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

Explaining Suicide

Suicide reflects the seriously inadequate development of those basic ego capacities governing a sturdy sense of self (sense of who one is), modulation of affect, and control over thinking and behavior. This causes profound feelings of worthlessness and, when exacerbated by an immediate stress, suicidal behavior may result.

 

Thus, a teenager doesn't suicide simply because they broke up with their boy/girl friend, and most recent soldiers who committed suicide never saw combat with many never even having left the USA.

 

Alcoholism and drug abuse reflect the attempted self-medication of emotional deficiencies. It's not easy to kill oneself, living being a biological imperative, unless one momentarily lacks self-control because of drugs or alcohol use. To paraphrase F. Scott Fitzgerald, 3AM is the darkest time of the day. Nelson Algren attempted suicide after the failure of his first novel in 1935. Fourteen years later he won the National Book Award for The Man With the Golden Arm.

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When the Fantasy of Having Had a Loving Mother Must End

After telling me his nightmare, a patient rejected my interpretation of it as reflecting anger toward his mother. "No, my mother always loved me," he said. Which may have been true for her relinquishing of parental rights enabled the patient's life to dramatically improve after his adoption and psychotherapy.


It is hard to accept being unloved at birth. Though the helpless infant can survive without physical care, psychological neglect can equally damage their future. And the most important person in their earliest years is their mother or mothering figure. Viewing the world with an immature mind, every child considers their parents to be omniscient. Thus if the child is unloved, it must be their fault.

 

Only with maturity, and possibly psychotherapy, can one accept a basic psychological truth: that while all children are lovable at birth, some mothers ore incapable of providing it. For this realization to occur, two things must happen: an acceptance of their parent's limitations, and their own.

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Treating PTSD With Hypnosis

I was a member of the American Society of Clinical Hypnosis for many years and, while a hospital administrator, got pains in my neck at the end of the day. A year later I interpreted this as reflecting some of my employees being a pain in the neck which they were. An ASCH entire journal issue was on cancer and hypnosis and I used one of the article's research protocols (the article related stress to the immune system and the tendency to develop cancer) to make a ten-minute tape which I then used twice and, low and behold, my neck pain disappeared.

 

Years later, when a nurse at my (stressful) job found that my blood pressure was high, an internist I had known since adolescence recommended that I take it as often as possible, there being no way that I would take medication. I did, used the self-hypnotic relaxation CD repeatedly daily and graphed my readings. My blood pressure readings gradually went down over several months to superb readings (low 120s over low 70s or better) and have remained so. I'm a great believer in the efficacy of hypnosis, considering it not a learned reaction but fostering the entrance into a different physiological state, this "drop" being experienced by many. Napping using self-hypnosis is far more restful too, a 1/2 hour nap, upon awakening, feeling like a several hour ordinary period of sleep.

 

I've since used the tape (now a CD and on my Android phone) daily and given it to all of my adult patients without charge for relaxation, though hypnosis is useful for far more. I regard hypnosis as mostly best for physical conditions such as alleviating the pain of childbirth, burns, and back ache; to lower high blood pressure along with the use of a digital blood pressure measuring device as a biofeedback mechanism; for sleep difficulty; to reduce the stress of asthmatic children so they're less likely to have an asthma attack, and with similar issues.

 

On the whole, apart from relieving stress and anxiety, I believe that hypnosis, and mostly the teaching of self-hypnotic technique which is quick, isn't particularly useful when coping with specific trauma. Here, psychological education about its nature and psychodynamic interpretation of the trauma residue would be most beneficial. It is also far safer than the use of medication.

 

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The Tragedy of Mental Illness:

Rudolph Schoenheimer, a loner and brilliant biochemist, was forced to leave Germany in 1933. He discovered that body constituents are in a continuous state of chemical renewal with chemicals appearing and disappearing even in adult organisms while their structure and form remain unchanged. Believed to be a certain winner of the Nobel Prize, he suffered from manic-depression and killed himself at the age of forty-three in 1941.

 

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Things Aren't Always As They Seem

Near Huntington, Long Island's railroad station is a lovely, condo-like, low-income housing development. A young teacher, walking to the home of a student for a parent visit, saw three teenagers sitting on a stoop and became frightened (everyone knows how dangerous teenagers are!). As she nervously walked by, one teenager asked the others, "Do you think she sells vacuums?"

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Sensations While Dreaming:

In a dream yesterday, I held hands with a long-past lover in school and felt the warmth of her hand on mine. Upon awakening, that wrist was painful. Now, this discomfort might have derived not from the dream but from having pulled too heavy a load in a cart that day or holding a tablet for too long while watching a movie. Which got me thinking.

 

Some people dream in color but for me this occurred only once and then momentarily. A coworker of years ago suffered nightmares from which she awoke screaming several times a week, then bearing marks on her wrist where, in the dream, her mother held her down while sexually abusing her. She had experienced this during childhood.

 

Dream content has inspired art and presented the solution to scientific problems. "There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy." (Shakespeare/Hamlet)

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The Unspoken Unavoidable Pain of Psychotherapists

A psychotherapist's work is catalytic, fostering the patient's unconscious mind in its quest for greater emotional health and improved functioning. While this cannot be guaranteed, it usually happens and patients leave therapy satisfied. Likely without achieving as great joy as they wished but that is not a reasonable goal since life gets in the way.

 

But there is also sadness for the doctor who, with rare exception, never learns how their patient's life progresses, like reading a novel with missing chapters. Unlike parents who, after surrendering their grown-up child, do learn of their offspring's continuing life.

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The Feared Unacknowledged Reasons for School Discipline Problems

Students misbehave for one or more of three reasons:

(1) A child's ability to control their thinking and behavior derive from basic ego capacities which form within the first three years of life. Their adequate development derives from a healthy interaction with their parents. Inadequate parenting causes weakness of these crucial abilities and the later inability to function in line with chronological maturity.

2. Students with emotional problems will be intermittently uncooperative. Schools, with exception, are clueless about coping with their difficulties and for good reason: teachers are trained to teach, not to operate a therapeutic environment.

3. School principals who do not take discipline seriously, by quickly intervening against bullying or other uncivil behavior, send the implicit message that these are not serious issues. Both students and staff soon get this message and student achievement deteriorates.

While these issues are not easily addressed, ignoring them by adopting the false explanations of prejudice or inadequate school funding will make this impossible.

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Online Moderation Can Lead to Problems

For years I contributed to a professional psychology site, eventually leaving it because it provided me with unneeded angst.

(1) The moderator threatened to remove me from the website because I disagreed with the clinical position of another psychologist and "hurt her feelings." My sense was that if her feelings were hurt (she later told  Read More 
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The Need for Publicized Psychological Autopsies in Mass Killings

Some years ago there was a particularly egregious incident in my area when a retired police officer killed himself and his children. Soon after, I asked a police official whether the results of the investigation would be made public. I was assured that it would be but never saw it.
Serving more than mere interest,  Read More 
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