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When Words Hurt: A Practical Approach To Bullying
Dr. Mitch Otu shares helpful and practical tips to approach bullying.
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Learn more about Mitch Otu, MD
Mitch Otu, MD
Mitch Otu, MD received his bachelor's degree in psychology from Washington University in St. Louis in 2011 and his masters degree and MBA from the University of Southern California in 2016. He completed his general psychiatry residency at the University of Miami before moving to Providence to begin his child and adolescent psychiatry fellowship at Brown University. While completing his fellowship, he pursued his interests in preventing and treating childhood maltreatment, healthcare administration, anti-racism, and medical education.Learn more about Mitch Otu, MD
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When Words Hurt: A Practical Approach To Bullying
Dr. Gregory Fritz: Bullying, will we ever be able to stop it? From politics to the playground, to school yard to social media, to the workplace, and even in families, bullying seems to be everywhere these days causing both mental and physical harm for those in the receiving end. Further, bullying is not something that can be waited out or ignored. Bullying is not a trait we're born with. It is learned. So in order to deal with it, we have to learn strategies to outsmart bullying behaviors and bullies themselves.
Today, we have the pleasure of speaking with Dr. Mitch Otu, a psychiatrist at Hasbro Children's Hospital and Bradley Hospital. He's going to help us understand why bullies bully, and what we as parents and caregivers can do about it. Welcome, Dr. Otu.
Dr. Mitch Otu: Thank you. It's great to be here.
Dr. Gregory Fritz: This is Mindcast: Healthy Mind, Healthy Child, a podcast from the mental health experts at Bradley Hospital, leaders in Mental Health care for children. I'm Dr. Greg Fritz with Dr. Anne Walters.
Dr. Anne Walters: Well, Dr. Otu, bullying is not something that we can take lightly. In our line of work, we end up seeing the effects of bullying day after day. And specifically, we're seeing a huge increase in cyberbullying. Can you tell us a little bit about what you are seeing?
Dr. Mitch Otu: Yeah. So when we talk about bullying, what we're talking about is a pattern of deliberate, targeted, unwanted aggression by one or more youths towards another youth where there's a power imbalance that favors the bullies. The repetitive nature and that power imbalance are really what differentiate bullying from other forms of aggression. And so, for example, the developmentally normal physical aggression that we might see in a two or three-year-old, that starts to look more like bullying when there's repeated deliberate physical aggression or verbal aggression that's targeted towards peers.
Dr. Anne Walters: And what ages do we start to see bullying behaviors start? How common is it?
Dr. Mitch Otu: So, we can start to see bullying behaviors as early as two or three years old and that preschool age. And then, really the forms start to change as we move into the elementary school ages. And into middle school and high school, we also start to see the form of bullying start to change as well.
Dr. Gregory Fritz: So, are there predictable character profiles of a bully and what about of the children that are bullied?
Dr. Mitch Otu: Well, there isn't a single character profile for bullies or they're victims, but there's some common themes that we see. So for bullies, oftentimes the social learning that sets up the bullying tends to start from home. And so, we may see that there are children who are exposed to domestic violence or who've been neglected or abused in some way, they're at higher risks of being bullies. But of course, that's not always the profile for bullies themselves.
Psychologically, bullies tend to think that other people are being hostile towards them, and so they might attribute more negative characteristics to others. They start to think that their behaviors are justified. Boys tend to be more likely to be bullies. But as we're seeing the rise of cyberbullying, we're seeing more and more avenues where relational bullying, which girls tend to be involved more, and those avenues are more and more available, and so we're seeing more girls. And then also, kids who don't typically have the power imbalance that you might normally see, so strength being a very common one in terms of at least physical bullying, those kids are starting to be involved in bullying as well.
Dr. Gregory Fritz: Just to be clear, what is relational bullying?
Dr. Mitch Otu: Yeah. So, relational bullying, we might be thinking about things like social exclusion, things where people are posting embarrassing photos online of people or videos. Those types of things where it's not necessarily physical aggression, it may be more indirect where there's more of that relational aggression that's happening.
Dr. Gregory Fritz: Got it.
Dr. Anne Walters: And I think that's so tricky, right? Because in past times, it might have been something that we used to think of as like a rumor mill or gossiping. But now, that can really blow up because it can be made so public among groups of children.
Dr. Mitch Otu: Yeah. At this point now, what we're seeing is like it's extending out past the school where kids at times had the refuge of, "Okay, I'm going to come home and at least I have this time to sit and be away from all of this stress that's going on at school, and then I can come back to it maybe." It's going on at all times these days
Dr. Anne Walters: And I think often children are embarrassed about bullying, right? They don't necessarily disclose that this is happening until they really can't bear it anymore. Can you help us identify some signs and symptoms that a child might show if they're a victim of bullying?
Dr. Mitch Otu: Yeah. So really, I think we should always be recommending that parents routinely talk to their kids about how they're treated by their peers, but then also how they're treating their peers, I should say. So oftentimes, what we may see is that kids are coming home with unexplained injuries. Their possessions might be broken. It might be that their kid who used to really love to go to school and, at this point now, they're not wanting to go to school anymore. Their grades are dropping. They might be eating differently. And so, these are some of those signs that say there's something going on, and maybe parents need to look into it a little bit more.
Dr. Gregory Fritz: So, can you tell us a little bit about the consequences of bullying? I mean, we're not talking about just a single fight at school, a kid comes home one day and has had a bad day. This is constant maltreatment that's repeated over and over and serious and constant. What are some of the sequelae of that sort of experience in your experience?
Dr. Mitch Otu: Yeah. So typically with ongoing bullying, the frequency and actually the higher levels of power imbalance tend to lead to more consequences. And oftentimes, what we'll see, depression and anxiety tend to be the most common consequences, and children might start to isolate. They might develop low self-esteem. They might have psychosomatic symptoms like headaches, stomach aches that make them want to stay away from school. And then, we can get into very serious consequences as well, things like suicidal ideation where they start thinking about death as an escape from what would really seem like a hopeless issue. And I know that obviously, it's a controversial and fictionalized experience, but what we saw in 13 Reasons Why I think gives some of that experience of what it's like to be bullied and especially cyberbullied and some of the very severe outcomes that we can have afterwards.
Dr. Anne Walters: We see that parents sometimes feel powerless in these situations. And so, one question that might come up is whether they should interfere, when should the school get involved, what's needed in terms of monitoring social media, for example. Can you help us understand that a little bit?
Dr. Mitch Otu: Yeah. So, parents play a huge role in terms of dealing with bullying, mainly for teaching their child how to handle that bullying and then, like you mentioned, stepping in when it makes sense to. So, parents can teach their child how to ignore, avoid, walk away from bullies. They can role play. How can you be assertive? How can you use humor to diffuse the situation? They can set limits on technology if their kids are dealing with cyberbullying as well. They're less under the demands and just those issues that are coming up from social media itself.
I think we also want to have parents fostering positive relationships with other children who can either directly step in and intervene when they see that the child is dealing with bullying, and then also just mitigate those negative consequences of bullying itself by fostering positive relationships, fostering self-esteem.
We want parents to step in with schools as well when, you know, those things aren't really working. And so, I think reaching out to schools, oftentimes schools have very high student-to-teacher ratios, the teachers just might not be aware. And so if they're able to recognize this, they may be able at that point to step in, doing things like changing classrooms, changing seats, all of these different things that can really help with mitigating bullying as well.
Dr. Anne Walters: I think especially in middle school, when kids are part of larger teams and they might have multiple teachers, it's so important to be able to pull a meeting together to figure out, you know, is it as simple as one class change or is it a full team change? And administrators are often so open to hearing about that.
Dr. Mitch Otu: Yeah. And so, I think once it comes to their attention, they really are able a lot of times to make the appropriate changes. I think at times though, we have to recommend to parents, like you may need to take it to higher levels of, you know, involving maybe the principal; higher than that, getting to the district level superintendents if needed. And then at times, depending on what's going on, whether there needs to be legal involvement as well with police.
Dr. Gregory Fritz: What if a parent realizes that their child is the bully and, instead of being bullied, is actually bullying other kids? What can they do in that situation?
Dr. Mitch Otu: Yeah. I think that's again why just talking to your children about their relationships with peers is super important, so that you can start to see, "Okay, are those signs? Is my kid dealing with kids in a way like where they're getting into lots of frequent physical or verbal fights? Are they getting in trouble at school?" All of these things that might lead you down the path of saying, "Okay, is my child being a bully to others?"
And at that point, you really want to intervene by stepping in and doing some modeling at home, where you're showing bullying is just not acceptable behavior. From more of an intervention standpoint, maybe involving them in like a social skills group as well. That may be something that is extremely helpful for them to learn some of those skills that they may just not have.
And then, looking at underlying causes as well, if there may be low self-esteem, depression, ADHD, other things that are leading to the behaviors that we're seeing. So at that point, you know, we want mental health professionals to step in, evaluate, and start creating a bit of a treatment plan so that we're able to really change things for those children.
Dr. Gregory Fritz: And one final question I have, how often are bullies bullied themselves?
Dr. Mitch Otu: Yeah. So unfortunately with shifting definitions of bullying, it's hard to kind of pin down the prevalence of bullies who are bullied. But bully victims are a really important and a group of kids who I think we need to do more research into. And so, what's been shown already is that those kids are oftentimes dealing with a lot of internalizing and externalizing problems. So where the victims of bullying tend to deal with more internalizing problems, the bullies are dealing more with externalizing problem, these kids are dealing with both. And so, we're just at a higher risk with these kids. And so, it's a very high risk population and a high risk subset that needs further intervention and just more research into how we can really step in and change things for them in a positive way.
Dr. Anne Walters: Thank you so much, Dr. Otu. This is an important topic. Bullying is the impotence for so many emotional symptoms and psychological issues as we talked about. Empowering children and helping children to build their confidence and assertiveness is so important when dealing with bullying behavior. While we can't control how others behave, we can control our reactions to their behavior. Thanks so much for being here with us today.
And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library at bradleyhospital.org/podcast. This is Mindcast: Healthy Mind, Healthy Child, a podcast from the experts at Bradley Hospital and Hasbro Children's Hospital. I'm Dr. Anne Walters with Dr. Greg Fritz. Thanks for listening.
When Words Hurt: A Practical Approach To Bullying
Dr. Gregory Fritz: Bullying, will we ever be able to stop it? From politics to the playground, to school yard to social media, to the workplace, and even in families, bullying seems to be everywhere these days causing both mental and physical harm for those in the receiving end. Further, bullying is not something that can be waited out or ignored. Bullying is not a trait we're born with. It is learned. So in order to deal with it, we have to learn strategies to outsmart bullying behaviors and bullies themselves.
Today, we have the pleasure of speaking with Dr. Mitch Otu, a psychiatrist at Hasbro Children's Hospital and Bradley Hospital. He's going to help us understand why bullies bully, and what we as parents and caregivers can do about it. Welcome, Dr. Otu.
Dr. Mitch Otu: Thank you. It's great to be here.
Dr. Gregory Fritz: This is Mindcast: Healthy Mind, Healthy Child, a podcast from the mental health experts at Bradley Hospital, leaders in Mental Health care for children. I'm Dr. Greg Fritz with Dr. Anne Walters.
Dr. Anne Walters: Well, Dr. Otu, bullying is not something that we can take lightly. In our line of work, we end up seeing the effects of bullying day after day. And specifically, we're seeing a huge increase in cyberbullying. Can you tell us a little bit about what you are seeing?
Dr. Mitch Otu: Yeah. So when we talk about bullying, what we're talking about is a pattern of deliberate, targeted, unwanted aggression by one or more youths towards another youth where there's a power imbalance that favors the bullies. The repetitive nature and that power imbalance are really what differentiate bullying from other forms of aggression. And so, for example, the developmentally normal physical aggression that we might see in a two or three-year-old, that starts to look more like bullying when there's repeated deliberate physical aggression or verbal aggression that's targeted towards peers.
Dr. Anne Walters: And what ages do we start to see bullying behaviors start? How common is it?
Dr. Mitch Otu: So, we can start to see bullying behaviors as early as two or three years old and that preschool age. And then, really the forms start to change as we move into the elementary school ages. And into middle school and high school, we also start to see the form of bullying start to change as well.
Dr. Gregory Fritz: So, are there predictable character profiles of a bully and what about of the children that are bullied?
Dr. Mitch Otu: Well, there isn't a single character profile for bullies or they're victims, but there's some common themes that we see. So for bullies, oftentimes the social learning that sets up the bullying tends to start from home. And so, we may see that there are children who are exposed to domestic violence or who've been neglected or abused in some way, they're at higher risks of being bullies. But of course, that's not always the profile for bullies themselves.
Psychologically, bullies tend to think that other people are being hostile towards them, and so they might attribute more negative characteristics to others. They start to think that their behaviors are justified. Boys tend to be more likely to be bullies. But as we're seeing the rise of cyberbullying, we're seeing more and more avenues where relational bullying, which girls tend to be involved more, and those avenues are more and more available, and so we're seeing more girls. And then also, kids who don't typically have the power imbalance that you might normally see, so strength being a very common one in terms of at least physical bullying, those kids are starting to be involved in bullying as well.
Dr. Gregory Fritz: Just to be clear, what is relational bullying?
Dr. Mitch Otu: Yeah. So, relational bullying, we might be thinking about things like social exclusion, things where people are posting embarrassing photos online of people or videos. Those types of things where it's not necessarily physical aggression, it may be more indirect where there's more of that relational aggression that's happening.
Dr. Gregory Fritz: Got it.
Dr. Anne Walters: And I think that's so tricky, right? Because in past times, it might have been something that we used to think of as like a rumor mill or gossiping. But now, that can really blow up because it can be made so public among groups of children.
Dr. Mitch Otu: Yeah. At this point now, what we're seeing is like it's extending out past the school where kids at times had the refuge of, "Okay, I'm going to come home and at least I have this time to sit and be away from all of this stress that's going on at school, and then I can come back to it maybe." It's going on at all times these days
Dr. Anne Walters: And I think often children are embarrassed about bullying, right? They don't necessarily disclose that this is happening until they really can't bear it anymore. Can you help us identify some signs and symptoms that a child might show if they're a victim of bullying?
Dr. Mitch Otu: Yeah. So really, I think we should always be recommending that parents routinely talk to their kids about how they're treated by their peers, but then also how they're treating their peers, I should say. So oftentimes, what we may see is that kids are coming home with unexplained injuries. Their possessions might be broken. It might be that their kid who used to really love to go to school and, at this point now, they're not wanting to go to school anymore. Their grades are dropping. They might be eating differently. And so, these are some of those signs that say there's something going on, and maybe parents need to look into it a little bit more.
Dr. Gregory Fritz: So, can you tell us a little bit about the consequences of bullying? I mean, we're not talking about just a single fight at school, a kid comes home one day and has had a bad day. This is constant maltreatment that's repeated over and over and serious and constant. What are some of the sequelae of that sort of experience in your experience?
Dr. Mitch Otu: Yeah. So typically with ongoing bullying, the frequency and actually the higher levels of power imbalance tend to lead to more consequences. And oftentimes, what we'll see, depression and anxiety tend to be the most common consequences, and children might start to isolate. They might develop low self-esteem. They might have psychosomatic symptoms like headaches, stomach aches that make them want to stay away from school. And then, we can get into very serious consequences as well, things like suicidal ideation where they start thinking about death as an escape from what would really seem like a hopeless issue. And I know that obviously, it's a controversial and fictionalized experience, but what we saw in 13 Reasons Why I think gives some of that experience of what it's like to be bullied and especially cyberbullied and some of the very severe outcomes that we can have afterwards.
Dr. Anne Walters: We see that parents sometimes feel powerless in these situations. And so, one question that might come up is whether they should interfere, when should the school get involved, what's needed in terms of monitoring social media, for example. Can you help us understand that a little bit?
Dr. Mitch Otu: Yeah. So, parents play a huge role in terms of dealing with bullying, mainly for teaching their child how to handle that bullying and then, like you mentioned, stepping in when it makes sense to. So, parents can teach their child how to ignore, avoid, walk away from bullies. They can role play. How can you be assertive? How can you use humor to diffuse the situation? They can set limits on technology if their kids are dealing with cyberbullying as well. They're less under the demands and just those issues that are coming up from social media itself.
I think we also want to have parents fostering positive relationships with other children who can either directly step in and intervene when they see that the child is dealing with bullying, and then also just mitigate those negative consequences of bullying itself by fostering positive relationships, fostering self-esteem.
We want parents to step in with schools as well when, you know, those things aren't really working. And so, I think reaching out to schools, oftentimes schools have very high student-to-teacher ratios, the teachers just might not be aware. And so if they're able to recognize this, they may be able at that point to step in, doing things like changing classrooms, changing seats, all of these different things that can really help with mitigating bullying as well.
Dr. Anne Walters: I think especially in middle school, when kids are part of larger teams and they might have multiple teachers, it's so important to be able to pull a meeting together to figure out, you know, is it as simple as one class change or is it a full team change? And administrators are often so open to hearing about that.
Dr. Mitch Otu: Yeah. And so, I think once it comes to their attention, they really are able a lot of times to make the appropriate changes. I think at times though, we have to recommend to parents, like you may need to take it to higher levels of, you know, involving maybe the principal; higher than that, getting to the district level superintendents if needed. And then at times, depending on what's going on, whether there needs to be legal involvement as well with police.
Dr. Gregory Fritz: What if a parent realizes that their child is the bully and, instead of being bullied, is actually bullying other kids? What can they do in that situation?
Dr. Mitch Otu: Yeah. I think that's again why just talking to your children about their relationships with peers is super important, so that you can start to see, "Okay, are those signs? Is my kid dealing with kids in a way like where they're getting into lots of frequent physical or verbal fights? Are they getting in trouble at school?" All of these things that might lead you down the path of saying, "Okay, is my child being a bully to others?"
And at that point, you really want to intervene by stepping in and doing some modeling at home, where you're showing bullying is just not acceptable behavior. From more of an intervention standpoint, maybe involving them in like a social skills group as well. That may be something that is extremely helpful for them to learn some of those skills that they may just not have.
And then, looking at underlying causes as well, if there may be low self-esteem, depression, ADHD, other things that are leading to the behaviors that we're seeing. So at that point, you know, we want mental health professionals to step in, evaluate, and start creating a bit of a treatment plan so that we're able to really change things for those children.
Dr. Gregory Fritz: And one final question I have, how often are bullies bullied themselves?
Dr. Mitch Otu: Yeah. So unfortunately with shifting definitions of bullying, it's hard to kind of pin down the prevalence of bullies who are bullied. But bully victims are a really important and a group of kids who I think we need to do more research into. And so, what's been shown already is that those kids are oftentimes dealing with a lot of internalizing and externalizing problems. So where the victims of bullying tend to deal with more internalizing problems, the bullies are dealing more with externalizing problem, these kids are dealing with both. And so, we're just at a higher risk with these kids. And so, it's a very high risk population and a high risk subset that needs further intervention and just more research into how we can really step in and change things for them in a positive way.
Dr. Anne Walters: Thank you so much, Dr. Otu. This is an important topic. Bullying is the impotence for so many emotional symptoms and psychological issues as we talked about. Empowering children and helping children to build their confidence and assertiveness is so important when dealing with bullying behavior. While we can't control how others behave, we can control our reactions to their behavior. Thanks so much for being here with us today.
And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library at bradleyhospital.org/podcast. This is Mindcast: Healthy Mind, Healthy Child, a podcast from the experts at Bradley Hospital and Hasbro Children's Hospital. I'm Dr. Anne Walters with Dr. Greg Fritz. Thanks for listening.