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A Psychologist's Thoughts on Clinical Practice, Behavior, and Life

A Prescient Sci-Fi Story About Modern Life

I recently read a science fiction story by Robert Silverberg, "Alaree," which was originally published in 1958. A crippled spaceship from Earth has landed for repairs on a small, previously unexplored planet. There they encounter a small humanoid creature with whom they speak using a speech converter. The creature has great difficulty understanding the concept of "I" since on his planet all the creatures are "we."

He becomes close to the space travelers, watching as they work. Soon other aliens appear, all identical to him. He implores the captain to take him with him back to Earth and, after initially refusing, the captain agrees, Alaree having said that if he remains he'll die. On the return journey, Alaree behaves in a puzzling manner, staring into the face of each of the crew members as if trying to merge with them. Then he suddenly dies and the captain understands why: because on his world he had been part of "we" and, when losing this identify and becoming an "I," he could not survive.
This reminded me of the fear of some people to reject popularly held concepts, perhaps from the subconscious fear that, like Alaree, they couldn't survive.

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The Benefits of Delusion

Once, during a routine medical examination, I remarked to the physician that I never had a chronic illness and doubted that I would. "That's a good delusion. Keep it," she advised. Which is true since even the healthiest person can't predict the vagaries of their genetics or fate.
This remembrance entered my mind after speaking with a patient whose delusional belief seemed ego-syntonic, enabling them to work productively though with difficulty in relationships.
A delusion,which is a fixed false balief, can range widely in both the personal and political spheres. Feeling unjustified guilt about their child's autism (which is a vastly misdiagnosed condition), a mother might falsely ascribe it to vaccination or air polution. Similarly, masochistic behavior or anorexia nervosa (which has the highest death rate of all the mental health conditions) may be considered "normal" by its sufferer rather than accurately, as deriving from damaged childhood experiences which can be healed through psychotherapy. And one who attributes their or their nation's problems to a minority population may feel better even if their life situation remains unimproved, as happened in Nazi Germany and today's inhabitants of some nations.
What determines a delusion's benefit or harm depends on its effect: whether or not it enables adequate functioning as a productive member of society without interfering with the rights of others and the maintenance of sound physical health.

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The Fear of "Going Crazy"

While the fear of "going crazy" is widespread, in reality it is a very difficult state to achieve requiring either drug/alcohol abuse or long term overwhelming stress. This fear contains several elements: becoming unable to control oneself; having impaired thinking; and an inability to care for oneself resulting in hospitalization. For most people what underlies this fear is the fear of losing control because of realization of unconscious hostile feelings or dependency needs, both of which are controlled during hospitalization. Yet this fear of loss of control may be caused by something innocuous, as becoming tearful by one who rarely does.

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Psychological Ignorance and Bliss in Modern Society

The number of unsophisticated beliefs about behavior in today's society is astounding due to widespread public ignorance about psychological functioning and development. But these come from the lips of clinicians too. Consider treatment acronyms like DBT, "Dialectical Behavior Therapy" which I thought to mean "Diabolical Behavior Therapy" when I first heard it. This and others are mere abbreviated corruptions of the basic long-held treatment postures of psychoanalytically oriented psychotherapy (Relationship, Replacement, Supportive, Analytic).
An enthralling Netflix documentary series about a Hollywood teenage burglary ring that robbed celebrities is "The Real Bling Ring." I usually watch only the first episode of these series before reading what happened on Wikipedia but watched this in entirety. As crazed (but clever) was their robbery planning is the celebrity culture they hungered to join.
And as far as being "traumatized" by a scene from a book or film or a comment. When one doesn't know the technical definition of "traumatized" it can mean "feeling upset" or "not liking it" or having "hurt feelings." Development requires learning to cope with such human failings as jealousy and envy and sadism, on jobs and elsewhere.
Long ago a woman told me that her therapist said, "I love you." "Wow! That's a pretty unusual thing for a therapist to say," I responded. "Well, he didn't say exactly that. He said, 'You're lovable.'" When words can mean whatever the speaker wishes them to mean and belief becomes fact, we are in a world in which everything is OK and acceptable, or perhaps a psychotic one. Nuff said.

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Parental Reluctance to Confront Their Child's Emotional Problems

Years ago a mother brought her child to my office. While speaking with her alone, I referred to her son's "emotional problems." "My child does not have emotional problems," the mother insisted, and stormed from my office. Had I been given the chance I might have asked, "Then why are you here?" but already knew the answer: to gain reassurance that, despite having observed his bizarre behavior, her child was perfectly fine.
This illogic, when a parent's emotion-based reality clashes with actual reality, is understandable. Though unwise, it reflects the parent's feeling of shame from the belief that they failed as a parent. Which is undeserved since children are not born with instructions nor have all parents experienced a "good enough" parenting during their own childhood. Once a parent gains help for their troubled child they have no reason to feel guilt and it is counter-productive to the success of their child's treatment. But not seeking treatment for their child, especially when it leads to harm, is inexcusable.

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Shooting Atrocities and Politician Response

While guns should certainly be kept from children and the mentally disturbed, behaving simplistically, as politicians tend to do following public distress, accomplishes little. The cause of the recent shooting atrocities is mental illness, virtually all deriving from lack of a "good enough" parenting during earliest childhood when the basic ego capacities governing control of thinking and behavior, modulation of mood, development of a sense of self, and the ability to separate fact from fantasy are formed. Yet no politician spoke this, doubtlessly because few know it since knowledge of child development is minimal even by doctors. What some seem to fear, even more greatly than guns, is awareness of the fearsome power of the unconscious. Can that a gun symbolizes this explain why it goes unspoken following shootings? Hmm...

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The Attempted Murder of Justice Kavanaugh and the Often Ignored Power of the Unconscious

An unfortunate current development is the ignoring of unconscious factors in human behavior. Thus in our "I'm OK, You're OK" era on steroids, virtually any belief or action has now become acceptable no matter how weird it was once considered. But the murder attempt on Justice Kavanaugh evidences the power of unconscious motivation.
That the accused, twenty-six-year-old Nicholas Roske, is mentally disturbed cannot be questioned since he admitted this. "I wouldn't say I'm thinking clearly," he said in court. Yet his preparations--acquiring pistol, pepper spray, the Justice's home address, and more--indicates coherence. Fortunately before acting, Mr. Roske phoned the local emergency services, stating his murderous plan and asking for help. Thus did the sound logical conscious element of what psychologists call the Executive Function overcome the unconscious conflict driving him to kill. As I never tire of stating, the unconscious is very powerful and one must respect its power.

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The Benefit and Danger of Tunnel Vision

While focused concentration is prized, too great focus can be dangerous. Like when, obsessed by a personal concern, one incautiously crosses a busy street or, depressed by a recent job loss or romantic breakup, the person suicides. In these cases perspective is lost as tunnel vision predominates.
Yet tunnel vision, exaggerated narrow focus, can save lives too as when traversing a crime-laden neighborhood or on the battlefield. Unhelpful tunnel vision happens when the presenting situation is misperceived: as a permanent rather than temporary setback, and being perilous not innocuous.

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The Benefit and Danger of Holding An Inaccurate Self-Image

While it is often believed that holding an incorrect concept of who one is (what psychologists term a "sense of self") is harmful, this is not always true. Being common with emotional disorders, these sufferers do benefit for it grants them hope and protection from deep suicidal despair. Moreover, the fantasy may indicate an embryonic talent which could lead to significant achievement after their healing through treatment. Yet while comforting, holding an unrealistic fantasy with no hope of success can lead to greater despair.

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The Murderers Among Us

The Killer Across The Table, by John Douglas and Mark Olshaker describes the interviews of noted serial killers during which childhood and psychological similarities were found.
All had a troubled childhood, having experienced a far from "good-enough" parenting with much cruelty and/or sexual abuse and, often, a particularly damaging relatioinship with their mother. Which is not surprising since the mother-infant interaction is paramount when the basic ego capacities governing impulse control and thinking are formed.
These killers had a remarkable ability for psychological "splitting," separating and walling-off one aspect of their thinking and emotional life from another. Thus they could murder and bury a young child but later volunteer to join a search party while being concerned that their child get to school.
Rage and power were the domineering factors even in killings with a sexual element. The killer of a young girl from a neighboring home, who came to the killer's house to deliver Girl Scout cookies, knew from the moment he opened the door that he would kill her. This man, a high school teacher who lived with his mother, was told that she would refuse to see him and cut him from her will if he married. This caused him to break his engagement and added to his two types of rage. One that he could control, as when a driver cut him off. But the second he could not, as when the unlucky girl came to his house.
Another killer repeated his crime after being paroled following his rape and murder of a young woman. That these killers are not insane (which is a legal term) is evidenced by the care they took during the murders and in disposing of the bodies to avoid being caught.
This book evidences: the crucial need for more accurate assessment of those who are arrested; to consider even such unlikely suspects as family friends and loving relatives as the potential culprit; and to take reported suspicions seriously since many killing sprees would have been ended earlier had this been done, particularly those in hospitals by medical staff.
According to the authors: all serial killers have psychological conflicts between grandiosity and inadequacy; a sense of personal entitlement causing them to feel that they need not follow society's laws; and the ability to choose, making them deserving of capital punishment.

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