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A Psychologist's Thoughts on Clinical Practice, Behavior, and Life

Mental Health Ignorance Causes Three Girls' Murder

In 2019 a 13-year-old British boy called a child welfare hotline and asked "What should I do if I want to kill somebody?" This year the 18-year-old did, murdering three girls at a dance class and trying to kill eight others and two adults who hoped to protect them. The police later found 164,000 documents and images on his digital devices, including images and videos of dead bodies, torture and beheadings, indicating his long obsession with killing. He downloaded an Al Qaeda training manual which included knife attack methods, and had made ricin, a biological toxin, that he kept in a lunchbox under his bed.

Teachers concerned about his interest in violence had reported him to authorities three times, when he was 13 and 14, without intervention since he was considered by them to be only crazed and not ideologically motivated. Diagnosed with autism at 14, he became increasingly reclusive, anxious, and aggressive in the years before the attack. He received mental health treatment for four years but "stopped engaging" with clinicians in 2023. His defense lawyer was reported to have said, in a statement which borders farce, that there was "no psychiatric evidence which could suggest that a mental disorder contributed" to his actions. With professional judgments like these, snails will soon take over the Earth.

Such killings are not rare, having occurred in Colorado Springs, Raleigh, Buffalo, Texas, Illinois, Serbia, Prague, Georgia, Wisconsin and most recently Nashville, I explaining the underlying motives in a previous article, "Understanding the Newtown Shooter," which is posted on my website (https://www.drstanleygoldstein.com/bio.htm). Sadly, knowledge of child psychological development is minimal among doctors, school personnel, and the general public, as is knowledge of developmental psychopathology, a term coined by my doctoral advisor decades ago. Nuff said.

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On Neurodiversity and Related Matters

This item was inspired by a Wall Street Journal Article ("Bill Gates: I Coded While I Hiked as a teenager. Was I on the Spectrum? Probably"/Jan. 24, 2025). There are fashions in labeling mental health disorders. A clinician confided that in his West Coast psychiatric hospital it was now forbidden to describe patients as "crazy," that the term "insane" must be used instead, and another that in his Washington DC hospital "crazy" was the preferred nomenclature with "insane" being forbidden. Similarly, the term "mentally retarded" has become abolished though without a favored accepted replacement. Or perhaps today all must be regarded as possessing genius lest feelings be hurt though both cognitive and physical abilities have long been known to follow the a bell curve, which is nature's way of saying that most people are about average.

During the newspaper interview, Gates was reported to have said that were he born today his obsessive interest in coding would be described as "neurodivergent," which has become the present term for children who were once termed "strange" or "weird." Even autism is now depicted as merely "neurodivergent," implying normality, though it is perhaps the most disabling of all mental health conditions, and often misdiagnosed.

Knowledge of child psychological development and developmental psychopathology (a term coined by my doctoral advisor decades ago) is minimal among both doctors and the general public.

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Suicide of a Young Athlete

The shocking suicide in May, 2024 of 30-year-old top golfer, Grayson Murray, stunned the golfing community. Diagnosed with social anxiety as a teenager, he battled distress for the rest of his life, perhaps not realizing that "social anxiety" is merely a description and not explanation for his unhappiness.
Suicide reflects complex motives deriving from early childhood during which one is made to feel worthless, a feeling that can resurrect during times of great stress. While almost all consider suicide at some point in their life, few do, the act being determined by whether suicidal intent (as contrasted with its mere thought) is present, the degree of self-control possessed, and if lethal means (as a gun or medication) are present. Though all such thoughts should be professionally investigated, the incidence of suicide when compared with its thought is like the proverbial needle in a haystack, which explains why suicide prevention programs tend to fail.
Because of the instinctive biological intent to live, when suicide does occur the use of alcohol or drugs is frequently involved.

Sadly, knowledge of child psychological development, which can prevent it early on, is minimal among doctors and the general public. One pediatrician, upon being told by his teenage patient that he was thinking of killing himself, responded, "You shouldn't talk like that. It upsets you mother." Nuff said.

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Of The Burned Alive Woman On The New York City Subway

News reports identified the murdered woman who was burned alive on a New York City subway as fifty-seven-year-old Debrina Kawam of Toms River, New Jersey. She had briefly stayed in a New York City homeless shelter despite her conventional early life. Forty-years before she was a high-school cheerleader with the public hope to be an airline stewardess and secret desire to "party forever." She was one of three girls voted to have a "million-dollar smile." Though working in her thirties as customer service representative for Merck, the giant pharmaceutical company, her life had been less than auspicious containing dozens of minor arrests for trespassing, public drinking, and disorderly conduct. She filed for bankruptcy in 2008 and her relationship with her romantic partner from 2011 to 2014 was chaotic.


The emotional conflicts precipitating Ms. Kawam's descent can only be speculated. At her father's death she described him as having been "the best father a daughter could have had" with the "regret that it took me later in life to figure that out." These statements may indicate that she ignored his sound advice. That alcohol abuse played a role seems likely in view of her many arrests for public drinking and disorderly conduct. Still, as with all troubled souls, she did her best, having lacked the needed support structure.
Yet while her burned body molders in the grave, her killer will enjoy for the remainder of his life, free food and health care and, in New York State prisons, a laptop, free college study (if desired), drugs (methadone) if he claims to be a drug abuser, and even a medical change of sex if sought.


Not fair. Not just. There is a justice of lawyers and the courtroom, and a justice of the Prophets and of God. Nuff said.

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PTSD Fact and Fiction

An article in The Wall Street Journal aroused these thoughts ("Green Beret in Tesla Explosion Suffered From PTSD, Authorities Say"/Jan. 3, 2025). PTSD (Post-Traumatic Stress Disorder) can occur in anyone, even children, when stress exceeds the mind's capacity to cope with it. Its possible feared, painful symptoms (nightmares, flashbacks, others) are not the real problem since they reflect the mind's normal healthy attempt to re-integrate after experiencing the unbearable stress. Thus the most effective treatment is education and psychotherapy with medication, which can produce serious side effects and interfere with thinking, being avoided or used only briefly. Which is not how it's usually treated.

As an aside, many American veterans who are receiving compensation for PTSD never experienced combat or even left the USA. Their symptoms reflect early life psychological issues exacerbated by recent extreme stress. That its diagnosis can involve financial compensation complicates its diagnosis and treatment. In Israel, which has had several wars and continuing danger, PTSD is treated differently. Their suffering soldiers are explained the nature of PTSD before being sent home for several weeks leave. They then return to their unit without the PTSD symptoms lingering. These statistics were remembered from a past article in Armed Forces and Society, an outstanding international journal on military and related matters. It's well worth subscribing.

 

 

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The Value of Anxiety and Depression

Though painful and feared, anxiety and depression (the "depressing" of feelings) are instinctive survival and developmental mechanisms of the human condition. Both can indicate the presence of danger, external or internal. With anxiety it might be hearing a close-by noise while traveling a crime-ridden neighborhood alone at night; with depression it could be the sensing of an impending long feared feeling for intimacy or self-assertion. A common problem is when the primary goal is to avoid the anxiety or depression rather than interpreting its reason. Which, admittedly, is not easy since emotional conflict is part of human personality development and distinguishing actual from unrealistic danger can be difficult since the unconscious is powerful.
Normal anxiety and depression associated with healthy grieving, as after the death of a loved one or the loss of a bodily function due to accident or illness, are exceptions to these statements.

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