["CRF\tdon't\thabituate:\tthey'll\trespond\tas\tmuch\tto\tthe\tfourth\tclap\tas\tto\tthe\tfirst.\\\"11 A\tthird\tset\tof\tchanges\toccurs\tin\tthe\tbrain's\topioid\tsystem,\twhich\tsecretes endorphins\tto\tblunt\tthe\tfeeling\tof\tpain.\tIt\talso\tbecomes\thyperactive.\tThis\tneural circuit\tagain\tinvolves\tthe\tamygdala,\tthis\ttime\tin\tconcert\twith\ta\tregion\tin\tthe cerebral\tcortex.\tThe\topioids\tare\tbrain\tchemicals\tthat\tare\tpowerful\tnumbing agents,\tlike\topium\tand\tother\tnarcotics\tthat\tare\tchemical\tcousins.\tWhen experiencing\thigh\tlevels\tof\topioids\t(\\\"the\tbrain's\town\tmorphine\\\"),\tpeople\thave\ta heightened\ttolerance\tfor\tpain\u2014an\teffect\tthat\thas\tbeen\tnoted\tby\tbattlefield surgeons,\twho\tfound\tseverely\twounded\tsoldiers\tneeded\tlower\tdoses\tof\tnarcotics to\thandle\ttheir\tpain\tthan\tdid\tcivilians\twith\tfar\tless\tserious\tinjuries. Something\tsimilar\tseems\tto\toccur\tin\tPTSD.12\tEndorphin\tchanges\tadd\ta\tnew dimension\tto\tthe\tneural\tmix\ttriggered\tby\treexposure\tto\ttrauma:\ta\tnumbing\tof certain\tfeelings.\tThis\tappears\tto\texplain\ta\tset\tof\t\\\"negative\\\"\tpsychological symptoms\tlong\tnoted\tin\tPTSD:\tanhedonia\t(the\tinability\tto\tfeel\tpleasure)\tand\ta general\temotional\tnumbness,\ta\tsense\tof\tbeing\tcut\toff\tfrom\tlife\tor\tfrom\tconcern about\tothers'\tfeelings.\tThose\tclose\tto\tsuch\tpeople\tmay\texperience\tthis indifference\tas\ta\tlack\tof\tempathy.\tAnother\tpossible\teffect\tmay\tbe\tdissociation, including\tthe\tinability\tto\tremember\tcrucial\tminutes,\thours,\tor\teven\tdays\tof\tthe traumatic\tevent. The\tneural\tchanges\tof\tPTSD\talso\tseem\tto\tmake\ta\tperson\tmore\tsusceptible\tto further\ttraumatizing.\tA\tnumber\tof\tstudies\twith\tanimals\thave\tfound\tthat\twhen they\twere\texposed\teven\tto\tmild\tstress\twhen\tyoung,\tthey\twere\tfar\tmore vulnerable\tthan\tunstressed\tanimals\tto\ttrauma-induced\tbrain\tchanges\tlater\tin\tlife (suggesting\tthe\turgent\tneed\tto\ttreat\tchildren\twith\tPTSD).\tThis\tseems\ta\treason that,\texposed\tto\tthe\tsame\tcatastrophe,\tone\tperson\tgoes\ton\tto\tdevelop\tPTSD\tand another\tdoes\tnot:\tthe\tamygdala\tis\tprimed\tto\tfind\tdanger,\tand\twhen\tlife\tpresents it\tonce\tagain\twith\treal\tdanger,\tits\talarm\trises\tto\ta\thigher\tpitch. All\tthese\tneural\tchanges\toffer\tshort-term\tadvantages\tfor\tdealing\twith\tthe\tgrim and\tdire\temergencies\tthat\tprompt\tthem.\tUnder\tduress,\tit\tis\tadaptive\tto\tbe\thighly vigilant,\taroused,\tready\tfor\tanything,\timpervious\tto\tpain,\tthe\tbody\tprimed\tfor sustained\tphysical\tdemands,\tand\u2014for\tthe\tmoment\u2014indifferent\tto\twhat\tmight otherwise\tbe\tintensely\tdisturbing\tevents.\tThese\tshort-term\tadvantages,\thowever, become\tlasting\tproblems\twhen\tthe\tbrain\tchanges\tso\tthat\tthey\tbecome predispositions,\tlike\ta\tcar\tstuck\tin\tperpetual\thigh\tgear.\tWhen\tthe\tamygdala\tand its\tconnected\tbrain\tregions\ttake\ton\ta\tnew\tsetpoint\tduring\ta\tmoment\tof\tintense trauma,\tthis\tchange\tin\texcitability\u2014this\theightened\treadiness\tto\ttrigger\ta\tneural hijacking\u2014means\tall\tof\tlife\tis\ton\tthe\tverge\tof\tbecoming\tan\temergency,\tand\teven an\tinnocent\tmoment\tis\tsusceptible\tto\tan\texplosion\tof\tfear\trun\tamok.","an\tinnocent\tmoment\tis\tsusceptible\tto\tan\texplosion\tof\tfear\trun\tamok. EMOTIONAL\tRELEARNING Such\ttraumatic\tmemories\tseem\tto\tremain\tas\tfixtures\tin\tbrain\tfunction\tbecause they\tinterfere\twith\tsubsequent\tlearning\u2014specifically,\twith\trelearning\ta\tmore normal\tresponse\tto\tthose\ttraumatizing\tevents.\tIn\tacquired\tfear\tsuch\tas\tPTSD,\tthe mechanisms\tof\tlearning\tand\tmemory\thave\tgone\tawry;\tagain,\tit\tis\tthe\tamygdala that\tis\tkey\tamong\tthe\tbrain\tregions\tinvolved.\tBut\tin\tovercoming\tthe\tlearned fear,\tthe\tneocortex\tis\tcritical. Fear\tconditioning\tis\tthe\tname\tpsychologists\tuse\tfor\tthe\tprocess\twhereby something\tthat\tis\tnot\tin\tthe\tleast\tthreatening\tbecomes\tdreaded\tas\tit\tis\tassociated in\tsomeone's\tmind\twith\tsomething\tfrightening.\tWhen\tsuch\tfrights\tare\tinduced\tin laboratory\tanimals,\tCharney\tnotes,\tthe\tfears\tcan\tlast\tfor\tyears.13\tThe\tkey\tregion of\tthe\tbrain\tthat\tlearns,\tretains,\tand\tacts\ton\tthis\tfearful\tresponse\tis\tthe\tcircuit between\tthe\tthalamus,\tamygdala,\tand\tprefrontal\tlobe\u2014the\tpathway\tof\tneural hijacking. Ordinarily,\twhen\tsomeone\tlearns\tto\tbe\tfrightened\tby\tsomething\tthrough\tfear conditioning,\tthe\tfear\tsubsides\twith\ttime.\tThis\tseems\tto\thappen\tthrough\ta\tnatural relearning,\tas\tthe\tfeared\tobject\tis\tencountered\tagain\tin\tthe\tabsence\tof\tanything truly\tscary.\tThus\ta\tchild\twho\tacquires\ta\tfear\tof\tdogs\tbecause\tof\tbeing\tchased\tby a\tsnarling\tGerman\tshepherd\tgradually\tand\tnaturally\tloses\tthat\tfear\tif,\tsay,\tshe moves\tnext\tdoor\tto\tsomeone\twho\towns\ta\tfriendly\tshepherd,\tand\tspends\ttime playing\twith\tthe\tdog. In\tPTSD\tspontaneous\trelearning\tfails\tto\toccur.\tCharney\tproposes\tthat\tthis may\tbe\tdue\tto\tthe\tbrain\tchanges\tof\tPTSD,\twhich\tare\tso\tstrong\tthat,\tin\teffect,\tthe amygdala\thijacking\toccurs\tevery\ttime\tsomething\teven\tvaguely\treminiscent\tof the\toriginal\ttrauma\tcomes\talong,\tstrengthening\tthe\tfear\tpathway.\tThis\tmeans that\tthere\tis\tnever\ta\ttime\twhen\twhat\tis\tfeared\tis\tpaired\twith\ta\tfeeling\tof\tcalm\u2014 the\tamygdala\tnever\trelearns\ta\tmore\tmild\treaction.\t\\\"Extinction\\\"\tof\tthe\tfear,\the observes,\t\\\"appears\tto\tinvolve\tan\tactive\tlearning\tprocess,\\\"\twhich\tis\titself impaired\tin\tpeople\twith\tPTSD,\t\\\"leading\tto\tthe\tabnormal\tpersistence\tof emotional\tmemories.\\\"14 But\tgiven\tthe\tright\texperiences,\teven\tPTSD\tcan\tlift;\tstrong\temotional memories,\tand\tthe\tpatterns\tof\tthought\tand\treaction\tthat\tthey\ttrigger,\tcan\tchange with\ttime.\tThis\trelearning,\tCharney\tproposes,\tis\tcortical.\tThe\toriginal\tfear ingrained\tin\tthe\tamygdala\tdoes\tnot\tgo\taway\tcompletely;\trather,\tthe\tprefrontal cortex\tactively\tsuppresses\tthe\tamygdala's\tcommand\tto\tthe\trest\tof\tthe\tbrain\tto","respond\twith\tfear. \\\"The\tquestion\tis,\thow\tquickly\tdo\tyou\tlet\tgo\tof\tlearned\tfear?\\\"\tasks\tRichard Davidson,\tthe\tUniversity\tof\tWisconsin\tpsychologist\twho\tdiscovered\tthe\trole\tof the\tleft\tprefrontal\tcortex\tas\ta\tdamper\ton\tdistress.\tIn\ta\tlaboratory\texperiment\tin which\tpeople\tfirst\tlearned\tan\taversion\tto\ta\tloud\tnoise\u2014a\tparadigm\tfor\tlearned fear,\tand\ta\tlower-key\tparallel\tof\tPTSD\u2014Davidson\tfound\tthat\tpeople\twho\thad more\tactivity\tin\tthe\tleft\tprefrontal\tcortex\tgot\tover\tthe\tacquired\tfear\tmore quickly,\tagain\tsuggesting\ta\tcortical\trole\tin\tletting\tgo\tof\tlearned\tdistress.15 REEDUCATING\tTHE\tEMOTIONAL BRAIN One\tof\tthe\tmore\tencouraging\tfindings\tabout\tPTSD\tcame\tfrom\ta\tstudy\tof Holocaust\tsurvivors,\tabout\tthree\tquarters\tof\twhom\twere\tfound\tto\thave\tactive PTSD\tsymptoms\teven\ta\thalf\tcentury\tlater.\tThe\tpositive\tfinding\twas\tthat\ta quarter\tof\tthe\tsurvivors\twho\tonce\thad\tbeen\ttroubled\tby\tsuch\tsymptoms\tno longer\thad\tthem;\tsomehow\tthe\tnatural\tevents\tof\ttheir\tlives\thad\tcounteracted\tthe problem.\tThose\twho\tstill\thad\tthe\tsymptoms\tshowed\tevidence\tof\tthe catecholamine-related\tbrain\tchanges\ttypical\tof\tPTSD\u2014but\tthose\twho\thad recovered\thad\tno\tsuch\tchanges.16\tThis\tfinding,\tand\tothers\tlike\tit,\thold\tout\tthe promise\tthat\tthe\tbrain\tchanges\tin\tPTSD\tare\tnot\tindelible,\tand\tthat\tpeople\tcan recover\tfrom\teven\tthe\tmost\tdire\temotional\timprinting\u2014in\tshort,\tthat\tthe emotional\tcircuitry\tcan\tbe\treeducated.\tThe\tgood\tnews,\tthen,\tis\tthat\ttraumas\tas profound\tas\tthose\tcausing\tPTSD\tcan\theal,\tand\tthat\tthe\troute\tto\tsuch\thealing\tis through\trelearning. One\tway\tthis\temotional\thealing\tseems\tto\toccur\tspontaneously\u2014at\tleast\tin children\u2014is\tthrough\tsuch\tgames\tas\tPurdy.\tThese\tgames,\tplayed\tover\tand\tover again,\tlet\tchildren\trelive\ta\ttrauma\tsafely,\tas\tplay.\tThis\tallows\ttwo\tavenues\tfor healing:\ton\tthe\tone\thand,\tthe\tmemory\trepeats\tin\ta\tcontext\tof\tlow\tanxiety, desensitizing\tit\tand\tallowing\ta\tnontraumatized\tset\tof\tresponses\tto\tbecome associated\twith\tit.\tAnother\troute\tto\thealing\tis\tthat,\tin\ttheir\tminds,\tchildren\tcan magically\tgive\tthe\ttragedy\tanother,\tbetter\toutcome:\tsometimes\tin\tplaying\tPurdy, the\tchildren\tkill\thim,\tboosting\ttheir\tsense\tof\tmastery\tover\tthat\ttraumatic\tmoment of\thelplessness. Games\tlike\tPurdy\tare\tpredictable\tin\tyounger\tchildren\twho\thave\tbeen\tthrough","such\toverwhelming\tviolence.\tThese\tmacabre\tgames\tin\ttraumatized\tchildren were\tfirst\tnoted\tby\tDr.\tLenore\tTerr,\ta\tchild\tpsychiatrist\tin\tSan\tFrancisco.17\tShe found\tsuch\tgames\tamong\tchildren\tin\tChowchilla,\tCalifornia\u2014just\ta\tlittle\tover an\thour\tdown\tthe\tCentral\tValley\tfrom\tStockton,\twhere\tPurdy\twreaked\tsuch havoc\u2014who\tin\t1973\thad\tbeen\tkidnapped\tas\tthey\trode\ta\tbus\thome\tfrom\ta summer\tday\tcamp.\tThe\tkidnappers\tburied\tthe\tbus,\tchildren\tand\tall,\tin\tan\tordeal that\tlasted\ttwenty-seven\thours. Five\tyears\tlater\tTerr\tfound\tthe\tkidnapping\tstill\tbeing\treenacted\tin\tthe\tvictims' games.\tGirls,\tfor\texample,\tplayed\tsymbolic\tkidnapping\tgames\twith\ttheir\tBarbie dolls.\tOne\tgirl,\twho\thad\thated\tthe\tfeeling\tof\tother\tchildren's\turine\ton\ther\tskin\tas they\tlay\thuddled\ttogether\tin\tterror,\twashed\ther\tBarbie\tover\tand\tover\tagain. Another\tplayed\tTraveling\tBarbie,\tin\twhich\tBarbie\ttravels\tsomewhere\u2014it\tdoesn't matter\twhere\u2014and\treturns\tsafely,\twhich\tis\tthe\tpoint\tof\tthe\tgame.\tA\tthird\tgirl's favorite\twas\ta\tscenario\tin\twhich\tthe\tdoll\tis\tstuck\tin\ta\thole\tand\tsuffocates. While\tadults\twho\thave\tbeen\tthrough\toverwhelming\ttrauma\tcan\tsuffer\ta psychic\tnumbing,\tblocking\tout\tmemory\tof\tor\tfeeling\tabout\tthe\tcatastrophe, children's\tpsyches\toften\thandle\tit\tdifferently.\tThey\tless\toften\tbecome\tnumb\tto the\ttrauma,\tTerr\tbelieves,\tbecause\tthey\tuse\tfantasy,\tplay,\tand\tdaydreams\tto recall\tand\trethink\ttheir\tordeals.\tSuch\tvoluntary\treplays\tof\ttrauma\tseem\tto\thead off\tthe\tneed\tfor\tdamming\tthem\tup\tin\tpotent\tmemories\tthat\tcan\tlater\tburst through\tas\tflashbacks.\tIf\tthe\ttrauma\tis\tminor,\tsuch\tas\tgoing\tto\tthe\tdentist\tfor\ta filling,\tjust\tonce\tor\ttwice\tmay\tbe\tenough.\tBut\tif\tit's\toverwhelming,\ta\tchild\tneeds endless\trepetitions,\treplaying\tthe\ttrauma\tover\tand\tover\tagain\tin\ta\tgrim, monotonous\tritual. One\tway\tto\tget\tat\tthe\tpicture\tfrozen\tin\tthe\tamygdala\tis\tthrough\tart,\twhich itself\tis\ta\tmedium\tof\tthe\tunconscious.\tThe\temotional\tbrain\tis\thighly\tattuned\tto symbolic\tmeanings\tand\tto\tthe\tmode\tFreud\tcalled\tthe\t\\\"primary\tprocess\\\":\tthe messages\tof\tmetaphor,\tstory,\tmyth,\tthe\tarts.\tThis\tavenue\tis\toften\tused\tin\ttreating traumatized\tchildren.\tSometimes\tart\tcan\topen\tthe\tway\tfor\tchildren\tto\ttalk\tabout a\tmoment\tof\thorror\tthat\tthey\twould\tnot\tdare\tspeak\tof\totherwise. Spencer\tEth,\tthe\tLos\tAngeles\tchild\tpsychiatrist\twho\tspecializes\tin\ttreating such\tchildren,\ttells\tof\ta\tfive-year-old\tboy\twho\thad\tbeen\tkidnapped\twith\this mother\tby\ther\tex-lover.\tThe\tman\tbrought\tthem\tto\ta\tmotel\troom,\twhere\the ordered\tthe\tboy\tto\thide\tunder\ta\tblanket\twhile\the\tbeat\tthe\tmother\tto\tdeath.\tThe boy\twas,\tunderstandably,\treluctant\tto\ttalk\twith\tEth\tabout\tthe\tmayhem\the\thad heard\tand\tseen\twhile\tunderneath\tthe\tblanket.\tSo\tEth\tasked\thim\tto\tdraw\ta\tpicture \u2014any\tpicture. The\tdrawing\twas\tof\ta\trace-car\tdriver\twho\thad\ta\tstrikingly\tlarge\tpair\tof\teyes,","The\tdrawing\twas\tof\ta\trace-car\tdriver\twho\thad\ta\tstrikingly\tlarge\tpair\tof\teyes, Eth\trecalls.\tThe\thuge\teyes\tEth\ttook\tto\trefer\tto\tthe\tboy's\town\tdaring\tin\tpeeking\tat the\tkiller.\tSuch\thidden\treferences\tto\tthe\ttraumatic\tscene\talmost\talways\tappear\tin the\tartwork\tof\ttraumatized\tchildren;\tEth\thas\tmade\thaving\tsuch\tchildren\tdraw\ta picture\tthe\topening\tgambit\tin\ttherapy.\tThe\tpotent\tmemories\tthat\tpreoccupy\tthem intrude\tin\ttheir\tart\tjust\tas\tin\ttheir\tthoughts.\tBeyond\tthat,\tthe\tact\tof\tdrawing\tis itself\ttherapeutic,\tbeginning\tthe\tprocess\tof\tmastering\tthe\ttrauma. EMOTIONAL\tRELEARNING\tAND\tRECOVERY\tFROM TRAUMA Irene\thad\tgone\ton\ta\tdate\tthat\tended\tin\tattempted\trape.\tThough\tshe\thad fought\toff\tthe\tattacker,\the\tcontinued\tto\tplague\ther:\tharassing\ther\twith obscene\tphone\tcalls,\tmaking\tthreats\tof\tviolence,\tcalling\tin\tthe\tmiddle\tof the\tnight,\tstalking\ther\tand\twatching\ther\tevery\tmove.\tOnce,\twhen\tshe\ttried to\tget\tthe\tpolice\tto\thelp,\tthey\tdismissed\ther\tproblem\tas\ttrivial,\tsince \\\"nothing\thad\treally\thappened.\\\"\tBy\tthe\ttime\tshe\tcame\tfor\ttherapy\tIrene had\tsymptoms\tof\tPTSD,\thad\tgiven\tup\tsocializing\tat\tall,\tand\tfelt\ta\tprisoner in\ther\town\thouse. \t Irene's\tcase\tis\tcited\tby\tDr.\tJudith\tLewis\tHerman,\ta\tHarvard\tpsychiatrist\twhose groundbreaking\twork\toutlines\tthe\tsteps\tto\trecovery\tfrom\ttrauma.\tHerman\tsees three\tstages:\tattaining\ta\tsense\tof\tsafety,\tremembering\tthe\tdetails\tof\tthe\ttrauma and\tmourning\tthe\tloss\tit\thas\tbrought,\tand\tfinally\treestablishing\ta\tnormal\tlife. There\tis\ta\tbiological\tlogic\tto\tthe\tordering\tof\tthese\tsteps,\tas\twe\tshall\tsee:\tthis sequence\tseems\tto\treflect\thow\tthe\temotional\tbrain\tlearns\tonce\tagain\tthat\tlife need\tnot\tbe\tregarded\tas\tan\temergency\tabout\tto\thappen. The\tfirst\tstep,\tregaining\ta\tsense\tof\tsafety,\tpresumably\ttranslates\tto\tfinding ways\tto\tcalm\tthe\ttoo-fearful,\ttoo\teasily\ttriggered\temotional\tcircuits\tenough\tto allow\trelearning.18\tOften\tthis\tbegins\twith\thelping\tpatients\tunderstand\tthat\ttheir jumpiness\tand\tnightmares,\thypervigilance\tand\tpanics,\tare\tpart\tof\tthe\tsymptoms of\tPTSD.\tThis\tunderstanding\tmakes\tthe\tsymptoms\tthemselves\tless\tfrightening. Another\tearly\tstep\tis\tto\thelp\tpatients\tregain\tsome\tsense\tof\tcontrol\tover\twhat\tis happening\tto\tthem,\ta\tdirect\tunlearning\tof\tthe\tlesson\tof\thelplessness\tthat\tthe trauma\titself\timparted.\tIrene,\tfor\texample,\tmobilized\ther\tfriends\tand\tfamily\tto form\ta\tbuffer\tbetween\ther\tand\ther\tstalker,\tand\twas\table\tto\tget\tthe\tpolice\tto intervene.","intervene. The\tsense\tin\twhich\tPTSD\tpatients\tfeel\t\\\"unsafe\\\"\tgoes\tbeyond\tfears\tthat dangers\tlurk\taround\tthem;\ttheir\tinsecurity\tbegins\tmore\tintimately,\tin\tthe\tfeeling that\tthey\thave\tno\tcontrol\tover\twhat\tis\thappening\tin\ttheir\tbody\tand\tto\ttheir emotions.\tThis\tis\tunderstandable,\tgiven\tthe\thair\ttrigger\tfor\temotional\thijacking that\tPTSD\tcreates\tby\thypersensitizing\tthe\tamygdala\tcircuitry. Medication\toffers\tone\tway\tto\trestore\tpatients'\tsense\tthat\tthey\tneed\tnot\tbe\tso\tat the\tmercy\tof\tthe\temotional\talarms\tthat\tflood\tthem\twith\tinexplicable\tanxiety, keep\tthem\tsleepless,\tor\tpepper\ttheir\tsleep\twith\tnightmares.\tPharmacologists\tare hoping\tone\tday\tto\ttailor\tmedications\tthat\twill\ttarget\tprecisely\tthe\teffects\tof PTSD\ton\tthe\tamygdala\tand\tconnected\tneurotransmitter\tcircuits.\tFor\tnow, though,\tthere\tare\tmedications\tthat\tcounter\tonly\tsome\tof\tthese\tchanges,\tnotably the\tantidepressants\tthat\tact\ton\tthe\tserotonin\tsystem,\tand\tbeta-blockers\tlike propranolol,\twhich\tblock\tthe\tactivation\tof\tthe\tsympathetic\tnervous\tsystem. Patients\talso\tmay\tlearn\trelaxation\ttechniques\tthat\tgive\tthem\tthe\tability\tto counter\ttheir\tedginess\tand\tnervousness.\tA\tphysiological\tcalm\topens\ta\twindow for\thelping\tthe\tbrutalized\temotional\tcircuitry\trediscover\tthat\tlife\tis\tnot\ta\tthreat and\tfor\tgiving\tback\tto\tpatients\tsome\tof\tthe\tsense\tof\tsecurity\tthey\thad\tin\ttheir lives\tbefore\tthe\ttrauma\thappened. Another\tstep\tin\thealing\tinvolves\tretelling\tand\treconstructing\tthe\tstory\tof\tthe trauma\tin\tthe\tharbor\tof\tthat\tsafety,\tallowing\tthe\temotional\tcircuitry\tto\tacquire\ta new,\tmore\trealistic\tunderstanding\tof\tand\tresponse\tto\tthe\ttraumatic\tmemory\tand its\ttriggers.\tAs\tpatients\tretell\tthe\thorrific\tdetails\tof\tthe\ttrauma,\tthe\tmemory\tstarts to\tbe\ttransformed,\tboth\tin\tits\temotional\tmeaning\tand\tin\tits\teffects\ton\tthe emotional\tbrain.\tThe\tpace\tof\tthis\tretelling\tis\tdelicate;\tideally\tit\tmimics\tthe\tpace that\toccurs\tnaturally\tin\tthose\tpeople\twho\tare\table\tto\trecover\tfrom\ttrauma without\tsuffering\tPTSD.\tIn\tthese\tcases\tthere\toften\tseems\tto\tbe\tan\tinner\tclock that\t\\\"doses\\\"\tpeople\twith\tintrusive\tmemories\tthat\trelive\tthe\ttrauma,\tintercut\twith weeks\tor\tmonths\twhen\tthey\tremember\thardly\tanything\tof\tthe\thorrible\tevents.19 This\talternation\tof\treimmersion\tand\trespite\tseems\tto\tallow\tfor\ta\tspontaneous review\tof\tthe\ttrauma\tand\trelearning\tof\temotional\tresponse\tto\tit.\tFor\tthose\twhose PTSD\tis\tmore\tintractable,\tsays\tHerman,\tretelling\ttheir\ttale\tcan\tsometimes trigger\toverwhelming\tfears,\tin\twhich\tcase\tthe\ttherapist\tshould\tease\tthe\tpace\tto keep\tthe\tpatient's\treactions\twithin\ta\tbearable\trange,\tone\tthat\twill\tnot\tdisrupt\tthe relearning. The\ttherapist\tencourages\tthe\tpatient\tto\tretell\tthe\ttraumatic\tevents\tas\tvividly\tas possible,\tlike\ta\thorror\thome\tvideo,\tretrieving\tevery\tsordid\tdetail.\tThis\tincludes not\tjust\tthe\tspecifics\tof\twhat\tthey\tsaw,\theard,\tsmelled,\tand\tfelt,\tbut\talso\ttheir","reactions\u2014the\tdread,\tdisgust,\tnausea.\tThe\tgoal\there\tis\tto\tput\tthe\tentire\tmemory into\twords,\twhich\tmeans\tcapturing\tparts\tof\tthe\tmemory\tthat\tmay\thave\tbeen dissociated\tand\tso\tare\tabsent\tfrom\tconscious\trecall.\tBy\tputting\tsensory\tdetails and\tfeelings\tinto\twords,\tpresumably\tmemories\tare\tbrought\tmore\tunder\tcontrol of\tthe\tneocortex,\twhere\tthe\treactions\tthey\tkindle\tcan\tbe\trendered\tmore understandable\tand\tso\tmore\tmanageable.\tThe\temotional\trelearning\tat\tthis\tpoint is\tlargely\taccomplished\tthrough\treliving\tthe\tevents\tand\ttheir\temotions,\tbut\tthis time\tin\tsurroundings\tof\tsafety\tand\tsecurity,\tin\tthe\tcompany\tof\ta\ttrusted\ttherapist. This\tbegins\tto\timpart\ta\ttelling\tlesson\tto\tthe\temotional\tcircuitry\u2014that\tsecurity, rather\tthan\tunremitting\tterror,\tcan\tbe\texperienced\tin\ttandem\twith\tthe\ttrauma memories. The\tfive-year-old\twho\tdrew\tthe\tpicture\tof\tthe\tgiant\teyes\tafter\the\twitnessed\tthe grisly\tmurder\tof\this\tmother\tdid\tnot\tmake\tany\tmore\tdrawings\tafter\tthat\tfirst\tone; instead\the\tand\this\ttherapist,\tSpencer\tEth,\tplayed\tgames,\tcreating\ta\tbond\tof rapport.\tOnly\tslowly\tdid\the\tbegin\tto\tretell\tthe\tstory\tof\tthe\tmurder,\tat\tfirst\tin\ta stereotyped\tway,\treciting\teach\tdetail\texactly\tthe\tsame\tin\teach\ttelling.\tGradually, though,\this\tnarrative\tbecame\tmore\topen\tand\tfree-flowing,\this\tbody\tless\ttense\tas he\ttold\tit.\tAt\tthe\tsame\ttime\this\tnightmares\tof\tthe\tscene\tcame\tless\toften,\tan indication,\tsays\tEth,\tof\tsome\t\\\"trauma\tmastery.\\\"\tGradually\ttheir\ttalk\tmoved\taway from\tthe\tfears\tleft\tby\tthe\ttrauma\tto\tmore\tof\twhat\twas\thappening\tin\tthe\tboy's day-to-day\tlife\tas\the\tadjusted\tto\ta\tnew\thome\twith\this\tfather.\tAnd\tfinally\tthe\tboy was\table\tto\ttalk\tjust\tabout\this\tdaily\tlife\tas\tthe\thold\tof\tthe\ttrauma\tfaded. Finally,\tHerman\tfinds\tthat\tpatients\tneed\tto\tmourn\tthe\tloss\tthe\ttrauma\tbrought \u2014whether\tan\tinjury,\tthe\tdeath\tof\ta\tloved\tone\tor\ta\trupture\tin\ta\trelationship, regret\tover\tsome\tstep\tnot\ttaken\tto\tsave\tsomeone,\tor\tjust\tthe\tshattering\tof confidence\tthat\tpeople\tcan\tbe\ttrusted.\tThe\tmourning\tthat\tensues\twhile\tretelling such\tpainful\tevents\tserves\ta\tcrucial\tpurpose:\tit\tmarks\tthe\tability\tto\tlet\tgo\tof\tthe trauma\titself\tto\tsome\tdegree.\tIt\tmeans\tthat\tinstead\tof\tbeing\tperpetually\tcaptured by\tthis\tmoment\tin\tthe\tpast,\tpatients\tcan\tstart\tto\tlook\tahead,\teven\tto\thope,\tand\tto rebuild\ta\tnew\tlife\tfree\tof\tthe\ttrauma's\tgrip.\tIt\tis\tas\tif\tthe\tconstant\trecycling\tand reliving\tof\tthe\ttrauma's\tterror\tby\tthe\temotional\tcircuitry\twere\ta\tspell\tthat\tcould finally\tbe\tlifted.\tEvery\tsiren\tneed\tnot\tbring\ta\tflood\tof\tfear;\tevery\tsound\tin\tthe night\tneed\tnot\tcompel\ta\tflashback\tto\tterror. Aftereffects\tor\toccasional\trecurrences\tof\tsymptoms\toften\tpersist,\tsays Herman,\tbut\tthere\tare\tspecific\tsigns\tthat\tthe\ttrauma\thas\tlargely\tbeen\tovercome. These\tinclude\treducing\tthe\tphysiological\tsymptoms\tto\ta\tmanageable\tlevel,\tand being\table\tto\tbear\tthe\tfeelings\tassociated\twith\tmemories\tof\tthe\ttrauma.","Especially\tsignificant\tis\tno\tlonger\thaving\ttrauma\tmemories\terupt\tat uncontrollable\tmoments,\tbut\trather\tbeing\table\tto\trevisit\tthem\tvoluntarily,\tlike any\tother\tmemory\u2014and,\tperhaps\tmore\timportant,\tto\tput\tthem\taside\tlike\tany other\tmemory.\tFinally,\tit\tmeans\trebuilding\ta\tnew\tlife,\twith\tstrong,\ttrusting relationships\tand\ta\tbelief\tsystem\tthat\tfinds\tmeaning\teven\tin\ta\tworld\twhere\tsuch injustice\tcan\thappen.20\tAll\tof\tthese\ttogether\tare\tmarkers\tof\tsuccess\tin reeducating\tthe\temotional\tbrain. PSYCHOTHERAPY\tAS\tAN\tEMOTIONAL TUTORIAL Fortunately,\tthe\tcatastrophic\tmoments\tin\twhich\ttraumatic\tmemories\tare emblazoned\tare\trare\tduring\tthe\tcourse\tof\tlife\tfor\tmost\tof\tus.\tBut\tthe\tsame circuitry\tthat\tcan\tbe\tseen\tso\tboldly\timprinting\ttraumatic\tmemories\tis\tpresumably at\twork\tin\tlife's\tquieter\tmoments,\ttoo.\tThe\tmore\tordinary\ttravails\tof\tchildhood, such\tas\tbeing\tchronically\tignored\tand\tdeprived\tof\tattention\tor\ttenderness\tby one's\tparents,\tabandonment\tor\tloss,\tor\tsocial\trejection\tmay\tnever\treach\tthe\tfever pitch\tof\ttrauma,\tbut\tthey\tsurely\tleave\ttheir\timprint\ton\tthe\temotional\tbrain, creating\tdistortions\u2014and\ttears\tand\trages\u2014in\tintimate\trelationships\tlater\tin\tlife. If\tPTSD\tcan\tbe\thealed,\tso\tcan\tthe\tmore\tmuted\temotional\tscars\tthat\tso\tmany\tof us\tbear;\tthat\tis\tthe\ttask\tof\tpsychotherapy.\tAnd,\tin\tgeneral,\tit\tis\tin\tlearning\tto\tdeal skillfully\twith\tthese\tloaded\treactions\tthat\temotional\tintelligence\tcomes\tinto\tplay. The\tdynamic\tbetween\tthe\tamygdala\tand\tthe\tmore\tfully\tinformed\treactions\tof the\tprefrontal\tcortex\tmay\toffer\ta\tneuroanatomical\tmodel\tfor\thow\tpsychotherapy reshapes\tdeep,\tmaladaptive\temotional\tpatterns.\tAs\tJoseph\tLeDoux,\tthe neuroscientist\twho\tdiscovered\tthe\tamygdala's\thair-trigger\trole\tin\temotional outbursts,\tconjectures,\t\\\"Once\tyour\temotional\tsystem\tlearns\tsomething,\tit\tseems you\tnever\tlet\tit\tgo.\tWhat\ttherapy\tdoes\tis\tteach\tyou\tto\tcontrol\tit\u2014it\tteaches\tyour neocortex\thow\tto\tinhibit\tyour\tamygdala.\tThe\tpropensity\tto\tact\tis\tsuppressed, while\tyour\tbasic\temotion\tabout\tit\tremains\tin\ta\tsubdued\tform.\\\" Given\tthe\tbrain\tarchitecture\tthat\tunderlies\temotional\trelearning,\twhat\tseems\tto remain,\teven\tafter\tsuccessful\tpsychotherapy,\tis\ta\tvestigial\treaction,\ta\tremnant\tof the\toriginal\tsensitivity\tor\tfear\tat\tthe\troot\tof\ta\ttroubling\temotional\tpattern.21\tThe prefrontal\tcortex\tcan\trefine\tor\tput\tthe\tbrakes\ton\tthe\tamygdala's\timpulse\tto rampage,\tbut\tcannot\tkeep\tit\tfrom\treacting\tin\tthe\tfirst\tplace.\tThus\twhile\twe","cannot\tdecide\twhen\twe\thave\tour\temotional\toutbursts,\twe\thave\tmore\tcontrol\tover how\tlong\tthey\tlast.\tA\tquicker\trecovery\ttime\tfrom\tsuch\toutbursts\tmay\twell\tbe one\tmark\tof\temotional\tmaturity. Over\tthe\tcourse\tof\ttherapy,\twhat\tseems\tto\tchange\tin\tthe\tmain\tare\tthe responses\tthat\tpeople\tmake\tonce\tan\temotional\treaction\tis\ttriggered\u2014but\tthe tendency\tfor\tthe\treaction\tto\tbe\ttriggered\tin\tthe\tfirst\tplace\tdoes\tnot\tdisappear entirely.\tEvidence\tfor\tthis\tcomes\tfrom\ta\tseries\tof\tstudies\tof\tpsychotherapy conducted\tby\tLester\tLuborsky\tand\this\tcolleagues\tat\tthe\tUniversity\tof Pennsylvania.22\tThey\tanalyzed\tthe\tmain\trelationship\tconflicts\tthat\tbrought dozens\tof\tpatients\tinto\tpsychotherapy\u2014issues\tsuch\tas\ta\tdeep\tcraving\tto\tbe accepted\tor\tfind\tintimacy,\tor\ta\tfear\tof\tbeing\ta\tfailure\tor\tbeing\toverly\tdependent. They\tthen\tcarefully\tanalyzed\tthe\ttypical\t(always\tself-defeating)\tresponses\tthe patients\tmade\twhen\tthese\twishes\tand\tfears\twere\tactivated\tin\ttheir\trelationships \u2014responses\tsuch\tas\tbeing\ttoo\tdemanding,\twhich\tcreated\ta\tbacklash\tof\tanger\tor coldness\tin\tthe\tother\tperson,\tor\twithdrawing\tin\tself-defense\tfrom\tan\tanticipated slight,\tleaving\tthe\tother\tperson\tmiffed\tby\tthe\tseeming\trebuff.\tDuring\tsuch illfated\tencounters,\tthe\tpatients,\tunderstandably,\tfelt\tflooded\tby\tupsetting feelings\u2014hopelessness\tand\tsadness,\tresentment\tand\tanger,\ttension\tand\tfear, guilt\tand\tself-blame,\tand\tso\ton.\tWhatever\tthe\tspecific\tpattern\tof\tthe\tpatient,\tit seemed\tto\tshow\tup\tin\tmost\tevery\timportant\trelationship,\twhether\twith\ta\tspouse or\tlover,\ta\tchild\tor\tparent,\tor\tpeers\tand\tbosses\tat\twork. Over\tthe\tcourse\tof\tlong-term\ttherapy,\thowever,\tthese\tpatients\tmade\ttwo\tkinds of\tchanges:\ttheir\temotional\treaction\tto\tthe\ttriggering\tevents\tbecame\tless distressing,\teven\tcalm\tor\tbemused,\tand\ttheir\tovert\tresponses\tbecame\tmore effective\tin\tgetting\twhat\tthey\ttruly\twanted\tfrom\tthe\trelationship.\tWhat\tdid\tnot change,\thowever,\twas\ttheir\tunderlying\twish\tor\tfear,\tand\tthe\tinitial\ttwinge\tof feeling.\tBy\tthe\ttime\tthe\tpatients\thad\tbut\ta\tfew\tsessions\tleft\tin\ttherapy,\tthe encounters\tthey\ttold\tabout\tshowed\tthey\thad\tonly\thalf\tas\tmany\tnegative emotional\treactions\tcompared\tto\twhen\tthey\tfirst\tstarted\ttherapy,\tand\twere\ttwice as\tlikely\tto\tget\tthe\tpositive\tresponse\tthey\tdeeply\tdesired\tfrom\tthe\tother\tperson. But\twhat\tdid\tnot\tchange\tat\tall\twas\tthe\tparticular\tsensitivity\tat\tthe\troot\tof\tthese needs. In\tbrain\tterms,\twe\tcan\tspeculate,\tthe\tlimbic\tcircuitry\twould\tsend\talarm\tsignals in\tresponse\tto\tcues\tof\ta\tfeared\tevent,\tbut\tthe\tprefrontal\tcortex\tand\trelated\tzones would\thave\tlearned\ta\tnew,\tmore\thealthy\tresponse.\tIn\tshort,\temotional\tlessons\u2014 even\tthe\tmost\tdeeply\timplanted\thabits\tof\tthe\theart\tlearned\tin\tchildhood\u2014can\tbe reshaped.\tEmotional\tlearning\tis\tlifelong.","14 Temperament\tIs\tNot\tDestiny \t So\tmuch\tfor\taltering\temotional\tpatterns\tthat\thave\tbeen\tlearned.\tBut\twhat\tabout those\tresponses\tthat\tare\tgivens\tof\tour\tgenetic\tendowment\u2014what\tof\tchanging\tthe habitual\treactions\tof\tpeople\twho\tby\tnature\tare,\tsay,\thighly\tvolatile,\tor\tpainfully shy?\tThis\trange\tof\tthe\temotional\tcompass\tfalls\tunder\tthe\tsweep\tof\ttemperament, the\tbackground\tmurmur\tof\tfeelings\tthat\tmark\tour\tbasic\tdisposition. Temperament\tcan\tbe\tdefined\tin\tterms\tof\tthe\tmoods\tthat\ttypify\tour\temotional life.\tTo\tsome\tdegree\twe\teach\thave\tsuch\ta\tfavored\temotional\trange;\ttemperament is\ta\tgiven\tat\tbirth,\tpart\tof\tthe\tgenetic\tlottery\tthat\thas\tcompelling\tforce\tin\tthe unfolding\tof\tlife.\tEvery\tparent\thas\tseen\tthis:\tfrom\tbirth\ta\tchild\twill\tbe\tcalm\tand placid\tor\ttesty\tand\tdifficult.\tThe\tquestion\tis\twhether\tsuch\ta\tbiologically determined\temotional\tset\tcan\tbe\tchanged\tby\texperience.\tDoes\tour\tbiology\tfix our\temotional\tdestiny,\tor\tcan\teven\tan\tinnately\tshy\tchild\tgrow\tinto\ta\tmore confident\tadult? The\tclearest\tanswer\tto\tthis\tquestion\tcomes\tfrom\tthe\twork\tof\tJerome\tKagan, the\teminent\tdevelopmental\tpsychologist\tat\tHarvard\tUniversity.1\tKagan\tposits that\tthere\tare\tat\tleast\tfour\ttemperamental\ttypes\u2014timid,\tbold,\tupbeat,\tand melancholy\u2014and\tthat\teach\tis\tdue\tto\ta\tdifferent\tpattern\tof\tbrain\tactivity.\tThere are\tlikely\tinnumerable\tdifferences\tin\ttemperamental\tendowment,\teach\tbased\tin innate\tdifferences\tin\temotional\tcircuitry;\tfor\tany\tgiven\temotion\tpeople\tcan\tdiffer in\thow\teasily\tit\ttriggers,\thow\tlong\tit\tlasts,\thow\tintense\tit\tbecomes.\tKagan's\twork concentrates\ton\tone\tof\tthese\tpatterns:\tthe\tdimension\tof\ttemperament\tthat\truns from\tboldness\tto\ttimidity. For\tdecades\tmothers\thave\tbeen\tbringing\ttheir\tinfants\tand\ttoddlers\tto\tKagan's Laboratory\tfor\tChild\tDevelopment\ton\tthe\tfourteenth\tfloor\tof\tHarvard's\tWilliam James\tHall\tto\ttake\tpart\tin\this\tstudies\tof\tchild\tdevelopment.\tIt\twas\tthere\tthat Kagan\tand\this\tcoresearchers\tnoticed\tearly\tsigns\tof\tshyness\tin\ta\tgroup\tof\ttwenty- one-month-old\ttoddlers\tbrought\tfor\texperimental\tobservations.\tIn\tfree\tplay\twith other\ttoddlers,\tsome\twere\tbubbly\tand\tspontaneous,\tplaying\twith\tother\tbabies without\tthe\tleast\thesitation.\tOthers,\tthough,\twere\tuncertain\tand\thesitant,\thanging","without\tthe\tleast\thesitation.\tOthers,\tthough,\twere\tuncertain\tand\thesitant,\thanging back,\tclinging\tto\ttheir\tmothers,\tquietly\twatching\tthe\tothers\tat\tplay.\tAlmost\tfour years\tlater,\twhen\tthese\tsame\tchildren\twere\tin\tkindergarten,\tKagan's\tgroup observed\tthem\tagain.\tOver\tthe\tintervening\tyears\tnone\tof\tthe\toutgoing\tchildren had\tbecome\ttimid,\twhile\ttwo\tthirds\tof\tthe\ttimid\tones\twere\tstill\treticent. Kagan\tfinds\tthat\tchildren\twho\tare\toverly\tsensitive\tand\tfearful\tgrow\tinto\tshy and\ttimorous\tadults;\tfrom\tbirth\tabout\t15\tto\t20\tpercent\tof\tchildren\tare \\\"behaviorally\tinhibited,\\\"\tas\the\tcalls\tthem.\tAs\tinfants,\tthese\tchildren\tare\ttimid about\tanything\tunfamiliar.\tThis\tmakes\tthem\tfinicky\tabout\teating\tnew\tfoods, reluctant\tto\tapproach\tnew\tanimals\tor\tplaces,\tand\tshy\taround\tstrangers.\tIt\talso renders\tthem\tsensitive\tin\tother\tways\u2014for\texample,\tprone\tto\tguilt\tand\tself- reproach.\tThese\tare\tthe\tchildren\twho\tbecome\tparalyzingly\tanxious\tin\tsocial situations:\tin\tclass\tand\ton\tthe\tplayground,\twhen\tmeeting\tnew\tpeople,\twhenever the\tsocial\tspotlight\tshines\ton\tthem.\tAs\tadults,\tthey\tare\tprone\tto\tbe\twallflowers, and\tmorbidly\tafraid\tof\thaving\tto\tgive\ta\tspeech\tor\tperform\tin\tpublic. Tom,\tone\tof\tthe\tboys\tin\tKagan's\tstudy,\tis\ttypical\tof\tthe\tshy\ttype.\tAt\tevery measurement\tthrough\tchildhood\u2014two,\tfive,\tand\tseven\tyears\tof\tage\u2014Tom\twas among\tthe\tmost\ttimid\tchildren.\tWhen\tinterviewed\tat\tthirteen,\tTom\twas\ttense and\tstiff,\tbiting\this\tlip\tand\twringing\this\thands,\this\tface\timpassive,\tbreaking\tinto a\ttight\tsmile\tonly\twhen\ttalking\tabout\this\tgirlfriend;\this\tanswers\twere\tshort,\this manner\tsubdued.2\tThroughout\tthe\tmiddle\tyears\tof\tchildhood,\tuntil\tabout\tage eleven,\tTom\tremembers\tbeing\tpainfully\tshy,\tbreaking\tinto\ta\tsweat\twhenever\the had\tto\tapproach\tplaymates.\tHe\twas\talso\ttroubled\tby\tintense\tfears:\tof\this\thouse burning\tdown,\tof\tdiving\tinto\ta\tswimming\tpool,\tof\tbeing\talone\tin\tthe\tdark.\tIn frequent\tnightmares,\the\twas\tattacked\tby\tmonsters.\tThough\the\thas\tfelt\tless\tshy\tin the\tlast\ttwo\tyears\tor\tso,\the\tstill\tfeels\tsome\tanxiety\taround\tother\tchildren,\tand\this worries\tnow\tcenter\ton\tdoing\twell\tat\tschool,\teven\tthough\the\tis\tin\tthe\ttop\t5 percent\tof\this\tclass.\tThe\tson\tof\ta\tscientist,\tTom\tfinds\ta\tcareer\tin\tthat\tfield appealing,\tsince\tits\trelative\tsolitude\tfits\this\tintroverted\tinclinations. By\tcontrast,\tRalph\twas\tone\tof\tthe\tboldest\tand\tmost\toutgoing\tchildren\tat\tevery age.\tAlways\trelaxed\tand\ttalkative,\tat\tthirteen\the\tsat\tback\tat\tease\tin\this\tchair,\thad no\tnervous\tmannerisms,\tand\tspoke\tin\ta\tconfident,\tfriendly\ttone,\tas\tthough\tthe interviewer\twere\ta\tpeer\u2014though\tthe\tdifference\tin\ttheir\tages\twas\ttwenty-five years.\tDuring\tchildhood\the\thad\tonly\ttwo\tshort-lived\tfears\u2014one\tof\tdogs,\tafter\ta big\tdog\tjumped\ton\thim\tat\tage\tthree,\tand\tanother\tof\tflying,\twhen\the\theard\tabout plane\tcrashes\tat\tage\tseven.\tSociable\tand\tpopular,\tRalph\thas\tnever\tthought\tof himself\tas\tshy.","The\ttimid\tchildren\tseem\tto\tcome\tinto\tlife\twith\ta\tneural\tcircuitry\tthat\tmakes them\tmore\treactive\tto\teven\tmild\tstress\u2014from\tbirth,\ttheir\thearts\tbeat\tfaster\tthan other\tinfants'\tin\tresponse\tto\tstrange\tor\tnovel\tsituations.\tAt\ttwenty-one\tmonths, when\tthe\treticent\ttoddlers\twere\tholding\tback\tfrom\tplaying,\theart\trate\tmonitors showed\tthat\ttheir\thearts\twere\tracing\twith\tanxiety.\tThat\teasily\taroused\tanxiety seems\tto\tunderlie\ttheir\tlifelong\ttimidity:\tthey\ttreat\tany\tnew\tperson\tor\tsituation as\tthough\tit\twere\ta\tpotential\tthreat.\tPerhaps\tas\ta\tresult,\tmiddle-aged\twomen\twho remember\thaving\tbeen\tespecially\tshy\tin\tchildhood,\twhen\tcompared\twith\ttheir more\toutgoing\tpeers,\ttend\tto\tgo\tthrough\tlife\twith\tmore\tfears,\tworries,\tand\tguilt, and\tto\tsuffer\tmore\tfrom\tstress-related\tproblems\tsuch\tas\tmigraine\theadaches, irritable\tbowel,\tand\tother\tstomach\tproblems.3 THE\tNEUROCHEMISTRY\tOF\tTIMIDITY The\tdifference\tbetween\tcautious\tTom\tand\tbold\tRalph,\tKagan\tbelieves,\tlies\tin the\texcitability\tof\ta\tneural\tcircuit\tcentered\ton\tthe\tamygdala.\tKagan\tproposes\tthat people\tlike\tTom,\twho\tare\tprone\tto\tfearfulness,\tare\tborn\twith\ta\tneurochemistry that\tmakes\tthis\tcircuit\teasily\taroused,\tand\tso\tthey\tavoid\tthe\tunfamiliar,\tshy\taway from\tuncertainty,\tand\tsuffer\tanxiety.\tThose\twho,\tlike\tRalph,\thave\ta\tnervous system\tcalibrated\twith\ta\tmuch\thigher\tthreshold\tfor\tamygdala\tarousal,\tare\tless easily\tfrightened,\tmore\tnaturally\toutgoing,\tand\teager\tto\texplore\tnew\tplaces\tand meet\tnew\tpeople. An\tearly\tclue\tto\twhich\tpattern\ta\tchild\thas\tinherited\tis\thow\tdifficult\tand irritable\tshe\tis\tas\tan\tinfant,\tand\thow\tdistressed\tshe\tbecomes\twhen\tconfronted with\tsomething\tor\tsomeone\tunfamiliar.\tWhile\tabout\tone\tin\tfive\tinfants\tfalls\tinto the\ttimid\tcategory,\tabout\ttwo\tin\tfive\thave\tthe\tbold\ttemperament\u2014at\tleast\tat birth. Part\tof\tKagan's\tevidence\tcomes\tfrom\tobservations\tof\tcats\tthat\tare\tunusually timid.\tAbout\tone\tin\tseven\thousecats\thas\ta\tpattern\tof\tfearfulness\takin\tto\tthe\ttimid children's:\tthey\tdraw\taway\tfrom\tnovelty\t(instead\tof\texhibiting\ta\tcat's\tlegendary curiosity),\tthey\tare\treluctant\tto\texplore\tnew\tterritory,\tand\tthey\tattack\tonly\tthe smallest\trodents,\tbeing\ttoo\ttimid\tto\ttake\ton\tlarger\tones\tthat\ttheir\tmore courageous\tfeline\tpeers\twould\tpursue\twith\tgusto.\tDirect\tbrain\tprobes\thave\tfound that\tportions\tof\tthe\tamygdala\tare\tunusually\texcitable\tin\tthese\ttimid\tcats, especially\twhen,\tfor\tinstance,\tthey\thear\ta\tthreatening\thowl\tfrom\tanother\tcat. The\tcats'\ttimidity\tblossoms\tat\tabout\tone\tmonth\tof\tage,\twhich\tis\tthe\tpoint when\ttheir\tamygdala\tmatures\tenough\tto\ttake\tcontrol\tof\tthe\tbrain\tcircuitry\tto","when\ttheir\tamygdala\tmatures\tenough\tto\ttake\tcontrol\tof\tthe\tbrain\tcircuitry\tto approach\tor\tavoid.\tOne\tmonth\tin\tkitten\tbrain\tmaturation\tis\takin\tto\teight\tmonths in\ta\thuman\tinfant;\tit\tis\tat\teight\tor\tnine\tmonths,\tKagan\tnotes,\tthat\t\\\"stranger\\\"\tfear appears\tin\tbabies\u2014if\tthe\tbaby's\tmother\tleaves\ta\troom\tand\tthere\tis\ta\tstranger present,\tthe\tresult\tis\ttears.\tTimid\tchildren,\tKagan\tpostulates,\tmay\thave\tinherited chronically\thigh\tlevels\tof\tnorepinephrine\tor\tother\tbrain\tchemicals\tthat\tactivate the\tamygdala\tand\tso\tcreate\ta\tlow\tthreshold\tof\texcitability,\tmaking\tthe\tamygdala more\teasily\ttriggered. One\tsign\tof\tthis\theightened\tsensitivity\tis\tthat,\tfor\texample,\twhen\tyoung\tmen and\twomen\twho\twere\tquite\tshy\tin\tchildhood\tare\tmeasured\tin\ta\tlaboratory\twhile exposed\tto\tstresses\tsuch\tas\tharsh\tsmells,\ttheir\theart\trate\tstays\televated\tmuch longer\tthan\tfor\ttheir\tmore\toutgoing\tpeers\u2014a\tsign\tthat\tsurging\tnorepinephrine\tis keeping\ttheir\tamygdala\texcited\tand,\tthrough\tconnected\tneural\tcircuits,\ttheir sympathetic\tnervous\tsystem\taroused.4\tKagan\tfinds\tthat\ttimid\tchildren\thave higher\tlevels\tof\treactivity\tacross\tthe\trange\tof\tsympathetic\tnervous\tsystem indices,\tfrom\thigher\tresting\tblood\tpressure\tand\tgreater\tdilation\tof\tthe\tpupils,\tto higher\tlevels\tof\tnorepinephrine\tmarkers\tin\ttheir\turine. Silence\tis\tanother\tbarometer\tof\ttimidity.\tWhenever\tKagan's\tteam\tobserved shy\tand\tbold\tchildren\tin\ta\tnatural\tsetting\u2014in\ttheir\tkindergarten\tclasses,\twith other\tchildren\tthey\tdid\tnot\tknow,\tor\ttalking\twith\tan\tinterviewer\u2014the\ttimid children\ttalked\tless.\tOne\ttimid\tkindergartener\twould\tsay\tnothing\twhen\tother children\tspoke\tto\ther,\tand\tspent\tmost\tof\ther\tday\tjust\twatching\tthe\tothers\tplay. Kagan\tspeculates\tthat\ta\ttimid\tsilence\tin\tthe\tface\tof\tnovelty\tor\ta\tperceived\tthreat is\ta\tsign\tof\tthe\tactivity\tof\ta\tneural\tcircuit\trunning\tbetween\tthe\tforebrain,\tthe amygdala,\tand\tnearby\tlimbic\tstructures\tthat\tcontrol\tthe\tability\tto\tvocalize\t(these same\tcircuits\tmake\tus\t\\\"choke\tup\\\"\tunder\tstress). These\tsensitive\tchildren\tare\tat\thigh\trisk\tfor\tdeveloping\tan\tanxiety\tdisorder such\tas\tpanic\tattacks,\tstarting\tas\tearly\tas\tsixth\tor\tseventh\tgrade.\tIn\tone\tstudy\tof 754\tboys\tand\tgirls\tin\tthose\tgrades,\t44\twere\tfound\tto\thave\talready\tsuffered\tat least\tone\tepisode\tof\tpanic,\tor\tto\thave\thad\tseveral\tpreliminary\tsymptoms.\tThese anxiety\tepisodes\twere\tusually\ttriggered\tby\tthe\tordinary\talarms\tof\tearly adolescence,\tsuch\tas\ta\tfirst\tdate\tor\ta\tbig\texam\u2014alarms\tthat\tmost\tchildren\thandle without\tdeveloping\tmore\tserious\tproblems.\tBut\tteenagers\twho\twere\ttimid\tby temperament\tand\twho\thad\tbeen\tunusually\tfrightened\tby\tnew\tsituations\tgot\tpanic symptoms\tsuch\tas\theart\tpalpitations,\tshortness\tof\tbreath,\tor\ta\tchoking\tfeeling, along\twith\tthe\tfeeling\tthat\tsomething\thorrible\twas\tgoing\tto\thappen\tto\tthem,\tlike going\tcrazy\tor\tdying.\tThe\tresearchers\tbelieve\tthat\twhile\tthe\tepisodes\twere\tnot","significant\tenough\tto\trate\tthe\tpsychiatric\tdiagnosis\t\\\"panic\tdisorder,\\\"\tthey\tsignal that\tthese\tteenagers\twould\tbe\tat\tgreater\trisk\tfor\tdeveloping\tthe\tdisorder\tas\tthe years\twent\ton;\tmany\tadults\twho\tsuffer\tpanic\tattacks\tsay\tthe\tattacks\tbegan during\ttheir\tteen\tyears.5 The\tonset\tof\tthe\tanxiety\tattacks\twas\tclosely\ttied\tto\tpuberty.\tGirls\twith\tfew signs\tof\tpuberty\treported\tno\tsuch\tattacks,\tbut\tof\tthose\twho\thad\tgone\tthrough puberty\tabout\t8\tpercent\tsaid\tthey\thad\texperienced\tpanic.\tOnce\tthey\thave\thad such\tan\tattack,\tthey\tare\tprone\tto\tdeveloping\tthe\tdread\tof\ta\trecurrence\tthat\tleads people\twith\tpanic\tdisorder\tto\tshrink\tfrom\tlife. NOTHING\tBOTHERS\tME:\tTHE\tCHEERFUL TEMPERAMENT In\tthe\t1920s,\tas\ta\tyoung\twoman,\tmy\taunt\tJune\tleft\ther\thome\tin\tKansas\tCity\tand ventured\ton\ther\town\tto\tShanghai\u2014a\tdangerous\tjourney\tfor\ta\tsolitary\twoman\tin those\tyears.\tThere\tJune\tmet\tand\tmarried\ta\tBritish\tdetective\tin\tthe\tcolonial\tpolice force\tof\tthat\tinternational\tcenter\tof\tcommerce\tand\tintrigue.\tWhen\tthe\tJapanese captured\tShanghai\tat\tthe\toutset\tof\tWorld\tWar\tII,\tmy\taunt\tand\ther\thusband\twere interned\tin\tthe\tprison\tcamp\tdepicted\tin\tthe\tbook\tand\tmovie\tEmpire\tof\tthe\tSun. After\tsurviving\tfive\thorrific\tyears\tin\tthe\tprison\tcamp,\tshe\tand\ther\thusband\thad, literally,\tlost\teverything.\tPenniless,\tthey\twere\trepatriated\tto\tBritish\tColumbia. I\tremember\tas\ta\tchild\tfirst\tmeeting\tJune,\tan\tebullient\telderly\twoman\twhose life\thad\tfollowed\ta\tremarkable\tcourse.\tIn\ther\tlater\tyears\tshe\tsuffered\ta\tstroke that\tleft\ther\tpartly\tparalyzed;\tafter\ta\tslow\tand\tarduous\trecovery\tshe\twas\table\tto walk\tagain,\tbut\twith\ta\tlimp.\tIn\tthose\tyears\tI\tremember\tgoing\tfor\tan\touting\twith June,\tthen\tin\ther\tseventies.\tSomehow\tshe\twandered\toff,\tand\tafter\tseveral minutes\tI\theard\ta\tfeeble\tyell\u2014June\tcrying\tfor\thelp.\tShe\thad\tfallen\tand\tcould\tnot get\tup\ton\ther\town.\tI\trushed\tto\thelp\ther\tup,\tand\tas\tI\tdid\tso,\tinstead\tof complaining\tor\tlamenting\tshe\tlaughed\tat\ther\tpredicament.\tHer\tonly\tcomment was\ta\tlighthearted\t\\\"Well,\tat\tleast\tI\tcan\twalk\tagain.\\\" By\tnature,\tsome\tpeople's\temotions\tseem,\tlike\tmy\taunt's,\tto\tgravitate\ttoward the\tpositive\tpole;\tthese\tpeople\tare\tnaturally\tupbeat\tand\teasygoing,\twhile\tothers are\tdour\tand\tmelancholy.\tThis\tdimension\tof\ttemperament\u2014ebullience\tat\tone end,\tmelancholy\tat\tthe\tother\u2014seems\tlinked\tto\tthe\trelative\tactivity\tof\tthe\tright and\tleft\tprefrontal\tareas,\tthe\tupper\tpoles\tof\tthe\temotional\tbrain.\tThat\tinsight\thas emerged\tlargely\tfrom\tthe\twork\tof\tRichard\tDavidson,\ta\tUniversity\tof\tWisconsin psychologist.\tHe\tdiscovered\tthat\tpeople\twho\thave\tgreater\tactivity\tin\tthe\tleft frontal\tlobe,\tcompared\tto\tthe\tright,\tare\tby\ttemperament\tcheerful;\tthey\ttypically","frontal\tlobe,\tcompared\tto\tthe\tright,\tare\tby\ttemperament\tcheerful;\tthey\ttypically take\tdelight\tin\tpeople\tand\tin\twhat\tlife\tpresents\tthem\twith,\tbouncing\tback\tfrom setbacks\tas\tmy\taunt\tJune\tdid.\tBut\tthose\twith\trelatively\tgreater\tactivity\ton\tthe right\tside\tare\tgiven\tto\tnegativity\tand\tsour\tmoods,\tand\tare\teasily\tfazed\tby\tlife's difficulties;\tin\ta\tsense,\tthey\tseem\tto\tsuffer\tbecause\tthey\tcannot\tturn\toff\ttheir worries\tand\tdepressions. In\tone\tof\tDavidson's\texperiments\tvolunteers\twith\tthe\tmost\tpronounced activity\tin\tthe\tleft\tfrontal\tareas\twere\tcompared\twith\tthe\tfifteen\twho\tshowed most\tactivity\ton\tthe\tright.\tThose\twith\tmarked\tright\tfrontal\tactivity\tshowed\ta distinctive\tpattern\tof\tnegativity\ton\ta\tpersonality\ttest:\tthey\tfit\tthe\tcaricature portrayed\tby\tWoody\tAllen's\tcomedy\troles,\tthe\talarmist\twho\tsees\tcatastrophe\tin the\tsmallest\tthing\u2014prone\tto\tfunks\tand\tmoodiness,\tand\tsuspicious\tof\ta\tworld they\tsaw\tas\tfraught\twith\toverwhelming\tdifficulties\tand\tlurking\tdangers.\tBy contrast\tto\ttheir\tmelancholy\tcounterparts,\tthose\twith\tstronger\tleft\tfrontal\tactivity saw\tthe\tworld\tvery\tdifferently.\tSociable\tand\tcheerful,\tthey\ttypically\tfelt\ta\tsense of\tenjoyment,\twere\tfrequently\tin\tgood\tmoods,\thad\ta\tstrong\tsense\tof\tself- confidence,\tand\tfelt\trewardingly\tengaged\tin\tlife.\tTheir\tscores\ton\tpsychological tests\tsuggested\ta\tlower\tlifetime\trisk\tfor\tdepression\tand\tother\temotional disorders.6 People\twho\thave\ta\thistory\tof\tclinical\tdepression,\tDavidson\tfound,\thad\tlower levels\tof\tbrain\tactivity\tin\tthe\tleft\tfrontal\tlobe,\tand\tmore\ton\tthe\tright,\tthan\tdid people\twho\thad\tnever\tbeen\tdepressed.\tHe\tfound\tthe\tsame\tpattern\tin\tpatients newly\tdiagnosed\twith\tdepression.\tDavidson\tspeculates\tthat\tpeople\twho overcome\tdepression\thave\tlearned\tto\tincrease\tthe\tlevel\tof\tactivity\tin\ttheir\tleft prefrontal\tlobe\u2014a\tspeculation\tawaiting\texperimental\ttesting. Though\this\tresearch\tis\ton\tthe\t30\tpercent\tor\tso\tof\tpeople\tat\tthe\textremes,\tjust about\tanyone\tcan\tbe\tclassified\tby\ttheir\tbrain\twave\tpatterns\tas\ttending\ttoward one\tor\tthe\tother\ttype,\tsays\tDavidson.\tThe\tcontrast\tin\ttemperament\tbetween\tthe morose\tand\tthe\tcheerful\tshows\tup\tin\tmany\tways,\tlarge\tand\tsmall.\tFor\texample, in\tone\texperiment\tvolunteers\twatched\tshort\tfilm\tclips.\tSome\twere\tamusing\u2014a gorilla\ttaking\ta\tbath,\ta\tpuppy\tat\tplay.\tOthers,\tlike\tan\tinstructional\tfilm\tfor\tnurses featuring\tgrisly\tdetails\tof\tsurgery,\twere\tquite\tdistressing.\tThe\tright-hemisphere, somber\tfolks\tfound\tthe\thappy\tmovies\tonly\tmildly\tamusing,\tbut\tthey\tfelt\textreme fear\tand\tdisgust\tin\treaction\tto\tthe\tsurgical\tblood\tand\tgore.\tThe\tcheerful\tgroup had\tminimal\treactions\tto\tthe\tsurgery;\ttheir\tstrongest\treactions\twere\tof\tdelight when\tthey\tsaw\tthe\tupbeat\tfilms. Thus\twe\tseem\tby\ttemperament\tprimed\tto\trespond\tto\tlife\tin\teither\ta\tnegative\tor a\tpositive\temotional\tregister.\tThe\ttendency\ttoward\ta\tmelancholy\tor\tupbeat temperament\u2014like\tthat\ttoward\ttimidity\tor\tboldness\u2014emerges\twithin\tthe\tfirst","temperament\u2014like\tthat\ttoward\ttimidity\tor\tboldness\u2014emerges\twithin\tthe\tfirst year\tof\tlife,\ta\tfact\tthat\tstrongly\tsuggests\tit\ttoo\tis\tgenetically\tdetermined.\tLike most\tof\tthe\tbrain,\tthe\tfrontal\tlobes\tare\tstill\tmaturing\tin\tthe\tfirst\tfew\tmonths\tof life,\tand\tso\ttheir\tactivity\tcannot\tbe\treliably\tmeasured\tuntil\tthe\tage\tof\tten\tmonths or\tso.\tBut\tin\tinfants\tthat\tyoung,\tDavidson\tfound\tthat\tthe\tactivity\tlevel\tof\tthe frontal\tlobes\tpredicted\twhether\tthey\twould\tcry\twhen\ttheir\tmothers\tleft\tthe\troom. The\tcorrelation\twas\tvirtually\t100\tpercent:\tof\tdozens\tof\tinfants\ttested\tthis\tway, every\tinfant\twho\tcried\thad\tmore\tbrain\tactivity\ton\tthe\tright\tside,\twhile\tthose\twho did\tnot\thad\tmore\tactivity\ton\tthe\tleft. Still,\teven\tif\tthis\tbasic\tdimension\tof\ttemperament\tis\tlaid\tdown\tfrom\tbirth,\tor very\tnearly\tfrom\tbirth,\tthose\tof\tus\twho\thave\tthe\tmorose\tpattern\tare\tnot necessarily\tdoomed\tto\tgo\tthrough\tlife\tbrooding\tand\tcrotchety.\tThe\temotional lessons\tof\tchildhood\tcan\thave\ta\tprofound\timpact\ton\ttemperament,\teither amplifying\tor\tmuting\tan\tinnate\tpredisposition.\tThe\tgreat\tplasticity\tof\tthe\tbrain\tin childhood\tmeans\tthat\texperiences\tduring\tthose\tyears\tcan\thave\ta\tlasting\timpact on\tthe\tsculpting\tof\tneural\tpathways\tfor\tthe\trest\tof\tlife.\tPerhaps\tthe\tbest illustration\tof\tthe\tkinds\tof\texperiences\tthat\tcan\talter\ttemperament\tfor\tthe\tbetter is\tin\tan\tobservation\tthat\temerged\tfrom\tKagan's\tresearch\twith\ttimid\tchildren. TAMING\tTHE\tOVEREXCITABLE\tAMYGDALA The\tencouraging\tnews\tfrom\tKagan's\tstudies\tis\tthat\tnot\tall\tfearful\tinfants\tgrow up\thanging\tback\tfrom\tlife\u2014temperament\tis\tnot\tdestiny.\tThe\toverexcitable amygdala\tcan\tbe\ttamed,\twith\tthe\tright\texperiences.\tWhat\tmakes\tthe\tdifference are\tthe\temotional\tlessons\tand\tresponses\tchildren\tlearn\tas\tthey\tgrow.\tFor\tthe timid\tchild,\twhat\tmatters\tat\tthe\toutset\tis\thow\tthey\tare\ttreated\tby\ttheir\tparents, and\tso\thow\tthey\tlearn\tto\thandle\ttheir\tnatural\ttimidness.\tThose\tparents\twho engineer\tgradual\temboldening\texperiences\tfor\ttheir\tchildren\toffer\tthem\twhat may\tbe\ta\tlifelong\tcorrective\tto\ttheir\tfearfulness. About\tone\tin\tthree\tinfants\twho\tcome\tinto\tthe\tworld\twith\tall\tthe\tsigns\tof\tan overexcitable\tamygdala\thave\tlost\ttheir\ttimidness\tby\tthe\ttime\tthey\treach kindergarten.7\tFrom\tobservations\tof\tthese\tonce-fearful\tchildren\tat\thome,\tit\tis clear\tthat\tparents,\tand\tespecially\tmothers,\tplay\ta\tmajor\trole\tin\twhether\tan innately\ttimid\tchild\tgrows\tbolder\twith\ttime\tor\tcontinues\tto\tshy\taway\tfrom novelty\tand\tbecome\tupset\tby\tchallenge.\tKagan's\tresearch\tteam\tfound\tthat\tsome of\tthe\tmothers\theld\tto\tthe\tphilosophy\tthat\tthey\tshould\tprotect\ttheir\ttimid toddlers\tfrom\twhatever\twas\tupsetting;\tothers\tfelt\tthat\tit\twas\tmore\timportant\tto help\ttheir\ttimid\tchild\tlearn\thow\tto\tcope\twith\tthese\tupsetting\tmoments,\tand\tso","adapt\tto\tlife's\tsmall\tstruggles.\tThe\tprotective\tbelief\tseems\tto\thave\tabetted\tthe fearfulness,\tprobably\tby\tdepriving\tthe\tyoungsters\tof\topportunities\tfor\tlearning how\tto\tovercome\ttheir\tfears.\tThe\t\\\"learn\tto\tadapt\\\"\tphilosophy\tof\tchildrearing seems\tto\thave\thelped\tfearful\tchildren\tbecome\tbraver. Observations\tin\tthe\thomes\twhen\tthe\tbabies\twere\tabout\tsix\tmonths\told\tfound that\tthe\tprotective\tmothers,\ttrying\tto\tsoothe\ttheir\tinfants,\tpicked\tthem\tup\tand held\tthem\twhen\tthey\tfretted\tor\tcried,\tand\tdid\tso\tlonger\tthan\tthose\tmothers\twho tried\tto\thelp\ttheir\tinfants\tlearn\tto\tmaster\tthese\tmoments\tof\tupset.\tThe\tratio\tof times\tthe\tinfants\twere\theld\twhen\tcalm\tand\twhen\tupset\tshowed\tthat\tthe protective\tmothers\theld\ttheir\tinfants\tmuch\tlonger\tduring\tthe\tupsets\tthan\tthe\tcalm periods. Another\tdifference\temerged\twhen\tthe\tinfants\twere\taround\tone\tyear\told:\tthe protective\tmothers\twere\tmore\tlenient\tand\tindirect\tin\tsetting\tlimits\tfor\ttheir toddlers\twhen\tthey\twere\tdoing\tsomething\tthat\tmight\tbe\tharmful,\tsuch\tas mouthing\tan\tobject\tthey\tmight\tswallow.\tThe\tother\tmothers,\tby\tcontrast,\twere emphatic,\tsetting\tfirm\tlimits,\tgiving\tdirect\tcommands,\tblocking\tthe\tchild's actions,\tinsisting\ton\tobedience. Why\tshould\tfirmness\tlead\tto\ta\treduction\tin\tfearfulness?\tKagan\tspeculates\tthat there\tis\tsomething\tlearned\twhen\ta\tbaby\thas\this\tsteady\tcrawl\ttoward\twhat\tseems to\thim\tan\tintriguing\tobject\t(but\tto\this\tmother\ta\tdangerous\tone)\tinterrupted\tby her\twarning,\t\\\"Get\taway\tfrom\tthat!\\\"\tThe\tinfant\tis\tsuddenly\tforced\tto\tdeal\twith\ta mild\tuncertainty.\tThe\trepetition\tof\tthis\tchallenge\thundreds\tand\thundreds\tof times\tduring\tthe\tfirst\tyear\tof\tlife\tgives\tthe\tinfant\tcontinual\trehearsals,\tin\tsmall doses,\tof\tmeeting\tthe\tunexpected\tin\tlife.\tFor\tfearful\tchildren\tthat\tis\tprecisely\tthe encounter\tthat\thas\tto\tbe\tmastered,\tand\tmanageable\tdoses\tare\tjust\tright\tfor learning\tthe\tlesson.\tWhen\tthe\tencounter\ttakes\tplace\twith\tparents\twho,\tthough loving,\tdo\tnot\trush\tto\tpick\tup\tand\tsoothe\tthe\ttoddler\tover\tevery\tlittle\tupset,\the gradually\tlearns\tto\tmanage\tsuch\tmoments\ton\this\town.\tBy\tage\ttwo,\twhen\tthese formerly\tfearful\ttoddlers\tare\tbrought\tback\tto\tKagan's\tlaboratory,\tthey\tare\tfar\tless likely\tto\tbreak\tout\tinto\ttears\twhen\ta\tstranger\tfrowns\tat\tthem,\tor\tan\texperimenter puts\ta\tblood-pressure\tcuff\taround\ttheir\tarm. Kagan's\tconclusion:\t\\\"It\tappears\tthat\tmothers\twho\tprotect\ttheir\thigh[ly] reactive\tinfants\tfrom\tfrustration\tand\tanxiety\tin\tthe\thope\tof\teffecting\ta benevolent\toutcome\tseem\tto\texacerbate\tthe\tinfant's\tuncertainty\tand\tproduce\tthe opposite\teffect.\\\"8\tIn\tother\twords,\tthe\tprotective\tstrategy\tbackfires\tby\tdepriving timid\ttoddlers\tof\tthe\tvery\topportunity\tto\tlearn\tto\tcalm\tthemselves\tin\tthe\tface\tof the\tunfamiliar,\tand\tso\tgain\tsome\tsmall\tmastery\tof\ttheir\tfears.\tAt\tthe\tneurological","level,\tpresumably,\tthis\tmeans\ttheir\tprefrontal\tcircuits\tmissed\tthe\tchance\tto\tlearn alternate\tresponses\tto\tknee-jerk\tfear;\tinstead,\ttheir\ttendency\tfor\tunbridled fearfulness\tmay\thave\tbeen\tstrengthened\tsimply\tthrough\trepetition. In\tcontrast,\tas\tKagan\ttold\tme,\t\\\"Those\tchildren\twho\thad\tbecome\tless\ttimid\tby kindergarten\tseem\tto\thave\thad\tparents\twho\tput\tgentle\tpressure\ton\tthem\tto\tbe more\toutgoing.\tAlthough\tthis\ttemperamental\ttrait\tseems\tslightly\tharder\tthan others\tto\tchange\u2014probably\tbecause\tof\tits\tphysiological\tbasis\u2014no\thuman quality\tis\tbeyond\tchange.\\\" Throughout\tchildhood\tsome\ttimid\tchildren\tgrow\tbolder\tas\texperience continues\tto\tmold\tthe\tkey\tneural\tcircuitry.\tOne\tof\tthe\tsigns\tthat\ta\ttimid\tchild will\tbe\tmore\tlikely\tto\tovercome\tthis\tnatural\tinhibition\tis\thaving\ta\thigher\tlevel\tof social\tcompetence:\tbeing\tcooperative\tand\tgetting\talong\twith\tother\tchildren; being\tempathic,\tprone\tto\tgiving\tand\tsharing,\tand\tconsiderate;\tand\tbeing\table\tto develop\tclose\tfriendships.\tThese\ttraits\tmarked\ta\tgroup\tof\tchildren\tfirst\tidentified as\thaving\ta\ttimid\ttemperament\tat\tage\tfour,\twho\tshook\tit\toff\tby\tthe\ttime\tthey were\tten\tyears\told.9 By\tcontrast,\tthose\ttimid\tfour-year-olds\twhose\ttemperament\tchanged\tlittle\tover the\tsame\tsix\tyears\ttended\tto\tbe\tless\table\temotionally:\tcrying\tand\tfalling\tapart under\tstress\tmore\teasily;\tbeing\temotionally\tinappropriate;\tbeing\tfearful,\tsulky, or\twhiny;\toverreacting\tto\tminor\tfrustration\twith\tanger;\thaving\ttrouble\tdelaying gratification;\tbeing\toverly\tsensitive\tto\tcriticism,\tor\tmistrustful.\tThese\temotional lapses\tare,\tof\tcourse,\tlikely\tto\tmean\ttheir\trelationships\twith\tother\tchildren\twill be\ttroubled,\tshould\tthey\tbe\table\tto\tovercome\ttheir\tinitial\treluctance\tto\tengage. By\tcontrast,\tit\tis\teasy\tto\tsee\twhy\tthe\tmore\temotionally\tcompetent\u2014though shy\tby\ttemperament\u2014children\tspontaneously\toutgrew\ttheir\ttimidity.\tBeing more\tsocially\tskilled,\tthey\twere\tfar\tmore\tlikely\tto\thave\ta\tsuccession\tof\tpositive experiences\twith\tother\tchildren.\tEven\tif\tthey\twere\ttentative\tabout,\tsay,\tspeaking to\ta\tnew\tplaymate,\tonce\tthe\tice\twas\tbroken\tthey\twere\table\tto\tshine\tsocially.\tThe regular\trepetition\tof\tsuch\tsocial\tsuccess\tover\tmany\tyears\twould\tnaturally\ttend\tto make\tthe\ttimid\tmore\tsure\tof\tthemselves. These\tadvances\ttoward\tboldness\tare\tencouraging;\tthey\tsuggest\tthat\tever innate\temotional\tpatterns\tcan\tchange\tto\tsome\tdegree.\tA\tchild\twho\tcomes\tinto the\tworld\teasily\tfrightened\tcan\tlearn\tto\tbe\tcalmer,\tor\teven\toutgoing,\tin\tthe\tface of\tthe\tunfamiliar.\tFearfulness\u2014or\tany\tother\ttemperament\u2014may\tbe\tpart\tof\tthe biological\tgivens\tof\tour\temotional\tlives,\tbut\twe\tare\tnot\tnecessarily\tlimited\tto\ta specific\temotional\tmenu\tby\tour\tinherited\ttraits.\tThere\tis\ta\trange\tof\tpossibility even\twithin\tgenetic\tconstraints.\tAs\tbehavioral\tgeneticists\tobserve,\tgenes\talone do\tnot\tdetermine\tbehavior;\tour\tenvironment,\tespecially\twhat\twe\texperience\tand","do\tnot\tdetermine\tbehavior;\tour\tenvironment,\tespecially\twhat\twe\texperience\tand learn\tas\twe\tgrow,\tshapes\thow\ta\ttemperamental\tpredisposition\texpresses\titself\tas life\tunfolds.\tOur\temotional\tcapacities\tare\tnot\ta\tgiven;\twith\tthe\tright\tlearning, they\tcan\tbe\timproved.\tThe\treasons\tfor\tthis\tlie\tin\thow\tthe\thuman\tbrain\tmatures. CHILDHOOD:\tA\tWINDOW\tOF\tOPPORTUNITY The\thuman\tbrain\tis\tby\tno\tmeans\tfully\tformed\tat\tbirth.\tIt\tcontinues\tto\tshape\titself through\tlife,\twith\tthe\tmost\tintense\tgrowth\toccurring\tduring\tchildhood.\tChildren are\tborn\twith\tmany\tmore\tneurons\tthan\ttheir\tmature\tbrain\twill\tretain;\tthrough\ta process\tknown\tas\t\\\"pruning\\\"\tthe\tbrain\tactually\tloses\tthe\tneuronal\tconnections that\tare\tless\tused,\tand\tforms\tstrong\tconnections\tin\tthose\tsynaptic\tcircuits\tthat have\tbeen\tutilized\tthe\tmost.\tPruning,\tby\tdoing\taway\twith\textraneous\tsynapses, improves\tthe\tsignal-to-noise\tratio\tin\tthe\tbrain\tby\tremoving\tthe\tcause\tof\tthe \\\"noise.\\\"\tThis\tprocess\tis\tconstant\tand\tquick;\tsynaptic\tconnections\tcan\tform\tin\ta matter\tof\thours\tor\tdays.\tExperience,\tparticularly\tin\tchildhood,\tsculpts\tthe\tbrain. The\tclassic\tdemonstration\tof\tthe\timpact\tof\texperience\ton\tbrain\tgrowth\twas\tby Nobel\tPrize-winners\tThorsten\tWiesel\tand\tDavid\tHubel,\tboth\tneuroscientists.10 They\tshowed\tthat\tin\tcats\tand\tmonkeys,\tthere\twas\ta\tcritical\tperiod\tduring\tthe first\tfew\tmonths\tof\tlife\tfor\tthe\tdevelopment\tof\tthe\tsynapses\tthat\tcarry\tsignals from\tthe\teye\tto\tthe\tvisual\tcortex,\twhere\tthose\tsignals\tare\tinterpreted.\tIf\tone\teye was\tkept\tclosed\tduring\tthat\tperiod,\tthe\tnumber\tof\tsynapses\tfrom\tthat\teye\tto\tthe visual\tcortex\tdwindled\taway,\twhile\tthose\tfrom\tthe\topen\teye\tmultiplied.\tIf\tafter the\tcritical\tperiod\tended\tthe\tclosed\teye\twas\treopened,\tthe\tanimal\twas functionally\tblind\tin\tthat\teye.\tAlthough\tnothing\twas\twrong\twith\tthe\teye\titself, there\twere\ttoo\tfew\tcircuits\tto\tthe\tvisual\tcortex\tfor\tsignals\tfrom\tthat\teye\tto\tbe interpreted. In\thumans\tthe\tcorresponding\tcritical\tperiod\tfor\tvision\tlasts\tfor\tthe\tfirst\tsix years\tof\tlife.\tDuring\tthis\ttime\tnormal\tseeing\tstimulates\tthe\tformation\tof increasingly\tcomplex\tneural\tcircuitry\tfor\tvision\tthat\tbegins\tin\tthe\teye\tand\tends in\tthe\tvisual\tcortex.\tIf\ta\tchild's\teye\tis\ttaped\tclosed\tfor\teven\ta\tfew\tweeks,\tit\tcan produce\ta\tmeasurable\tdeficit\tin\tthe\tvisual\tcapacity\tof\tthat\teye.\tIf\ta\tchild\thas\thad one\teye\tclosed\tfor\tseveral\tmonths\tduring\tthis\tperiod,\tand\tlater\thas\tit\trestored, that\teye's\tvision\tfor\tdetail\twill\tbe\timpaired. A\tvivid\tdemonstration\tof\tthe\timpact\tof\texperience\ton\tthe\tdeveloping\tbrain\tis in\tstudies\tof\t\\\"rich\\\"\tand\t\\\"poor\\\"\trats.11\tThe\t\\\"rich\\\"\trats\tlived\tin\tsmall\tgroups\tin cages\twith\tplenty\tof\trat\tdiversions\tsuch\tas\tladders\tand\ttreadmills.\tThe\t\\\"poor\\\" rats\tlived\tin\tcages\tthat\twere\tsimilar\tbut\tbarren\tand\tlacking\tdiversions.\tOver\ta","period\tof\tmonths\tthe\tneocortices\tof\tthe\trich\trats\tdeveloped\tfar\tmore\tcomplex networks\tof\tsynaptic\tcircuits\tinterconnecting\tthe\tneurons;\tthe\tpoor\trats'\tneuronal circuitry\twas\tsparse\tby\tcomparison.\tThe\tdifference\twas\tso\tgreat\tthat\tthe\trich rats'\tbrains\twere\theavier,\tand,\tperhaps\tnot\tsurprisingly,\tthey\twere\tfar\tsmarter\tat solving\tmazes\tthan\tthe\tpoor\trats.\tSimilar\texperiments\twith\tmonkeys\tshow\tthese differences\tbetween\tthose\t\\\"rich\\\"\tand\t\\\"poor\\\"\tin\texperience,\tand\tthe\tsame\teffect\tis sure\tto\toccur\tin\thumans. Psychotherapy\u2014that\tis,\tsystematic\temotional\trelearning\u2014stands\tas\ta\tcase\tin point\tfor\tthe\tway\texperience\tcan\tboth\tchange\temotional\tpatterns\tand\tshape\tthe brain.\tThe\tmost\tdramatic\tdemonstration\tcomes\tfrom\ta\tstudy\tof\tpeople\tbeing treated\tfor\tobsessive-compulsive\tdisorder.12\tOne\tof\tthe\tmore\tcommon compulsions\tis\thand\twashing,\twhich\tcan\tbe\tdone\tso\toften,\teven\thundreds\tof times\tin\ta\tday,\tthat\tthe\tperson's\tskin\tcracks.\tPET\tscan\tstudies\tshow\tthat obsessive-compulsives\thave\tgreater\tthan\tnormal\tactivity\tin\tthe\tprefrontal lobes.13 Half\tof\tthe\tpatients\tin\tthe\tstudy\treceived\tthe\tstandard\tdrug\ttreatment, fluoxetine\t(better\tknown\tby\tthe\tbrand\tname\tProzac),\tand\thalf\tgot\tbehavior therapy.\tDuring\tthe\ttherapy\tthey\twere\tsystematically\texposed\tto\tthe\tobject\tof their\tobsession\tor\tcompulsion\twithout\tperforming\tit;\tpatients\twith\thand-washing compulsions\twere\tput\tat\ta\tsink,\tbut\tnot\tallowed\tto\twash.\tAt\tthe\tsame\ttime\tthey learned\tto\tquestion\tthe\tfears\tand\tdreads\tthat\tspurred\tthem\ton\u2014for\texample,\tthat failure\tto\twash\twould\tmean\tthey\twould\tget\ta\tdisease\tand\tdie.\tGradually,\tthrough months\tof\tsuch\tsessions,\tthe\tcompulsions\tfaded,\tjust\tas\tthey\tdid\twith\tthe medication. The\tremarkable\tfinding,\tthough,\twas\ta\tPET\tscan\ttest\tshowing\tthat\tthe behavior\ttherapy\tpatients\thad\tas\tsignificant\ta\tdecrease\tin\tthe\tactivity\tof\ta\tkey part\tof\tthe\temotional\tbrain,\tthe\tcaudate\tnucleus,\tas\tdid\tthe\tpatients\tsuccessfully treated\twith\tthe\tdrug\tfluoxetine.\tTheir\texperience\thad\tchanged\tbrain\tfunction\u2014 and\trelieved\tsymptoms\u2014as\teffectively\tas\tthe\tmedication! \t CRUCIAL\tWINDOWS Of\tall\tspecies\twe\thumans\ttake\tthe\tlongest\tfor\tour\tbrains\tto\tfully\tmature.\tWhile each\tarea\tof\tthe\tbrain\tdevelops\tat\ta\tdifferent\trate\tduring\tchildhood,\tthe\tonset\tof","puberty\tmarks\tone\tof\tthe\tmost\tsweeping\tperiods\tof\tpruning\tthroughout\tthe brain.\tSeveral\tbrain\tareas\tcritical\tfor\temotional\tlife\tare\tamong\tthe\tslowest\tto mature.\tWhile\tthe\tsensory\tareas\tmature\tduring\tearly\tchildhood,\tand\tthe\tlimbic system\tby\tpuberty,\tthe\tfrontal\tlobes\u2014seat\tof\temotional\tself-control, understanding,\tand\tartful\tresponse\u2014continue\tto\tdevelop\tinto\tlate\tadolescence, until\tsomewhere\tbetween\tsixteen\tand\teighteen\tyears\tof\tage.14 The\thabits\tof\temotional\tmanagement\tthat\tare\trepeated\tover\tand\tover\tagain during\tchildhood\tand\tthe\tteenage\tyears\twill\tthemselves\thelp\tmold\tthis\tcircuitry. This\tmakes\tchildhood\ta\tcrucial\twindow\tof\topportunity\tfor\tshaping\tlifelong emotional\tpropensities;\thabits\tacquired\tin\tchildhood\tbecome\tset\tin\tthe\tbasic synaptic\twiring\tof\tneural\tarchitecture,\tand\tare\tharder\tto\tchange\tlater\tin\tlife. Given\tthe\timportance\tof\tthe\tprefrontal\tlobes\tfor\tmanaging\temotion,\tthe\tvery long\twindow\tfor\tsynaptic\tsculpting\tin\tthis\tbrain\tregion\tmay\twell\tmean\tthat,\tin the\tgrand\tdesign\tof\tthe\tbrain,\ta\tchild's\texperiences\tover\tthe\tyears\tcan\tmold lasting\tconnections\tin\tthe\tregulatory\tcircuitry\tof\tthe\temotional\tbrain.\tAs\twe\thave seen,\tcritical\texperiences\tinclude\thow\tdependable\tand\tresponsive\tto\tthe\tchild's needs\tparents\tare,\tthe\topportunities\tand\tguidance\ta\tchild\thas\tin\tlearning\tto handle\ther\town\tdistress\tand\tcontrol\timpulse,\tand\tpractice\tin\tempathy.\tBy\tthe same\ttoken,\tneglect\tor\tabuse,\tthe\tmisattunement\tof\ta\tself-absorbed\tor\tindifferent parent,\tor\tbrutal\tdiscipline\tcan\tleave\ttheir\timprint\ton\tthe\temotional\tcircuitry.15 One\tof\tthe\tmost\tessential\temotional\tlessons,\tfirst\tlearned\tin\tinfancy\tand refined\tthroughout\tchildhood,\tis\thow\tto\tsoothe\toneself\twhen\tupset.\tFor\tvery young\tinfants,\tsoothing\tcomes\tfrom\tcaretakers:\ta\tmother\thears\ther\tinfant\tcrying, picks\thim\tup,\tholds\tand\trocks\thim\tuntil\the\tcalms\tdown.\tThis\tbiological attunement,\tsome\ttheorists\tpropose,\thelps\tthe\tchild\tbegin\tto\tlearn\thow\tto\tdo\tthe same\tfor\thimself.16\tDuring\ta\tcritical\tperiod\tbetween\tten\tand\teighteen\tmonths, the\torbitofrontal\tarea\tof\tthe\tprefrontal\tcortex\tis\trapidly\tforming\tthe\tconnections with\tthe\tlimbic\tbrain\tthat\twill\tmake\tit\ta\tkey\ton\/off\tswitch\tfor\tdistress.\tThe\tinfant who\tthrough\tcountless\tepisodes\tof\tbeing\tsoothed\tis\thelped\talong\tin\tlearning\thow to\tcalm\tdown,\tthe\tspeculation\tgoes,\twill\thave\tstronger\tconnections\tin\tthis\tcircuit for\tcontrolling\tdistress,\tand\tso\tthroughout\tlife\twill\tbe\tbetter\tat\tsoothing\thimself when\tupset. To\tbe\tsure,\tthe\tart\tof\tsoothing\toneself\tis\tmastered\tover\tmany\tyears,\tand\twith new\tmeans,\tas\tbrain\tmaturation\toffers\ta\tchild\tprogressively\tmore\tsophisticated emotional\ttools.\tRemember,\tthe\tfrontal\tlobes,\tso\timportant\tfor\tregulating\tlimbic impulse,\tmature\tinto\tadolescence.17\tAnother\tkey\tcircuit\tthat\tcontinues\tto\tshape itself\tthrough\tchildhood\tcenters\ton\tthe\tvagus\tnerve,\twhich\tat\tone\tend\tregulates","the\theart\tand\tother\tparts\tof\tthe\tbody,\tand\tat\tthe\tother\tsends\tsignals\tto\tthe amygdala\tfrom\tthe\tadrenals,\tprompting\tit\tto\tsecrete\tthe\tcatecholamines,\twhich prime\tthe\tfight-or-flight\tresponse.\tA\tUniversity\tof\tWashington\tteam\tthat assessed\tthe\timpact\tof\tchildrearing\tdiscovered\tthat\temotionally\tadept\tparenting led\tto\ta\tchange\tfor\tthe\tbetter\tin\tvagus-nerve\tfunction. As\tJohn\tGottman,\tthe\tpsychologist\twho\tled\tthe\tresearch,\texplained,\t\\\"Parents modify\ttheir\tchildren's\tvagal\ttone\\\"\u2014a\tmeasure\tof\thow\teasily\ttriggered\tthe\tvagus nerve\tis\u2014\\\"by\tcoaching\tthem\temotionally:\ttalking\tto\tchildren\tabout\ttheir\tfeelings and\thow\tto\tunderstand\tthem,\tnot\tbeing\tcritical\tand\tjudgmental,\tproblem-solving about\temotional\tpredicaments,\tcoaching\tthem\ton\twhat\tto\tdo,\tlike\talternatives\tto hitting,\tor\tto\twithdrawing\twhen\tyou're\tsad.\\\"\tWhen\tparents\tdid\tthis\twell,\tchildren were\tbetter\table\tto\tsuppress\tthe\tvagal\tactivity\tthat\tkeeps\tthe\tamygdala\tpriming the\tbody\twith\tfight-or-flight\thormones\u2014and\tso\twere\tbetter\tbehaved. It\tstands\tto\treason\tthat\tthe\tkey\tskills\tof\temotional\tintelligence\teach\thave critical\tperiods\textending\tover\tseveral\tyears\tin\tchildhood.\tEach\tperiod represents\ta\twindow\tfor\thelping\tthat\tchild\tinstill\tbeneficial\temotional\thabits\tor, if\tmissed,\tto\tmake\tit\tthat\tmuch\tharder\tto\toffer\tcorrective\tlessons\tlater\tin\tlife.\tThe massive\tsculpting\tand\tpruning\tof\tneural\tcircuits\tin\tchildhood\tmay\tbe\tan underlying\treason\twhy\tearly\temotional\thardships\tand\ttrauma\thave\tsuch\tenduring and\tpervasive\teffects\tin\tadulthood.\tIt\tmay\texplain,\ttoo,\twhy\tpsychotherapy\tcan often\ttake\tso\tlong\tto\taffect\tsome\tof\tthese\tpatterns\u2014and\twhy,\tas\twe've\tseen, even\tafter\ttherapy\tthose\tpatterns\ttend\tto\tremain\tas\tunderlying\tpropensities, though\twith\tan\toverlay\tof\tnew\tinsights\tand\trelearned\tresponses. To\tbe\tsure,\tthe\tbrain\tremains\tplastic\tthroughout\tlife,\tthough\tnot\tto\tthe spectacular\textent\tseen\tin\tchildhood.\tAll\tlearning\timplies\ta\tchange\tin\tthe\tbrain, a\tstrengthening\tof\tsynaptic\tconnection.\tThe\tbrain\tchanges\tin\tthe\tpatients\twith obsessive-compulsive\tdisorder\tshow\tthat\temotional\thabits\tare\tmalleable throughout\tlife,\twith\tsome\tsustained\teffort,\teven\tat\tthe\tneural\tlevel.\tWhat happens\twith\tthe\tbrain\tin\tPTSD\t(or\tin\ttherapy,\tfor\tthat\tmatter)\tis\tan\tanalog\tof the\teffects\tall\trepeated\tor\tintense\temotional\texperiences\tbring,\tfor\tbetter\tor\tfor worse. Some\tof\tthe\tmost\ttelling\tof\tsuch\tlessons\tcome\tfrom\tparent\tto\tchild.\tThere\tare very\tdifferent\temotional\thabits\tinstilled\tby\tparents\twhose\tattunement\tmeans\tan infant's\temotional\tneeds\tare\tacknowledged\tand\tmet\tor\twhose\tdiscipline\tincludes empathy,\ton\tthe\tone\thand,\tor\tself-absorbed\tparents\twho\tignore\ta\tchild's\tdistress or\twho\tdiscipline\tcapriciously\tby\tyelling\tand\thitting.\tMuch\tpsychotherapy\tis,\tin a\tsense,\ta\tremedial\ttutorial\tfor\twhat\twas\tskewed\tor\tmissed\tcompletely\tearlier\tin life.\tBut\twhy\tnot\tdo\twhat\twe\tcan\tto\tprevent\tthat\tneed,\tby\tgiving\tchildren\tthe","life.\tBut\twhy\tnot\tdo\twhat\twe\tcan\tto\tprevent\tthat\tneed,\tby\tgiving\tchildren\tthe nurturing\tand\tguidance\tthat\tcultivates\tthe\tessential\temotional\tskills\tin\tthe\tfirst place?","PART\tFIVE EMOTIONAL\tLITERACY","15 The\tCost\tof\tEmotional\tIlliteracy \t It\tbegan\tas\ta\tsmall\tdispute,\tbut\thad\tescalated.\tIan\tMoore,\ta\tsenior\tat\tThomas Jefferson\tHigh\tSchool\tin\tBrooklyn,\tand\tTyrone\tSinkler,\ta\tjunior,\thad\thad\ta falling-out\twith\ta\tbuddy,\tfifteen-year-old\tKhalil\tSumpter.\tThen\tthey\thad\tstarted picking\ton\thim\tand\tmaking\tthreats.\tNow\tit\texploded. Khalil,\tscared\tthat\tIan\tand\tTyrone\twere\tgoing\tto\tbeat\thim\tup,\tbrought\ta\t.38 caliber\tpistol\tto\tschool\tone\tmorning,\tand,\tfifteen\tfeet\tfrom\ta\tschool\tguard,\tshot both\tboys\tto\tdeath\tat\tpoint-blank\trange\tin\tthe\tschool's\thallway. The\tincident,\tchilling\tas\tit\tis,\tcan\tbe\tread\tas\tyet\tanother\tsign\tof\ta\tdesperate need\tfor\tlessons\tin\thandling\temotions,\tsettling\tdisagreements\tpeaceably,\tand\tjust plain\tgetting\talong.\tEducators,\tlong\tdisturbed\tby\tschool\tchildren's\tlagging\tscores in\tmath\tand\treading,\tare\trealizing\tthere\tis\ta\tdifferent\tand\tmore\talarming deficiency:\temotional\tilliteracy.1\tAnd\twhile\tlaudable\tefforts\tare\tbeing\tmade\tto raise\tacademic\tstandards,\tthis\tnew\tand\ttroubling\tdeficiency\tis\tnot\tbeing addressed\tin\tthe\tstandard\tschool\tcurriculum.\tAs\tone\tBrooklyn\tteacher\tput\tit,\tthe present\temphasis\tin\tschools\tsuggests\tthat\t\\\"we\tcare\tmore\tabout\thow\twell\tschool children\tcan\tread\tand\twrite\tthan\twhether\tthey'll\tbe\talive\tnext\tweek.\\\" Signs\tof\tthe\tdeficiency\tcan\tbe\tseen\tin\tviolent\tincidents\tsuch\tas\tthe\tshooting\tof Ian\tand\tTyrone,\tgrowing\tever\tmore\tcommon\tin\tAmerican\tschools.\tBut\tthese\tare more\tthan\tisolated\tevents;\tthe\theightening\tof\tthe\tturmoil\tof\tadolescence\tand troubles\tof\tchildhood\tcan\tbe\tread\tfor\tthe\tUnited\tStates\u2014a\tbellwether\tof\tworld trends\u2014in\tstatistics\tsuch\tas\tthese:2 In\t1990,\tcompared\tto\tthe\tprevious\ttwo\tdecades,\tthe\tUnited\tStates\tsaw\tthe highest\tjuvenile\tarrest\trate\tfor\tviolent\tcrimes\tever;\tteen\tarrests\tfor\tforcible\trape had\tdoubled;\tteen\tmurder\trates\tquadrupled,\tmostly\tdue\tto\tan\tincrease\tin shootings.3\tDuring\tthose\tsame\ttwo\tdecades,\tthe\tsuicide\trate\tfor\tteenagers\ttripled, as\tdid\tthe\tnumber\tof\tchildren\tunder\tfourteen\twho\tare\tmurder\tvictims.4 More,\tand\tyounger,\tteenage\tgirls\tare\tgetting\tpregnant.\tAs\tof\t1993\tthe\tbirthrate","among\tgirls\tten\tto\tfourteen\thas\trisen\tsteadily\tfor\tfive\tyears\tin\ta\trow\u2014some\tcall it\t\\\"babies\thaving\tbabies\\\"\u2014as\thas\tthe\tproportion\tof\tunwanted\tteen\tpregnancies and\tpeer\tpressure\tto\thave\tsex.\tRates\tof\tvenereal\tdisease\tamong\tteenagers\thave tripled\tover\tthe\tlast\tthree\tdecades.5 While\tthese\tfigures\tare\tdiscouraging,\tif\tthe\tfocus\tis\ton\tAfrican-American youth,\tespecially\tin\tthe\tinner\tcity,\tthey\tare\tutterly\tbleak\u2014all\tthe\trates\tare\thigher by\tfar,\tsometimes\tdoubled,\tsometimes\ttripled\tor\thigher.\tFor\texample,\theroin\tand cocaine\tuse\tamong\twhite\tyouth\tclimbed\tabout\t300\tpercent\tover\tthe\ttwo\tdecades before\tthe\t1990s;\tfor\tAfrican-American\tyouth\tit\tjumped\tto\ta\tstaggering\t13\ttimes the\trate\tof\ttwenty\tyears\tbefore.6 The\tmost\tcommon\tcause\tof\tdisability\tamong\tteenagers\tis\tmental\tillness. Symptoms\tof\tdepression,\twhether\tmajor\tor\tminor,\taffect\tup\tto\tone\tthird\tof teenagers;\tfor\tgirls,\tthe\tincidence\tof\tdepression\tdoubles\tat\tpuberty.\tThe frequency\tof\teating\tdisorders\tin\tteenage\tgirls\thas\tskyrocketed.7 Finally,\tunless\tthings\tchange,\tthe\tlong-term\tprospects\tfor\ttoday's\tchildren marrying\tand\thaving\ta\tfruitful,\tstable\tlife\ttogether\tare\tgrowing\tmore\tdismal\twith each\tgeneration.\tAs\twe\tsaw\tin\tChapter\t9,\twhile\tduring\tthe\t1970s\tand\t1980s\tthe divorce\trate\twas\taround\t50\tpercent,\tas\twe\tentered\tthe\t1990s\tthe\trate\tamong newlyweds\tpredicted\tthat\ttwo\tout\tof\tthree\tmarriages\tof\tyoung\tpeople\twould\tend in\tdivorce. AN\tEMOTIONAL\tMALAISE These\talarming\tstatistics\tare\tlike\tthe\tcanary\tin\tthe\tcoal\tminer's\ttunnel\twhose death\twarns\tof\ttoo\tlittle\toxygen.\tBeyond\tsuch\tsobering\tnumbers,\tthe\tplight\tof today's\tchildren\tcan\tbe\tseen\tat\tmore\tsubtle\tlevels,\tin\tday-to-day\tproblems\tthat have\tnot\tyet\tblossomed\tinto\toutright\tcrises.\tPerhaps\tthe\tmost\ttelling\tdata\tof\tall \u2014a\tdirect\tbarometer\tof\tdropping\tlevels\tof\temotional\tcompetence\u2014are\tfrom\ta national\tsample\tof\tAmerican\tchildren,\tages\tseven\tto\tsixteen,\tcomparing\ttheir emotional\tcondition\tin\tthe\tmid-1970s\tand\tat\tthe\tend\tof\tthe\t1980s.8\tBased\ton parents'\tand\tteachers'\tassessments,\tthere\twas\ta\tsteady\tworsening.\tNo\tone problem\tstood\tout;\tall\tindicators\tsimply\tcrept\tsteadily\tin\tthe\twrong\tdirection. Children,\ton\taverage,\twere\tdoing\tmore\tpoorly\tin\tthese\tspecific\tways:","\u2022\tWithdrawal\tor\tsocial\tproblems:\tpreferring\tto\tbe\talone;\tbeing\tsecretive; sulking\ta\tlot;\tlacking\tenergy;\tfeeling\tunhappy;\tbeing\toverly\tdependent \u2022\tAnxious\tand\tdepressed:\tbeing\tlonely;\thaving\tmany\tfears\tand\tworries; needing\tto\tbe\tperfect;\tfeeling\tunloved;\tfeeling\tnervous\tor\tsad\tand\tdepressed \u2022\tAttention\tor\tthinking\tproblems:\tunable\tto\tpay\tattention\tor\tsit\tstill; daydreaming;\tacting\twithout\tthinking;\tbeing\ttoo\tnervous\tto\tconcentrate;\tdoing poorly\ton\tschoolwork;\tunable\tto\tget\tmind\toff\tthoughts \u2022\tDelinquent\tor\taggressive:\thanging\taround\tkids\twho\tget\tin\ttrouble;\tlying\tand cheating;\targuing\ta\tlot;\tbeing\tmean\tto\tother\tpeople;\tdemanding\tattention; destroying\tother\tpeople's\tthings;\tdisobeying\tat\thome\tand\tat\tschool;\tbeing stubborn\tand\tmoody;\ttalking\ttoo\tmuch;\tteasing\ta\tlot;\thaving\ta\thot\ttemper \t While\tany\tof\tthese\tproblems\tin\tisolation\traises\tno\teyebrows,\ttaken\tas\ta\tgroup they\tare\tbarometers\tof\ta\tsea\tchange,\ta\tnew\tkind\tof\ttoxicity\tseeping\tinto\tand poisoning\tthe\tvery\texperience\tof\tchildhood,\tsignifying\tsweeping\tdeficits\tin emotional\tcompetences.\tThis\temotional\tmalaise\tseems\tto\tbe\ta\tuniversal\tprice\tof modern\tlife\tfor\tchildren.\tWhile\tAmericans\toften\tdecry\ttheir\tproblems\tas particularly\tbad\tcompared\tto\tother\tcultures',\tstudies\taround\tthe\tworld\thave\tfound rates\ton\ta\tpar\twith\tor\tworse\tthan\tin\tthe\tUnited\tStates.\tFor\texample,\tin\tthe\t1980s teachers\tand\tparents\tin\tthe\tNetherlands,\tChina,\tand\tGermany\trated\tchildren\tat about\tthe\tsame\tlevel\tof\tproblems\tas\twere\tfound\tfor\tAmerican\tchildren\tin\t1976. And\tsome\tcountries\thad\tchildren\tin\tworse\tshape\tthan\tcurrent\tU.S.\tlevels, including\tAustralia,\tFrance,\tand\tThailand.\tBut\tthis\tmay\tnot\tremain\ttrue\tfor\tlong. The\tlarger\tforces\tthat\tpropel\tthe\tdownward\tspiral\tin\temotional\tcompetence\tseem to\tbe\tpicking\tup\tspeed\tin\tthe\tUnited\tStates\trelative\tto\tmany\tother\tdeveloped nations.9 No\tchildren,\trich\tor\tpoor,\tare\texempt\tfrom\trisk;\tthese\tproblems\tare\tuniversal, occurring\tin\tall\tethnic,\tracial,\tand\tincome\tgroups.\tThus\twhile\tchildren\tin\tpoverty have\tthe\tworst\trecord\ton\tindices\tof\temotional\tskills,\ttheir\trate\tof\tdeterioration over\tthe\tdecades\twas\tno\tworse\tthan\tfor\tmiddle-class\tchildren\tor\tfor\twealthy children:\tall\tshow\tthe\tsame\tsteady\tslide.\tThere\thas\talso\tbeen\ta\tcorresponding threefold\trise\tin\tthe\tnumber\tof\tchildren\twho\thave\tgotten\tpsychological\thelp (perhaps\ta\tgood\tsign,\tsignaling\tthat\thelp\tis\tmore\tavailable),\tas\twell\tas\ta\tnear doubling\tof\tthe\tnumber\tof\tchildren\twho\thave\tenough\temotional\tproblems\tthat they\tshould\tget\tsuch\thelp\tbut\thave\tnot\t(a\tbad\tsign)\u2014from\tabout\t9\tpercent\tin","1976\tto\t18\tpercent\tin\t1989. Urie\tBronfenbrenner,\tthe\teminent\tCornell\tUniversity\tdevelopmental psychologist\twho\tdid\tan\tinternational\tcomparison\tof\tchildren's\twell-being,\tsays: \\\"In\tthe\tabsence\tof\tgood\tsupport\tsystems,\texternal\tstresses\thave\tbecome\tso\tgreat that\teven\tstrong\tfamilies\tare\tfalling\tapart.\tThe\thecticness,\tinstability,\tand inconsistency\tof\tdaily\tfamily\tlife\tare\trampant\tin\tall\tsegments\tof\tour\tsociety, including\tthe\twell-educated\tand\twell-to-do.\tWhat\tis\tat\tstake\tis\tnothing\tless\tthan the\tnext\tgeneration,\tparticularly\tmales,\twho\tin\tgrowing\tup\tare\tespecially vulnerable\tto\tsuch\tdisruptive\tforces\tas\tthe\tdevastating\teffects\tof\tdivorce, poverty,\tand\tunemployment.\tThe\tstatus\tof\tAmerican\tchildren\tand\tfamilies\tis\tas desperate\tas\tever....\tWe\tare\tdepriving\tmillions\tof\tchildren\tof\ttheir\tcompetence and\tmoral\tcharacter.\\\"10 This\tis\tnot\tjust\tan\tAmerican\tphenomenon\tbut\ta\tglobal\tone,\twith\tworldwide competition\tto\tdrive\tdown\tlabor\tcosts\tcreating\teconomic\tforces\tthat\tpress\ton\tthe family.\tThese\tare\ttimes\tof\tfinancially\tbesieged\tfamilies\tin\twhich\tboth\tparents work\tlong\thours,\tso\tthat\tchildren\tare\tleft\tto\ttheir\town\tdevices\tor\tthe\tTV\tbaby- sits;\twhen\tmore\tchildren\tthan\tever\tgrow\tup\tin\tpoverty;\twhen\tthe\tone-parent family\tis\tbecoming\tever\tmore\tcommonplace;\twhen\tmore\tinfants\tand\ttoddlers\tare left\tin\tday\tcare\tso\tpoorly\trun\tthat\tit\tamounts\tto\tneglect.\tAll\tthis\tmeans,\teven\tfor well-intentioned\tparents,\tthe\terosion\tof\tthe\tcountless\tsmall,\tnourishing exchanges\tbetween\tparent\tand\tchild\tthat\tbuild\temotional\tcompetences. If\tfamilies\tno\tlonger\tfunction\teffectively\tto\tput\tall\tour\tchildren\ton\ta\tfirm footing\tfor\tlife,\twhat\tare\twe\tto\tdo?\tA\tmore\tcareful\tlook\tat\tthe\tmechanics\tof specific\tproblems\tsuggests\thow\tgiven\tdeficits\tin\temotional\tor\tsocial competences\tlay\tthe\tfoundation\tfor\tgrave\tproblems\u2014and\thow\twell-aimed correctives\tor\tpreventives\tcould\tkeep\tmore\tchildren\ton\ttrack. TAMING\tAGGRESSION In\tmy\telementary\tschool\tthe\ttough\tkid\twas\tJimmy,\ta\tfourth\tgrader\twhen\tI\twas\tin first\tgrade.\tHe\twas\tthe\tkid\twho\twould\tsteal\tyour\tlunch\tmoney,\ttake\tyour\tbike, slug\tyou\tas\tsoon\tas\ttalk\tto\tyou.\tJimmy\twas\tthe\tclassic\tbully,\tstarting\tfights\twith the\tleast\tprovocation,\tor\tnone\tat\tall.\tWe\tall\tstood\tin\tawe\tof\tJimmy\u2014and\twe\tall stood\tat\ta\tdistance.\tEveryone\thated\tand\tfeared\tJimmy;\tno\tone\twould\tplay\twith him.\tIt\twas\tas\tthough\teverywhere\the\twent\ton\tthe\tplayground\tan\tinvisible bodyguard\tcleared\tkids\tout\tof\this\tway. Kids\tlike\tJimmy\tare\tclearly\ttroubled.\tBut\twhat\tmay\tbe\tless\tobvious\tis\tthat","Kids\tlike\tJimmy\tare\tclearly\ttroubled.\tBut\twhat\tmay\tbe\tless\tobvious\tis\tthat being\tso\tflagrantly\taggressive\tin\tchildhood\tis\ta\tmark\tof\temotional\tand\tother troubles\tto\tcome.\tJimmy\twas\tin\tjail\tfor\tassault\tby\tthe\ttime\the\treached\tsixteen. The\tlifelong\tlegacy\tof\tchildhood\taggressiveness\tin\tkids\tlike\tJimmy\thas emerged\tfrom\tmany\tstudies.11\tAs\twe\thave\tseen,\tthe\tfamily\tlife\tof\tsuch aggressive\tchildren\ttypically\tincludes\tparents\twho\talternate\tneglect\twith\tharsh and\tcapricious\tpunishments,\ta\tpattern\tthat,\tperhaps\tunderstandably,\tmakes\tthe children\ta\tbit\tparanoid\tor\tcombative. Not\tall\tangry\tchildren\tare\tbullies;\tsome\tare\twithdrawn\tsocial\toutcasts\twho overreact\tto\tbeing\tteased\tor\tto\twhat\tthey\tperceive\tas\tslights\tor\tunfairness.\tBut the\tone\tperceptual\tflaw\tthat\tunites\tsuch\tchildren\tis\tthat\tthey\tperceive\tslights where\tnone\twere\tintended,\timagining\ttheir\tpeers\tto\tbe\tmore\thostile\ttoward\tthem than\tthey\tactually\tare.\tThis\tleads\tthem\tto\tmisperceive\tneutral\tacts\tas\tthreatening ones\u2014an\tinnocent\tbump\tis\tseen\tas\ta\tvendetta\u2014and\tto\tattack\tin\treturn.\tThat,\tof course,\tleads\tother\tchildren\tto\tshun\tthem,\tisolating\tthem\tfurther.\tSuch\tangry, isolated\tchildren\tare\thighly\tsensitive\tto\tinjustices\tand\tbeing\ttreated\tunfairly. They\ttypically\tsee\tthemselves\tas\tvictims\tand\tcan\trecite\ta\tlist\tof\tinstances\twhen, say,\tteachers\tblamed\tthem\tfor\tdoing\tsomething\twhen\tin\tfact\tthey\twere\tinnocent. Another\ttrait\tof\tsuch\tchildren\tis\tthat\tonce\tthey\tare\tin\tthe\theat\tof\tanger\tthey\tcan think\tof\tonly\tone\tway\tto\treact:\tby\tlashing\tout. These\tperceptual\tbiases\tcan\tbe\tseen\tat\twork\tin\tan\texperiment\tin\twhich\tbullies are\tpaired\twith\ta\tmore\tpeaceable\tchild\tto\twatch\tvideos.\tIn\tone\tvideo,\ta\tboy drops\this\tbooks\twhen\tanother\tknocks\tinto\thim,\tand\tchildren\tstanding\tnearby laugh;\tthe\tboy\twho\tdropped\tthe\tbooks\tgets\tangry\tand\ttries\tto\thit\tone\tof\tthose who\tlaughed.\tWhen\tthe\tboys\twho\twatched\tthe\tvideo\ttalk\tabout\tit\tafterward,\tthe bully\talways\tsees\tthe\tboy\twho\tstruck\tout\tas\tjustified.\tEven\tmore\ttelling,\twhen they\thave\tto\trate\thow\taggressive\tthe\tboys\twere\tduring\ttheir\tdiscussion\tof\tthe video,\tthe\tbullies\tsee\tthe\tboy\twho\tknocked\tinto\tthe\tother\tas\tmore\tcombative, and\tthe\tanger\tof\tthe\tboy\twho\tstruck\tout\tas\tjustified.12 This\tjump\tto\tjudgment\ttestifies\tto\ta\tdeep\tperceptual\tbias\tin\tpeople\twho\tare unusually\taggressive:\tthey\tact\ton\tthe\tbasis\tof\tthe\tassumption\tof\thostility\tor threat,\tpaying\ttoo\tlittle\tattention\tto\twhat\tis\tactually\tgoing\ton.\tOnce\tthey\tassume threat,\tthey\tleapfrog\tto\taction.\tFor\tinstance,\tif\tan\taggressive\tboy\tis\tplaying checkers\twith\tanother\twho\tmoves\ta\tpiece\tout\tof\tturn,\the'll\tinterpret\tthe\tmove\tas \\\"cheating\\\"\twithout\tpausing\tto\tfind\tout\tif\tit\thad\tbeen\tan\tinnocent\tmistake.\tHis presumption\tis\tof\tmalevolence\trather\tthan\tinnocence;\this\treaction\tis\tautomatic hostility.\tAlong\twith\tthe\tknee-jerk\tperception\tof\ta\thostile\tact\tis\tentwined\tan equally\tautomatic\taggression;\tinstead\tof,\tsay,\tpointing\tout\tto\tthe\tother\tboy\tthat","equally\tautomatic\taggression;\tinstead\tof,\tsay,\tpointing\tout\tto\tthe\tother\tboy\tthat he\tmade\ta\tmistake,\the\twill\tjump\tto\taccusation,\tyelling,\thitting.\tAnd\tthe\tmore such\tchildren\tdo\tthis,\tthe\tmore\tautomatic\taggression\tbecomes\tfor\tthem,\tand\tthe more\tthe\trepertoire\tof\talternatives\u2014politeness,\tjoking\u2014shrinks. Such\tchildren\tare\temotionally\tvulnerable\tin\tthe\tsense\tthat\tthey\thave\ta\tlow threshold\tfor\tupset,\tgetting\tpeeved\tmore\toften\tby\tmore\tthings;\tonce\tupset,\ttheir thinking\tis\tmuddled,\tso\tthat\tthey\tsee\tbenign\tacts\tas\thostile\tand\tfall\tback\ton\ttheir overlearned\thabit\tof\tstriking\tout.13 These\tperceptual\tbiases\ttoward\thostility\tare\talready\tin\tplace\tby\tthe\tearly grades.\tWhile\tmost\tchildren,\tand\tespecially\tboys,\tare\trambunctious\tin kindergarten\tand\tfirst\tgrade,\tthe\tmore\taggressive\tchildren\tfail\tto\tlearn\ta modicum\tof\tself-control\tby\tsecond\tgrade.\tWhere\tother\tchildren\thave\tstarted\tto learn\tnegotiation\tand\tcompromise\tfor\tplayground\tdisagreements,\tthe\tbullies\trely more\tand\tmore\ton\tforce\tand\tbluster.\tThey\tpay\ta\tsocial\tprice:\twithin\ttwo\tor\tthree hours\tof\ta\tfirst\tplayground\tcontact\twith\ta\tbully,\tother\tchildren\talready\tsay\tthey dislike\thim.14 But\tstudies\tthat\thave\tfollowed\tchildren\tfrom\tthe\tpreschool\tyears\tinto\tthe teenage\tones\tfind\tthat\tup\tto\thalf\tof\tfirst\tgraders\twho\tare\tdisruptive,\tunable\tto\tget along\twith\tother\tkids,\tdisobedient\twith\ttheir\tparents,\tand\tresistant\twith\tteachers will\tbecome\tdelinquents\tin\ttheir\tteen\tyears.15\tOf\tcourse,\tnot\tall\tsuch\taggressive children\tare\ton\tthe\ttrajectory\tthat\tleads\tto\tviolence\tand\tcriminality\tin\tlater\tlife. But\tof\tall\tchildren,\tthese\tare\tthe\tones\tmost\tat\trisk\tfor\teventually\tcommitting violent\tcrimes. The\tdrift\ttoward\tcrime\tshows\tup\tsurprisingly\tearly\tin\tthese\tchildren's\tlives. When\tchildren\tin\ta\tMontreal\tkindergarten\twere\trated\tfor\thostility\tand\ttrouble making,\tthose\thighest\tat\tage\tfive\talready\thad\tfar\tgreater\tevidence\tof\tdelinquency just\tfive\tto\teight\tyears\tlater,\tin\ttheir\tearly\tteens.\tThey\twere\tabout\tthree\ttimes\tas likely\tas\tother\tchildren\tto\tadmit\tthey\thad\tbeaten\tup\tsomeone\twho\thad\tnot\tdone anything\tto\tthem,\tto\thave\tshoplifted,\tto\thave\tused\ta\tweapon\tin\ta\tfight,\tto\thave broken\tinto\tor\tstolen\tparts\tfrom\ta\tcar,\tand\tto\thave\tbeen\tdrunk\u2014and\tall\tthis before\tthey\treached\tfourteen\tyears\tof\tage.16 The\tprototypical\tpathway\tto\tviolence\tand\tcriminality\tstarts\twith\tchildren\twho are\taggressive\tand\thard\tto\thandle\tin\tfirst\tand\tsecond\tgrade.17\tTypically,\tfrom\tthe earliest\tschool\tyears\ttheir\tpoor\timpulse\tcontrol\talso\tcontributes\tto\ttheir\tbeing poor\tstudents,\tseen\tas,\tand\tseeing\tthemselves\tas,\t\\\"dumb\\\"\u2014a\tjudgment confirmed\tby\ttheir\tbeing\tshunted\tto\tspecial-education\tclasses\t(and\tthough\tsuch children\tmay\thave\ta\thigher\trate\tof\t\\\"hyperactivity\\\"\tor\tlearning\tdisorders,\tby\tno","means\tall\tdo).\tChildren\twho\ton\tentering\tschool\talready\thave\tlearned\tin\ttheir homes\ta\t\\\"coercive\\\"\tstyle\u2014that\tis,\tbullying\u2014are\talso\twritten\toff\tby\ttheir teachers,\twho\thave\tto\tspend\ttoo\tmuch\ttime\tkeeping\tthe\tchildren\tin\tline.\tThe defiance\tof\tclassroom\trules\tthat\tcomes\tnaturally\tto\tthese\tchildren\tmeans\tthat they\twaste\ttime\tthat\twould\totherwise\tbe\tused\tin\tlearning;\ttheir\tdestined academic\tfailure\tis\tusually\tobvious\tby\tabout\tthird\tgrade.\tWhile\tboys\ton\ta trajectory\ttoward\tdelinquency\ttend\tto\thave\tlower\tIQ\tscores\tthan\ttheir\tpeers,\ttheir impulsivity\tis\tmore\tdirectly\tat\tcause:\timpulsivity\tin\tten-year-old\tboys\tis\talmost three\ttimes\tas\tpowerful\ta\tpredictor\tof\ttheir\tlater\tdelinquency\tas\tis\ttheir\tIQ.18 By\tfourth\tor\tfifth\tgrade\tthese\tkids\u2014by\tnow\tseen\tas\tbullies\tor\tjust \\\"difficult\\\"\u2014are\trejected\tby\ttheir\tpeers\tand\tare\tunable\tto\tmake\tfriends\teasily,\tif at\tall,\tand\thave\tbecome\tacademic\tfailures.\tFeeling\tthemselves\tfriendless,\tthey gravitate\tto\tother\tsocial\toutcasts.\tBetween\tgrade\tfour\tand\tgrade\tnine\tthey commit\tthemselves\tto\ttheir\toutcast\tgroup\tand\ta\tlife\tof\tdefying\tthe\tlaw:\tthey show\ta\tfive\tfold\tincrease\tin\ttheir\ttruancy,\tdrinking,\tand\tdrug\ttaking,\twith\tthe biggest\tboost\tbetween\tseventh\tand\teighth\tgrade.\tBy\tthe\tmiddle-school\tyears, they\tare\tjoined\tby\tanother\ttype\tof\t\\\"late\tstarters,\\\"\twho\tare\tattracted\tto\ttheir defiant\tstyle;\tthese\tlate\tstarters\tare\toften\tyoungsters\twho\tare\tcompletely unsupervised\tat\thome\tand\thave\tstarted\troaming\tthe\tstreets\ton\ttheir\town\tin\tgrade school.\tIn\tthe\thigh-school\tyears\tthis\toutcast\tgroup\ttypically\tdrops\tout\tof\tschool in\ta\tdrift\ttoward\tdelinquency,\tengaging\tin\tpetty\tcrimes\tsuch\tas\tshoplifting,\ttheft, and\tdrug\tdealing. (A\ttelling\tdifference\temerges\tin\tthis\ttrajectory\tbetween\tboys\tand\tgirls.\tA study\tof\tfourth-grade\tgirls\twho\twere\t\\\"bad\\\"\u2014getting\tin\ttrouble\twith\tteachers\tand breaking\trules,\tbut\tnot\tunpopular\twith\ttheir\tpeers\u2014found\tthat\t40\tpercent\thad\ta child\tby\tthe\ttime\tthey\tfinished\tthe\thigh-school\tyears.19\tThat\twas\tthree\ttimes\tthe average\tpregnancy\trate\tfor\tgirls\tin\ttheir\tschools.\tIn\tother\twords,\tantisocial teenage\tgirls\tdon't\tget\tviolent\u2014they\tget\tpregnant.) There\tis,\tof\tcourse,\tno\tsingle\tpathway\tto\tviolence\tand\tcriminality,\tand\tmany other\tfactors\tcan\tput\ta\tchild\tat\trisk:\tbeing\tborn\tin\ta\thigh-crime\tneighborhood where\tthey\tare\texposed\tto\tmore\ttemptations\tto\tcrime\tand\tviolence,\tcoming\tfrom a\tfamily\tunder\thigh\tlevels\tof\tstress,\tor\tliving\tin\tpoverty.\tBut\tnone\tof\tthese factors\tmakes\ta\tlife\tof\tviolent\tcrime\tinevitable.\tAll\tthings\tbeing\tequal,\tthe psychological\tforces\tat\twork\tin\taggressive\tchildren\tgreatly\tintensify\tthe likelihood\tof\ttheir\tending\tup\tas\tviolent\tcriminals.\tAs\tGerald\tPatterson,\ta psychologist\twho\thas\tclosely\tfollowed\tthe\tcareers\tof\thundreds\tof\tboys\tinto young\tadulthood,\tputs\tit,\t\\\"the\tantisocial\tacts\tof\ta\tfive-year-old\tmay\tbe\tprototypic","of\tthe\tacts\tof\tthe\tdelinquent\tadolescent.\\\"20 SCHOOL\tFOR\tBULLIES The\tbent\tof\tmind\tthat\taggressive\tchildren\ttake\twith\tthem\tthrough\tlife\tis\tone\tthat almost\tensures\tthey\twill\tend\tup\tin\ttrouble.\tA\tstudy\tof\tjuvenile\toffenders convicted\tof\tviolent\tcrimes\tand\tof\taggressive\thigh-school\tstudents\tfound\ta common\tmind-set:\tWhen\tthey\thave\tdifficulties\twith\tsomeone,\tthey\timmediately see\tthe\tother\tperson\tin\tan\tantagonistic\tway,\tjumping\tto\tconclusions\tabout\tthe other\tperson's\thostility\ttoward\tthem\twithout\tseeking\tany\tfurther\tinformation\tor trying\tto\tthink\tof\ta\tpeaceful\tway\tto\tsettle\ttheir\tdifferences.\tAt\tthe\tsame\ttime,\tthe negative\tconsequence\tof\ta\tviolent\tsolution\u2014a\tfight,\ttypically\u2014never\tcrosses their\tmind.\tTheir\taggressive\tbent\tis\tjustified\tin\ttheir\tmind\tby\tbeliefs\tlike,\t\\\"It's okay\tto\thit\tsomeone\tif\tyou\tjust\tgo\tcrazy\tfrom\tanger\\\";\t\\\"If\tyou\tback\tdown\tfrom\ta fight\teveryone\twill\tthink\tyou're\ta\tcoward\\\";\tand\t\\\"People\twho\tget\tbeaten\tup\tbadly don't\treally\tsuffer\tthat\tmuch.\\\"21 But\ttimely\thelp\tcan\tchange\tthese\tattitudes\tand\tstop\ta\tchild's\ttrajectory\ttoward delinquency;\tseveral\texperimental\tprograms\thave\thad\tsome\tsuccess\tin\thelping such\taggressive\tkids\tlearn\tto\tcontrol\ttheir\tantisocial\tbent\tbefore\tit\tleads\tto\tmore serious\ttrouble.\tOne,\tat\tDuke\tUniversity,\tworked\twith\tanger-ridden\tgrade-school troublemakers\tin\ttraining\tsessions\tfor\tforty\tminutes\ttwice\ta\tweek\tfor\tsix\tto twelve\tweeks.\tThe\tboys\twere\ttaught,\tfor\texample,\tto\tsee\thow\tsome\tof\tthe\tsocial cues\tthey\tinterpreted\tas\thostile\twere\tin\tfact\tneutral\tor\tfriendly.\tThey\tlearned\tto take\tthe\tperspective\tof\tother\tchildren,\tto\tget\ta\tsense\tof\thow\tthey\twere\tbeing\tseen and\tof\twhat\tother\tchildren\tmight\tbe\tthinking\tand\tfeeling\tin\tthe\tencounters\tthat had\tgotten\tthem\tso\tangry.\tThey\talso\tgot\tdirect\ttraining\tin\tanger\tcontrol\tthrough enacting\tscenes,\tsuch\tas\tbeing\tteased,\tthat\tmight\tlead\tthem\tto\tlose\ttheir\ttemper. One\tof\tthe\tkey\tskills\tfor\tanger\tcontrol\twas\tmonitoring\ttheir\tfeelings\u2014becoming aware\tof\ttheir\tbody's\tsensations,\tsuch\tas\tflushing\tor\tmuscle\ttensing,\tas\tthey\twere getting\tangry,\tand\tto\ttake\tthose\tfeelings\tas\ta\tcue\tto\tstop\tand\tconsider\twhat\tto\tdo next\trather\tthan\tstrike\tout\timpulsively. John\tLochman,\ta\tDuke\tUniversity\tpsychologist\twho\twas\tone\tof\tthe\tdesigners of\tthe\tprogram,\ttold\tme,\t\\\"They'll\tdiscuss\tsituations\tthey've\tbeen\tin\trecently,\tlike being\tbumped\tin\tthe\thallway\twhen\tthey\tthink\tit\twas\ton\tpurpose.\tThe\tkids\twill talk\tabout\thow\tthey\tmight\thave\thandled\tit.\tOne\tkid\tsaid,\tfor\texample,\tthat\the just\tstared\tat\tthe\tboy\twho\tbumped\thim\tand\ttold\thim\tnot\tto\tdo\tit\tagain,\tand walked\taway.\tThat\tput\thim\tin\tthe\tposition\tof\texerting\tsome\tcontrol\tand\tkeeping","walked\taway.\tThat\tput\thim\tin\tthe\tposition\tof\texerting\tsome\tcontrol\tand\tkeeping his\tself-esteem,\twithout\tstarting\ta\tfight.\\\" This\tappeals;\tmany\tsuch\taggressive\tboys\tare\tunhappy\tthat\tthey\tlose\ttheir temper\tso\teasily,\tand\tso\tare\treceptive\tto\tlearning\tto\tcontrol\tit.\tIn\tthe\theat\tof\tthe moment,\tof\tcourse,\tsuch\tcool-headed\tresponses\tas\twalking\taway\tor\tcounting\tto ten\tso\tthe\timpulse\tto\thit\twill\tpass\tbefore\treacting\tare\tnot\tautomatic;\tthe\tboys practice\tsuch\talternatives\tin\trole-playing\tscenes\tsuch\tas\tgetting\ton\ta\tbus\twhere other\tkids\tare\ttaunting\tthem.\tThat\tway\tthey\tcan\ttry\tout\tfriendly\tresponses\tthat preserve\ttheir\tdignity\twhile\tgiving\tthem\tan\talternative\tto\thitting,\tcrying,\tor running\taway\tin\tshame. Three\tyears\tafter\tthe\tboys\thad\tbeen\tthrough\tthe\ttraining,\tLochman\tcompared these\tboys\twith\tothers\twho\thad\tbeen\tjust\tas\taggressive,\tbut\tdid\tnot\thave\tthe benefit\tof\tthe\tanger-control\tsessions.\tHe\tfound\tthat,\tin\tadolescence,\tthe\tboys who\tgraduated\tfrom\tthe\tprogram\twere\tmuch\tless\tdisruptive\tin\tclass,\thad\tmore positive\tfeelings\tabout\tthemselves,\tand\twere\tless\tlikely\tto\tdrink\tor\ttake\tdrugs. And\tthe\tlonger\tthey\thad\tbeen\tin\tthe\tprogram,\tthe\tless\taggressive\tthey\twere\tas teenagers. PREVENTING\tDEPRESSION Dana,\tsixteen,\thad\talways\tseemed\tto\tget\talong.\tBut\tnow,\tsuddenly,\tshe just\tcould\tnot\trelate\twith\tother\tgirls,\tand,\tmore\ttroubling\tfor\ther,\tshe could\tnot\tfind\ta\tway\tto\thold\ton\tto\tboyfriends,\teven\tthough\tshe\tslept\twith them.\tMorose\tand\tconstantly\tfatigued,\tDana\tlost\tinterest\tin\teating,\tin having\tfun\tof\tany\tkind;\tshe\tsaid\tshe\tfelt\thopeless\tand\thelpless\tto\tdo anything\tto\tescape\ther\tmood,\tand\twas\tthinking\tof\tsuicide. The\tdrop\tinto\tdepression\thad\tbeen\ttriggered\tby\ther\tmost\trecent breakup.\tShe\tsaid\tshe\tdidn't\tknow\thow\tto\tgo\tout\twith\ta\tboy\twithout getting\tsexually\tinvolved\tright\taway\u2014even\tif\tshe\twas\tuncomfortable about\tit\u2014and\tthat\tshe\tdid\tnot\tknow\thow\tto\tend\ta\trelationship\teven\tif\tit was\tunsatisfying.\tShe\twent\tto\tbed\twith\tboys,\tshe\tsaid,\twhen\tall\tshe\treally wanted\tto\tdo\twas\tget\tto\tknow\tthem\tbetter. She\thad\tjust\tmoved\tto\ta\tnew\tschool,\tand\tfelt\tshy\tand\tanxious\tabout making\tfriends\twith\tgirls\tthere.\tFor\tinstance,\tshe\theld\tback\tfrom\tstarting conversations,\tonly\ttalking\tonce\tsomeone\tspoke\tto\ther.\tShe\tfelt\tunable\tto let\tthem\tknow\twhat\tshe\twas\tlike,\tand\tdidn't\teven\tfeel\tshe\tknew\twhat\tto","say\tafter\t\\\"Hello,\thow\tare\tyou?\\\"22 \t Dana\twent\tfor\ttherapy\tto\tan\texperimental\tprogram\tfor\tdepressed\tadolescents at\tColumbia\tUniversity.\tHer\ttreatment\tfocused\ton\thelping\ther\tlearn\thow\tto handle\ther\trelationships\tbetter:\thow\tto\tdevelop\ta\tfriendship,\thow\tto\tfeel\tmore confident\twith\tother\tteens,\thow\tto\tassert\tlimits\ton\tsexual\tcloseness,\thow\tto\tbe intimate,\thow\tto\texpress\ther\tfeelings.\tIn\tessence,\tit\twas\ta\tremedial\ttutorial\tin some\tof\tthe\tmost\tbasic\temotional\tskills.\tAnd\tit\tworked;\ther\tdepression\tlifted. Particularly\tin\tyoung\tpeople,\tproblems\tin\trelationships\tare\ta\ttrigger\tfor depression.\tThe\tdifficulty\tis\tas\toften\tin\tchildren's\trelationships\twith\ttheir\tparents as\tit\tis\twith\ttheir\tpeers.\tDepressed\tchildren\tand\tteenagers\tare\tfrequently\tunable or\tunwilling\tto\ttalk\tabout\ttheir\tsadness.\tThey\tseem\tunable\tto\tlabel\ttheir\tfeelings accurately,\tshowing\tinstead\ta\tsullen\tirritability,\timpatience,\tcrankiness,\tand anger\u2014especially\ttoward\ttheir\tparents.\tThis,\tin\tturn,\tmakes\tit\tharder\tfor\ttheir parents\tto\toffer\tthe\temotional\tsupport\tand\tguidance\tthe\tdepressed\tchild\tactually needs,\tsetting\tin\tmotion\ta\tdownward\tspiral\tthat\ttypically\tends\tin\tconstant arguments\tand\talienation. A\tnew\tlook\tat\tthe\tcauses\tof\tdepression\tin\tthe\tyoung\tpinpoints\tdeficits\tin\ttwo areas\tof\temotional\tcompetence:\trelationship\tskills,\ton\tthe\tone\thand,\tand\ta depression-promoting\tway\tof\tinterpreting\tsetbacks,\ton\tthe\tother.\tWhile\tsome\tof the\ttendency\tto\tdepression\talmost\tcertainly\tis\tdue\tto\tgenetic\tdestiny,\tsome\tof that\ttendency\tseems\tdue\tto\treversible,\tpessimistic\thabits\tof\tthought\tthat predispose\tchildren\tto\treact\tto\tlife's\tsmall\tdefeats\u2014a\tbad\tgrade,\targuments\twith parents,\ta\tsocial\trejection\u2014by\tbecoming\tdepressed.\tAnd\tthere\tis\tevidence\tto suggest\tthat\tthe\tpredisposition\tto\tdepression,\twhatever\tits\tbasis,\tis\tbecoming ever\tmore\twidespread\tamong\tthe\tyoung. A\tCOST\tOF\tMODERNITY:\tRISING\tRATES\tOF\tDEPRESSION These\tmillennial\tyears\tare\tushering\tin\tan\tAge\tof\tMelancholy,\tjust\tas\tthe twentieth\tcentury\tbecame\tan\tAge\tof\tAnxiety.\tInternational\tdata\tshow\twhat seems\tto\tbe\ta\tmodern\tepidemic\tof\tdepression,\tone\tthat\tis\tspreading\tside\tby\tside with\tthe\tadoption\tthroughout\tthe\tworld\tof\tmodern\tways.\tEach\tsuccessive generation\tworldwide\tsince\tthe\topening\tof\tthe\tcentury\thas\tlived\twith\ta\thigher risk\tthan\ttheir\tparents\tof\tsuffering\ta\tmajor\tdepression\u2014not\tjust\tsadness,\tbut\ta paralyzing\tlistlessness,\tdejection,\tand\tself-pity,\tand\tan\toverwhelming","hopelessness\u2014over\tthe\tcourse\tof\tlife.23\tAnd\tthose\tepisodes\tare\tbeginning\tat earlier\tand\tearlier\tages.\tChildhood\tdepression,\tonce\tvirtually\tunknown\t(or,\tat least,\tunrecognized)\tis\temerging\tas\ta\tfixture\tof\tthe\tmodern\tscene. Although\tthe\tlikelihood\tof\tbecoming\tdepressed\trises\twith\tage,\tthe\tgreatest increases\tare\tamong\tyoung\tpeople.\tFor\tthose\tborn\tafter\t1955\tthe\tlikelihood\tthey will\tsuffer\ta\tmajor\tdepression\tat\tsome\tpoint\tin\tlife\tis,\tin\tmany\tcountries,\tthree times\tor\tmore\tgreater\tthan\tfor\ttheir\tgrandparents.\tAmong\tAmericans\tborn\tbefore 1905,\tthe\trate\tof\tthose\thaving\ta\tmajor\tdepression\tover\ta\tlifetime\twas\tjust\t1 percent;\tfor\tthose\tborn\tsince\t1955,\tby\tage\ttwenty-four\tabout\t6\tpercent\thad become\tdepressed.\tFor\tthose\tborn\tbetween\t1945\tand\t1954,\tthe\tchances\tof having\thad\ta\tmajor\tdepression\tbefore\tage\tthirty-four\tare\tten\ttimes\tgreater\tthan for\tthose\tborn\tbetween\t1905\tand\t1914.24\tAnd\tfor\teach\tgeneration\tthe\tonset\tof\ta person's\tfirst\tepisode\tof\tdepression\thas\ttended\tto\toccur\tat\tan\tever-earlier\tage. A\tworldwide\tstudy\tof\tmore\tthan\tthirty-nine\tthousand\tpeople\tfound\tthe\tsame trend\tin\tPuerto\tRico,\tCanada,\tItaly,\tGermany,\tFrance,\tTaiwan,\tLebanon,\tand New\tZealand.\tIn\tBeirut,\tthe\trise\tof\tdepression\ttracked\tpolitical\tevents\tclosely, the\tupward\ttrends\trocketing\tduring\tperiods\tof\tcivil\twar.\tIn\tGermany,\tfor\tthose born\tbefore\t1914\tthe\trate\tof\tdepression\tby\tage\tthirty-five\tis\t4\tpercent;\tfor\tthose born\tin\tthe\tdecade\tbefore\t1944\tit\tis\t14\tpercent\tat\tage\tthirty-five.\tWorldwide, generations\tthat\tcame\tof\tage\tduring\tpolitically\ttroubled\ttimes\thad\thigher\trates\tof depression,\tthough\tthe\toverall\tupward\ttrend\tholds\tapart\tfrom\tany\tpolitical events. The\tlowering\tinto\tchildhood\tof\tthe\tage\twhen\tpeople\tfirst\texperience depression\talso\tseems\tto\thold\tworldwide.\tWhen\tI\tasked\texperts\tto\thazard\ta guess\tas\tto\twhy,\tthere\twere\tseveral\ttheories. Dr.\tFrederick\tGoodwin,\tthen\tdirector\tof\tthe\tNational\tInstitute\tof\tMental Health,\tspeculated,\t\\\"There's\tbeen\ta\ttremendous\terosion\tof\tthe\tnuclear\tfamily\u2014a doubling\tof\tthe\tdivorce\trate,\ta\tdrop\tin\tparents'\ttime\tavailable\tto\tchildren,\tand\tan increase\tin\tmobility.\tYou\tdon't\tgrow\tup\tknowing\tyour\textended\tfamily\tmuch anymore.\tThe\tlosses\tof\tthese\tstable\tsources\tof\tself-identification\tmean\ta\tgreater susceptibility\tto\tdepression.\\\" Dr.\tDavid\tKupfer,\tchairman\tof\tpsychiatry\tat\tthe\tUniversity\tof\tPittsburgh medical\tschool,\tpointed\tto\tanother\ttrend:\t\\\"With\tthe\tspread\tof\tindustrialization after\tWorld\tWar\tII,\tin\ta\tsense\tnobody\twas\thome\tanymore.\tIn\tmore\tand\tmore families\tthere\thas\tbeen\tgrowing\tparental\tindifference\tto\tchildren's\tneeds\tas\tthey grow\tup.\tThis\tis\tnot\ta\tdirect\tcause\tof\tdepression,\tbut\tit\tsets\tup\ta\tvulnerability. Early\temotional\tstressors\tmay\taffect\tneuron\tdevelopment,\twhich\tcan\tlead\tto\ta depression\twhen\tyou\tare\tunder\tgreat\tstress\teven\tdecades\tlater.\\\"","depression\twhen\tyou\tare\tunder\tgreat\tstress\teven\tdecades\tlater.\\\" Martin\tSeligman,\tthe\tUniversity\tof\tPennsylvania\tpsychologist,\tproposed:\t\\\"For the\tlast\tthirty\tor\tforty\tyears\twe've\tseen\tthe\tascendance\tof\tindividualism\tand\ta waning\tof\tlarger\tbeliefs\tin\treligion,\tand\tin\tsupports\tfrom\tthe\tcommunity\tand extended\tfamily.\tThat\tmeans\ta\tloss\tof\tresources\tthat\tcan\tbuffer\tyou\tagainst setbacks\tand\tfailures.\tTo\tthe\textent\tyou\tsee\ta\tfailure\tas\tsomething\tthat\tis\tlasting and\twhich\tyou\tmagnify\tto\ttaint\teverything\tin\tyour\tlife,\tyou\tare\tprone\tto\tlet\ta momentary\tdefeat\tbecome\ta\tlasting\tsource\tof\thopelessness.\tBut\tif\tyou\thave\ta larger\tperspective,\tlike\ta\tbelief\tin\tGod\tand\tan\tafterlife,\tand\tyou\tlose\tyour\tjob,\tit's just\ta\ttemporary\tdefeat.\\\" Whatever\tthe\tcause,\tdepression\tin\tthe\tyoung\tis\ta\tpressing\tproblem.\tIn\tthe United\tStates,\testimates\tvary\twidely\tfor\thow\tmany\tchildren\tand\tteens\tare depressed\tin\tany\tgiven\tyear,\tas\topposed\tto\tvulnerability\tover\ttheir\tlifetime. Some\tepidemiological\tstudies\tusing\tstrict\tcriteria\u2014the\tofficial\tdiagnostic symptoms\tfor\tdepression\u2014have\tfound\tthat\tfor\tboys\tand\tgirls\tbetween\tten\tand thirteen\tthe\trate\tof\tmajor\tdepression\tover\tthe\tcourse\tof\ta\tyear\tis\tas\thigh\tas\t8\tor\t9 percent,\tthough\tother\tstudies\tplace\tit\tat\tabout\thalf\tthat\trate\t(and\tsome\tas\tlow\tas about\t2\tpercent).\tAt\tpuberty,\tsome\tdata\tsuggest,\tthe\trate\tnearly\tdoubles\tfor\tgirls; up\tto\t16\tpercent\tof\tgirls\tbetween\tfourteen\tand\tsixteen\tsuffer\ta\tbout\tof depression,\twhile\tthe\trate\tis\tunchanged\tfor\tboys.25 THE\tCOURSE\tOF\tDEPRESSION\tIN\tTHE\tYOUNG That\tdepression\tshould\tnot\tjust\tbe\ttreated,\tbut\tprevented,\tin\tchildren\tis\tclear from\tan\talarming\tdiscovery:\tEven\tmild\tepisodes\tof\tdepression\tin\ta\tchild\tcan augur\tmore\tsevere\tepisodes\tlater\tin\tlife.26\tThis\tchallenges\tthe\told\tassumption that\tdepression\tin\tchildhood\tdoes\tnot\tmatter\tin\tthe\tlong\trun,\tsince\tchildren supposedly\t\\\"grow\tout\tof\tit.\\\"\tOf\tcourse,\tevery\tchild\tgets\tsad\tfrom\ttime\tto\ttime; childhood\tand\tadolescence\tare,\tlike\tadulthood,\ttimes\tof\toccasional disappointments\tand\tlosses\tlarge\tand\tsmall\twith\tthe\tattendant\tgrief.\tThe\tneed\tfor prevention\tis\tnot\tfor\tthese\ttimes,\tbut\tfor\tthose\tchildren\tfor\twhom\tsadness\tspirals downward\tinto\ta\tgloom\tthat\tleaves\tthem\tdespairing,\tirritable,\tand\twithdrawn\u2014a far\tmore\tsevere\tmelancholy. Among\tchildren\twhose\tdepression\twas\tsevere\tenough\tthat\tthey\twere\treferred for\ttreatment,\tthree\tquarters\thad\ta\tsubsequent\tepisode\tof\tsevere\tdepression, according\tto\tdata\tcollected\tby\tMaria\tKovacs,\ta\tpsychologist\tat\tWestern Psychiatric\tInstitute\tand\tClinic\tin\tPittsburgh.27\t.Kovacs\tstudied\tchildren","diagnosed\twith\tdepression\twhen\tthey\twere\tas\tyoung\tas\teight\tyears\told,\tassessing them\tevery\tfew\tyears\tuntil\tsome\twere\tas\told\tas\ttwenty-four. The\tchildren\twith\tmajor\tdepression\thad\tepisodes\tlasting\tabout\televen\tmonths on\taverage,\tthough\tin\tone\tin\tsix\tof\tthem\tit\tpersisted\tfor\tas\tlong\tas\teighteen months.\tMild\tdepression,\twhich\tbegan\tas\tearly\tas\tage\tfive\tin\tsome\tchildren,\twas less\tincapacitating\tbut\tlasted\tfar\tlonger\u2014an\taverage\tof\tabout\tfour\tyears.\tAnd, Kovacs\tfound,\tchildren\twho\thave\ta\tminor\tdepression\tare\tmore\tlikely\tto\thave\tit intensify\tinto\tmajor\tdepression\u2014a\tso-called\tdouble\tdepression.\tThose\twho develop\tdouble\tdepression\tare\tmuch\tmore\tprone\tto\tsuffer\trecurring\tepisodes\tas the\tyears\tgo\ton.\tAs\tchildren\twho\thad\tan\tepisode\tof\tdepression\tgrew\tinto adolescence\tand\tearly\tadulthood,\tthey\tsuffered\tfrom\tdepression\tor\tmanic- depressive\tdisorder,\ton\taverage,\tone\tyear\tin\tthree. The\tcost\tto\tchildren\tgoes\tbeyond\tthe\tsuffering\tcaused\tby\tdepression\titself. Kovacs\ttold\tme,\t\\\"Kids\tlearn\tsocial\tskills\tin\ttheir\tpeer\trelations\u2014for\texample, what\tto\tdo\tif\tyou\twant\tsomething\tand\taren't\tgetting\tit,\tseeing\thow\tother\tchildren handle\tthe\tsituation\tand\tthen\ttrying\tit\tyourself.\tBut\tdepressed\tkids\tare\tlikely\tto be\tamong\tthe\tneglected\tchildren\tin\ta\tschool,\tthe\tones\tother\tkids\tdon't\tplay\twith much.\\\"28 The\tsullenness\tor\tsadness\tsuch\tchildren\tfeel\tleads\tthem\tto\tavoid\tinitiating social\tcontacts,\tor\tto\tlook\taway\twhen\tanother\tchild\tis\ttrying\tto\tengage\tthem\u2014a social\tsignal\tthe\tother\tchild\tonly\ttakes\tas\ta\trebuff;\tthe\tend\tresult\tis\tthat depressed\tchildren\tend\tup\trejected\tor\tneglected\ton\tthe\tplayground.\tThis\tlacuna in\ttheir\tinterpersonal\texperience\tmeans\tthey\tmiss\tout\ton\twhat\tthey\twould normally\tlearn\tin\tthe\trough-and-tumble\tof\tplay,\tand\tso\tcan\tleave\tthem\tsocial\tand emotional\tlaggards,\twith\tmuch\tcatching\tup\tto\tdo\tafter\tthe\tdepression\tlifts.29 Indeed,\twhen\tdepressed\tchildren\thave\tbeen\tcompared\tto\tthose\twithout depression,\tthey\thave\tbeen\tfound\tto\tbe\tmore\tsocially\tinept,\tto\thave\tfewer friends,\tto\tbe\tless\tpreferred\tthan\tothers\tas\tplaymates,\tto\tbe\tless\tliked,\tand\tto have\tmore\ttroubled\trelationships\twith\tother\tchildren. Another\tcost\tto\tthese\tchildren\tis\tdoing\tpoorly\tin\tschool;\tdepression\tinterferes with\ttheir\tmemory\tand\tconcentration,\tmaking\tit\tharder\tto\tpay\tattention\tin\tclass and\tretain\twhat\tis\ttaught.\tA\tchild\twho\tfeels\tno\tjoy\tin\tanything\twill\tfind\tit\thard\tto marshal\tthe\tenergy\tto\tmaster\tchallenging\tlessons,\tlet\talone\texperience\tflow\tin learning.\tUnderstandably,\tthe\tlonger\tchildren\tin\tKovacs's\tstudy\twere\tdepressed, the\tmore\ttheir\tgrades\tdropped\tand\tthe\tpoorer\tthey\tdid\ton\tachievement\ttests,\tso that\tthey\twere\tmore\tlikely\tto\tbe\theld\tback\tin\tschool.\tIn\tfact,\tthere\twas\ta\tdirect correlation\tbetween\tthe\tlength\tof\ttime\ta\tchild\thad\tbeen\tdepressed\tand\this\tgrade- point\taverage,\twith\ta\tsteady\tplummet\tover\tthe\tcourse\tof\tthe\tepisode.\tAll\tof\tthis","point\taverage,\twith\ta\tsteady\tplummet\tover\tthe\tcourse\tof\tthe\tepisode.\tAll\tof\tthis academic\trough\tgoing,\tof\tcourse,\tcompounds\tthe\tdepression.\tAs\tKovacs observes,\t\\\"Imagine\tyou're\talready\tfeeling\tdepressed,\tand\tyou\tstart\tflunking\tout of\tschool,\tand\tyou\tsit\thome\tby\tyourself\tinstead\tof\tplaying\twith\tother\tkids.\\\" DEPRESSIONOGENIC\tWAYS\tOF THOUGHT Just\tas\twith\tadults,\tpessimistic\tways\tof\tinterpreting\tlife's\tdefeats\tseem\tto\tfeed the\tsense\tof\thelplessness\tand\thopelessness\tat\tthe\theart\tof\tchildren's\tdepression. That\tpeople\twho\tare\talready\tdepressed\tthink\tin\tthese\tways\thas\tlong\tbeen known.\tWhat\thas\tonly\trecently\temerged,\tthough,\tis\tthat\tchildren\twho\tare\tmost prone\tto\tmelancholy\ttend\ttoward\tthis\tpessimistic\toutlook\tbefore\tthey\tbecome depressed.\tThis\tinsight\tsuggests\ta\twindow\tof\topportunity\tfor\tinoculating\tthem against\tdepression\tbefore\tit\tstrikes. One\tline\tof\tevidence\tcomes\tfrom\tstudies\tof\tchildren's\tbeliefs\tabout\ttheir\town ability\tto\tcontrol\twhat\thappens\tin\ttheir\tlives\u2014for\texample,\tbeing\table\tto\tchange things\tfor\tthe\tbetter.\tThis\tis\tassessed\tby\tchildren's\tratings\tof\tthemselves\tin\tsuch terms\tas\t\\\"When\tI\thave\tproblems\tat\thome\tI'm\tbetter\tthan\tmost\tkids\tat\thelping\tto solve\tthe\tproblems\\\"\tand\t\\\"When\tI\twork\thard\tI\tget\tgood\tgrades.\\\"\tChildren\twho say\tnone\tof\tthese\tpositive\tdescriptions\tfits\tthem\thave\tlittle\tsense\tthat\tthey\tcan\tdo anything\tto\tchange\tthings;\tthis\tsense\tof\thelplessness\tis\thighest\tin\tthose\tchildren who\tare\tmost\tdepressed.30 A\ttelling\tstudy\tlooked\tat\tfifth\tand\tsixth\tgraders\tin\tthe\tfew\tdays\tafter\tthey received\treport\tcards.\tAs\twe\tall\tremember,\treport\tcards\tare\tone\tof\tthe\tgreatest sources\tof\telation\tand\tdespair\tin\tchildhood.\tBut\tresearchers\tfind\ta\tmarked consequence\tin\thow\tchildren\tassess\ttheir\trole\twhen\tthey\tget\ta\tworse\tgrade\tthan they\texpected.\tThose\twho\tsee\ta\tbad\tgrade\tas\tdue\tto\tsome\tpersonal\tflaw\t(\\\"I'm stupid\\\")\tfeel\tmore\tdepressed\tthan\tthose\twho\texplain\tit\taway\tin\tterms\tof something\tthey\tcould\tchange\t(\\\"If\tI\twork\tharder\ton\tmy\tmath\thomework\tI'll\tget\ta better\tgrade\\\").31 Researchers\tidentified\ta\tgroup\tof\tthird,\tfourth,\tand\tfifth\tgraders\twhom classmates\thad\trejected,\tand\ttracked\twhich\tones\tcontinued\tto\tbe\tsocial\toutcasts in\ttheir\tnew\tclasses\tthe\tfollowing\tyear.\tHow\tthe\tchildren\texplained\tthe\trejection to\tthemselves\tseemed\tcrucial\tto\twhether\tthey\tbecame\tdepressed.\tThose\twho\tsaw","their\trejection\tas\tdue\tto\tsome\tflaw\tin\tthemselves\tgrew\tmore\tdepressed.\tBut\tthe optimists,\twho\tfelt\tthat\tthey\tcould\tdo\tsomething\tto\tchange\tthings\tfor\tthe\tbetter, were\tnot\tespecially\tdepressed\tdespite\tthe\tcontinuing\trejection.32\tAnd\tin\ta\tstudy of\tchildren\tmaking\tthe\tnotoriously\tstressful\ttransition\tto\tseventh\tgrade,\tthose who\thad\tthe\tpessimistic\tattitude\tresponded\tto\thigh\tlevels\tof\thassles\tat\tschool and\tto\tany\tadditional\tstress\tat\thome\tby\tbecoming\tdepressed.33 The\tmost\tdirect\tevidence\tthat\ta\tpessimistic\toutlook\tmakes\tchildren\thighly susceptible\tto\tdepression\tcomes\tfrom\ta\tfive-year\tstudy\tof\tchildren\tbeginning when\tthey\twere\tin\tthird\tgrade.34\tAmong\tthe\tyounger\tchildren,\tthe\tstrongest predictor\tthat\tthey\twould\tbecome\tdepressed\twas\ta\tpessimistic\toutlook\tcoupled with\ta\tmajor\tblow\tsuch\tas\tparents\tdivorcing\tor\ta\tdeath\tin\tthe\tfamily,\twhich\tleft the\tchild\tupset,\tunsettled,\tand,\tpresumably,\twith\tparents\tless\table\tto\toffer\ta nurturing\tbuffer.\tAs\tthe\tchildren\tgrew\tthrough\tthe\telementary-school\tyears, there\twas\ta\ttelling\tshift\tin\ttheir\tthinking\tabout\tthe\tgood\tand\tbad\tevents\tof\ttheir lives,\twith\tthe\tchildren\tincreasingly\tascribing\tthem\tto\ttheir\town\ttraits:\t\\\"I'm getting\tgood\tgrades\tbecause\tI'm\tsmart\\\";\t\\\"I\tdon't\thave\tmany\tfriends\tbecause\tI'm no\tfun.\\\"\tThis\tshift\tseems\tto\tset\tin\tgradually\tover\tthe\tthird\tto\tfifth\tgrades.\tAs\tthis happens\tthose\tchildren\twho\tdevelop\ta\tpessimistic\toutlook\u2014attributing\tthe setbacks\tin\ttheir\tlives\tto\tsome\tdire\tflaw\tin\tthemselves\u2014begin\tto\tfall\tprey\tto depressed\tmoods\tin\treaction\tto\tsetbacks.\tWhat's\tmore,\tthe\texperience\tof depression\titself\tseems\tto\treinforce\tthese\tpessimistic\tways\tof\tthinking,\tso\tthat even\tafter\tthe\tdepression\tlifts,\tthe\tchild\tis\tleft\twith\twhat\tamounts\tto\tan emotional\tscar,\ta\tset\tof\tconvictions\tfed\tby\tthe\tdepression\tand\tsolidified\tin\tthe mind:\tthat\the\tcan't\tdo\twell\tin\tschool,\tis\tunlikable,\tand\tcan\tdo\tnothing\tto\tescape his\town\tbrooding\tmoods.\tThese\tfixed\tideas\tcan\tmake\tthe\tchild\tall\tthe\tmore vulnerable\tto\tanother\tdepression\tdown\tthe\troad. SHORT-CIRCUITING\tDEPRESSION The\tgood\tnews:\tthere\tis\tevery\tsign\tthat\tteaching\tchildren\tmore\tproductive\tways of\tlooking\tat\ttheir\tdifficulties\tlowers\ttheir\trisk\tof\tdepression.*\tIn\ta\tstudy\tof\tone Oregon\thigh\tschool,\tabout\tone\tin\tfour\tstudents\thad\twhat\tpsychologists\tcall\ta \\\"low-level\tdepression,\\\"\tnot\tsevere\tenough\tto\tsay\tit\twas\tbeyond\tordinary unhappiness\tas\tyet.35\tSome\tmay\thave\tbeen\tin\tthe\tearly\tweeks\tor\tmonths\tof\twhat was\tto\tbecome\ta\tdepression. In\ta\tspecial\tafter-school\tclass\tseventy-five\tof\tthe\tmildly\tdepressed\tstudents learned\tto\tchallenge\tthe\tthinking\tpatterns\tassociated\twith\tdepression,\tto\tbecome","more\tadept\tat\tmaking\tfriends,\tto\tget\talong\tbetter\twith\ttheir\tparents,\tand\tto engage\tin\tmore\tsocial\tactivities\tthey\tfound\tpleasant.\tBy\tthe\tend\tof\tthe\teight- week\tprogram,\t55\tpercent\tof\tthe\tstudents\thad\trecovered\tfrom\ttheir\tmild depression,\twhile\tonly\tabout\ta\tquarter\tof\tequally\tdepressed\tstudents\twho\twere not\tin\tthe\tprogram\thad\tbegun\tto\tpull\tout\tof\ttheir\tdepression.\tA\tyear\tlater\ta quarter\tof\tthose\tin\tthe\tcomparison\tgroup\thad\tgone\ton\tto\tfall\tinto\ta\tmajor depression,\tas\topposed\tto\tonly\t14\tpercent\tof\tstudents\tin\tthe\tdepression- prevention\tprogram.\tThough\tthey\tlasted\tjust\teight\tsessions,\tthe\tclasses\tseemed to\thave\tcut\tthe\trisk\tof\tdepression\tin\thalf.36 Similarly\tpromising\tfindings\tcame\tfrom\ta\tspecial\tonce-a-week\tclass\tgiven\tto ten-to\tthirteen-year-old\tyoungsters\tat\todds\twith\ttheir\tparents\tand\tshowing\tsome signs\tof\tdepression.\tIn\tafter-school\tsessions\tthey\tlearned\tsome\tbasic\temotional skills,\tincluding\thandling\tdisagreements,\tthinking\tbefore\tacting,\tand,\tperhaps most\timportant,\tchallenging\tthe\tpessimistic\tbeliefs\tassociated\twith\tdepression\u2014 for\texample,\tresolving\tto\tstudy\tharder\tafter\tdoing\tpoorly\ton\tan\texam\tinstead\tof thinking,\t\\\"I'm\tjust\tnot\tsmart\tenough.\\\" \\\"What\ta\tchild\tlearns\tin\tthese\tclasses\tis\tthat\tmoods\tlike\tanxiety,\tsadness,\tand anger\tdon't\tjust\tdescend\ton\tyou\twithout\tyour\thaving\tany\tcontrol\tover\tthem,\tbut that\tyou\tcan\tchange\tthe\tway\tyou\tfeel\tby\twhat\tyou\tthink,\\\"\tpoints\tout psychologist\tMartin\tSeligman,\tone\tof\tthe\tdevelopers\tof\tthe\ttwelve-week program.\tBecause\tdisputing\tthe\tdepressing\tthoughts\tvanquishes\tthe\tgathering mood\tof\tgloom,\tSeligman\tadded,\t\\\"it's\tan\tinstant\treinforcer\tthat\tbecomes\ta habit.\\\" Again\tthe\tspecial\tsessions\tlowered\tdepression\trates\tby\tone\thalf\u2014and\tdid\tso\tas long\tas\ttwo\tyears\tlater.\tA\tyear\tafter\tthe\tclasses\tended,\tjust\t8\tpercent\tof\tthose who\tparticipated\tscored\tat\ta\tmoderate-to-severe\tlevel\ton\ta\ttest\tof\tdepression, versus\t29\tpercent\tof\tchildren\tin\ta\tcomparison\tgroup.\tAnd\tafter\ttwo\tyears,\tabout 20\tpercent\tof\tthose\tin\tthe\tcourse\twere\tshowing\tsome\tsigns\tof\tat\tleast\tmild depression,\tcompared\tto\t44\tpercent\tof\tthose\tin\tthe\tcomparison\tgroup. Learning\tthese\temotional\tskills\tat\tthe\tcusp\tof\tadolescence\tmay\tbe\tespecially helpful.\tSeligman\tobserves,\t\\\"These\tkids\tseem\tto\tbe\tbetter\tat\thandling\tthe\troutine teenage\tagonies\tof\trejection.\tThey\tseem\tto\thave\tlearned\tthis\tat\ta\tcrucial\twindow for\trisk\tof\tdepression,\tjust\tas\tthey\tenter\tthe\tteen\tyears.\tAnd\tthe\tlesson\tseems\tto persist\tand\tgrow\ta\tbit\tstronger\tover\tthe\tcourse\tof\tthe\tyears\tafter\tthey\tlearn\tit, suggesting\tthe\tkids\tare\tactually\tusing\tit\tin\ttheir\tday-to-day\tlives.\\\" Other\texperts\ton\tchildhood\tdepression\tapplaud\tthe\tnew\tprograms.\t\\\"If\tyou want\tto\tmake\ta\treal\tdifference\tfor\tpsychiatric\tillness\tlike\tdepression,\tyou\thave\tto do\tsomething\tbefore\tthe\tkids\tget\tsick\tin\tthe\tfirst\tplace,\\\"\tKovacs\tcommented.","do\tsomething\tbefore\tthe\tkids\tget\tsick\tin\tthe\tfirst\tplace,\\\"\tKovacs\tcommented. \\\"The\treal\tsolution\tis\ta\tpsychological\tinoculation.\\\" EATING\tDISORDERS During\tmy\tdays\tas\ta\tgraduate\tstudent\tin\tclinical\tpsychology\tin\tthe\tlate\t1960s,\tI knew\ttwo\twomen\twho\tsuffered\tfrom\teating\tdisorders,\tthough\tI\trealized\tthis\tonly after\tmany\tyears\thad\tpassed.\tOne\twas\ta\tbrilliant\tgraduate\tstudent\tin mathematics\tat\tHarvard,\ta\tfriend\tfrom\tmy\tundergraduate\tdays;\tthe\tother\twas\ton the\tstaff\tat\tM.I.T.\tThe\tmathematician,\tthough\tskeletally\tthin,\tsimply\tcould\tnot bring\therself\tto\teat;\tfood,\tshe\tsaid,\trepulsed\ther.\tThe\tlibrarian\thad\tan\tample figure\tand\twas\tgiven\tto\tbingeing\ton\tice\tcream,\tSara\tLee\tcarrot\tcake,\tand\tother desserts;\tthen\u2014as\tshe\tonce\tconfided\twith\tsome\tembarrassment\u2014she\twould secretly\tgo\toff\tto\tthe\tbathroom\tand\tmake\therself\tvomit.\tToday\tthe mathematician\twould\tbe\tdiagnosed\twith\tanorexia\tnervosa,\tthe\tlibrarian\twith bulimia. In\tthose\tyears\tthere\twere\tno\tsuch\tlabels.\tClinicians\twere\tjust\tbeginning\tto comment\ton\tthe\tproblem;\tHilda\tBruch,\tthe\tpioneer\tin\tthis\tmovement,\tpublished her\tseminal\tarticle\ton\teating\tdisorders\tin\t1969.37\tBruch,\tpuzzled\tby\twomen\twho were\tstarving\tthemselves\tto\tdeath,\tproposed\tthat\tone\tof\tthe\tseveral\tunderlying causes\tlay\tin\tan\tinability\tto\tlabel\tand\trespond\tappropriately\tto\tbodily\turges\u2014 notably,\tof\tcourse,\thunger.\tSince\tthen\tthe\tclinical\tliterature\ton\teating\tdisorders has\tmushroomed,\twith\ta\tmultitude\tof\thypotheses\tabout\tthe\tcauses,\tranging\tfrom ever-younger\tgirls\tfeeling\tcompelled\tto\tcompete\twith\tunattainably\thigh standards\tof\tfemale\tbeauty,\tto\tintrusive\tmothers\twho\tenmesh\ttheir\tdaughters\tin\ta controlling\tweb\tof\tguilt\tand\tblame. Most\tof\tthese\thypotheses\tsuffered\tfrom\tone\tgreat\tdrawback:\tthey\twere extrapolations\tfrom\tobservations\tmade\tduring\ttherapy.\tFar\tmore\tdesirable,\tfrom a\tscientific\tviewpoint,\tare\tstudies\tof\tlarge\tgroups\tof\tpeople\tover\ta\tperiod\tof several\tyears,\tto\tsee\twho\tamong\tthem\teventually\tcomes\tdown\twith\tthe\tproblem. That\tkind\tof\tstudy\tallows\ta\tclean\tcomparison\tthat\tcan\ttell,\tfor\texample,\tif\thaving controlling\tparents\tpredisposes\ta\tgirl\tto\teating\tdisorders.\tBeyond\tthat,\tit\tcan identify\tthe\tcluster\tof\tconditions\tthat\tleads\tto\tthe\tproblem,\tand\tdistinguish\tthem from\tconditions\tthat\tmight\tseem\tto\tbe\ta\tcause,\tbut\twhich\tactually\tare\tfound\tas often\tin\tpeople\twithout\tthe\tproblem\tas\tin\tthose\twho\tcome\tfor\ttreatment. When\tjust\tsuch\ta\tstudy\twas\tdone\twith\tmore\tthan\tnine\thundred\tgirls\tin\tthe","seventh\tthrough\ttenth\tgrades,\temotional\tdeficits\u2014particularly\ta\tfailure\tto\ttell distressing\tfeelings\tfrom\tone\tanother\tand\tto\tcontrol\tthem\u2014were\tfound\tto\tbe\tkey among\tthe\tfactors\tleading\tto\teating\tdisorders.38\tEven\tby\ttenth\tgrade,\tthere\twere sixty-one\tgirls\tin\tthis\taffluent,\tsuburban\tMinneapolis\thigh\tschool\twho\talready had\tserious\tsymptoms\tof\tanorexia\tor\tbulimia.\tThe\tgreater\tthe\tproblem,\tthe\tmore the\tgirls\treacted\tto\tsetbacks,\tdifficulties,\tand\tminor\tannoyances\twith\tintense negative\tfeelings\tthat\tthey\tcould\tnot\tsoothe,\tand\tthe\tless\ttheir\tawareness\tof what,\texactly,\tthey\twere\tfeeling.\tWhen\tthese\ttwo\temotional\ttendencies\twere coupled\twith\tbeing\thighly\tdissatisfied\twith\ttheir\tbody,\tthen\tthe\toutcome\twas anorexia\tor\tbulimia.\tOverly\tcontrolling\tparents\twere\tfound\tnot\tto\tplay\ta\tprime role\tin\tcausing\teating\tdisorders.\t(As\tBruch\therself\thad\twarned,\ttheories\tbased\ton hindsight\twere\tunlikely\tto\tbe\taccurate;\tfor\texample,\tparents\tcan\teasily\tbecome intensely\tcontrolling\tin\tresponse\tto\ttheir\tdaughter's\teating\tdisorder,\tout\tof desperation\tto\thelp\ther.)\tAlso\tjudged\tirrelevant\twere\tsuch\tpopular\texplanations as\tfear\tof\tsexuality,\tearly\tonset\tof\tpuberty,\tand\tlow\tself-esteem. Instead,\tthe\tcausal\tchain\tthis\tprospective\tstudy\trevealed\tbegan\twith\tthe\teffects on\tyoung\tgirls\tof\tgrowing\tup\tin\ta\tsociety\tpreoccupied\twith\tunnatural\tthinness\tas a\tsign\tof\tfemale\tbeauty.\tWell\tin\tadvance\tof\tadolescence,\tgirls\tare\talready\tself- conscious\tabout\ttheir\tweight.\tOne\tsix-year-old,\tfor\texample,\tbroke\tinto\ttears when\ther\tmother\tasked\ther\tto\tgo\tfor\ta\tswim,\tsaying\tshe'd\tlook\tfat\tin\ta\tswimsuit. In\tfact,\tsays\ther\tpediatrician,\twho\ttells\tthe\tstory,\ther\tweight\twas\tnormal\tfor\ther height.39\tIn\tone\tstudy\tof\t271\tyoung\tteenagers,\thalf\tthe\tgirls\tthought\tthey\twere too\tfat,\teven\tthough\tthe\tvast\tmajority\tof\tthem\twere\tnormal\tin\tweight.\tBut\tthe Minneapolis\tstudy\tshowed\tthat\tan\tobsession\twith\tbeing\toverweight\tis\tnot\tin\tand of\titself\tsufficient\tto\texplain\twhy\tsome\tgirls\tgo\ton\tto\tdevelop\teating\tdisorders. Some\tobese\tpeople\tare\tunable\tto\ttell\tthe\tdifference\tbetween\tbeing\tscared, angry,\tand\thungry,\tand\tso\tlump\tall\tthose\tfeelings\ttogether\tas\tsignifying\thunger, which\tleads\tthem\tto\tovereat\twhenever\tthey\tfeel\tupset.40\tSomething\tsimilar seems\tto\tbe\thappening\tin\tthese\tgirls.\tGloria\tLeon,\tthe\tUniversity\tof\tMinnesota psychologist\twho\tdid\tthe\tstudy\tof\tyoung\tgirls\tand\teating\tdisorders,\tobserved\tthat these\tgirls\t\\\"have\tpoor\tawareness\tof\ttheir\tfeelings\tand\tbody\tsignals;\tthat\twas\tthe strongest\tsingle\tpredictor\tthat\tthey\twould\tgo\ton\tto\tdevelop\tan\teating\tdisorder within\tthe\tnext\ttwo\tyears.\tMost\tchildren\tlearn\tto\tdistinguish\tamong\ttheir sensations,\tto\ttell\tif\tthey're\tfeeling\tbored,\tangry,\tdepressed,\tor\thungry\u2014it's\ta basic\tpart\tof\temotional\tlearning.\tBut\tthese\tgirls\thave\ttrouble\tdistinguishing among\ttheir\tmost\tbasic\tfeelings.\tThey\tmay\thave\ta\tproblem\twith\ttheir\tboyfriend, and\tnot\tbe\tsure\twhether\tthey're\tangry,\tor\tanxious,\tor\tdepressed\u2014they\tjust","experience\ta\tdiffuse\temotional\tstorm\tthat\tthey\tdo\tnot\tknow\thow\tto\tdeal\twith effectively.\tInstead\tthey\tlearn\tto\tmake\tthemselves\tfeel\tbetter\tby\teating;\tthat\tcan become\ta\tstrongly\tentrenched\temotional\thabit.\\\" But\twhen\tthis\thabit\tfor\tsoothing\tthemselves\tinteracts\twith\tthe\tpressures\tgirls feel\tto\tstay\tthin,\tthe\tway\tis\tpaved\tfor\teating\tdisorders\tto\tdevelop.\t\\\"At\tfirst\tshe might\tstart\twith\tbinge\teating,\\\"\tLeon\tobserves.\t\\\"But\tto\tstay\tthin\tshe\tmay\tturn\tto vomiting\tor\tlaxatives,\tor\tintense\tphysical\texertion\tto\tundo\tthe\tweight\tgain\tfrom overeating.\tAnother\tavenue\tthis\tstruggle\tto\thandle\temotional\tconfusion\tcan\ttake is\tfor\tthe\tgirl\tnot\tto\teat\tat\tall\u2014it\tcan\tbe\ta\tway\tto\tfeel\tyou\thave\tat\tleast\tsome control\tover\tthese\toverwhelming\tfeelings.\\\" The\tcombination\tof\tpoor\tinner\tawareness\tand\tweak\tsocial\tskills\tmeans\tthat these\tgirls,\twhen\tupset\tby\tfriends\tor\tparents,\tfail\tto\tact\teffectively\tto\tsoothe either\tthe\trelationship\tor\ttheir\town\tdistress.\tInstead\ttheir\tupset\ttriggers\tthe\teating disorder,\twhether\tit\tbe\tthat\tof\tbulimia\tor\tanorexia,\tor\tsimply\tbinge\teating. Effective\ttreatments\tfor\tsuch\tgirls,\tLeon\tbelieves,\tneed\tto\tinclude\tsome\tremedial instruction\tin\tthe\temotional\tskills\tthey\tlack.\t\\\"Clinicians\tfind,\\\"\tshe\ttold\tme,\t\\\"that if\tyou\taddress\tthe\tdeficits\ttherapy\tworks\tbetter.\tThese\tgirls\tneed\tto\tlearn\tto identify\ttheir\tfeelings\tand\tlearn\tways\tto\tsoothe\tthemselves\tor\thandle\ttheir relationships\tbetter,\twithout\tturning\tto\ttheir\tmaladaptive\teating\thabits\tto\tdo\tthe job.\\\" ONLY\tTHE\tLONELY:\tDROPOUTS It's\ta\tgrade-school\tdrama:\tBen,\ta\tfourth\tgrader\twith\tfew\tfriends,\thas\tjust\theard from\this\tone\tbuddy,\tJason,\tthat\tthey\taren't\tgoing\tto\tplay\ttogether\tthis\tlunch period\u2014Jason\twants\tto\tplay\twith\tanother\tboy,\tChad,\tinstead.\tBen,\tcrushed, hangs\this\thead\tand\tcries.\tAfter\this\tsobs\tsubside,\tBen\tgoes\tover\tto\tthe\tlunch\ttable where\tJason\tand\tChad\tare\teating. \\\"I\thate\tyour\tguts!\\\"\tBen\tyells\tat\tJason. \\\"Why?\\\"\tJason\tasks. \\\"Because\tyou\tlied,\\\"\tBen\tsays,\this\ttone\taccusatory.\t\\\"You\tsaid\tthis\twhole\tweek that\tyou\twere\tgonna\tplay\twith\tme\tand\tyou\tlied.\\\" Ben\tthen\tstalks\toff\tto\this\tempty\ttable,\tcrying\tquietly.\tJason\tand\tChad\tgo\tover to\thim\tand\ttry\tto\ttalk\tto\thim,\tbut\tBen\tputs\this\tfingers\tin\this\tears,\tdeterminedly ignoring\tthem,\tand\truns\tout\tof\tthe\tlunchroom\tto\thide\tbehind\tthe\tschool Dumpster.\tA\tgroup\tof\tgirls\twho\thave\twitnessed\tthe\texchange\ttry\tto\tplay\ta peacemaker\trole,\tfinding\tBen\tand\ttelling\thim\tthat\tJason\tis\twilling\tto\tplay\twith him\ttoo.\tBut\tBen\twill\thave\tnone\tof\tit,\tand\ttells\tthem\tto\tleave\thim\talone.\tHe","nurses\this\twounds,\tsulking\tand\tsobbing,\tdefiantly\talone.41 A\tpoignant\tmoment,\tto\tbe\tsure;\tthe\tfeeling\tof\tbeing\trejected\tand\tfriendless\tis one\tmost\teveryone\tgoes\tthrough\tat\tsome\tpoint\tin\tchildhood\tor\tadolescence.\tBut what\tis\tmost\ttelling\tabout\tBen's\treaction\tis\this\tfailure\tto\trespond\tto\tJason's efforts\tto\trepair\ttheir\tfriendship,\ta\tstance\tthat\textends\this\tplight\twhen\tit\tmight have\tended.\tSuch\tan\tinability\tto\tseize\tkey\tcues\tis\ttypical\tof\tchildren\twho\tare unpopular;\tas\twe\tsaw\tin\tChapter\t8,\tsocially\trejected\tchildren\ttypically\tare\tpoor at\treading\temotional\tand\tsocial\tsignals;\teven\twhen\tthey\tdo\tread\tsuch\tsignals, they\tmay\thave\tlimited\trepertoires\tfor\tresponse. Dropping\tout\tof\tschool\tis\ta\tparticular\trisk\tfor\tchildren\twho\tare\tsocial\trejects. The\tdropout\trate\tfor\tchildren\twho\tare\trejected\tby\ttheir\tpeers\tis\tbetween\ttwo\tand eight\ttimes\tgreater\tthan\tfor\tchildren\twho\thave\tfriends.\tOne\tstudy\tfound,\tfor example,\tthat\tabout\t25\tpercent\tof\tchildren\twho\twere\tunpopular\tin\telementary school\thad\tdropped\tout\tbefore\tcompleting\thigh\tschool,\tcompared\tto\ta\tgeneral rate\tof\t8\tpercent.42\tSmall\twonder:\timagine\tspending\tthirty\thours\ta\tweek\tin\ta place\twhere\tno\tone\tlikes\tyou. Two\tkinds\tof\temotional\tproclivities\tlead\tchildren\tto\tend\tup\tas\tsocial\toutcasts. As\twe\thave\tseen,\tone\tis\tthe\tpropensity\tto\tangry\toutbursts\tand\tto\tperceive hostility\teven\twhere\tnone\tis\tintended.\tThe\tsecond\tis\tbeing\ttimid,\tanxious,\tand socially\tshy.\tBut\tover\tand\tabove\tthese\ttemperamental\tfactors,\tit\tis\tchildren\twho are\t\\\"off\u2014whose\tawkwardness\trepeatedly\tmakes\tpeople\tuncomfortable\u2014who tend\tto\tbe\tshunted\taside. One\tway\tthese\tchildren\tare\t\\\"off\tis\tin\tthe\temotional\tsignals\tthey\tsend.\tWhen grade\tschoolers\twith\tfew\tfriends\twere\tasked\tto\tmatch\tan\temotion\tsuch\tas\tdisgust or\tanger\twith\tfaces\tthat\tdisplayed\ta\trange\tof\temotions,\tthey\tmade\tfar\tmore mismatches\tthan\tdid\tchildren\twho\twere\tpopular.\tWhen\tkindergarteners\twere asked\tto\texplain\tways\tthey\tmight\tmake\tfriends\twith\tsomeone\tor\tkeep\tfrom having\ta\tfight,\tit\twas\tthe\tunpopular\tchildren\u2014the\tones\tothers\tshied\taway\tfrom playing\twith\u2014who\tcame\tup\twith\tself-defeating\tanswers\t(\\\"Punch\thim\\\"\tfor\twhat to\tdo\twhen\tboth\tchildren\twanted\tthe\tsame\ttoy,\tfor\texample),\tor\tvague\tappeals for\thelp\tfrom\ta\tgrown-up.\tAnd\twhen\tteenagers\twere\tasked\tto\trole-play\tbeing sad,\tangry,\tor\tmischievous,\tthe\tmore\tunpopular\tamong\tthem\tgave\tthe\tleast convincing\tperformances.\tIt\tis\tperhaps\tno\tsurprise\tthat\tsuch\tchildren\tcome\tto feel\tthat\tthey\tare\thelpless\tto\tdo\tany\tbetter\tat\tmaking\tfriends;\ttheir\tsocial incompetence\tbecomes\ta\tself-fulfilling\tprophecy.\tInstead\tof\tlearning\tnew approaches\tto\tmaking\tfriends,\tthey\tsimply\tkeep\tdoing\tthe\tsame\tthings\tthat\thave not\tworked\tfor\tthem\tin\tthe\tpast,\tor\tcome\tup\twith\teven\tmore\tinept\tresponses.43 In\tthe\tlottery\tof\tliking,\tthese\tchildren\tfall\tshort\ton\tkey\temotional\tcriteria:\tthey","In\tthe\tlottery\tof\tliking,\tthese\tchildren\tfall\tshort\ton\tkey\temotional\tcriteria:\tthey are\tnot\tseen\tas\tfun\tto\tbe\twith,\tand\tthey\tdon't\tknow\thow\tto\tmake\tanother\tchild feel\tgood.\tObservations\tof\tunpopular\tchildren\tat\tplay\tshow,\tfor\texample,\tthat they\tare\tmuch\tmore\tlikely\tthan\tothers\tto\tcheat,\tsulk,\tquit\twhen\tlosing,\tor\tshow off\tand\tbrag\tabout\twinning.\tOf\tcourse,\tmost\tchildren\twant\tto\twin\tat\ta\tgame\u2014 but\twin\tor\tlose,\tmost\tchildren\tare\table\tto\tcontain\ttheir\temotional\treaction\tso\tthat it\tdoes\tnot\tundermine\tthe\trelationship\twith\tthe\tfriend\tthey\tplay\tgames\twith. While\tchildren\twho\tare\tsocially\ttone-deaf\u2014who\tcontinually\thave\ttrouble reading\tand\tresponding\tto\temotions\u2014end\tup\tas\tsocial\tisolates,\tthis\tdoes\tnot apply,\tof\tcourse,\tto\tchildren\twho\tgo\tthrough\ta\ttemporary\tperiod\tof\tfeeling\tleft out.\tBut\tfor\tthose\twho\tare\tcontinually\texcluded\tand\trejected,\ttheir\tpainful outcast\tstatus\tclings\tto\tthem\tas\tthey\tcontinue\ttheir\tschool\tyears.\tThe consequences\tof\tending\tup\tat\tthe\tsocial\tmargins\tare\tpotentially\tgreat\tas\ta\tchild continues\ton\tinto\tadulthood.\tFor\tone,\tit\tis\tin\tthe\tcauldron\tof\tclose\tfriendships and\tthe\ttumult\tof\tplay\tthat\tchildren\trefine\tthe\tsocial\tand\temotional\tskills\tthat they\twill\tbring\tto\trelationships\tlater\tin\tlife.\tChildren\twho\tare\texcluded\tfrom\tthis realm\tof\tlearning\tare,\tinevitably,\tdisadvantaged. Understandably,\tthose\twho\tare\trejected\treport\tgreat\tanxiety\tand\tmany\tworries, as\twell\tas\tbeing\tdepressed\tand\tlonely.\tIn\tfact,\thow\tpopular\ta\tchild\twas\tin\tthird grade\thas\tbeen\tshown\tto\tbe\ta\tbetter\tpredictor\tof\tmental-health\tproblems\tat\tage eighteen\tthan\tanything\telse\u2014teachers'\tand\tnurses'\tratings,\tschool\tperformance and\tIQ,\teven\tscores\ton\tpsychological\ttests.44\tAnd,\tas\twe\thave\tseen,\tin\tlater stages\tof\tlife\tpeople\twho\thave\tfew\tfriends\tand\tare\tchronically\tlonely\tare\tat greater\trisk\tfor\tmedical\tdiseases\tand\tan\tearly\tdeath. As\tpsychoanalyst\tHarry\tStack\tSullivan\tpointed\tout,\twe\tlearn\thow\tto\tnegotiate intimate\trelations\u2014to\twork\tout\tdifferences\tand\tshare\tour\tdeepest\tfeelings\u2014in our\tfirst\tclose\tfriendships\twith\tsame-sex\tchums.\tBut\tchildren\twho\tare\tsocially rejected\tare\tonly\thalf\tas\tlikely\tas\ttheir\tpeers\tto\thave\ta\tbest\tfriend\tduring\tthe crucial\tyears\tof\telementary\tschool,\tand\tso\tmiss\tout\ton\tone\tof\tthe\tessential chances\tfor\temotional\tgrowth.45\tOne\tfriend\tcan\tmake\tthe\tdifference\u2014even when\tall\tothers\tturn\ttheir\tbacks\t(and\teven\twhen\tthat\tfriendship\tis\tnot\tall\tthat solid). COACHING\tFOR\tFRIENDSHIP There\tis\thope\tfor\trejected\tchildren,\tdespite\ttheir\tineptness.\tSteven\tAsher,\ta","University\tof\tIllinois\tpsychologist,\thas\tdesigned\ta\tseries\tof\t\\\"friendship coaching\\\"\tsessions\tfor\tunpopular\tchildren\tthat\thas\tshown\tsome\tsuccess.46 Identifying\tthird\tand\tfourth\tgraders\twho\twere\tthe\tleast\tliked\tin\ttheir\tclasses, Asher\tgave\tthem\tsix\tsessions\tin\thow\tto\t\\\"make\tplaying\tgames\tmore\tfun\\\"\tthrough being\t\\\"friendly,\tfun,\tand\tnice.\\\"\tTo\tavoid\tstigma,\tthe\tchildren\twere\ttold\tthat\tthey were\tacting\tas\t\\\"consultants\\\"\tto\tthe\tcoach,\twho\twas\ttrying\tto\tlearn\twhat\tkinds\tof things\tmake\tit\tmore\tenjoyable\tto\tplay\tgames. The\tchildren\twere\tcoached\tto\tact\tin\tways\tAsher\thad\tfound\ttypical\tof\tmore popular\tchildren.\tFor\texample,\tthey\twere\tencouraged\tto\tthink\tof\talternative suggestions\tand\tcompromises\t(rather\tthan\tfighting)\tif\tthey\tdisagree\tabout\tthe rules;\tto\tremember\tto\ttalk\twith\tand\task\tquestions\tabout\tthe\tother\tchild\twhile they\tplay;\tto\tlisten\tand\tlook\tat\tthe\tother\tchild\tto\tsee\thow\the's\tdoing;\tto\tsay something\tnice\twhen\tthe\tother\tperson\tdoes\twell;\tto\tsmile\tand\toffer\thelp\tor suggestions\tand\tencouragement.\tThe\tchildren\talso\ttried\tout\tthese\tbasic\tsocial amenities\twhile\tplaying\tgames\tsuch\tas\tPick-up\tSticks\twith\ta\tclassmate,\tand were\tcoached\tafterward\ton\thow\twell\tthey\tdid.\tThis\tminicourse\tin\tgetting\talong had\ta\tremarkable\teffect:\ta\tyear\tlater\tthe\tchildren\twho\twere\tcoached\u2014all\tof whom\twere\tselected\tbecause\tthey\twere\tthe\tleast-liked\tin\ttheir\tclass\u2014were\tnow solidly\tin\tthe\tmiddle\tof\tclassroom\tpopularity.\tNone\twere\tsocial\tstars,\tbut\tnone were\trejects. Similar\tresults\thave\tbeen\tfound\tby\tStephen\tNowicki,\tan\tEmory\tUniversity psychologist.47\tHis\tprogram\ttrains\tsocial\toutcasts\tto\thone\ttheir\tability\tto\tread and\trespond\tappropriately\tto\tother\tchildren's\tfeelings.\tThe\tchildren,\tfor\texample, are\tvideotaped\twhile\tpracticing\texpression\tof\tfeelings\tsuch\tas\thappiness\tand sadness,\tand\tare\tcoached\tto\timprove\ttheir\temotional\texpressiveness.\tThey\tthen try\tout\ttheir\tnewly\thoned\tskills\twith\ta\tchild\tthey\twant\tto\tmake\tfriends\twith. Such\tprograms\thave\treported\ta\t50\tto\t60\tpercent\tsuccess\trate\tin\traising\tthe popularity\tof\trejected\tchildren.\tThese\tprograms\t(at\tleast\tas\tpresently\tdesigned) seem\tto\twork\tbest\tfor\tthird\tand\tfourth\tgraders\trather\tthan\tchildren\tin\thigher grades,\tand\tto\tbe\tmore\thelpful\tfor\tsocially\tinept\tchildren\tthan\tfor\thighly aggressive\tones.\tBut\tthat\tis\tall\ta\tmatter\tfor\tfine-tuning;\tthe\thopeful\tsign\tis\tthat many\tor\tmost\trejected\tchildren\tcan\tbe\tbrought\tinto\tthe\tcircle\tof\tfriendship\twith some\tbasic\temotional\tcoaching. DRINKING\tAND\tDRUGS:\tADDICTION\tAS\tSELF- MEDICATION","Students\tat\tthe\tlocal\tcampus\tcall\tit\tdrinking\tto\tblack\t\u2014bingeing\ton\tbeer\tto\tthe point\tof\tpassing\tout.\tOne\tof\tthe\ttechniques:\tattach\ta\tfunnel\tto\ta\tgarden\those,\tso that\ta\tcan\tof\tbeer\tcan\tbe\tdowned\tin\tabout\tten\tseconds.\tThe\tmethod\tis\tnot\tan isolated\toddity.\tOne\tsurvey\tfound\tthat\ttwo\tfifths\tof\tmale\tcollege\tstudents\tdown seven\tor\tmore\tdrinks\tat\ta\ttime,\twhile\t11\tpercent\tcall\tthemselves\t\\\"heavy drinkers.\\\"\tAnother\tterm,\tof\tcourse,\tmight\tbe\t\\\"alcoholics.\\\"48\tAbout\thalf\tof college\tmen\tand\talmost\t40\tpercent\tof\twomen\thave\tat\tleast\ttwo\tbinge-drinking episodes\tin\ta\tmonth.49 While\tin\tthe\tUnited\tStates\tuse\tof\tmost\tdrugs\tamong\tyoung\tpeople\tgenerally tapered\toff\tin\tthe\t1980s,\tthere\tis\ta\tsteady\ttrend\ttoward\tmore\talcohol\tuse\tat\tever- younger\tages.\tA\t1993\tsurvey\tfound\tthat\t35\tpercent\tof\tcollege\twomen\tsaid\tthey drank\tto\tget\tdrunk,\twhile\tjust\t10\tpercent\tdid\tso\tin\t1977;\toverall,\tone\tin\tthree students\tdrinks\tto\tget\tdrunk.\tThat\tposes\tother\trisks:\t90\tpercent\tof\tall\trapes reported\ton\tcollege\tcampuses\thappened\twhen\teither\tthe\tassailant\tor\tthe\tvictim\u2014 or\tboth\u2014had\tbeen\tdrinking.50\tAlcohol-related\taccidents\tare\tthe\tleading\tcause\tof death\tamong\tyoung\tpeople\tbetween\tfifteen\tand\ttwenty-four.51 Experimentation\twith\tdrugs\tand\talcohol\tmight\tseem\ta\trite\tof\tpassage\tfor adolescents,\tbut\tthis\tfirst\ttaste\tcan\thave\tlong-lasting\tresults\tfor\tsome.\tFor\tmost alcoholics\tand\tdrug\tabusers,\tthe\tbeginnings\tof\taddiction\tcan\tbe\ttraced\tto\ttheir teen\tyears,\tthough\tfew\tof\tthose\twho\tso\texperiment\tend\tup\tas\talcoholics\tor\tdrug abusers.\tBy\tthe\ttime\tstudents\tleave\thigh\tschool,\tover\t90\tpercent\thave\ttried alcohol,\tyet\tonly\tabout\t14\tpercent\teventually\tbecome\talcoholics;\tof\tthe\tmillions of\tAmericans\twho\texperimented\twith\tcocaine,\tfewer\tthan\t5\tpercent\tbecame addicted.52\tWhat\tmakes\tthe\tdifference? To\tbe\tsure,\tthose\tliving\tin\thigh-crime\tneighborhoods,\twhere\tcrack\tis\tsold\ton the\tcorner\tand\tthe\tdrug\tdealer\tis\tthe\tmost\tprominent\tlocal\tmodel\tof\teconomic success,\tare\tmost\tat\trisk\tfor\tsubstance\tabuse.\tSome\tmay\tend\tup\taddicted\tthrough becoming\tsmall-time\tdealers\tthemselves,\tothers\tsimply\tbecause\tof\tthe\teasy access\tor\ta\tpeer\tculture\tthat\tglamorizes\tdrugs\u2014a\tfactor\tthat\theightens\tthe\trisk\tof drug\tuse\tin\tany\tneighborhood,\teven\t(and\tperhaps\tespecially)\tthe\tmost\twell-off. But\tstill\tthe\tquestion\tremains,\tof\tthe\tpool\tof\tthose\texposed\tto\tthese\tlures\tand pressures,\tand\twho\tgo\ton\tto\texperiment,\twhich\tones\tare\tmost\tlikely\tto\tend\tup with\ta\tlasting\thabit? One\tcurrent\tscientific\ttheory\tis\tthat\tthose\twho\tstay\twith\tthe\thabit,\tbecoming increasingly\tdependent\ton\talcohol\tor\tdrugs,\tare\tusing\tthese\tsubstances\tas\ta medication\tof\tsorts,\ta\tway\tto\tsoothe\tfeelings\tof\tanxiety,\tanger,\tor\tdepression.","Through\ttheir\tearly\texperimentation\tthey\thit\tupon\ta\tchemical\tfix,\ta\tway\tto\tcalm the\tfeelings\tof\tanxiety\tor\tmelancholy\tthat\thave\ttormented\tthem.\tThus\tof\tseveral hundred\tseventh-and\teighth-grade\tstudents\ttracked\tfor\ttwo\tyears,\tit\twas\tthose who\treported\thigher\tlevels\tof\temotional\tdistress\twho\tsubsequently\twent\ton\tto have\tthe\thighest\trates\tof\tsubstance\tabuse.53\tThis\tmay\texplain\twhy\tso\tmany young\tpeople\tare\table\tto\texperiment\twith\tdrugs\tand\tdrinking\twithout\tbecoming addicted,\twhile\tothers\tbecome\tdependent\talmost\tfrom\tthe\tstart:\tthose\tmost vulnerable\tto\taddiction\tseem\tto\tfind\tin\tthe\tdrug\tor\talcohol\tan\tinstant\tway\tto soothe\temotions\tthat\thave\tdistressed\tthem\tfor\tyears. As\tRalph\tTarter,\ta\tpsychologist\tat\tthe\tWestern\tPsychiatric\tInstitute\tand\tClinic in\tPittsburgh,\tput\tit,\t\\\"For\tpeople\twho\tare\tbiologically\tpredisposed,\tthe\tfirst\tdrink or\tdose\tof\ta\tdrug\tis\timmensely\treinforcing,\tin\ta\tway\tothers\tjust\tdon't\texperience. Many\trecovering\tdrug\tabusers\ttell\tme,\t'The\tmoment\tI\ttook\tmy\tfirst\tdrug,\tI\tfelt normal\tfor\tthe\tfirst\ttime.'\tIt\tstabilizes\tthem\tphysiologically,\tat\tleast\tin\tthe\tshort term.\\\"54\tThat,\tof\tcourse,\tis\tthe\tdevil's\tbargain\tof\taddiction:\ta\tshort-term\tgood feeling\tin\texchange\tfor\tthe\tsteady\tmeltdown\tof\tone's\tlife. Certain\temotional\tpatterns\tseem\tto\tmake\tpeople\tmore\tlikely\tto\tfind\temotional relief\tin\tone\tsubstance\trather\tthan\tanother.\tFor\texample,\tthere\tare\ttwo\temotional pathways\tto\talcoholism.\tOne\tstarts\twith\tsomeone\twho\twas\thighly-strung\tand anxious\tin\tchildhood,\twho\ttypically\tdiscovers\tas\ta\tteenager\tthat\talcohol\twill calm\tthe\tanxiety.\tVery\toften\tthey\tare\tchildren\u2014usually\tsons\u2014of\talcoholics\twho themselves\thave\tturned\tto\talcohol\tto\tsoothe\ttheir\tnerves.\tOne\tbiological\tmarker for\tthis\tpattern\tis\tundersecretion\tof\tGABA,\ta\tneurotransmitter\tthat\tregulates anxiety\u2014too\tlittle\tGABA\tis\texperienced\tas\ta\thigh\tlevel\tof\ttension.\tOne\tstudy found\tthat\tsons\tof\talcoholic\tfathers\thad\tlow\tlevels\tof\tGABA\tand\twere\thighly anxious,\tbut\twhen\tthey\tdrank\talcohol,\ttheir\tGABA\tlevels\trose\tas\ttheir\tanxiety fell.55\tThese\tsons\tof\talcoholics\tdrink\tto\tease\ttheir\ttension,\tfinding\tin\talcohol\ta relaxation\tthat\tthey\tcould\tnot\tseem\tto\tget\totherwise.\tSuch\tpeople\tmay\tbe vulnerable\tto\tabusing\tsedatives\tas\twell\tas\talcohol\tfor\tthe\tsame\tanxiety-reduction effect. A\tneuropsychological\tstudy\tof\tsons\tof\talcoholics\twho\tat\tage\ttwelve\tshowed signs\tof\tanxiety\tsuch\tas\ta\theightened\theart\trate\tin\tresponse\tto\tstress,\tas\twell\tas impulsivity,\tfound\tthe\tboys\talso\thad\tpoor\tfrontal\tlobe\tfunctioning.56\tThus\tthe brain\tareas\tthat\tmight\thave\thelped\tease\ttheir\tanxiety\tor\tcontrol\ttheir impulsiveness\tbrought\tthem\tless\thelp\tthan\tin\tother\tboys.\tAnd\tsince\tthe\tpre- frontal\tlobes\talso\thandle\tworking\tmemory\u2014which\tholds\tin\tmind\tthe consequences\tof\tvarious\troutes\tof\taction\twhile\tmaking\ta\tdecision\u2014their\tdeficit","could\tsupport\ta\tslide\tinto\talcoholism\tby\thelping\tthem\tignore\tthe\tlong-term drawbacks\tof\tdrinking,\teven\tas\tthey\tfound\tan\timmediate\tsedation\tfrom\tanxiety through\talcohol. This\tcraving\tfor\tcalm\tseems\tto\tbe\tan\temotional\tmarker\tof\ta\tgenetic susceptibility\tto\talcoholism.\tA\tstudy\tof\tthirteen\thundred\trelatives\tof\talcoholics found\tthat\tthe\tchildren\tof\talcoholics\twho\twere\tmost\tat\trisk\tfor\tbecoming alcoholics\tthemselves\twere\tthose\twho\treported\thaving\tchronically\thigh\tlevels\tof anxiety.\tIndeed,\tthe\tresearchers\tconcluded\tthat\talcoholism\tdevelops\tin\tsuch people\tas\t\\\"self-medication\tof\tanxiety\tsymptoms.\\\"57 A\tsecond\temotional\tpathway\tto\talcoholism\tcomes\tfrom\ta\thigh\tlevel\tof agitation,\timpulsivity,\tand\tboredom.\tThis\tpattern\tshows\tup\tin\tinfancy\tas\tbeing restless,\tcranky,\tand\thard\tto\thandle,\tin\tgrade\tschool\tas\thaving\tthe\t\\\"fidgets,\\\" hyperactivity,\tand\tgetting\tinto\ttrouble,\ta\tpropensity\tthat,\tas\twe\thave\tseen,\tcan push\tsuch\tchildren\tto\tseek\tout\tfriends\ton\tthe\tfringe\u2014sometimes\tleading\tto\ta criminal\tcareer\tor\tthe\tdiagnosis\tof\t\\\"antisocial\tpersonality\tdisorder.\\\"\tSuch\tpeople (and\tthey\tare\tmainly\tmen)\thave\tas\ttheir\tmain\temotional\tcomplaint\tagitation; their\tmain\tweakness\tis\tunrestrained\timpulsivity;\ttheir\tusual\treaction\tto\tboredom \u2014which\tthey\toften\tfeel\u2014is\tan\timpulsive\tsearch\tfor\trisk\tand\texcitement.\tAs adults,\tpeople\twith\tthis\tpattern\t(which\tmay\tbe\ttied\tto\tdeficiencies\tin\ttwo\tother neurotransmitters,\tserotonin\tand\tMAO)\tfind\tthat\talcohol\tcan\tsoothe\ttheir agitation.\tAnd\tthe\tfact\tthat\tthey\tcan't\tstand\tmonotony\tmakes\tthem\tready\tto\ttry anything;\tcoupled\twith\ttheir\tgeneral\timpulsivity,\tit\tmakes\tthem\tprone\tto\tabusing an\talmost\trandom\tlist\tof\tdrugs\tbesides\talcohol.58 While\tdepression\tcan\tdrive\tsome\tto\tdrink,\tthe\tmetabolic\teffects\tof\talcohol often\tsimply\tworsen\tthe\tdepression\tafter\ta\tshort\tlift.\tPeople\twho\tturn\tto\talcohol as\tan\temotional\tpalliative\tdo\tso\tmuch\tmore\toften\tto\tcalm\tanxiety\tthan\tfor depression;\tan\tentirely\tdifferent\tclass\tof\tdrugs\tsoothes\tthe\tfeelings\tof\tpeople who\tare\tdepressed\u2014at\tleast\ttemporarily.\tFeeling\tchronically\tunhappy\tputs people\tat\tgreater\trisk\tfor\taddiction\tto\tstimulants\tsuch\tas\tcocaine,\twhich\tprovide a\tdirect\tantidote\tto\tfeeling\tdepressed.\tOne\tstudy\tfound\tthat\tmore\tthan\thalf\tthe patients\tbeing\ttreated\tat\ta\tclinic\tfor\tcocaine\taddiction\twould\thave\tbeen diagnosed\twith\tsevere\tdepression\tbefore\tthey\tstarted\ttheir\thabit,\tand\tthe\tdeeper the\tpreceding\tdepression,\tthe\tstronger\tthe\thabit.59 Chronic\tanger\tmay\tlead\tto\tstill\tanother\tkind\tof\tsusceptibility.\tIn\ta\tstudy\tof four\thundred\tpatients\tbeing\ttreated\tfor\taddiction\tto\theroin\tand\tother\topioids,\tthe most\tstriking\temotional\tpattern\twas\ta\tlifelong\tdifficulty\thandling\tanger\tand\ta quickness\tto\trage.\tSome\tof\tthe\tpatients\tthemselves\tsaid\tthat\twith\topiates\tthey","finally\tfelt\tnormal\tand\trelaxed.60 Though\tthe\tpredisposition\tto\tsubstance\tabuse\tmay,\tin\tmany\tcases,\tbe\tbrain- based,\tthe\tfeelings\tthat\tdrive\tpeople\tto\t\\\"self-medicate\\\"\tthemselves\tthrough\tdrink or\tdrugs\tcan\tbe\thandled\twithout\trecourse\tto\tmedication,\tas\tAlcoholics Anonymous\tand\tother\trecovery\tprograms\thave\tdemonstrated\tfor\tdecades. Acquiring\tthe\tability\tto\thandle\tthose\tfeelings\u2014soothing\tanxiety,\tlifting depression,\tcalming\trage\u2014removes\tthe\timpetus\tto\tuse\tdrugs\tor\talcohol\tin\tthe first\tplace.\tThese\tbasic\temotional\tskills\tare\ttaught\tremedially\tin\ttreatment programs\tfor\tdrug\tand\talcohol\tabuse.\tIt\twould\tbe\tfar\tbetter,\tof\tcourse,\tif\tthey were\tlearned\tearly\tin\tlife,\twell\tbefore\tthe\thabit\tbecame\testablished. \t NO\tMORE\tWARS:\tA\tFINAL\tCOMMON\tPREVENTIVE PATHWAY \t Over\tthe\tlast\tdecade\tor\tso\t\\\"wars\\\"\thave\tbeen\tproclaimed,\tin\tturn,\ton\tteen pregnancy,\tdropping\tout,\tdrugs,\tand\tmost\trecently\tviolence.\tThe\ttrouble\twith such\tcampaigns,\tthough,\tis\tthat\tthey\tcome\ttoo\tlate,\tafter\tthe\ttargeted\tproblem has\treached\tepidemic\tproportions\tand\ttaken\tfirm\troot\tin\tthe\tlives\tof\tthe\tyoung. They\tare\tcrisis\tintervention,\tthe\tequivalent\tof\tsolving\ta\tproblem\tby\tsending\tan ambulance\tto\tthe\trescue\trather\tthan\tgiving\tan\tinoculation\tthat\twould\tward\toff the\tdisease\tin\tthe\tfirst\tplace.\tInstead\tof\tmore\tsuch\t\\\"wars,\\\"\twhat\twe\tneed\tis\tto follow\tthe\tlogic\tof\tprevention,\toffering\tour\tchildren\tthe\tskills\tfor\tfacing\tlife\tthat will\tincrease\ttheir\tchances\tof\tavoiding\tany\tand\tall\tof\tthese\tfates.61 My\tfocus\ton\tthe\tplace\tof\temotional\tand\tsocial\tdeficits\tis\tnot\tto\tdeny\tthe\trole of\tother\trisk\tfactors,\tsuch\tas\tgrowing\tup\tin\ta\tfragmented,\tabusive,\tor\tchaotic family,\tor\tin\tan\timpoverished,\tcrime-and\tdrug-ridden\tneighborhood.\tPoverty itself\tdelivers\temotional\tblows\tto\tchildren:\tpoorer\tchildren\tat\tage\tfive\tare already\tmore\tfearful,\tanxious,\tand\tsad\tthan\ttheir\tbetter-off\tpeers,\tand\thave\tmore behavior\tproblems\tsuch\tas\tfrequent\ttantrums\tand\tdestroying\tthings,\ta\ttrend\tthat continues\tthrough\tthe\tteen\tyears.\tThe\tpress\tof\tpoverty\tcorrodes\tfamily\tlife\ttoo: there\ttend\tto\tbe\tfewer\texpressions\tof\tparental\twarmth,\tmore\tdepression\tin mothers\t(who\tare\toften\tsingle\tand\tjobless),\tand\ta\tgreater\treliance\ton\tharsh punishments\tsuch\tas\tyelling,\thitting,\tand\tphysical\tthreats.62 But\tthere\tis\ta\trole\tthat\temotional\tcompetence\tplays\tover\tand\tabove\tfamily\tand economic\tforces\u2014it\tmay\tbe\tdecisive\tin\tdetermining\tthe\textent\tto\twhich\tany"]
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