Power drills vs. dental drills

At the beginning of this year I went to the dentist for the first time in… a while, and learned I had five cavities. Five! I brush my teeth – I even floss! – but somehow three of my old fillings had failed me and two new ones were needed. This wouldn’t have been that big of a deal except… and now you’re really going to judge me… I am afraid of Novocaine.

Now, let me say as clearly as I can: this is a 95% irrational fear. Novocaine is extremely safe and I trust my dentist to use it properly, and I am even fairly certain if I used it nothing bad would happen. But because I have an anxiety brain, this was my thought process upon learning I needed five fillings:

Shit, that’s going to be expensive and take a while. Also, crap, they’ll give me Novocaine, and that has the potential to cause heart palpitations, and I’ll probably already be having them because I’ll be nervous, and that could create a dangerous situation, oh shit shit how do I get around this?

Again, Novocaine is extremely safe. Irregular heart beat is a very rare potential side effect associated with many medications – it’s part of the generic list of allergic reactions a step above itchiness and swelling. But since I’ve dealt (rather poorly, I’ll admit) with heart palpitations caused by stress and anxiety for years, I am hyper-vigilant about avoiding situations that might cause them. So, how did I get around it? I opted out. I said no to the Novocaine and sucked it up. And yeah, it hurt. I spaced the procedure out into three visits to spread out both the cost and the pain. In the end, each procedure took less time than it would have with numbing, and I was able to eat and drink right afterward. Most of all, I survived (which of course I would have regardless). The dentists and hygienists kept calling me a badass and saying how well I handled the pain, but I wasn’t proud; I was honestly a little embarrassed, and exhausted, and sore.

As I waited in the chair for each procedure to start, I stared at a flat screen monitor. The first time it scrolled through pictures of cute kids and puppies (including a truly awesome slideshow of dogs that look like other things); on my second visit it was a silent presentation about my dentist’s trip to Haiti, complete with facts about the country; and on the third and final visit I was treated to calming videos of waves crashing on sand.

During each procedure, there was a moment or two when I thought I couldn’t handle any more – when the drill would hit a specific spot on the tooth that was just too close to a nerve. During those times, I had the old calming television standby to distract me from another monitor on the ceiling: HGTV. (I have seen this in at least one other dental office and several specialists’ offices – there’s just something about Chip and Joanna…) And I have to tell you, these things worked. In the moments I would have gritted my teeth at the pain (which was obviously impossible) I instead focused all of my energy and attention on the wall demo or sconce selection happening on the ceiling screen. And it worked, in the sense that avoiding a full-on panic attack or biting off my dentist’s fingers = “working.” Which… I’ll take it!

It’s not shiplap that helps with pain and anxiety in the dental chair – it’s that shift in energy and attention. And it still works on me even though I know this. And I actually found myself thinking, as I left the dental office for the last time (for a while, at least…I hope…) that I really wish more medical offices had this kind of programming. Not just HGTV, but slideshows and silent videos made with the explicit goal of helping patients calm down. Not just cheesy quotes about serenity, but soothing images that are scientifically correlated with lower blood pressure and cortisol. Imagine if more clinicians acknowledged that we might be anxious, and rather than ignoring that or explaining it away, just empathized with it and tried to set a calmer tone. This sort of thing is relatively common in dentistry and in pediatrics; imagine if our anxiety and potential medical trauma was taken more seriously even in cardiology, physical therapy, dermatology, and other offices! I think it’s something to work toward.

 

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On empathy, endorsement, and what happens next

I walk a little over a mile to and from work each day, and I usually spend it listening to podcasts, or to books on Audible. After more than a year of this, I really look forward to certain days when I know certain podcasts will have a new episode out. Note to Self is one of them. I love Manoush Zomorodi’s style of reporting on technology and how it affects our lives, and I love how she’s styled herself as a guide to “our accelerating world.” Because wow, yes, is it ever accelerating.

Note to Self is often about technology in a technical sense, but the show also takes occasional detours into the psychology of how we interact with tech. This, of course, is my favorite thing to write and read about. So I was really excited when Zomorodi recently interviewed Dylan Marron. He’s a progressive YouTuber and writer who also has a new podcast, called Conversations With People Who Hate Me. It’s pretty much exactly what it sounds like. Remember when Lindy West called her troll and it became a viral This American Life episode? Marron does a similar thing on each episode of Conversations. He talks to the people who profess to think he’s the scum of the earth, and tries to find out why.

This is something I’m going to write more about soon – podcasts and radical empathy – but for the purposes of this blog post I really want to focus on one thing Marron said during this Note to Self episode: empathy doesn’t mean endorsement. This is a fact that’s become so obvious to me, I think I forget to enunciate it to others when I talk about empathy. I’ve never found such a succinct way of saying it, either. But it’s absolutely the truth: sitting down and listening to someone does not necessarily mean validating them, and it definitely doesn’t mean agreeing with them. It’s just…acknowledging them. Taking their perspective.

That can feel a little scary. I know that I have had experiences in which I read something written by someone with vastly different views from my own and as I prepare to put myself in their shoes I think, what if I can’t get back out? What if they convince me? But things don’t really happen that abruptly, most of the time. We make our decisions and create our ideologies based on a mix of experiences and information, and it all sort of flows together and tries to balance itself out, rarely truly solidifying into one thing. What I mean is, we’re always learning, always changing our minds a little bit, even if we don’t always notice it, or want to.

I thought about this concept a lot as I watched the recent Alabama election unfold. Everyone around me kept asking, “How could these people vote for a pedophile?” I can’t say the answer is the same for everyone who voted for Roy Moore, but I can say pretty confidently that many of them did so because they didn’t believe what they heard about him. Or, they only believed parts of what they heard about him.

Brian Resnick has a great piece about this up at Vox. He interviewed a lot of Moore supporters in Alabama before the election, and reading this piece, I feel like I can really empathize with these people. Trying to put myself briefly in their shoes, I feel afraid, I feel disappointed, I feel betrayed. This is something I tried to do when reading story after story about Trump supporters last year as well. And I think it’s a worthwhile practice. But the part that nobody really seems to talk about is… then what?1

What do I do with this information? What do I do with the fact that people of all parties and ideologies cling to confirmation bias and “motivated reasoning?” Well, it’s made me feel a little bit less hopeless about change, for one thing. That might seem counter-intuitive, but knowing that we’re all susceptible to this, and witnessing people have conversations about it that don’t end in name-calling or fist fights, is encouraging. It also helps me feel less angry, which is no small thing. Over the past couple of years I’ve found anger to be less and less useful for me, at least on a personal level. Being mad at friends or family or strangers who did something I see as wrong doesn’t actually accomplish anything for me, except raising my blood pressure. When I understand their points of view a bit better, I can take some of the emotion out of my reaction to them. And if we’re both on the same page about that, we can have a conversation, and figure out where we agree. And sometimes… sometimes, one or both of us can bend a little. Without the pressure to immediately admit or agree to anything, this can feel a lot easier.

There’s one major caveat to all of this. And it’s never far from my mind when reading and listening to these conversations. This isn’t just about liberals learning to empathize with conservatives. There’s a lot going on in the other direction as well. And, especially after the election of Doug Jones over Roy Moore in Alabama, it’s way past time to start asking people to empathize with another group who doesn’t get nearly enough attention despite their huge impact and disproportionate burden: black voters. Especially black women. It’s good that we’re talking about empathy so much, but we also need to be real with ourselves about who we reserve it for.

Empathy, virtual reality, and anniversary anxiety

I’ve been working on a lot of things lately, and I’m sorry to say that this blog has not been one of them… but it will be again soon, worry not! In the meantime, here’s a look at two stories I recently published:

Can Virtual Reality Change Minds on Social Issues? at Narratively, about how nonprofits and other organizations are using virtual reality to trigger empathy and, ideally, action. There’s still some debate about whether this actually works at scale, but it can’t be denied that people are making some amazing, moving things with VR. Give the story a read, and check out the awesome gif at the top of the page!

A couple of days before the anniversary of the presidential election, I got the opportunity to write about why anniversaries like this are hard for people, psychologically. It turned into a really interesting piece that I think is relevant to the kind of behavioral science stuff I’m thinking about all the time: Why The Election Anniversary Is Hitting You So Hard at Lifehacker

More to come soon!

On Empathy & Time

Hi friends.

My work life has been bananas lately, but today I took a little bit of time to read one of the most recent Brain Pickings newsletters from the incredible Maria Popova. (It came into my inbox 9 days ago, to give you a sense of how busy I’ve been!) In it, she writes about Alan Burdick’s book Why Time Flies: A Mostly Scientific Investigation. The entry gets pretty existential (as do most of them in this newsletter!) but this part stuck out to me most:

an internal clock inheres in our capacity for intersubjectivity, intuitively governing our social interactions and the interpersonal mirroring that undergirds the human capacity for empathy.

How are empathy and time – or, at least, our perception of time – connected? How we measure and experience time, Popova writes, is innately social. She writes about a study Burdick cites in his book, in which French neuropsychologist Sylvie Droit-Volet presented people with neutral, happy, angry, and frightened faces on a screen, each displayed for between half a second and a second and a half. She found that happy faces were perceived to last longer than neutral ones and shorter than angry or scared ones, even when all of those faces were shown for the same amount of time. Here’s how Burdick explains the results (emphasis mine):

The key ingredient seems to be a physiological response called arousal, which isn’t what you might think. In experimental psychology, “arousal” refers to the degree to which the body is preparing itself to act in some manner. It’s measured through heart rate and the skin’s electrical conductivity; sometimes subjects are asked to rate their own arousal in comparison to images of faces or puppet figures. Arousal can be thought of as the physiological expression of one’s emotions or, perhaps, as a precursor of physical action; in practice there may be little difference. By standard measures, anger is the most arousing emotion, for viewer and angry person alike, followed by fear, then happiness, then sadness. Arousal is thought to accelerate the pacemaker, causing more ticks than usual to accumulate in a given interval, thereby making emotionally laden images seem to last longer than others of equal duration… Physiologists and psychologists think of arousal as a primed physical state — not moving but poised to move. When we see movement, even implied movement in a static image, the thinking goes, we enact that movement internally. In a sense, arousal is a measure of your ability to put yourself in another person’s shoes.

I won’t give away much more, but this really fascinated me, and it’s something I’ll have to think about for a while. We so often talk about empathy as if it’s an action, but in many ways it’s an automatic process our brains undergo over and over again throughout every day. To think about that in relation to our very perception of time is kind of mind-blowing! I’ll leave you with one more quote from Burdick, and I highly recommend heading to brainpickings.org to read more!

Our shared temporal distortions can be thought of as manifestations of empathy; after all, to embody another’s time is to place oneself in his or her skin.

 

 

Back To School, With Empathy

Summer is somehow over!

For a lot of you, that probably means your kids are going back to school. I know that a few are even starting college! There’s a lot to think about during this time, but if your kids are anything like me when I was starting school, one of my biggest concerns was making friends. I don’t remember putting that much thought into making those friends. I tried to be friends with my roommates, of course, and I naturally became friends with some people in my classes and members of the groups I joined. But, if a new Stanford study is right, I might have unconsciously been making decisions about my different friend groups based on two main things: fun, and empathy.

Keeping in mind that stress levels can be high in college – especially at the beginning – the Stanford researchers put about 200 freshmen through some tests. Among other things, they answered questions about their social networks within the dorms they’d just moved into. Specifically, the researchers asked who in their dorm made them feel most positive, and who they might turn to when going through something difficult. They found that students were more picky about which friends became part of their “trust networks,” seeking out people with more empathic traits for those coveted friend spots, as opposed to their broader “fun and excitement” networks. When it was time to party, the students cared more about their friends’ happiness level than their empathy.

“What we find here is not only that people’s networks of fun-based friendships are denser than their more trust- and stress-based networks,” said professor Matthew Jackson, “but also that more central people in a network have personalities that match the purpose of that network in intuitive ways. ”

Now that I think about it, I can see that this was absolutely true for me while in college, especially as a freshman. I actually had a more explicit split between these groups than many probably do – my “fun” friends were my dorm-mates and classmates, while my empathic group (which included my then-boyfriend/now-husband) was about an hour away at another school.

You and your kids may not find this to be true, and even if it is, it might not seem intentional. Either way, it might be worth thinking about. “The study offers an opportunity for college students to examine their own relationships, especially against the landscape of social media where they can have seemingly countless ‘friends’ across the country and the world,” professor Sylvia Morelli recently told Phys.org. “Our work suggests that people will turn to only a small handful of these friends when things get stressful, and that they will trust their friends who show empathy and concern.”

 

(This post also appeared in my monthly On Empathy newsletter. If you want to subscribe to that, you can do so here.)

Are we doing empathy wrong?

We tend to think of empathy as something we’re born with.

The truth is that the science on empathy is still relatively young. And while there is a general consensus that most of us are born with the ability to empathize, if we don’t start learning how to do it from a young age, we can run into problems. And it’s not as simple as learning to put yourself in someone else’s shoes. According to several recent pieces of research, there’s a “wrong” way to do empathy… or at least a way that can make things more difficult for ourselves and others.

recent study from the University of Pennsylvania (in collaboration with SUNY Buffalo and Brown University) suggests that rather than actually imagining yourself in someone else’s position, it’s healthier for all parties to simply “reflect on the nature” of their suffering.

The study had 200 college-aged subjects read a story about a person who had money troubles after being in a car accident and was also struggling to care for a younger sibling after losing their mother. One group was asked to focus on how they would feel in that situation, while a second was asked to consider the perspective of the person who wrote the story but be as detached as possible.

The researchers found that the second group experienced the least stress. We’ve talked about this in this newsletter before – empathy can raise cortisol levels and blood pressure, which over the long term can be problematic. But when it comes to connecting with people on an everyday level, what’s wrong with feeling a little stress?

Well, maybe nothing, unless you’re a caregiver or a medical professional. In this study, the researchers’ takeaway was that doctors and nurses might want to put a little more distance between themselves and their patients.

“When we consider the situation with a little more distance, you’re feeling concern, compassion and a desire to help, but you don’t feel exactly what that other person is feeling,” one of the researchers told the Philly Voice. “Empathy is very important, and for a lot of caregivers probably is the reason they chose their field. We don’t have to teach our medical professionals to suppress that emotional response; we just have to try to help them have the right kind of response, thinking of others as opposed to thinking how they would feel in the same situation.”

The bigger takeaway for all of us, I think, is that at this point there are a couple of pretty well-established routes to empathy: direct perspective-taking, which can cause distress, and more distant compassion, which affects us less. But this raises the question: isn’t the point of empathy to be affected by what affects others? Will we be less likely to spring to action in response to someone else’s pain if we only employ the latter kind of empathy?

Personally, I struggle to avoid imagining myself in others’ shoes. Sometimes I get so overwhelmed by seeing or reading an account of something harrowing that I have a physical reaction (I’m probably a researcher’s dream!) So studies like this make me wonder about what might be going on with my own body, if it’s possible to change how I empathize…and if I’d actually want to!

On empathy and stress

Last week, I reached a stress peak.

I’ve always experienced a slightly higher-than-average level of anxiety, and after several weeks of disturbed sleep and steadily increasing work stress, I sort of lost it. Instead of spending the (finally) warm Brooklyn weekend outside, I spent most of it in bed, binge-watching Netflix and trying to recover from burnout. I even canceled my Easter plans to visit family. This week, I feel a lot better, and I’m beginning to analyze what went wrong in order to avoid repeating the same cycle in the future. So when this study about the connection between stress and empathy popped into my inbox, I was intrigued.

Stress is often described as part of our biological “fight or flight” response. When we get too stressed too often, our bodies can start to mistake relatively benign situations for potentially dangerous ones, and we can get stuck in “fight or flight” mode at inappropriate times and for long periods. There are a lot of other things at play as well – I don’t want to simplify stress! But for the purposes of understanding this research, let’s think about it that way. And then let’s shake up that thinking, because, according to Science Daily,

“NEWER FINDINGS REVEALED THAT HUMANS SHOW AN INCREASE IN PROSOCIAL BEHAVIOR UNDER STRESS.”

That’s prosocial, as opposed to antisocial, the latter of which is generally how one would describe fighting or fleeing. Claus Lamm and his team from the University of Vienna asked study participants to solve difficult tasks under a time limit while providing regular negative feedback (hello, stress) and measured their cortisol levels and brain activity. Then, they showed the participants photos of painful medical procedures and asked them to “vividly imagine” the pain of the patients in the photos. In some cases, they told the participants that the patients had received anesthesia. The researchers then also played the experimental economics “dictator game,” in which participants have to distribute a certain amount of money in whatever ratio they see fit (it’s used to test self-interest).

According to the fMRI results, the participants’ neural empathy networks reacted more strongly to the painful-looking images when they were under stress. The surprising thing was that this was true regardless of whether or not they believed the patient in the photos had received anesthesia. The same neural activation also reportedly correlated with the amount of money shared during the “dictator game.” The stronger the apparent empathy reaction in the game, the more money the participant shared.

“OUR RESULTS THUS SUPPORT THE HYPOTHESIS THAT HUMANS SHOW MORE EMPATHY AND ARE MORE PRONE TO HELPING OTHERS WHEN THEY ARE UNDER STRESS, BUT THAT THEIR PERSPECTIVE TAKING SKILLS MIGHT DETERIORATE,” SAID CLAUS LAMM.

Which is perhaps why, even though I felt myself getting more and more stressed out over the past few weeks, I kept saying yes to bids for my attention, work, and physical presence. It wasn’t until I had to leave a meeting to catch my breath and then cancel everything for a long weekend that I snapped out of this empathy-stress-empathy cycle.

Now that I’m on the other side of my stress crisis, I can see how I misread several situations during that time, and how internalizing those misread emotions so deeply could have caused further unnecessary damage to my already frayed nerves. Think about it – do you feel especially affected by others’ emotions and experiences when you are stressed yourself? When you’re at your wit’s end, do you feel like you empathize more with each person who asks you for something, or the main character in the show you’re binge-watching? Or are you more likely to shut down?

Of course, this is just one piece of research. But if Lamm had put me in an fMRI machine this time last week and asked me to look at photos of patients undergoing painful medical procedures, anesthesia or not, I certainly would have felt something!