18 AND UNDER At Last, Facing Down Bullies (and Their Enablers)

June 9, 2009

By PERRI KLASS, M.D.
Back in the 1990s, I did a physical on a boy in fifth or sixth grade at a Boston public school. I asked him his favorite subject: definitely science; he had won a prize in a science fair, and was to go on and compete in a multischool fair.

The problem was, there were some kids at school who were picking on him every day about winning the science fair; he was getting teased and jostled and even, occasionally, beaten up. His mother shook her head and wondered aloud whether life would be easier if he just let the science fair thing drop.

Bullying elicits strong and highly personal reactions; I remember my own sense of outrage and identification. Here was a highly intelligent child, a lover of science, possibly a future (fill in your favorite genius), tormented by brutes. Here’s what I did for my patient: I advised his mother to call the teacher and complain, and I encouraged him to pursue his love of science.

And here are three things I now know I should have done: I didn’t tell the mother that bullying can be prevented, and that it’s up to the school. I didn’t call the principal or suggest that the mother do so. And I didn’t give even a moment’s thought to the bullies, and what their lifetime prognosis might be.

In recent years, pediatricians and researchers in this country have been giving bullies and their victims the attention they have long deserved — and have long received in Europe. We’ve gotten past the “kids will be kids” notion that bullying is a normal part of childhood or the prelude to a successful life strategy. Research has described long-term risks — not just to victims, who may be more likely than their peers to experience depression and suicidal thoughts, but to the bullies themselves, who are less likely to finish school or hold down a job.

Next month, the American Academy of Pediatrics will publish the new version of an official policy statement on the pediatrician’s role in preventing youth violence. For the first time, it will have a section on bullying — including a recommendation that schools adopt a prevention model developed by Dan Olweus, a research professor of psychology at the University of Bergen, Norway, who first began studying the phenomenon of school bullying in Scandinavia in the 1970s. The programs, he said, “work at the school level and the classroom level and at the individual level; they combine preventive programs and directly addressing children who are involved or identified as bullies or victims or both.”

Dr. Robert Sege, chief of ambulatory pediatrics at Boston Medical Center and a lead author of the new policy statement, says the Olweus approach focuses attention on the largest group of children, the bystanders. “Olweus’s genius,” he said, “is that he manages to turn the school situation around so the other kids realize that the bully is someone who has a problem managing his or her behavior, and the victim is someone they can protect.”

The other lead author, Dr. Joseph Wright, senior vice president at Children’s National Medical Center in Washington and the chairman of the pediatrics academy’s committee on violence prevention, notes that a quarter of all children report that they have been involved in bullying, either as bullies or as victims. Protecting children from intentional injury is a central task of pediatricians, he said, and “bullying prevention is a subset of that activity.”

By definition, bullying involves repetition; a child is repeatedly the target of taunts or physical attacks — or, in the case of so-called indirect bullying (more common among girls), rumors and social exclusion. For a successful anti-bullying program, the school needs to survey the children and find out the details — where it happens, when it happens.

Structural changes can address those vulnerable places — the out-of-sight corner of the playground, the entrance hallway at dismissal time.

Then, Dr. Sege said, “activating the bystanders” means changing the culture of the school; through class discussions, parent meetings and consistent responses to every incident, the school must put out the message that bullying will not be tolerated.

So what should I ask at a checkup? How’s school, who are your friends, what do you usually do at recess? It’s important to open the door, especially with children in the most likely age groups, so that victims and bystanders won’t be afraid to speak up. Parents of these children need to be encouraged to demand that schools take action, and pediatricians probably need to be ready to talk to the principal. And we need to follow up with the children to make sure the situation gets better, and to check in on their emotional health and get them help if they need it.

How about helping the bullies, who are, after all, also pediatric patients? Some experts worry that schools simply suspend or expel the offenders without paying attention to helping them and their families learn to function in a different way.

“Zero-tolerance policies that school districts have are basically pushing the debt forward,” Dr. Sege said. “We need to be more sophisticated.”

The way we understand bullying has changed, and it’s probably going to change even more. (I haven’t even talked about cyberbullying, for example.) But anyone working with children needs to start from the idea that bullying has long-term consequences and that it is preventable.

I would still feel that same anger on my science-fair-winning patient’s behalf, but I would now see his problem as a pediatric issue — and I hope I would be able to offer a little more help, and a little more follow-up, appropriately based in scientific research.

Commentary: How words can last a lifetime

By Bob Greene

CNN Contributor

Editor's note: CNN contributor Bob Greene is a best-selling author whose current book is "When We Get to Surf City: A Journey Through America in Pursuit of Rock and Roll, Friendship, and Dreams."

(CNN) -- The enduring moments of our lives, the ones that stay with us the longest, don't necessarily make the headlines.

The other afternoon I was talking with a woman by the name of Virginia Florey. She's 80 years old; she has lived in Midland, Michigan, all her life.

She was telling me that when she was 11 years old, she and her best friend, Charlotte Fenske, would walk to school together every morning. At the corner of East Carpenter Street and Haley Street, across from a Pure Oil filling station, there was a small grocery -- Thompson's grocery store, it was called.

"We would get there at around 7:30," she told me. "It must have opened up at 7 a.m., because the grocer would always be sweeping the floor when we came in.

"Charlotte and I would have a nickel, and we would buy a candy bar to split between us every morning. We would stand there in front of the man who owned the grocery and decide which kind to buy each day -- Butterfinger, or Milky Way, or Oh Henry!, or Hershey bar. We always talked about which one we wanted to spend our five cents on. We weren't very fast about it.

"And. . . ."

Here, Virginia Florey's voice grew almost wistful as she remembered it; here, almost 70 years later, you could hear the gratitude in her tone:

"He was never impatient with us. Never once."

Think of all the world-changing events that have transpired in the years since those days when the two girls in Midland would stop in at that grocery store; think of all the events that must have occurred in their own lives.

Yet back then someone was gracious toward them -- someone didn't rush them as they debated how to spend that precious nickel each Michigan morning. And now, in 2009, she sounded still thankful at the memory of it.

There's a lesson in that. In our current era, when offhanded cruelty at times seems to be the coin of the cultural realm, it may be worth giving a little thought to the idea that the small moments of people treating us with decency and empathy can last for a very long time -- that the echoes of kindness can be as loud as the echoes of callousness.

I asked her why she thought the memory of those mornings was still so vivid.

"I don't know," she said. "But I can still see him now. He would have the broom in his hand, and sometimes the dustpan in another. He would be standing by this black metal stove in the middle of his store. He was a thin man -- he wore a white butcher's-style apron, and he was so thin that he would have wrapped the apron string around his waist a few times and tied it in the front.

"And it was just so. . .calming, I think that's the word. . .for us to go in there and know that he wasn't going to rush us."

I have a feeling there are memories like that in a lot of lives -- small and sweet memories that are strong enough to override other memories of bitterness. I recall once interviewing a woman named Atsuko Saeki, who lived in Fujisawa, Japan. She told me she had attended college in the United States; she came to the U.S. knowing no one, and there were times, she said, when she had felt nervous and utterly alone.

In a physical education class, the students played volleyball. "I was very short, compared to the other students," she told me. "I felt I wasn't doing a very good job. To be very honest, I was a lousy player."

One day, she said, when she was playing especially poorly, trying without success to set the ball up for other players, a young man on her team, sensing her discomfort, walked up to her. He whispered to her, so no one else could hear:

"You can do that."

Something so simple. But, years later, she told me:

"I have never forgotten the words. 'You can do that.' When things are not going so well, I think of those words.

"If you are the kind of person who has always been encouraged by your family or your friends or somebody else, maybe you will never understand how happy those words made me feel. Four words: 'You can do that.'"

This weekend, in the central Ohio town where I grew up, there will be a charity race through the streets in honor of Jack Roth, who was my best friend since we were 5 years old.

Jack died of cancer in 2004. We hold the race in his name each year at this time. He may have been the kindest person I have ever known. It was his defining quality; whenever he would see a little kid in a driveway trying mightily to shoot baskets, Jack would instinctively call out: "Nice shot!" Whenever he would see a child struggling to throw a baseball, he would say: "Good arm!" Seemingly small moments -- I must have seen him do it a thousand times during our lives. And every time, he made someone feel a little better.

There will be hundreds of people running in that race this weekend, and if Jack were there, I know exactly what he would be doing: standing near the finish line, applauding for the racers who are the slowest, the ones who come in near the back of the pack. Cheering them on. Telling them that they've done a good job.

"He was never impatient with us," Virginia Florey, remembering the grocer at the corner of Carpenter and Haley, said, the timbre of thankfulness in her voice. "Never once."

Seventy years later, she sounded as if the memory of such a thing still matters.

Which, of course, is why it does.

The opinions expressed in this commentary are solely those of Bob Greene.

Verbal assaults -- how to defend yourself

(OPRAH.com) -- Cutting remarks, "helpful" suggestions, subtle (or not-so-subtle) stabs -- how to handle these verbal ambushes?


The author says she realized she could use the basic martial arts principles to fight verbal assaults as well.

You can slink away, lose your cool ... or employ Martha Beck's cleverly adapted martial arts techniques to turn your attackers' words against them. Hiiiiii-yaa!

"Don't worry, hon," said Theresa's husband, Guy, when she failed to extinguish all her birthday candles in one breath. "A woman your age has to be in shape to make wishes come true. You just don't have the lung capacity."

Guy chortled. Theresa's face turned scarlet. The rest of us chuckled nervously. We were used to Guy, to the jocular way he planted and twisted stilettos between his wife's ribs. Like most of Theresa's friends, I'd always found him just charming enough to be tolerable.

But as I watched him serve Theresa's cake, something dawned on me: Guy was a mean person. He'd intentionally humiliated his wife, and he did such things often. It was like that moment in a horror movie when you understand that the rogue car, rather than simply straying off course, is actively pursuing children and puppies. Oprah.com: How to set personal boundaries

I recall an urge to kick Guy in the throat, which I controlled by reminding myself that it was both illegal and difficult to pull off in heels. I was studying karate at the time, and though it didn't occur to me then, I would eventually realize that the basic principles taught at my dojo could be used to fight evil not just in action but in conversation as well.

I think of it as martial arts of the mind, and if you're subject to subtle stabs, deliberate snubs, or cutting remarks, you might find these techniques an effective defense against the Guys of your world.

Principle 1: Find your fighting stance

Every form of martial arts requires a fighting stance that's fluid, flexible, and centered. Standing this way makes you much less likely to lose your balance, and if someone jumps you, you can quickly duck or dodge in any direction without falling.

Physical fighting stances involve balance, alignment, weight distribution, and posture. A psychological fighting stance is all about emotional balance: self-acceptance, abiding by your own moral code (something you're probably doing anyway), forgiving yourself for failing to reach perfection (this is rarer), and, finally, offering yourself as much compassion as you'd give a beloved friend (I suspect some of us need work in this department).

Simply put, you must never be mean to yourself.

This works because cruelty, to be effective, has to land on a welcoming spot in the victim's belief system. Guy mocked Theresa's age and lack of physical fitness because he knew she hated those things about herself. Oprah.com: Why are people mean?

If she hadn't already believed his insults, they would have left her feeling puzzled but not devastated -- the way I was when I learned that calling someone a "turtle's egg" is a horrific insult in China. She would have seen Guy as the pathetic head case he was. And that may have led her to our second principle.

Principle 2: Practice the art of invisibility

I once purchased a book that promised to teach the ninja's fabled "art of invisibility." I was crestfallen to read that the first step in a technique called vanishing was "Wait until your opponent is asleep." The whole book was like that: Get your enemy drunk, throw dust in his eyes, thump him on the head with a wok, then tiptoe away, forever. Well, I could've told you that.

Nevertheless, I recommend these ninja techniques for dealing with mean people. Get away from them, full stop. Sound extreme? It's not. Cruelty, whether physical or emotional, isn't normal. It may signal what psychologists call the dark triad of psychopathic, narcissistic, and Machiavellian personality disorders.

One out of about every 25 individuals has an antisocial personality disorder. Their prognosis for recovery is zero, their potential for hurting you about 100 percent. So don't assume that a vicious person just had a difficult childhood or a terrible day; most people with awful childhoods end up being empathetic, and most people, even on their worst days, don't seek satisfaction by inflicting pain.

When you witness evil, if only the tawdry evil of a conversational stiletto twist, use your ninjutsu. Wait for a distraction, then disappear.

"But," you may be thinking, "what if you're stuck with a mean family member, co-worker, or neighbor? What's poor Theresa supposed to do?" Well, Grasshopper, that's when the martial arts of the mind really come in handy.

Principle 3: Master defensive techniques

All martial arts teach strategies to deflect different attacks. For instance, I was taught to defend against a lapel grab with a punching combination called Crouching Falcon, follow that with a multiple-kick series known as Returning Viper, and finish with the charmingly titled technique Die Forever.

(I prefer my own techniques, such as Silent Sea Slug, which entails lying down and hoping things improve, or Disgruntled Panda, which is mostly curling up and refusing to mate.)

I also learned this closely guarded martial arts secret: Although there are countless techniques, most fighters need only a few. For instance, judo star Ronda Rousey has clobbered numberless opponents using the Arm Bar technique.

Her opponents know she's going to do it, but that doesn't keep her from snapping their elbows like dry spaghetti. Each good technique goes a long, long way. The following are a few that I highly recommend, in order of degree of difficulty.

Yellow belt technique: Trumpet melodiously

I'm a lifelong fan of "Japlish," English prose translated from the Japanese by someone whose sole qualification is owning a Japanese-to-English dictionary.

One classic Japlish instruction, which I picked up from a car rental company, advised: "When passenger of foot heave in sight, tootle the horn. Trumpet him melodiously at first, but if he still obstacles your passage then tootle him with vigor."
I borrowed the phrase "trumpet him melodiously" for your first anti-meanness technique. It's meant to nip hurtful behavior in the bud. Use it when someone -- say a small child or an engineer -- makes a remark that may or may not be intentionally cruel:

"You smell like medicine," "I can see through your pants," "Why don't you have a neck?"... You can trumpet him melodiously by saying, "Hey, dude, that's kind of mean. Back off, okay?" If the behavior continues, tootle him with vigor by saying, "I'm serious. You're out of line. Stop it." Oprah.com: How to have the hard talks

Practice these lines until you're saying them in your sleep, with clear delivery, calm energy. Then, when you use them in real life, a normal person will react by immediately ceasing all hurtful behavior, and even mean people will be taken aback by your directness. They may even begin to behave themselves. Mission accomplished.

Brown belt technique: Zig-zig

As a martial artist, you'll need to get used to doing the opposite of whatever your enemies expect. For example, if someone were to push you backward, you might push back for a few seconds, then abruptly reverse, and pull your assailant in the direction he's pushing. He'd be toppled by his own momentum.

This is zig-zigging. It works beautifully on mean people. They expect a fight-or-flight reaction from their victims -- either angry pushback or slinking away. The one thing they don't anticipate is relaxed discernment. Scuttle their plans by zigging instead of zagging, cheerfully accepting any accurate statement they might make while ignoring their malicious energy.

You can observe this technique in the movie "Spanglish," when a young wife, played by Téa Leoni, lashes out at her mother. "You were an alcoholic and wildly promiscuous woman during my formative years, so I'm in this fix because of you!"

As the mother, Cloris Leachman nods and says pleasantly, "You have a solid point, dear. But right now the lessons of my life are coming in handy for you." This response stops the daughter cold, partly because it's true and partly because it contains not a whiff of pushback. The mother zigs when the daughter expects her to zag. The result is peace.

Black belt anti-meanness technique: Wicked-kind parent

If you keep a balanced stance and surround yourself with normal people, you'll eventually master the black belt skill I've named Wicked-kind parent. Mean people are adept at adopting the tone of a critical parent, making others unconsciously regress into weak, worried children.

To use this defense, refuse to be infantilized. Instead, use the only thing that trumps the emotional power of a bad parent: the emotional power of a good one. This is what happened at Theresa's birthday party. As Guy served cake and cruelty, Theresa's older sister Wendy spoke up.

"Now, Guy," she said, in precisely the tone Supernanny uses with kids on TV, "that kind of petty meanness doesn't become you. Show us all you can do better." Guy tried to laugh, but a glance around the room silenced him.

Wendy had called on her good-parent energy to tap a great resource: normal people. Kind people. Outplayed and outnumbered, Guy slunk away, leaving Theresa to enjoy her birthday.

This is virtually always the outcome when a mental martial artist encounters a Mean Guy. If you choose the way of the warrior, it will happen for you.

Principle 4: Walk the way of the warrior

Being a martial artist is a way of life. You can't use your skills in an emergency unless you practice them every day. And such daily practice may lead to unexpected adventures. You'll no longer watch helplessly as some Mean Guy emotionally abuses his wife -- even if you happen to be the wife in question. Where your prewarrior self would've simply wilted, your warrior self will speak up or, if you're the wife, walk away.

This may require drastic changes in your life. Are you ready for that? Well, you are if meanness has pushed you to the point of anger or despair. You are if you want to be the change you wish to see in the world.

You can begin today. Adopt the stance of dauntless self-acceptance, avoid combat when possible, and practice your techniques until they become second nature. Though it might be helpful to remember that it really does help to wait until your opponent is asleep.

By Martha Beck from "O, The Oprah Magazine"

Hope on the horizon for seniors

May 02, 2008
Carol Goar

Paul Williams calls himself "a professional cynic" who is savouring a rare burst of hope.

Williams, a health policy professor at the University of Toronto, has spent the past 20 years trying to convince politicians, bureaucrats and medical authorities that most seniors don't belong in nursing homes. Few listened. Even when he did get a sympathetic hearing, nothing changed.

Then eight months ago, to his surprise – and nearly everyone else's – Health Minister George Smitherman announced a $700-million Aging at Home Strategy.

This spring, funds started flowing to Ontario's 14 regional health units. They'll soon be able to ramp up home care and offer seniors an array of services, from housekeeping to snow removal, to allow them to live independently for as long as possible.

What Williams finds particularly encouraging is that 20 per cent of the provincial money has been earmarked for innovative projects. Local providers are brainstorming, experimenting, listening to their clients.

"You really do have some choices," he told a roomful of active pensioners this week. "For the first time in my career, I see the possibility of real change in Ontario."

He is still cautious. He wonders if results-obsessed provincial officials will take into account intangibles such as dignity and quality of life. And he warns that without public support, Smitherman may have to back off or slow down.

"But we can try things we could never do before."

He gave a poignant example. He once watched an elderly gentleman's life spiral out of control because he could no longer buy cat food. No public program deals with that. The cat slowly died and the senior fell into a deep depression. He ended up in a nursing home.

"Should we provide pet care?" Williams asked. "No, not across-the-board. But it would have been a cheap solution in this case."

Under the old rules, there was no room for cheap solutions, no matter how sensible or humane. Under the new system, there will be flexibility to offer seniors the help they need, rather than slotting them into one-size-fits-all programs.

The federal government has tested this approach on a limited basis. Twenty-seven years ago, aging veterans were pressing for more nursing home beds. Instead, Ottawa offered them a choice: more beds or more support in their homes.

The vast majority opted to stay in their homes, drawing on the services they needed. There were nurses to treat medical conditions, personal care workers to help with bathing and dressing, housekeepers to assist with cleaning and laundry and yard workers to cut the lawn and clear the snow. Each client was assessed individually. As his or her needs changed, the arrangements were modified.

"Which of the services do you think was used most?" Williams asked. To most listeners' surprise, it was groundskeeping.

"Why not fix the eavestrough or shovel the sidewalk?" he asked. "It costs far less than long-term care."

A nursing home bed in Ontario costs $130 a day. The government pays $80 and the resident pays $50 (or whatever they can afford).

For that same $80 public expenditure, community agencies could provide most seniors with all the services they need. They'd be healthier. And hospitals would be able to release them back into their homes, rather than waiting for a nursing home bed to become available (at a cost of $1,500 to $3,000 a day).

Funding has begun to shift and mindsets have started to change, Williams says, but there is still a long way to go. Doctors will have to make house calls. Teamwork will have to replace patchwork. And taxpayers will have to understand that unconventional solutions – from buying cat food to building wheelchair ramps – are often the best solutions.

Most seniors don't want to end up in a nursing home, Williams said, to emphatic nods throughout the room.

But many expect they will. This time, the nods were grudging.

Williams used to offer such audiences moral support. Now he can offer them hope.

Carol Goar's column appears Monday, Wednesday and Friday.

Men, what are you doing to protect the women you know?

ONE REASON to get educated about violence against women -- if you are a man -- is because you have a mom. I happen to be a brother with a sister. That's another great reason. Or maybe you're a father with a daughter. Too often we men are bystanders to abusive, controlling, or violent behavior. We don't even recognize what we are seeing, how to interrupt it, or how to stop it. We need to begin to learn to use our personal power and our constructive collective power.

Here is what we can do if we are good-hearted men. We can make the world a safer place for women with our actions, words and deeds. We can commit ourselves today to take an active role in protecting the emotional and physical well-being of someone who brought us into the world, someone we love and care for, or someone we brought into the world. It's important to pay attention to the way men treat women in our society. We may have to learn how.

It is OK if it doesn't come naturally. Other good-hearted men can help each other learn. It is important that we do. Violence against women may seem like a "woman's problem" until it happens to someone you love. When it affects you directly that way, violence becomes a problem for you too. Violence is a human problem. I hope you learn about violence against women from your own free will. I hope, for the sake of you and your family, that you are not forced to learn about it when something bad happens.

If you are a good-hearted man, it is very hard to get bad news about what some men do to hurt women. Yet men are responsible for 95 percent of violence against women. If you are a good-hearted man, that news may feel like an affront to your dignity or an insult to your integrity -- and you haven't even been a victim of violence.

One in four women and one in six men will have unwanted sexual contact by the time they are 18. That runs the gamut from sexual harassment and unwanted touching to aggravated felonious sexual assault. That's a lot of human beings affected. Play this little game with statistics: look around. Maybe that's two people on your softball team, or the woman in your carpool, perhaps a half dozen people in the class you're taking at school, a dozen people at your work or congregation or coffee shop.

There's no shame in being a survivor. That's what it looks like, human faces, human beings, working on healing and mending their lives, perhaps looking or working for justice. That's what I want for you to do as a good-hearted man. Join others who are working for healing and justice. Be an ally. Use your voice, your knowledge, your clear thinking and calm action to help stop sexual and domestic violence in our society.

I'll be joining the celebration of White Ribbon Day this year and inviting my male friends to join me. Men from around the state will join Gov. John Lynch and me at the State House to use our voices against violence tomorrow at noon. We know and love women who have been subjected to violence and we want it to stop. Please come join us or call the New Hampshire Coalition Against Domestic and Sexual Violence and tell them you would like to get involved.

As one good-hearted man to another, I hope you'll come along. We can make New Hampshire a better, safer place for all people and we can start today.

Rick Agran is a former New Hampshire Coaltion Against Domestic and Sexual Violence board member. He also worked as an outreach coordinator at the Sexual Harassment and Rape Prevention Program at UNH.