The Problem of Blame

Philip Hickey, PhD
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On January 27 I posted a blog, Maternal Attachment in Infancy and Adult Mental Healthon my website Behaviorism and Mental HealthIn this article I reviewed a longitudinal study by Fan et al.  The main finding of the study was:

“Infants who experience unsupportive maternal behavior at 8 months have an increased risk for developing psychological sequelae later in life.”

In my article, I pointed out that the correlation between the low maternal attachment ratings and subsequent “mental health” issues was not perfect, so clearly this was not the only factor involved in the adult children’s subsequent problems.  But I also made the point that what we do as parents affects how our children function in adulthood.

For me this is simply an obvious fact of life that tragically has been barred from discussion by the psychiatric mantra – that all significant problems of thinking, feeling, and/or behavior are genetic-linked brain illnesses, and that parents couldn’t have impacted the outcome one way or the other.

The post generated a few comments on the blame-the-parents issue, and, since this is a critical topic in the current psychiatric debate, I thought it might be helpful to discuss the matter further.

. . . . . . . . . . . . . . . .

Firstly, we can’t have our cake and eat it too.  If we reject the facile psychiatric brain illness theory, then we ought to be willing to discuss other notions, and follow the evidence wherever it leads us.  Most people have no difficulty accepting the notion that the experience of being bullied during childhood can promote the development of significant problems in adult life.  Why is it such a reach that cold, detached parenting during infancy might also have importance in this respect?

Secondly, in matters of human behavior, there are always multiple paths to the same place.  In other words, two people might be engaging in pretty much the same kinds of activity, but for very different reasons.

Thirdly, human behavior (including thinking and feeling) is always multi-determined.  In other words, not only are there different ways to get to the same place, but a given individual may have traversed several of these routes simultaneously to arrive at his present position.  Linear, simplistic explanations of human activity are almost always incomplete, and sometimes downright false.

Fourthly, looking for, and finding, reasons for human behavior is not at all the same thing as assigning blame.  I read of an incident recently in our local newspaper that nicely illustrates this difference.

A few months back we had a tragic traffic accident on one of our highways.  Earlier, there had been a fender-bender in which a vehicle had been disabled and was blocking a lane.  A police officer and a tow-truck driver were clearing things up, when another vehicle, the driver of which had clearly become distracted, plowed through at about 70 mph, killing the tow-truck driver and seriously injuring the policeman.  The driver was charged, of course, and the case is grinding its way through the legal system.

Recently the widow of the tow-truck driver asked the court if the matter could be expedited, because she and her family had forgiven the culprit, recognized that it was a tragic accident, understood how it had happened, and wanted to move on.

The point of the story is that blaming and asking why are two completely different activities.  The former is generally unhelpful; the latter is necessary if we are to learn from our mistakes.

Fifthly, in my experience, most parents are willing to accept a measure of credit when their children do well and a measure of responsibility when they don’t do so well.  I often hear parents of grown children say things like:  my son is kind of timid, and I think maybe it’s because I was too hard on him; or my daughter doesn’t have a lot of initiative, I think maybe we were too protective; or my son is a bit on the wild side, I don’t think I was strict enough, etc…

Most parents of grown children, including myself, can identify with these kinds of statements, and can see in hindsight things we might have done differently.  So why should the problems embraced by the term “mental health” be conceptualized differently?  These are not a special class of problem, despite psychiatry’s insistence to the contrary.

Psychiatry routinely condemns as parent-bashing any attempt to explore or discuss these problems in terms of family dynamics.  Anyone who doesn’t accept their orthodoxy must be a parent-basher.  This spurious nonsense has been developed and promoted to win parents over to the “take-your-pills-for-life” philosophy, but in fact it is nothing more than deceptive propaganda.  What they’re saying essentially is:  all significant problems are gene-linked brain illnesses, and anyone who suggests otherwise must be a parent-basher.  We need to recognize this self-serving nonsense for what it is.

So for all of these reasons, I think we need to keep an open mind.  I’m certainly not advocating a return to the “cherchez-la-femme” type of thinking that was popular in the 50’s, but we do ourselves no favors if we over-react to that kind of approach and deny the simple reality – clear and obvious to previous generations – that parents, mothers and fathers, have a significant impact on their children’s lives.  We are not the only influencing factor, but our impact is not trivial.  We can do a great deal of good, but we can also do a great deal of harm.

Psychiatry – in pursuit of its own self-serving agenda – has made this a taboo subject.  We need to break this taboo, and start discussing these matters, as well as other pertinent factors such as poverty, discrimination, injustice, bullying, etc., openly and honestly – not in a mode of blame and censure – but rather in a mode of exploration and understanding.  Some of the most effective therapy I’ve ever done was with parents and their grown children, where these kinds of issues were aired with openness and candor.

With regards to the Fan et al paper, I have no inside information, but in general terms the study seems to have been conducted in a thorough and careful manner.  Longitudinal studies of this kind are something of a gold standard in addressing these sorts of questions, and it would, in my view, be foolish to ignore the results.

It would also be foolish to overstate the results.  As I pointed out in my earlier article, in many cases where low maternal attachment was noted in infancy, there were no “mental health” problems in adult life; and in some cases where low maternal attachment was not noted there were “mental health” problems later.  The study does not give us a simple discriminator that we can apply blindly to all mother-infant interactions.  Rather, it leaves us with the suggestion that it might be a good thing to encourage mothers to interact positively and affectionately with their babies, especially in cases where this kind of interaction does not seem to be happening.  And who can argue with that?

It might be objected that this kind of material is self-evident, and that everybody knows that mothers should be affectionate and comforting to their babies.  It could be argued that conducting research on something this obvious is a waste of time and resources.  But we should remember that for two or three generations prior to the 1950’s, it was widely promoted and accepted in pediatric circles that parents should avoid “excessive” affection with their babies and young children.  In 1894, Luther Emmett Holt, MD, a leading American pediatrician, wrote The Care and Feeding of Children.  This book quickly became a bestseller, and remained influential well into the twentieth century.  Here are two quotes:

Are there any valid objections to kissing infants?

There are many serious objections. Tuberculosis, diphtheria, and many other grave diseases may be communicated in this way. The kissing of infants upon the mouth by other children, by nurses, or by people generally, should under no circumstances be permitted. Infants should be kissed, if at all, upon the cheek or forehead, but the less even of this the better.” p 168

 “At what age may playing with babies be begun?

Babies under six months old should never be played with; and the less of it at any time the better for the infant.”  p 165

The psychologist John Watson (1878-1958) also advocated a businesslike approach to child-rearing.  In the book Psychological Care of the Infant and Child (1928), which he co-authored with his wife, Rosalie Raynor Watson, he stated:

“Let your behavior always be objective and kindly firm. Never hug and kiss them, never let them sit on your lap. If you must, kiss them once on the forehead when they say goodnight. Shake hands with them in the morning. Give them a pat on the head if they have made an extraordinary good job of a difficult task.” (Quoted in Bigelow and Morris, John B. Watson’s Advice on Child Rearing, Behavioral Development Bulletin, Vol. 1, Fall 2001).

 As with Dr. Holt, the Watsons’ child-rearing advice was generally well received.

So the notion that parenting, even of very young babies, should be rather businesslike and unemotional had a lot of momentum in the first half of the twentieth century, and in fact it was largely in reaction to this kind of child-rearing ethos that Benjamin Spock, MD, wrote his famous book The Commonsense Book of Baby and Child Care in 1946.

It was presumably also in response to these kinds of ideas that the 1960’s researchers who initiated the longitudinal study currently under discussion had included a measure of maternal over-involvement which included displays of affection.  Not surprisingly, this measure was found to be not associated with the development of problems in adulthood.

Underlying the parent-bashing objection there is an unspoken assumption: that if a mother is not displaying strong emotional attachment to her baby, then she must be a “bad mother” – somehow defective – a disgrace to her gender.  But, in fact, there are all sorts of reasons why a mother might be emotionally detached.  Perhaps she’s an abused spouse.  Perhaps she’s never had role models and doesn’t really know what to do.  This is an increasing problem as families get smaller, and children aren’t involved in the care of younger siblings.  Perhaps the new mother lacks confidence and fears she might hurt the baby.  Perhaps she’s carrying some trans-generational vestige of the old Holt-Watson ideas.  Or perhaps she’s so worn-out and tired that she can’t generate much enthusiasm for anything beyond the bare necessities of childcare.  Whatever the reason, she needs help and coaching rather than censure.

But this kind of help won’t happen until we get to a point where we can discuss the link between parent-child interactions and subsequent development openly, and undefensively.  If this had been a study about sports, for instance, and had found that children of parents who encouraged their toddlers in sporting activities were more likely to pursue sports in later life, we would have no difficulty in joining the dots.  But the logic is essentially the same.  We critique psychiatrists for cherry picking their research results.  Let’s not fall into the same trap.  If there are methodological flaws in the Fan et al study, let’s critique them.  But we shouldn’t resist the paper just because we don’t like its conclusions.  We must not allow psychiatry’s threat, to brand us as parent-bashers, to scare us from stating the obvious.

***

Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

42 COMMENTS

  1. I am so relieved and grateful to see this post. In my own practice and general experience, talking about the issues of parent/child relationship within the context of mental health continues to be challenging–which I understand completely, of course.

    I try to distinguish between neutral cause-and-effect and the judgmental energy of ‘blame,’ but I don’t always do a very effective job with this, in the moment. Gets very emotional, and defenses go way up. I feel this is an area of communication where I can learn a lot. It’s hard to move forward in this conversation, which is why I’m so pleased to see this on MIA.

    I think that with as much mindfulness as possible about how this issue affects people, this discussion holds the potential for a lot of significant clarity that has been out of reach, precisely due to the resistance described in this article. It’s also a good place to learn self-compassion and forgiveness.

    I had to forgive myself and others a million times when I finally saw the truth about my family dynamics. Led to a lot of really good things, starting with freedom and relief. Eventually my whole world transformed, and I felt out of the dark, once and for all.

    Not just me, but other family members, too, benefitted from coming to a place of peace with the truth. Not all do, which is the tough part. Some really have trouble seeing themselves, while for others, it’s welcome. That’s the gamble, here, but at least for me, it was highly beneficial to bring the family dynamics to light, and let everyone have the opportunity to grow from that information.

  2. Thanks for a very thought provoking piece. As the mother of a young man who developed a serious mental illness, I have been questioning every single thing my husband and I have ever done for years, and wondering why my other children turned out just fine. Yes, I have heard all the theories about bad parenting, bullying, living in a stressful environment, etc. Certainly, parenting and environment must have some effect on a person’s mental state.

    But still I find it impossible to believe that these factors alone could cause a person who was a fine young man who graduated from college with honours and lived a fine privileged life to suddenly become psychotic. There must be some biological cause for many cases of so-called “Mental illness”.

    Although there seem to be many on this website who do not believe in biological causes of mental illness that is not true of all of us. There are many known biological causes of psychosis including bacterial and viral infections, malnutrition, heavy metal poisoning, auto-immune disorders and many others. Many hospitals do not check for any of these causes and simply dismiss the patient as “mental”. That means a diagnosis based on behaviour rather than a blood test or neurological exam. It means being told that the patient must be on meds for life after a ten minute consultation with a psychiatrist. It means being held for weeks and being forcibly medicated. When the meds don’t work the patient is told that he has a “personality disorder” and there is nothing that can be done for him. Because the drugs didn’t work the patient is now sent to a social worker who will attempt to educate the parents on what they have done wrong and what they should do now.

    Blaming the parents, the patient, the bullies, society, etc. cannot explain many of the “mental illnesses” that I have witnessed. Real scientists are studying these illnesses and I wish them the best. It is too bad that so many doctors and psychiatrists are unwilling to look at scientific evidence and continue to hold onto their pet theories.

    • The author specifically cautioned against blaming the parents.

      Diagnosis is indeed based on behavior. But I, like some of the authors who have contributed to this website, consider psychiatric diagnosis as dangerous and irrelevant.

      Everything that you say that follows diagnosis is indeed the norm and most of the people who read and contribute to this website would agree with you that it is harmful nonsense.

      Alternatives to diagnosis circle around the ideas of looking into, with the person who is distressed, what problem the person is experiencing, what might have caused it, and asking what might help? Drawing in the persons wider social network into this conversation has also been shown to be helpful.

      Often such conversations reveal hurtful incidents in the persons past. Often they are in the persons family. This is not theory, it is a commonplace experience that I and others have of talking to people who have diagnosis such as schizophrenia, bipolar and personality disorder and finding sometimes horrific things in their past, sometimes merely very difficult things.

      These conversations are not easy, they take time, patience and luck. There are serious scientists who have studied these things, who compare the rate of various traumas in those who are seriously distressed compared to the general population. The scientific studies of Richard Bentall compare to the experiences of talking to people with serious diagnosis. Trauma causes mental distress. Serious trauma makes serious mental distress more likely.

      Sometimes when people are close to us it is hard to listen, understand and hear the problems that caused the distress. We often need help in doing that. I need help in talking over things with the people I work with, never mind my family. It is not likely we will get that from the mental health system as it is at the moment. But that is hardly the same as having a social worker, “Educate the parents on what they have done wrong and what they should do now.”

      The research also shows that some people with diagnosis of schizophrenia, for example, have no easily identifiable trauma, but that these are in the minority.

      It may well be that some of the people who have no identifiable trauma have some biological problem that is causing their distress. It might also be true that some of those who do have obvious traumas also have some biological issue that is adding to their distress. However that does not take away from the research and common everyday experience of psychological trauma (child sexual assault, family violence, bullying, homophobia, racism and poverty, difficult family relationships) all have some causative factors in extreme mental distress.

      There is a degree of parent blaming in the psychiatric system, and it is often mother blaming, however that is not the same of offering understanding to parents and distressed adult children so that they can better understand each other, and in particular understand the experience of the distressed child.

      Parents who are told to keep away from hospital are often being blamed and this is of no help to anyone. But that is different from what I thought the author was addressing

    • @madincanada

      You wrote:

      “There are many known biological causes of psychosis including bacterial and viral infections, malnutrition, heavy metal poisoning, auto-immune disorders and many others. Many hospitals do not check for any of these causes and simply dismiss the patient as ‘mental’. That means a diagnosis based on behaviour rather than a blood test or neurological exam.”

      I agree.

      Duane
      discoverandrecover.wordpress.com

      • “Mental” illnesses can have many underlying causes. But they are *never* caused by psychiatric drug deficiencies. Never!

        I don’t think it does a lot of good to arbitrarily pass blame; but I don’t think it’s bad to place the responsibility for injury where it often belongs: psychiatric “treatment”.

        Duane

      • Thank you so much for your support Duane. There are so few people who understand what our family has been through. Even though I can understand that people may try to explain anxiety and depression as caused by life’s difficulties, it is impossible for me to attribute severe psychosis to such causes. After reading the book “Brain on Fire” by Susan Cahalan I have become convinced that psychosis must be caused by inflammation. My son had many of the physical symptoms of brain inflammation,(visual disturbances, loss of appetite, deja-vu) but we were never asked about this by any doctors or psychiatrists. My son was asked so many times if he was bullied or abused that he started to believe that he had been.

        • The vast majority of the readers on this site have very little respect for conventional psychiatry.

          Unfortunately, there are very few who have an appreciation for physical *root causes*. IMO, this should be addressed *first*.

          http://discoverandrecover.wordpress.com/root-causes-of-mental-illness/

          This seems like a no-brainer, but so many people have been injured by psychiatry, that the idea of addressing a physical cause is frightening.

          Duane

          • “…so many people have been injured by psychiatry, that the idea of addressing a physical cause is frightening.”

            Duane,

            My observation is that, quite often, those who’ve risen above and fully transcended a psychiatric ‘diagnosis’ of so-called “serious mental illness” are people who’ve come to realize, quite well, this vitally important/key necessity, that they must make substantial dietary changes.

            Such a necessity is attributed, quite often, to ones having had his/her immune system compromised by psychiatric drugs.

            However, there are also many instances, in which former psychiatric “patients” explain, that their former way of eating had been key to their development of what was called “psychosis.”

            That was my experience.

            And, IMHO, unique food sensitivities, allergies and exceedingly poor diets (malnutrition of various kinds) can surely, in the long run, cause chronic physical conditions (which often includes inflammation), which can, of course, creates underlying emotional sufferings, that may lead to an unusual degree of negative self-talk, isolation and/or ‘excessive ruminating,’ all of which increases the odds of ones developing a form of ‘psychosis’.

            The ‘psychosis’ may bring up truly key issues (quite often, family issues), which do require addressing; typically, the family members of the identified “patient” usually prefer to deny that such issues are relevant.

            I have previously addressed some of my own experiences along these lines, in my comments, on this website; sometimes I’ve done so on a comment thread that was hardly noticed.

            So…

            Now, please excuse me if I seem to become momentarily lazy and/or self-indulgent…

            (I am going to repeat myself somewhat, as I care to avoid the time and effort it takes to find a new way to say what I’ve already said well enough…)

            Here, as follows, I offer a few paragraphs of a previous MIA comment, that I posted roughly a year and a half ago…

            Virtually everyone realizes that alcohol and drug addictions tend to be associated with much interpersonal trauma, that can lead to huge difficulties; but, not everyone realizes that excessive ‘simple carb’ and/or sugar consumption (both, or either) can *cause* immense physical trauma (i.e., metabolic trauma), which can wind up being expressed as seeming “mood disorders” and other supposed “psychiatric” conditions; in fact, an apparent “psychosis” can be generated largely (and, perhaps, even entirely) as the result of adopting a ‘diet’ that’s, in truth, altogether incompatible with ones needs.

            Many young adults, upon first leaving the nest, may suddenly adopt a completely different diet – and, perhaps, a truly horrible diet (such as I did); indeed, being adolescents, suddenly living on their own, in any number of ill-advised ways, they may test their physical limits (e.g., deliberately not sleeping) – and, thus, develop a seeming ‘psychosis.’

            The resulting crisis is *not* necessarily caused by childhood trauma; though, it may raise festering, unresolved ‘family-of-origin’ issues…

            https://www.madinamerica.com/2012/06/atypicals-associated-with-diabetes-in-adults-without-schizophrenia-or-bipolar-diagnoses/#comment-12596

            IMHO, it’s very important to recognize and acknowledge, that: There can be many meaningful aspects, of a seeming ‘psychosis’; IMHO, those who care for the identified “patient” should be encouraged to deliberately consider and ‘own’ the full truth, of whatever is coming up, difficult as that may be for them…

            Respectfully,

            Jonah

      • Thanks to all who wrote in response to my comment. Although it is always upsetting to hear people blaming families for mental illness, you have made some valid points. Certainly mental illness is a complex problem with no one simple cause
        . In the case of our family we may have smothered our youngest son with too much attention and care. I was always somewhat anxious and over-protective. I didn’t let my kids eat junk food, forced them to wear bike helmets and take drivers training. I was a bit of a health nut, always feeding them salads and vitamins and warning them about the dangers of smoking, drugs, etc. I think that when my youngest son got away from home he did what Jonah did and rebelled by eating nothing but junk food. I only wish the doctors had realized this and worked with him on his diet instead of forcing him on drugs which he really didn’t want to become addicted to. I truly believe that the forced hospitalization worsened his condition because he was trying so hard to live life on his own terms and it was a real setback for him. He has been trying to rebuild his life for a few years now and I really need to thank Robert Whitaker and the many writers on this site who have taught me so much about mental illness and how to deal with it. My son’s recovery is taking a long time but he is slowly getting better and I am very proud to say that he has done it without drugs.

  3. Phillip, thank you for your post. I agree that Family of Origin issues can indeed have a large impact on the mental health of children and can impact their adult lives significantly. I don’t think you’d find much disagreement, even from psychiatrists, that children born in abusive, or negligent families can develop serious mental and emotional distress.

    But I think we have to be careful about saying to what degree “Nurture” has an impact, especially when it comes to a tendency towards severe symptoms such as a susceptibility to psychosis, repeated manias, etc. Like MadInCanada, I have seen one family member develop psychosis while her siblings raised in the same family do not. I have seen studies of twins separated at birth who both developed psychosis at a much higher rate than the norm. To me, I worry that if we promote “nurture” as the primary etiology of mental illness, we would indeed return to a “blame the mother” period of time.

    I think the real problem is that Big Pharma has way over played the biological argument. They not only have neglected family of origin issues, but also socio-economic factors, nutritional, psychological and interpersonal factors in favor of a one size fits all argument. They have also extrapolated to promote the biological argument for all “disorders.”

    Finally, and most importantly in my mind, even if their argument that mental illness is rooted mainly in biology is correct, (which I entirely dispute), they make the deeply illogical leap to the premise that strong neuroleptic drugs can somehow “treat” these illnesses.

    • Jonathan,

      Thanks for coming in. You make some important points.

      I don’t think we can blame the biologizing of problems entirely on Big Pharma. Psychiatry invented the concept; pharma just exploited it and bankrolled its promotion.

      I certainly agree with you on the matter of “treating” anything with neurotoxic chemicals!

      Best wishes.

  4. Most often, parents treat their children differently, not the same. Relationships with parents can be competitive, and parents can foster this. Each child has a different set of circumstances in childhood and in life to which to respond, and a different innate focus.

    Anyone has their challenges in life, whether biological or environmental or both. Often they’re connected, and usually, one can be factored in as having a greater impact on an individual.

    I’m curious how people would discern which is which in each person; that is, which factor–bio, socio, other–would most likely cause chronic mental distress over the others? Or is it a particular combination? That would seem like something only the individual being called ‘mentally ill’ would really be able to inform about, accurately.

    Either way, it could never hurt to check our relationship skills, and make sure we’re not holding on to any deep seated resentment that is undermining our flow of nurturing to others. We can be draining to others if we’re not aware of how we relate to others, and that can cause all sorts of problems after a time. After all, I, like others, naturally and unconsciously looked to our parents to see how they handled their issues in life, and with others. Mine were not good role models for a variety of reasons, unfortunately, and I had to unlearn what I learned from them. I had good teachers who taught me how to find my own voice, separate from their beliefs. That’s when things changed for me, when I took that responsibility on for myself.

    A person is never inherently ‘defective,’ and the effects of bad family dynamics are never inherently permanent, so I wouldn’t call it anything more than a learning process, rather than any kind of illness–under ANY circumstances. It’s a learning process for all concerned.

    • I would also add that experiences outside of the family will effect the child.

      And I want to reiterate what the article said, that certain parental behavior will make adult mental distress more likely, though not inevitable, and that any behavior is multi-factorial.

      It seems such a hard lesson for people to hear.

      • Thanks, Jonah, there are a lot of perspectives out there, and I’m glad we see eye to eye on this.

        John, I agree without question that there are myriad experiences and interactions that affect a child’s development and coping skills. A child’s self-perception is always morphing, according to the challenges they face on a daily basis, in all sorts of environments. Just as well, their overall health is affected by a variety of factors, both internal and external.

        When I think of mental distress (mine or another’s), however, I don’t focus on behavior, for me it’s more about how a person is feeling, especially about themselves. That committee of inner critics can be chronic and harsh, regardless of our circumstances in life. I think this is what can ruin our health, and which definitely can compromises our mental health and ability to, both, focus on point, and follow through on tasks. Where does this severe inner criticism come from? I don’t believe we’re born this way, and it obscures our joy of life.

        When we are raised to believe the best about ourselves and are supported to discover our own unique process, we can take on anything that life and the world has to dish out, and life becomes a highly creative experience, no matter what. Conversely, when we’re raised in fear, judgment and invalidation, we live in fear, frustration, and/or rage. Resentment builds, and this is what causes us to lose our center.

        Mindful nurturing teaches us how to get back to center, when life has caused us to stretch, which it always does, from time to time. No one stays in their center 100% of the time, but some people do know what works for them to let go of stress on a daily basis and come back into natural balance. That keeps anything from becoming chronic.

        And yes, psychiatry teaches us to take a pill, rather than how to naturally find our center. Even if there IS a biological issue going on, such as nutrient deficiency or some other organ imbalance, knowing how to self-nurture is what leads to healing. If one does not have this experience as a child, then life is harder because what then to do when life throws us a few curve balls? The self-nurturer does not worry, and can live life with confidence rather than fear. They fall down, they get back up, stronger and wiser. They grow.

        Like Steve and uprising write, below, this process of identifying where the family could have done better is what leads to compassion and forgiveness, and this is healing for all concerned. Everyone does the best they can with what they know how at the time. Yes, our parents were once children with same or similar issues.

        We can stop this generational downwardly spiraling cycle by acknowledging how these dynamics can lead to negative self-beliefs which make life much more challenging than one who has been taught to go easy on themselves, and that mistakes are fine, no one is a ‘loser,’ and they are encouraged to do the best in life, following the path that makes them happiest. Problems arise, and we address them and learn from them as we go.

        When the invalidation and emotional neglect snowballs enough, and this level of neglect is compounded in society, and then made worse in the mental health system, then, indeed, it can turn into what we call psychosis or delusional or bipolar or whatever. It’s an extremely high level of anxiety, that is for sure. Adrenaline goes wild in these circumstances. There’s only so much emotional neglect a person can take before their mind fragments and their behavior becomes a cry for help. By then, communication has severely shut down. I believe this originates in family dynamics.

        For sure, everyone in the family needs support around this kind of healing, as it comes up. This would be the end of the identified patient as one person, but more so, as the family dynamic. That is what needs shifting, these relationship dynamics that neglect some of its members’ needs. This then ripples out as a society issue, as families are merely microcosms of society.

        There are all kinds of ways one can end up disadvantaged in a family system. It’s not always a traumatic event, but it can also be a series of wounding family experiences over a long period of time. They can be subtle and hard to detect because this would be the ‘norm’ of the family.

        When a child sees through this, they are generally not allowed to call the elephant in the room, as it does challenge the parents and family system too much. So they internalize this information, along with their role, which is an unreasonably heavy burden for a child. But to their mind, their survival hangs in the balance, as parents are the ones with the money and safety at their disposal.

        Healing would occur when this norm shifts, but often family members rebel against this, and would instead, prefer to seek help for the scapegoat (truth-seer), as if something were wrong with them, with no regard for how the other family members play into the skewed system. This is to protect the system. That is devastating to a person, and is how, I believe, mental illness is born.

        • I want to amend the last sentence in my above paragraph to say, “…and this is ONE WAY, I believe, that mental illness is born.”

          I’m open to learning in what other ways what we call ‘mental illness’ originates, but I feel that what I describe above is a lot of peoples’ story, and from resistance, we create distractions or simply come to the ‘conclusion’ that “it’s complicated,” which, in turn, keeps things complicated and vague, and therefore overly-challenging to discover the truth in order to resolve the issue.

          By pinpointing where it originates in a family, we can at least solve the problem of emotional neglect. Then, we’ll see what we’re left with.

          I believe that focusing here will solve more problems than we currently realize, although the process of change will be inherently challenging. This is where a lot of difficult emotions will surface and things can get a bit confusing. Still, I can’t think of a better opportunity for really thorough healing and perspective-shifting than owning our family issues, through and through.

          • Thanks for pointing this out, Jonah. I never take offense at a disagreement or negative feedback, I know it’s not personal. And even when it is intended to be personal, out of the need to attack or to throw some projection, I never at all take it that way, I know that would not be about me.

            We’re all trying to get clarity about this stuff (well, many of us, at least), so I appreciate what you say about my language, here. That’s valuable.

            You’re right, it is a contradiction. I should have stated it the way I say in my addendum, “what we are calling ‘mental illness.'” (Still vague, but transitioning the language is a work in progress).

            It’s a challenge discussing all of this due to our language issues, and how we each interpret certain words and terms, and also the internet makes that part even more challenging. I so prefer to have face to face discussions about these issues, where it’s so much easier to read from tone, body language, and to ask for clarification in the moment. Internet has a lot of limitations when we are dealing with subtle and significant nuance.

            You are very sharp about these things, I always notice, and I truly appreciate that about you. You’d keep me well in line, here, which is always helpful.

            With that said, I do believe that being marginalized in a family system is a core cause of negative feelings toward one’s self, and a somewhat skewed perception of others. I believe it is what can throw us off balance, and make it challenging to ground. This can cause problems of mental focus, too, as well as emotional sensitivity to the point of fearing interacting with society. It can also cause our consciousness to fragment, creating psychosis-like manifestations. I believe being marginalized and scapegoated by the family can cause this more than anything else, but I’m open to being challenged about this.

            Would this phrasing be more acceptable and accurate to you to describe the effects of family scapegoating on our mental and emotional state of being?

        • “Thanks, Jonah, there are a lot of perspectives out there, and I’m glad we see eye to eye on this.”

          Alex,

          Actually, we are no longer seeing eye to eye.

          After all, at the end of your latest comments, you declare, “mental illness is born.”

          That declaration directly contradicts the conclusion of your earlier comment (on January 30, 2014 at 3:10 pm) — that comment which I so highly praised — wherein we were, indeed, seeing eye to eye. (You’d concluded that most excellent comment, quite beautifully, declaring: “I wouldn’t call it anything more than a learning process, rather than any kind of illness–under ANY circumstances. It’s a learning process for all concerned.”)

          I deeply appreciate what you are saying in these latest comments (what you are saying resonates with my own experiences) before you come to the end.

          No way will I agree to anyone’s theory that “mental illness” is created this way or that way.

          I will not do so, ever — as I strongly believe that “mental illness” is a term that’s forever fraught with terribly misleading implications.

          And, almost inevitably, such discussions wind up failing to fully acknowledge and put into perspective the iatrogenic (medically caused) effects, which are viewed as part and parcel of a supposed “mental illness.”

          Thanks for having presented so much lucidity before the end of these last two comments you offered.

          I genuinely appreciate everything that you’ve been saying here, to this point, in this comment thread… until you say “mental illness is born.”

          You have developed tremendous insight…

          Respectfully,

          Jonah

          • oops, response posted in wrong space—please see above your comment for my response…like I said, many challenges on the internet that add to the loopiness of the conversation!

          • Referring to my above response, I left out what I feel is the most important item: I do believe all of this can heal. We can rewrite our neurons through understanding, compassion and forgiveness, if we accept that our path is our path, and learn from it, rather than burn in blame and resentment. In turn, we become emotionally free, and this also unleashes our gifts.

            To me, that’s always the most important message–anything can heal. We start with our beliefs, and from that, we create our journey and outcomes. Don’t like the outcome? Change your beliefs. That’s how to reprogram neurons, no medical intervention needed.

          • And from this rewrite, where we feel good about ourselves, and deserving, we will have the inspiration and motivation to know our bodies better, and what it needs. Indeed, diet and all else we ingest affects our balance and clarity.

            But if we don’t feel good about ourselves to begin with and have too much negative self-talk, then we’re generally not terribly motivated to restrict our diets. Health gut flora is vital for good physical and mental health, no argument there. Chemicals take away our natural balance. Forced chemicals are outright poison.

    • Alex,

      “Most often, parents treat their children differently, not the same.”

      I think this is so true – and for literally millions of reasons.

      I also am in complete agreement with you regarding the need to see each individual as unique. Blanket explanations are generally not much use. If I want to understand how a person got to where he is today, I have to be willing to spend a good deal of time talking to, and more importantly, listening to him.

      Best wishes.

  5. This is, indeed, a very sensitive area. I think we do need to acknowledge (and I think Philip clearly does so early in this article) that lack of nurturance is not the ONLY cause of what has come to be called “mental illness.” But it is a factor that needs to be considered.

    It’s clear there ARE physiological causes of psychosis and other phenomena labeled as “mental illness,” with drug intoxication being only the most obvious one. My objection is not to the idea that there could be physiological causes of psychosis (or other “mental illness” manifestations), only to the idea that the ONLY possible causal factor is physiological.

    Moreover, there are many other environmental factors that impact “mental health,” including living in an urban area, certain kinds of pollution (heavy metals are particularly implicated), unemployment, poverty, racism, sexism, various traumas, etc. Siblings play a role, too, as does neighborhood violence and cultural trends and expectations. To try and reduce all of this either to “you had a bad mom” or “you have bad genes” is reductionistic in the most extreme degree.

    If we were really serious about finding causal factors for what is termed “mental illness,” we would stop grouping people together based on symptoms and start looking for differential causes that might underlie similar presentations. For instance, some “ADHD” symptoms may be a result of lack of structure at home. Some may be a result of prenatal drug and alcohol exposure. Some may be a result of inappropriate classroom expectations, the child being bored, the child being asked to do things that are over his/her head, the child being too young to be in school at all, the child having low iron, the child having a sleep apnea problem, the child being exposed to domestic abuse at home, or the child suffering the side effects of some other drug s/he is taking. That’s a very incomplete list of possibilities, all of which have evidence to support their potential to cause these “symptoms.” And of course, more than one of these can be going on at the same time. If “ADHD” symptoms can be caused by all these disperate things, what is the point of calling it ADHD? Wouldn’t it make more sense to find out what is behind it?

    The last thing I’ll add is that psychiatry has been materially aided by NAMI in putting out this message. NAMI is mostly a creation of parents whose kids have developed “bipolar” or “schizophrenic” symptoms (which, of course, can have just as many causes as “ADHD” symptoms), and who wanted to stop being blamed for their kids developing these problems. As such, they have been very willing to accept psychiatric mantras and money, and have fully embraced the “biological brain disease” theory because it absolves them of any blame. Unfortunately, they have become a bit part of the problem, and have intensely promoted this idea that any discussion of parental responsibility is “parent bashing” and must be immediately hushed up.

    Bottom line is, parents do make mistakes, almost always with the very best of intentions, and children suffer. Parents were children once, and their parents made mistakes with them, too, which they often repeat unless there is some kind of crisis or intervention to disrupt the pattern. It is not blameful to recognize this simple fact, and attempt to deal with the harmful impact of their behavior also opens the door to them healing from their own childhood traumas, and the opportunity to establish more trusting and intimate relationships with their children as adults. As Alex rightly says, not all parents will want to engage in this process, and that’s sad, but it doesn’t really help to support them in denying that they have caused some pain to their kids, because it’s their pain, too, and they also deserve a chance to heal, even if they choose not to take advantage of it.

    Responsibility is not the same as blame. Responsibility means a willingness to look at the facts and to do something to solve the problem. More responsibility leads to more healing. While there are many, many reasons why adults and children suffer emotionally, we do parents no favors by letting them off the hook. After all, who is better placed to help a child who is suffering than his/her parent?

    — Steve

    • Steve,

      Thanks for your comment. I agree with the things you say.

      You rhetorically ask: “…What is the point of calling it ADHD?”

      My answer to this is: to legitimize the prescribing and selling of drugs. For me, this is psychiatry’s great shame. They adamantly refuse to take on board that the individuals embraced by their diagnoses are an extremely heterogeneous group – as you so cogently point out. They pay lip service to the notion of diverse presentations, of course, but the treatment is almost always the same. And stimulant drugs have become blockbusters.

      Best wishes.

  6. Thank you so much for this post. I especially appreciate the distinction you made between assigning blame and determining reasons.

    I would like to state the obvious, and say that abusive parents generally hate it when their children figure out that what happened to them was abuse.

    And sometimes, for people who have been abused by parents, blame is a natural part of the healing process. It can be a necessary step toward compassion for oneself and others – a recognition that yes, what was done to one by one’s parents was WRONG. Blaming the guilty is an improvement over being gas-lighted, invalidated, and made to feel inherently broken.

      • Thanks, Philip.

        It was clear to me that you were addressing parenting mistakes in this post and not out and out abuse. I did not mean to imply otherwise. I recognize that my comments were perhaps tangential to your superb essay.

        I also agree that reconciliation should probably be the goal, whenever possible.

        The purpose of my comment was merely to acknowledge that there are parents out there who are not at all interested in reconciliation – who couldn’t care less about the harm they have done to their own children. Such parents see themselves as incapable of making mistakes, and the fruits of their abuse are always portrayed as the “faults” of their children. Sometimes it seems like this is hard for most parents (who genuinely want to do right by their children) to comprehend, and the result is that it is easier for the truly abusive parents to conceal and carry on with what they do. (“Oh, he’s just blowing things out of proportion again!” and “She’s just being dramatic!” and “They have mental problems.”)

        Now, thinking about these issues, my hands are beginning to shake and the room to spin again, just like yesterday. It was a coincidence that I read the above article just after I had tried to reach some kind of reconciliation with one of my parents. All I got were precious quotes such as (re: abuse),
        “I don’t understand why it made you weaker and not stronger.”

  7. I am amazed that an entire industry can believe all one’s problems are based completely upon nurture, or completely based upon nature. I find either extreme so absurdly simplistic and ridiculous that it’s difficult to have any respect for such an ignorant “profession.”

  8. Thank you for this post. You are clearly saying that to blame parents is stupid but to ignore the effect of parenting on someone’s state of mind is also stupid. This reflects my experience.

    Several times down the day center I have met people who have at times been severely distressed. When these people tell me about their lives they tell me about how as a child their families were in contact with social services and from what they tell me social services failed them.

    Many times, in fact so often it is a story that I am unfortunately at the same time disgusted and bored by, I meet people with diagnosis of personality disorder, schizophrenia and bipolar disorder who tell me about: violent fathers, surviving child sexual assault, and neglectful and self obsessed parents. I am told shocking stories of abuse and neglect. I then ask these people if the services know about this and they almost always tell me that they do not. They may have been in contact with services for years, or more likely decades, yet the workers do not know the basic facts of this persons life. I on the other hand am told these facts during a couple of hours conversation, often in a cafe.

    If we want to reduce the level of distress in society then we need to look at the causes and feed that back into social policy. If we want to help people in serious distress we need to bare in mind the sorts of things that cause distress. This is not blaming anyone. It is up to the people who have suffered abuse and neglect if they want to blame anyone. The rest of us are merely there to take account of what is actually going on and what has gone on in the past in someone’s life.

    • John,

      Thanks for your comment. You are so correct in saying: “If we want to reduce the level of distress in society then we need to look at the causes and feed that back into social policy.”

      One of my criticisms of psychiatry is that they constitute a barrier to this kind of feedback. At the present time, they are self-servingly lobbying the government hard to pour more money into neuro-genetic research, when we would be better off diverting these recourses into the kind of areas that you mention.

      Best wishes.

  9. Pleased to see that you highlighted that parents, mothers and fathers have a significant impact on their childrens lives.

    I understand the focus on the maternal behaviour in these studies, but as a father i sometimes wonder if this tends to create a view that fathers play little if any part in development. Or is this precisely what these studies tell us? Oh well, i will continue to be the best father i can, and keep deluding myself that I’m having an effect on my child’s development.

    Thankyou for highlighting the role of fathers Philip

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