In my new book, The Silenced Child, I offer evidence based on stories from my pediatric practice, integrated with contemporary developmental science, that the disease model of biological psychiatry may interfere in a child’s development if we fail to protect the time needed to listen to what a child’s behavior is communicating. Recently I came upon a powerful blog post eloquently articulating exactly this idea, but told from the perspective of a mother who herself was a psychiatric patient as a child.
The author, Faith Rhyne, wrote the post in the wake of the viral blog post I am Adam Lanza’s Mother, that followed the Newtown shootings. She tells her own story, offering alternatives to the disease model of mental illness that she views as highly destructive.
First she writes of her own struggles as a child:
“At age 12, I sat in a room with my mother, in an office that I didn’t want to be in, and listened to her discuss with a doctor what might be “wrong” with me. She was concerned and she had every right to be. In fact, she had a responsibility to be and, as a mother, she had an instinct to be. I was her child and I was struggling. I was angry, violent, suicidal, sullen, and rude.”
She identifies how in this type of evaluation, the nuanced details of a child’s struggles may not be heard:
“I don’t know if they told those doctors that I had just watched our family land be cleared and developed or that I was terrified of my math teacher or that, the year before, I had gone to Catholic school for a year, where an 8th grader had kissed me on the bus.”
She fully acknowledges that she was suffering, but that the suffering was in no way alleviated by the notion that there was something “wrong” with her brain:
“My family spent many thousands of dollars trying to help me and, as it turned out, the help hurt me more. Further, the idea that I had something out-of-whack in my brain drove an invisible wedge between me and the rest of my family, who spoke in measured tones and who would glance at me furtively, wondering if I was about to explode.”
She echoes the work of Stanley Greenspan, who identified the intimate connection between our sensory and affective experience, when she writes:
“It wasn’t until 20 years later that I learned that the way I process information affects how I feel and that not everybody’s brain works like mine…For some, the world is a loud and clumsy place, full of laughter that isn’t understood and a deep observant sadness. For others, clothes hurt and school is a nightmare. The lights buzz. The cafeteria stinks. The kids are mean and the teachers are uninspiring. For some, it is all very confusing and hard to keep up with. The frustration alone brings tears and anger.”
She highlights the complexity of the genetic aspect of emotional struggles when she sees similar qualities in her own children. Not only do they seem to share these traits with her, but also when she observes their struggles it provokes painful memories of her own childhood. She speaks from a place of deep empathy for both parent and child:
“No parent wants to see their child struggle. I am the mother of children sometimes remind me a bit of myself as a kid, kids who are bright and sensitive, who feel things deeply and who sometimes aren’t easy to comfort when they have simply had enough. I understand how it feels to not know what to do, to see that your child is struggling and to find that efforts to “make it better” seem to cause more upset.”
She calls attention to the need for families to:
“find skilled and conscientious supporters to help empower their children to be confident in the worth of their differences and to find self-determined ways to navigate challenges.”
And to take time to listen to what the child’s behavior is communicating:
“Often, children don’t know how to articulate what they need. However, they will try to tell you. Sometimes, when children “act out,” they are trying to tell you.”
She captures the painful sense of betrayal that accompanies being told that there is something wrong with your brain:
“What does it feel like when the people you most need to believe in the strength of your future and the sincerity of your struggle sit down and inform you that there is something imbalanced in your brain and that it means you’ll probably always struggle and that it means, also, that people may be scared of you, because they don’t understand.”
She articulates how the very effort to decrease stigma by equating mental and physical illness actually worsens stigma:
“The idea of mental illness creates and sustains stigma, by informing us that people who struggle with their humanity in ways outside of the acceptable range of normality are inherently flawed.”
Finally, she seems to channel the ideas of pediatrician and psychoanalyst D.W.Winnicott when she describes how the disease model may obstruct healthy development by interfering in a parent’s ability to see the child’s “true self:”
“When the professionals teach mothers to see their children as ill, both mother and child are harmed in that they lose something essential to the parent-child relationship, which is the ability to see their children clearly, with compassion, love and a commitment to their brightest possible futures.”
My major divergence from Ms. Rhyne lies in the fact that that while she appears to have joined the “anti-psychiatry” movement, I do not see this problem as the “fault” of psychiatry alone. Rather, as I also articulate in my new book, I see a complex set of cultural forces that have come together in a way that amounts to prejudice against children. A range of professionals who care for children, including psychiatrists, pediatricians, occupational therapists, educators, and many others, must join together with parents to overcome this prejudice. We must recognize the value and necessity of protecting time and space to listen to these youngest voices. In doing so we support their healthy development of the next generation, who represent the future of our society.
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.
As a clinical psychologist, when every client enters my therapy room — adult or child or family — I clearly educate them that the myths perpetrated by psychiatry and Big Pharma are false. There is almost certainly nothing biologically or genetically damaged or diseased about their brain. For children, this normalization is essential. As I explain on http://www.SelfAcceptancePsychology.com the core issue in those with “depression” or “anxiety” or “ADHD” or “behavioral problems” is a sense of feeling unworthy, unlovable or ashamed. Pathologizing these normal emotional responses only worsens a person’s sense of aloneness and separateness. We all have primal responses to fear (hyper-vigilance to threat which can show up as over-reactive emotions or the hypersensitivity to sensory inputs the blogger described), to social exclusion, to shame, to lack of bonding or attachment to family members, or to developmental trauma (parental rejection, abuse, neglect, etc.). Labeling normal emotional responses as diseased and different is fundamentally shaming and harmful to people. We must stop the DSM/ICD falsehoods. I urge clinicians to read more at http://www.SelfAcceptancePsychology.com
I often feel hopeful when I read articles and comments on MIA. But then I read things like this piece from NPR http://www.npr.org/sections/health-shots/2016/04/24/475461959/how-talking-openly-against-stigma-helped-a-mother-and-son-cope-with-bipolar-diso. This piece is about how the son of the person who wrote I am Adam Lanza’s Mother. At the age of 16 was diagnosed with juvenile bipolar disorder. He says in the piece: “After Dr. Papolos diagnosed Walton with childhood bipolar disorder, everything got better.”I got the correct diagnosis. I got put on the right medication.” The article holds their story out as a model of good care. is such a long way to go before there is an understanding of how the illness model of biological psychiatry is itself stigmatizing. I wonder what things will look like for this boy 5-10 years from now.
Liza Long is about one step removed from a Munchausen mother. Assuming that her son even has a “mental illness”, she may – *may* – not be partially or totally to blame for it. (Her ex-husband sounds just as bad as she does.) But she is absolutely enjoying the power-trips and attention-trips that “parenting a brain-damaged child” has sent her on. Dr. Gold, you’re right about our toxic culture. The Liza Longs of America are not self-made or a product of *only* the Big Pharma propaganda machine. Lots of factors spawn these Mama Ratcheds, not the least of which is the glorification of “MEEEEE”! Hehe!
Claudia, Thank you for your article and your book. Your article has lots of links and so I am still reading them. But just let me say that I am a huge fan of Elizabeth Young-Bruehl, and I believe that what she says explains so much.
I don’t usually discuss any personal affairs, as I am not looking for either online therapy or pity. Beyond a point one comes to realize that the very existence of the Mental Health system and its role in the lives of children is already a state of war.
When I deviate from this, it is only to demonstrate a point.
I was sent to a psychiatrist when I was in the 4th grade. I would say that the guy was a shit. But on the other hand he probably saved my life. The reason for this was that with all his diplomas on the wall and all, he was someone my parents would listen to.
He fixed it right away so that I and my parents would alternate seeing him every other week. This was good.
But he was still then complicit in my parents using me.
Okay, but what he always counseled was de-escalation of pointless conflict. He could browbeat my parents into accepting this. So things did change.
I was still left feeling that I had a defect though. And I did eventually get my visits to the doctor cut off.
Okay, but what no doctor or counselor or anyone would say was, “Your parents are wrong.”
And even better, “Your parents are wrong and either things are going to change right now, or they are going to be very sorry.”
This is what was really needed, as it would have showed that our society does not allow what my parents were doing, and this was not there. But I aim to change this.
I’ll read your other links now, as they do look interesting, as does you book.
I have seen this in many lives including those of my son and myself.
The prejudice in the “broken human brain” idea and the accompanying idea that it is a life long “defect”. It was my son who had the courage to refuse medication and I supported him in that after several failures and side-effects that were horrid. Then I watched the evolution of “disease” (from “he has ASD” to “he has AD/HD” to “he has bi-polar” all by the age of 11!) and I understood in one moment what was happening to him and what had happened to me. Once DSM’ed you will be there for a lifetime on one page or another and the entire system is now constructed to keep you there from education, to medicine to judicial and it’s just getting worse. The magic in is that he taught me about life, about how differences enhance value (because we have something to offer in differences), how parental denial and a need to “fix” hurts children, how the school system exploits vulnerable kids for the coveted “special needs” dollars to survive… he taught me about truth the value that we all have whatever our perceived differences. He is my hero and I have told him so.
I hope there are more adults, more “helpers” more people out there who are able to value our children. To understand that they are great mentors if they are allowed to be and we are able to learn from/with them. Listen to their voices and their actions and understand that you have played a part in where they are. Please choose to take action and do the hard work of changing yourself and assisting them. True change will not come from a pill or delegating the responsibility for their life outcome to someone else.
My child was a patient of Dr. Stanley Greenspan’s for many years. We clocked in hours of floortime, and it was really, incredibly helpful. But none of that work made any impact at all until the medications stabilized his symptoms. Make no mistake, without the medication, my child was exactly like Liza Long’s son. Their life was exactly like ours, only we got effective psychiatric and psychological treatment because of where we live and our resources. If my child did not have medication, h/she would not have been available at all for Dr. Greenspan’s therapy. Also, Dr. Greenspan’s opinion about medication was much more nuanced than you imply in your article. He encouraged us to keep our child on medication. The level of violence and aggression that we, like Liza Long’s family, endured was so severe, that without medication, we would have have had to place him in an institutional setting by age eight. We never had to. I have lived this life you are writing about. Severe mental illness is biologically based. But there are severe psychological ramifications, too, and parents must be present and available. We had to learn an entirely different type of parenting for our child. Please be careful not to classify SMI treatments as an “either-or” situation. My child, and hence the entire family, needed both. For the most part we have had excellent professionals: psychiatrists, psychologists, play therapists, OTs, nutritionists and groups. Instead of discounting medical treatment, please consider writing about how consumers can discern between good psychiatrists and poor ones. Help people to recognize a good fit between a professional and the child and their family. Thank-you.
Hi wtime I appreciate your point. You will not find anything in this article, or in my book, that is “anti-medication.” In my book I do acknowledge that there are circumstances where medication can make children available for other forms of intervention. The point is that our current system of care does not protect time to listen to the story but rather jumps to find something “wrong” with a child.
you write “Severe mental illness is biologically based.” I have no proof of that. Do you?
If you do not I will assume that you are just restating what psychiatrists have told you, which they tell themselves, but for which there is no proof.
I believe this a dangerous myth that needs countering at every opportunity. I maybe wrong. If so please correct me.
Hi, I would strongly suggest that you and other now practicing with families and children do a Oliver Saks research move. He went deep into the past and by doing so came up with some very interesting information that had been missing in his field for decades. Thanks for your work but please look into the writings of Selma Fraiberg MSW, DW Winnicot, Anna Freud, Clark Moustakous sp ? Fritz Redl , Daniel Stern, Ann Schraf Wilson, Maria Montessori original research, and others.
The environment in which the child lives in, the parents own histories, specific traumatic incidents were all acknowledged in some way shape or form by these folks. Of course they were not perfect but they had the the right sense if nothing else. And for those who dont know Anna Freud worked with the children of World War II — those that had become refugees and those that had been placed outside of their families home for safety.
Somehow the baby was thrown out with the bath water and medication became a god.I am thankful at the very least that maybe the tide may just begin to be changing.
READ and RESEARCH! It’s all there! Even if you initially don’t like their thinking there are gems to be found.
We can have both the best of the old and the new. Really! The whole survivor movement is a goldmine if we can only be heard and learn to dialogue as much as times we would prefer to curse and scream bloody murder.
If only we can be heard and acknowledged we can bring depths of knowledge and adding with others work maybe a chance for hope that is real and solid for children, families and adults who either have dealt with trauma or think in a different way.
I’m confused why this piece was published in Mad In America. The author makes clear that as a pediatrician she is NOT anti-psychiatry or anti-psych-drugging; so why wasn’t this piece given to the New York Times, for example, which mounts defenses of labelling (ADHD, ODD, IED, ADD, pediatric bipolar, and on and on…) and child-drugging regularly to readers who are happy to hear it and never question the basis of any of it. However, MIA publishes research and news daily of the terrible and tragic short- and long-term harm being done to children by psychiatry and by the psychiatric drugs forced on them [‘forced’, as children cannot give informed consent, and neither can adult caregivers since pharma manufacturers lie and obfuscate about their terrible products].
MIA publishes reports that include suicide, death, shrunken brains, growth problems, nerve issues, weight problems, metabolic problems, mood problems, secondary/tertiary substance-abuse (not to mention the emotional/spiritual/psycho-social effects)…and many of these accidental/unintended test subjects aren’t even grown yet. What effects will they experience decades in the future? Who speaks for children? Not this author, as she says there is nothing against psychiatric drugs in her writings. MIA needs authors with the courage to say unequivocally that they are indeed anti-psychiatry and anti-child-drugging.
I understand that the author seeks the widest possible audience for the promotion of her new book and it serves to reason that she wants to be all things to all people, so I understand why she wants to be here. But I am disappointed that MIA published the piece, since I can read this kind of fence-sitting by medical professionals anywhere on the Web. This is the single place for voices that are unashamedly and proudly anti-psychiatry and anti-psych drugs. I believe that psychiatrist Kelly Brogan, MD speaks unequivocally against psych drugs and that she does not prescribe them.
The most egregious example of fence-sitting: On one hand the author correctly makes a reference to the hatred and fear of children at the root of some of society’s problems with children. Yet she makes a point of saying that she is absolutely not against drugging children, which is society’s favorite contemporary tool of control for the wild children it hates. Psych drugs don’t treat, heal, or cure; they control and restrain. This reminded me of other professionals who also want it all ways at once when dealing with very difficult children. I just don’t come to MIA to read their views.
I intentionally steered clear of all of these conventional types when my own family was in crisis and I was trying to uncover the root of my child’s rages and violence. The schools and ‘health’ systems were clearly confused, misinformed, labelling, pathologizing, drugging, controlling, and authoritarian. Instead, I did my own research and found critical and independent thinking on the issues that led me to answers. Thank goodness I avoided MDs, psychiatrists, and child-drugging.
I come to MIA for courageous voices of dissent against the tyranny of psychiatry and its culture of child-drugging. I’m discouraged to read pieces like this here. No, children should not be controlled through the use of psychotropic drugs for any more than a moment of extreme emergency. Psychiatry has little to offer anyone in any state, and least of all to difficult children.
Hi Liz I find your comment to be very thought-provoking. There are two reasons why I choose not to use the term “anti-psychiatry” to describe myself and my work. The first, as I allude to in this piece, is that from my perspective as a pediatrician, I see the problem of the silenced child as extending well beyond the field of psychiatry. The lack of paid parental leave, the increased academic demands of early childhood education, the complexities of the health insurance industry that place demands on the time of primary care clinicians and take away from opportunity for listening are just some of the cultural forces that contribute to what I refer to, drawing on the work of Elizabeth Young-Breuhl, as prejudice against children.The second is that, as you point out, I want these views to be heard by a broad audience. I think that identifying yourself as “anti-psychiatry” provokes members of this discipline, that wields a good deal of power in our society, to defensively shut down and not listen. In an ideal world, where we offered a holding environment to support children and families starting in infancy, we would not use psychiatric medication at all. But in the real world, as it exists today, there are as you identify “emergency situations” such as the child in foster care who will be removed from their fourth placement if their violent behavior is not brought under control, where medication has a role to play. I do look with hope to they day when we as a society take note of the explosion of science showing how the brain grows in relationships, value parents and children and by supporting healthy development from the start, and so do not have such dire situations. That long term, perhaps lofty goal is what motivates me to write my blog posts and my books.
I was diagnosed as genetic garbage with a hopelessly flawed biology at age 20. That’s when I decided my life was worthless and wanted to kill myself. Psychiatry is directly responsible.
A good psychiatrist? Hmm. A good torturer? A good drug dealer?
I wish my psychiatrist had put a bullet in my head instead of “diagnosing” me with a damning stigma and forcing me to take drugs that gave me seizures every day! It would have been much kinder. But he wouldn’t have made as much money either….