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

The Unspoken "Elephant in the Room" Afflicting American Society

If all parents read first to and then with their toddlers, almost all children would be reading simple books by kindergarten. And, apart from emergency situations, their parents never said to them, "Do it because I say so," but rather gave explanation,  their adult functioning would be better too since the former depresses the development of the capacity for abstract thinking as psychologists have long known. The lack of a "good-enough" parenting is the unspoken, politically incorrect, "Elephant in the Room," that explains most inadequate academic and work performance.

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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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On Dreaming

An article in the March 22, 2023 issue of The Wall Street Journal ("Choose What to Dream Tonight") suggests that a person can guide their dreams but I'm not so sure. The unconscious is powerful and, despite all the electronic gadgets used in brain research, one must respect its power. Elements in dreams arise from recent events like a movie viewed or long ago memories. If, before falling asleep, you tell yourself you will have a dream and remember it (as I advise patients to do) you'll be more likely to but this isn't certain since mental operations are complex. If you don't write the dream down upon awakening you likely won't remember it later since the conscious logical part of the mind largely takes over mental functioning then from the unconscious illogical part that creates dreams. Nightmares, which are very emotionally charged dreams, are remembered longer and common. Those unreceptive to dealing with their unconscious conflicts will tend not to remember their dreams, and dream remembrance seems also affected by some medications.

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Admission Into Selective High Schools (And My Thanks To Madonna)

A March 11, 2023 article in The Wall Street Journal ("Parents Challenge Lottery Systems Used to Diversify Elite High Schools") aroused reader comment, virtually all opposing the ending of admission testing and underlying premise that all are equally talented. As one reader humorously wrote, "Ya know that NBA team is over represented by talented and tall men. We need to achieve equity so hence forth we open the NBA to tryouts by lottery."
The reality is that student achievement derives both from innate ability and having experienced a "good-enough" early life parenting during which psychodynamics develop and the basic ego capacities form including control of thinking and behavior, modulation of mood, and others. Poor parenting is the ever-present "Elephant in the Room" that politicians fear to confront, preferring to raise the false hot-button argument of "discrimination.".

Having attended a test-selective high school I don't believe that I learned more than I could at most high schools except that here there were no fights or other disturbances, no bullying, and few parties (to which I was never invited). Nor do I remember there being any school athletic teams. It's almost embarrassing to see how many leaders of industry and founders of startups will be celebrated at the school's upcoming anniversary celebration to which I received an invitation. And no, I'm not one of them.

To elaborate on my high school failings, I share the following. There was a boy in my grade that I envied since he seemed to have it all: preppy dress, many friends, even a girl-friend. As he once approached me, I fantasized he wanted to be my friend and that, through him, I would become popular too and maybe even get a girl-friend. This was not to be. He asked to borrow money which I lent him. He didn't pay me back and never spoke to me again. I felt humiliated, developed the deep hatred that an insulted teenager can, and his name (Eric) is the only student's name that I remembered. Decades later I read in the school newsletter that he died and compared my life to his. He too gained a doctorate though in a different field and I wrote more books that him. I also achieved something that he likely never did. Once, while driven in a limousine to a TV interview, the driver stopped at a red light, turned to me and said, "The last person who sat where you're sitting was Madonna." Eric, you bastard, I beat you, I childishly thought. Thank you, Madonna!


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Let All Praise The School Nurse

School can be distressful time for students caused by social discrimination or bullying or when family-based issues overwhelm. Then the normal symptoms of anxiety may arise: feeling restless or tense and impending doom; breathing rapidly (hyperventilating); sweating or trembling; feeling tired or weak; headache or stomach distress. All being quickly remedied in the school nurse's office who, in addition to her medical skills and counseling ability, offers juice and respite from stress. Thus, let all praise the school nurse, whose critical role is too-little appreciated despite she being a student's first line of defense when their parent isn't available.

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How I Learned To Be An Effective Manager

A March 3, 2023 article in The Wall Street Journal ("Late to Work? Thank the Transit Union - A labor group in New York blocks a common-sense schedule update") aroused memories. Long ago I was hired as a hospital administrator at a huge, greatly troubled medical center facing bankruptcy which the federal government pressured to change. To say that I was unprepared for this task would be an understatement since I had no managerial experience and the city was historically corrupt. I joked that the local daily newspaper was read to see which of one's friends had been indicted. But I was unemployed and had unexpectedly been offered the post, likely because I wrote a book and had good credentials.

I tried my best, wanting to be a modern enlightened manager, speaking to the union representative in this light and intending for us to work together to improve things. Though congenial, he had none of it. For his workers, the hospital was a great job, they gossiping with each other and doing little else all the working day. Abandoning my warm friendly demeanor, I became a tight-lipped hardass and the setting became professional as I instituted needed education and procedures. I also began getting neck pain by the end of each day, interpreting this well-known symptom of stress as my employees giving me a pain in the neck.

Incidentally, I have no present animus toward unions, having been a member of both the Teamsters and the IBEW (International Brotherhood of Electrical Workers), and learning of many incompetent managers and unneeded worker suffering through mine and my patients' experiences.

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