Dr. Stanley Goldstein - Author and Psychologist

The alleged "mystery" of substance abuse is well-known: that, after using an illicit drug or alcohol, one feels better though these are habits which are best left unacquired.

The etiology of substance abuse is not to be found in genes but in early life experience. Substance abuse usually begins during adolescence though, rarely, it begins earlier or later.The basic ego capacities, those governing control of thinking and behavior, are created beginning in infancy and, for their successful development, require a "good enough"  though not perfect parenting. When lacking, the child will have difficulty surmounting the critical adolescent tasks of separating from parents, developing a sturdy sense of who they are ("sense of self"), dating, and making sound education and career decisions. If unsuccessful at these and seeking relief from stress, some turn to alcohol or drug use for relief. Which does work though at great cost to health and emotional stability. Psychological treatment is required to heal the personality deficiencies but this, unlike the substance, requires time and why many fail substance abuse treatment.

Better and more widespread parenting education is one solution to this problem, to stop childhood based problems from developing early and provide earlier mental health treatment when needed. Another is more substance abuse education beginning in the early years. One six-year-old girl said, apropos of nothing as we played a board game, "Don't use drugs. They're bad!" Her mother later told me she had a DARE (Drug Abuse Resistance Education) class that day.

That most children should be able to read when beginning kindergarten is well known by psychologists though this depends on their earlier experience. Parents should begin reading to their toddlers about the age of 2 1/2, having them sit beside them and running the parent's finger along the lines as they read. If done, most children will be able to read simple books by the time they start school.

They do this by using the same inborn cognitive mechanism that they used to learn the grammatical structure of the language of the country into which they were born. Thus a child born in Spain naturally learns to speak Spanish and a child born in France naturally learns to speak French, not by memorizing the placement of one word after the other which would be impossible, but by inducting the grammatical structure of the language. Similarly, a young child, if provided a helpful experience with reading, will induct its nature and learn to read.

No expensive gadgets are necessary for this critical childhood achievement, just simple books and willing parents. Try it.

"You don't live forever" is a well-worn phrase though one which isn't thought by the emotionally ill for whom daily survival is priority. The unconscious is powerful and prioritizes pain reduction above all else, reality and self-awareness being secondary. Its powerful weapons of anxiety and fear hone and direct behavior at the ignoring of the reality which is obvious to others.

An organized sense of self, sense of who one is, which originates with the childhood experience of a "good-enough" parenting, is needed to experience time passing and wasted years. Like the addict whose world has become reduced to gaining their next "fix" or those surviving a mortal illness, the sensing of time has become absent. Only with greater health can they rejoin the universal human quest for individual fulfillment.

The destructive power of loneliness has long been recognized. Lengthy solitary confinement, even when needed to insure the safety of others, has been condemned as torture, and it is not unknown for a spouse to die soon after the death of their beloved. Humans are social beings and suffer when isolated. While a newborn could not survive on their own an adult can for they have other capacities: imagination can transform a solitary existence into a happier time and productive work can grant life meaning.

Coping with the memory of past mistakes is painful too. Forgiveness may be divine but is not easy, and more so when one is socially isolated. A recent article in The Wall Street Journal described the murder suicide of a Connecticut technology executive who, after a lengthy marriage which ended in divorce, lived with his mother. Suffering from substance abuse and mental health problems he found a friend in his Artificial Intelligence companion who exuded sympathetic and reassured his views, feeling less isolated as he became more delusional. While suicide has complex roots and, as has been said, is a permanent solution to a temporary problem, murder/suicide reflects both anger and unconsciously forcing the suicide that is believed deserved because of feelings of worthless, of being unworthy of life.

Relationships are not easy and their absence can devastate but allowing oneself to hope can reduce suffering since memories of survived pains and earlier joys do persist in the recesses of one's mind.

The greatest danger of poor psychotherapy is not its waste of time and money but rather that the process becomes distrusted by the patient. Conducting psychotherapy may be one of the most complex of jobs since it involves interaction between the conscious and unconscious minds of two people, this causing inevitable errors. The antidote for this is self-awareness by the therapist, their good training, and honesty. But no therapy is perfect, an eminent British psychoanalyst, Michael Balint, wrote long ago in a paper posthumously published by his wife, that having been treated by the most eminent British analysts he gained a little understanding of his life from each.
If a therapist is excessively narcissistic and the patient feels inadequate they may become tied to their therapist, unable to leave and gain more competent treatment. This is the greatest danger of inadequate treatment: that the patient henceforth avoids it, no longer trusting the process because of their earlier destructive experience. 

A long held tenet of psychosomatic medicine is that what cannot be spoken will be expressed through the body. Thus when anger or another emotion is suppressed, physical symptoms may develop: pain in parts of the body, anxiety symptoms such as fearing that one is about to faint, skin conditions, even eye symptoms (ocular migraine). This discomfort may develop when positive strivings which conflict with injunctions from early childhood parenting are felt. If healthy assertiveness was then condemned, confidence became eroded and the belief that one was worthy of love may fail to develop. The unconscious is powerful and one must respect its power.

A recent article in the Wall Street Journal described how some wealthy are seeking to create intellectually gifted children using genetic testing and gifted surrogates. Yet most such efforts are doomed to fail though the children of high IQ parents do tend to have a higher IQ.
The best psychological tests are those of intelligence, the individually administered Stanford-Binet and Wechsler Scales. Studies have long found that the correlation between the intelligence of parents and their children is among the highest of all behavioral correlations but it is not perfect being in the low 80s. And though intelligence tests are excellent instruments, the accuracy of their findings depends on the skill of the examiner and the emotional and psychological readiness of the child to perform at their best. Moreover, for intelligence to flourish requires that the child experience a "good enough" though not perfect parenting during their earliest years, which can be problematic. Perhaps these parents would do better concentrating on parenting skills rather than biology. 

The popular concept of Neurodiversity is as fallacious as that of Attention Deficit Hyperactivity Disorder which symptoms reflect the anxiety and depression that are present in nearly all medical and psychological concerns. The basis for considering various social symptoms as Neurodiverse rather than psychological is the disfavor which many have for considering their children to possess mental health difficulties. One mother said she would prefer her child to have a brain tumor since this could be cut out!

The notion of neurodiversity tends to be affixed to the common symptoms of autism and Asperger's Disorder, which are among the most socially debilitating of all psychological disorders. The social limitations of these youth derive from their lack of awareness of and experience with such basic human characteristics as trust, sharing and gaining warmth from others, and love. To heal these deficiencies the appropriate psychotherapeutic and social experiences must be provided.

Far greater improvement can be expected when these critical limitations are considered psychological and the result of inadequate childhood parenting experiences rather than neurological and fixed.

Long ago a psychiatrist friend made an important statement: that the unconscious is powerful and one must respect its power. Yet, because of this power, one is often unaware of its influence over poor decisions involving relationships, jobs, and life itself. To defend against the power of the unconscious, as the impulse to engage in a particular behavior at that moment, resist the urge! While not making a decision is also a decision, avoiding poor ones should be the goal. Thus, think rather than act. Road rage behavior is a common example of destructive impulsivity as is suicide of which a well-worn statement is that it reflects a permanent solution to a temporary situation.
Deciding on the choice of therapist is more complex since virtually all therapists are friendly but therapy is a a business relationship and not a friendship. If, over a period of time, one has not gained greater insight into one's behavior and greater enjoyment in life the choice of therapist should be questioned. Which is not to say that change through therapy is rapid or painless but its goal IS change: to gain greater control over the unconscious forces affecting one's life and, ultimately, greater enjoyment.

The Netflix documentary "The Program: Cons, Cults, and Kidnapping," is important and riveting viewing. It describes the so-called residential therapeutic residential school industry run with unlicensed teachers and so-called therapists, using behavior modification techniques resembling concentration camp demands and frequently resulting in complex Post-traumatic Stress Disorder with many suicides and addiction problems resulting. That federal legislation to outlaw this child abuse has not yet been passed is more than troubling. Watch it.

The popularity of these destructive institutions derive from several factors: the widespread lack of knowledge of child psychological development among parents and their desperation to find a solution for their pain. Parents sending their children to these institutions are not evil or incompetent but have been lulled by sophisticated marketing. Moreover, there has long been belief in the usefulness of behavior, modification techniques with children and others, which is false.

Behavior modification, the punishment of undesired behavior and the reward of desired behaviors, works with dogs, but not cats, with people of very low levels of intelligence since it so simplifies their environment that they know what to do, and for those in such institutions as prisons where there is tight control over inmates. Which is exactly what the facilities described in the Netflix documentary have been, though not even in prisons would they be tolerated once becoming public.There is no substitute for knowledge.