. . . and it's not their genes either. – Dr. C

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THE HORRIBLE KID – Chapter III: A tale from the Lone Arranger

Horrible Kid 2

Chapter III:  Heeeere’s Jerry!!

Gloria got up, went to the door, and walked out to the van.

I’m praying he’ll be good, Dr. Cima,” she grimaced, “but I can’t guarantee it.”  Gramma Eleanor began to cry, again.

Before Jerry arrived, Gloria said they never knew what to expect when Jerry came home.  Sometimes he’d have a smile on his face, other times his face would be beet red from anger.  He might ask for an apple, or toss his backpack at his mother.  It was common for Jerry to be the only child in the school van, “for safety reasons.”  Good day or bad, whether alone or with other kids, there was an extra staff member assigned to sit next to him, to and from school.

We decided it would be a good idea for me to meet with Jerry alone so, as planned, I followed Gloria outside.  I met the teacher’s aide, and “escort,” John.  He told Gloria that Jerry had a “mixed” day.  He was “good” in the morning, but “he became very agitated in the afternoon, so we had him in a ‘time out.’”    

 “Time out” meant he was taken from the classroom, and a staff member was assigned to supervise him in a separate and isolated room.  No teaching occurred.  It was supervision only, so Jerry wouldn’t disrupt the classroom.  John was twenty-something, liked his job, very nice, and very poorly trained in child management methods.

Jerry was a normal sized 9-year-old, maybe a bit smaller than most, but not by much.  He was slender and he looked in good health.  He had light brown hair, he was fair skinned, and he was dressed nicely by his mother.  However, his clothes were disheveled, as though he had been wrestling.  I learned later, while being escorted out of the classroom to his “time out,” Jerry had to be restrained by John and another aide at school.  I remember thinking, when I first saw him, he looked like an angry Dennis the Menace.

In her most cautious voice, as though she was trying to avoid an “outburst,” mother started to introduce me to Jerry.  I interrupted, just a little, as I smiled at Jerry.  I learned during my conversation with Gloria and her mother that he liked baseball.

 “Hi Jerry,” I said, “I’m Dr. Cima.  Wanna play catch?”

“Yeah!,” he answered.

He dropped his backpack, ran to his room, got a ball, and came back outside – with a good looking grin on his face.  For the next 15 minutes or so, we played catch, and we were having some fun.  He wasn’t very good at playing catch, as though he hadn’t had much practice.  He was going to get some, we both found out.  For the next six months, whenever I came to his house, he wouldn’t talk with me until we played catch, for about 15 minutes or so.  It was our routine, and a small price to pay, having some fun with this fun-loving Star.  That, and not coincidentally, he got better and better at catching and throwing a ball, and I was able let him know it.

By the way, when you can, it’s a good idea to meet a child, for the first time, when he’s at his best, not his worst.  How does he behave when he’s happy?  What does she like to do?  What energizes him?  What entices her interest?  Besides, I knew all about Jerry at his worst, as attested to by his mother, grandmother, teacher, and social worker.

We had a short conversation, mostly about things he liked to do, nothing about things he didn’t like to do.  He was wary.  I was just another adult in his life, probably there to “boss me around, like everyone else.”  It’s worth pointing out, Jerry was bright.  That is, he could read adults very well.  He knew how to provoke, or charm, as needed.

He told me liked to play, that was clear, and he told me he liked to draw.  I learned from mother he did a lot of drawing in his room, using pencils from a set she bought him.  I saw a few of his drawings.  They were very colorful, some were well done, for a promising artist.  If there was a “theme” to his drawings, I didn’t see one.  There were pictures of animals, cactus, and unnamed people.  No particular “emotion” jumped out at me either.  These were mostly drawings of his surroundings.  He didn’t keep many, and not many people had seen them.

About 45 minutes or so passed and I declared Jerry, to myself, as perfectly normal.  He was, of course.  At his best, he was cute, he was happy, and he was fun.  To be sure, he was driving adults “crazy,” and they were ready to restrict his movements at a moment’s notice.  Still others were clamoring to give him some sort of “medicine,” also intended to restrict his movements, and to get him to finally “pay attention!!”

Our Approach

If you were expecting this to be about how we “changed” or “fixed” Jerry, well, you may be surprised, though I hope not.  After all, this blog is called “Your Kids Aren’t Sick.”  That includes Jerry.  He didn’t need “changing” or “fixing” and, from a temperament perspective, that’s not even possible.  Instead, as you will see, we helped adults change their behavior, and Jerry’s followed.  This is always true, and usually denied, by adults – especially professional adults.

I was confident we could help mother and grandmother. They had “lost control” of their child some years before, for reasons that really don’t matter (I’ll give some details at the end of this tale).  I knew mother and grandmother felt defeated.  However, I also knew they wanted Jerry to remain at home, despite their doubts.  Please remember, as a wraparound program, our mission was to keep the family whole.  With a few child management techniques, and some modeling by our team, mother and grandmother would be “back in control” in a relatively short period.

My major concern was school.  I had a scheduled meeting the next day with Jerry’s teacher, and others.  I was sure with time, persistence, and some good work by our team, we could get Jerry to school in the morning, every day, with a smile on his face.  I wasn’t sure, however, without interactive changes by the school, how long the smile would last once we did.

The School

I brought my wraparound counselor, Angela, with me.  The two of us met, after school hours, with Jerry’s teacher, two teacher’s aides from his classroom, the school psychologist, and the Principal.  Wraparound was a new California statewide service in 1999, it was court ordered, and most professionals were supportive.  When I asked for a general meeting with everyone, they readily agreed.  They needed, and wanted, help too, so I knew we would have willing participants, at least in the beginning.  The trick is to encourage the participants to become our partners in this endeavor.

For the temperament-tuned, Angela was a Champion Idealist, and her enthusiasm alone was enough to give everyone a much needed positive “boost.”  She was smart, she was an experienced trainer in child management, she was good with kids, kids liked her, and so did everyone else.  Her relationship with school personnel was going to be key to creating the changes that needed to occur.

The school reported, as determined in Jerry’s Individual Education Plan (IEP), that Jerry needed an abundance of one-on-one time.  They assigned staff members to bring him to school and to take him home.  Others were there “to be with him” at breaks, recess, and lunch.  He was rarely “in the right mood” to interact with the other children.  His demeanor went, seemingly, from flat to fiery in a matter of moments.  They used a “token economy” in the classroom to provide “motivation” and “behavioral guidance.”  They also relied on “Zero Tolerance” as their discipline program.  None of this seemed to help.  Without hesitation, the Principal, teacher, and aides all agreed Jerry was their most difficult “challenge” of all their students.

The psychologist also reminded Angela and me of his professional assessment.  He stated Jerry is “obviously ADHD.”  He said he would like to refer Jerry to a psychiatrist and that “mother is not cooperating.”  In private, those words rankle me to my core.  Parents are routinely chastised, increasingly often, for not giving permission to a doctor to give their child amphetamine, for a “disease” that doesn’t exist.  Nevertheless, in this meeting, I listened.  I wasn’t there to debate the school psychologist.

Instead, we told everyone we’d be developing a plan, and that we would like to “partner” with the teacher and aides.  I said we were confident that, together, we could all help Jerry’s mother reach her goals.  We also decided, at this first “team meeting,” that we were going to delay other recommendations, including psychiatric.  It’s important to get everyone on board.  They were skeptical, perhaps cynical, and they were expecting us to “change” Jerry.  Nevertheless, we had their commitment, and that’s all we wanted to accomplish at our initial meeting.

Now, it was our turn.  Angela and I needed to gather our team at the office.  We needed to put together the plan.

Chapter IV:  The Plan

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TEMPERAMENT ADDENDUM

Stars

Innately quiet, and perhaps the most artistic of the Stars, Composer Artisans make up about 10% of the population.  Icons include Amadeus Mozart, Cher, Steven Spielberg, Barbara Streisand, Mel Brooks, and a personal favorite, Harpo Marx, to name a few.

As children, Stars in general are known in some circles as the “wild child,” a “firecracker,” a “little pistol,” or even a “little monster,” due to their boundless energy and propensity to attend to their current impulse.  Sometimes they’ll say “he’s wired,” or “explosive” and, “he’s so unpredictable.”  Those from education declare him “learning disabled,” or “learning handicapped,” and they will say has a reading, writing, or math “disorder.”

He had “minimal brain dysfunction” nearly 40 years ago when I first got into this field and, soon afterwards, he had “hyperkinetic reaction of childhood.”  Modern day medics, psychologists, and therapists say he has “ADHD,” or “childhood schizophrenia,” or “conduct disorder,” or a variety of other “diseases” and “disorders.”  Most distressing, if he’s quiet enough and seemingly “uncommunicative,” these particular Stars are currently being diagnosed as “autistic” during the past 20-year “epidemic” of autism diagnosers.  They’ve always called him something.  By the way, have your noticed?  It’s almost always “him.”

Stars, even the quiet ones, have an abundance of energy and an eye for adventurous pursuits, excitement their aim, boredom their bane.  It’s their nature.  This can be problematic for adults – teacher and parents alike –  who are responsible to provide directives to complete pursuits Stars do not like.  This is when child management trumps therapy and punishment, the two dominant styles of interacting with troublesome children.

Jerry wasn’t “sick,” he didn’t have “ADHD,” he wasn’t a “little monster,” he wasn’t “disabled,” and he sure as hell wasn’t a “horrible kid.”  He was a Star, a young Composer Artisan to be exact, and he was behaving as these Stars do when shame overwhelms them.  Ironically, Keirsey notes that Composer Artisans “show a kindness unmatched by all the other types.”  Often, unwittingly, we treat them, in turn, so unkindly.

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“Mondays with David”

Keirsey Picture 3 

It has taken me more than a month to write this.

My friend, David West Keirsey, died July 30, 2013.  He was 91.  I’m so proud, and fortunate, to call him my friend.  Up until a few years ago, he was Professor Keirsey to me, and I hadn’t seen nor spoke to him for 30 years.

As far as I know, Dr. Keirsey was humankind’s last Gestalt psychologist, and that’s something you should know.  His ideas are historic, and I’ll be writing much more about them, and similar things, for the rest of my life.  First, though, before I tell you more about Dr. Keirsey, I want to tell you about my friend, David, and the loves in his life.

David loved his country.  He was a proud veteran of World War II.  He joined the Navy in 1942. After flight training, he took his commission as a Marine fighter pilot and flew several missions in Japan towards the end of the war.  He wrote in some detail about his military experience in his autobiographical essay, Turning Points.

Those times, and the depression before the war, had a lifelong impact on David, as it did with everyone from the greatest generation.  He believed we were morally obligated to fight World War II, and he knew many who gave their lives protecting our freedoms.  He considered himself lucky to come home, and grateful, for the rest of his life, that he did.  Thank you David, for your service, from all of us.

David loved questions.  For the past 18 months or so I’ve been meeting with him on Mondays for three or four hours, often with his son David Mark, talking about temperament and psychology, and many other things.  I often took notes on my iPad.  I put them in my “Mondays with David” file on my computer.  I love asking questions, he loved answering, so our friendship grew.  We had much to talk about, and it was always fun. (You can read more about this from a prior blog, here.)

At times he became frustrated, his memory sometimes needing more and more of his depleted energy.  When I arrived for a visit I’d often ask, “how was your weekend David?”  He’d reply, with a smile, “I don’t remember, but I’m sure it was fine.”  Once he added, again with a smile, “. . . although I could try to retrieve the information for you if you wish.”  It takes energy to retrieve information.  At 91, you have the privilege of choosing where you want to spend your energy.  It was a polite question anyway.  I always knew where he was every weekend.  He was with his wife and his family.  He cherished his weekends.

Once we started talking about something he was interested in, he became focused, taking his memory to task, retrieving important ideas, if triggered by the right question.  Precision, more than anything, was his forte, organizing and analyzing ideas to a depth only a very few can imagine, simplicity his reasoned pursuit, efficiency always a welcome bi-product.  He never stopped “tinkering,” often spending hours at the computer, changing single words at a time in his many essays about temperament and “madness.”

I put madness in quotes because, well, David wouldn’t have it any other way.  Professor David West Keirsey was so much more than temperament theory.  His humane, holistic, and thoughtful explanation of “madness,” is above all else, his legacy to humankind, as far as I’m concerned.  His seminal work, Dark Escape, provides our species, for the first time in human history, a way out of the “madness” of modern day psychology and psychiatry.  I will be writing much more about this.

 David loved to read.  He read everything.  I mean everything.  I mean anything, and everything, and that started when he was a seven year old, and it never stopped.  The last time I saw him he was reading a favorite novel, for the fifth time.  Why?  “I might find something new – and I like it!” he said.  This wasn’t unusual.  From Turning Points:

I began reading when I was seven. Read (most of) a twelve volume set of books my parents bought, Journeys through Bookland. Read countless novels thereafter, day in and day out. I educated myself by reading books. Starting at age nine my family went to the library once a week, I checking out two or three novels which I would read during the week. Then, when I was sixteen, I read my father’s copy of Will Durant’s The Story of Philosophy. I read it over and over again, now and then re-reading his account of some of the philosophers. (Long afterwards I read his magnificent eleven volumes—The Story of Civilization. I also have read his The Lessons of History many times, this being his brilliant summary of the eleven volumes.)

I mention Durant’s book The Story of Philosophy because it was a turning point in my life, I to become a scholar as did Durant, thereafter reading the philosophers and logicians—anthropologists, biologists, ethologists, ethnologists, psychologists, sociologists, and, most important, the etymologists, all of the latter—Ernest Klein, Eric Partridge, Perry Pepper, and Julius Pokorny—of interest to me now as then.

So, I said to myself, who better to ask questions than someone who has read everything – over and over?  He had so many useful answers.  I’ll be sharing them with you too.

David loved words.  Not as a wordsmith or author, though he was certainly both.  He loved words as an etymologist – the only one I’ve ever met.  He often said he may be the only one left.  David studied words.  From Turning Points:

I became a scholar, one of three boys in the scholarship society in 1942. I took a course in word study. I have studied words ever since, even during the war, pasting lists of words on the bathroom mirror wherever I stayed. Why etymology (word signs) instead of linguistics (word sounds)? Because word sounds shorten with use becoming only remnants of what they were, while word signs are written and therefore remain the same. My interest was in what is written, not in what is spoken.”     

Many times on Mondays, triggered by something we were talking about, we’d go upstrairs and sit at his computer in his comfortable, book-filled library – me to his left, him behind the keyboard – looking at an online etymology site, researching a word.  He called it “fun” and, wouldn’t you know it, so did I.

David loved kids.  He started working with troublesome teenagers at the Verdemont Boys Ranch as a young psychologist, figuring out ways to manage these boys, and to help their families.  He worked in schools most of his career, doing the same, training thousands of teachers and counselors and psychologists in methods that work, not theories that don’t.  He began collecting the many techniques to manage and counsel adults and children that was to become the core of his one-of-a-kind, and highly successful Counseling Psychology graduate program at California State University, Fullerton.

He wrote some remarkable essays in defense of children, and every parent and professional should read them.  So, please, do that.  You can read Drugged Obedience in the School here, and The Evil Practice of Narcotherapy for Attention Deficit here, and The Great ADD Hoax, here.  There are many other important and useful essays you will find at the same site.

His solution to helping troubled and troublesome children?  “Be nice to them, and keep them away from those drugs.”  We had a lot in common about kids.  I’ll also be writing about useful child management techniques, from a temperament point of view.

David loved his family.  David Mark, his son and lifelong companion, joined our Monday morning conversations often, and I cherished those times in particular.  A gifted computer scientist, David Mark called his father “Daddy.”  He honored his father.

The two of them could, and often would, debate an obscure, yet important idea with the same passion as when the debate started 30, or 40, or even 50 years earlier.  His father honored him too.  Often, when it was just David and me, he would boast about his son Mark, as fathers who love their sons often do.  How lucky they were to have each other.  I envied them.

Every weekend David and his wife Alice went to Del Mar to meet with the rest of the Keirsey clan and, when they didn’t, family members came to their home.  David and Alice traveled and vacationed with their children and grandchildren.  The two of them together made sure they gave their family the best gift you can give to people you love:  wonderful memories.

Mostly, David loved Alice.  What was the first thing this returning WW II veteran did when he came back from the war?  He married his junior college sweetheart, Alice.  He admired her so.  “Alice has done such a wonderful job of keeping our family together and close over the years,” he often said, with much pride.

When you walk up the circular stairs of their beautiful home you will meet all of the family.  Alice has dozens of family pictures and other mementos adorned on the walls and on the stairs – and everywhere else throughout their warm, loving home.  This, you can tell, is a family that cares for each other, and they are grateful to have each other to love.  I recognized their family quickly.  I come from one too.

Alice – he called her “babe” – from they way he liked to tell it, was a dynamo of her own when she was working in elementary schools.  David said she was always the head of a department or committee or project, or part of some other crusade to care for all those kids for which she loved and cared.

They never quarreled, he told me, more than once, because, he said, more than once, “we were made for each other.”  That certainly proved to be true.  They were married in December, 1945.  I was two months old.

Why did it take so long to write this, and anything else, for that matter?  Well, honestly, I’ve been mourning my friend.  Just a few days before he died, my wife and I visited David and Alice at their home.  As we were leaving, I leaned over, gently grasped his hand to say goodbye, and to tell him, “I’ll see you soon, David.  I have another two or three thousand more questions to ask.”  Without hesitation, he replied, “Good,” and added, “I have two or three thousand more answers.”

His spirit, more than willing, his body, so weary.  During some of our best conversations, he would remind me, and David Mark, “there’s still much work to be done.”  Lucky for me, he trusted me with all that he has written.  The answers to my questions are all there, and that’s good.  I will be doing a lot more reading.  It’s not the same though, and not nearly as much fun, as asking my friend, David, just a few more questions.

You can tell a lot about a person when you know the loves in his life.  I admired him.  I loved him too.  I miss him, very much.

Mondays, for me, will never be the same.

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“I just want the world to understand, there’s no such thing as ‘madness.’”

David West Keirsey

GOTH GIRL – Part IV: A tale from the Lone Arranger

Goth Girl ImageHow 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 much more steady with this unsteady, 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.

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Epilogue

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

 A final few words about Evie.  Why, some have asked, was she “hallucinating?  Why was she cutting on her arms?  What, in a nutshell, is the “cause” of such “madness?”  The short, temperament-based answer?  Those are behaviors that Spheres (Idealists) use to ward of feelings of shame.  A longer answer?  This is what one of Keirsey’s disciples, Dr. Milton Lucius, wrote 30 years ago:

 “ . . . , the reaction to stress will differ according to a person’s temperament.  What may be stressful for the Idealist (Sphere) may be exciting for the Artisan (Star), and perhaps a boring problem for the Guardian (Square) or Rational (Cube).  This is so because stress for each temperament is not merely the pressure to act or decide.  Such pressure is merely pressure.  Stress has particular meaning in temperament theory.   

 “Stress occurs when an individual does not satisfy the basic desire of his or her particular temperament.   This is the essence of a ‘crisis of self-esteem.’  If stress is maintained long enough, or is intense enough, people turn their natural temperamental behavior style to an effort to protect themselves from further stress, and away from further efforts to produce satisfaction for their core need.  Their behavior becomes protective rather than productive.”  (Milton Lucius, Ph.D., 1983).

Whether you like the short or long answer, those of us temperament trained need not dwell on the “why” of behavior.  More important, if the intent is to help, the only question to ask is how do I intervene?  And that, whether parent or professional, above all else, is based on temperament.

These tales are about intervention with children who are troubled, or troublesome, and their families.

Why Star, Square, Sphere, and Cube?

I’ve been asked a few times how I decided on geometric shapes to designate the four temperaments.  It wasn’t easy.  With much consternation at the time – more than 20 years ago – and dozens of workshops since, I’ll be telling that story in my next blog.  Hint:  you’ll be learning a little about Gestalt (form) Theory as well.

Finally, I started writing “Goth Girl” last year.  While reviewing some articles online, I found a video about another girl.  Her name is Emily Longden.  She was hearing voices too.  I wrote a blog about her.  You can learn about the Hearing Voices Network, and you can meet – and see –  this brave young woman, here.

Next:  The Horrible Kid

Horrible Kid 2The next tale is about a nine year old male Star (Artisan) boy who was terrorizing his mother and grandmother.  The family was isolated by choice because he was “horrible” at home, and they didn’t want any neighbors.  The school was demanding that mother “medicate” her child because he was “horrible” in the classroom.  He had no friends.  Social Services was threatening to remove him from home and place him in a facility for other “horrible” kids.

In 1999, I was the Executive Director of one of the first private, non-profit “wrap-around” programs in California.  Our job was to keep him home and out of placement.  See how our team intervened to do that, without therapy, and without those phony chemicals.

GOTH GIRL – Part III: A tale from the Lone Arranger

Goth Girl Image

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 far and away 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 awhile 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 criss-crossed 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 “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.

NEXT TIME:  How Did it End? 

 

GOTH GIRL – Part II: A tale from the Lone Arranger

Goth Girl Image

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 and 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 she 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 and, from the portrayal Pamela gave me, 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.  (See About Evie’s Father in footnotes [i])

Making Progress

By the third or fourth time I met with Evie alone I asked again, towards the end of our conversation, 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 talking 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.

NEXT WEEK:  An act of chivalry

______________________

[1] About Evie’s Father

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.  She let me know her feelings about this in her ongoing conversation with Vlad


GOTH GIRL – A tale from the Lone Arranger

Goth Girl ImageChemical Cocktail 6

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 awhile, 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.  You can see more famous Spheres/Idealists here.)

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 even 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 usually 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.”

NEXT TIME:  The Story

 

How’s Business?

HOW'S BUS 2 GRAPHIC

Business has never been better, thanks for asking.

As long as the public – you and I – continue to demand newer and better quick fix chemicals, we act as a sales force for this huge industry.  Psychiatry, like any business, is subject to market pressure.  Right now, there is pressure to create more and more chemicals for more and more “diseases.”  Our demand is met, happily, by their supply.

Let’s take a quick look at “ADHD,” just one example out of hundreds of fake diseases.  “ADHD” has been a financial boon for Big Pharma.  It’s been increasing nearly 6% a year for the past decade.  In America – like no other country on earth – one of every 12 children between the ages of 3 and 17 are given this tag, most of them prescribed an amphetamine (“speed”).  That’s more than five million American teenagers, grammar school kids, and toddlers – most of them boys. (See CDC FastStat here)

And, dear parents, your doctor can choose from 61 different chemicals for “ADHD” – with more on the horizon.  There are 78 chemicals for depression, and there are 7 “kinds” of depression.  Antipsychotic chemicals?  26.  There are 12 chemicals to treat autism, the most maligned of all children, as you will see in an upcoming essay.  Anxiety disorder of some sort?  There are 188 chemicals in 9 different “topics” to help you if you are too anxious.  Anxiety “relief,” as you can tell, is a big seller.  (See Drugs.com here.)

What’s A DSM?
Let’s get a picture of the growth of this industry in the past 60 years.

The Diagnostic and Statistical Manual (DSM) is psychiatry’s modern day witches brew.  It contains all the American Psychiatric Association (APA) approved “diseases.”  If it’s not in the book, it’s not a “disease.”

In 1952, there were 106.  In 1968, the second edition of DSM was published.  There were 182 “diseases.”  The third edition, published in 1980, had 265, and then was revised in 1987 to total 292.  And, finally, in 1994, the fourth edition contained 297 “diseases” – and if you count the “disorders,” it’s over 400 (see the entire list here).  No cures, you may remember.  Treatment only, usually forever, because mental health “diseases,” once diagnosed, according to the vast majority of psychiatrists, last forever.  Ask them.  (See more about the DSM here.)

The DSM is a billing device for the profession, nothing else.  It has no other value.  Still, as a billing device, everyone must use it.  By everyone I mean government, big business, non-profits, academia, licensed individuals, public and private providers, schools – everyone.  Without a diagnosis from the DSM, no services will be given; not without a designated name and number from this book of incantations.  (See upcoming article Diagnosing for Dollars soon)

So, you can see, it pays to be in the book.

DSM V –  Progressing Backwards
The DSM is being revised again, due in May of 2013.  If you guessed there would be more diseases, you’d be right.  One addition is particularly egregious.  Grief.  If you lose a loved one, and if you don’t snap out of it after a few weeks, you are “diagnosable.”  I’m not kidding.  Complicated Grief Disorder (CGD) is in the book.  Ethical professionals from all disciplines are screaming at this “medicalizing” of human sorrow.

For the record, and full of irony, no one is screaming louder than Dr. Allen Frances, the Chairman of the DSM IV Task Force.  The irony is that the biggest foe of the fifth book of diseases is the psychiatrist who led the group that wrote the fourth book of diseases.  For many of us, editions 1-4 are just as unscientific and nonsensical as the fifth, though the latest version is now, officially, the worst. (More about Dr. Frances and the DSM V controversy here.)

Not quite everyone is screaming, by the way.

Not the DSM Task force, for sure.  They voted CGD into the book.  Certainly not Big Pharma.  They’re applauding.  Their market was increased.  Now that your new “disease” is in the book you can be prescribed one or more of those 188 “anti-anxiety” chemicals already available.  This will have to do until the new and improved “anti-grief” chemical is developed.

Then there’s this.

At first it appeared – and then it was confirmed – that 70% of the DSM V Task Force members have reported direct industry ties.”  New diseases are proposed every year.  The people making those decisions are benefitting from those decisions, as are their “industry ties,” as they decide who wins and who loses. Many professionals, including me, are crying foul about the ethics of the task force whose members openly admit their connection to Big Pharma, mostly to deaf ears. (More about DSM V here.)

Who are the winners?
The scientists and doctors from Academia and Big Pharma corporations who get their newest “disease” in the book are the winners, and it’s very competitive.  Major Universities and massive corporations – and individuals with “connections” – stand in line to present their self funded “research.”  If you can get an unwanted behavior proclaimed a “disease” by the disease proclaimers – the DSM Task Force – and placed in the book, then the doctors, universities and corporations who invented the “diseases” will be enriched because, well . . .  because we give them fistfuls of money for their products.

Big Pharma’s most important customer, by the way, is the doctor, not you.  Doctors, after all, are the ones who sell their products to us.  While these companies aim their endless advertisements to entice you, it’s the doctor who has the power to grant permission, and they are the focus of the Big Pharma’s substantial financial coffers.  From an article from Time: Health & Family, Psychiatrist Contends the Field Is Committing Professional Suicide,” October, 2012:

In 2004 alone, pharmaceutical companies spent about $58 billion on marketing, 87% of which was aimed squarely at the roughly 800,000 Americans with the power to prescribe drugs. The money was spent mainly on free drug samples and sales visits to doctors’ offices; studies find that both free samples and sales calls increase prescribing of brand-name drugs and raise medical costs without improving care.  (Read more: here.)

And talk about lucrative.  Global sales of pharmaceuticals was nearly 800 billion through 2008, and is likely to be closing in on a trillion dollars annual income now.  Thanks to their customers – us –  90% of those sales occur in the United States.

5 Million and Counting
Finally, let’s talk just a bit more about those 5 million kids given doses of “speed” for “ADHD.”  That’s a lot of kids.  For this to be true, you have to believe American kids are much less healthy than kids in rest of the world.  Or, is it that the rest of the world’s kids are just as unhealthy as ours, only they don’t know it?

Maybe it’s because our healthcare services are state-of-the-art, our workforce so well trained, the research and science from our Universities so sophisticated that we’re just that much better at “diagnosing” ADHD in kids who need medical help.  This explanation, by the way, is what both Academia and Big Pharma wants us to believe.  Our system, they say, is modern and compassionate, and that’s why we can, and do, provide so much needed medical care to “mentally ill” children.

By now, I trust, you know this isn’t true for a lot of reasons we’ve already discussed.  The most important reason?  I think you already know.

Your kids aren’t sick.

NEXT:  Here’s Where We’re Going

A brief interlude 2 . . .

~~~~~~~~~~~~~~~~~~~

Well, maybe not so brief an interlude.

I’ve been off my blog for several months, though I haven’t been idle.  I’m ready to get back to it.  Let me tell you why.

I’m now on the Board of Directors of the International Society for Ethical Psychiatrists and Psychologists (ISEPP), and I’m the newly named Membership Director.  I joined ISEPP three years ago when I retired.  It’s the only group I’ve ever joined.  We are professionals, parents, psychiatric survivors, and others dedicated to ending the use of the medical model and those abusive chemicals we take for fictitious diseases.  As a reminder, I’m here to convince you the use of chemicals to “treat” unwanted behaviors in adults and children is modern day voodoo.  We count ourselves in the hundreds at ISEPP, though our network has tens of thousands  – and we’re growing.  You can find more about ISEPP here.

By the way, here’s a recent article you may want to read.  It’s about “neuroscience,” and “neurology,” and “neurolinguistics,” and “neural pathways in the brain” – and other “neuro-babbles.”  It’s called Your Brain on Pseudoscience:  The Rise of Popular Neurobollocks. It’s written for us to read, by Stephen Poole, a British author and journalist.  He’s not a scientist and the article isn’t about science.  It’s about false science, and how we are duped daily.  It’s a little long, about 2500 words, but it’s interesting and worth your time.  When you can, spend 20 minutes here.

And if I haven’t mentioned him before, I should have. Robert Whitaker is another journalist, American born, who authored what many of us consider to be the most important book written on the subject.  It’s had national acclaim and recognition, and it’s written for you and me.  Titled Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, if you read it, you’ll never be able to view psychiatry in the same way again.  You can find it everywhere.

What’s Next?

I’ll be picking up where I left off on my blog.  My last entry was YKAS 5:  A Most Valued Customer.  YKAS 6 & 7 will be following soon.  YKAS is a series of articles that will become an iBook soon.  Your Kids Aren’t Sick has been a project for a few years, and I’ll be finishing it this year.

After YKAS 6 & 7, we’ll be talking about chemicals, starting with, of all things, snails, followed by the history of salt.  You’ll also find out about Mr. Unhappimon, my chemistry teacher when I was 19.  He was a terrible teacher, but I learned something valuable about chemicals and their effects on human beings.  Not because of what he said.  Instead, it was something he did – in front of the entire classroom.  I’ll be telling you, too, a story of a young mother’s “adrenaline rush,” and how that experience that will put into question everything you think you know about psychiatry.

Most important, we’ll get focused on all those those chemicals your friendly psychiatric doctor wants us to take for our “mental disorders.”  You may think of yourself as informed about “anti-depressant,” “anti-psychotic,” and “anti-anxiety” medication, to name a few.  If you dismiss the medical model as I do – as well as hundreds of thousands of others – then you know these terms are meaningless and worse, their names mask the true and undeniable toxic and disorienting effects chemicals have on our body.  You know them as “side effects.”  As you’ll see, there’s nothing “side” about these effects.  You’ll meet Dr. Grace Jackson, in time, who will tell us much more about these harmful chemicals and their lifelong effects on our physical well being.

Speaking of chemicals, here’s 497 chemicals you can find for just 14 of the 400+ “psychiatric diseases” found in the latest incantation of the Diagnostic and Statistical Manual (DSM V), psychiatry’s bag of tricks:

  1. ADHD (62 drugs in 2 topics)
  2. Agitation (19 drugs in 3 topics)
  3. Anxiety (117 drugs in 7 topics)
  4. Autism (11 drugs in 2 topics)
  5. Bipolar Disorder (65 drugs in 4 topics)
  6. Body Dysmorphic Disorder (9 drugs)
  7. Borderline Personality Disorder (10 drugs)
  8. Depression (101 drugs in 7 topics)
  9. Intermittent Explosive Disorder (4 drugs)
  10. Neurosis (2 drugs)
  11. Obsessive Compulsive Disorder (23 drugs in 4 topics)
  12. Paranoid Disorder (5 drugs)
  13. Psychosis (14 drugs in 2 topics)
  14. Schizophrenia (55 drugs in 2 topics)
                                      (Source:  drugs.com here)

You may remember, at YKAS, there are only four kinds of chemicals:  stimulants (“uppers”), depressants (“downers”), hallucinogens (“confusers”), and tranqulizers (“calmers”).  Imagine, if you will, that it’s possible to take all those different chemicals that Big Pharma cleverly sells to us for every uncomfortable emotion and experience imaginable, and place them into one of these four categories.  It’s that’s simple, and you’ll be surprised how useful.

I’ll also be adding to the “Meet .  .  .” series as well.  There are a number of people I’d like you to know.  The next one you’ll meet, Tom Bratter, was a kindred spirit.  My one and only conversation with him last year was over the phone for half an hour.  We were going to meet, and talk, at the conference in Philadelphia.  He died last August.  You’ll meet him and you’ll understand why.  Likewise, I’ll be continuing the “Here’s something . . .” series as well.  These will occur as I find interesting information and sources for you to ponder.

The Tales of the Lone Arranger

I’m adding a new series of articles too, dubbed “The Tales of the Lone Arranger.  Why that name?  Two reasons.

The first and most important is David West Keirsey.  I learned in my continuing talks with Doctor Keirsey that, in temperament terms, I’m an “arranger.”  He continues to fine tune his theory, tinkering with his words every day, precision and simplicity his goal.  Thirty years ago I was an “INTJ Skeptic,” then an “INTJ/Mastermind.”  He has since abandoned the letters and metaphors, replacing them with words that describe what a person does. In his own inimitable way, Dr. Keirsey has settled on “arranger” for my type.  And, not surprisingly, the term fits like a glove.  It’s what I do.

The second reason?  My favorite TV Saturday morning cowboy show in the early ‘50’s – and there were lots of them – was The Lone Ranger.  I’ll tell you a little more about both of them soon.

The Tales of the Lone Arranger will be about children I knew and counseled, from a temperament point of view.  To remind you, I use the terms Stars (Artisans), Squares (Guardians), Spheres (Idealists), and Cubes (Rationals) to describe the four Keirseyan temperaments of children.  I’ll tell you more about those names, and their “nicknames” too.

The first tale – Goth Girl – is about a 14 year old Sphere (Idealist) who was heavily medicated.  After a “72-hour hold” in a psychiatric hospital, Evie was placed in my facility.  She was “goth,” she was hearing voices, and she was a “cutter.”  She purposely took sharp objects and scratched her arms and legs until they bled.  Like all Spheres, it’s about their feelings – or abscence of them.  The story has a good ending – at least from the last contact I had with her mother a few years ago.

There will be more temperament tales to follow.  While so-called “normal” childhood behaviors follow observable temperament patterns to trained eyes, so too are the patterns of troubled and troublesome children.  Children “act-out” their shame in ways consistent with their temperament, and therein lies clues for adults who want to intervene.

I’m working on some other articles as well that I will likely post at a different site, only because of the length. Diagnosing for Dollars is about our Medicaid system and how professional providers are mandated to diagnose “mental diseases,” so they can be paid for their services.

I’m just about done with an article titled Sergeant Bales.  You may remember Sergeant Bales.  He was responsible for the slaughter of 17 innocent Afghanistan villagers.  He is just now coming to trial.  The article is about the rush of some of my colleagues to declare that the “cause” of this horror was the “psyche meds” the Sergeant may or may not have been taking.  I believe this idea suffers from the same false logic and science of those who declare that there’s a “chemical imbalance” that “causes” violent acts.  Many of my like-minded colleagues do not agree with me about this.  We’ll see if you do.

I’m also beginning another article I’m calling It’s A No-Brainer I’m more convinced than ever that modern neurology, psychiatry, and other “brain sciences” has nothing to teach us about human psychology.  I voraciously look for information daily.  Based on speculation, tired theories, and unproven science, the fundamentals of how the brain works is simply not known when it comes to personality, psychological distress, and human behavior.  Well, at least that’s what I’ll be saying.

I’m also about done with an article about Sandy Hook.  I don’t know of another incident in my lifetime that shook our country as deeply and as profoundly as the news of the twenty children, six educators, and one mother who were murdered on December 14, 9:30 AM, EST.  It changed our culture, and our national conversation.  I’ll have some thoughts about guns and violence and mental health and Hollywood.  I’m calling the article 300,000,000.

Finally, just a reminder:  You’re kids aren’t sick, and neither are you.

Now, back to work.  I have a lot of writing to do.

Dr. C

If we want a child to change his direction, we must understand what makes him move.

                                                                                         –  Rudolf Dreikers, M.D.

 

YKAS 5: A Most Valued Customer – Your Child

First Contact – Someone is “Concerned”
It usually starts like this for parents of active kids – especially parents blessed with very active kids.

There’s a call from your child’s teacher.  You were half expecting it.  About two weeks earlier you met with her about your nine year-old’s behavior in the classroom.  She said he’s a nice enough boy, very cute, however, he’s inattentive and easily distracted.  That, and he’s much too active during classroom hours.  Oddly enough, you’ve seen him at home when he’s using the PlayStation III.  That too active, inattentive kid can be so focused on the TV screen he won’t budge – even if it’s pizza for dinner.  He seems intensely attentive, to the point you have to pry him away from the game.

Nevertheless, this time the teacher tells you “. . . your child still isn’t paying attention and he continues to be up and down all day long, and we are concerned.”  She said “we,” so now you know there’s at least one other person at the school who’s concerned, and that concerns you.

The teacher said she would like to refer your child to the school psychologist for an “evaluation,” with your consent.  Your concern increases so, of course, you consent.  After all, these are the experts, you reason, and you must trust them.

They know best.

The Disease Model Indoctrination Process
You have a meeting with the school psychologist.  She’s a doctor of some kind, and you’re a little intimidated.  While you were expecting her to test your child, you’re given a behavioral questionnaire to complete too.  You didn’t expect that, but that’s good.  At least something is being done to help your son, and the experts are being thorough.

You’re beginning to learn about the process, and you’re impressed.

In a week or so, you’re informed the evaluation is done, and you’re asked to attend another meeting.  You’ve been worried and you’ll be glad to get an answer.  Then you get your answer.  The psychologist recommends you seek medical assistance for your child because he likely has “attention deficit disorder” with, God forbid, “hyperactivity.”  She uses the term “disorder” for the first time, and it unsettles you.  She tells you she can’t treat him because “this is a medical problem.”

A doctor of psychology recommends you seek help from a doctor of medicine.

Enter the MD – With Chemicals
By now, you know this is serious.  You have to inform your family too, and that won’t be easy.  You’re a conscientious parent, and you’re persistent.  You want the best for your child, so you search for a “child psychiatrist,” as others have suggested.  Maybe someone you know, or the school, makes a referral. If you’re “lucky,” you’ll find one.

You do, and you make an appointment.  The nurse takes your child’s vitals, you provide a family medical history, and they’re done with your child.  You’re a little surprised.  You were expecting something more “medical.”  Maybe an x-ray, a blood test, a “scan” of some kind, or another medical procedure that can be measured or weighed or looked at – something.  After all, that psychologist told you “this is a medical problem.”

You’re learning a little more about the process.

A Family Changing Event – The Diagnosis
You meet with the doctor and, for the most part, you do most of the talking.  You tell him about the school’s concern and the tests from the psychologist.  Maybe your child is asked a few questions, maybe not.  It doesn’t matter.  He’s not there to talk.  He really doesn’t need to be there at all.  The doctor is there to make a diagnosis based on the information you give him.  The doctor’s only function is to do nothing, or prescribe a chemical – and he can’t prescribe a chemical without a diagnosis.

Within 10 to 20 minutes, the child psychiatrist has heard enough and says “. . . I’m prescribing a chemical to help with your son’s Attention Deficit Hyperactivity Disorder.”  Maybe he calls it a “mental illness, or a “mental disability,” or “mental disorder,” or “psychiatric disease” or just plain “disorder.”  It’s what you expected.  You’ve talked with family and friends before this meeting. Still, hearing it for the first time from an MD makes it much too real.

There’s a brief explanation of the “disorder.”  He says something about “brain chemistry” and some sort of “imbalance,” and you know he mentioned “dopamine.”  You know you’ve read about dopamine somewhere.  It all sounded so “medical.”  The special chemical he’s giving your son, you’re told, helps to fix all this, so that your son will sit still in his chair during school hours, and so your son will do his school work when the teacher tells him to do his school work.

You’re anxious to get the treatment part of the process started.

How Soon Will It Work?
Well, you first have to know it will take some time – a few weeks, maybe more, maybe less –  for the chemical to begin to have an “effect” because it has to “build up in his bloodstream.”  Once in his bloodstream, you may begin to see some improvement, although there will undoubtedly be some “adjustments” along the way due to unpredictable yet very common “side effects.”  It’s been made clear to you:  there will be good days, and there will be bad days.

Strangely enough, you’re still a little relieved.  At least the medical doctor knows what your child “has,” and you leave the office confident this new chemical will help your child in school, and that’s all that matters.  You privately fret your child has a “disease” or “disorder,” and you’re not clear how long your son will have to take this chemical – the doctor was vague about predictions – nonetheless, you’re reassured, and optimistic.

The teacher is pleased you are taking steps to help your son.  The school is happy too, and, to some degree, so are you.  You find comfort when you hear, over and over from friends and professionals, “it’s just like diabetes.”*  That means, thankfully, your son’s “ADHD” can be “treated,” with the right chemical.

He’s Just A Little Flawed
About your child, well, at some point you have to explain to him he has a “handicap ” –  or “disorder,” or “disease,” or a “mental illness” or, maybe, “an imbalance” – and that’s why he’s not sitting still, and that’s why he’s not paying attention to the teacher in school, and that’s why he needs this chemical to help him.  It’s tricky, but with the advice of others who’ve gone through the same thing, you do it.  You make sure he understands he’s not responsible for his unwanted behavior in the classroom.  You make sure he understands it’s not him, it’s not you, it’s not his teacher, it’s not his school – it’s his “disease.”

Four months go by and you’re disappointed.  Yes, the teacher said she saw “some initial improvement,” but a month later, she began to complain again.  You’ve had two “follow-up” appointments with the doctor to “review” your son’s chemicals to find out how they are helping or not helping.  At the last appointment he increased the dosage of the chemical.  Now, at this appointment, he’s suggesting a change of chemicals “that has less side effects, and better results.”  Of course, this means this new chemical will have to “build up in his bloodstream” too, and there will be new “adjustments” to make along the way.

By this time, you’ve done research, so this wasn’t unexpected.  You’ve surfed the web for the past few months, read dozens of articles, and you’ve talked with other parents who also have children with “disorders.”  Changing chemicals, up and down doses, extra chemicals for the “side effects” is the rule – not the exception.  You’ve talked with some parents whose children are taking 3 or 4, or as many a 5 different chemicals.  You hope you don’t get there.

Don’t Worry – It’s “Normal”
You’re troubled too.  He’s not sleeping well.  His appetite comes and goes.  He’s not doing any better in school either – maybe a little worse – and now they’re talking about special classes, and you have to make some decisions.  On top of that the doctor says he can give you another chemical to help with the “side effects” of the first chemical.  You have to think about that one.  You do, and you agree.

Your child seems to be a little more distressed too, a little more unhappy, a little more frustrated, maybe a little more angry.  You are too – all of it.  It’s going to be a longer road than you expected, but you’re going to stay with it and do whatever is necessary.

You know by now from your doctor, through your research, and by talking with other parents, all of this is a “normal part of the process.”

And It’s Done
You and your child are now willing, all-in customers of the disease model of “modern” psychiatry.  You can’t stop the “treatment” now.  It’s been made clear to you, and you know it as fact, your son has a “medical condition.”  Now you’re the one who educates others that “it’s just like diabetes,” and you wouldn’t dare stop treating diabetes.

You now know everything you need to know about the process.  You’re indoctrinated.  You’re an advocate.  You’re an expert.  You’re fully prepared to indoctrinate another parent.

And so it goes.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

For a very real, very recent example of the indoctrination process, read a mothers story about her experience with her 8-year old son – and how he’s doing now – in her article in the NY Times:  “Raising the Ritalin Generation” here.

* See “It’s Just Like Diabetes” in the forthcoming essay:  Psychi-Babble – Psycho-Babble’s Evil Twin

NEXT:  How’s Business?

YKAS 4: The Business of Selling Chemicals

This is the fourth in a series of essays on the YKAS blog.
The original article – Your Kids Aren’t Sick –  can be read here.

Let’s Call Them Chemicals
If you’ve read my prior essays, you may have noticed by now.  I don’t refer to them as “medications” or “drugs.”  I call them what they are: chemicals.  I’ll continue to use that term, so, please, while you may consider Valium or Xanax or Mellaril as medication, I refer to them as chemicals.  Likewise, you may think of heroin, cocaine, and marijuana as drugs.  Here, all illicit drugs are called chemicals too.  In that way, we don’t have to be concerned about why you take them or where you get them, and whether they are legal or illegal.  Instead, we only need to know what effects these chemicals have on people.

Does it Work?
The selling of psychiatric diseases and the chemicals that treat them is as much a political issue as it is a for-profit commodity.  A Big Pharma company prepares a sophisticated and detailed application to seek approval from the United States Government’s Food and Drug Administration (FDA).  New cancer chemicals, for example, must provide some evidence of success, or what is referred to in scientific circles as “efficacy” – as in “efficient.”  Doctor’s and their clients – you and I – need to know if the chemical is “efficacious.”  In other words, does it work?  After all, we pay taxes to make sure the chemicals created by business really do what they say they do, and to ensure business and government work together to produce safe products.

That’s the good news.

Off-Label Use.
However, and maybe you don’t know this, once a chemical is approved for cancer, for example, the newly approved “efficacious” chemical can be prescribed by a doctor for any human malady, regardless of what it was originally designed to treat.

If a pharmaceutical “rep” shows the doctor a “study” that “suggests” this same cancer chemical is effective for, let’s say carbuncles, then the doctor can prescribe the cancer chemical to his patient to battle carbuncles.  Despite the fact the chemical was thoroughly scrutinized by the FDA specifically for cancer treatment and nothing else, once approved a doctor can prescribe it for anything, and no one will bat an eye.  In the business, this is called “Off-Label Use.”  From Wikipedia here:

  • The FDA does not have the legal authority to regulate the practice of the medicine, and the physician may prescribe a drug off-label. Contrary to popular notion, it is legal in the United States and in many other countries to use drugs off-label, including controlled substances such as opiates.

What does this mean to you?  While the FDA is strident to ensure any new chemical they approve meets very rigid standards, once approved, any chemical can be prescribed for any human need by any doctor, anywhere, anytime.

So much for “efficacy.”

You can thank Big Pharma lobbyists and our bought-and-paid-for legislators working in tandem for this too clever and excessively obvious tactic to get around FDA scrutiny.  Together they made this practice “legal,” and there is no recourse for you or me.  Why do they do it?  Why do you think?  To widen their customer base.  Here’s an example.

Zoloft – The Miracle Chemical
If you’re not familiar with Zoloft, you should be.  In 2007, nearly 30 million prescriptions for Zoloft were written.  The chemical name is Setraline Hydrochloride.  It was created by Pfizer and approved by the FDA in 1991 as an “antidepressant.”  Once approved to treat depression, and thanks to that beneficial law, Pfizer got busy.

In the mid 90’s, by way of their self-financed “studies,” they “discovered” Zoloft was “better than a placebo” for treatment of Obsessive-Compulsive Disorder. The “discovery” of this new use didn’t need the FDA’s approval or oversight.  Pfizer just declared it, and their sales force provided doctors with their “evidence.”  (By the way, the phrase “better than a placebo” is common in these studies.  More about that, and an explanation of the scientific-sounding-yet-phony phrase “double-blind studies” will follow in the essay “Psychi-Babble.”)

Pfizer was just getting started.  From the late 1990’s through the present, other amazing “discoveries” were made about this chemical – through Pfizer financed “studies.”  Take a look:

  • By 2000, they tell us, “in four large double-bind studies setraline was shown to be superior to a placebo for the treatment of panic disorder.” 
  • By 2003, “studies” showed setraline was “successfully used for the treatment of social anxiety disorder.” 
  • Around this same time, and through the same means, setraline was found to be “effective” for Pre-Menstrual Dysphoric Disorder
  • And, though not nearly done, this same miracle chemical was subjected to two “double-blind studies” that “confirmed the efficacy of setraline for severe chronic Post-Traumatic Stress Syndrome (PTSD) in civilians.”

Let’s Keep Score
This one miraculous chemical can treat 1) depression – the original approval – as well as; 2) obsessive-compulsive disorder; 3) panic disorder; 4) social phobia; 5) premenstrual dysphoric disorder and; 6) posttraumatic stress disorder.  You’d think that would be enough, as ridiculous as this already is.

Think again.  There’s more to come.

There are “indications,” we are told, from the latest “placebo-controlled double-blind clinical trials,” that Zoloft may also be useful for: 7) Generalized Anxiety Disorder; 8) binge eating disorder; 9) night eating syndrome; 10) bulimia nervosa; 11) syncope (fainting) in children and adolescents and – who would have thought; 12) premature ejaculation.

That’s six official uses now, with six more on the horizon.  An even dozen.  We’re told more “studies” are needed to confirm these “indications.” Do you think Pfizer will make sure the studies get done?  What do you think the outcomes will be when they do?  (For more information about Zoloft, see Setraline here.)

 Business As Usual
This is how it’s done.  It’s an “efficacious” business practice for all of Big Pharma.

If you create a toothpaste and you “discovered” a little later that the toothpaste was good for cuts and bruises too, as well as a lubricant for doorknobs, and it’s a good quick drying glue on top of that, my goodness, think of all the customers you’d have.

You’d be rich.

(You can read about PsychRights and attorney Jim Gottstein’s ongoing strategic litigation campaign against forced psychiatric drugging, electroshock and off-label use in the United State here.)

 NEXT:  A Most Valued Customer – Your Child