Dr. Stanley Goldstein - Author and Psychologist

The number of unsophisticated beliefs about behavior in today's society is astounding due to widespread public ignorance about psychological functioning and development. But these come from the lips of clinicians too. Consider treatment acronyms like DBT, "Dialectical Behavior Therapy" which I thought to mean "Diabolical Behavior Therapy" when I first heard it. This and others are mere abbreviated corruptions of the basic long-held treatment postures of psychoanalytically oriented psychotherapy (Relationship, Replacement, Supportive, Analytic).
An enthralling Netflix documentary series about a Hollywood teenage burglary ring that robbed celebrities is "The Real Bling Ring." I usually watch only the first episode of these series before reading what happened on Wikipedia but watched this in entirety. As crazed (but clever) was their robbery planning is the celebrity culture they hungered to join.
And as far as being "traumatized" by a scene from a book or film or a comment. When one doesn't know the technical definition of "traumatized" it can mean "feeling upset" or "not liking it" or having "hurt feelings." Development requires learning to cope with such human failings as jealousy and envy and sadism, on jobs and elsewhere.
Long ago a woman told me that her therapist said, "I love you." "Wow! That's a pretty unusual thing for a therapist to say," I responded. "Well, he didn't say exactly that. He said, 'You're lovable.'" When words can mean whatever the speaker wishes them to mean and belief becomes fact, we are in a world in which everything is OK and acceptable, or perhaps a psychotic one. Nuff said.

As a psychologist, I have known of world-class devastating marriages and divorces, experiences too improbable for a novel, lived by people who felt that personality doesn't matter in a relationship if there is attraction to each other. Emotional immaturity and impulsivity are key warning signs, as are a history of abusive relationships and lacking independence from parents.

But it can take time to know someone too. In 1930s Vienna, before an unmarried American psychiatrist departed after completing his training analysis, Freud said he hoped the doctor had the good fortune to achieve a happy marriage. "Does one need luck with all your psychological knowledge?" the doctor asked, and Freud replied, "Of course, for only after living with someone for a long time does one really know them." 

In addition to the therapist lacking talent and training, certain professional practices will insure that a patient's treatment fails. (1) Using a vague unintelligible diagnosis will make the patient be considered untreatable. One like "Borderline Personality Characteristics reflective of Post-Autistic Development" would be excellent. To insure confusion and professional acceptance, a biologic or genetic phrase can be added like "A possible malformation of the patient's adrenal medulla causing irregular production of the epinephrine and norepinephrine hormones may influence the patient's moods." (2) Advising that psychological deterioration is inevitable unless many years of twice-weekly individual treatment is obtained since this is rarely possible. (3) Having the most disturbed patient be treated by the clinic's least experienced worker. A beginner trainee would be a wise choice. (4) Making life decisions for the patient. This will further lower their self-esteem by indicating how inadequate their doctor believes them to be. (5) Never responding directly to a patient's question. Thus if asked why their symptom exists the doctor should reply, with an air of condescension and omniscience, "Severe problems like yours take a long time to understand." This, even if the symptom has been long understood since psychotherapy is least likely to fail when a patient receives explanation.

Though the psychodynamics of Anorexia Nervosa are well understood, it remains the deadliest of mental health disorders with the highest death rate. Its origin lies in parental failure to encourage their child's independence with the child's only possible autonomous behavior being to control what they eat.

Symptoms begin at a time of expected independence for this child who is socially immature and has little awareness of their feelings, the family power struggle around eating being a substitute for the normal developmental struggle of separating from parents and entering adult relationships. Thus symptoms arise when personal autonomy is required: beginning school, entering puberty, or leaving for college.

The initial treatment goal must be to restore and maintain the patient's healthy nutrition. Starvation affects the central nervous system causing increased irritability, hyperactivity, and an obsession with food. Individual psychotherapy can then help the patient resolve their dependency issues and rage toward parental figures, with their low self-esteem naturally rising as normal developmental goals are achieved.

A newly installed manager's initially successful behavior has the potential to deteriorate into paranoia. Their positive abilities of extreme alertness to business change and goal directedness may descend into rigidity, with delusions of grandeur fostering unrealistic projects and irrational suspicion causing scapegoating, poor morale, and high staff turnover. Having the checks and balances of a conscientous corporate board can enable the needed organization change, protect staff against the abuse of power, and rescue the manager from what Plato described as "convulsive fear and distractions" by forcing them to abide by reality rather than fantasy.

While humans are born with instinctive psychological abilities like the ability to learn language, a child being able to induct the grammatical structure of their native language (thus a child born in China easily learns Chinese while a child born in Germany easily learns German), the successful development of more complex functions depend on experiencing the "good-enough" interaction with their earliest parenting figure, which for most children is their mother. Because of an infant's psychological immaturity, conflict between their desires and the needs of their parents are inevitable. Yet, from this, the child's mind usually expands healthffully. It is only when parents don't encourage their child's struggle for individuation that unneeded exaggerated tension occurs. Caused by the parents lacking knowledge about child development (a baby doesn't exit the womb with instructions), or the lingering effects of the parents' psychological struggles with their parents. 

Healing during psychotherapy occurs through the therapist-patient interaction which, ideally, is the "good-enough" parenting that the patient lacked during their early development. While emotional expression heals during psychotherapy, unconsciously derived reactions are common: forgetting an appointment, day-dreaming during the therapy session, or boredom. These, termed "transference" on the part of the patient and "counter-transference" on the part of the therapist, are inevitable. Though sometimes reducing the effectiveness of treatment when experienced by the therapist, they are part of the human condition, occur whenever people interact, and can point the therapist toward providing better treatment.

Though suicide is never an acceptable alternative to living, it can seem so in an experienced world of continuous unbearable anxiety and hopelessness. One may also choose suicide to communicate how intolerable their life had become. During this struggle between life and death a relationship with a compassionate friend or psychotherapist, from whom to draw strength, can enable time for ego strength and self-esteem to recover with the powers focused on life and not ending it. Freed from the self-imposed punishment of death to use their abilities and resolve important life issues.

Triangulation is the commonly occurring reduction of anxiety in a problematic relationship by introducing a third element into the situation. At work this can be a person or corporate directive depicted as "crazy" and in a marriage a child being termed "impossible." Though reducing anxiety, this unconscious maneuver is destructive since it doesn't resolve the problem. To accomplish this a third party, a management consultant or a psychotherapist, must reframe communication so the real issues are confronted. But here triangulation can also occur if the consultant identifies with the worker or the psychotherapist with the patient(s). As I never tire of repeating, the unconscious is very powerful and one must respect its power.

Though widely believed to be merely a folklore belief of primitive societies, psychogenic death or "voodoo death," a physically healthy person's demise solely because of their belief, has been well documented. In these cases people found themselves in an impossible situation, unable to struggle, to flee or to fight. This giving-up is often complemented by a rejection of their critically important nurturing figures. During psychotherapy this can be an ending of the intense emotional attachment of patient to therapist, resurrecting the early childhood fear of rejection by their mother, akin to cutting the umbilical cord too soon. But this belief of inescapable death may be reversed, stopping the person's deterioration by introducing a powerful figure, a family member (particularly their mother) or a more flexible therapist.