Popping a Tylenol for physical pain has become second nature for many – but groundbreaking research suggests this common painkiller may also be numbing our emotional capacity for caring, with potentially profound social consequences.
For many, reaching for a Tylenol to relieve a headache or sore muscles has become almost automatic. But groundbreaking research suggests that while this popular over-the-counter drug may effectively dull physical pain, it could also be numbing users’ ability to empathize with others on an emotional level – a side effect with deeply troubling societal implications.
A study published last month in Frontiers of Psychology adds to the growing body of evidence that acetaminophen (the generic name for Tylenol) reduces empathy for others’ suffering.1 Researchers at Ohio State University conducted a double-blind, randomized trial in which 114 college students received either 1,000 milligrams of acetaminophen or a placebo. One hour later, participants read scenarios depicting the experiences of various protagonists.
The results were striking: those who had taken acetaminophen reported significantly lower empathic concern and personal distress in response to the characters’ misfortunes compared to the placebo group.1 Notably, even positive empathy was dampened, with the acetaminophen users experiencing less vicarious joy for the protagonists’ uplifting experiences.1 As the authors note, these muted emotional reactions raise concern given the role of empathy in fostering compassion, connection, and prosocial behavior.1
This was not the first study to highlight acetaminophen’s psychosocial side effects. A seminal 2016 paper by some of the same Ohio State researchers first revealed that a typical dose of the drug blunted participants’ empathy for others’ pain, as measured by brain activity and subjective ratings.2 The authors sounded an early alarm:
“Because empathy regulates prosocial and antisocial behavior, these drug-induced reductions in empathy raise concerns about the broader social side effects of acetaminophen, which is taken by almost a quarter of adults in the United States each week.”2
Since then, evidence of acetaminophen’s psychological risks has only mounted. A 2019 study by the Ohio State team showed that the drug inhibited users’ ability to share in others’ positive experiences, suggesting effects on empathy beyond reactions to physical pain alone.3 Once again, the researchers warned about potential consequences, as “taking pleasure from the good fortune of others fosters interpersonal connection, trust, and – ultimately – prosocial behavior.”3
Other unsettling behavioral changes have also surfaced. Just last year, Baldwin Way, an Ohio State psychology professor who co-authored the empathy studies, published findings that acetaminophen made participants more willing to take risks.4 Compared to a placebo group, those given 1,000mg of the drug not only rated hypothetical activities like skydiving and unsafe sex as less risky, but also took more risks in a computerized task to earn rewards.4
Coupled with the empathy deficits, these disinhibiting effects paint a worrisome picture. As Way commented, considering that a quarter of American adults take acetaminophen each week, “even slight changes in risk-taking behavior could have important effects on society.”4 Other research has linked greater risk-taking on this type of simulated task with increased likelihood of real-world risky behaviors like stealing, substance use, and reckless driving.5
So how exactly does acetaminophen exert these effects on the mind? The answer likely lies in the brain regions it targets. Neuroimaging studies show that the drug reduces activity in areas like the anterior insula and anterior cingulate cortex,6,7 which are involved in processing both physical and social pain, as well as positive empathy.1 By tamping down these key emotional centers, acetaminophen may provide physical relief at the cost of emotional blunting.
The picture that emerges is one of a medication that, while highly effective at treating aches and pains, may also numb the emotional capacities that make us fully human. As the Ohio State researchers argue, acetaminophen’s “broader psychological effects…may have profound social implications that are only now beginning to be understood.”1
These discoveries underscore the importance of holistic approaches to pain management that address root causes rather than simply masking symptoms. They also highlight the risks of viewing any drug, even familiar over-the-counter remedies, as completely benign. With acetaminophen in particular, the ease of access and assumption of safety8 belie the major questions that remain about long-term psychological impacts, especially at a societal level.
As more and more evidence links this common painkiller to deficits in quintessentially human traits like empathy, it serves as a clarion call to reevaluate the full spectrum of effects – both intended and unintended – of one of the most widely consumed drugs on the planet. The health of our bodies and our social fabric may very well depend on it.
Summary: A study examining the effects of cannabis on empathy reveals intriguing findings.
Regular cannabis users showed greater emotional comprehension and heightened functional connectivity in the anterior cingulate cortex (ACC), a brain region crucial for empathy. This increased connectivity was particularly notable with the left somatomotor cortex (SMC), suggesting a better understanding of others’ emotions.
These results open new perspectives on the potential positive impacts of cannabis use on interpersonal relationships and mental health.
Key Facts:
Regular cannabis users demonstrated higher emotional comprehension, particularly in understanding others’ emotions, compared to non-users.
Enhanced functional connectivity was observed in the ACC, especially with the left SMC, in cannabis users, indicating a deeper empathic processing.
The findings challenge traditional views of cannabis effects, suggesting potential positive impacts on empathy and social interactions.
Source: Neuroscience News
In an intriguing turn of events, a recent study has brought to light a potentially positive aspect of regular cannabis use – an enhanced understanding of others’ emotions and increased brain connectivity in empathy-related areas.
This research, conducted on a sample of regular cannabis users compared to non-users, could shift the narrative around the implications of cannabis consumption on mental health and interpersonal relationships.
Cannabis, often associated with various negative mental health outcomes, may have an unexpected silver lining. Researchers found that regular users have an improved capacity for emotional comprehension, a critical facet of cognitive empathy. This involves a deeper understanding of the emotional states of others, a skill that is fundamental in human social interactions.
The study, involving 85 regular cannabis users and 51 non-users, utilized psychometric scoring of empathy subscales and resting state functional MRI to delve into the underlying neural mechanisms. The results were striking.
Regular cannabis users showed significantly higher scores in Emotional Comprehension compared to the control group. This suggests that these individuals are better at recognizing and understanding the emotions of others, a skill that is crucial in forming and maintaining social bonds.
A closer look at the brain’s functioning via fMRI revealed that this increased emotional comprehension in cannabis users is linked to greater functional connectivity (FC) in the anterior cingulate cortex (ACC).
The ACC is known to play a pivotal role in mediating empathic responses, making its enhanced activity in cannabis users particularly noteworthy. Notably, increased connectivity was observed between the ACC and the left somatomotor cortex (SMC), areas integral to processing and understanding emotions.
These findings are in stark contrast to the traditional view of cannabis as detrimental to mental health. Instead, the study suggests that regular cannabis use might positively influence the brain’s empathic processing.
This has significant implications for our understanding of the social and psychological effects of cannabis.
The study’s results also have broader implications for mental health and social interaction. Empathy, a critical component of social relationships, is enhanced in regular cannabis users. This might explain some of the positive social behaviors observed in these individuals, such as increased prosocial behavior and reduced hostility.
Furthermore, the findings could be used to develop new approaches to treating conditions characterized by deficits in empathy, such as certain personality disorders.
However, the study is not without its limitations. The researchers point out that the enhanced empathy and brain connectivity observed in cannabis users might be a pre-existing condition rather than a direct result of cannabis use.
Additionally, the study relied on self-reported data for cannabis consumption, which could introduce biases. Future research using more objective measures of cannabis use and a more balanced gender distribution is needed to build on these findings.
Despite these limitations, the study is a significant step forward in understanding the complex effects of cannabis on the brain and behavior. It challenges the prevailing negative perception of cannabis use, suggesting that, under certain conditions, it could have positive effects on mental health and social functioning.
In conclusion, this groundbreaking study opens new avenues for research into the therapeutic applications of cannabis. It suggests that, contrary to popular belief, regular cannabis use might enhance empathy and improve social interactions.
As we continue to explore the multifaceted effects of cannabis on the human brain, this research lays the groundwork for a more nuanced understanding of this commonly used substance.
About this cannabis, empathy, and brain connectivity research news
Empathy-related differences in the anterior cingulate functional connectivity of regular cannabis users when compared to controls
It has been reported that cannabis consumption affects the anterior cingulate cortex (ACC), a structure with a central role in mediating the empathic response. In this study, we compared psychometric scores of empathy subscales, between a group of regular cannabis users (85, users) and a group of non-consumers (51, controls).
We found that users have a greater Emotional Comprehension, a cognitive empathy trait involving the understanding of the “other” emotional state. Resting state functional MRI in a smaller sample (users = 46, controls = 34) allowed to identify greater functional connectivity (FC) of the ACC with the left somatomotor cortex (SMC), in users when compared to controls.
These differences were also evident within the empathy core network, where users showed greater within network FC. The greater FC showed by the users is associated with emotional representational areas and empathy-related regions. In addition, the differences in psychometric scores suggest that users have more empathic comprehension.
These findings suggest a potential association between cannabis use, a greater comprehension of the other’s affective state and the functional brain organization of the users. However, further research is needed to explore such association, since many other factors may be at play.
The humanities, from music and painting to literature and poetry, offer limitless opportunities to grow as a professional and as an individual.
For physicians in particular, although medicine is doubtless an endeavor into the sciences, their knowledge and expertise can only be improved with a dollop of the arts — and the empathy it can inspire.
“I do think that the humanities, as a broader field, is very important, and that we should not be allowing ourselves to become one-sided in terms of the science,” Ronald F. van Vollenhoven, MD, PhD, told Healio Rheumatology. Source: Ronald F. van Vollenhoven, MD, PhD
“I think that we are in a time where we need more humanities in medicine to balance the science that we are blessed with,” Leonard H. Calabrese, DO, director of the RJ Fasenmyer Center for Clinical Immunology at the Cleveland Clinic, told Healio Rheumatology.
That science, and the advancements it has made possible, from the revolution in biologic therapies to the emergence of precision medicine and improved diagnoses, has been a boon for rheumatology — both for patients and providers. However, there is another side to patient care, one that is strengthened not by trials and data but through exercising empathy and connecting with patients.
Leonard H. Calabrese
According to Calabrese, physicians who take part in various artistic pursuits, be it classical piano, reflecting deeply with a piece of writing or examining the life of artists long passed, can bring those qualities — empathy and human connection — from the studio into the clinic.
Yet, this requires an understanding that the humanities and the arts can be just as important as the hard sciences.
“It’s almost like the art of medicine is not given any credence, it’s all hard data and science, and there’s a lot more to medicine than that, I think,” Ronan Kavanagh, MD, a rheumatologist at the Galway Clinic, in Ireland, told Healio Rheumatology.
Kavanagh, who had a previous life as a musician before pursuing medicine, is also the founder of dotMD, an annual 2-day “festival of curiosity” for physicians and other health care professionals that seeks to “awaken a sense of wonder and curiosity about medicine that some may have lost along the way,” according to its website. The festival accomplishes this by, among other means, “viewing medicine with fresh eyes through the lenses of culture, the arts, philosophy and technology.”
According to both Kavanagh and Calabrese, and others, rheumatology requires a balance between the seemingly — but not necessarily — opposing disciplines of science and art, a balance that becomes easier to achieve when providers are steeped in the humanities.
Maintaining the Engine of Empathy
For medical doctors, the humanities formed the cornerstone of the profession until the 19th century, when the scientific setting of the laboratory seemed to remove medicine from the arts, according to Calabrese. The result of this divergence, he explained, was rising skepticism regarding the value of indulging in the humanities. One prevailing opinion was that the feeling and passion involved with music, literature and the like made the humanities all but incompatible with the data-based path medicine seemed to be following.
However, according to Calabrese, by engaging in the arts, either through active participation or passive observation, the humanities can provide physicians with the opportunity to develop their humanity and empathy — attributes that are key in medicine.
“Empathy is an incredibly important attribute of the healing relationship,” Calabrese said. “It’s transmitting feelings.
“This is not just to make someone ‘feel good,’ but it has the capacity to both heal in terms of empowering patients and strengthen the healer-patient relationship, as well as imprint the messages from the visit,” he added. “Our patients may forget the details of what we instruct them, but they never forget how we made them feel during a visit.”
As such, Calabrese said he considers engagement with the humanities to be an amplifier of personal empathy, which can then be drawn upon “to both help our patients and enrich ourselves at the same time.”
Ronan Kavanagh
Specially, engaging with the arts on a passive level, be it reading an enthralling novel or attending a gripping concert, can “soften up the edges,” for physicians, making them able to better connect with patients, said Kavanagh.
“If reading a book helps me empathize or connect with a patient a bit better, I think that has to be a good thing,” he added.
Meanwhile, active engagement with the arts can exercise myriad qualities that can be invaluable in practice, including not only empathy but also curiosity and self-awareness.
Iris Y. Navarro-Millan, MD, of the Hospital for Special Surgery and Weill Cornell Medicine, in New York, describes herself online as a musician who happens to be a doctor. A lifetime of playing music with family members and singing her way through college as an undergrad before joining a band has resulted in a sharpened sense of empathy, she said.
Iris Y. Navarro-Millan
“I think empathy, kindness and curiosity definitely lend toward understanding patients’ reality, and eliciting their specific goals,” Navarro-Millan said, adding that involvement in the arts has also helped to sharpen her self-awareness.
According to Navarro-Millan, empathy gained from her involvement with music lends itself toward reflecting more on the world around her, allowing her to connect with her patients much more easily.
“I think it makes me more sensitive, more self-aware,” she added.
As an example, Navarro-Millan recalled one patient from Colombia who spoke only Spanish. When the patient asked Navarro-Millan if she knew a specific song, the two sang together, forging a connection between patient and doctor that Navarro-Millan still recalls fondly.
“I do think that the humanities, as a broader field, is very important, and that we should not be allowing ourselves to become one-sided in terms of the science,” Ronald F. van Vollenhoven, MD, PhD, professor of rheumatology at Amsterdam University Medical Center, and a classical pianist, told Healio Rheumatology.
Although the humanities have the power to foster empathy and deeper understanding between patients and their caregivers, for many involved in both the arts and medicine, their connection to the former long predates their career in the latter.
A Lifetime Pursuit
For many who play and have a connection to music, it is not uncommon for that connection to have been forged at a young age. Vollenhoven originally picked up piano as a child at the urging of his parents, and kept up with the habit throughout his life. Additionally, both Kavanagh and Navarro-Millan played music in various capacities before ultimately finding medicine.
According to Navarro-Millan, music is not necessarily something to be performed for other people, although she has done a fair bit of that as well. When she was growing up and family got together, music was guaranteed to fill the air.
“Nobody wanted to be famous — it was about having a good time and a connection while enjoying music,” Navarro-Millan said.
In a family filled with musicians and singers, there was always the chance to join in the song or pick up a guitar. Navarro-Millan was trained as a bel canto singer in high school and sang mezzo soprano opera throughout college, before joining a band with some peers in medical school.
“It was something that I felt like I needed to do because it gave me purpose,” she said. “It is something that is so mine and only mine. It doesn’t depend on a peer review process or the outcome of a patient.”
Navarro-Millan’s relationship with music, from informal song performances with family to playing bars in Mexico through medical school, has rarely remained static for long.
Similarly, others with a strong relationship to music have had to put the passions of their youth aside to continue professional development.
Kavanagh, who practices rheumatology in his hometown of Galway, Ireland, said that the musical and artistic culture of the city seeped into his personality. In the late 1980s, he was part of the original line-up of The Stunning, playing keyboard. Their 1988 single “Got to Get Away” reached No. 17 on the Irish charts, and the group would eventually become one of the most well-known rock bands to come out of Ireland.However, just before The Stunning exploded in popularity, Kavanagh made the call to step away and study medicine.
“I played keyboards with them for about 2 years, but really, like Pete Best and the Beatles, just as they were about to really take off, I had to make a call, and I decided I was going to continue with my medical studies,” Kavanagh said. “I live in a town that is deeply immersed in the arts and culture. So, everything that’s done, is done surrounded by a culture of music and theater, and it somehow seeps into your pores.”
Meanwhile, Vollenhoven’s own musical journal started with piano lessons as a young child before finding a deeper passion for music as a teenager.
“It’s something I have done all my life. I mean, I was a kid when I started taking piano lessons, and I guess I was in my teenage years when I really found the enjoyment in paying and also listening to piano music,” he said. “I also had times in my life where I did not have that much time to play piano, so there were periods of time where I had hardly any time to spend on it.”
Still, no matter the duration of those stretches of time when other duties denied him the opportunity to regularly play, Vollenhoven said he always — eventually — has been able to return to music.
Lives filled with art and music also give physicians the ability to view rheumatic care not only as a sterile science, but also as a performance.
Improvisation ‘At the Heart’ of Patient Care
According to Kavanagh, there is bound to be something missing when physicians practice medicine, be it rheumatology or any other specialty, strictly as a science.
“The more you know, and the more patients you see, the more automatic your decision making becomes, and the more possible it becomes to stop thinking of yourself and your own performance,” Kavanagh said.
For that reason, it is important and useful to approach rheumatology, at least in part, as a performance, including everything from improvisation to communication between doctor and patient, he added.
Influenced by the work of Penn State medical educator Paul Haidet, MD, MPH, who has written about the connections between jazz and the art of medicine, Kavanagh has looked to legendary trumpeter Miles Davis as an inspiration in the school of thinking of patient care as a performance. The way Davis used improvisation, from paying attention to the music made by those performing with him to responding with the perfect notes and rhythms, can teach rheumatologists a lot about interacting with patients, he said.
“I believe that improvisation is at the heart of really good patient care,” Kavanagh said, noting the importance of listening and taking each individual patient factor into account before recommending a course of action.
Although many aspects of patient care can be completed simply by following algorithms and ordering the appropriate tests, this may not always be appropriate in every situation. Just as performing a composition exactly as written may leave a piece sounding a bit lifeless and without expression, so too should physicians, including rheumatologists, emphasize communication and think beyond the algorithm in patient care, according to Vollenhoven.
“Even if you do exactly as it says on the sheet in music, it will sound boring and not very inspiring. There is so much more to be done,” he said. “If you do that in medicine, you’re also missing something, because you need the art of medicine on top of that.”
By incorporating your own communication and treatment styles, it not only brings life to the practice of rheumatology, but makes that practice more humane and creative, Vollenhoven said.
Additionally, although music offers a great pathway to achieve this, it is by no means the only route.
Long before Navarro-Millan met and sang with the patient from Colombia, she was regularly attending plays and theater productions while in college. She credits those experiences, combined with the near-constant presence of music, with helping to develop her ability to connect with patients.
“I think it is something that makes me also reflect on the world around me,” she added. “I do think that it makes me more empathetic and more compassionate to the reality and challenges of my patients.”
Although a history of deep involvement in the humanities can have the impact of improving communication and increasing empathy with patients, there are also conferences and events that can help to reframe and reorient the goal of patient care for art-minded physicians.
Reframing the Focus
Kavanagh’s dotMD, the arts-meets-science conference he founded to help expand the horizons of health care professionals around the world, has been attracting rheumatologists, primary care physicians, psychiatrists, hospitalists and emergency physicians to Galway since 2013.
“The aim of the festival is to reawaken a sense of wonder and curiosity about medicine that some of us may have lost along the way,” Kavanagh said, adding that many who attend are able to find deeper meaning in medicine.
The joke, he says, is that dotMD is a meeting for doctors who “used to play the piano.”
The meeting is billed as “anti-reductionist,” and serves as a way for a wide variety of speakers to help attendees gain a different perspective, Kavanagh said. What the meeting lacks in traditional rheumatological lectures, it makes up for in talks focusing on the parallels in developing expertise in non-medical and medical professions.
Although Vollenhoven and Calabrese have not attended dotMD, the idea and goal of reawakening a passion and unlocking perspectives is one that both agree is a worthy cause. Calabrese regards attending the meeting as an item on his wish list, while Vollenhoven would appreciate a wider adoption of similar events.
“I very much applaud that kind of initiative,” Vollenhoven said.
In terms of success, Kavanagh measures dotMD not by the number of attendees, but through the impact it has on those who attend.
“We do a simple questionnaire for feedback afterwards, and 98% grade their experience as ‘excellent’ or ‘very good,’ but the best possible outcome is not the information they learned, but the feedback we get about how the meeting makes them feel,” Kavanagh said.
Recalling feedback, terms like “transformative,” “sublime,” and “breathtaking,” come to mind, he added.
Although it is important to engage with medicine in non-traditional ways, such as at meetings and talks that allow for some artistic reflection, rheumatologists can also learn from the artists themselves who have dealt with life-changing diseases such as RA and scleroderma in their own time.
Determination and Passion
Throughout history, many artists, including several iconic painters, have dealt with rheumatic and musculoskeletal diseases. James Louie, MD, professor emeritus of medicine at the University of California, Los Angeles, has spoken about several of them and how they attended to the challenges of their rheumatic diseases, as well as how their determination enabled them to display the beauty of their art in personal, technical and philosophical terms.
“To enable patients in their decisions for best care of their rheumatic diseases, it is often helpful to describe how other famous persons throughout history had met their challenges and continued the creativity and grace of their lives,” Louie said.
For example, Pierre-Auguste Renoir (1841-1919), the renowned French painter who contributed to the impressionist style, developed rheumatoid arthritis at the age of 47 years. According to Louie, he sought out the best available physician, took the non-steroidal therapy of that time, designed his own physical and spa therapies, and continued to mature his style of painting.
By age 71, Renoir could no longer ambulate and was restricted to a wheelchair and bed, yet he continued to paint with enthusiasm until his death at age 78 years, saying, “The pain passes but the beauty endures.”
“That was his goal in life, to share his sense of beauty as he saw life, regardless of what he went through,” Louie said.
In the next generation, Raoul Dufy (1877-1953), French painter and designer of artistic tapestries, fabrics and ceramic pieces, developed rheumatoid arthritis at age 58 years. When he no longer responded to gold injections, at age 73 years, he traveled from Paris to Boston to participate in a therapeutic study of corticosteroids.
“He then returned to his painting,” said Louie. “His friend wrote, ‘Viva le difference.’ While continuing his cortisone, he died of a gastrointestinal bleed two years later.”
In the last generation, John Outterbridge (1933-2019), an assemblage artist and sculptor in Los Angeles, developed rheumatoid arthritis at age 60 years. When he sought out best care, he enrolled in a study of a TNF inhibitor and returned to his constructs, directing the Watts Towers Art center for 27 years.
“Using refuse from the Watts riots, he built a ship with three masts for children to walk through,” said Louie, who provided care for Outterbridge. “He explained to me, ‘I want the children to know that after a riot and life is a mess, if you reach down, pick up the pieces and build something that raises your eyes up to God, you will be okay.’”
According to Louie, the determination and dedication of these three artists encourages patients and physicians to pursue the best care together, particularly as science has provided more effective therapies.
“Ben Franklin suggested, ‘Teach me and I remember, involve me and I learn,’” he said. “And Franz Kafka predicted, ‘Anyone who keeps the ability to see beauty never grows old.’”
For Calabrese, engagement with the arts began early in his career when the Cleveland Clinic assumed the care of the newly formed Cleveland Ballet.
“That was at a time when the field of dance medicine was in its infancy,” he said.
Calabrese described how exciting it was to combine medical care for injured dancers with research into the epidemiology, risks and attendant medical problems they were first noted to be experiencing. Soon after, he began to perform similar work with instrumentalists as part of a newly formed collaborative multidisciplinary group dedicated to care and research across the arts.
According to Calabrese, this early exposure and experience enriched him both professionally and personally in ways that have remained with him for his entire career.
“To me, it was an opportunity to grow,” he said. “My involvement with dance and dancers over these many decades has been very fulfilling for me. I think it has helped me grow as a person.”
After caring for dancers throughout his career, Calabrese said that he grew to appreciate the art form.
“You don’t have to be a performer to reap the benefits of arts in medicine,” Calabrese said.
In Galway, Kavanagh has similarly cared for musicians throughout his career.
“I kind of found myself, full circle, learning from them,” Kavanagh said.
Enriching the Profession
According to Calabrese, engaging with humanity-enriching art is an essential part of the profession of caring for patients.
“This is important because humanism is vital for a successful and fulfilling career as a healer,” he said. “I think that through the arts, we can fuel this humanistic need that we all have.”
Calabrese, who describes himself as a “guerilla writer,” offers reflections in Healio and other outlets, but he is also involved with the reflective writing course for medical students at the Cleveland Clinic.
“We de-emphasize the grammar and the style, and we instead emphasize sharing what is on your mind,” he said.
Meanwhile, Vollenhoven and Navarro-Millan satisfy their artistic impulses by finding time to attend concerts and visit museums when the opportunity arises.
Losing the art and becoming engulfed in the science side of things presents a “real risk,” Vollenhoven said.
“Music can be just a very superficial enjoyment, but if you take a little bit more serious interest and try to discern the reasons behind the composition, there is much to be learned from that,” he added.
Similarly, Kavanagh argued that the more perspectives an individual has access to, and an understanding of, the better life can be.
“If reading a book helps me empathize or connect with a patient a bit better, I think that has to be a good thing,” Kavanagh said. “It expands the human dimension of who we are, to be immersed in arts and literature. I think it would make them better human beings.”
According to Navarro-Millan, music in general can ignite joy and provide a sense of purpose. That joy transcends every facet of her life, she said, including rheumatology, and allows her to connect with patients more naturally.
“I think that authenticity is what probably makes me take better care of patients,” Navarro-Millan said.
Apart from engaging in the humanities through active or passive involvement, it is imperative that no matter the inclination, diversity of style in the rheumatology field remains strong.
Although art and the humanities offer ways for physicians to connect to patients, and see and be seen as “real people,” there is still a significant place in medicine for professionals who do not, or cannot, engage as vehemently, Kavanagh said.
“There is no question in my mind that there are people at the very top of their game in rheumatology, who dedicate their entire lives to the mastery of our specialty through the lens of science, who are wonderful rheumatologists,” he said. “You need people who have those supreme analytical skills to deep-dive and get to work in the lab. We wouldn’t be where we are in medicine without those people.
“However, I guess what I’m advocating for is a broader perspective of how we look at our specialty — one of course firmly grounded in science, but also one where multiple perspectives from the world of the arts and performance science are valued,” he added. “I think it has made me a better rheumatologist.”
Get lost in a good book. Time and again, reading has been shown to make us healthier, smarter, and more empathic.
Fitness headlines promise staggering physical results: a firmer butt, ripped abs, bulging biceps. Nutritional breakthroughs are similar clickbait, with attention-grabbing, if often inauthentic—what, really, is a “superfood?”—means of achieving better health. Strangely, one topic usually escaping discussion has been shown, time and again, to make us healthier, smarter, and more empathic animals: reading.
Reading, of course, requires patience, diligence, and determination. Scanning headlines and retweeting quips is not going to make much cognitive difference. If anything, such sweet nothings are dangerous, the literary equivalent of sugar addiction. Information gathering in under 140 characters is lazy. The benefits of contemplation through narrative offer another story.
The benefits are plenty, which is especially important in a distracted, smartphone age in which one-quarter of American children don’t learn to read. This not only endangers them socially and intellectually, but cognitively handicaps them for life. One 2009 study of 72 children ages eight to ten discovered that reading creates new white matter in the brain, which improves system-wide communication.
White matter carries information between regions of grey matter, where any information is processed. Not only does reading increase white matter, it helps information be processed more efficiently.
Reading in one language has enormous benefits. Add a foreign language and not only do communication skills improve—you can talk to more people in wider circles—but the regions of your brain involved in spatial navigation and learning new information increase in size. Learning a new language also improves your overall memory.
In one of the most fascinating aspects of neuroscience, language affects regions of your brain involving actions you’re reading about. For example, when you read “soap” and “lavender,” the parts of your brain implicated in scent are activated. Those regions remain silent when you read “chair.” What if I wrote “leather chair?” Your sensory cortex just fired.
Continuing from the opening paragraph, let’s discuss squats in your quest for a firmer butt. Picture the biomechanics required for a squat. Your motor cortex has been activated. Athletes have long envisioned their movements—Serena Williams’s serve; Conor McGregor’s kicks; Usain Bolt’s bursts of speed—to achieve better proficiency while actually moving. That’s because their brains are practicing. That is, they’re practicing through visualization techniques.
Hard glutes are one thing. Novel reading is a great way to practice being human. Rather than sprints and punches, how about something more primitive and necessary in a society, like empathy? As you dive deeper into Rabbit Angstrom’s follies or Jason Taylor coming of age, you not only feel their pain and joy. You actually experience it.
In one respect novels go beyond simulating reality to give readers an experience unavailable off the page: the opportunity to enter fully into other people’s thoughts and feelings.
This has profound implications for how we interact with others. When encountering a 13-year-old boy misbehaving, you most likely won’t think, “Well, David Mitchell wrote about such a situation, and so I should behave like this,” but you might have integrated some of the lessons about young boys figuring life out and display a more nuanced understanding in how you react.
Perhaps you’ll even reconsider trolling someone online regarding their political opinion, remembering that no matter how crass and inhumane a sentiment appears on screen, an actual human is sitting behind the keyboard pecking out their thoughts. I’m not arguing against engaging, but for the love of anything closely resembling humanity, argue intelligently.
Because reading does in fact make us more intelligent. Research shows that reading not only helps with fluid intelligence, but with reading comprehension and emotional intelligence as well. You make smarter decisions about yourself and those around you.
All of these benefits require actually reading, which leads to the formation of a philosophy rather than the regurgitation of an agenda, so prevalent in reposts and online trolling. Recognizing the intentions of another human also plays a role in constructing an ideology. Novels are especially well-suited for this task. A 2011 study published in the Annual Review of Psychology found overlap in brain regions used to comprehend stories and networks dedicated to interactions with others.
Novels consume time and attention. While the benefits are worthwhile, even shorter bursts of prose exhibit profound neurological effects. Poetry elicits strong emotional responses in readers and, as one study shows, listeners. Heart rates, facial expressions, and “movement of their skin and arm hairs” were measured while participants listened to poetry. Forty percent ended up displaying visible goose bumps, as they would while listening to music or watching movies. As for their craniums:
Their neurological responses, however, seemed to be unique to poetry: Scans taken during the study showed that listening to the poems activated parts of participants’ brains that, as other studies have shown, are not activated when listening to music or watching films.
These responses mostly occurred near the conclusion of a stanza and especially near the end of the poem. This fits in well with our inherent need for narrative: in the absence of a conclusion our brain automatically creates one, which, of course, leads to plenty of heartbreak and suffering when our speculations prove to be false. Instead we should turn to more poetry:
There is something fundamental to the poetic form that implies, creates, and instills pleasure.
Whether an Amiri Baraka verse or a Margaret Atwood trilogy, attention matters. Research at Stanford showed a neurological difference between reading for pleasure and focused reading, as if for a test. Blood flows to different neural areas depending on how reading is conducted. The researchers hope this might offer clues for advancing cognitive training methods.
I have vivid memories of my relationship with reading: trying to write my first book (Scary Monster Stories) at age five; creating a mock newspaper after the Bernard Goetz subway shooting when I was nine, my mother scolding me for “thinking about such things”; sitting in the basement of my home in the Jersey suburbs one weekend morning, determined to read the entirety of Charlie and the Chocolate Factory, which I did.
Reading is like any skill. You have to practice it, regularly and constantly. While I never finished (or really much started) Scary Monster Stories, I have written nine books and read thousands more along the way. Though it’s hard to tell if reading has made me smarter or a better person, I like to imagine that it has.
What I do know is that life would seem a bit less meaningful if we didn’t share stories with one another. While many mediums for transmitting narratives across space and time exist, I’ve found none as pleasurable as cracking open a new book and getting lost in a story. Something profound is always discovered along the way.
Trolling is an online antisocial behaviour with negative psychological outcomes.
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Current study predicted trolling perpetration from gender and personality.
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Trolls more likely to be male with high levels of trait psychopathy and sadism
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Trolls have lower affective empathy, and psychopathy moderates cognitive empathy.
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Results have implications for establishing education and prevention programs.
Abstract
Online trolling is of particular concern due to the harmful negative outcomes its victims experience. The current study sought to explore and extend the personality profile of Internet trolls. After gender was controlled for, psychopathy, sadism, and empathy (affective empathy, cognitive empathy, and social skills) were examined for their predictive utility of trolling behaviour. A sample of 415 participants (36% men, 63% women, 1% other) with a mean age of 23.37 years (SD = 7.19) completed an online questionnaire. Results showed that men were more likely than women to engage in trolling, and higher levels of trait psychopathy and sadism predicted trolling behaviour. Lower levels of affective empathy predicted perpetration of trolling, and trait psychopathy moderated the association between cognitive empathy and trolling. Results indicate that when high on trait psychopathy, trolls employ an empathic strategy of predicting and recognising the emotional suffering of their victims, while abstaining from the experience of these negative emotions. Thus, trolls appear to be master manipulators of both cyber-settings and their victims’ emotions.
People with extremely sunny attitudes find it difficult to empathize with people who are recounting a negative experience, according to a study recently published at PLOS ONE. Ironically, positive people also reported being better at empathizing than did people who labelled themselves as slightly less than bubbly.
For the study, participants were shown videos of people telling life stories: two happy and two sad. The viewers were asked to rate, second-by-second, the level of positive or negative emotion they thought the speaker was feeling. Alex Fradera, at the British Psychological Society’s Research Digest, describes the result:
“Participants with a more upbeat personality believed their accuracy on this task to be higher than others. However, the speakers had conducted an identical rating process on their own videos, and it turns out the happier participants were no closer to the true feelings than the more downbeat participants. In fact, happy participants found it harder to judge the emotional tone of a highly negative monologue, in which a participant described the death of a parent.”
Dev Patnaik, author and founder of Jump Associates, argues that empathy is not just a personal quality that we all (are blessed to) have. Empathy, he argues, is an essential business skill that corporations must possess to help their employees innovate and to create a loyal customer base.
A surprisingly consistent body of research exists indicating that conventional medical training actually reduces practitioner empathy. What is worse, the decline in empathy appears even more pronounced at the time that the curriculum shifts towards patient-care activities.
In one study published in 2009 in the journal Academic Medicine entitled “The devil is in the third year: a longitudinal study of erosion of empathy in medical school,” the authors conclude:
It is ironic that the erosion of empathy occurs during a time when the curriculum is shifting toward patient-care activities; this is when empathy is most essential.”
In another, higher-powered systematic review published in the same journal last year entitled “Empathy decline and its reasons: a systematic review of studies with medical students and residents,” researchers looked at data from 1990-2010, which included 18 studies, and found:
The five longitudinal and two cross-sectional studies of residents showed a decrease in empathy during residency. The studies pointed to the clinical practice phase of training and the distress produced by aspects of the “hidden,” “formal,” and “informal” curricula as main reasons for empathy decline.”
They Concluded
The results of the reviewed studies, especially those with longitudinal data, suggest that empathy decline during medical school and residency compromises striving toward professionalism and may threaten health care quality.”
While the ironic decline of empathy associated with clinical practice during medical training is cause for concern, what may be even more disturbing is that the decline in empathy persists after training has ended.
In a 2005 study published in Academic Medicine and entitled “Mood change and empathy decline persist during three years of internal medicine training,” researchers noted that some of themood disturbances and declines in empathy associated with residency/internship “never fully recover,” indicating that conventional medical training may produce real, diagnosable psychological traumas that may never be fully resolved and may adversely affect the quality of healthcare provided.
Empathy, after all, has concrete and measurable therapeutic effects in others. In 2009, researchers found that practitioner empathy reduced the duration of the common cold in their patients. Conversely, a negative and/or indifferent attitude towards the patient has measurable adverse effects, also known as the nocebo effect. Indeed, our recent article titled, “Research: Some Cancer Diagnoses Kill You Quicker Than the Cancer,” discusses the finding that the risk of suicide is up to 16 times higher and the risk of heart-related death 26.9 times higher during the first week following a cancer diagnosis versus those who were diagnosed cancer free.
Empathy is a quality that is integral to most people’s lives – and yet the modern world makes it easy to lose sight of the feelings of others. But almost everyone can learn to develop this crucial personality trait, says Roman Krznaric.
Open Harper Lee’s classic novel To Kill A Mockingbird and one line will jump out at you: “You never really understand another person until you consider things from his point of view – until you climb inside of his skin and walk around in it.”
Human beings are naturally primed to embrace this message. According to the latest neuroscience research, 98% of people (the exceptions include those with psychopathic tendencies) have the ability to empathise wired into their brains – an in-built capacity for stepping into the shoes of others and understanding their feelings and perspectives.
The problem is that most don’t tap into their full empathic potential in everyday life.
You can easily find yourself passing by a mother struggling with a pram on some steps as you rush to a work meeting, or read about a tragic earthquake in a distant country then let it slip your mind as you click a link to check the latest football results.
Can you read someone’s mind through their eyes?
The empathy gap can appear in personal relationships too – like when I find myself shouting in frustration at my six-year-old twins, or fail to realise that my partner is doing more than her fair share of the housework.
So is there anything you can do to boost your empathy levels? The good news is that almost everyone can learn to be more empathic, just like we can learn to ride a bike or drive a car.
A good warm up is to do a quick assessment of your empathic abilities. Neuropsychologist Simon Baron-Cohen has devised a test called Reading the Mind in the Eyes in which you are shown 36 pairs of eyes and have to choose one of four words that best describes what each person is feeling or thinking – for instance, jealous, arrogant, panicked or hateful.
The average score of around 26 suggests that the majority of people are surprisingly good – though far from perfect – at visually reading others’ emotions.
Going a step further, there are three simple but powerful strategies for unleashing the empathic potential that is latent in our neural circuitry.
Make a habit of “radical listening”
“What is essential,’ wrote Marshall Rosenberg, psychologist and founder of Non-Violent Communication, “is our ability to be present to what’s really going on within – to the unique feelings and needs a person is experiencing at that very moment.”
Listening out for people’s feelings and needs – whether it is a friend who has just been diagnosed with breast cancer or a spouse who is upset at you for working late yet again – gives them a sense of being understood.
Let people have their say, hold back from interrupting and even reflect back what they’ve told you so they knew you were really listening. There’s a term for doing this – “radical listening”.
Radical listening can have an extraordinary impact on resolving conflict situations. Rosenberg points out that in employer-employee disputes, if both sides literally repeat what the other side just said before speaking themselves, conflict resolution is reached 50% faster.
Look for the human behind everything
A second step is to deepen empathic concern for others by developing an awareness of all those individuals hidden behind the surface of our daily lives, on whom we may depend in some way. A Buddhist-inspired approach to this is to spend a whole day becoming mindful of every person connected to your routine actions.
So when you have your morning coffee, think about the people who picked the coffee beans. As you button your shirt, consider the labour behind the label by asking yourself: “Who sewed on these buttons? Where in the world are they? What are their lives like?”
Think about all the people you take for granted
Then continue throughout the day, bringing this curiosity to who is driving the train, vacuuming the office floor or stacking the supermarket shelves. It is precisely such mindful awareness that can spark empathic action on the behalf of others, whether it’s buying Fairtrade coffee or becoming friends with the office cleaner.
Bertolt Brecht wrote a wonderful poem about this called A Worker Reads History, which begins: “Who built the seven gates of Thebes? / The books are filled with the names of kings / Was it the kings who hauled the craggy blocks of stone?”
Become curious about strangers
I used to regularly walk past a homeless man around the corner from where I live in Oxford and take virtually no notice of him. One day I stopped to speak to him.
It turned out his name was Alan Human and he had a degree in Philosophy, Politics and Economics from the University of Oxford. We subsequently developed a friendship based on our mutual interest in Aristotle’s ethics and pepperoni pizza.
This encounter taught me that having conversations with strangers opens up our empathic minds. We can not only meet fascinating people but also challenge the assumptions and prejudices that we have about others based on their appearance, accents or backgrounds.
It’s about recovering the curiosity everyone had as children, but which society is so good at beating out of us. Get beyond superficial talk but beware interrogating people. Respect the advice of oral historian Studs Terkel – who always spoke to people on the bus on his daily commute: “Don’t be an examiner, be the interested inquirer.”
These are the kinds of conversations you will find happening at the world’s firstEmpathy Museum, which is launching in the UK in late 2015 and will then be travelling to Australia and other countries.
Amongst the unusual exhibitions will be a human library, where instead of borrowing a book you borrow a person for conversation – maybe a Sikh teenager, an unhappy investment banker or a gay father. In other words, the kind of people you may not get to meet in everyday life.
Empathy is the cornerstone of healthy human relationships.
As the psychologist and inventor of emotional intelligence Daniel Goleman puts it, without empathy a person is “emotionally tone deaf”.
It’s clear that with a little effort nearly everyone can put more of their empathic potential to use. So try slipping on your empathy shoes and make an adventure of looking at the world through the eyes of others.
How does witnessing a hateful person in pain compare to witnessing a likable person in pain? The current study compared the brain bases for how we perceive likable people in pain with those of viewing hateful people in pain. While social bonds are built through sharing the plight and pain of others in the name of empathy, viewing a hateful person in pain also has many potential ramifications. In this functional Magnetic Resonance Imaging (fMRI) study, Caucasian Jewish male participants viewed videos of (1) disliked, hateful, anti-Semitic individuals, and (2) liked, non-hateful, tolerant individuals in pain. The results showed that, compared with viewing liked people, viewing hateful people in pain elicited increased responses in regions associated with observation of physical pain (the insular cortex, the anterior cingulate cortex, and the somatosensory cortex), reward processing (the striatum), and frontal regions associated with emotion regulation. Functional connectivity analyses revealed connections between seed regions in the left anterior cingulate cortex and right insular cortex with reward regions, the amygdala, and frontal regions associated with emotion regulation. These data indicate that regions of the brain active while viewing someone in pain may be more active in response to the danger or threat posed by witnessing the pain of a hateful individual more so than the desire to empathize with a likable person’s pain.
Healthy communication is the cornerstone of cultivating and sustaining healthy relationships. We connect and express ourselves through the spoken and written word, which ultimately allows us to develop our “voice” in the world.
How well you communicate directly correlates with how understood and heard you feel by the response you receive from the other end of the dialogue.
When it comes to communicating through text or email, the rules and guidelines for good communication don’t change. The integrity of your words should remain the same, and all the skills and etiquette you would apply in real life need to be applied.
Words are powerful with or without voice, and it’s even more important to be clear when tone is absent. Words are vulnerable to being twisted and misconstrued when they lack intonation, and human expression.
How many times have you sent an email or text to someone only to find that they have completely misinterpreted or misread what you were trying to say? Your correspondence with others reflects your ability to express yourself in real time, so if you struggle with getting your point across in general, you will most likely bump into obstacles when trying to do it through the written word.
Whether you are writing a work email, communicating with your Ex about something uncomfortable, or responding to a difficult situation, here are 5 skills to help you draft better correspondence.
These are skills that work both on and off the computer or smart phone, and should be applied in any conversation that requires a delicate touch.
In any correspondence you always want to make your intention clear. There is usually one point you want to get across, but if you just let your words flow without much reflection you are bound to step into a landmine. Before you even start drafting clarify your ultimate intention. Is it to get the person to do something? Are you looking for an answer or response? Do you want an apology? Knowing what you are hoping to get will increase your chances of actually achieving that goal. Asking, “what is my intention?” is a good practice before beginning any conversation.
2. Establish boundaries
Believe it or not, boundaries can be conveyed as much through written word as they can in person. A boundary is a clear line defining what you are willing to accept or tolerate, and what is too much. Boundaries are conveyed through language like “I can’t allow you to…” or “I cannot accept the fact that…”
Boundaries can also come from your strong belief in how you feel. This is different then needing to be right, it’s more about being very clear that your experience is valid and true for you. This works when you are being accused of something, or blamed for something you don’t feel you did. A response to this might look something like “I appreciate your perspective, but I am confident that this isn’t true for me…”
3. Empathy
Using language that conveys a sense of empathy in your correspondence is always a good practice. Everyone wants to feel acknowledged and understood on some level, so you will need to pause and understand where the other person is coming from. Even if you don’t agree, it’s always a good idea to say that you can understand why or how they see things the way they do, and to let them know that you understand their position on the issues at hand.
Empathy is diffuser in communication, and it can calm even the most upset person. Look at it like a virtual hug. Empathy is contagious, and it’s hard to respond to it in a negative way.
4. Accountability
In any two-way conversation there are always two opinions, two perspectives and two subjective experiences. It’s rarely always the other person. Being accountable to how you might have contributed to the breakdown of what is happening, or acknowledging that you didn’t communicate well is a great habit to develop. Stepping back and asking yourself how you could have done things differently will help you clarify your point as well. Simply writing something like “I recognize that I have some responsibility in this situation…” opens up space for the other person to do the same.
5. Always maintain integrity
The written word can be as much a trigger as speaking with someone in person. There are some situations where even the most skillfully drafted communication will still ignite a negative response from the other party. If you are dealing with verbal attacks, and you know you aren’t going to get anywhere step out of the power struggle and end it with integrity. This is a graceful exit without being pulled down to the other person’s level.
Stepping out requires letting go of needing to feel validated or heard, and accepting that this person simply cannot engage on a healthy and productive level. This is a great practice in both virtual and real life because it shows you that you are always in control of how you feel, and how you respond.
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