Peer bullying is a problem that the UN(United Nations) has raised alarm about worldwide. Victimized children are knocking on the doors of psychiatrists. But what about the bullies! Nobody cares. What should families and schools do?  According to Yeditepe University Hospitals Psychiatry Specialist Assoc. Prof. Dr. Oğuzhan Zahmacıoğlu, the real subject of psychiatric examination is bullies. Here's all about bullying.

Peer bullying is a form of violence that is applied deliberately and systematically. Violence doesn't always have to be physical. Threatening, teasing, mocking, humiliating, spreading rumors, excluding, not participating in games, ignoring friends, extorting... All of these are within the definition of peer bullying. Sometimes it is applied by a single person and sometimes in a group. Generally, children or young people who are more vulnerable, younger, and have different physical appearances become victims of bullying.
According to the report shared by the United Nations Children's Fund (UNICEF) in 2018, half of the students aged 13-15 around the world are exposed to peer violence. The report, based on data from 122 countries, emphasizes that girls and boys are equally at risk of bullying. However, girls are at higher risk of being exposed to psychological and social forms of bullying, such as spreading rumors and being ostracized. Men are at greater risk of physical violence and threats.

When we look at Turkey's peer bullying report card, the picture is not very bright. According to the 2017 'Bullying in Schools' report of the Organization for Economic Co-operation and Development (OECD), 19 percent of students aged 15 in Turkey are exposed to physical or verbal violence by their peers at least several times a month.
So why is peer bullying so common? Is bullying a psychiatric disorder? What kind of dangers await children who are bullied? What are the duties of families, schools and society in the struggle We talked in detail about the issue of peer bullying with Assoc. Prof. Dr.  Oğuzhan Zahmacıoğlu.

Which Situations Fall Under the Definition of Peer Bullying?

'Bullying or not?' Our basic rule for answering the question is human rights accepted in the world. If there is a violation of sexual, emotional, physical or religious rights, we call the situation peer bullying. Of course, it is also very important how much the daily life of the victim of bullying is affected. For example, does he/she go to school with trembling hands and fear, or can he/she go to school without worry? In the first scenario, there is a high probability that the situation will be serious.

When you look at children who are exposed to bullying more frequently, do you see certain characteristics?

Children with different physical appearances, such as those who are shorter than their peers, wear glasses, are overweight, have prominent ear problems or have a disability, may be bullied more. Again, situations such as stuttering, ethnicity, and special education needs can cause children to experience more bullying.

What kind of risks does a maltreated child pose in the short and long term?

They may face psychiatric problems such as anxiety and depression. The victim child himself may turn into a bully later on.

Do child victims usually disclose their experiences to their families or do they tend to hide them?

Unfortunately, sometimes what is happening is not made very clear, and the child cannot go to his family and say, "I am experiencing such things at school." Because he/she is afraid of criticism from his/her family such as "You are a weak character, you should have done the same thing to him/her." Especially if there is a case of sexual abuse, the situation can be kept the lid on by saying "I will be disgraced at school, no one will be friends with me. My parents will blame me."

So, are bullies or victims usually referred to clinics?

I have been doing this job for 23 years, and when I scan my mind, I see that I work with victims of bullying more than with bullies. It's a bit annoying, but bullies aren't often sent to clinics. This is a social shame for all of us because they cannot be reached in any way and they are afraid to say anything to their families.

Do you think bullying is a psychiatric disorder?

We generally tend to think of it as a psychiatric disorder. But we cannot make such a generalization. It would be good for clinicians or young friends who will read this article to know this: If we hastily count bullying as a psychiatric disorder, a negative hole will be created for both the bully and the victim. Because psychiatric diagnosis is actually a rank for the bully. The bully may say, 'I have a psychiatric illness, I have the capacity to continue my bad behavior.' The victim may interpret what happened as "I was subjected to bad behavior by someone who cannot think intelligently, but he is actually someone who needs help." In other words, bullying is somehow legalized with a psychiatric diagnosis.
Why does one child bully another? Why do some children resort to using physical or psychological force?
There's probably a core of bullying in all of us. This is not something I discovered, it is something cultural anthropologists have highlighted. Before civilization, we were not very mild creatures in the wild, and that's why we were able to survive. In all of us, even the most innocent ones, we still have the codes of living in the wild and in harsh conditions. When we look at human history, it hasn't been that long, actually, we are talking about 5 thousand years ago. In other words, 5 thousand years ago, we had ancestors who were very agile and even behaved in ways that we would now call terrifying. We were among wild animals, we had to find food. Now, in the world of 2023, we no longer need to exhibit these behaviors. But that core, the essence within us that we assumed was extinguished, is still there. So we can turn into a bully at any time we feel threatened. That's why our basic human duty today is to silence the tyrant within us. What is acceptable and civilized is to be able to restrain him/her and prevent him/her from going out.

When we think about children specifically, what can awaken the bully in them?

If he/she sees all eyes on him/her when he/she enters the classroom, if no one plays with him/her, if he/she doesn't feel valuable and valued, he/she may turn into a bully. One of the things I want to say is this: Unfortunately, people who do not exhibit bullying are treated as 'losers', while those who do not violate someone else's rights are called 'I think he/she is a weak person'. Look, we often hear definitions such as alpha male and beta male, and we see these people glorified as 'strong'. However, these people are violators who see themselves as capable of doing anything. This is a very harmful story because the child will say, 'I want to be the alpha male too, and the way to do that is to treat girls badly.' Therefore, a society that glorifies bullying, the child's environment, what he hears, what he sees, and the people he takes as role models may cause the bully within him to awaken.

So, do bullies and victims have common characteristics? For example, there is an opinion that children who grow up in a verbally or physically abusive home have a higher potential to become bullies.

When you look at the literature, have such risk factors been identified?

These are topics that have been extensively studied in the literature. The familial structures of the people we call bullies were scanned, their sociocultural and socioeconomic conditions were examined, but nothing in common was found. We usually think that bullies are uneducated, did not grow up in a good home, and have an unhealthy diet. However, the children of people who grew up in a very decent home and whose parents are very educated can very well become full-fledged tyrants. Just like when you look from the outside, a kind, educated, sane, wealthy man commits violence against his wife or lover. Therefore, we must make such social readings and comments carefully. We should not ignore that our neighbor, our friend next door, or even ourselves have the potential to turn into a bully. I always give this example to my students in classes: "I don't think I'm a bully or that I torture anyone. But I don't know what I could do if I were in life-threatening danger. I've never been tested with this." So actually bullying is a bit of a dark issue. 'Are we actually a potential tyrant?' This goes back to the question: There is also evidence of this. For example, there were sad and terrifying stories during civil wars. People who did not bear any hostility towards each other in peacetime, ate together, sang songs, and held weddings could turn into murderers in a civil war. Men who were university educated and had double master's degrees were able to pick up guns and go shoot their neighbors. They all had their own valid reasons.
Bullying must have a price
What if we shine a spotlight on the bully kid and ask him/her, 'Why are you doing something like this?' If we ask, he/she will probably tell you a story. He/She will say, 'They did this to me, I was victimized like this.' When we look at the story of the people we call psychopaths, psychopaths are tyrants as we know them, they will all tell you a story, a reason, right or wrong... They may tell you a story like 'I loved him/her very much, he/she didn't reciprocate me, but I deserved it'. If you are an emotional person who does not know how to look cool, you may even agree with him/her. On the one hand, this is very dangerous because you serve to normalize bullying. I think this is done a lot nowadays. You look at a lot of people who exhibit bullying, not only in our country but all over the world, they are very popular, they are successful, they do not lose anything from their reputation. They even add to their fame. This is actually a sociological story rather than a psychological or psychiatric issue. If bullying is rewarded and applauded in the geography where it occurs, a child who sees this may say, 'This man is very popular. This must be the way to be loved, approved and applauded. Why shouldn't I do the same?' Therefore, if you look at the issue only from a psychiatric perspective, you will confine tyranny to a narrow area such as 'Then treat them, send them to a reformatory, keep them in prison'. Of course, bullying must have a price, the way and procedure for this is debatable, you cannot subject a 7-year-old child to the same treatment as a 15-year-old child, but bullying must definitely be punished. Otherwise, bullies will proliferate.

What should be done if a child constantly pressures, humiliates, bullies or physically abuses another?

Let's say such a case comes to me, I think he/she is a bully. What I can do as a child and adolescent psychiatrist is to provide the child who is bullying with an opportunity to meet in a safe environment. Because maybe he/she doesn't have a safe environment, maybe he/she is a victim of bullying. As a therapist, I say, 'This is a safe place for you. You will not be judged here because I am a physician. I want to know you as much as possible. First of all, I need to give the message that I am ready to listen to you. So that he/she does not think that he/she is in an interrogation room or that he/she will be detained here or locked up somewhere. If I were a police officer or a lawyer, maybe I would say different things, but on my side, it is acceptable for things to happen this way. Otherwise, if I listen with my eyebrows furrowed with judgmental eyes, he/she will get defensive and definitely won't tell me anything. That's why the doctor must exercise sweet and firm authority. I even recommend this to teachers. If we are compassionate towards the child who is bullying, we can say, 'This child was not loved enough in his time. Unfortunately, an approach such as "Let's not hug him, maybe we can nourish his good-hearted intentions and integrate him into society" does not work. If we turn the needle towards a very compassionate attitude, this time you start to be abused. He doesn't hesitate to see you as a 'loser', in popular parlance, and display his supremacist attitude. Let's say we turned the tables, this time we said, 'This child is not disciplined enough, let me give him/her a hard time and intimidate him/her.' This doesn't work either. Because then he/she tries to fight you, and he/she is not untrained in war anyway. Therefore, the narrow band that I find acceptable is to apply sweet and harsh authority. Showing neither our relaxed and compassionate face nor our strong and overwhelming attitude is the solution. It is necessary to keep the corners neat and set the rules. We need to show him/her that the order and rules that we assume do not exist in his/her life are at least in the therapy room.

Let's say a child is brought to you with behavior that demonstrates bullying. What do you do in therapy?

We can use practical behavior models, reward-punishment application, and behavioral models. For younger children, we can use some methods such as drawing pictures, playing with them, and having them tell their favorite fairy tales. It is important for us to get information about the TV series, movies that both children and adolescents watch, the music they listen to, the computer games they play, and which characters they identify with. These give us an idea about the child's inner world. The therapist needs to listen without chattering too much. Again, if there is a story of victimization in the past, it may be necessary for us to go back to the past.

What exactly is the goal of therapy? Does therapy have the power to dissuade a child from bullying behavior?

My wish, if I can succeed, is to transfer the aggression in the child or young person. The first thing that comes to mind here, and I think the most likely way, is to get him/her to engage in art or sports. Activities such as playing an instrument, drawing a picture, or going to a Far Eastern gym can somehow curb the beast hidden within them. We know from biographies that all the writers, directors, musicians and painters we love are not very moderate. When we look at their lives, we often see problematic people. So what have they achieved? Actually, he/she might have committed a crime and ended up in prison, but he/she sat down and wrote a book. We are reading his/her magnificent work right now. Therefore, what I mean is this: Whether the child we encounter is a victim or a bully, we must find a medium that will transfer aggression to him/her. I advise families in this direction to the extent of their means. It is not necessary to be a professional artist or athlete. But he/she should do something so that he feels valuable. In fact, if these children feel valuable, if their self-esteem somehow increases, if they somehow understand that they are useful, 99 percent will stop bullying.

Do medications have a role in bullying treatment?

Although not for everyone, we can use medication for children who are exposed to bullying and who develop problems such as anxiety and depression. If the bully is prone to violence or has impulsive problems, we can use medications to prevent them. In fact, the treatment is carried out in an integrated manner, it is not just therapy or medication, they are used together when necessary. It is necessary to present treatment models specifically for each case.

Summer vacation is here, and now the time children spend on the internet has started to increase. What would you like to say about cyber bullying?

The digital world has opened a new arena in the bullying crisis. Even though it is a new field, the nature of bullying does not change here, digital bullying threatens mental health in the same way. But the amount of bullying on the internet is increasing, and it is also harder to control. Almost every home now has a tablet or smartphone. Of course, we must say that it is more difficult to detect a bully on the internet. There is a possibility that bullying at school or on the street will be seen, but this may be overlooked on social media. In this respect, we can talk about a more hidden danger.

What can you suggest against cyberbullying? For example, do you think restricting the usage time is a solution?

Families ask me this question very often, but I cannot give a proper answer. We are not sure how much we can control social media and the internet. 'Should the internet be taken away from the child?', 'Should he/she be given an hour?', 'Which applications can he/she use?' There is no clear answer or guide to questions such as these yet. No psychiatrist knows this. Because the digital world has grown very quickly. Of course, the incident should not be narrowed down to a psychiatric issue. Maybe a workshop should be held for children's online safety. Psychiatrists, psychologists, educators, politicians, social media celebrities came together and said, 'We have such a problem. Let's take some precautions on this issue. Let's consider a 15-16 year old teenager who has two million followers but follows someone on social media who exhibits typical bullying. This young man who is looking for an idol may turn into a bully by following him. I don't know if this will be a salve for the workshop topic, but maybe at least a way out can be found.

What kind of duties do families have to combat bullying, and what precautions can we take?

'What is rights violation, what are the rights of children?' It is important to raise children's awareness about this issue. For example, it is useful to say, 'If someone hits you or constantly makes fun of you, tell an adult, security guards, or your parents about this.' I think this is the most concrete thing we can do. Again, it is very important to teach children kindness, to be able to say 'Hitting and mocking is not a good behavior at all', and to remind them that saying a bad word to someone or crushing them is not a cool thing to do.
How loved is my child, can he/she maintain a healthy relationship, is he/she accepted by his/her peers?' Is it important to try to find answers to questions such as?
It is important, of course, but there is actually something that families need to do much more fundamentally: Provide a safe environment for your child, even if you do not have much financial means. It's already hard outside, but the child should at least come home saying, 'I have a home, a warm bed, and parents who take care of me.' These are very priceless things. At least let his/her home be a shelter for him. If the house is not a shelter, if you always look at him/her questioningly when he/she comes home, if you talk too much about his/her failures or inadequacies, the child will say, 'There is no one who loves me outside anyway, everyone is attacking me, the people at home are not much different.' He/she says. This is where the real impasse occurs. There are families who cannot send their children to courses or take them on vacation, and therefore regret it very much. Of course, these are sad, I wish they had the opportunity, but actually parents can feel relieved by saying: 'I can provide a safe environment for my child.' Look, a safe family environment doesn't come with money. If you have established a relationship that includes affection, sweetness and authority, you are the best parent. Another important issue is being able to listen to the child. There are very few people who can take a breath and listen to a child or young person without immediately giving advice. We adults talk too much and put words in the child's mouth. Maybe it has things to tell, but we are missing them. Then the child says, "He/She always talks himself/herself, he/she doesn't listen to me," and goes to his/her room.

There is also the school side of the issue. What can be the school's duties in combating bullying?

First of all, guidance services should send the real bully to the psychiatrist. Okay, let them send the victims away, but they should not forget the bully. I object to this somewhat. Bullies are generally left out of the frame by not being sent to a psychiatrist. It is said about the victim child, "Actually, the child was too touchy and misunderstood the joke because he/she was very sensitive." Actually, it has nothing to do with it, it's not a joke or anything. If you approach the victim like this, you will make him/her suffer in hell and make him/her say, 'No one understands me, not even my teacher...' In this case, you will deal a blow to that child and make him/her feel all alone.

Let's say a child is systematically bullied at school, could changing schools be a solution?

It may happen sometimes, but when I looked at it on a case-by-case basis, there were situations where I said, 'Take that child out of there.' The child gets into such a dead end that such a fever spreads that a change of school may become inevitable.
Apart from the bully and the victim, sometimes there is a third party to bullying, that is, the audience, or even the audience filming with a camera...
Those who want to benefit from the popularity of the bully can be called the supporters of the bully. We see it on social media, sometimes there is actually someone filming that video and giggling. Giggles actually send the following message to the bully: 'I am loved, there are people in the stands applauding me. 'I need to kick it into higher gear.' Unfortunately, what actually leads to a deadlock is that the bully is not exposed, judged, or excluded by the majority... On the contrary, good-hearted people are excluded. Therefore, the authority also has a responsibility here. Bullies should be given a fair punishment so that they don't get away with what they did or people don't come out and say, 'Let me punish this.' I wish I could say something optimistic, but unfortunately we see no signs of this abating anytime soon.

At the beginning of our conversation, you said, "Kids sometimes hide that they're being bullied." Are there clues that a child is being bullied?

This issue is really important because when the child comes home in the evening, he/she may not say 'Something like this happened to me' at the dinner table. In this case, changes in attitude should be a warning for families. For example, he/she is normally a quiet child, but you see that recently he/she outspeaks , his/her attitude and facial expressions changed. Or his/her appetite and sleep patterns are different from before. The child who loves to eat and sleep now has no appetite or does not know how to go to bed. The opposite is also true, of course. The child may suddenly fall asleep a lot and not lift his/her head from the pillow. Or a child who used to be aggressive is now calm ... Children who exhibit such a change in attitude may have become victims if nothing else comes to mind to explain the situation.