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

The Psychiatric Hospitalized Adolescent

The adolescent whose acting-out behavior requires treatment in a psychiatric hospital suffers from psychological damage that occurred during their second and third year of life, the normal infant-mother symbiosis and separation having failed to occur and they not developing a secure "sense of self," sense of who they are, and  "soothing introject," ability to self-sooth themselves.

Earlier life problems and symptoms now become exacerbated from distress at their inability to cope with basic adolescent goals: separation from parents; exploring intimacy through dating; and the creation of realistic educational and vocational goals.

Revolving-door/short-term treatment cannot aid such youth who require a secure therapeutic environment within which their defective ego capacities can redevelop sufficiently for them to function in the adult world they will soon enter. For the more disturbed youth, residential treatment is needed; others can accomplish the needed psychological changes through individual psychodynamic out-patient psychotherapy.

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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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Why Psychiatric Diagnoses Are Often Worthless

Frequently after a horrifying multiple murder surfaces, news of the criminal's prior psychiatric diagnoses follows: that he had been diagnosed as "psychotic" or suffering from OCD (Obsessive-Compulsive Disorder") or ADHD (Attention Deficit Hyperactivity Disorder) or another. Yet the treatment that followed each diagnosis was unsuccessful and the critical question remains: why?
Despite the complexity of human behavior this answer is simple: because naming a condition according to current diagnostic nomenclature (ICD-10), which is required for insurance payment, has taken the place of understanding the person for which study of their childhood is essential but usually absent.
To explain a person's behavior one must know the state of their ego capacities, which develop before the age of four- years, since these govern the ability to control thinking and behavior, to modulate mood, to distinguish reality from fantasy, and others, all comprising the Executive Function. But for decades, the false reductionist pseudo-neurological/chemical notion of what governs human psychology, as the existence of a "chemical imbalance" best treated with medication haa been followed, with only recent increased criticism of this spurious notion. As the crimes and suffering continue.

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The Benefit and Danger of Holding An Inaccurate Self-Image

While it is often believed that holding an incorrect concept of who one is (what psychologists term a "sense of self") is harmful, this is not always true. Being common with emotional disorders, these sufferers do benefit for it grants them hope and protection from deep suicidal despair. Moreover, the fantasy may indicate an embryonic talent which could lead to significant achievement after their healing through treatment. Yet while comforting, holding an unrealistic fantasy with no hope of success can lead to greater despair.

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Reducing the Terror of Psychological Symptoms and Length of Treatment

The treatment of a psychological disorder is often long. Yet to paraphrase Freud's comment of a hundred years ago, it would be nice to have a rapid cure for severe medical problems too. But the problems of living do differ. A traumatic event troubling a previously healthy person may require only one to two months of therapy but not those reflecting a lifetime of distress.


For these sufferers it is important to intermittently relate their current (adult) symptoms to the early developmental experiences which produced them, as can result when one lacked a "good enough" parenting. This enables the patient to understand their life, why they repeat their mistakes. It also reduces their fear from believing that anxiety and depression are magical and may invade their consciousness at any time. All symptoms have a logical reason for existing. Learning their unconscious cause reduces the terror they inspire and gives hope.

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Treating the Diagnostically Hopeless Psychiatric Patient

To successfully treat those with severer mental health disorders, the therapist must take little for granted, ignoring accepted beliefs about prognosis and motivation  since clinician prejudice can arouse unjustified feelings of defeatism and hopelessness.


Each person is unique with another being unable to know their experience fully and the depth of their suffering. The sicker patient knows much about themself but, from guilt or fear of acting-out impulsively, is afraid to allow themselves to feel what they know. Nor because of their low self-esteem do they value this knowledge. So they retreat from what is most useful: to feel what they know.


Thus when a patient refers to the presumed hopelessness of the diagnoses they had formerly been told, they should be reminded that they are a complex human being and not a simple diagnostic classification.

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Assisted Suicide For the Intractably Mentally Ill: The Persisting Notion of Incurability in Mental Illness

Considering the widespread public and clinician ignorance about psychological development it is unsurprising that Canadian legislation is being considered to assist suicide of the "unbearably suffering mentally ill." While death is inevitable for all and none would wish to prolong pain, I suggest that this proposal reflects both the universal fear of insanity and the reluctance to accept that treatment competence affects healing.


The fear of insanity has a central organizing role in living since what is termed the Executive Function controls behavior, what is considered human. To sense its importance, try to consider how your life would change were you to believe yourself sliding toward psychosis. Many widespread fears, as that of flying or elevators, owe their power to this underlying fear which is usually repressed and thus unavailable for conscious awareness.


While a doctor's skill is considered crucial in the treatment of biological illnesses, this tends not to be the case with psychological disorders though education and talent should logically be considered critical factors in the healing of both. This disparity derives from the widespread ignorance of public and clinicians of the effect of stresses on normal psychological development, this enabling the attractive notion that significant life issues can be quickly resolved using drugs or gadgets. There are now being marketed do-it-yourself, brain-wave machines which purportedly eliminate depression and anxiety. Where little is understood, everything is deemed possible and particularly among those who treat feelings as facts.


To quote F. Scott Fitzgerald in his final line of The Great Gatsby, "So we beat on, boats against the current, borne back ceaselessly into the past." Our sorry past of lobotomies and shock treatments which have destroyed so many lives.

 

https://nationalpost.com/news/politics/government-agrees-mentally-ill-should-have-access-to-maid-in-two-years

 

More about Canada's assisted suicide law for the mentally ill

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Swamped by the Worried Well in the Emergency Room

Emergency Room workers are being swamped by medically healthy people who are frantically seeking testing for coronavirus. Though the present national period time is exceptional, their behavior is no different from anytime when anxiety escalates and panic overwhelms.


Anxiety is the normal, healthy experience when the mind senses danger. It can produce symptoms that mimic virtually any medical disorder: pain in the head or back; nausea or dry mouth; scarily heightened blood pressure; skin eruption; lack of appetite. All instantly vanishing when the fear that aroused them disappears. During normal times, forty to sixty percent of the people arriving at an Emergency Room who fear that they're having a heart attack are really suffering a Panic Disorder. This is the condition when the normal symptoms of anxiety are misinterpreted as a deadly medical event.


More public education about the human mind is sorely needed.

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Is Your Child Autistic Like a World Renowned Physicist Was "Schizophrenic"?

Newspaper and other reports often indicate high rates of autism among children. One, in South Korea, asserted a huge rate of one in thirty-eight, it also including some "highly functioning children."
These provoke understandable alarm for autism is probably the most devastating of all the mental health disorders. It cripples childhood and later adult  Read More 
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The Cause of Mental Health Difficulties

Today, professions battle to be considered relevant in the public financing landscape.Thus, schools seek fancy technology for their problematic students and clinics promulgate quickie solutions and electrical gadgets that a witch doctor would admire. Sadly, these ignore The Elephant In The Room: that the mind is complex, the unconscious is powerful, and good  Read More 
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