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Odd Man Out

April 11, 2011

I first saw “Walter” (not his real name) sitting in the clinic waiting room, slumped to the side, with his head resting on the arm of the couch. He was completely motionless but his eyes were open wide. For some reason he struck me as nothing so much as an alien who had found himself in an odd and incomprehensible world and despaired of ever finding his way home. Walter was depressed, and the reason for it was clear. He had a life-long developmental disorder that made it very difficult for him to understand and engage in social interactions. As a result, he had become increasingly isolated over the years until he was entirely without friends in high school.

This is not an unusual experience. A study last year (“Bullying and Ostracism Experiences in Children with Special Health Care Needs”; Journal of Developmental and Behavioral Pediatrics; Kimberly Twyman and colleagues) found that students with a range of learning and developmental challenges were significantly more vulnerable to social isolation and to being bullied than were other children. The vulnerable group encompassed kids with learning disabilities, ADHD, mental health disorders, and autism spectrum disorders.

These kids often fly under our radar. To a large extent, peer social problems often seem like something that “just happen”. Most of us remember feelings of loneliness and fear of bullies from our own childhoods, and these experiences come to seem like normal rites of passage. It’s an issue addressed in a recent study called “Empathy Gaps for Social Pain: Why People Underestimate the Pain of Social Suffering” (Loran Nordgren and colleagues, Journal of Personality and Social Psychology). In a series of studies the authors found that we tend to underestimate the emotional pain experienced by someone being excluded in our presence, and that we also tend to remember our own experiences of exclusion as being less painful than they actually were at the time. They also found that middle school teachers who underestimated the pain of ostracism tended to intervene less intensively in instances of bullying among students.

There was a time in the history of psychology when we underestimated what it meant for a child to lose the supportive environment of their family. Parents were seen primarily as sources of physical needs – food, warmth, etc – not in terms of emotional connection. It was partly through observing children who had been separated from or neglected by their parents that psychologists came to appreciate the true nature of the desire that children have for parental attachment as a basic, primary, “real” need in itself, more vital even than the material needs of existence.

In some ways, I think that our current perception of the need that older children and teenagers have for peer acceptance and belonging mirrors the attitude that earlier generations had towards the need that babies and young children have for parental acceptance and love. We view it with a certain degree of condescension – if it is there, great…but if not, no big deal. It’s an attitude highlighted by the “empathy gap” in the Nordgren study. The reality, though, is that the peer group serves a function very similar to that served by the family earlier in life. In early childhood the family (at a minimum, the relationship with a consistent caregiver) provides the solid ground for a child to stand on. It’s a petri dish where a child’s confidence in themselves and in the world as a reliable, basically positive place can grow.

The same thing needs to happen later, on a larger scale, within the peer social environment. Children and adolescents need to see themselves reflected back in their peer’s eyes as interesting, and attractive, and fun…just as they needed to see themselves in their parents eyes as both lovable and capable. When that doesn’t happen, they often wind up like Walter…sinking into depression, withering like a plant not potted in nurturing soil.

There’s no single answer for kids like Walter. In his case, he transitioned to a private school for students with diagnoses similar to his where he met kindred spirits and began to thrive. Many cases, however, have less happy endings. The lesson from the research, however, is that we need to be vigilant for two things. First, we need to watch for the ostracism and bullying that so often plays out right under our noses. Second, we need to be aware of our own blind spots around this issue, our own tendency to underestimate the pain that these kids feel and to minimize the emotional impact that it has on kids as they develop.

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