Anandhi Narasimhan, M.D. is a Board Certified Physician accredited by the American Board of Psychiatry and Neurology specializing in Adult, Child, and Adolescent Psychiatry. Dr. Narasimhan completed her adult psychiatry residency training at Duke University Medical Center in Durham, North Carolina, and completed her child and adolescent psychiatry fellowship training at University of California Los Angeles Medical Center in Los Angeles, California. She talks to us about The Effects of Bullying.
Below is a transcript of her interview on The Effects of Bullying with Ciaran Connolly:
Dr. Anandhi: My name is doctor (Anandhi Narasimhan). I am an adult and child physiatrist and I practice in Los Angeles, California, United states. I have a lot of interest in bullying, both in perpetrators and victims, and what happens on the long term. More than that, I even have a lot of interest in prevention on an individual basis with children, families, schools but on a larger basis raising awareness because it really is a societal issue. Everybody needs to be aware of it. Everyone needs to know how to watch out for it, warning signs of it and to know how to intervene because it is everyone’s responsibility.
Ciaran Connolly: Very good! Do you think bullying has increased in recent years or is it something that is static and we just haven’t got to the real cause and fixed it?
A: Well, you know, it is not a new problem. There has been research dating far back that there has been reports of bullying. There has even been reports of some children and teenagers committing suicide and there has been a correlation with them having been bullied before. So, we have got data from past years or in the past that shows us it’s not a new problem, but I think now that there is more awareness. There are several more studies that have come out and there are surveys that have been done in high schools and middle schools and talking to children and finding out how many of them are being either a victim or they’ve bullied themselves or both; they have been a victim and participated in bullying. So, it is not a new problem for sure.
The Effects of Bullying: Cyberbullying and Technology
C: And have you seen a change in how bullies are actually carrying out their victimization in recent years? I guess we have a lot of new technology. Things are changing.
A: Absolutely. The technological forms definitely give more of a platform for different types of bullying like texting. People still use the phone, but texting and internet and all these social networking sites that people can go on and post things on for everyone else to read. So, I’ve definitely seen more of that even among my patient population and the children and families that I treat. There has definitely been a rise in cyberbullying and what happens online and with cellphones and text messages.
C: Interesting! And the media, at the moment or in the last few years, has been covering a lot of stories especially about cyberbullying. Do you think this extra attention from the press and journalists in general is helping raise this as an issue or is it causing or giving us a false sense of security that everyone is talking about it so the problem must be getting looked up and getting fixed?
A: That’s an interesting question. I do think that disseminating information as to, you know, what are the consequences if these things aren’t addressed is very important. So, for everyone in the general public to know about it is very important. It is hard. There is, and I have actually participated in, some research that is looking at how the media reporting incidents of this kind or how they report trauma or how that affects public perception for example things like gun shootings and schools shootings and things like that. I have been involved in some research.
There is some research that’s going on that’s looking at [that]. There is truth that whatever is reported in the media does influence people’s thinking about things and gives attention to things, that’s for sure. So, exactly the details of that will still be coming out later. But I do think that these reports in the media do have people more tuned to it. The hope is that parents and teachers and providers are also more attentive to the potentially fatal consequences of it. I think there was a time where people thought it’s a rite of passage for all children to go through that. That it just happens and you are just going to have to deal with it and move on.
But more and more that we have looked into it and that the researchers looked into it; it’s not that simple. It is not always something that can just be shrugged off. It can have very serious consequences if it is not dealt with appropriately.
The Effects of Bullying: The Aftermath
C: Of course! Have you actually seen where the consequences have been severe? Of course, there is an impact on the person, maybe they start to lose confidence, but are there other side effects we aren’t aware of, I guess, from a child being bullied?
A: Absolutely. We know that bullying increases the risk of depression [and] depressive symptoms. Children can have trouble sleeping at night. They could have trouble with their appetite. Their grades may drop because they are not able to concentrate and in addition, as you said, their self-esteem can drop. Anxiety. They may not want to go to school. They may not want to go out in public. They may be afraid all the time and there has also been some research showing that this may not just be time limited as a child. These effects can actually be carried on to adulthood too or it could be a trigger to those kind of symptoms later on as well.
C: Very interesting and we are talking about the victim in that case. Is there any impact on the bully’s life? If someone, when they were young, does that set them up for the rest of their life?
A: Possibly. Actually, it is interesting because the rates of depressive symptoms and anxiety and panic disorder are also present in the person who is doing the bullying, and the people who are victims of bullying and doing the bullying because one thing also to remember is that, sometimes, the bully may also be bullied themselves in their home. They may have parents that express a lot of anger towards them and that translates to their behaviour at school. So, there is evidence that actually the perpetrators may have behavioural problems and symptoms of depression and anxiety and be at risk for things like suicide attempts themselves as well.
C: So, actually, it sounds like it really is, or could be, a full cycle that just continues and continues and continues. So, we talked at the start and mentioned society and society’s impact, and I guess it has a role to play in helping stop bullying but also I guess stakeholders who are parents, and schools of course as well. We are only talking about children here at the moment but society has, with role models who may be in sports, aren’t always acting or behaving in a professional way and that reflects back on our society. Stars as well. What, I guess, part does each stakeholder have to play; schools and parents and society as a whole? Everyone has their equal part or is someone more responsible than others do you think?
A: I think everyone has an equal part, you know. If we start with, let’s say we start with parents. One of the key factors is the relationship between the parent and the child. A parent really wants their child to be able to come to them and to talk to them about whatever is going on. So that relationship is very important and if the child is afraid, the parent is going to be mad or they are not going to listen to them or they may not feel comfortable sharing that with their parents. A parent really needs to cultivate that kind of level of trust within their child and I also tell parents it’s very reasonable for you, and I encourage them, to ask their children “What is going on at school?”, you know, “How are things with their friends?”. It’s very appropriate for a parent to check in with their children. The other thing is that we do know that parents who know their children’s friends and know the parents of their children’s friends. That can actually help in mitigating bullying too. So, I always tell parents as much as possible [to] get involved with the people your children are with.
Get to know them and cultivate a relationship with them so you can hear about things that are happening and address it. The other thing, as a provider myself who sees children, one of things I do is I always ask my patients “How you are being treated? How you are being treated at school?” and that actually, that sentence, can open the dialogue with the young person. They kind of tell me, “Well, there is this issue with this one girl or boy who has been calling me names” and, you know, I get the story and then I’ll explore further and say “Have you talked with anyone about it? Have you told the teacher? Have you told your mum and dad? ”. They may say yes or no or they may say, you know, “I thought of it but I didn’t because I don’t want to be a snitch” or “I don’t want kids thinking I am just a tattle-tale” and then we talk about how it’s not their fault and why it’s important for adults to know and then, often, I will talk to the parent as well; all with the child involved. Then, we set-up a plan for how we are going to approach the school and what to do next and all of that. So, I find that [this] kind of model and that protocol is highly effective.
The Effects of Bullying on The Victims
C: And do the children often feel that it’s their fault that they are being bullied?
A: You know, I would say a good number of them at some level know that it’s not right. That they don’t deserve this but it depends on how severe and how often it’s happening. And sometimes they feel helpless like they don’t know how to stop it or what to do about it or what their rights are even and sometimes they need that reassurance and encouragement that they are doing the right thing by talking about it to an adult and that so we can address it. I think the other thing is the society. I definitely don’t think that one needs to be a parent or a teacher or a psychiatrist to be involved.
I think there are several opportunities to volunteer in the ‘No Bullying Campaign’. Even going to, like, volunteering or participating in the school board when this is addressed. A lot of schools in the United States, I am not certain how it is in the UK, but in the United States a lot of schools have now adopted the zero tolerance policy which means they have a system [that] when the child is caught bullying they get a warning the first time or they get a detention. And the second offence there is a serious penalty and then it can lead to expulsion if it continues. Often times, they’ll have interventions where they bring the child that is being bullied and the child that is a bully and have a meeting with them and have an intervention kind of thing. So, a lot of schools are adopting that more in the United States and parents are involved and community members can be involved in implementing a zero tolerance policy.
C: Very good. And do you think the zero tolerance policy, you think it will work? Is it working? Is it better than what was there before?
A: I do think it is working. I do think it provides children with hope that adults are here to protect us and they are going to do something if I am not being treated right and it’s great role-modelling because it shows other children “Hey! This is what’s going to happen if you do bully. We are not just going to let you get away with it”. And this is wrong because children, they don’t know or they may be modelling what’s happening at home so they don’t know. They need to be taught what the right way to treat other kids is. I am seeing that it is having some positive effects.
C: Very good! If a young person is watching us now listening to this video, and they are being bullied, what advice would you give them? What would your first steps for them to take be?
A: Well, I would just tell them it is important to talk. If they are being bullied, if they see other kids being bullied, it’s important for them to talk about it. Tell a teacher. If the teacher doesn’t hear you, tell a principal. Tell your parents. Tell whoever will listen. It is important for kids to keep talking about it. It is important for them to understand that bullying can have some serious consequences. Not only making another person feel bad, it can have a lot of serious effects later on. Then, I also think it’s important how young people don’t understand the dangers of internet and social networking sites. That people are not always in their best interest and they need to be aware of that. I also think one of the best ways to handle that is supervision. Parents do need to know what their children are doing online and be aware of it. So, I would say conversation is very important; for young people to keep talking about it and standing up when they see it happen.
C: I think you touched on something of interest to us here. At the moment, we are starting to see an increase in problems with the internet and with mobile phones and texting. Have you seen many cases yourself?
A: Absolutely! Yes, I have. I have even personally got involved with a family and the police and detectives. I have had teenagers that have been videotaped by a boyfriend or whatever and that’s been put online. I have had all sorts of cases where it has been taken to another kind of level with the internet and things have been put on Facebook. Threats have been put on Facebook or other social networking sites. So, yes. I have seen a rise in that.
C: And young people generally don’t realize that when they post something, the whole world can see it or it is there forever? Or is that just a moment’s lapse?
A: They don’t. I actually think that they don’t realize the magnitude of the impact because, you know, it could be such an impulsive act to post something without realizing. I mean, we have seasoned politicians who can’t seem to realize that one tweet or one post can affect or offend a whole lot of people because, in the moment, it can be done impulsively that you don’t really think it through.
C: If you don’t mind another question. If someone posts something that is negative about another person and a class of ten or five or another eight or ten people like it and engage in a post and the original comment was cyberbullying. Are those people, by liking and sharing and engaging in the post?
A: It is a group dynamic that has been formed by more people getting involved.
C: And it is very easy to press “like” on a picture without even thinking. It is very easy.
C: Before talking about cyberbullying, you mentioned bystanders to actually not be silent and stand up and say something. I guess that the same goes for the internet. If we see something on someone’s wall or someone is posting something that isn’t appropriate, it will take a brave person to actually go against the crowd and say [that] it isn’t right. But to be honest, I don’t see that really often, and not even for myself I am sad to say.
A: Yes, you are right. People may think it’s not the cool thing or they don’t want to get involved. Yes it is an act of courage to stand out.
Communication and The Effects of Bullying
C: Just to finish off, if you have some advice for parents, then you are saying communication is key. To communicate with their children. What should a parent look for in their child if they think they might be getting bullied? Is there tell-tale signs that should set off alarm bells?
A: Yes. Sometimes it can be obvious and sometimes it can be subtle especially if the child is kind of quiet and shy and not the most expressive. You may not always be aware, but if you see obvious changes like differences in sleep patterns or if they are having a lot of physical complaints like stomach-aches and headaches and they’re saying they don’t want to go to school and this is happening repeatedly or they don’t want to participate in activities they used to like or their grades are dropping. I think all those can be a sign that a child is being bullied, as a possibility.
The best way to know is to ask them and if you don’t feel that they are disclosing, I think there is a big stigma about having your child see someone like a counsellor or a therapist or something. But sometimes trained professionals are better able to kind of know how to put the child at ease so that they disclose more. So, sometimes getting outside help can be very useful in these situations if the child is very scared of disclosing something. Sometimes kids also may act out; they may become a bully. They may be aggressive at home or they may talk back or start becoming defiant. That can be a sign that something is going on at school as well and I think for parents, communication is key even if it’s spending just a few minutes with the child. Ten to fifteen minutes talking to them can really have a profound impact. And also talking to the school and asking the schools: ”Hey! What’s your policy on bullying? How do you handle it when a child is being bullied?” And if they don’t have any kind of protocol or policy, maybe rounding up other parents and coming up with it or suggesting it or signing a petition for the school to come up with something because every school should have a way that they deal with it; a systematic way so that they can handle bullying.
C: Excellent! You touched on something that’s very popular. We don’t have such a strong culture of going and seeking help outside the family in Ireland and the UK, we really don’t. We know that this happens a lot in America but parents don’t get a manual. We learn by trial and error and actually talking to someone that has been there and is dealing with this all the time, I can really understand how you can help because you have seen cases like this before and you’ve got answers and ideas that we, as parents, just wouldn’t know where to start. So, again, thank you for your time today. It’s been brilliant taking time out to talk to us and share your knowledge with us. If anyone wanted to contact you or to reach out and seek some advice or help, how can anyone reach you?
A: My website is www.doctoranandhi.com