Docsplainin' -- it's what I do

Docsplainin'--it's what I do.
After all, I'm a doc, aren't I?

Sunday, February 24, 2013


Physical bullying at school, as depicted in th...
Physical bullying at school, as depicted in the film Rebecca of Sunnybrook Farm. (Photo credit: Wikipedia)
Bullied as a kid? Does it still bug you? Then you will be not the least surprised at the results of a study published in JAMA last week. This study is being touted in the media  as demonstrating that the effects persist into adulthood ("Scarred for life", says the Standard, a UK paper), which I suppose any adult bullied as a kid could have told you. After following over 1400 kids from 11 North Carolina counties for nearly 20 years, researchers found that victims had a higher prevalence of agoraphobia, generalized anxiety, and panic disorder in young adulthood than kids who were not bullied. 

A search of the American Psychological Association's database turned up only one--one!--other study of long-term effects, a retrospective study asking gay and lesbian adults about their experiences in school and checking for any correlations with mental health concerns in adulthood. Their results suggested that as many as 17% of gays and lesbians bullied in school might have at least some symptoms of posttraumatic stress disorder in adulthood.

An author of the first study has been quoted as being surprised by the results. I am not.  Therapists are exquisitely attuned to the verbal messages our clients received from their parents about who they were, their place in the family and in the world, their value as human beings. And we all know, and have known for nearly 100 years that clients who were told, just as one example, that they were stupid will continue to believe that right into their dotage. Anything smart they do will be seen either as a fluke, as dumb luck, or as not smart at all--something anyone could do. Our peers have less influence on us, but not by much. And they have nearly as much access to us, seeing us five days of every week, nine months out of every year, throughout some of the most formative years of our lives. They have plenty of opportunity to beat us down.

One very damaging aspect is the response of the people in charge. Bullying victims get doubly traumatized when teachers, administrators, and parents do nothing: This is experienced as a betrayal, an abandonment, or as further abuse--and sometimes, as all three. For example, a boy who was physically assaulted in front of a raft of teachers who did nothing reported it both the assault and the faculty's inaction to the principal. That worthy's response was that this would not have happened had the student not chosen to come out. In actual point of fact the boy had been outed by one of the bullies some months previously in a separate incident, and he had reported it at the time. So the victim gets the message that nobody cares, nobody's going to do anything, and it's his fault anyway. I suspect that, as studies of childhood sexual abuse have demonstrated, this kind of response on the part of adults is a risk factor for some of the more negative outcomes for the child.

Nor, as far as I can tell, are long-term effects limited to childhood experiences: I know one fellow, retired about four years now, who still has regular nightmares about workplace bullying he suffered. And I have worked with several veterans who count abuse by their superiors as among the worst experiences of their careers.

So am I surprised by the results of this study? Not hardly.
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