Pathologising Infancy

I had an epiphany the day I first saw my son in a coffin after his suicide. The moments following his hanging himself were a blur of sirens, screaming, people running, violent medical interventions, the nightmare of panic and noise that accompany a violent death. By contrast, walking into the quiet, peaceful atmosphere of a funeral home and seeing my child apparently asleep but never to wake again was a very different experience than that of the immediate aftermath of his death.

As I looked down on him, stroked his hand and kissed his forehead, the meaning of life became clear to me. There was no doubt in my mind that it is to watch your children grow up and have their own children. For me anyway, understanding what I am here for, what my purpose and legacy are is as simple as that. I understood it, at the moment it was taken away from me, when the SSRI he was prescribed led my only child to put a noose around his neck and end not only the life I had given him, but the lives he would have given the children he often talked about having.

Those who know me, know how deeply I grieve for the daughter my son often talked of having, who he and his girlfriend jokingly referred to as ‘Princess Leia.’ The child of Toran’s imagination who lives on in mine, who never got to be born because her father became a victim of the dogma of psychiatry. Of a pseudo-science in which people are viewed as a set of deficiencies and drugged for being sad or scared or different.

The Princess is my imaginary friend now. I see her everywhere I go. In the face of the baby one of Toran’s friends had recently and the smile of the little girl who put money in the CASPER collection bucket on Sunday. I see her in my son’s baby photos and feel her arms around my neck whenever a child hugs me. She is a fantasy child, who lives a perfect life of smiles, cuddles and bedtime stories. She is never sad, never feels afraid and never, ever naughty.  She lives in Aotearoa, New Zealand where she has Christmas on the beach, a pukeko at the bottom of the garden and a pair of jandals in every colour of the rainbow.

But the Princess also lives in a country where people like psychiatrist Dr Denise Guy peddle the notion that 12-15% of 10 month old babies suffer psychopathology in the form of a raft of mental disorders.[1] Where ‘infant mental health’ is the new black, and advising government that significant percentages of our 0-4 year old kiwi kids are mentally ill produces a steady stream of funding.

As is typical of psychiatry, a range of assessment and diagnostic tools have been developed and published to assess mental illness in babies. Also typical is the fact they are completely deficit based, providing checklists of poor parenting (over involved, under involved, emotionally, physically and sexually abusive) and ‘abnormal’ responses in newborns, infants and toddlers.

Most commonly used is the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood-Revised (DC: 0-3R) a diagnostic manual that provides clinical criteria for categorizing mental health and developmental disorders in infants and toddlers.

Used alongside the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-R), and the International Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health Organization it is a tool promoted as providing a robust system for the assessment, diagnosis, and treatment of mental health problems in infants and toddlers by allowing for the identification of disorders not addressed in other classification systems.

Two commonly diagnosed mental disorders in babies are ‘excessive crying’ and ‘dysphoric fussiness.’ The first is what we used to call colic.

According to research published last year[2], “the the clinical syndrome of excessive crying in early infancy is a precursor of clinically significant behavioral and emotional problems at 30 months.”  Apparently international consensus is that the scientific criteria for differentiating between normal and excessive crying at the age of 6 weeks draw on the “rules of threes” – crying and fussing for more than 3 hours a day, for more than 3 days a week, and for more than 3 weeks, in an infant who is well-fed and otherwise healthy. The author claims the prevalence of excessive crying of all infants aged 0-3 months at 29.4%.

According to the literature, excessive crying and feeding disorders precede later sleep disorders in 64.3% and 20.0% of infants and when coupled with dysfunctional sleep-wake organization precede later feeding disorders in 55.5% and 59.2% of cases, respectively and with with later excessive clinginess (69.5%) and excessive defiance (64.8%).

Frighteningly, research from 2008 on excessive crying in adults found that “There is a remarkable similarity between the precipitating factors in normal crying and Excessive Crying” and advised that treatment with low doses of antidepressants yields promising results.[3]

In New Zealand we recorded a 140% increase in the prescribing of antidepressants to babies and children aged 0-4 years in a 12 month period, the period in which infant mental health units became an established feature of our mental health services. We do not record the diagnosis that precipitated this prescribing and so do not know whether recommendations that antidepressants be prescribed for adults who cry ‘more than normal’ is being adopted for babies who do the same.

According to the baby psychs, Dysphoric fussiness replaces excessive crying and peaks at age 9 months. It’s diagnostic criteria is a lack of interest in play. Dysphoric fussiness is estimated to affect almost a third of children this age with prevalence estimated at 30.1%.

After Toran died, his girlfriend and I both hoped she was pregnant. She wasn’t. When I gave up on the miracle of Toran being revived from the dead, I turned my attention to hoping that one day, a girl would arrive at my home with a baby that looked just like him and give me his daughter to raise. The refusal of Toran’s school guidance counsellor, for a period of 18 months after he died, to provide me with his records on the basis that he had disclosed something confidential fuelled this fantasy (the disclosure was that he had come to school without lunch!).

Imagine though, if the Princess had been brought to me. If she had been a real baby born after her daddy’s tragic death and raised by her grieving grandmother. I have no doubt that first year would have been difficult. She might have cried a lot. The sadness in our house might have made her less interested in playing. I have no doubt that in cherishing her like I would have, I would have been seen as ‘over-involved.’ Most definitely I would have refused to have her involved in any way in infant mental health services and I wouldn’t let her in the same room as an antidepressant let alone let her take one. And despite the fact I would have loved and nurtured her like I loved and nurtured her father, I have no doubt she would have been taken from me.

And so, while I cry for her loss as I cry for Toran’s, I am sometimes glad she exists only in my dreams and fantasies. She’s safe there. But I worry for the children Toran’s friends are starting to have, who with Dr Denise Guy and her colleagues around, are not safe from the labelling and drugging that harms and even kills kiwi kids.

 


[1]Eileen Goodwin Otago Daily Times Online Edition Fri, 11 Feb 2011 http://www.odt.co.nz/lifestyle/health/147319/being-baby-can-be-tough-psychiatrist-says

[2] Joon Sik Kim, MD Excessive crying: behavioral and emotional regulation disorder in infancy Korean J Pediatr. 2011 June; 54(6): 229–233

[3] Nieuwenhuis-Mark RE, van Hoek A, Vingerhoets A.2011 Understanding excessive crying in neurologic disorders: nature, pathophysiology, assessment, consequences, and treatment.Cogn Behav Neurol. 2008 Jun;21(2):111-23.

 

 

16 COMMENTS

  1. I’m so sorry for the loss of one so dear to you, and for the loss of the one you can never know. If not for the pain you suffer in these circumstances, would you be so angered at the mental health field? As an Infant Mental Health (IMH) Specialist, I’m pleased to read about our field in places other than professional journals & in the sister-professions such as early intervention (Early On), public health nursing (WIC), or education (Early Head Start), to name a few. Some 40+ years after its beginnings here in Michigan, IMH has become an evidence-based psychotherapy model which focuses on secure parent-infant relationships. The model sees infant development–physical, cognitive, social & emotional–as dependent on a secure, trusting, nurturing, & consistent relationship with a primary caregiver. This is a strengths-based vs. a deficit model. Very simply put, for little ones, mental health is social-emotional health. The now standard definition of IMH is: an infant’s developing capacity to form close relationships, to experience, regulate, & express emotions, and to explore the environment & learn, all within family, culture, & community. (http://www.healthychild.ucla.edu/First5CAReadiness/Conferences/materials/InfantMH.definition.pdf)
    With the focus is on parent-infant relationships, we endeavor to form close trusting relationships with the parents we serve, so that this model of secure relationships can be gifted to baby. This, then, can become baby’s new model of relationships for their future. We see many mothers who suffer from moderate to very severe mental illness, some requiring medications in order to begin their journey toward recovery from their mental illness. But very, very few in our field have ever seen an infant/toddler prescribed psychotropic medications. I know of no psychiatrist who would be at all comfortable doing so, except in extreme cases such as a preschooler who might have burned the family home down, or one who might be threatening to hang himself. These scenes are probably impossible to imagine, as your often-dreamt-of granddaughter frames your face with her tiny hands so that she can plant her kiss on your cheek. That’s what is known as social-emotional health for a little one. That is Infant Mental Health.

    • I met a mother at a local mental health event who was in contact with adult services and her son was in contact with CAMH services. He was on ritalin. She was struggling as a single mother, living in poverty with what looked to me like obvious traumas.

      She wanted to make sure her son was able to use adult mental health services when he was old enough.

      She said when a Dr went out of her way to give her some attention her life improved for a short time (and presumably her ability to parent her rather lively son improved too).

      I wanted the services to do their proper job and give her the support she needed to resolve her problems instead of turning her and her son into legalised drug addicts. If, when the Dr when out of her way to give the woman some support, then presumably if enough support was on offer then the woman would not need drugs and she might find her son easier to manage.

      I am in Reading in the UK. I am told by a colleague who has professional contact with Child and Adolescent Mental Health services that if a parent refuses to give ritalin to their children they are refused any other service. The services have become the delivery system of the multi-national drug companies.

      Where you are may be somewhere the drug company influence has on the whole not reached yet, but the author of this piece is in New Zealand and I am in the UK. This is a kind of global colonialism by some of the richest multi-nationals in the world.

      To the drug companies, we are all potential consumers, the drugs are product and their PR and marketing departments use huge amounts of money to create the market, no matter what the cost. The mass drugging of children and the turning of everyday distress into so called illnesses is an example of contemporary capitalism at it’s most ruthless and selfish.

    • “For little ones mental health is social-emotional health” While that may be true in a “statistically significant” population of infants/toddlers I am far from convinced that the secure parent child relationship will turn out to be the most influential factor effecting our children’s mental health.
      One must admit that psychiatry is in an infancy of its own. History will likely look back at our current practices as misinformed and at times barbaric.
      I believe a far more likely scenario will be a number of environMENTAL factors, some more sensitive to them than others. I know some lousy parents that have produced some incredible kids without a single early intervention or any “strength” that would appear on some evidence based algorithm

  2. Giving babies medication for apparent brain disorders is akin to having a chemical babysitter but with dire consequences.

    If I had young children [I don't, they are all grown up] I would research any babysitter. If they had a history of child abuse I wouldn’t employ their services.

    In psychiatric drugs we see a large body of evidence that suggests they can cause suicidal thoughts not only in children but in adults too.

    Therefore, it’s a no-brainer for me.

    Although Pamela Pitlanish has more than likely gone through med school and is quite capable of putting her side of the story across, I see no actual scientific evidence for her claims.

    If the field of psychiatry isn’t ploughing drugs into adults then they are targeting teenagers. Not content with that, it appears babies as young as 2 are next on their list. One would think the lunacy would stop there, alas with early intervention programs it now seems that psychiatry can actually predict if someone will fall foul of a mental disorder in future years.

    When is this ‘profession’ going to stop this utter lunacy, when are they going to provide those that speak out against them with scientific data?

    I find the practice of drugging infants abhorrent and those that practice it quite delusional. They have taken natural human emotions, force fed them into the wheels of advertising until they have been spewed out at the other end with a remarkable pill that corrects something that isn’t actually there!

    Unless of course Pamela Pitlanish can show me the chemical imbalance that exists in those she treats?

    Ticking boxes does not prove a person has a mental disorder nor does it give the right to ply a witchcraft trade.

  3. Governements and psychiatry want everyone to be like clones and fit in the same box, labelled “normal”. And who decides what is normal? Stand out a little and they will want to drug you. The mind boggles!My daughter was a bright, shy child and her teachers wanted her diagnosed something or other because she didn’t like talking to them and reveal her inner thoughts.As far as she was concerned those teachers weren’t her friends: they were hasseling her. I had to fight off the school nurse. It happened 20 years ago: I am not sure if I would have been so lucky today. They tend to overrule parents nowadays. My daughter remembers her schooldays with horror.

  4. “The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood-Revised (DC: 0-3R) a diagnostic manual that provides clinical criteria for categorizing mental health and developmental disorders in infants and toddlers.”

    Gross! If ever a book deserved to be burned, this is it. How about you stage a massive book burning and invite the press?

  5. Babies and children are not the sick ones here! The people who are sick are the ones who prescribe psychiatric drugs for these little ones! All of this about babies and children being mentally ill is nothing but absollute and unadulterated rubbish. I would call it something else but am trying to remember where I am posting. It is nothing but absolute rubbish. Any parent who allows their baby or child to be fed these toxic drugs should not have custody of children. And the psychiatrists and other medical staff who support this outright durgging of children have a level in Hell reserved especially just for them, or at least I certainly and fervently hope so. Where are we going to draw the line and scream, “NO MORE STUPIDITY!?”

  6. Those at the upper tier of psychiatry are most likely eugenists. In America, and i am sure elsewhere, pregnant mothers were given SSRI’s. I actually read articles on Plos that said to do this. Secondly, an increasing number of people are going to be viewed as mentally ill as western society spins out of control. Psychiatry has the backing of big pharma and, more importantly, the state. It is all connected. The massive fraud committed by the banks, the endless wars, the increasing police state, and the creeping medical tyranny. We must view psychiatry as another cog in the system by which the “elite” control humanity. Simply put, the powers that be want you dead.

  7. Maria,
    I am so sorry for your losses. As a mother, I can imagine none greater. Thank you for telling your story here.

    Thanks also for clearing up my illusions about health care, mental health care and attitudes toward children and families being “better” and more humane in New Zealand. The long web of multi-national corporations reach around the globe.

    Thanks for saying what you say so eloquently.

    The schools in my home state of Oregon recieve more money for each and every child that has an “IEP”, paperwork that asserts the child has “special” educational needs as determined by the teachers. Masters level educators can legally give a child a DSM psychiatric diagnosis.

    Much of the diagnosis made in a child psychiatrist’s office rests on information from the teachers. Teachers can and do demand that the parent drug their kids before they may return to class. Parents home with their children risk job loss and all that comes with that.

    I am made so heart-sick by the drugging of children and now babies,that I’ve run out of words.

    Thanks for using yours where I have none left.

    Alice

  8. Maria,

    My condolences for your loss.

    “There is a sacredness in tears. They are not the mark of weakness, but of power. They speak more eloquently than ten thousand tongues. They are messengers of overwhelming grief…and unspeakable love.” – Washington Irving

    Duane