Your Kids Aren't Sick

Goth Girl

Goth Girl is about a 14 year old who was lost, self-abusive, and hearing voices. Medical doctors were forcing her to take chemicals for her “psychosis.” Placed in a mental health facility for “crazy kids,”  Evie lost her feelings along the way.  You already may know, that can be a terrible feeling.

ORIGINALLY PUBLISHED @ BESTTHINKING.COM – JUNE 2013

If we want a child to change his direction, we must understand what makes him move.   –  Rudolf Dreikers, M.D.

Part I: Meet Evie
I’ll call her Evie.  That’s not her real name, but her real name was just as pretty.  It’s best to honor her privacy, as a professional and as a fellow human being.  After all, this is her story, not mine.

Evie was 14 when I met her.  Six months earlier, she was involuntarily placed in an emergency mental health hospital (called a “5150” in California) for her “psychosis.” She was given chemicals almost immediately and, after the legally required 72-hour hold, she was declared medically fit to go back home.

About two months later another 5150 occurred.  This time, they gave her a new batch of chemicals (see Evie’s Chemical Cocktail above) and upon release 72 hours later, she was placed, without her consent, in a residential mental health facility for teenagers.  About four months later, I was brought in by the same agency as a consultant.  I was there to train and supervise the therapeutic staff, and to train the child-care staff.  For reasons you will see, I became Evie’s therapist.  She was my only client.

Evie was “hearing voices,” according to the notes I read from her prior therapist.  As I found out later, it was one voice.  Evie had a friend who would talk to her once in a while, especially when she was alone and when her emotions were in turmoil.  I’ll call him Vlad.  “Vlad is my friend, Dr.  Cima,” she once told me.  She wasn’t frightened.  Vlad “spoke” to her at times, and she wrote to him.

Temperament: Sphere
For those trained in Keirseyan temperament theory, Evie is a Sphere – a young Idealist.  That makes her rare (about one in twenty), and very hard to spot, especially in residential settings.  Young spheres tend to blend in and take on the characteristics of Stars (young Artisans) or Squares (young Guardians), though, for reasons I’ll talk about later, they rarely, if ever, take on the characteristics of Cubes (young Rationals).

However, when Spheres are alone with someone they trust, their vivid metaphorical imagery quickly exposes their identity to an observant adult.  We all use our imagination to some degree, now and again.  However, Spheres stand alone in their ability to express their life experiences with metaphorical language.  Little wonder why so many writers and poets are Spheres.  (A few famous adult Sphere/Idealists: Emily Dickinson, Pearl Buck, Charles Dickens, James Joyce, Leo Tolstoy, Upton Sinclair, Oliver Stone, Paul Robeson, Joan Baez – and Plato.)

Goth
Evie was “Goth.” Goth – from gothic – is one of those adolescent subcultures found in every generation.  “Hippies,” “Hip-hops,” “Emos,” “Grunges” – and don’t forget the “beatniks” of the 1950’s” – are just a few adolescent subcultures.  The more shocking and defiant the subculture, the more it brings out the worst in adults intent on “dealing with it.” Unwittingly, by “dealing with it” adults fortify one of the reasons kids join these subcultures – to gleefully irritate and annoy their supervisors.  Another reason?  Goth culture offers comforting refuge for some unhappy kids struggling to find their lost identity, especially true for Spheres.

Goth is often described as “somber, macabre, and glamorous.”  You can throw in a touch of romance too.  Black is the color of choice for the Goth crowd, and you could always find it in Evie’s lipstick, eye makeup, nail polish, and clothes – down to her black socks and black shoes.  Evie always wore something in her dyed black hair too, usually flowers, often a black flower.  Evie liked flowers.

She was introduced to Goth when she was twelve.  She told me she fit in almost immediately.  She started to read Gothic novels.  A combination of horror and romance, famous Gothic literature includes novels like the Headless Horseman, The Legend of Sleepy Hollow, and The Adventures of Ichabod and Mr. Toad.  Modern movie renditions include Edward Scissorhands, Beetlejuice and Batman.  (You can read more about the Goth subculture here.)

Something Else You Should Know
Evie was a “cutter.”  Cutting is a form of self-mutilation.  It occurs when a child takes sharp objects like razors, knives, or even pieces of glass and cut themselves, usually in secret.  It’s mostly done on the underside of the forearm, on the tops of thighs, but anywhere on the body is possible.  When it occurs in residential settings, it can be “contagious.”  Children vying for the attention of adults notice that “cutters” get a lot of attention.  Like no other child at this 40-bed facility, Evie had the attention of everyone, and everyone was worried.  She was an “active cutter.”  (Nearly all long term “cutters,” in my experience, are Spheres.)

Also, as if there wasn’t enough turmoil in her life, for reasons unrelated to this story, her assigned therapist abruptly left the organization the Friday before I started, without a goodbye.  Evie lost her only confidant, and she was devastated.  When I arrived the following Monday morning, a number of staff members let me know Evie had an emotional, “cutting” weekend.  I decided to be her therapist.

Summing up
Evie was emotionally turbulent.  Her family had deteriorated, and so had Evie.  She drifted into the Goth subculture a few years earlier.  She was talking to a voice in her head, and she was cutting on herself almost daily.  Four months earlier, she was removed from home and placed in a facility that was, as she would say over and over – “a place for crazy kids” – and she just lost her therapist, the one person she could trust.

The worst of this? The medical profession declared Evie “mentally ill” and gave her chemicals because she was “psychotic” and she was depressed.  Good thing I’ve seen this hundreds of times in my career or I would have been depressed too – and maybe a little “psychotic.”

Part II: The Story
Unlike most therapists in society who meet with their clients once a week in an office, in residential settings, the kids live and the staff work at a self-contained campus.  Bedrooms, classrooms, and therapist rooms are usually within short walking distance of each other.

That means, if you’re a therapist, it’s not unusual to have lunch with one of the teenagers, or to meet with her teacher, or to take a walk and have a private conversation – in addition to a more formal one-hour session in the office.  In fact, it was my job to make sure therapists didn’t linger in their offices too much.  “If you want to know how your kids are doing,” I would tell them, “go see them where they live.” So, I spent some time where Evie lived.

I began to see Evie, formally, once a week.  Our first meeting was cordial.  My job was to develop a trusting relationship, and Evie was rightfully cautious.  As I had lectured my staff ad nauseam over the years, the adult is responsible to earn the child’s trust, not the reverse.  I talked to her about things she liked.  She said she liked to write.  I asked what she wrote about, and if she would share them with me.  “Oh no Dr.  Cima,” she said, “I’d be way too embarrassed!”  I told her I understood and maybe she would share with me some day.  We talked about her life a little bit.  She told me she loved her mother very much, though she had many “acting out” episodes when she lived with her mom, especially in the last year or two.

I also learned Evie had sporadic, unpredictable contact with her stepfather.  He married Evie’s mother when she was three, and he was the only father she ever knew.  Her parents divorced a year earlier and were more or less estranged for at least two years before the divorce was final.  Evie’s stepfather had a girlfriend, and her mother was not dating.

Meet Pamela and Tom
I contacted Evie’s mother after my first talk with her.  I’ll call her Pamela.  Pamela lived by herself in her home about an hour from the facility.  She worked long hours in a responsible position.  I asked her if she was able to meet with me, she said of course, and we met the following Monday.

Over the next several months, I routinely met with Pamela at the facility.  The two of us would have a conversation, and then we would bring in Evie.  Pamela needed her own private time too.  A good mother, she was confidently independent.  She had a good enough paying job that she could afford to pay her bills and take care of her daughter even if her ex-husband didn’t contribute, which was often.  (For the temperament trained reader, Pamela is a Protector Guardian.)

Sometimes, though, she was overwhelmed with self-recrimination about how all this happened, about what happens next, how the ex-husband’s girlfriend “didn’t help,” that she had no interest in dating, how she is responsible for all of Evie’s troubles, how her ex-husband is responsible for all of Evie’s troubles, and everything else that occurs when couples, with children, divorce.  It’s important to keep in mind divorce is a process, not a date on the calendar, and it inevitably involves unavoidable upset for everyone involved.  Evie was Pamela’s only child, and they were always very close.

Evie’s stepfather – let’s call him Tom – was a blue-collar worker (from Pamela’s portrayal, probably a Promoter Artisan).  I never met him, though we did have one conversation over the phone.  From what Pamela told me, over the past three years, Tom has been less and less involved in Evie’s life, missing gifts for birthdays and Christmas, and often not showing up for scheduled visits.  Still, Evie wanted to see her dad.

In my one conversation with Tom, I told him he would have to make appointments to see Evie with me, and that I wouldn’t tell Evie about this until he showed up.  In the next six months, Tom called my office on two different occasions to arrange a visit with Evie.  He didn’t show up either time.  I emailed him a few times and I left a few voice messages.  I offered to go to his house to meet with him.  He never responded.  It was a choice he made.  This also meant Evie didn’t hear from him during this time either.  Evie let me know her feelings about this through her ongoing conversation with Vlad.

Making Progress
By the third or fourth time I met with Evie alone I asked again to read some of her stories.  I could tell she was glad that I remembered to ask a second time.  This time she said “okay,” with an apprehensive smile.  She gave me her well-worn spiral binder and she asked me if I could read it right away.  I told her I would.

I’ve read many stories and many poems from children in foster care over the years.  Anger is a common theme, as is fear, and so is freedom.  Despair is almost always part of them.  For many kids in foster care, futures can be dim.  Evie’s was different.  It really wasn’t a story.

When I first began to read her words, I couldn’t make heads or tails of what she was saying.  Her spelling was okay and her grammar was about the same.  She capitalized the first letter of every sentence, every sentence ended in a period, and each sentence made sense.  There were no questions marks, no exclamation marks, no quotation marks – just periods.  After a while, when I read the sentence “Where are you going Vlad,” I finally got it.

Imagine reading a novel, and the person who wrote it deleted everything in the novel except the dialogue.  There was no introduction, no building of the scene, no sense of when or where this was taking place, or even who was talking.  Instead, the first sentence of the story started in the middle of a conversation between two people, neither of them identified, one sentence after another.  I finally realized Evie wasn’t writing a story for someone to read.  She was writing down the conversation she was having with Vlad, like dictation.

What was the conversation about?  Well, for lack of a better description, it was about a “fair maiden in distress,” who was receiving advice by a loving friend named Vlad.  Vlad was heroic, sometimes dark (he spoke of werewolves and may have been one himself according to Evie).  Vlad loved the maiden in the conversation, Evie once told me, “just as a friend, Dr.  Cima.”  Nothing sexual about this relationship, at least in her written and spoken words, and Evie wanted me to know that.

Part III: An act of chivalry
When the three of us were in session – Evie, her mom, and me – I would read aloud the most recent additions to her conversation.  By now, she always wanted to hear what I had to say, and that was good.  She spoke of her many troubles, and Vlad comforted her with sound advice and concern.

I should tell you I already had a few private conversations with Evie’s mom about this.  Pamela told me Evie always had a vivid imagination.  She had “friends” she would talk to when she was a toddler, as many kids do.  Like most kids, she grew out of it by the time she started school.  Pamela never thought it was a problem.  She thought it was normal for some kids.  It is, of course, for all kids, with spheres by far the most adept at using their imaginings to tell stories about their life experiences.

Vlad arrived right around the time their marriage was “falling apart,” Pamela told me.  As she entered her teens, Evie was becoming increasingly alone, questioning everything her mother did or should have done.  She was becoming desperate as her father receded from her world.  She was angry, hurt, and isolated.

Once, while I read her story for the three of us, the fair maiden (the girl in the story didn’t have a name other than “maiden”) said to Vlad, “Thank you for your chivalry my friend.”  I smiled.  What could this sad and frightened little 14-year-old Goth girl from Southern California know about chivalry, I said to myself.  So, I asked her.  Before she could answer, Pamela interrupted, beaming, and proudly said, “She knows what it means too!”

“Really?” I said.  “What does chivalry mean, Evie?”

“Dr.  Cima!” She was a little angry.  “I know what chivalry means! It means that when a fair maiden is about to step into a puddle of water, the gentleman is supposed to take off his coat and lay it on the ground so she won’t get her feet wet,” she said grinning, with as much pride as her mother.  It was a good moment for all three of us.  From that time forward, we changed her story of desperation into her search for inspiration.

About That Voice-In-Her-Head
One day, sometime in the second month or so that I knew her, Evie asked me, causally, “Dr.  Cima, do you think I’m crazy?”  It was, I think, a question to test my answer more than anything else.  She had her fill of answers by then.

Her doctor told her, and her mother, she had “schizoaffective disorder” and something called “major depressive disorder,” and that she needed a chemical to make her better.  Her therapist told her she was “substituting Vlad for her father,” though she had a “psychiatric disease” too.  Her social worker told her she sent her to this facility for her “mental illness.” A few counselors, frustrated because she wasn’t improving, told her she was “psychotic.” The other kids at the facility? They told her she was a “wing-nut,” and other similar terms, as you can imagine.  All of this convinced Evie this really was “a place for crazy kids.”  I answered her question.

“No Evie,” I said, “I don’t think you’re crazy.”

“Ok, Dr.  Cima,” she replied, almost as a challenge, “then where does Vlad come from?”

I shrugged and said “I think it’s just you talking to you.  What do you think Evie?”

“Yeah,” she said with a sly grin, “it’s just me talking to me.”

That seemed to help.  After all, that’s what it is.  We should remember, parents and professionals alike, there really isn’t another person talking, and the voice isn’t coming from the clouds.  It’s her own imagination at work, nothing more.  She’s having a discussion with herself, it seems spontaneous, it seems to be real and, for the most part, she’s was okay with it.  We decided she was having “a wide-awake dream, that’s all.”  That seemed to make sense to her.  We never talked about why she was having her wide-awake-dreams, so it made it easier for her to talk to me about them.

After a while our conversations were about the words she wrote, and the metaphorical meanings they had in her life.  It was a great way for her to explain her inner turmoil, and a great way to encourage her candor.  She was, in the next few months, increasingly candid.

About That Cutting
About one month into our relationship, at a particularly vulnerable and honest moment, I asked Evie if I could see her scars.  She was very ashamed of her scars, in front of me, and she always wore long sleeve shirts to hide them.  Evie took off her jacket and extended her arms.  There were several dozen crisscrossed scratches from her wrist to three fourths of the way up both of her arms, most of them permanent scars.  When I gently held her arm to look, she started to cry.

I’m sorry, Dr. Cima,” she said, her eyes fixed on the floor.

“Sorry,” I replied, “why are you sorry Evie?”

“Because it’s a stupid thing to do!” she said, with a bit of anger in her voice.

She said, at different times, she did it because she couldn’t stop herself, and because Vlad said it was a sacrifice she had to make, and because she felt so empty inside, and because her dad wasn’t around, and because it brought her a lot of attention and, sometimes, because she was bored.  Mostly, she said, “I do it when I don’t feel anything.”

Not a small item for Spheres, the loss of feelings.  Feelings provide Spheres their life energy.  Spheres without feelings are like Cubes without a puzzle to solve, or Squares without a job to do, or Stars without a game to play.  In desperate times, in a strange place for “crazy kids,” feeling something is better than feeling nothing.  We talked about her feeling nothing, and decided that feeling nothing was a feeling too.  Even if it felt terrible and empty, it was a feeling.  At least, we decided, she was feeling something.  Evie slowed and then stopped cutting herself six weeks after we met.

About That Chemical Cocktail
I convinced Pamela her daughter didn’t have a “disorder” or a “disease.”  Frankly, and not surprising to me, it didn’t take that much to convince her.  She never saw any improvement in her daughter’s behavior, despite the number of chemical cocktails they tried.  She consented because a doctor said her daughter needed “medicine.”

This is a common experience for the many hundreds of parents I’ve worked with in my career.  Parents will say they saw improvement in the first few weeks, then things began to get back to where they were.  Chemicals were increased, or decreased, or changed, or added – it didn’t matter much.  Over time, nothing changed, often their child was worse, and now their child was living in “a place for crazy kids.”

Pamela expressed her right as a parent and asked that her daughter be taken off her “medication.”  The doctor cautioned her against doing so, however, Pamela insisted.  With my support, we began a titration schedule, and simply reduced and eliminated both her chemicals in a matter of a few weeks.  Good riddance, and a huge boost to the self-confidence of Evie – and her mom.

How Did it End?
Evie went home to her mother about six months after I arrived.  She had stopped cutting for more than four months, she was still writing in what we were calling her journal by then, and most important to me, she was chemical free.  Evie called me two times in the first month just to say hello and to say that she was doing okay.  She was in school, and she was glad to be home.  She thanked me a few times, and I thanked her for trusting me.  We never spoke again.

About four months later, Pamela called.  She wanted to let me know that Evie was still in school, doing okay.  She said Evie seldom wrote anything in her journal anymore.  She also said she thought Evie may have a boyfriend.  Nothing had changed with the relationship with her step-father, although Evie, according to Pamela, was more stable with this unstable, one-sided, relationship.  Finally, Pamela told me she was dating.  She met a man at work, they had lunch, and they had dinner.  A third date was planned.  She sounded happy.  I think that’s why she really called, but that’s just me.

This is how it usually ends in my business.  It’s rare to have much contact with children and their families once they leave these kinds of facilities, as it should be.  After all, we are there to help them during an extended life crisis, not to ensure everyone lives a good life.  Our job is to provide them with our security, our trust, our guidance, and to discover and encourage their strengths, as children and families work to move forward in their lives.

Epilogue
I started writing “Goth Girl” two weeks before I found a video about another girl.  Her name is Emily Longden.  She was hearing voices too.  I wrote a blog about her at “Your Kid’s Aren’t Sick.” You can learn about the Hearing Voices Network, and you can meet – and see – this brave young woman @ https://www.youtube.com/watch?v=AgZHOSxN5cE&feature=youtu.be.

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READER COMMENT:

Eitan Schwarz, MD FAACAP DLFAPA

June 11, 2013 at 12:55 am

You have described Evie beautifully.  In this age of increased emphasis of the mind as a function of the brain, you remind us of the need for balance.  As a child and adolescent specialist for 40 yrs, I have met and sought to understand several Evies.  They can be very different from each other.  They have in common a blend of fierceness and delicacy, lace and leather.  They are worthy conversationalists and usually quite expert in something interesting.  Some try their own chemicals.  Many have had decent therapists who helped them accept their medication and became happier Goths for longer.

I also know of how varied kids are and frightened parents are.  I know that there are some doctors and “therapists” out there unworthy of trust because they don’t talk with people and don’t think carefully about the symptoms or diagnosis, like the type and function of “auditory hallucinations” and then misdiagnose and mistreat, often overmedicating with the same drugs.  I am always glad to see folks alert to that.

Yet I wonder to myself what is really new about your approach — it is pretty standard for the rest of us who work with kids and like to see their lives improve, except we don’t jump into a therapy relationship in quite the way you describe your involvement too often.

Your POV is not unusual either.  But would you consider that the medical chemicals made it possible for Evie to connect with you initially?

REPLY:

Dr.  Schwarz: Thank you for your comment, and sorry for this very late response.  My wife and I were on a long overdue, extended vacation.

The short answer to your question, politely, is no – the medical chemicals had nothing to do with connecting with Evie.  It was an on obstacle to overcome – for her, her mother, and me.  The long answer is a little more telling.

Evie – and her mother – first had to be convinced she wasn’t crazy when the evidence (5150, removal from home, “psychosis,” etc.) was just the opposite – topped off by those chemicals to fix her diseases.  Having done this many hundreds of times, I know parents are very reluctant to take their children off medication.  That’s a problem to solve too.  So, no thanks, medication has never been an asset to developing a relationship with a child.  Evie didn’t trust me because she was taking a pill.  I had to earn her trust.

Sounds like we both have been doing this work since the 70’s.  We both know these so-called medications were being used for kids on an experimental basis in those days.  I know from first hand observation, the experiment failed – and most professionals deny it.  You should know that too.  Unequivocally, from watching thousands of children, I’ve never seen these chemicals do any of them any good, and always did harm.  I know of no exceptions.

Nonetheless, I don’t deny that you have a knack for what we do.  You must.  You’re instincts about Evie were so accurate.  I can tell you’ve had Evie – and kids just like her – in front of you many times.  Lucky for them.  I suggest you had those instincts with you as you entered grad school and medicine.  That knack (or connection) can’t be taught, and it has nothing to do with medicine.

A psychiatrist friend told me a long time ago “I try to make sure my training doesn’t get in the way of my effectiveness.” I suspect you do the same.  I applaud your effectiveness.  You, in particular, didn’t need to prescribe any chemicals to anyone.  You’re the vessel of efficacy, not a chemical.  Respectfully, prescribing chemicals not only masks “symptoms,” they often mask the impotence of the prescriber.  Medicine is needed for broken bones, not broken hearts, broken families, or broken spirits.

The Era of Chemicals – Redux

ORIGINALLY PUBLISHED @ BESTTHINKING.COM – OCTOBER 2012

Dear Reader:

I wrote the essay – The Era of Chemicals – in 1988. A year earlier, I was awarded my Ph.D. in Clinical Psychology. I was in my second year as the Director of a 66-bed residential facility in Southern California for boys placed from probation, social services, and mental health agencies. It was the first of three large mental health facilities than I’ve managed. I wrote this essay late one night in my office.

I never did much with it. I used to give it to my colleagues to read. I continued to do that over the years until I retired. I dusted it off to publish it now, because, well, it’s time. In fact, as you will see, it’s overdue.

When I managed facilities as the Director, I didn’t allow children to be given chemicals for their behavior. Admittedly, it was a lot easier in the mid-1980’s. The psychiatric Medical Model didn’t have the stranglehold on our profession as it does now. I just said no.

I had my reasons – professional, theoretical, philosophical – and they all added up to no. There was no wiggle room either, by the way. You’re either all in or all out with this failed model, so I didn’t allow any dabbling. There were many times I had therapists – especially new therapists – in my office cajoling, begging, angrily advocating, with articles-in-hand (no internet back then), to allow them to encourage the psychiatrist to prescribe a chemical “just for this one kid – please!” I said no. Luckily, they liked working with me, and I liked their work too – and we did good work together. By the time I started my third agency in 2003, I was more seasoned, less strident and, I’m happy to say, as successful.

The essay is a little awkward and stiff and some of the sentences go on forever. I ask for your patience, please. This was my first attempt at writing something serious about the subject. Nonetheless, other than some grammar and structure and other similar kinds of things, I wouldn’t change anything, so I didn’t.

I admit, though, there is the one thing that haunts me. The last paragraph. I used the word “perhaps” four times, including the last word of the essay. I was naïve. I was hoping the essay would have lost its relevance by now. It didn’t, I’m sorry to note. 

I’ll tell you this now, a quarter century later: there’s nothing “perhaps” about it. We’ve gone from a few hundred thousand children given these toxic chemicals, to eleven million – and counting. It’s our shame, and our responsibility to put an end to it.

For now – The Era of Chemicals – from 1988. 

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We learn early in life that there are simple solutions to complex life problems. Whether a headache, tension, stress, depression, excessive activity, insufficient activity, insomnia, bed-wetting, bad grades, bad dreams, hallucinations, poor reading skills, too much appetite, not enough appetite, and so on, a simple trip to the drugstore, to the liquor cabinet, or to the “corner connection,” will ease these annoying and sometimes pervasive life-symptoms.

It’s as if unpleasant personal interactions, disappointments, tragedies, elations, moods, lack of skills, uncomfortable thoughts, undesirable physical appearance, and other events experienced by most human beings are best dealt with by the ingestion of one type of chemical or another. There may be a day when these chemical medications will carry the disclaimer: “Caution: The Surgeon General has determined that living may be hazardous to your health.”

The Medical (or Disease) Model is the prevailing theory in the helping professions. When discussing people who are sick or ill pertaining to a psychological description of behavior, the Medical Model is inferred. Indeed, the body’s chemicals do have an effect on behavior. As the chemist will state, in some ways “it’s all chemical.”Neurons are chemically stimulated, and they, in turn, chemically stimulate muscles and organs, and so on. Yet with some theorists, scholars, and students of human nature there exists a vast difference between the physiology of motion and the cause of behavior.

When someone behaves in a socially inappropriate way the physician seeks to explain the behavior by discovering the chemicals that are either missing, are in short supply, or are in overabundance within the individual. This is the cause of the disturbance, and they will treat the anomaly with chemicals of their own. When questioned, the physician will claim there is an imbalance of some kind, in less than understood ways. Yet there is offered little, if any, explanation of what “balance” means. The fact the depressive is elevated by Elavil is enough to conclude the effects are beneficial, and that this is evidence of the efficacy of the drug. Most often the physician is at a loss to explain why the chemical works, how the chemical works, what can be predicted about its effects, or how long the person being treated will have to use the chemical.

Another concern is found in the term side-effects. This euphemism is used to water-down the stigma of the unwanted physiological and psychological consequences of chemical use. Drugs only have effects. With chemotherapy, for example, hair loss, loss of appetite, and other effects of the chemicals used are well known. However, when psychotropic medication is given to human beings for a psychological disturbance of some sort, unavoidable problems arise. The term “Thorazine shuffle” was coined by the employees in psychiatric settings, as their observations of the side-effects of this drug were noted.

The use of Ritalin, or methylphenidate hydrochloride, provides another example. This overused and misused drug has been around for over a quarter of a century and is almost exclusively used for children. Its main purpose is to “calm” the hyperactive child. How does this work? How does a stimulant have just the opposite effect with very active children? No one seems to know. Turning to the Physicians’ Desk Reference, a volume of over 2200 pages that give a detailed description of all legal chemicals, here are some remarks about Ritalin. The PDR, states:

Ritalin is a mild central nervous system stimulant. The mode of action in man is not completely understood, but Ritalin presumably activates the brain stem arousal system and cortex to produce its stimulant effect. There is neither specific evidence that clearly establishes the mechanism whereby Ritalin produces its mental and behavioral effects in children, nor conclusive evidence regarding how these effects relate to the condition of the central nervous system. (Physicians Desk Reference – 1987 edition)

The authors of the PDR also state Ritalin should not be given to children under six, and it is contraindicated when the child has marked anxiety, tension, and agitation as Ritalin may aggravate these symptoms. Continuing, they note data on safety and efficacy of long-term use of Ritalin in children is not yet available noting: “although a causal relationship has not been established, suppression of growth (i.e., weight gain, and/or height) has been reported with the long-term use of stimulants in children.”         

And what are the side effects of this stimulant? Nervousness and insomnia are the most common reactions, along with hypersensitivity, skin rash, anorexia, nausea, dizziness, palpitations, headache, dyskinesia, drowsiness, blood pressure and pulse changes (up and down), tachycardia, angina cardiac arrhythmia, abdominal pain, and weight loss, to name some. An overdose may induce vomiting, agitation, tremors, hyperreflexia, muscle twitching, convulsions, euphoria confusion, hallucinations, delirium, sweating, flushing headache, hyperpyrexia tachycardia, hypertension, hydrias, and dryness of mucous membranes.

The most common place that a child first comes in contact with medication is in school, due to “disruptiveness”or “inattentiveness,” or in general, “poor school performance.” Dr. David Keirsey, author and professor emeritus has these remarks about the use of medication with school children:

The parents blame the school, as they should, but the school blames the child. He’s “dyslexic,” has “minimal brain dysfunction,” is “hyperactive,” has a “learning disability.”  Therefore, says the school, he “needs medication.” Then some well-meaning but ill-advised physician prescribes massive daily doses of some stimulant drug, parroting others’ assumption that the stimulant has a “paradoxical effect” of acting as a depressant. The victim is thus given his daily fix and its false high, his teacher claiming that he’s “calmer and works better.” Who wouldn’t be with that big a fix? And of course the child need not aspire to much; after all, what can you expect of a person with a bent brain? And later on? No. The child’s real problem is the school, not his brain; his brain is just fine.                                                     Portraits of Temperaments – Pg. 26

So why is the use of medication so pervasive with particular children? Usually because the child is a management problem, although this is most often denied. The child is ostensibly given drugs “to help him.” Yet close observation will note it is the teacher who needs help, or the mother, or the counselor. The belief is if someone is in profound psychological distress due to chemical imbalances, and this is interfering with more traditional treatment, then chemicals are prescribed to ease the distress in order to enter into a therapeutic conversation. Yet this seldom, if ever, occurs.

Instead, the teacher is initially relieved she was heard, and while the child’s behavior doesn’t really improve, “at least he’s being treated.” Mother is now reluctant to take her child off medication for fear of a recurrence of past events, even though her son is tired all the time and doesn’t eat right, and in a bad mood constantly. Ironically, even the most ardent disciples of the Medical Model make no claim chemicals used for psychological disturbances cure the disturbance. Instead, most will say some people will have to be on medication for “the rest of their lives.”

All professionals, including therapists, teachers, child-care counselors, teacher’s aides, social workers, and others, should become familiar the with the PDR. There are good reasons for this. Once a child is placed on medication designed to treat a psychological shortcoming of some sort, it soon becomes impossible to distinguish with any degree of accuracy between behavior that is due to the child’s psychological distress and behaviors due to the side-effects of the prescribed chemicals.

Is the child agitated, now, because of internal strife, or is the prolonged use of medication affecting him? Is the child awake at night because of a sense of unbelonging, or is she simply exhibiting an effect of the particular chemical she is taking? When the child becomes disruptive at school and breaks another window, does this mean an increase in the medication, another type of medication, a decrease in medication, the medication is an irritant, or what?

Medical personnel refer to this process as “adjusting the meds.” The pursuit, really, is to adjust the child. Many experienced physicians are adept at creating just the right high, so the child is awake, yet sedate. Often out of frustration and desperation – and genuine care – a child is referred to a doctor for his medical problem. However, when chemicals are used to manage the recalcitrant child, other more damaging side-effects inevitably follow.

Once medicated, the child has a disease in addition to stressful life experiences he may have to endure. This disease is something beyond his control, something which he and his family now may have to cope. The child is seldom told of the prescription until it has been decided by others “for your own good.” He is given vague reasons as to why he has to take the medication (“to help you”), can soon become dependent (“I can’t go to school without my meds”), loses control over his behavior (“I can’t help it/it’s not my fault/I’m not responsible – I’m hyperactive”), lowers his own expectations about his future, mimicking the view others’ have of him, because of his “handicap.”

Chemicals have the effect of altering the physical-emotional-psychological affect or consciousness of human beings. About that there is no doubt. Yet this is a poor reason to give medication to children in psychological distress. “Why Mellaril instead of a ‘shot of booze’” asked one professional.” There is no good answer. Chemicals, for the most part, create dependence rather than independence. Most disturbing is the dependence created in many professionals and lay persons alike. After a confrontation it is not unusual to hear in some settings: “somebody take him to the psychiatrist and get his meds straight!!”

Chemicals taken into the body do have an impact on the human being. Give a child Ritalin, and his body is affected. Introduce Valium to the overworked bank teller and watch him calm. Allow the lonely housewife her vodka for the day and see a different housewife. Many simply can’t go to work without a cup of coffee. Others must smoke a cigarette as soon as they wake in the morning. And so on.

The use of drugs permeates every level of contemporary society. If one was to include all legal drugs in addition to the illegal drugs, then there are very few of us who are truly drug-free. In fact, it could be argued the cause of the drug problem in our society lies not in the area aimed at by our “war on drugs,” which is the attempt to eliminate the use and distribution of a handful of illicit drugs. Instead, it could be argued the thesis the origin of the drug abuse problem in this society falls at the feet of the 3200+ legal drugs, and the permeating idea of quick fixes that begins at a very early age. Moreover, as the distribution of legal drugs is a multi-billion-dollar industry, new so-called breakthroughs are common as the relief of life-symptoms can be done even more effectively with the “new and improved” products.

George Washington, after retiring from his two-term presidency, lived his final days in Mount Vernon. It’s likely this national hero and “father of our country” would have had the most updated and best medical professionals of his time at his calling. The state-of-the-art, unfortunately for Washington, proved to be unsuccessful. He was inadvertently bled to death in an attempt to cure him.

With hindsight, his treatment seems uncivilized and uninformed. Yet within the medical profession this was the best solution at the time. With foresight, one may wonder how our progeny will view the use of drugs in our current society. Perhaps they will look back and view us as uncivilized and uninformed. Perhaps they will wonder what we were doing to ourselves. Perhaps they will, as they review their history, refer to us as living in the Era of Chemicals.

Perhaps.

The Sugar Lie

ORIGINALLY PUBLISHED @ BESTTHINKING.COM – DECEMBER 2012

Dr. Dean Edell started his radio broadcast in 1978. His common sense and clear answers earned him the accolades of millions of Americans. Dr. Dean retired in 2010. “No nonsense, no BS, no medi-babble” could have been his motto. Enjoy your retirement, Dr. Dean.

I was listening to him in the late seventies and early eighties when he would periodically tell his listeners there was no such thing as a sugar high. More than that, he implored his audience to pass this information around to others. I was surprised. How, I asked myself, could Dr. Dean be so wrong about this, and so right about most everything else?

At the time my wife and I were living with 8 boys ages 12-17 years old in a group home. They were active. We got them up in the morning, readied them for school, greeted them after school, helped them with chores, ate dinner with them, helped them with homework, and got them to bed. As professionals, and as surrogate parents, we stopped giving them sweets because we knew sweets added to their already too active behaviors, and we cared about these kids.

We knew about the behavioral power of sugar because we heard it from all of our sources at the time including psychiatrists, psychologists, social workers, therapists, teachers, teacher’s aides and other parents. My wife and I were parents with young children at the time. Like our friends and family who had young children, we all knew about the “sugar high,” the “sugar rush,” and, though less well known, the “sugar crash” – that’s what happens when sugar is depleted and all of the child’s energy is spent. The child “crashes.” We were informed parents and, as knowledgable child behaviorists, we were compelled to educate colleagues and the general public whenever we could.

Dr. Dean ruined all of that.

I did some homework, which was a lot more difficult back then. The internet wasn’t born yet. I was working towards my Master’s degree at Cal State Fullerton and I had access to their library. I used to study there before class, and from time to time I would research this question. To my utter dismay, I found out Dr. Dean was right. Conclusive. No kidding. No doubt. There was – and still is – no scientific evidence anywhere to support the idea that sugar has anything to do with increased activity – child or adult. There is no “high,” there is no “rush,” there is no “crash” either, even though those terms were so much part of our culture back then and, most distressing, still are.

I succumbed to this truth. I quickly converted, cleansed myself, and became a disciple. I felt obligated to pass this information on to friends, family and colleagues, as Dr. Dean suggested. Together we could help kill this myth, and get on with the task of helping children.

Not so fast there buddy. When I would tell people there’s no such thing as a sugar high, many would get mad at me, and the rest would ridicule me – as if I needed to modernize my thoughts. The same psychiatrists, psychologists, social workers, therapists, teachers, teacher’s aides – and nearly all parents – refused to listen to this. This is still true, and it’s 2011.

Well informed mothers, fathers, caretakers and professionals are quick to point out they have watched children’s behavior become “manic” when too much sugar enters their blood streams. They’ve witnessed what is clearly a physiological effect with their own eyes and, way too often, their own ears. It’s obvious to anyone, they say without hesitation. Too much sugar “hypes” kids. So obvious that many parents dread birthday parties, Christmas cookies and, God-forbid, Halloween.

The simple reply is, respectfully, no, you didn’t see what you said you saw. You may have seen your child’s activity increase, but it didn’t have anything to do with sugar. You get madder still.

So, nowadays, in the 21st Century, I refer everyone to their own encyclopedia, the world wide web. Please, when you have an extra 20 minutes, take the time to Google, Yahoo, or Bing “sugar high” or “sugar rush.” See what you find. In the meantime, here are excerpts from five different sites I selected – there are many more – with their web addresses:

From The Straight Dope: In 1995 the Journal of the American Medical Association published a review of 23 comparatively rigorous studies conducted between 1982 and 1994. These were your classic controlled double-blind affairs: two groups of kids, one fed a bunch of sugar, the other given a placebo (i.e., artificial sweetener), everyone kept sufficiently in the dark as to who’d gotten what, etc. The results? No discernible relationship between sugar ingested and how the kids acted. It didn’t matter how old they were, how much sugar they got, what their diets were like otherwise — nothing. The JAMA authors stopped shy of drawing any definitive conclusions, but if there were a legitimate sugar-high effect out there, you’d like to see it turn up in the lab every so often.(http://www.straightdope.com/columns/read/2747/does-giving-sweets-to-kids-produce-a-sugar-rush)

From a nutritionist in Hawaii: It is not unusual, due to the misinformation that abounds out there in the public media (books, magazines, newspapers, word-of-mouth testimonials), to think that a ‘sugar high’ is a real thing. In some of the research that I have done with adolescents (almost 200 of them, at one time), we fed the boys as much sugar as we could cram into a breakfast, and not a one had a hormonal profile that suggested hypoglycemia; and, none of them experienced anything resembling a ‘sugar high.’ In fact, if you follow the biochemical pathway of sugar (glucose or sucrose) in the body, what it predicts is a calming effect of sugar, providing nothing else is eaten at the same time.(http://www.madsci.org/posts/archives/2000-01/947564807.Me.r.html)

From a Yahoo source on Health and Wellness: Here’s the big news. The scientific research that has been conducted not only finds no direct correlation between hyperactive activity and sugar, but actually has produced evidence that sugar may well have a palliative effect.(http://www.associatedcontent.com/article/515073 sugar_high_myth_or_reality_pg2.html?cat=5)

From a mother, at Daily Dose of Common Sense: My daughter had a birthday yesterday, and I had several well-wishers ask if she was bouncing off the walls because of sugar. Well, no, actually she was no more hyper yesterday than any other day. Yes, she ate a cupcake, Cracker Jack, Nerds, and a bunch of other junk, but she’s a healthy kid. That, and there’s no such thing as a “sugar high.” I know, it takes a second for it to sink in. We have been led to believe that sugar makes people (especially kids) hyper. But, it’s just not true. Our bodies do a really good job of regulating the sugar we intake. Many studies have been done on this topic and the conclusions are the same: the amount of sugar that a kid eats does not affect his or her level of activity. Jessie from Rational Moms did a great in-depth debunking of the sugar high myth. I highly recommend giving it a read. So, don’t worry about your kids being up all night after eating a bunch of sugar. They’re up late because they want to be up late. Duh. (http://www.dailydoseofcommonsense.com/2009/07/22/the-sugar-high-myth/)

Finally, and maybe you should go here first, this from Rational Moms: Even confronted with this evidence it can be difficult to believe. I’ve heard people grudgingly accept that it may not cause hyperactivity in children but insist that it causes rapid spikes and falls in blood sugar levels which create the feeling of the “Sugar Rush” and the “Sugar Crash.” . . . In this study all mothers identified their children as “sugar sensitive”. All the children were given a placebo (aspartame) but half of the mothers were told that their child was given a large amount of sugar. The mothers who thought their child was given sugar tended to stay physically closer to their child, criticized, looked at and talked to their children more then the parents who knew their children had the placebo. The mothers who thought their children ate sugar also rated their children as significantly more hyperactive than the control group.(http://www.rationalmoms.com/2008/12/01/the-myth-of-the-%E2%80%9Csugar-high%E2%80%9D/)

So, you’ve read the excerpts. More important, I hope you took some time to research this on your own. Good. Now you know for sure – a certainty – that there is no physiological sugar high, rush, or crash in human beings, and that includes little human beings. Not because I said it, or Dr. Dean said it, or those others you read on the web said it. But because, now, you say it. When it comes to behavior the unequivocal answer is no, children aren’t sugar sensitive, there isn’t a sugar high, a sugar rush, or a sugar crash – and there isn’t any wiggle room.

Why is this important? For a few reasons.

One. You and I – and everyone else convinced at one time or another that too much sugar causes children to be hyperactive – are mistaken. That includes your doctor, psychiatrist, teacher, aide, school psychologist, therapist, social worker, and any other professional you’ve relied on to make sure you are accurately informed.

Two. We become frantic when our children eat too much sugar, especially at the wrong time. Sometimes we even chastise the child because he – and it’s almost always he – doesn’t monitor his own sugar intake. After all, he should know by now that he has “ADHD” or an “imbalance” or “sensitivity” of some kind. He is, in a word, sick, and we’re just being cautious about his “condition.” We now know – you and I – this was never true. (By the way, maybe you know someone who has a very bright, 14 year old boy who has said on more than one occasion: “Sorry mom. I know I got hyper last night! I couldn’t stop! OK, OK, you were right! I had too much candy! Sorrreeeee!” Now you know for sure – and so does the 14 year old boy – it’s not the candy.)

Three. We can no longer place responsibility for a child’s behavior on this chemical because of a flaw in his body that was never there in the first place. This idea is going to become very important in Part II.

Four. We both now know our beliefs – even strong, heartfelt beliefs based on our care, our concern and our professional consultation – can alter our perceptions. Whoops, our bad. We need to make up for our mistake, and apologize to our children. You can still say he’s “too active,” however, you at least know now to eliminate sugar as a cause.

What’s the big deal? Is it really that harmful – this false truth about children that we’ve kept alive for way too long? My goodness, parents are educated to believe their child is sensitive to sugar in the way a diabetic is sensitive to sugar. A range of informed professionals explain to parents in convincing detail – usually something about brain chemicals – that their child may be “sugar-sensitive,” or worse, may have a “psychological disease.”

And what do conscientious parents do with this information? They seek out a doctor for their child’s medical condition. The doctor tells parents to monitor the child’s sugar intake, that much is obvious, and that maybe your child should take some medicine – usually Adderall or Ritalin or some other amphetamine – and your child’s disease is treated. Never fixed or cured – there are no fixes or cures available from these doctors – but medically treated.

Here’s an idea, if you have the gumption. The next time you have the opportunity, maybe in private, ask your child’s doctor, therapist, counselor, teacher or teacher’s aide if too much sugar causes children to engage in too much activity. If the teacher tells you it does, correct this common, misguided, and harmful answer. If the therapist persists, share your information and ask that it be checked out. If the doctor becomes frustrated trying to make you understand that you’re a layman, well, when you can, as politely as you think necessary, find another doctor. This one is woefully uninformed – and stuck in it – unlike you. Dr. Dean warned us decades ago that the most resistant to this information are informed professionals. Please, help them out.

Is there a physiological effect of taking in too much sugar? Sure there is. Ask anyone who substituted a pound of Sees candies or a quart of Ben and Jerry’s ice cream for their dinner. When finished with their indulgence, they yearn to nap. In fact, an abundance of sugar does have a calming effect on human physiology, especially on an empty stomach. Also, sugar is often referred to as “empty calories,” and sweets certainly add to the obesity epidemic, not to mention the part it plays in tooth decay. And, as you already know, sugar certainly has a role in diabetes. (More about psychiatry’s dastardly psychi-babble use of diabetes in Part II).

You may guess my point about this. If we could both be so wrong about what we thought was so right, then are there other “truths” that need to be revealed as myths or comfortable conventions or false science? My goodness yes. Psychiatry is the biggest offender, as you will see in the upcoming article.

Finally, fellow convert, please help. To obliterate this harmful lie – and to make it right to all those kids we falsely accused and to ensure the next generation is accurately informed – we must be bold. When you’re at the check-out stand and you hear a stranger talk about “sugar high,” with a smile, ask them to “Google it.” When you’re at your PTA meeting and parents are concerned about all those “sugar snacks” the school is giving, make sure it’s because of calories and general health, and not because “sugar hypes kids.” Keep smiling, and educate them. And the next time you have a family reunion, deliberately bring this subject up so you can get into a friendly family argument and have it settled on the internet. You’ve just done a world of good for the kids in your family, and that’s always good for a smile.

Lest I forget, you can also forward this article to your friends, family members, doctors, teachers, therapists, neighbors – everyone. It’s 21st Century information. It’s not mine. It’s not Dr. Dean’s.

Now it’s yours. Make it someone else’s.

Let’s put the sugar lie to bed – for good.