The "Cyberball" Approach to Promoting Self-Regulation

How do we react when we are socially excluded (i.e.; left out, rejected, or made fun of)? More specifically, what does the experience of social exclusion "look like" in our brains?

Cyberball Experiments: Functional Neuro-Imaging of Social Exclusion

Functional neuroimaging studies of reactions to social exclusion have identified common activation patterns in our brains that are associated with being socially excluded. Here's how it works.

People (research participants) lay in a functional magnetic resonance imaging (fMRI) machine that is focused on monitoring their brain activity. They must stay (mostly) still. They can, however, still look at a computer screen and use their fingers to manipulate a gaming device while playing "cyberball”—that is, pass a digital "ball" back and forth on the screen with two other "people."

They are usually told these other "people" are other research participants in their own fMRI machines; in reality, they're interacting with a computer program.

At first, everyone plays fair; the ball is shared relatively equally and the research subject receives and passes the ball to one of the other people about one-third of the time as baseline brain activity is measured.

Then, without explanation, the other two "people" start passing the ball back and forth to each other while leaving the research subject out—in other words, social exclusion.

Quick and automatic "emotional brain" systems (such as the limbic system) usually light up—that is, they become almost instantly more active in response to this experimentally induced experience of social exclusion. This can include systems that tend to become active when we experience anger, anxiety, shame, and even physical pain.

A bit later (5-10 seconds), the "thinking brain" (pre-frontal cortex and closely associated systems) becomes more active and inhibits the "emotional brain" activity, which subsides.

Here is what I think is the best—and most clinically relevant—part. When the research subjects were asked what they were experiencing, including what was going through their mind while in the fMRI, they reported first experiencing themselves as excluded and feeling distress and then thinking things like “This is just a game,” or “Who cares? I don’t even know these people” and feeling better.

The fMRI is, in a way, "seeing" the kinds of cognitions or self-talk therapists help patients learn and use to self-regulate their emotional responses and increase their ability to moderate and recover from experiences of exclusion and frustration, loss, anxiety, and more.

Teaching About Cyberball Experiments: The Child or Adolescent Version

When working with children, and with their parent(s) also present, I raise and hold up my open hand, fingers up and thumb stretched to the side, shift my voice and cadence into "storytelling mode," and say, in developmentally appropriate language, something like:

My thumb is like the emotional part of our—you, me, your parents—brains. My fingers are like the thinking part, up here [I point to the top front of my head].

When something stressful happens—we are left out, we are blocked from doing something we want to do, we hear or see something that scares us [I choose examples relevant to that child’s issues]—our emotional brain [I wiggle my thumb] quickly and automatically springs into action and makes us ready to fight, run away, or hide. A little while later, our thinking brain [I wiggle my fingers] becomes active and begins to calm down [I close my hand with my fingers over my thumb] our emotional brain.

We then calm down, feel better, and are more likely to do the right thing even when it is the hard thing to do.

I then describe the cyberball experiment, using developmentally appropriate language and simultaneously doing this hand demonstration again.

I often note that our "emotional brain" is important and its responses can be very adaptive. When driving a car, for example, if a ball followed by a child darts into the road, we don’t want to mentally stop and think something like, “This is dangerous—what should I do?” We want to quickly and automatically hit the brakes.

I then help the child identify their own problematic "emotional brain" reactions and discuss possible "thinking brain" responses (while holding up their own hand and wiggling their own thumb and fingers, of course). I have parents do the same, identifying their own "emotional brain" reactions to their child’s meltdowns or defiance and more adaptive "thinking brain" responses.

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I often use a solution-focused approach to identifying individualized self-talk strategies: “Tell me about times when you did experience emotional self-regulation/self-control. What were you thinking/saying to yourself at those times? What was going through your mind?” Solution-focused therapy highlights and expands upon successes and exceptions to problem behaviors.

We may also discuss how escalating parent-child conflicts can be seen as their "emotional brains" interacting while their "thinking brains" are still offline, and how slowing down the interaction, taking a break or deep breathing can give their "thinking brains" enough time to get involved.

How the Cyberball Approach Enhances Cognitive Therapy

Children and their parents are usually pretty fascinated—and thus engaged—by the cyberball experiment, especially the part about the fMRI "seeing" emotional reactions and cognitive responses. Their understanding of and engagement in what we are working on in cognitive therapy (e.g., self-talk strategies) increases.

Some families even come to use some part of the hand demonstration (usually closing fingers over the thumb) as a visual cue or signal, at home and in real-time, to prompt stopping and thinking rather than impulsively or responding. For many neuro-developmentally atypical children, these kinds of visuals can work better than words.

Some parents use their version of the hand demonstration preventatively—they "prime" their child with this non-verbal communication before their child enters a challenging situation. Some parents even use their version of the hand demonstration to remind each other to slow an escalating interaction down, take a break, etc.

The Cyberball Approach and ADHD Medications

When parents, or their children, have questions about stimulant medication, I may discuss how these medications "stimulate" the thinking brain to act more quickly to inhibit the "emotional brain," while again doing the hand demonstration.

I also note, though, that in addition to and even instead of medication, we can rehearse and practice, in and out of therapy, cognitive strategies (self-talk). We can train our "thinking brain" to react more quickly—something like practicing dribbling, passing, or shooting before an actual game.

Try it Out

I have found describing the cyberball experiment and teaching the hand demonstration described above to be a helpful psycho-educational tool in my practice.

You might find this approach helpful as well. Practice first, though, in front of a mirror or with another adult before attempting with your child, making sure the demonstration is smooth and the explanation is clear. You may also want to read one or more of the cyberball and social exclusion experiment articles referenced below.