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

Is Adult ADHD a Childhood-Based Hypersensitivity to Impending Anxiety, a Paralyzing Fear of Fear?

There may be no more unsophisticated, longer-lasting diagnosis than ADHD which was described two-hundred-years ago as "mental restlessness, later as Minimal Brain Dysfunction (MBD), and most recently as Attention Deficit Hyperactivity Disorder (ADHD). This, despite its diagnostic symptoms of anxiety, depression, and concentration difficulty being present in nearly all serious medical and psychological disorders.

Unsurprisingly, adult ADHD has now  become a popular diagnosis, often resulting in treatment with a stimulant medication having potential side effects of seizure, stroke, abnormal heartbeat, mood changes, and more.

But concentration difficulty that has existed since childhood may also reflect a paralyzing fear of fear, a heightened sensitivity to anxiety against which normal ego defense mechanisms had never developed due to the early faulty interaction between parent and child. During thoughtful work, an individual is experiencing their sense of self, an ego capacity that can be deficient due to childhood deficits.


Relieving this deficit's crippling effect in an adult, in the absence of lengthy individual psychotherapy to replace their deficient ego capacities with more mature ones, may possibly be gained with the same technique which is used for battling many fears: by providing psychodynamic understanding, and engaging in the feared activity under a controlled circumstance.


Thus, one who has difficulty concentrating should practice concentrated work for a short time each day. As the fear of impending anxiety is reduced, their ability to concentrate may improve. Being cost-free and lacking dangerous side-effects, this technique is certainly worth a try.

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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.




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

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Becoming a New Parent and Then Changing Again

Becoming a parent involves not only bearing a child but adopting a new identity, an expected identity, and new behavior. If soon after birth one asked a mother or a father if they felt like a parent they would say "no," and likely give the same answer several months later since they had not yet fully incorporated parenting into their self-image and range of behavior. The young parent must battle to safeguard an area of "self" against the demands of their baby-intruder.

Then, years later, the opposite happens when the parent must re-discover and re-mold their sense of who they are when their child leaves the home, depriving them of the caretaking role.

Slowly, throughout life, multiple behaviors and new functions are added to the expanding sense of who one is: the being as sexual, the being as worker, and the being as parent, all intertwined, similar to how the biological body metabolizes food to make it usable before incorporating its nutrition within itself.

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The Healthy Benefits of Painful PTSD Symptoms

The pandemic has brought Post-traumatic Stress Disorder to the attention of many for its upset is considerable: distressing thoughts and nightmares; recollections of the traumatic event(s) which may include reliving them through illusions and dissociative flashbacks; avoiding conversations about the event(s) or places where they occurred; marked symptoms of anxiety causing problems with sleep, concentration, and functioning on the job.


Yet though painful, these symptoms are intended by the mind to be helpful for they serve two critical functions: forcing into consciousness the fact that the person's tolerance for stress has been exceeded and change must be made, and reflecting its healthy, normal attempt to re-integrate--to repair itself--from the damage of intolerable stress. The unconscious is very powerful, and one must respect its power.

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Confronting Adolescent Evil

The recent attacks by bicycle riding teenagers on two cars in mid-town Manhattan, a taxi driver (causing him thousands of dollars in damage) and another containing a terrorized family, were shocking but unsurprising during these days when society's expectation of personal responsibility has diminished. Yet even more surprising was mere official call for "consequences," and a victim's hope that the perpetrators aren't jailed.


The psychological capacities enabling a person to distinguish reality from fantasy, modulate mood, develop a secure identity or "sense of self," and to control their behavior and thinking develop within the first three years of life. For their healthy growth a "good-enough" parenting is required which some lack, this reducing their likelihood of successfully achieving adolescent goals (to provisionally separate from parents; to construct realistic educational and vocational goals; to explore intimacy through dating). This failure produces frustration and anger and, in some youth, acting-out behavior though only rarely like these teenagers which, according to local shopkeepers, was not their first outrage.


As has long been known, exemplary adults can arise from the most impoverished families since it is parenting that counts. The famed, recently deceased, Black economist, Walter E, Williams, credited his achievements to having had a demanding mother and teachers "who didn't give a damn about my self-esteem." His mother must have taught him values too.

No matter how greatly distressed, destructive behavior should not be engaged in and cannot be tolerated. All, including parents who do their best, are the product of an imperfect childhood and will make mistakes though some are inexcusable.

A school's structure and rules enable psychologically damaged youth to function better, and society relies on the police and law to do this in the larger society. Yet regardless of personal inadequacies, evil cannot be tolerated and must be condemned and punished since no desirable society can exist which lacks this.

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Silicon Valley Discovers Hypnosis

An article in today's (December 29, 2020) issue of The Wall Street Journal told of Silicon Valley's recent financing of startups marketing hypnosis apps aroused by stress caused by the pandemic. Yet hypnosis is a long accepted psychological technique for alleviating the distress of many conditions including cancer, burns, high blood pressure, headaches, and childbirth. It is taught to asthmatic children since the less stress they experience the less likely they are to have an asthma attack.


Basically, hypnosis is "selective attention" with researchers having varied between considering it a learned reaction to those believing it a entirely different physiological state. I have long believed the latter based on personal experience, that of feeling a "drop" at some point and being reluctant to "wake-up."

About ninety-percent of the population can use hypnosis to reduce stress, with ten-percent of these being such good subjects that major surgery can be performed while in the hypnotic state. Ten-percent of the population can't be hypnotized. A quick test of hypnotic suggestibility is asking whether the subject lost themselves in reading as a child, they usually being good hypnotic subjects. Using hypnosis to lose weight or stop smoking depends on motivation and rapid change should not be expected. Those who accomplished this were extraordinarily well-motivated.

Several warnngs: (1) do not become a subject for a hypnosis event in a club or while on a cruise ship. While often skillful practitioners, there have been cases in which not all of their suggestions were eliminated with the subject winding up in an Emergency Room weeks later complaining of weird symptoms that no one can figure out; (2) do not use hypnosis while wearing contact lenses; (3) do not use listen to a hypnosis audio while driving (this may seem obvious, but...).


With these cautions, hypnosis is eminently safe though best learned with professional guidance (the American Society of Clinical Hypnosis can be contacted for a local practitioner).

On a personal note, decades ago a nurse who took the blood pressure of clinic workers advised that mine was high. A physician who I had known since my teenage years agreed, saying that if it stayed that way I could take medication, which I was adamant against. Taking my blood pressure frequently would more likely yield accurate readings, he added (having abnormally readings during a stressful doctor's visit is well known).

I followed his advice, also frequently using using a self-hypnotic relaxation audio that I made from the research protocol in a journal article relating the use of hypnosis to stress reduction and the development of cancer. After two months, my blood pressure readings became optimal and have remained so.


By graphing these readings I found that my systolic reading (higher number, the force of blood against the artery walls) correlated with my pulse rate while my diastolic reading (lower number, the heart's resting rate or blood pressure between heartbeats) was independent of both. With digital blood pressure monitors being cheap, it would be well for all to monitor their blood pressure at home.

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Autism and Creativity


An English researcher and author of The Pattern Seekers: How Autism Drives Human Invention, Dr. Baron-Cohen, has found an association between autism and the capacity for hyper-systematizing, the ability to see patterns where others cannot, which is important in creative invention. Yet it is important to keep in mind that these individuals are but a tiny minority of autistic sufferers, that autism is vastly mis-diagnosed and of a wide range and, when severe, is perhaps the most disabling of all the mental health conditions and the most resistant to healing since it originates very early in life.

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Advice to Writers From Somerset Maugham

"The writer should seek his reward in the pleasure of his work and in release from the burden of his thought; and, indifferent to aught else, care nothing for praise or censure, failure or success." - From The Moon and Sixpense

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The Promise and Peril of Silicon Valley Medicine

The COVID-19 crisis has fast-tracked change in the delivery of health services though diagnosis and treatment recommendations via audio-video have existed in a more primitive fashion for decades. It is thus unsurprising that start-ups are bolstering their product with the promise of near instant service. Have a headache/backache/sinus problem/fever? they ask. There's no need to worry! For a small sum per month you can consult a doctor as often and whenever you wish, change doctors at your whim, all being top notch! Yeah…


My objection is not that these services are delivered via audio-video since the accessing of health services without travel is a welcome development. But will these companies meet their vow with sufficient quality staff? How many doctors will sit before their computer on a 24/7 basis, and how low must their wages be to assure the company a healthy profit?


The rudiments of this service have long been provided by health insurers using nurses and telephones. Can the only thing that these startups are adding is killer advertising? Hmm…now that would be a cynical judgment.


Moreover, the major public health crises derive from habits. The choices of poor diet, alcohol and substance abuse, and unhealthy lifestyle are not easily changed without lengthy contact with one clinician. But we must be modern, mustn't we?

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The Unacknowledged Benefits of Delusional Thinking

A middle-aged woman told her physician, "I've never had a chronic illness and don't think I can develop one." "That's a good delusion. Keep it," the doctor replied. Yet delusions have a bad history, being associated in many minds with horrific scenes from countless horror movies. But delusional thinking can have benefits too.

A person whose life has been a succession of personal disasters from psychiatric hospitalizations to painful injury to poverty develops the delusion that the FBI is watching them. Similarly, a soldier on the battlefield, close by comrades who are being killed, tells themself they will survive. In the first example, the delusion may protect the person from suicide, since if the FBI is watching them, they must be of great importance and is thus worthy of respect. A soldier's delusion of certain longevity keeps them fighting and increases their and their comrades' probability of survival.

Yet delusional thinking is, of course, generally destructive since only through reality-based thinking can the problems of living be resolved. The anxious depression that accompanies delusional thinking is proper since this type of thinking reduces situational adaptability and thus increases personal peril.

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