Age 10-11

This blog is in progress, it is a multi-week project.  Please stay tuned.

How many psychiatrists does it take to change a light bulb? One, but only if it really wants to change.

Ten year old children hearing that joke would think in a rather concrete manner. Their thoughts would be, “how could a light bulb want to change?” They might imagine a psychiatrist standing up on a ladder changing a light bulb in the ceiling.

Before age 12, children have a concrete thinking pattern. They believe that things are the way they superficially perceive them. There isn’t much depth to their thinking. Pre-teenager thinking is rule based. If you see a ten-year-old who is throwing stones against the window and you say, “Don’t throw stones against the window,” he would ask, “why?” If you say, “We have a rule here, to not throw stones against the window.” and he say, “Okay” and not throw stones against the window. Children tend to follow rules because their thinking is organized around rules.

Pre-teenage children are also oriented toward their families. A child feels at home and protected in a bubble that includes their mother and father and siblings. They are aware that there is a world outside that bubble, including their school, their town and maybe their country, but children’s emotional concerns are mostly with their mother and father and siblings.

During the adolescent years, youth get two “brain upgrades.” I use the word “upgrade” because it is almost like what happens with a computer when the Pentium Processor is upgraded with a faster one. The difference with teenagers, is that the upgrades do not happen suddenly. They occur gradually in fits and starts over a period of time. One major brain upgrade occurs at age twelve and another major brain upgrade occurs at age sixteen.

Copyright 2010, Henry Doenlen, M.D. All rights reserved.

Age 12-13

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During age eleven to thirteen years, children start to understand how other people behave. They observe, learn, and they make assumptions about what other people think and feel. They are particularly attuned to what their peers think about them. Permanent psychological damage can result from children being mean to each other, particularly in middle school. When children are made to be outside the peer groups, and when other children repeatedly made fun of them, permanent damage may result because these children will not trust other people when they grow up. As adults, they will consider that other people may be nice in their outward behavior but are thinking negative things about them.

Students can be really mean at some middle schools, and sometimes the meanness goes well above and beyond the call of duty. Years ago, two eighth grade girls in the same middle school attempted suicide. When they got back to school, word got around. Some of the students came up to them and said, "Why don't you just try to kill yourself right here in front of the class?" They would do this over and over again. One girl went on to repeat her suicide attempt. The other girl made the taunters feel guilty, but went on to abuse drugs and drop out of high school.

Pre-teenagers and teenagers look for the respect of their peers. Being considered "popular" is one way of getting respect from peers. Some children try to gain popularity by interfering with their peers respect of others, and they make fun of other children. The thought is that if a peer is less respected, then logically, the one who is doing the damage can be more respected. Fortunately, that thought does not last forever, or otherwise, we would have a terrible world as adults.

Copyright 2010, Henry Doenlen, M.D. All rights reserved.

Age 14-15

This blog is in progress, it is a multi-week project.  Please stay tuned.

At age fourteen to fifteen, teenagers are very peer oriented. They gradually loose their family identity as their sense of themselves becomes oriented toward their peers. In this age, teenagers tend to make relationships in collective groups of peers. Sometimes, these groups are called cliques. It is almost as if a second family is created, except this time, there is nobody in charge. The members of a group have high regard for each other.

The thoughts of fourteen and fifteen-year-old teenagers are intense and single-minded. When they get an idea, they focus on that idea with passion. They do not allow anything to interfere with that idea. They believe that just by their force of will, they should be able to get things accomplished.

Teenagers tend to be self-centered, particularly around age thirteen, fourteen and fifteen. Their self-centeredness is not necessarily selfish, in that they don't always want everything for themselves. They are self-centered in that they assume that other people think the way they do. For example, if a fourteen-year-olds are asked "Can you imagine what that starving child in Africa feels like?" They will answer that they do understand, but the answer they give would be how they would feel if they were in that starving person's shoes. They do not consider that a person might think even differently than them. That can cause a very confusing situation in boy-girl relationships, because the thirteen, fourteen and fifteen-year-olds will assume that members of the opposite sex think the way they do. The truth is that boys and girls think very differently in this age range.

Copyright 2010, Henry Doenlen, M.D. All rights reserved.

Age 16-17

This blog is in progress, it is a multi-week project.  Please stay tuned.

Facial Expression, Communication's Second Channel

It is said that we use only 10 percent of our brain at any one time. That is fortunate, because even with only 10 percent active, the brain is using 20 percent of our oxygen, 20 percent of our nutrients, and 20 percent of our blood. The brain is the only organ with four separate arteries bringing blood to it. If we used 100 percent of our brain, out bodies would be like large balloons to breath enough oxygen, and we would eat constantly to get enough nutrients to support a fully active brain. (Image shown here is modified from The Human Brain Atlas at the Michigan State University Brain Biodiversity Banks, Sudheimer DK, Winn BM, Kerndt GM, Shoaps JM, Davis KK, Fobbs AJ, Johnson JI. Radiology Department, Communications Technology Laboratory, and College of Human Medicine, Michigan State University; National Museum of Health and Medicine, Armed Forces Institute of Pathology)


The parts of brain being used turned on, are given more blood, then turned off as information moves and is processed by different parts of the brain, which then are turned on, are given more blood, then turned off. The functional MRI is able to tell the difference between oxygenated hemoglobin and hemoglobin which is not carrying oxygen. Thus, the functional MRI is able to detect which parts of the brain are active at any given instant by detecting which parts of the brain are recieving more blood.  Using the functional MRI, researchers have been able watch the areas of activity skip across sections of the brain after a face is viewed. (Face perception is mediated by a distributed cortical network. Ishai A, Schmidt CF, Boesiger P. Brain Res Bull. 2005 Sep 30;67(1-2):87-93.)

The image of the face is constructed in the visual cortex (VC) from data recieved from the eyes. The facial image is then moved to the superior lateral sulcus (SLS) and the fusiform gyrus (FG). The superior lateral sulcus very quickly extracts the emotional information from the image of the face, and mostly from the area around the eyes. The emotional information is sent to the amygdala (Amyg) where a an initial personal emotional response is generated. The emotions from the face along with the personal emotional response is sent to the prefrontal cortex (PFC) for thinking and decisions about behavior. You can feel this pathway working particularly when you have a sudden emotion reaction to some else rolling their eye. (Affective neural circuitry during facial emotion processing in pediatric bipolar disorder. Pavuluri MN, O'Connor MM, Harral E, Sweeney JA. Biol Psychiatry. 2007 Jul 15;62(2):158-67. Epub 2006 Nov 9.)

Simultaneously, the fusiform gyrus (FG) performs a more detailed topographic analysis, looking separately at the eyes and surrounding area, the mouth, and the remaining face. The topographical information also sent to the frontal lobe, to be considered with the emotional information and the words which were heard. This pathway is used when you study the face, trying to figure out what makes that face look interesting. The fusiform gyrus pathway is also used when you ask, "where do I know him from," trying to recall the name that goes with the face. (Effective connectivity within the distributed cortical network for face perception. Fairhall SL, Ishai A. Cereb Cortex. 2007 Oct;17(10):2400-6. Epub 2006 Dec 26.)

Face-to-face conversation provides a second channel of communication in addition to the spoken words. Observing facial expression gives important information about emphasis and importance in what is being said, as well as how well we are being understood. When face-to-face, we can combine the speaker's words with their emotion, adding our own emotional reaction, and determine our own reaction with words, expressions, and behaviors. Texting or messaging with Facebook or another messenger allows for more frequent communication, but does not give the emotional richness of personal contact.

Personal interaction is important in the transfer of emotions. Interacting with a person who expresses happiness can induce a happy feeling in ourselves. The superior lateral sulcus to amygdala connection allows us to feed off other people's emotions. That is why attitude is so important, why happy people are more attractive, why happy people make a class or workplace more pleasant.

Copyright 2010, Henry Doenlen, M.D. All rights reserved.