Joyce Hesselberth

18 AND UNDER

Dr. Perri Klass on family health.

The mother was trying to hold the baby still, and I was pulling gently on the ear, angling for a better look at the infant’s eardrum. The wriggling baby didn’t like any of it, and her whimpering quickly turned to full-fledged wails.

Suddenly the baby’s 3-year-old brother, an innocent bystander in no danger of having his own ears examined, began to wail as well, creating the kind of harmonic cacophony that makes passers-by wince in recognition. And the poor mother, her hands full, could only look over and reassure him: Your sister is O.K., don’t worry, don’t feel bad.

But really, was that why the 3-year-old was crying? Was he tired and frustrated, scared by the noise, jealous of his mother’s attention? Or was he, in fact, upset because his sister was upset — an early step toward empathy, sympathy, kindness and charity?

The capacity to notice the distress of others, and to be moved by it, can be a critical component of what is called prosocial behavior, actions that benefit others: individuals, groups or society as a whole. Psychologists, neurobiologists and even economists are increasingly interested in the overarching question of how and why we become our better selves.

How do children develop prosocial behavior, and is there in fact any way to encourage it? If you do, will you eventually get altruistic adults, the sort who buy shoes for a homeless man on a freezing night, or rush to lift a commuter pushed onto the subway tracks as the train nears?

Nancy Eisenberg, a professor of psychology at Arizona State University, is an expert on the development in children of prosocial behavior, “voluntary behavior intended to benefit another.” Such behavior is often examined through the child’s ability to perceive and react to someone else’s distress. Attempts at concern and reassurance can be seen in children as young as 1.

Dr. Eisenberg draws a distinction between empathy and sympathy: “Empathy, at least the way I break it out, is experiencing the same emotion or highly similar emotion to what the other person is feeling,” she said. “Sympathy is feeling concern or sorrow for the other person.” While that may be based in part on empathy, she said, or on memory, “it’s not feeling the same emotion.”

By itself, intense empathy — really feeling someone else’s pain — can backfire, causing so much personal distress that the end result is a desire to avoid the source of the pain, researchers have found. The ingredients of prosocial behavior, from kindness to philanthropy, are more complex and varied.

They include the ability to perceive others’ distress, the sense of self that helps sort out your own identity and feelings, the regulatory skills that prevent distress so severe it turns to aversion, and the cognitive and emotional understanding of the value of helping.

Twin studies have suggested that there is some genetic component to prosocial tendencies. When reacting to an adult who is pretending to be distressed, for example, identical twins behave more like each other than do fraternal twins. And as children grow up, these early manifestations of sympathy and empathy become part of complex decision-making and personal morality.

“There is some degree of heritability,” said Carolyn Zahn-Waxler, a senior research scientist at the University of Wisconsin-Madison, who has done some of these twin studies. But she notes that the effect is small: “There is no gene for empathy, there is no gene for altruism. What’s heritable may be some personality characteristics.”

Scott Huettel, a professor of psychology and neuroscience at Duke, described two broad theories to explain prosocial behavior. One, he said, was essentially motivational: It feels good to help other people. Economists have also looked at the question of altruism, and have hypothesized about a “warm glow effect” to account for charitable giving.

Experimental studies have shown that the same brain region that is activated when people win money for themselves is active when they give to charity — that is, that there is a kind of neurologic “reward” built into the motivational system of the brain.

“Charitable giving can activate the same pleasure-reward centers, the dopaminergic centers, in the brain that are very closely tied to habit formation,” said Bill Harbaugh, an economist at the University of Oregon who studies altruism. “This suggests it might be possible to foster the same sorts of habits for charitable giving you see with other sorts of habits.”

The other theory of prosocial behavior, Dr. Huettel said, is based on social cognition — the recognition that other people have needs and goals. The two theories aren’t mutually exclusive: Cognitive understanding accompanied by a motivational reward reinforces prosocial behavior.

But shaping prosocial behavior is a tricky business. For instance, certain financial incentives seem to deter prosocial impulses, a phenomenon called reward undermining, Dr. Huettel said.

Consider that in the United States, historically, blood donors could be paid, but not in Britain. And the British donated more blood. “When you give extrinsic motivations, they can supplant the intrinsic ones,” he said.

What would the experts say about fostering prosocial behavior in children, from kindness on to charity?

Parental modeling is important, of course; sympathy and compassion should be part of children’s experience long before they know the words.

“Explain how other people feel,” Dr. Eisenberg said. “Reflect the child’s feelings, but also point out, look, you hurt Johnny’s feelings.”

Don’t offer material rewards for prosocial behavior, but do offer opportunities to do good — opportunities that the child will see as voluntary. And help children see themselves and frame their own behavior as generous, kind, helpful, as the mother in my exam room did.

Working with a child’s temperament, taking advantage of an emerging sense of self and increasing cognitive understanding of the world and helped by the reward centers of the brain, parents can try to foster that warm glow and the worldview that goes with it. Empathy, sympathy, compassion, kindness and charity begin at home, and very early.

A version of this article appeared in print on 12/11/2012, on page D5 of the NewYork edition with the headline: Understanding How Children Develop Empathy.

Let’s face it: When the family is all together during the holidays on long car rides to Grandma’s house or cooped up in the house when the weather is cold and wet, the circumstances are ripe for conflict to arise.  Here are some tips on how to defuse conflict and create greater family harmony:

I know, it sounds so ridiculously simple how could it possibly work? Well, the family that breathes together finds peace together. Designate someone in the family as the breath expert and let her/him learn how to do this simple breath exercise and then teach and lead others to do it together. Practice together when you’re all calm and in good spirits so when tension arises you’ll all be prepared to pull this tool out of the tool belt.
1. Sit up or stand straight to ensure ample lung capacity.
2. Breathe in through the nose to the count of 5 allowing belly to expand with the in-breath.
3. Hold breath in for count of 2
4. Breathe out through the nose to count of 5 allowing belly to contract in toward spine as breath is pressed out
5. Hold breath out for count of 2
6. Repeat 4 more times and consider closing eyes while you breathe to keep focus.

by Lynn Louise Wonders, LPC, RPT-S

Q. I don’t get it. I keep seeing snip-its in magazines about how we should not say “good girl” or “good job” to our kids. I thought we were supposed to be helping them feel good about themselves as parents.

A.  I like to help parents be very clear about their vision and purpose when considering how they interact with their children. We want kids to develop an intrinsic sense of worth and value rather than be dependent on extrinsic sources to boost their self esteem. More simply said, we want children to feel good about themselves from their own conclusions rather than be addicted to having their parents and teachers tell them how good they are. So, I recommend parents remove the words “good” and “bad” from their vocabulary to begin. I teach parents how to encourage and reflect rather than review and rate. Praise focuses on the product while encouragement focuses on the effort.  

Consider this scenario: Your child brings you a drawing she’s been working on at the dining room table and she says with a big smile on her face, “Mommy, look!” If you say, “Sweetie, that is beautiful! Good job!” you have just reviewed and rated your daughter’s product. If alternatively you say, “You spent a lot of time working on this. Look at all the colors you chose to use. I can tell by the smile on your face that you are very proud,” then you are reflecting the emotion (pride and pleasure with her own effort) she is presenting, reflecting back your observation of the effort she put forth and encouraging her to continue to work hard and to feel proud of herself.

Try telling your child, “Thank you for helping with the dishes. That was very helpful,” instead of, “Good job.”  Next time your son takes out the garbage without having to be asked you might say, “You noticed the garbage can was getting full and you chose to bag it up and take it out without anyone asking you to. You’re realizing this is your house too and pitching in shows that you care about keeping things nice around here.” 

An occasional pat on the back and “good job” is not at all ill-advised.  In fact, every once in a while some praise in healthy doses can be a nice peppering of positive reinforcement. Day in and day out, however, parents are going to see a more lasting positive result, higher levels of self esteem, more motivation and initiative in your kids if you provide relfective encouragement rather than ratings and reviews.

There is a lot of pressure often engendered by our commercially driven society to be on the go without pause during the holiday season. Between ultra-busy scheduling, budget busting buying sprees, sugar laden holiday treats and lots of family togetherness many families find the holidays to be a time of stress and frenzy.  When parents feel stressed, it trickles down to the children. When children feel stressed, they typically act out or melt down. Let’s consider a few tips for how to avoid this downward spiral.

1. Limit the commitments. Cut back on the number of parties and events you reply “yes” to this year.  Leave room for unstructured time in your family’s schedule. Unstructured, unscheduled time is where spontaneous family fun can emerge or where silent snuggles occur.  Less running and going means more time to relax into the holidays.  

2. Honor the bedtime routine: Often children get off their regular sleep routines. While unstructured, unscheduled time is important, honoring a bedtime routine is important as well.  Children (and adults) need their sleep all the time but especially during the holidays with all the stimuli and activity.

3. Step away from the cookies: Too much sugar and white flour, sprinkles and food coloring seems to correlate with cranky children and irritable adults.  A sweet holiday treat after a healthy well balanced meal is a wonderful thing. A bowlful of candies and tins full of cookies up for grabs at all times may contribute to blood sugar spikes followed by crashes and moodiness to boot.

4. Don’t go Grizwold: I confess I cringed when I heard a friend of mine say her husband had decided he’s “going Grizwold” this year. The reference is to that very funny movie Christmas Vacation starring Chevy Chase where he covers his house in lights in pursuit of “the best Christmas ever” and is met with a very stressful holiday.  I believe it is best for parents and children to keep it simple. Decorations need not be the brightest and most expensive. Gifts need not be voluminous and bank breaking. Consider that it is the quality of time a family has together rather than how big and bright the holiday looks from the outside.

5. Eat at the table: Make a commitment to eat as many of your meals together as a family at the table. If all family members are not present, you can still take your meals at the table. Eat off of a dish, light a candle, take a breath, say a prayer of thanks or just take a moment to look at your food, savor and eat slowly.  Let mealtime be a time of coming together whether with your family or just by yourself. Take time to taste your food, chew slowly and focus on being in the moment. 

6. Observe simple rituals: If you don’t already have family rituals, the holidays are a good time to begin. Regardless of your religion, there is always room for a candle to be lit as a way of observing what you believe – even if you aren’t religious at all. Light a candle, read a famous holiday story out loud in front of the fire, make a holiday pie together, sing songs together, watch It’s a Wonderful Life or Rudolph or some other special movie reserved just for the holidays. Children gain a sense of belonging and comfort in having certain rituals that they can count on each year.

7. Carve out time for silence: Observe silence a little bit every day. Well, more than just a little bit. Commit to 20 to 30 minutes a day. Turn off the TV, turn off your phone, shut down your computer and find a comfortable chair or seat on the floor. See if you can just sit and just notice the natural flow of your breath and the silence of the house (or car, or office).  You might choose after the children are asleep or during your commute to work in the morning.  If you are not driving, close your eyes and see if you can settle your mind by simply observing the rhythm of your breath.  Listen to the silence outside of you.  It’s golden.

8. Re-evaluate the to-do list: Do you really have to do all those things that others may expect of you on your list? It’s just a question to consider.  Try this: Substitute the word “could” instead of “should” every time you find yourself saying or thinking “I should….”  Consider that it’s all a choice.  You don’t have to send out 1000 holiday cards. You don’t have to participate in this year’s cookie swap.  You don’t have to spend 6 hours at the office holiday party. Take another look at that list and see if you can find ways to simplify, cut back on the number of items and reclaim your time for yourself and your family.

If you can find way to implement these ideas into your life this holiday season, I am betting you will experience unexpected moments of greater joy and peace.  Drop me a line and let me know how it goes. 

Happier holidays,

Lynn Louise Wonders, LPC, RPT-S, E-RYT

Q. My 6-year-old daughter has a lot of worries. She worries about things that don’t make a lot sense. Is there anything I can do to help her or should I take her to see a therapist?

A.  Everyone worries. Everyone has a level of anxiety at some point in their lives.  It’s normal for kids to fret. Some kids fret more than others.  When the worries get to the point where basic functioning is interrupted, it may be time to seek professional support from a children’s therapist. There are some things, though, that parents can do to help so that maybe therapy won’t be necessary.

1.  Do not laugh, dismiss, criticize or negate your child’s worries.  Let’s say your daughter comes to you in tears after the bedtime routine and says, “Mommy, I’m really afraid pythons are going to fall out of the trees outside my window and come into my room!”  It might be hard to suppress a giggle but suppress you must.
2.  Validate her feelings. The content about which she is worried we’ll address in a minute. Right now you just have to reflect and validate.  “Sweetie, I can see you are feeling really frightened right now by these pictures in your mind of pythons!”
3.  Pause and let her speak.  Keep your sincere empathy in gear with your face and just listen.  She may need to tell you more about how worried she is or about the visions of pythons slithering in her head.  Just listen and let her know you are listening.  Be fully present.
4.  Provide comforting facts.  Like this:  “Honey, did you know that pythons live in the jungle way down in South America? They don’t live in Georgia.” Gauge her reaction.  Does she have a follow-up question? Answer it factually and honestly, but be sympathetic to her fear.
5.  Summarize and help soothe. Assuming she is feeling better now, summarize the facts but help her to remember how to help herself be soothed. Encourage deep, long breaths and remind her of her cuddly bunny that helps her feel safe.  Teach her to count slowly backwards from 30 as she pictures her favorite place (the beach, the mountain cabin, the back yard, playing with her friends).

You can apply these steps to most any apparently outlandish worry your child might have.  What about the worries based in reality you ask?  Let’s say your neighbor had a terrible house fire and your child is worried his house is going to burn to the ground.  Or what about the child who is being bullied at school? Let’s see if we can apply these same principles.

1. Do not laugh, dismiss criticise or negate your child’s worries. Regardless of how serious or realistic it may or may not seem to you, it’s serious business in your child’s mind.
2.  Validate his feelings.  “Son, I can see you are having a lot of worry thoughts about fire and I can understand why.  When scary things happen in the world, sometimes we have worried feelings that it might happen to us.  I can understand you are feeling frightened right now.”
3.  Pause and let him speak.  Providing a space for your child to talk without interruption, without you rushing in to fix it, or dismiss the foundation of the worries, is invaluable.  
4.  Provide comforting facts:  “Remember, we have a safety plan if there ever was a fire and we’ve posted it in every room. We have fresh batteries in the smoke alarms.  We practiced yesterday, remember?  Your mom and I are making sure there are no candles left burning and the stove is off and that there is no chance for an accidental fire.  And the fire department is just down the street. Remember how fast they came to help our neighbor?
5.  Summarize and help soothe: “Okay, so now you know, your mom and I are going to make sure the house is safe before we go to bed. We’ve got a safety plan and we’ve practiced. Now, it’s time for you to help yourself feel calm. Let’s take ten slow, deep breaths together…”  Help your child to remember some ways he’s felt calm when upset in the past.

If these tips aren’t enough, there is no shame at all in bringing your child in for counseling.  You’ll want to seek out a counseling center that caters to children and a therapist who does play therapy with children.  Children’s therapists are well trained and experienced in knowing how to help children work through their anxieties and develop new skills for coping.