children


I knew that you loved me since I knew what love was. You always took great care of me, showed interest, were available, warm, firm and encouraging. And I could tell that you were great parents as soon as I got to the age that my peers started complaining about their parents. I rarely had anything to add to those conversations. I loved you and respected you too, but I was of course ignorant of just how lopsided our relationship was.

Two months ago,  when Margo was born, this deep, strong glow of love and devotion gripped me, and I thought, “Oh my God, Mom and Dad felt like this about me!” It’s been a major shock to and reorganization of my emotional system, that all this time you have had this in your hearts for me. It’s been on my mind during every interaction with you since then.

It’s a sad, almost tragic, part of human life that children have to be ignorant of the intensity of their parent’s love. I suppose it might be too much to bear for us as children, especially if it came along with the knowledge of how much it takes to provide that safe and safe-feeling life. But we stay ignorant into adulthood until we have children of our own, long after we could handle that knowledge, long after we need it, really, to understand who we are and where we come from.

So almost forty-five years of ignorance precedes this letter.  Sorry about that! But mostly, thank you. I learned how to love from you, since the day I was born. Thanks for how deeply and effortlessly I love my daughter!

Nathen

Fam of 3

Dad, Mom & me, 1971. Photo by Stan Zarakov

FullSizeRender (12)

Me & Margo, 2016. Photo by Reanna Alder

I read Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America as a counterpoint assignment in one of the diagnosis classes in my Couples & Family Therapy program. It was an excellent book about the history and science of several psychological problems, both as phenomena and diagnoses, including depression, depression, bipolar disorder, ADHD, and schizophrenia. As a university student, I had the opportunity to check out for free any of the many academic citations in the book that piqued my interest, and each one that I looked at seemed indeed to provide the evidence he claimed. I haven’t read anything like all of them (there are nearly 700), but enough to satisfy myself that Whitaker has done some good journalism here, and that his hypotheses are credible.

Two of these hypotheses is about childhood bipolar disorder, the first of which he calls the “ADHD to bipolar pathway.” The side effects of stimulants such as those used to treat ADHD are substantially similar to bipolar symptoms, as shown in the table below, from p. 238. (The formatting is slightly different than Whitaker’s, thanks to an Open Office/Wordpress interaction.) Multiplying the estimated rate of stimulant-induced bipolar-like symptoms by the 3,500,000 children and teens taking those medications, Whitaker estimates we should see approximately 400,000 “bipolar youth” as a result.

The ADHD to Bipolar Pathway

Stimulant-Induced Symptoms

Bipolar Symptoms

Arousal

Dysphoric

Arousal

Dysphoric

Increased lethargy

Intensified focus

Hyperalertness

Euphoria

Agitation, anxiety

Insomnia

Irritability

Hostility

Hypomania

Mania

Psychosis

Somnolence

Fatigue, lethargy

Social withdrawal, isolation

Decreased spontaneity

Reduced curiosity

Constriction of affect

Depression

Emotional lability

Increased energy

Intensified goal-directed activity

Decreased need for sleep

Severe mood change

Irritability

Agitation

Destructive outbursts

Increased talking

Hypomania

Mania

Sad mood

Loss of energy

Loss of interest in activities

Social isolation

Poor communication

Feelings of worthlessness

Unexplained crying

The second part of Whitaker’s thinking on childhood bipolar disorder is an SSRI to bipolar pathway. Estimates of the rate of the well-know SSRI side effect of mania, multiplied by 2,000,000 children and adolescents on the medications, give us the possibility of producing at least 500,000 SSRI-induced bipolar disorders in young people.

If true, these hypotheses could go a long way to explain the skyrocketing rates of childhood bipolar disorder diagnoses, as most diagnoses of childhood bipolar disorder are made on children who are already taking stimulants and/or SSRIs. The primary alternative, and more mainstream, hypothesis is not that stimulants and SSRIs are iatrogenic, but that since those medications solve the problems of ADHD and depression, the symptoms of bipolar disorder that emerge show that the diagnostician had initially guessed wrong, and that bipolar disorder was the previously-existing and underlying cause of the ADHD and/or depression. This, of course, may be true, but it seems very important to discover for certain whether it is!

Dandy Treeclimbing, Camp Latgawa

Serena

Session 1 Advisee Group

Christian, Jeannie, Ia'ala, Yared, John

Community Meeting, Session 2

Angry Mob Takes Blake to the Swimming Hole

Christian, Reanna, My Knees

Reanna, Ia'ala

Reanna, Nathen, Camp Myrtlewood

In his lecture “Fixing Broken Government” for the Long Now Foundation, Philip K. Howard suggests that this time of trouble in the US might be one in which we can make some big, useful changes. He hopes for a change in “governmental operating system” comparable to the Progressive, New Deal, and Civil Rights eras. Instead of protecting children and other workers, establishing safety nets, or addressing civil rights abuses, however, he would like to un-paralyze our government.

Based on the idea that laws have “piled up like sediment in the harbor,” paralyzing our public servants, and on his truism, “Only real people, not rules, make things happen,” Howard proposes three new principles for modern government:

1) A spring-cleaning on all law with budgetary implications. A law does not become one of the 10 Commandments because some dead people passed it. He also proposes an “Omnibus Sunset Law” under which all laws with budgetary implications automatically expire after 10-20 years.

2) Laws should be radically simplified. Replace 95% of the 100,000,000 words of binding federal law, all the details, with individual responsibility. Allow public servants to use their judgment. Laws are to set goals, general principles, and allocate budgets and to determine who is responsible if the goals are not met.

3) Public employees have to be accountable. There is no need for minutia in law if people are held accountable if they do a bad job. That means they have to be fire-able.

On playgrounds:

“There is nothing left in playgrounds for a kid over the age of 4. Nothing. Seesaws, jungle-gyms, climbing ropes…merry-go-rounds are abandoned. There are a few diving boards left, but not many. Not very many high boards. Why’s that? Because they all involve not just the risk, but the certainty that something might go wrong. They also happen to attract kids to the playground so they don’t get fat and die of obesity. They also happen to teach kids how to take responsibility for themselves, and to be athletic. These risks are vital for  for child development, which the American Academy of Pediatrics and all kinds of other boring people would write books about, but we don’t have a legal system that allows kids to take the ordinary risks of childhood. It’s lunacy. ….The range of exploration of a 9-year-old in America has declined by over 90% since 1970. Kids are not allowed to leave home by themselves. And that ability to wander around the neighborhood, to explore the creek, all that sort of thing is absolutely vital.”

I go swimming most Friday evenings with my six-year-old friend, Akira. We started about a year and a half ago, calling it “swimming lessons.” Now we just call it “swimming.” It has been a joy to watch him learn to swim, just the way I think people should learn to swim: Having fun in the water, discovering new skills and games at whatever pace feels right. It took him almost exactly a year before he actually swam. He had slowly gotten comfortable putting his face in the water of the hot tub, and then found that when he did, he could lift his feet off of the bottom and float, which he started doing for 15-20 seconds at a time. Then one night he just started swimming, face down, slowly and relaxed, all the way across the hot tub. When he came up for a breath he was so excited. “Nathen! I don’t even have to swim! The water holds me up and all I have to do is pretend to swim!”

He is swimming three times a week now, and looks like a real natural–complete comfort in the water. You would never guess how nervous and circumspect he had been about water. He wouldn’t even blow bubbles for eight months–the bubbles popped uncomfortably close to his nose and eyes.

I am also getting to watch him grow up, which is mostly delightful. He is getting confident and funny–not surprising, since his parents are two of the funniest people I know.

Tonight, we were in the hot tub with another kid Akira’s age, and that kid started trying to make friends. “What’s your name?” “Can you do this?” Stuff like that. He seemed like a nice, friendly kid, and Akira was playing along. At a certain point the kid made an awkward move, standing too close and smiling too much. I realized later that he was going to try to lift Akira up out of the water a little, like he had seen me do. It created this awkward moment, though, and Akira said, “Weird.” The kid’s smile turned a little anxious, but he didn’t move away. Akira said “You’re weird. Get away from me.” The kid followed through with the lifting-up move, but instead of the original, playful feel, it ended up feeling aggressive, like, “This is what you get for calling me weird.”

I had an impulse to intervene, to stop the misunderstanding somehow. I had thought of this kid as a potential friend for Akira. I just didn’t think of anything to say besides, “Stop!” or “Don’t be mean.” Neither of those seemed right. The kid’s dad was there too, watching, and he didn’t say anything either. Akira started staying close to me, making a game of walking over my lap. I realized that he was nervous, that when he had said, “You’re weird,” he had been uncomfortable, a little scared.

Then it hit me what a powerful tool “You’re weird” is to a kid. Weird is the worst thing you can be at that age, the doorway to isolation and bullying. Being able to say “You’re weird” with enough poise shows where you stand in the hierarchy and rallies the troops of conformity to your aid. It is also a way to avoid vulnerability: A year ago, Akira would have just retreated, outwardly scared and confused. He would have whispered in my ear, “Can we go to the cold pool now?” Saying “you’re weird” was standing up for himself, a six-year old’s way of saying, “The way you are standing close to me is making me uncomfortable. Please stop doing that.”

So partly I was proud of him, and partly I was sad about the struggle he is entering into. It takes constant vigilance. Don’t be the weird one, the one who cries, the one who stands too close, the outcast, the one you can safely tease. Then, a few years later, don’t be the uncool one, the awkward one, the kid who gets beat up with impunity. Then, a few years later, don’t be the unhip one, who doesn’t quite know the right music in time, who has to pay close attention to stay on the tail-end of trends, the wannabe. For God’s sake, don’t let yourself be vulnerable! Every action must shout invulnerable and in control. And inside it’s, “Please believe me. He is the weird one. Not me. Him.”

I think conformity is a stage, unavoidable unless you are truly incapable of achieving it. I think it has to be negotiated by the kids, between the kids, for the most part. When Akira told me, “That kid is weird,” I said, “Well, I think he just wants to be friends,” but I couldn’t tell if it sunk in. And I don’t know how useful it would be if it did. Maybe the sooner he masters conformity, the sooner he can reject it and start exploring the joys and pain of vulnerability again.

One of the heads of my Couples & Family Therapy program, Jeff Todahl, is launching an exciting and inspiring campaign this coming Saturday. It’s called “90 by 30,” referring to his intention to reduce domestic violence and child maltreatment by 90% by the year 2030 in Eugene and Springfield.  He announced the launch at a domestic violence awareness event I helped put on with the University of Oregon Men’s Center last fall. [Here’s the video of his talk. It’s good.] As an expert on domestic violence and part of the Trauma Healing Project in Eugene, he has decided:

1) We know how to do it–all of the programs necessary have been invented and proven effective in various parts of the US.

2) It is feasible to bring all of those programs into one area and virtually eliminate domestic violence and child maltreatment here.

3) Doing so will be a huge step toward the elimination of domestic violence and child maltreatment nationally and globally.

4) The elimination of domestic violence and child maltreatment would shrink the 943-page Diagnostic and Statistical Manual of Mental Disorders to the size of a pamphlet. That is, it would mean a virtual elimination of mental health problems for humans.

If you are in Lane County and this sounds like an interesting project, join us for a panel presentation by Jeff and his collaborators February 5th, 2011, from 11am – 2pm at the University of Oregon. The event will be held in Room 220, HEDCO building, at 17th and Alder, Eugene, Oregon.

baby photo, reading

The author, circa 1974

As previously mentioned, Nathen enlisted some help to manage his publishing empire while he is at Not Back to School Camp. Until now, the help has been pushing the publish button on previously authored posts, but with Nathen out of internet range again, it’s time to post a gratuitously cute photo of him.

His mother says he’s two or three in this photo, and that “he’s never stopped reading since.”

Most parenting psychology literature talks about four parenting styles, derived from the combinations of two parenting qualities, warmth (also called “responsiveness”) and demandingness, like this:

Parenting Style Warmth Demandingness
Authoritative High High
Authoritarian Low High
Permissive High Low
Neglectful Low Low

Parents who are both warm and demanding (having high standards) are called “authoritative” and considered in psychology to be the best parents. Parents who are both not warm and have low standards are called “neglectful” and considered to be the worst parents. Authoritarian parents and permissive parents (also called “indulgent”) come out in the middle somewhere, the first lacking warmth, the second lacking standards.

The table of parenting styles below is from Rodriguez, Donovick, and Crowley’s 2009 article, “Parenting Styles in a Cultural Context: Observations of ‘Protective Parenting’ in First-Generation Latinos.” In their work with Latino parents, they decided to add a third category, autonomy granting, giving us four new parenting styles: protective, cold, affiliative, and a new kind of neglectful. I’m still thinking about this, but it seems like it could be a breakthrough in parenting theory.

It will be interesting to see if this idea is meaningful in terms of outcomes for the kids of these different kinds of parents. There is evidence, for example, that the kids of authoritarian parents have a lot more trouble with alcohol abuse than those of authoritative, and kids of permissive parents have even more trouble than that. Will there be a significant difference on this outcome between authoritarian and “cold” parents, who differ only in their giving their kids the chance to mess up or not? How about between permissive and “affiliative”?

Parenting Style Warmth Demandingness Autonomy Granting
Authoritative High High High
Authoritarian Low High Low
Permissive High Low High
Neglectful Low Low Low
Protective High High Low
Cold Low High High
Affiliative High Low Low
Neglectful II Low Low High

Family therapy got started when the grandparents of the field, interested in cybernetics–the science of self-regulating systems–started studying communication in families. Some of the more interesting ideas they came up with were the three progressively more problematic kinds of contradiction. This is a summary of Virginia Satir’s version of those contradictions, from Conjoint Family Therapy:

Simple contradiction: This is when a person says two things that contradict each other straightforwardly, as when someone might say, “I love you but I don’t love you.” This kind of contradiction consists of assertions that are incompatible, but at least out in the open, in an easily decodable way. That means that the receiver of the message can easily comment on the contradiction, saying “I don’t understand what you mean. You didn’t make sense to me just then.”

Paradoxical (or incongruent) communication: A paradox is a special kind of contradiction, where the incompatible statements exist on different “logical levels.” That is, one of the statements is part of the context of the other statement. These are significantly more difficult to decode and comment on. The two logical levels in human communication are usually verbal and non-verbal behavior, where the non-verbal behavior is the context for the verbal. For example (from p.83) “A says, ‘I hate you,’ and smiles.” If A had said “I hate you” with an angry look on their face, that would be congruent, but what does “I hate you” mean in the context of a smile? This is more confusing than the simple contradiction, both because it is more difficult to track the two levels of communication simultaneously, and because we have unspoken social norms against commenting about how someone is speaking. Consequently, it takes more awareness and bravery to question the speaker’s intent when they present you with this kind of contradictory communication. (Satir calls paradoxical communication “incongruent communication.”) Being able to metacommunicate, or comment on the communication going on, is the major tool of the psychotherapist. We don’t usually know it, but this skill is the main thing we go to therapists for.

The double bind: The double bind is a special kind of paradoxical communication that was first laid out in Watzlawick and colleagues’ Pragmatics of Human Communication. A double bind is a paradox with two additional rules, giving four total requirements:

1) A verbal statement

2) A contradictory non-verbal context

3) A rule that you are not allowed to metacommunicate

4) A rule that you are not allowed to leave the field

This happens to people all the time. Children, especially, mercilessly, unconsciously, are put in this position a lot because they are not in a position to leave their parents “field.” They are completely subject to their parents on every level.

Here’s an example: A parent, obviously stressed out, tense, and in pain for whatever reason, says to their child, “I love you.” This puts the child into a double bind, because the statement is contradicted by the “I don’t love you” expressed by the parents’ body language and facial expression. That’s 1) and 2). Third is that the child can’t comment on the contradiction because they don’t have the tools, and even if they did, and said something like, “Mom, I hear you saying that you love me but it doesn’t really seem like you love me right now. It seems like you’re having other feelings,” the child would almost certainly be punished in some way for being insubordinate, for questioning the parent’s love, for questioning the parent’s word, for making the parent feel uncomfortable. Fourth is that the child is not allowed to leave the field. That is, even if they had the communication tools, the awareness, and the bravery, they have no where else to go if they are rejected by the parent. Their lives are dependent on the love and support of the parent. They are stuck in the field. To cope, they “learn” one or both of the following:

I am not lovable. My parent knows this, and I have figured it out, but at least they are pretending that they love me, which keeps me alive, so I’ll go along with the pretense that they love me.

I may be lovable, but love feels awful. Still, it’s the best thing available.

Then the child grows up and, having their own children, perpetuate the process, being a pretending-to-be-lovable parent with awful-feeling love to give to the next generation. Not only that, but they develop adaptations to this way of living that look like DSM-diagnosable Mental Disorder conditions.

Metacommunication and congruent communication: Notice that metacommunication is the key out of all of these situations. In the case of a true double bind, you might need the help of someone else’s (a therapist’s or friend’s) metacommunication, but metacommunication is still the key. Someone needs to stand up and say, “I’m confused! Can we slow down here and talk about what we’re talking about? What can you say to me right now that your body language and facial expression will agree with?”

I’m learning a lot about child abuse this term. It is no fun. It’s got me feeling sad–depressed, even–pissed off, and creeped out. Did you know that 1 in 20 American men sexually assaults a child? That’s 15,000,000 men! I’m having trouble with that.

I saw a documentary last night called Playground, about child sex traffic in the US. I’m still feeling heavy about it. One of the points it made: If someone broke into a woman’s room and raped her, a video of the crime would not be called “pornography.” It would be called “footage of a crime” or “evidence of sexual assault” or something like that. Footage of a child being raped shouldn’t be called “pornography,” either. That gives it too much legitimacy, like it’s just one of the more repulsive niches of that booming industry, pornography. How about we call it “footage of a child being raped”?

Next Page »