When David* came to Sunnybrook, he was quick to tell his psychiatrist that his classmates were bad people. His classmates threw things at him on the bus to and from school, the 16-year-old said; they relentlessly called him names in the schoolyard, and he felt like he couldn't contribute to classroom conversations without snide comments being whispered behind his back. The bullying caused him such anxiety that he routinely took himself out of social situations, and his parents sought help at Sunnybrook
Dr. Gili Adler Nevo, staff psychiatrist in Sunnybrook’s Division of Youth Psychiatry, set to work on guiding him out of his distress – and that included understanding whether David’s own behaviour was unintentionally attracting the attention of bullies.
“This does not place any blame on the victim at all; on the contrary, it empowers them,” says Dr. Adler Nevo. “The fact that bullying – degrading another human being – is wrong is clear cut and there are no two ways about it. That is the bully’s responsibility, but any therapy operates on the understanding that no human being is perfect. It’s not the victims’ fault and they’re not to blame, but you always need two to tango. For every two people there’s an interaction.”
Bullying is a hot topic in the media due partly to tragic cases that have ended in suicide. Bullying is common enough to cause concern; Public Safety Canada reports
that 10 per cent to 13 per cent of boys and 4 per cent to 11 per cent of girls in grades 6 to 10 reported being bullied at least once or twice a month. Bullying may not be necessarily worse than it was 30 years ago, but we hear more about it due to better communication and a better understanding of the lasting damage it can have on a
teen’s social development.
And so school boards have scrambled to adopt zero-tolerance policies. They’ve established approaches to address the bullies and programs aimed at teaching students how they can help quash bullying when it arises. These approaches are essential, Dr. Adler Nevo says. But there’s an equally important angle: the victim. Dr. Adler Nevo is one of several Sunnybrook psychiatrists focused on care for the victim – addressing the connection between bullying, depression and anxiety so that the victims don’t fall through the cracks.
The victim, not the crime
“What is missing from the picture is treatment for the bullied themselves,” she explains. “The systemic problem should be addressed and the bully treated, but the one who needs the most help is the victim.”
She points to research that shows bullied children often continue to be harassed even after they change schools, for example, and that factors such as appearance, ethnicity and disabilities don’t determine whether a student is bullied. Bullies are drawn to those who lack a social group – and that often includes teens who suffer anxiety or depression. Her treatment focuses on helping bullied teens understand the role they have in the dynamic in the hopes of breaking the cycle.
“Take a teen starting high school. He or she may have anxiety, and think: ‘Nobody is going to like me, and I’m not going to have any friends. I’m going to be awkward.’ So the teen sticks to the wall, and really does seem awkward, and the people around him feel that and react to it,” explains Dr. Adler Nevo. “Inside the teen could be all these wonderful things, but the way he or she behaves could deter people from approaching.”
Through support, understanding and validation of what they’re feeling, Dr. Adler Nevo helps her patients develop insight into how their thoughts, emotions and behaviour influence how others perceive them, she says. Since teens who remove themselves from regular social interactions tend to be prime targets for bullies, finding a way to become social again is key.
Though she won’t divulge her entire approach (her therapy works best when it’s a journey for which the teen oesn’t have a roadmap, she says), it’s a customized cognitive behavioural therapy that includes Prolonged Exposure, traditionally used to treat post-traumatic stress disorder patients.