horror. (Please, I’m just reporting his argument).

2.      The second explanation makes more sense to me. Basically, it is this: we vicariously learn how to behave in extremely dangerous situations in the relative safety of a movie theatre or our own homes while reading a book. The situation as portrayed on a screen (or in a book for that matter) is indeed well beyond the norm and highly life threatening – but it is fictional. As a result, we learn how to mentally prepare for and handle unbelievable situations without the risk. This process has its parallel in childhood play. Kids act out practical strategies of survival in all kinds of games and activities. Pretend play is fun and pleasurable – and kids are vicariously learning all kinds of behaviors which are applicable to real life in years to come: problem solving, negotiating, self-control, assertiveness, physical safety responses and so on.

To put it simply, enjoying horror stories allows us to practice survival strategies and to form bonds with other survivors – all within very low-risk situations. As Clasen states, consuming horror is adaptive – we learn new skills for survival and practice and rehearse them in thrilling and uncanny encounters that aren’t real. How cool is that?

What about the people who don’t like horror? Well, I suppose they’ll be relying on us to keep them safe during the upcoming apocalypse. It’ll be annoying, but what the heck – everyone will get a chance to snuggle.

Clasen, M. (2012). Monsters evolve: A biocultural approach to horror stories. Review of General Psychology, 16, 222-229.

I’ve been talking about an article by Mathias Clasen entitled “Monsters Evolve: A Biocultural Approach to Horror Stories” which was published in the Review of General Psychology in 2012. In the previous blog, I summarized Clasen’s model that fear and anxiety are evolutionary adaptations to dangerous environments – these are the very emotions that help us deal with dangers… and they served our ancestors well.

This “threat-detection and handling system” has been deeply ingrained in our nervous system over hundreds of thousands of years (or however long we’ve been at this thing).  Professor Clasen says it far better than I can: “Human attention is preferentially engaged by evolutionary recurrent, fear-relevant stimuli”.  So, we’re wired to be frightened by snakes, large animals with fangs, and so on. Some psychologists also suspect we’re hard wired to fear being judged negatively by others. For our unlucky ancestors, being judged unworthy meant banishment from the clan or tribe. Banishment, in turn, meant death. Today, this fear translates into other modern fears of being judged negatively: public speaking, social anxiety, dating anxiety.

All by way of saying, we are preprogrammed to display emotional states of fear and anxiety to certain stimuli, because this reaction faired our ancestors well. However, we can’t go around with this vague response without it being adapted for our current culture. Therefore, the management system is constantly subjected to shaping and refinement to fit the local environment.

Now, as you may have guessed, horror stories fit nicely into threat-detection system. Monsters ghosts, serial killers, zombies, werewolves, vampires all qualify as something that we should react to in order to save our lives. Our reaction is unproductive, however, because books and movies are not a major threat to our survival. However, we have the reaction, the jolt anyway, and get to laugh about it later because, after all, we survived and that really couldn’t happen to us.  (By the way, versions of these monsters have been around forever. So, they are part of our psyche – whether they exist or not. We are on the lookout for these things – we’re programmed to do it…)

More on this topic in the next blog…

Why is there a market for horror? Why does a segment of the population gleefully submit themselves voluntarily to books and movies which are designed to frighten and unnerve them?

Why do educated people fall for this stuff?

I recently read a scholarly article by Mathias Clasen entitled “Monsters Evolve: A Biocultural Approach to Horror Stories” which was published in the Review of General Psychology in 2012. (Full disclosure: I became aware of this article from the web site “This is Horror” which was citing a blog by the Huffington Post-UK which in turn was citing the Clasen article. Got that?) In this article, Professor Clasen attempts to answer these very questions, and I must say he does so in a most fascinating manner. I was rather skeptical before reading the piece; only because I expected some regurgitated psychobabble we’ve seen many times in the past on this topic. I was pleasantly surprised.

Professor Clasen posits a biocultural model whereby our reaction to and fascination with horror stories is the result of an evolutionary process combined with cultural adaptation. Let me try and summarize some of the main points:

According to Professor Clasen, we have a cognitive “architecture” designed for the management of danger. Our own evolution involved developing various adaptive survival strategies to cope with and survive threatening situations. Those strategies that weren’t helpful died out with our unlucky ancestors who died trying to use them.

As result of human evolution and evolutionary psychology, all of us are born with a wide range of adaptive strategies designed to help us survive and surmount a wide range of dangers. In simplest terms, we are all aware of the nearly instantaneous a flight or fight response at the slightest hint of danger.

The flight or fight response served our ancestors well when a rustling sound in the nearby bushes could be a saber-toothed tiger or an angry mammoth. Of course, these same reactions are less helpful today – we often don’t face life or death fears like our ancestors did at a moment’s notice. Nonetheless, we still have these intense reactions, and typically in the face of considerably milder dangers or no danger at all (for instance, in anticipation of giving a speech, taking a test, being alone, unhappy with our physical appearance). Unfortunately, these very reactions are the physiological basis of anxiety disorders – when we perceive threat and danger in harmless situations and react with fear and avoidance.

So, what has all of this to do with horror stories? Well the best is yet to come. Sadly, I’ve gone on much too long. I will resume this discussion in the next blog.