Face Power

A few times in my life, at moments of great emotional intensity, I have felt that I could not look at a particular person in the face. It was as if looking at them caused my eyes and mind to burn with a weird emotional fire so that I felt compelled, actually forced as though from outside my own self, to look away.  It seemed to me in those moments that I was experiencing both my own and the other person’s emotions and hearing their ideas, not as voices, but as an unshakable certainty about how they saw me. In a milder form, sometimes looking people in the face, particularly making eye contact, can cause me an itchy uncomfortable sensation, or a feeling of intimacy, or both. This isn’t psychosis. In fact, it isn’t even unusual; I see other people react in much the same way all the time. Reading and responding to a face for signals about another’s mental states is a powerful impulse in infants that is probably biological prompted and that we retain into adulthood.

The psychologist Simon Baron-Cohen writes about how most humans, from a very early age and as part of a biologically driven process, develop a complex series of perceptual and psychological tools for “mindreading;” understanding first that we and other people have all sorts of inner states and second, for making good guesses at what those inner states are and finally for understanding that different people will have different inner states. We have a powerful natural drive towards psychology. This is also sometimes called “mentalization.” Baron-Cohen makes the case that much of this is done through paying close attention to another’s facial expressions, particularly, the direction of the other person’s gaze.

He posits that the sub-skills of mindreading are developmental. If you have a watched a 15 month old go up and down stairs over and over and over again, you know the power of development. Human (and other animal) babies at a young age spend a lot of time looking at other’s eyes to assess where they are looking. Later children will point at an object that interests them to encourage another person to share attention, then look back to see that they are looking both of which are ways for children to develop an understanding of what is going on in another person’s mind. They seem to do this without being taught to do so. Early on, we have an innate urge to build mental tools for accessing another’s mind via their face.

In many ways Baron-Cohen’s model of mindreading is similar to John Bowlby and Mary Ainsworth’s model of attachment; the biological drive of infants to form a mutual connection with a caregiver. Both are biological drives of early childhood towards a social and psychological model of the world. It is interesting that Baron-Cohen doesn’t connect ‘mindreading’ with attachment since it seems that one of the early important functions of mindreading is being attuned with one’s caregiver. It would also help explain the intensity of emotional responses people have to facial cues from their partners in conflict; these are attachment responses.

When couples fight, I have observed a curious thing often happens. They often become very preoccupied with their partner’s state of mind. “Look, he’s so angry right now. Do you see how she’s thinking that I don’t do my share around the house?” Sometimes when people are talking about very hurtful experiences from their past, they will assume the voice of the person who hurt them and take on the voice of that person, mimicking it and amplifying its negative tone, its hurtful cadences, pausing to add in what the person was thinking when they said this. They also tend to exaggerate the facial expressions of the person. They particularly echo or exaggerate facial expressions that connote contempt.

Consider the eye roll. Holy smokes, can an eye roll ever escalate a conflict in couple or a family. The couple’s therapist and research psychologist John Gottman talks about the corrosive power of contempt deployed in arguments, usually expressed non-verbally such as an eye-roll, to poison a relationship. I suspect that there is something about the primal nature of face/mindreading and attachment processes that makes negative facial micro-expressions, particularly the eye-roll so dysregulating.

Partners are very good at reading one another’s non-verbal cues, particularly fast, involuntary facial expressions, or “micro-expressions” and most particularly their eyes. We have the idea that when we see these negative micro-expressions we are seeing the truest expression of our partner’s feelings about us. People believe that because these expressions are largely involuntary they have more weight than all the voluntary, willed behaviours of the other person, such as offering support or kindness. In this weird emotion-logic of arguments - ‘what is not willed is more true than what is done deliberately’ - the eye-roll has a special place because it is partially but only partially, involuntary, a silicon semiconductor of micro-expressions. A hurt partner can understand an eye-roll as both a willful act of cruelty and a revelation of a partner’s hidden contempt for them.

I once read a psychologist refer to “hypermentalization” meaning over-interpreting another’s mental states, particularly negative mental states. They went on to joke about “excrementalization;” meaning a shitty ability to read another’s mental states. That’s what we do when we are in a fight with our partner; we excrementalize. We tend to accurately see negative expressions that cross our partner’s face but completely miss or minimize expressions of neutral or positive mental states. If my partner thinks “I’d like to strangle him,” and that causes her to raise her eyebrow in a way which betrays her thought to me I don’t credit her for NOT SAYING a hurtful thing, for refraining from being nasty. If she then sincerely says, “I love you and I want to work things out” both in words and in facial expression, I will probably remain focussed on the eyebrow-raise as a true expression of her emotion and the rest as unimportant or even more destructive, as a lie.

If you understand from your partner’s look that they are pissed off or resentful of you, it may be useful to remember that your understanding of their expression may be very accurate, the product of a well-built and primal system for mindreading and checking on connection to the one you love. But it is almost certainly incomplete. When we are in conflict, with our attachment responses pumping and our mindreading on high alert for negative we see, correctly, that the glass is partially empty, and reject the 93% that is full. In that circumstance, force yourself to look for information that may disprove your idea about your partner.

Progressive's Pachinko and the Executive Meeting

In the last few weeks I have seen clients struggling with a lot of internal division. These are people who are pretty self-reflective and for whom examining their actions and their motivations is an important part of their identity. These are good qualities but like all good qualities, they can be carried too far. I get to see from outside how they can end up hamstringing people.

We know about the trap of black and white thinking but there is a self-reflection trap that sometimes causes people a lot of grief. I think of it as Progressive’s Pachinko. In the Japanese pinballish game the ball is continually bouncing off one nail or another, unable to pursue a clear course, like Bob Dole/Dan Savage’s phrase “A liberal is someone who can’t take their own side in an argument.” People with a progressive outlook can often get hit with this pretty hard, rehashing in their own minds the ethical implications of every decision. They are often uncomfortable with hierarchical decision making, even in their own minds.

I definitely identify. I had a dificult decision to make recently. It was a decision that had some important implications for me. Every ten minutes, I would ask myself what I should do. I felt like my clients feel; stressed and angry at myself because it felt self-inflicted.

So I used for myself a process that I had stumbled on with clients. First, I asked, “Have you already made a decision that some part of you is having difficulty catching up with?” It turned out I had. I had decided, but I felt apprehensive about my decision. People can spend a lot of time and energy trying to maintain the idea that they haven’t made a decision when they already have.

Second, I asked myself if there was any new information or perspectives on the issue that merited re-examining the decision that it turned out I had already made. The answer was no. So an emergency meeting of the executive committee of Jeremy Wexler Global Enterprises about this decision would not bring a different result but will bring more worry.

Third, I set a date to convene the executive committee to review the decision. It turned out I had made a decision even though I was having a hard time acknowledging that I had. Making a decision can bring some peace, but living in my head it was like trying to work in an office where people were constantly rehashing questions that were settled at the last meeting. “Maybe we should try it this way.” “I still think we should have gone with plan C.” These different voices have important stuff to say. One part is in charge of being scared of anything new. One part is responsible for protecting my sense of independence. One part manages the division of me that dives into any new thing because the grass is always greener. They all bring something to the table. But they tend to be unruly, and will argue their various points all day long. But my wise mind is the boss, a really good boss, a boss who cares about everyone, who takes everybody’s perspective seriously and then makes tough decisions and implements them.

My wise mind had already listened to all the factors. It had already made a choice based on what I knew and what I felt. Re-opening the decision was only adding extra emotional friction. But, it was clear that some members of the executive committee still had serious reservations.

“Okay,” said the wise mind. “We already committed to this course of action for good reasons. I know some of you don’t like it but I expect everyone to give it an earnest try. We will reconvene the executive committee in three months on, January 10, when we will have some new information and we will check in about how this is going. I assure you that I am fully open to the possibility of changing course at that time.”

And that seems to have been enough to appease the dissidents.

Too much social awareness and too little; Autism and Borderline

I work with a lot of kids with Autism Spectrum Disorders (ASD) in the context of family therapy.  One client of mine will sometimes say something pretty innocuous and then suddenly get worried.  He looks at me anxiously, trying to read my expression.  He asks me “Are you mad? Did I do something wrong?”  He feels like the world is filled with unexpected land-mines. Social situations seem to follow weird rules that everyone but him knows intuitively.  People often get angry at him for mysterious reasons, so I might as well.  This is pretty common for people with ASDs.  They have a tougher time with something called “mentalizing,” which means understanding that other people have different mental states -- knowledge, thoughts and feelings -- than themselves. (I wrote in a previous piece about Theory of Mind, which is very similar to mentalizing. There is a great video demonstrating what this looks like in kids.)  People with ASDs can find it really hard to figure out what those other mental states might be, based on cues that most of us read without thinking about it much like tone of voice, facial expression or posture. 

Some neuroscientists think that the neurology of people with ASDs is different from other people, that they may have fewer 'mirror neurons,' neurons that are thought to help with connecting to another's experiences on a totally unconscious, physiological basis.  Prominent among these is VS Ramachandran, who, in addition to being one of the foremost neuroscientists today, and an interesting philosophical mind, has maybe the coolest accent of anyone I have ever heard speak.

Mirror neurons are pretty spectacular according to Ramachandran, but others dissent.  One of the biggest doses of cold rain on the mirror neuron parade is the fact that we lack clear evidence that they exist in humans.   

Whatever the reason, people with ASDs do really poorly on a relatively new test for reading social cues called the Movie for the Assessment of Social Cognition or MASC. MASC is a really neat psychology test that lacks the flash of fMRIs but actually quantifies people's understanding of social situations very well.  The subject is shown a video of a social situation and asked a series of true or false questions about the mental states of the people in the video.  What is really interesting to me is what researchers have found out about people with Borderline Personality Disorder (BPD) when they take the MASC test.  

Among other things, BPD is characterized by very conflictual interpersonal relationships.  This great animation outlines some of the things that go on for people with BPD and the criteria for diagnosis.  

People with BPD do very poorly on the MASC test but for almost exactly the opposite reason than people with ASDs. While people with ASDs tend to mentalize poorly -- that is to consider and evaluate correctly the inner experiences of the people in the video -- people with BPD tend to “hypermentalize.”  They are very tuned in to the mental states of others, perhaps too tuned in.  Some research indicates that people with BPD may actually be better at correctly “reading” other people's emotional states based on limited information than non-BPD people.  But like many people with ASD, people with BPD can find the social environment confusing and overwhelming, not because they have too little information to understand what is happening, but too much.  I suspect they are also lopsided because their hypermentalizing often tends towards the negative; that is they read negative cues very clearly but positive cues get less focus.  

Think about how many quick, frustrated glances or disapproving sighs a person might encounter in the social landscape in a typical afternoon.  People who don't have BPD may register them almost unconsciously, as subtle social cues to "hurry up", "hold on a minute" or "give me some space".  Those things help most of us adjust our social behaviour.  But people with BPD experience each negative micro-expression like an angry, screaming tirade leaving them as bewildered as the young boy with ASD asking, “what did I do wrong?”

Your therapist, Ron Swanson?

Men often fear that therapy is stacked against them.  Whether it is couple, family or individual therapy, they think that they are entering a domain where their skills and strengths will be counted as liabilities and they will be asked to do things that aren't just difficult or scary but unbecoming.  That isn't a man problem.  That's a therapy problem.  I was talking recently with another male therapist, Dr. Darrell Johnson, a friend and mentor.  I mentioned this campaign to him... (Okay, it isn't Ron Swanson but a Ron Swanson knock-off.)

It is from the Office of Suicide Prevention of the Colorado Department of Public Health and Environment.  It's geared at connecting with men, particularly working-age 25-54 men who are twice as likely to commit suicide as any other age group according to the white paper that was used to develop the Mantherapy campaign (US stats).  Darrell and I talked about the idea that men are typically more resistant to therapy (part of what accounts for their higher suicide rates than women).  I joked that soon it would be possible for therapists to use cookies to give different design templates to their websites so that women and men would be presented with different web sites that are gender specific since too much "feelings" language might be off-putting for men, essentially presenting themselves as Rick Mahogany when men click through.  But the Colorado campaign doesn't seem to have been a raging success despite the high production values.  The Richard Mahogany video that has the most views on YouTube is at around 8,000.  Maybe those are 8,000 saved lives and if so, great, but I don't imagine that therapy's problem with men has been touched much.  I think the character seems inauthentic, not just playfully unreal, and for men or women authenticity in therapy is important. 

There were a few things in the white paper that I thought were really interesting for therapists to consider about working with men, things that hadn't occurred to me despite having worked with boys and men a lot.  One is the value men often place on fixing something themselves and how to make therapy an exercise in 'solving it myself (or ourselves) with help'.  One man said to the researchers of the white paper, "Show me how to stitch up my own wound like Rambo."  Okay, that's some pretty serious hyper-masculinity but the point is that therapy can benefit from emphasizing the client's efficacy in problem-solving with the therapist as trusted assistant. 

The other thing that I thought was really wonderful was the importance some men place on giving back.  I was in Hawaii last year.  A companion and I went kayaking.  We visited a small island and had a great time but when we went to get back in our kayak, we got hit by several waves in succession and my companion got knocked over in the surf and couldn't get up.  I watched, barely able to keep myself afloat trapped on the other side of the kayak thinking I might very well see this strong, capable person drown before my eyes in three and half feet of water.  But before that could happen two kayakers (much more capable than us) grabbed our kayak and my companion, hoisting him out of the water.  I thanked them.  They said, "That's what we do."  They viewed helping as part and parcel of who they were.  I, on the other hand, felt grateful but unsatisfied as they paddled away.  I couldn't pay back the debt I owed them.  Therapy is a uni-directional process as far as help goes; codes of ethics forbid outside relationships so it is very hard for a client to pay his debt with his skills through labour exchange or barter.  I never thought about how important it can be for some clients to be able to show their competency and mastery to a therapist by doing meaningful work or sharing their own products, to give help for help received, and that men might feel that more acutely.  The report points out how central the idea of repaying a debt is to AA, for instance.  Now I am considering requiring clients in some circumstances to agree to pay part of the cost of therapy by "paying forward" to others using their own strengths and capabilities (see the Milwaukee African Violet Queen).  Ron, would like the idea of paying off your therapy by carving duck decoys with kids in an after-school program? 

"I'm a a bit fearful that we are verging on what I call 'feelings territory.'"

When do kids 'get' irony?

The ability to understand that other people have different ideas and information about the world from one's self emerges in most kids by around four years old.  This ability that most of us share is really nicely illustrated by this video.  According to psychologist (and brother-of-Borat) Simon Baron-Cohen, kids with Autism Spectrum disorder have a much harder time with tasks such as these.  A recent study in Frontiers in Psychology found that empathy and the ability to understand irony are correlated in kids. 

“Empathy was strongly associated with several aspects of irony comprehension and processing, suggesting that emotional reasoning abilities are important to development of irony comprehension. ”

— http://www.frontiersin.org/Journal/10.3389/fpsyg.2013.00691/full#h5

Makes sense.  Irony is a disconnect between what a person says and his or her inner state.  By around eight years of age most kids can 'get' that disconnect.  The authors point out that these are both areas that are difficult for people with ASDs.  Empathy and reading irony both require projecting one's self into another person's inner experience; Theory of Mind.  In the case of irony, one has to do that while swimming upstream, as it were, against the current of the literal message.  I have noticed in my practice how hard and frustrating it is for kids with ASDs to read and irony. 

Emotional Intelligence

Great piece about the benefits and pitfalls of teaching emotional intelligence.  I kept asking myself, "what about the role of parents?"  Schools are asked to do an awful lot and parents modelling emotional intelligence for kids is extremely powerful and needs to be supported.  Nevertheless a great read by Jennifer Kahn in the NYTM.   

“ Depending on our personalities, and how we’re raised, the ability to reframe may or may not come easily. Richard Davidson, a neuroscientist at the University of Wisconsin-Madison, notes that while one child may stay rattled by an event for days or weeks, another child may rebound within hours. (Neurotic people tend to recover more slowly.) In theory, at least, social-emotional training can establish neurological pathways that make a child less vulnerable to anxiety and quicker to recover from unhappy experiences. One study found that preschoolers who had even a single year of a social-emotional learning program continued to perform better two years after they left the program; they weren’t as physically aggressive, and they internalized less anxiety and stress than children who hadn’t participated in the program.

It may also make children smarter. Davidson notes that because social-emotional training develops the prefrontal cortex, it can also enhance academically important skills like impulse control, abstract reasoning, long-term planning and working memory. Though it’s not clear how significant this effect is, a 2011 meta-analysis found that K-12 students who received social-emotional instruction scored an average of 11 percentile points higher on standardized achievement tests. A similar study found a nearly 20 percent decrease in violent or delinquent behavior.

”

— http://www.nytimes.com/2013/09/15/magazine/can-emotional-intelligence-be-taught.html?smid=pl-share