Recent events in the Middle East have raised a lot of questions about why would people dedicate their lives to the pursuit of destruction. My observation is that this unspeakable behavior is the ultimate expression of what is learned in school beginning in pre-school. Every child entering school has a baseline anxiety that is heightened by leaving the familiar surroundings of home even if the home environment is dysfunctional. We are not taught how to process anxiety at any age, especially early on. It has been disturbing to me, as I talk to my patients in pain, that many report having significant anxiety since age five or six. I realize that I have a self-selected group but the vast majority of them report crippling anxiety during their teens. The main antidote for anxiety is control. The more power you have the more control you can exert. Since every child has this need what we are calling socialization is simply a pure power struggle without an endpoint. When you lose control you will become angry as a last-ditch effort. Anger also covers up the vulnerable feelings associated with anxiety. Unfortunately anger is destructive. There is also a physiological reward for possessing power. Every human being depends on anxiety for survival. Your nervous system, through all of the senses is constantly scanning the environment for danger. This is an unconscious function that you will become aware of only when a certain threshold is reached. You are constantly controlling your environment of your behavior to minimize anxiety. The corollary of this scenario is that the more power you possess the more control you can exert. Indeed the benefits of power have been demonstrated in a study looking at inflammatory markers in students who have been bullied versus the bullies. C-reactive protein is a blood test that is elevated in the presence of inflammation. It is often drawn to determine the presence of a hidden infection. Chronically elevated levels also indicate a stressed and overactive immune system. One consequence can be occlusion of the blood vessels to the heart. It is not to have an elevated C-reactive protein. Researchers drew samples of this marker on children who had been bullied and found significantly elevated levels of C-reactive protein compared to those who had not been bullied. Being bullied, as your introduction to the real world is not a great start. What I find even more disturbing is that the levels of C-reactive protein in bullies were lower than the norm. There is both a social and physiological reward for possessing more power. How all of this plays out in adulthood is not subtle. Why would you want to give up the power of anger? Although we can pay lip service to the concepts of world peace and compassion these basic conscious and unconscious survival patterns will always win out when you are exposed to a stressful situation. The problem is further magnified by society’s emphasis on accomplishments and winning rather than play. The quest for power is endless as anxiety always increases with age. Although power is necessary to deal with bullies who are terrorizing the world, fighting violence with violence is not a viable long-term solution. Anxiety-driven anger is the root problem. By correctly addressing anxiety from a neurological public health perspective beginning in pre-school we could actually create a massive shift in human behavior and relationships. Why are we continuing to nurture a school environment where being a bully is your best chance of surviving? What has happened to the concept of play?