John Rosemond April 2019 Columns
Copyright 2019, John K. Rosemond
Confronting 'Biochemical Imbalance' in Children
The Wall Street Journal recently (3/16/2019) printed a letter-to-the-editor in which Upland, California psychiatrist/psychoanalyst Charlene Moskovitz promotes the alleged benefits of medication and psychotherapy for children diagnosed with depression, anxiety, and ADHD (and, presumably, other emotional and behavioral issues). According to Moskovitz, children who exhibit the behaviors in question may be dealing with “biochemical abnormalities.”
She asks, rhetorically, “Would such a child not benefit from having his or her biochemical issues helped with medication and thus build further strengths and coping mechanisms to deal with the other difficult aspects of his life? Does such a child not benefit more fully from the psychotherapy a skilled therapist provides?”
In all fairness to her, Moskovitz is only acting as a spokesperson for the mental health and pharmaceutical industries that have built up around the practice of diagnosing children as young as two with various mental disorders. Said practitioners routinely explain the behaviors in question – depression, anxiety, inattention, impulsivity, defiance, frequent and extreme tantrums, sudden mood swings – in terms of “biochemical imbalances” and prescribe medication as well as various forms of therapy.
In 2009, I published a book on this subject: The Diseasing of America’s Children. My co-author –pediatrician Bose Ravenel of Greensboro, North Carolina – and I put forth evidence that these brain-based explanations and therapies have no scientific validity.
Concerning the oft-referenced “biochemical imbalance,” for example, since no one has ever quantified biochemical “balance” in the human central nervous system, it is nothing short of disingenuous for medical scientists to lead the public to believe they know what they’re talking about when they refer to a CNS imbalance. A leading psychiatrist, well-known in his professional community, has said that the term biochemical imbalance is “nothing but a useful metaphor.”
“How is it useful?” one may ask. To sell the public on the unproved notion that psychiatric drugs are the answer to problems of emotion and cognition, that’s how. After all, it makes sense to assume that a biologically-based condition requires an intervention that targets the biological fault or dysfunction. The problem is, no one has ever established beyond reasonable doubt that psychiatric disorders are biologically-based. And yes, that includes schizophrenia and manic-depression. The current state of evidence strongly suggests that the term “mental illness” is a misnomer. Moskovitz’s fundamental premise – that many of the kids in question have “biochemical abnormalities” – is one that neither she nor anyone else can prove concerning any given child.
Furthermore, the medications in question, although approved by the FDA, have not reliably outperformed placebos in double-blind clinical trials. Unlike placebos, however, they have often-dangerous and even life-threatening side effects. In other words, the question of whether these drugs truly “work” is not fully resolved.
As for psychotherapy with children, and with all due respect to folks like Moskovitz, no study done by an objective third party has conclusively verified the reliable efficacy of any form of child therapy. Over the course of my 40-plus year career, hundreds of parents have told me that putting their kids in talking or play therapy made matters considerably worse.
Several psychiatrists have confirmed to me that what I’ve written in this column concerning medication and child therapy is known by many of their colleagues…yet the band plays on.
That just might qualify as a mental illness.
Key to Effective Discipline Is Right Attitude
“We’ve tried everything!” is one of the more common testimonials I hear from parents who’ve just described persistent and highly vexing discipline problems with a child or children.
Setting aside that it’s never the case that “everything” has been tried in conscientious fashion, the complaint reflects the wrong-headed notion – common to American parenting since the early 1970s – that proper/effective discipline is a matter of correctly manipulating consequences vis a’ vis some method, technique, or strategy.
I must confess to having contributed, perhaps greatly, to this mistaken idea. Early on in my now forty-plus-year career as a syndicated columnist, my editors repeatedly emphasized the need for me to tell people what to do. So that’s what I did. I was deft at coming up with creative approaches to behavior problems; furthermore, at that point in my ongoing development as a “parenting expert,” I believed that for any given problem, there was a method that would solve it.
I believed in behavior modification, in short. I believed that the proper use of positive consequences would strengthen right behavior and, likewise, the proper use of negative consequences would shut down wrong behavior. It took me a while to discover what I was not told in graduate school: no one has ever proven that behavior modification works on human beings. It works on dogs, rats, monkeys, even amoeba, but when you throw free will into the equation, behavior modification falls flat. In fact, children who are the targets of behavior modification are likely to learn to be manipulative.
Having said that, it’s important to note that consequences are necessary. Children need to learn that in the real world, right behavior is usually rewarded in some way and bad behavior is usually punished – the operative word in both cases being “usually.” But whereas consequences work reliably and predictably with, say, dogs, they do not work reliably or predictably on humans. For example, a child who is punished for a certain misbehavior may become that much more determined to get away with it. And researchers have found that a child who is rewarded for a certain something may stop doing it. Humans are paradoxical. Dogs, not so much.
The key to effective discipline is a right attitude. Without the right attitude in question, no consequence-based approach to discipline is going to work for long (any new approach, because of the novelty effect, may work for a few days or weeks). With the right attitude, just about any approach is going to work and keep on working. Furthermore, the right attitude will eventually render consequences all-but unnecessary.
The right attitude involves letting a child know that there is absolutely nothing he can do that is going to knock you, the parent, off balance; nothing he can do that will ruffle your feathers. He can disappoint you, but he cannot upset you. He has no power over your emotions.
The right attitude involves projecting complete confidence in the legitimacy of your authority concerning the child in question. You are clear on the fact that as a general is superior to a lieutenant, you are your child’s superior. Children need superior beings in their lives. They need adults who act like they know what they’re doing. That is essential to their sense of well-being.
The right attitude “says” to the child, “I really don’t care one whit whether you like me at any given moment in time. I know that I love you enough to give you my seat in the lifeboat, and that – which you can’t fathom so I’m not going to try to get you to fathom it – is what really counts.”
The right attitude is very old fashioned. But where children are concerned, there is nothing new under the sun.
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Parenting in an Age of Technology
Julie Jargon is a reporter with the Wall Street Journal. Heretofore, she has written about food companies like Starbucks and McDonalds. As of April 2, however, Ms. Jargon is writing a WSJ column titled “Family and Tech,” described as dealing with “the impact of technology on family life.”
In her inaugural column (April 2, 2019), which could have been written by public relations folks at Sony and the American Psychological Association, Ms. Jargon strives to convince her audience that simply because a child has difficulty putting down the game controller and finding creative, productive things to do does not mean he’s a video game addict.
Given that addiction is defined as being obsessed with and having great difficulty ceasing the use of a harmful substance or involvement in a non-productive or pathological activity, I fail to see anything but contradiction in Ms. Jargon’s thesis. We’re talking about kids who will not stop playing video games unless a parent or the imminence of a bodily function forces them to stop. How’s that not an addiction?
The manager of a large west coast convention hotel once told me that when his property hosted a “gamers” convention, his staff had to threaten attendees with pulling the plug on their devices to get them to drink water or eat even a cracker. Many of the attendees wore adult diapers so they wouldn’t have to stop playing. That, by any other name, is addiction. It’s also sick. It’s also where a child or teen’s obsession with video games may lead if parents don’t pull the plug before some hotel manager has no choice…that or risk a lawsuit from a gamer who becomes dehydrated and suffers a cardiac episode.
Ms. Jargon seems loathe to call a spade a spade. After relating two horror stories that clearly describe addiction, she refers to psychologists who advise parents to stop worrying about whether their kids are addicted and figure out instead if they’re using video games to cope with depression, anxiety or stress. She cites a study finding that teens who played video games four or more hours a day on average showed more signs of depression than kids who played less than four hours a day.
Note that the psychologists in question (unidentified) posit that depression and other mental health issues cause obsession with/addiction to video games as opposed to the other way around. That’s a clever means of covering ineptitude while at the same time claiming rights to treatment (keep in mind, dear reader, I am a psychologist). Besides, it’s so much easier to tell parents their child needs a daily dose of a drug than it is to get them to do something that will cause their child to hate them and act deranged until cured, not to mention something that may cause them to never make another appointment.
I once persuaded parents to “disappear” their 15-year-old son’s console while he was at school. He was so “into” video games he would not come down to dinner or participate in any family activity and was usually up well past midnight every night. When he discovered that his supply of videopioid had been terminated, he went nuts. He all-but destroyed his room, for example. Two weeks of silence and self-imposed seclusion later, he admitted to his parents that he felt much, much better and was going to try and help other boys conquer their addictions.
To prevent an addiction from developing, Ms. Jargon passes along such hackneyed tips as creating rules around playing and following them consistently. Okay, but that assumes parents who have no difficulty establishing limits that cause their kids distress. The problem is that all too many of today’s parents have an abundance of said difficulty, meaning Jargon’s advice is moot out of the gate.
Thankfully, there are still parents who will stand up to child-rearing challenges and face them head-on; parents who are not trying to be their kids’ friends; parents who understand that children, including most teens, know only what they want, which is precisely why they require adults in their lives who know what they need.
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