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

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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Screen Time and Child Development

An article in the February 25, 2023 of The Wall Street Journal ("Why I'm Not Writing About Kids and Screen Time Anymore - The next phase of research on screen use will focus on family dynamics") referred to a Harvard study which found no relationship between a child's screen time and their language development.

There is widespread ignorance of child psychological development among the public and doctors too. The human mind has an innate ability to induct the grammatical structure of language which is why a child born in Germany comes to speak German and a child born in France comes to speak French. Similarly, if first read to and then with by their parent(s) as a toddler, almost all children will induct the nature of reading and be able to read simple books by kindergarten. Unfortunately, this sound parenting practice isn't universal. Another critical parenting behavior is, apart from a true emergency situation, to never say "Do it because I say so" to a child but rather to explain parental requests since the former depresses the development of the capacity for abstract thinking as psychologists have known since the 1960s.

Regarding "screen time": this obsessive-compulsive activity (an obsession is a continually repeated thought while a compulsion is a continually repeated physical activity) is often an attempt by both youth and adults to reduce their anxiety, the mind's obsessive-compulsive ego defense being one of its most effective and developmentally mature ways of doing so. Nuff said.

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A Nonsense Mental Health Diagnosis That Many Believe In

A February 25, 2023 article in The Wall Street Journal ("Administration Moves to Put Limits On Some Telehealth Drug Prescriptions") describes new government restrictions to rein in the COVID regulations permitting the online prescription of controlled substances including Adderall which is widely dispensed for the so-called Attention Deficit Hyperactivity Disorder or ADHD. ADHD is a popularly believed though unsophisticated notion with symptoms identical to anxiety and depression which are present in almost all medical and psychological disorders. It has a 200-year-old history from 18th century England onwards ("mental restlessness") to the Minimal Brain Dysfunction (MBD) of early 1900s America (of which a Harvard psychiatrist then remarked that only a doctor suffering from a minimal brain dysfunction would use this diagnosis), to its latest ADHD incarnation. Widespread ignorance of child psychological development and developmental psychopathology maintain belief in such nonsensical notions and treatments, fostered of course by businesses that profitably hustle these wares.

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The Recent Frightening Teeange Suicide Statistics

A February 18, 2023 article in The Wall Street Journal ("Teens' Mental-Health Distress Could Be Worse Than CDC Data Suggest") describes an alleged crisis. I tend to be leery of alarming statistics and particularly about suicide. As a psychologist who has treated children and teenagers for decades, my experience is that true suicidal ideation, having all the required diagnostic symptoms of suicidal plan, intent, means, and inadequate self-control, is rare. Searching for such individuals is, as has long been stated, like searching for a needle in a haystack. I remember only two youth that I've referred for hospitalization. While all such instances should be professionally evaluated, many youth are inappropriately hospitalized causing harmful development consequences.

With regard to the effect of the COVID emergency on youth academics: some survived it without difficulty, doing as well as they usually did; others missed their friends but also did as usual except for math which seems of particular difficulty when taught online; and others did poorly, particularly those for whom sports are important. Certainly not an enviable situation but... The COVID situation seemed regarded by youth with equanimity, being typical of the adults' craziness they must endure and, when grown-up, will remedy.

The important of "good-enough" parenting, from infancy and toddlerhood onward but particularly then, is critical to healthy psychological development. Sophisticated knowledge of child psychological development is widely lacking among doctors, the public, and school systems resulting in student misery and inadequate academic achievement.

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Reducing Crime By Battling The Unconscious

After recent horrendous murders (the Massachusetts mother who killed her three children; the killing and multiple injuries by a psychotic van driver in New York City; several mass shootings) one would hope there would be wider belief in the power of the unconscious but this is not so. Instead, legislators restrict the power of judges to jail dangerous offenders, allowing them to prey until they kill when their danger is finally taken seriously.
I long thought that the best way to increase public safety would be to increase the prevailing psychological knowledge by providing indisputable facts which psychologists have long known. These include that the development of the ego capacities enabling control of thinking and behavior, control of mood, and development of a sense of who one is (one's "sense of self"), occurs in the first three years of life, dependent on a child having experienced a "good-enough" parenting. And that substance abuse nearly always begins in a teenager who fails at mastering the critical adolescent tasks of development (separation from parents; making realistic education and career decisions; dating) and tries to feel better by self-medicating their distress with alcohol or drugs.
Would wider knowledge of these facts really reduce crime? Ultimately, if healthier childhood experiences prevail, and better evaluation was used to distinguish those criminal offenders who must be incarcerated to protect society from those who are needlessly jailed.

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Children and Reading

Children have the genetically ingrained capacity to induct the grammar of their native language. Thus does a child born in Germany naturally learn to speak German and a child born in Italy naturally learn to speak Italian. This has been known by psychologists for many years. Similarly, the brain has the ingrained capacity to induct the nature of reading, but only if the child is first read to and then with by a parent when they are a toddler. Given this interaction, most children will be reading simple books by the time they begin kindergarten. While the public education system is generally poor at teaching children with difficulties, attempting to paper-over their inadequacies with trumpeted pronouncements, teachers cannot be expected to take the place of children who have failed to receive the "good-enough" parenting that is the birthright of all children. Thus many children are unable to read and unready to learn, or even cognizant of basic courtesy as teachers complain. Nuff said.

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Can AI (Artificial Intelligence) Produce Truly Creative Works?

A February 4, 2023 article in The Wall Street Journal ("AI Tech Enables Industrial-Scale Intellectual-Property Theft, Say Critics") bemoaned the effect of artificial intelligence software on the production of creative works, some believing it would be its death and certainly reduce the financial livelihood of creators. I am less pessimistic, being unable to conceive of software that is capable of truly mimicing a human mind. Literature derives from the unconscious part of the mind which, after mysteriously opening, closes when the creative work is completed. I now lack motivation to write the fiction and non-fiction books that I wrote or even can conceive how I did. Moreover, artists have always had a difficult financial time. H. Somerset Maugham, one of the most commercially successful writers of his time, wrote "...the successful books are but the successes of a season...the writer should seek his reward in the pleasure of his work and to release from the burden of his thought; and, indifferent to aught else, care nothing for praise or censure, failure or success." Sage advice from a master of the craft. As I advise teenagers who wish a creative career: first figure how you'll support yourself, then try it part-time before deciding.

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