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

The Unconscious Factors Underlying Some Learning Difficulties

Psychology has long known of the association between unconscious emotional attitudes and academic failure, or with a subject that is considered disagreeable from association with a parent's occupation. Reading difficulty can result from the angry feelings it arouses or a frightening experience of self, and school failure from the unconscious desire for criticism and punishment. A child's problems with their mother, the most important figure in their early development, can extend to their relationship with their teacher.
An overly narcissistic mother, or one who views their child as defective, will hinder their child's ability to adapt to reality, particularly when speech is used to gain praise rather than communicate. Underachievement, a failure to learn, can reflect hostility, an indirect passive attack on parents and society. Clearly, for some children, the powerful, genetically endowed hunger to learn has been throttled.

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The Borderline Personality Disorder Continuum

Like all mental health disorders, those suffering from Borderline Personality Disorder exhibit symptoms of varying severity depending on their capacity for relationships. Those closest to a psychotic disorder are openly angry, having given up their desire for relationships. Less severe are those that vacillate between moving toward and away from others. The next group lack a secure "sense of self" or sense of who they are, and mold their behavior according to what others expect; while the least disturbed group continually seek a symbiotic relationship with a mothering figure, having lacked a "good-enough" parenting figure early in life. This continuum of pathology reflects the deficient ability to tolerate intimacy, a contining modulation of closeness by moving toward and away from others.

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The Curative Factors in Psychotherapy

Several factors are now considered to comprise the healing elements of individual psychotherapy, both classic psychoanalytic treatment, which is uncommon today and suited for few, and the frequent psychodynamically oriented treatment. Gaining insight into one's behavior has far less effect than has been promulgated by movies since a patient who gains great insight may achieve little life change. A second factor is the patient's attachment to their therapist, the theapeutic relationship, within which a more benign and thoughtful orientation toward themselves is adopted. During this corrective emotional experience the patient comes to view themselves and others differently, and long-held, unconscious terrors are extinguished.

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Psychosomatic Disorders and Anxiety

The human organism was once an undifferentiated mass from which subsystems developed: the enzymatic (hormone) system; the nervous system; the psychological system; and the organ system. Their boundaries are imprecise with activity in one being continuously communicated to others. A change in one that is caused by stress causes changes in others with their normal smooth integration being affected. Stress initially arouses helpful body defenses but too great stress causes a breakdown between system boundaries, a de-differentiation in which energy is discharged through violent fighting activity or running movements.
Mild anxiety is experienced as a signal of danger and can result in more efficient action or thought. But if the anxiety is too intense, with psychological means or behavior being unable to reduce it, primitive psychosomatic defenses attempt to replace the unsuccessful psychological maneuvers, stirring up harmful organ or system effects that can persist after the anxiety disappears.

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Why Nurses Leave VA Hospitals

Research on why nurses leave VA hospitals, by Dongjin Oh' and Keon-Hyung Lee, was reported in the October, 2022 issue of Armed Forces and Society (pp. 760-779). The biggest factor was emotional burnout and stress caused by the sense of loss, grief, and powerlessness over the frequent deaths of patients who they had long cared for. Far more patient deaths occur after VA hospitalization than in civilian hospitals since VA patients are older with many having been exposed to harmful environments during their military service. An excessive workload from the VA's policy of having nurses work overtime because of staff shortage reduced their ability to recover from grief. Being ordered to do time-consuming non-nursing tasks, and the lack of flexibility in work scheduling which would enable a healthy work/personal life balance, were other factors.
The same could be said of nurses who struggled through the COVID crisis at other hospitals where patient workloads were high and critical medical equipment and masks were often lacking.

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Why Many Children Can't Read

That many children can't read shouldn't be happening since this ability is innate and learning it presents no greater difficulty than learning to eat with a spoon. Why it does is the unacknowledged "Elephant in the Room," and not the fault of teachers but of parents.
A child naturally learns the language of their country of birth. Thus one born in the U.S.A. learns English and one born in Germany learns German and the same for other countries. They accomplish this not by memorizing all combinations of words which is impossible, but by inducting the grammatical structure of their language, a task for which the human brain is genetically programmed at birth.

Thus if parents first read to and then with their toddler beginning at two years of age, aiding the reading learning process by moving their finger along the printed line, their child will read simple books upon beginning kindergarten. Not all children but nearly all, provided that they are experiencing a "good-enough" parenting since its lack can create psychological difficulties affecting learning.

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The Critical Need For the Psychological Evaluation of Inmates

No psychologist likes working in a prison since even those with supportive congenial colleagues contain difficult characteristics: being unable to keep a personal phone within the institution, and having to exit multiple locked gates before rejoining the normal world. Yet these psychologists play a critical role.
While a county chief psychologist I often evaluated inmates at the local jail. An experience which, perhaps contrary to popular belief, they valued and even enjoyed. An inmate's life in a local jail lacks the treatment and educational facilities of larger state prisons. Thus receiving the undivided attention of another person is a gift not to be spurned. Moreover comprehensive psychological testing, which includes intelligence and personality instruments, is inherently interesting and provides exhaustive information. So much that my reports were nicknamed "magic" though their creation reflected the lengthy psychometric research and study of others.
By helping judges make better informed decisions, my reports always aided these. One young man who violated parole was released when my testing revealed that he was intellectually limited. Another, handsome and charming except when pressed, had much unconscious rage toward women which had already erupted in attempted rape.
Society would be safer and more just if psychological testing played a greater role in the judicial system. 

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Why Battered Wives Remain Married

Why women who experience repeated threats and physical assaults from their spouse remain with them seems inexplicable yet is readily understandable.Through their experiences they have been programmed to be submissive, enslaved by their husband through a paralyzing terror of continuous agitation, anxiety bordering on panic, and psychosomatic symptoms, these creating passivity and feelings of hopelessness. Only rarely does their deeply repressed rage become homicidal.
Studies have revealed that many of these women had alcoholic fathers and had married as teenagers when pregnant. The husbands drank heavily and kept their wives isolated, accusing them of infidelity and beating them after their return home, causing the women to live in constant fear and unable to meet with supportive female friends and keep medical appointments. Their low self-esteem, lack of safety and financial resources, and feeling of shame cause them to stay with their battering husband.

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"1984" Redux or Currently Permitted Language

There is a robust discussion about the "sensitivity industry" on the Authors Guild Community website. It details how publishers have come to take criticism seriously from even unknown online complainants about books. In one case, criticism of a bunny in a book aroused corporate angst. And no, the complaint was NOT from the bunny.
To this discussion I added my experience of participating on a Facebook parenting group where, in response to the many unsophisticated comments, I explained Borderline Personality Disorder in terms of developmentally derived weakness of basic ego capacities. I was then criticized for using the term "weakness" since this allegedly put people down. I thought to respond that following this logic, tuberculosis and polio must be considered beneficial rather than disabling but didn't. Responding to know-nothings is fruitless.
I dropped out of Facebook parenting advice groups, my tolerance for idiocy having been exceeded, after one group's moderator stated that anyone who henceforth used the term "breast-feeding" in place of "chest-feeding" would be expelled. After reporting this incident on the Authors Guild Community website a cleverer writer than me advised that I should have responded, "Send me your child to chest-feed," and others contributed. One said that employees of a state mental health department on the West Coast were instructed that henceforth the term "insane" should be used in place of "crazy," while another posted that his friend at a Washington D.C. facility was ordered to use the term "crazy" in place of "insane." You figure.
Which leaves me puzzled. I have long believed that, considering all their responsibilities (home, child-care, job, ill pet, etc.) it is fortunate that it is women who have babies since they must be the stronger sex. Will I now be pilloried for stating this?

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Psychiatric Diagnostic Misunderstanding and Popular Culture

For some illogical reason, perhaps as a reaction to poor clinical practice or popular movies, some mental health disorders have become viewed as benefit rather than illness. Among these is Borderline Personality Disorder, a serious psychological illness describing severe, fixed weakness of the basic ego capacities governing thinking, behavior, affect, and more, deriving from faulty developmental experiences, principally the lack of a "good-enough" parenting during the early years when basic ego capacities form. A theoretical concept, "Elements of a Borderline Psychotic Psychostructural Organization," which is far more common than BPD, is a continuum of weaknesses of one or more ego capacities and far less severe. It is often mis-diagnosed for BPD particularly when substance abuse is present. Sadly, inadequate child development knowledge is the rule for both the general public and many clinicians.

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