Richard G. Petty, MD

Men, Women and Forgiveness

We recently discussed the importance of forgiveness on health. Over the years studies have shown that men tend to be more vengeful than women, presumably because they have been taught from childhood to empathize with others and build relationships. Though there could yet be a biological basis for this difference.

New data from Case Western Reserve University, Florida State University, Arizona State and Hope College published in the Journal of Personality and Social Psychology suggests that forgiveness does not come naturally for both sexes. Psychologist Julie Juola Exline’s research indicates that men have a harder time forgiving than women do. However that can change if men develop empathy toward an offender by seeing they may also be capable of similar actions. That empathy closes the gender gap and men become less vengeful.

The authors conducted seven forgiveness-related studies (1,2,3,4,5,6,7) between 1998 and 2005 that involved more than1,400 college students: Gender differences have been a robust finding.

The studies used hypothetical situations, actual recalled offenses, individual and group situations and surveys to study the ability to forgive. When men were asked to recall offenses they had committed themselves, they became less vengeful toward people who had offended them. Women started at a lower baseline for vengeance, but thinking about their own transgressions had no effect on levels of unforgiving. When women were asked to recall a similar offense in relation to the other's offense, women felt guilty and tended to magnify the other's offense.

The researchers found that people of both genders are more forgiving when they see themselves as capable of committing a similar action; it tends to make the offense seem smaller and increases empathic understanding of the offense. Therefore people similar to the offenders and therefore more forgiving attitudes.

The ability to identify with the offender and forgive also happens in intergroup conflicts. In a study on forgiveness of the 9/11 terrorists Exline comments that,

"When people could envision their own government committing acts similar to those of the terrorists, they were less vengeful. For example, they were less likely to believe that perpetrators should be killed on the spot or given the death penalty, and they were more supportive of negotiations and economic aid."

It is not difficult to see that prosecution and defense attorneys are going to study this data carefully. It will likely come into play during jury selection processes.

And I am going to think about it the next time that I am called upon to serve on a medical school interview board.


“An eye for an eye will only serve to make the whole world blind.”
--Mahatma Gandhi (Indian Nationalist and World Teacher, 1869-1948)

“And be ye kind one to another, tenderhearted, forgiving one another, even as God, for Christ’s sake, hath forgiven you.”
--The Bible (Ephesians 4:32)

“Everyone and everything I see will lean toward me and bless me. I will recognize in everyone my dearest friend. What could there be to fear in a world that I have forgiven, that has forgiven me?”
--A Course in Miracles (Book of Spiritual Principles Scribed by Dr. Helen Schucman between 1965 and 1975, and First Published in 1976)

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)

Altruism and the Brain

There is a fascinating new study which will be out next month in the journal Nature.

Colleagues from Duke University Medical Center in Durham, North Carolina, believe that they have found a region of the brain that is associated with altruism: selfless concern for the well-being of others.

Some scientists have claimed that it is of no value because it has no survival advantage. I've never been able to agree with that extreme position. Another view is that the survival advantage comes from an ability to perceive the intention of others and therefore to anticipate their actions. I'm also not certain that this is genuine altruism, in the sense that altruism should be selfless.

45 volunteers were asked to play a computer game and also to watch the computer play the game. In some instances successful completion of the game resulted in the volunteers winning money for themselves, and in other instances it resulted in money being donated to a charity that each person had chosen at the beginning of the experiment. During these games the researchers took functional magnetic resonance imaging (fMRI) scans of the participants' brains.

According to the old fashioned - and false - theory that pleasure and pain are THE main drivers of behavior, it was assumed that altruistic acts would activate the reward systems in the brain.

They do not.

A region of the brain called the posterior superior temporal cortex (pSTC) is activated by altruism and is very sensitive to the difference between doing something for personal gain and doing it for someone else's gain. The pSTC appears to help us tune into perceiving and giving meaning to the actions of others. It is not focused on reward.

In the next stage of the research the participants were asked questions about the type and frequency of their altruistic or helping behaviors. The researchers then analyzed the responses to generate an estimate of a person's tendency to act altruistically and compared each person's level against their fMRI brain scan. The results showed that pSTC activity rose in proportion to a person's estimated level of altruism. Note that it was their estimated level rather than their actual altruistic acts.

The suggestion by the researchers is that the ability to perceive other people's actions as meaningful is critical for altruism.

I am going to be a Devil's advocate and interpret the data differently. I think it more likely that people who have a good understanding of social relationships are more likely to do things for other people. Helping other just makes sense to you. Both the tests and the imaging could be interpreted in terms of social understanding and empathy. In other words we are looking at an aspect of social cognition.

There may also be another correlation here. Some years ago we showed that in people with chronic schizophrenia there is a shift in the handedness of a particular region of the brain called the planum temporale, which lies on the top of the temporal lobe. This lead to the hypothesis that when people are hearing voices, they really are hearing something being generated in the right hemisphere of the brain. People with schizophrenia sometimes have trouble with reading other people's intentions and may attach meaning to random events. This new research mat help us understand why that can happen.

It also makes clinical sense: the best ways of helping people with mental illness who have these problems is to ensure that they are not on medicines that impair their social cognition, and to use social skills training.

“What we have done for ourselves alone dies with us; what we have done for others and the world remains and is immortal.”
--Albert Pike (American Lawyer, Masonic Author and Historian, 1809-1891)

“Spiritual energy flows in thankfulness and produces effects on the phenomenal world.”
--William James (American Psychologist and Philosopher, 1842-1910)

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.

Lassie and the Shepherd

On the same day that I read some research purporting to show that dogs aren’t much good at sounding the alarm if a human is in trouble, I also read about a Scottish shepherd who collapsed after having a stroke while herding his flock. His two sheepdogs, Border Collies - surely the smartest dogs in the world - kept him warm overnight as he lay in a field. The following morning he was found by helicopter rescuers after one of the dogs ran around trying to catch their attention.

The research ended by saying that Lassie would probably have left Jimmy in the well.

But I’m not so sure. When I’m not traveling, I’m around animals all day long. They all have their personalities: they have their favorite other animals, their favorite – and least favorite – humans, as well as a clear sense of propriety. If one of the clan gets attention, then they all expect equal amounts of talking to, petting and generally being made a fuss over. They are all very good barometers of the character of the people whom they meet.

Some people come to the house and the dog and the cats are all over them like a nasty rash. With others they keep their distance or avoid them altogether.

If they like you they will do anything for you in their own feline, canine or equine ways. If you are not on their most favored humans list, they probably wouldn’t cross the road to spit on you if you were on fire.

I don’t see any evidence in the research that the dogs’ subjective feelings were taken into account.

It’s a safe bet that the Scottish shepherd loved those dogs like his own children and they probably reciprocated. You have to fabricate some really creative explanations as to why two dogs would stay out in the perishing cold with their human when they could have just taken off and found themselves a warm place for the night.

And as for my comment about the intelligence of Border Collies? You may have heard the jokes about how many dogs it takes to change a light bulb:

Golden Retriever:
 The sun is shining, the day is young, we've got our whole lives ahead of us, and you're inside worrying about a stupid burned out bulb?


Poodle: I'll just blow in the Border Collie's ear and he'll do it. By the time he finishes rewiring the house, my nails will be dry.


Border Collie: Just me. And while I’m here I’ll make sure that your entire wiring is up to code.

Your Mind and Your Brain Know the Difference Between the Real and the Imagined

I have just seen a psychologist do a spot on television where, in the middle of some otherwise great advice, she repeated a well-known piece of nonsense: “Your brain can’t tell the difference between organizing your closets and organizing to prepare for a disaster.” This notion that the brain and the mind react the same way to real and imagined events has launched hundreds of self-help programs, but is dead wrong.

We have loads of evidence that the brain is extremely good at telling the difference between an image in external space and something that you are visualizing in your mind’s eye. Your brain wouldn’t be much good to you if it couldn’t tell the difference between an imagined event and the real thing!

Here’s just one example from many. I’ve written about empathy before: a crucial attribute for healthy functioning. There has been a debate going on for many years now: how can you put yourself into some one else’s shoes? Does it somehow involve merging our own view of the world with someone else’s? A new study sheds important light on this topic.

When you are empathizing with someone you can imagine how they perceive a situation and the feelings that they experience as a result. When you imagine someone else’s pain, is it the same as imagining pain on oneself? Many of us become quite emotional when we hear about something sad, but is the genesis of the emotion the same as it would be if something sad is happening to us? These experiments used functional magnetic resonance and participants were shown pictures of people with their hands or feet in painful or non-painful situations and instructed to imagine and rate the level of pain perceived from different perspectives. These results show that imagining someone else’s discomfort or one’s own, activated different regions in the brain. People did not somehow merge themselves with their image of the other person.

That makes good sense: we need to be able to keep ourselves separate from other people, until we have gained a high degree of internal control. I have known dozens of empaths and psychics who have been damaged by being unable to separate another person’s experiences form their own. Many have come to see me as patients, because they were experiencing the distress of others around them. They were helped not by medication, but by energetic work and training in how to control their gifts.

“All persons are a puzzle until at last we find in some word or act the key to the man, to the woman; straightaway all their past words and actions lie in light before us.”

--Ralph Waldo Emerson (American Poet and Essayist, Known as America's Teacher, 1803-1882)

Technorati tags: Imagination Empathy Brain Psychic

Presence and Charisma

I was reading a heart-warming story reported by the BBC of a unique case of a young woman who had a heart transplant at the age of two, and when, ten years later, her adolescent body began to reject the heart, the transplant was removed, and her original heart, which had been resting for ten years, was able to take over. A medical first, but that was not what attracted my attention. Neither was it the lymphoma that she developed several years ago, perhaps because of the original illness that damaged her heart, or perhaps because of the anti-rejection medicines that she has had to take all these years.

It was instead the smiling face of Professor Sir Magdi Yacoub (I just love the pictures of him here.) who did the original operation and who consulted on this new operation. He recently turned 70 and no longer operates himself. I cast my mind back almost 25 years, when I was working at the National Heart Hospital in London and first met him. There are two things that I remember about him. The first is that he was the person who allowed me to show the successful use of acupuncture to treat people who had gone through open-heart surgery, and still had pain in their chests. And the second is the reason for today’s item: Magdi had the most extraordinary personal “Presence.” When he walked in a room, everyone would notice him. Most had no idea who he was, or his extraordinary achievements; they were just drawn to him.

I have met many people who have this “presence” or “aura.” In the Eastern world it is often thought of as another manifestation of “Qi.” Closely related to “presence” is charisma: a compelling attractiveness or charm that can inspire devotion in others. In the ancient world charisma was thought to be a divine power or talent, and the word comes from the Greek word kharis meaning “grace” or “favor.” There is a small scientific literature on this phenomenon of charisma, which often flows from having a strong presence. Some of the research is summarized here.

There are clearly many types of charisma: Political, sports, performance, business, spiritual, literary. scientific and so on. The only two people whom I’ve met who knew Einstein told me that people would usually all stand up when he entered the room. Charisma is more than just a personal characteristic; it can also be conceptualized as the way in which certain groups interact with each other. There is a fascinating book entitled Charisma and Social Structure by Raymond Trevor Bradley, that has a fascinating discussion of the transformative and transcendent power of charisma. It must also not be forgotten that there are those who have used charisma for evil ends: three of the most wicked people of the last century were also possessed of extraordinary personal charisma.

Clearly some people have presence and charisma. The question is whether theses characteristics can also be developed. The answer is yes, they can be. Presence is created by an overall impression constituted of posture, eye contact, stillness, silence, self-confidence, competence and serenity. People with a strong presence are often a little mysterious, in the sense that they tend not to reveal much about themselves or their accomplishments. I have also felt if very strongly in people who have worked to develop the subtle systems of their bodies. One of the most potent examples was a Korean Ki-Master who spoke not a word of English, but whose presence could be felt the moment he entered a packed room. Work on your subtle systems will likely cause you to be more still and serene and to have a better posture and that's a great start.

There are a number of things that you can do to improve your own charisma:

1. Create a strong first impression by developing your presence
2. Develop a good impression when you speak
3. Be a good active empathic listener who connects with other people and asks pertinent questions
4. Be supportive of other people and their aspirations
5. Be persuasive
6. Be resilient and adaptable
7. Expand your vision of what is possible
8. Practice thinking creatively
9. Use humor
10. Be committed and courageous
11. Initiate persistent action
12. Instill hope in the people around you

Technorati tags: Sir Magdi Yacoub, Charisma, presence, empathy, acupuncture

Taking the Measure of a Society

“You don’t have to be big to be great.” -- Sholom Aleichem (a.k.a. Solomon Rabinowitz, a.k.a. “The Jewish Mark Twain,” Russian-born American Yiddish Writer, 1859-1916)

How do we really take the measure of a society? How do we decide whether it is compassionate and great? Is it just a subjective, culture-bound opinion? I have faced this question on many occasions when doing interviews and having meetings in which I am advocating for the mentally ill. I have seen are many different criteria for trying to evaluate a society and a country:

1. The way in which a society treats its youngest and oldest citizens;

2. How a society honors its dead;

3. What opportunities it offers to its citizens and for people who come to the country and join the society;

4. How it behaves toward other countries;

5. The leaders it chooses to follow.

All of those are correct. But I would like to suggest that we should expand on those.

For me:  “The true measure of a society is how it treats its weakest members.”

For this is a measure of how far a society has progressed from a dog-eat-dog dominator model toward a more egalitarian partnership model. I have previously described my admiration for the work of Riane Eisler, and in my book and CD program Healing, Meaning and Purpose, I dedicate a whole chapter to ways of applying and expanding on some of her work.

I was once speaking to a Minister of Health in another country, and he expressed the view that providing care for the mentally ill was not the responsibility of government, and that they were simply a drag on the country’s economy. I politely but firmly disagreed, and was able to show him that providing good quality compassionate care for the mentally ill was not just the right thing to do, but it could also have a positive impact on his country’s bottom line. It happened that we were in a Buddhist country and he had a small image of the Buddha in his office, with some incense in front of the statue. At the end of my presentation I used a quotation attributed to the Buddha:

“In separateness lies the world's great misery; in compassion lies the world's true strength.”

When I talk about the advantages of an expanded, five dimensional model of thinking about people and their interactions, it is exceedingly practical. Many of the same things that are good for individuals are also good for society as a whole. That seems such an obvious statement, but when you think it through and apply my same principles of personal integration to integrate relationships and to produce an integrated society, the results can be remarkable.

“Compassion is the chief law of human existence.” -- Fyodor Dostoevsky (Russian Writer, 1821-1881)

Technorati tags: Riane Eisler, compassion, Buddha, society

An Addendum to "Empathy"

I promised that I would be posting more on some of these important matters. If you've had the opportunity to look at the posting on empathy, and why it is likely more than just a neurological phenomenon, I would now like to pose two questions for you:

1. Is there any down side to being a powerful empath?

2. What would be the consequence of a complete lack of empathy?

I am not going to try and answer my own questions, but instead make a couple of suggestions. I think that strong empathy, if attached to amorality would produce the perfect con man. Hervey Cleckley's classic book, the Masks of Sanity, identified a small proportion of sociopaths (a.k.a. psychopaths) whom he described as "charismatic" and could be totally charming and apparently warm and caring. But only in as far as it suited them. These people tend to have a weird kind of empathy, in that they can use empathic skills, but do not attach them to any emotion.

The much larger group of sociopaths seem to have a lack of empathy, no conscience and an inability or unwillingness to learn from experience. There is clearly a genetic component to this type of behavior and personality, but as I pointed out in the earlier post, biology is not destiny. There are some interesting points made at: http://www.cassiopaea.com/cassiopaea/psychopath.htm

I would also like to make another suggestion, and that is that a good definition of human evil is a complete lack of empathy."

Technorati tags: Empathy Sociopath

Empathy

"The great gift of human beings is that we have the power of empathy."
--Meryl Streep (American Emmy and Oscar-winning Actress, 1949-)

Most people think of empathy as the ability to understand and share the feelings of another person, human or otherwise. Yet there is another piece to empathy, and that is the ability to communicate that understanding back to the other person. We use empathy in our day-to-day interactions with others; by showing others that we know how they feel. Empathy is a skill that helps us navigate our way through life: if we know how someone else feels, we can imagine how he or she might react and plan accordingly. Good therapists have to be good empaths, and so do good interviewers. One of Oprah’s extraordinary skills is her ability to empathize and establish rapport in a matter of seconds.

Yet we know learn that empathy is not a purely human attribute. Until 4-5 years ago, most scientists said that emotion and empathy were unique to humans, and were some of the ways in which we were differentiated from the other inhabitants of our world. Yet everyone who lives with a non-human creature knows that that is not so. Now scientific research has confirmed it. Some of it is summarized in a very nice new book by Frans de Waal, entitled Our Inner Ape. Professor de Waal is originally from Holland, but now directs the Living Links Center at the Yerkes Primate Center in Atlanta. Many mammals have been shown to have higher levels of empathy such as being able to take on the perspective of other animals and show great caring and sharing. The Darwinian idea that competition is the key factor driving behavior is giving way to an understanding that cooperation is a key to the survival of groups.

In the last decade, there have been some stunning breakthroughs in neurology. We have learned that genes in the brain do not so much determine behavior, but they instead predict how an individual will respond to the environment. That is why we constantly say that "Biology is not destiny." Yet there is more. Vittorio Gallese and Giacomo Rizzolatti at the University of Parma in Italy have made an extraordinarily interesting discovery. They discovered that there are in the frontal cortex of the brain what they call "mirror neurons." If I gently touch one of your fingers, a group of neurons will light up in the sensory parts of your brain, and so will some association neurons in the frontal lobes. If you now watch me touch my own fingers in the same way, those areas in your frontal lobes will light up once again. Just watching the touching produces a mirror effect. If I taste peanut butter ice cream, part of my brain illuminates. When I watch you eat peanut butter ice cream, the same part of my brain illuminates again. The implication is that my brain is resonating with what someone else is feeling. This is a lot more than salivating because someone else is eating something that I enjoy. V.S. Ramachandran from the University of California, San Diego, quite rightly described this discovery as the single most important and unreported story of the last decade. "Rama" as everyone calls him, is the author of a marvelous book – A Brief Tour of Human Consciousness: From Imposter Poodles to Purple Numbers - which I recommend highly.

So we have a probable neurological explanation for one of our key behaviors. But is that the end of it? Far from it. Empathy can almost certainly be learned and amplified. Ten years ago a Canadian Educator named Mary Gordon founded a project called Roots of Empathy, which has been shown to increase the ability in children, and many medical schools are trying to teach medical students to be more empathic.

"Empathy feels these thoughts; your hurt is in my heart, your loss is in my prayers, your sorrow is in my soul, and your tears are in my eyes."
--William Arthur Ward (American Writer, Pastor and Teacher, 1921-1997)

But there are dimensions of empathy which stretch beyond the neurological. Researchers at the Institute of HeartMath in California have reported that brain rhythms synchronize to the rhythmic activity of the heart, and when people are feeling love or appreciation, their blood pressure and respiratory rhythms become entrained with that of the heart. Sustained positive emotions produce a state of coherence throughout the body. But this is where it becomes even more interesting. The electromagnetic field of the heart can transmit information between people, up to a range of about five feet, and one person’s brain waves can synchronize to the heart of another.

There is also increasing research indicating that empathy can be a non-local phenomenon, enabling people to pick up thoughts and feelings over great distances.

I am going to post some more material about this fascinating field over the next few weeks

Technorati tags: empathy