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

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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