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

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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Rittenhouse and the Common Teenage Fantasy

Despite the wide public clamor about Rittenhouse's actions when seventeen, there has been no exploration of how these relate to the common adolescent yearning to improve the world.

A not unusual element of teenage dreams is an explosion. Not that the dreamer hopes to blow up something but rather to transform the world. Which seems possible based on their limited knowledge though adults can believe this too. Once, during a workshop in Washington, I was floored by the expertise of the government speakers, naively believing that if our group worked together we could accomplish anything.
Perhaps seventeen-year-old Rittenhouse, when taking up his rifle and medic kit to protect a community, was driven by a similar fantasy, a not inexplicable desire since he had worked as a lifeguard. But, as many more adults than teenagers realize, events don't always proceed according to plan.

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How Abuse Victims Fall Apart (Psychologically Decompensate)

Abuse victims fall apart psychologically (decompensate) in stages. The victim first denies the reality of imminent danger with a stubbornness bordering on psychotic. When this defense against the reality of the situation fails, the victim tends to lose control of themselves and give up.

As other people fail to help them, the victim feels given up on and enters a state of resignation. Finally, as all sense of a different future disappears, flashbacks of past trauma occur and the victim enters a state of complete surrender. This is not easily breached without outside help or getting a lucky break. Victims who are coerced into behavior that violate their moral code may be at greatest peril.

 

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Emotional Desensitization After Trauma

A common characteristic of Post-Traumatic Stress Disorder (PTSD) is emotional desensitization, becoming unable to feel those feelings which make us human such as warmth, closeness, and joy in relationships. What feeling is experienced is rage which may be expressed through unwise, self-defeating, or even violent behavior, the mind having created this blockage as a survival mechanism after the frightening, paralyzing trauma.

The extreme behavior that can follow reflects the anger of frustration and attempt to smash this blockage of feelings, to feel something.
This emotional blockage can derive from combat or civilian experience as an adult or a child, from a terrorist bombing or the continuing child abuse of grossly inadequate parenting. Insight into its nature increases the probability of healing.

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How To Explain Scary Dreams To A Child

Though scary dreams frighten and can greatly upset, "they are our friends" I tell my young patients. Stories that our mind creates to tell what is bothering us and, like the mystery movies we love, that we must try to figure out.

A scary dream could mean that we are nervous about school the next day or learning a new task like swimming. Or even of growing up and leaving home, which is a common worry as one grows older.
Explaining nightmares in this manner reassures a child and reduces their fear. And, if scary dreams don't frighten their parents, perhaps they are not to be feared at all. Once, having spoken this way to a five-year-old girl and repeating myself a month later, she dismissively said, "Oh I know that!"

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The Havana Syndrome and the Power of the Unconscious Mind

There has been much publicity about what has been termed the Havana Syndrome: debilitating physical and cognitive symptoms allegedly caused by an unknown foreign government. So certain is this origin that doctors relating these symptoms to psychological causation are ridiculed though experts insist that no evidence of such weapon has been found nor are they conceptually possible.


I have no special knowledge of the Havana Syndrome nor do I wish to minimize the symptoms or pain of its sufferers though the power of the unconscious generally tends to be ignored or minimized. All would prefer to believe they have ultimate power over their behavior. Which is true except when stress or emotions overpower it. Then physical symptoms can occur. Forty-to-sixty percent of those rushing to an Emergency Room, fearful that they are suffering a heart attack, are really suffering the extreme anxiety of Panic Attack during which the normal symptoms of anxiety are misinterpreted as a deadly medical event.


Anxiety symptoms can mimic virtually every physical disorder, even causing visual symptoms when stress causes an optical migraine. Nature behaves economically, having adapted systems to multiple uses with a large gland like the liver performing hundreds of tasks from processing glucose to generating hemoglobin.


A hospital coworker suffered recurring nightmares from which she awoke screaming with marks on her wrists, these being identical to those occurring when she had been repeatedly held down and sexually abused as a child.


The unconscious is very powerful and one must respect its power.

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When Families Must Cope With Their Child's Serious Chronic Illness

Parents have varying levels of success in coping with their child's lingering medical illness. This derives from whether "poorer" or "better" interactions are used by their doctors and medical establishments. Some are vague regarded diagnosis and prognosis when communicating with parents while others describe the illness realistically but also focus on possible research breakthroughs and the parents' hopes during remissions when the child lives comfortably at home. Yet family mourning is inevitable since, until the child's diagnosis, they were considered normal and happy rather than chronically ill and suffering.

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Recurring Nightmares and their Elimination

Dreaming occurs nightly but they are not always remembered. The more painful the dream, the more likely it will be remembered and dreams can be painful indeed.

 

A young child dreamed repeatedly of being eaten by wild animals, and for an adult woman the dreams mirrored her continued sexual abuse when a child. Yet eliminating this pain is not rocket science since dreaming has long been understood. And despite their occasional discomfort, all dreams are our friends I tell my young patients. They are movies that we create in our mind to tell what is troubling us, perhaps being afraid of a school test or the like.

 

Interpreting a recurring nightmare, whether of a child or adult, will usually eliminate it. Unless the interpretation was faulty, or incomplete with there being more to the emotional conflict that it symbolizes with the person being unable to resolve it at that point in their life. An adult's nightmare that persisted for decades took three years and two interpretations to disappear completely, there having been important personality changes needing to occur first. The initial interpretation reduced the nightmare's frequency but a timely, second interpretation was needed to eliminate it.

 

There is a logic to nightmares just as with physical symptoms. A fever disappears when the infection is gone, as does a nightmare when the emotional conflict that it symbolizes is resolved.

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Why Fanciful Explanations of Autism Persist

While parents rarely feel guilty when their child becomes physically ill, this is not true when they develop emotional problems. Autism is perhaps the most affected of these attitudes which, in its severest form, devastates family life.

 

Though recent infant research has confirmed what clinicians have long sensed, that the parent-child interaction plays an overwhelming role in its development, denial of this fact persists. Thus we read of continued, failed attempts to relate autism to vaccines or pollution or whatever, any cause but parenting. This is understandable since the sight of a severely autistic child horrifies and no parent would willingly accept blame for this.

 

All children have strengths and limitations, as do parents who had their own childhood struggles. A parent's personality must mesh with their unselected child and mismatches naturally occur. The unconscious is very powerful, and one must recognize its power. Thus, once a child's emotional problem is recognized and help for it is sought, any parental guilt is undeserved and counter-productive.

 

A positive thought is that autism is vastly and inaccurately over-diagnosed. In my long experience, in both medical and psychological settings, I have seen fewer than five severely disturbed, self-mutilating autistic children, and fewer than twenty diagnosable autistic children with lesser symptoms. Moreover, young children whose behavior exhibit some autistic features can have these symptoms disappear through ordinary play psychotherapy, sometimes in just a few months. And with lengthy, extensive services, major change can be made in even the most disturbed autistic child's life.

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Failure and Success in the Psychotherapy of Autistic Children

The aloofness noted in autistic children often becomes a self-fulfilling prophecy when their therapist considers it a given, something amenable only to simplistic reward/punishment behavior modification techniques. But the autistic child does have relationships though these are inadequate and require nurturing through play therapy.

No special techniques are required since the basic difficulty of autistic children is communication and play is the primary language in conducting psychotherapy with children. Thus, autistic children must be related to individually with their aloofness not being taken as a rejection of interpersonal contact but merely their inadequacy at it. A recent study found that most infants, who had communication difficulties associated with autism in their second year of life, were later no longer diagnosable as autistic when their mothers were given early intense instruction in communicating with them.

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