Dr. Stanley Goldstein - Author and Psychologist

Yesterday's article on Ozempic in The Wall Street Journal ("A 12-Year-Old's Journey Into the World of Ozempic. A mother found success with a weight-loss drug after a lifelong battle. Noticing her daughter start down the same path...") aroused several thoughts.

The baby's first source of food is their mother and they later learn eating habits from their family. Children with eating disturbances tend to develop in families where food serves other purposes beside nourishment.

Anorexia (which has the highest death rate of all mental health disorders) and Bulimia develop in children where eating becomes entwined with their healthy desire for autonomy, which is resisted by their mother. Thus, control over eating for the child serves their emotional need of exhibiting their independence and, once created, is difficult to treat as it entwines with fanciful notions about beauty, nutrition, and exercise. Obsessive-compulsive exercising has its own motivation since, as reflecting an ego defense against anxiety, it serves to reduce the continuing anxiety of the anorexic/bulimic child.

Sadly, many doctors ignore the family underpinnings of these behavioral disturbances.

Some marital conflicts may arise from one partner seeking to heal their early developmental deficits through interaction with the other partner. Those who lacked a loving supportive parenting experience may seek this from their spouse, not recognizing its unconscious elements. Because of this, the partner may respond inappropriately, describing the behavior as silly or babyish, unworthy of a mature adult.

While the healing of these emotional deficits are best done through psychotherapy during which unconscious motives are recognized and their affect on behavior reduced, this is not to say that a supportive, loving relationship cannot provide its own healing element

Some parents believe their child's emotional difficulties derive from excessive video gameplay but this is not true. Video games are heavily obsessive-compulsive. An obsession is a repetitive thought and a compulsion is a repetitive behavior. An example is repeatedly worrying that one did not lock a door and then continually checking that it was done. Thus both youth and adults who play video games excessively do so because they're anxious, and the gameplay reduces their anxiety using the mind's instinctive obsessive- compulsive ego defense.
So it is anxiety which creates excessive gameplay and not the gameplay which creates anxiety or emotional difficulties. To reduce their child's play, a parent should try to discover what is distressing their child and alleviate it, alone or with the aid of a mental health professional. Only then will the gameplay become less important to them. Odering their child not to play the game won't work and will create the feeling they are misunderstood and arouse distrust.

An October 4, 2024 Wall Street Journal essay ("Why Do Older People Waste Their Time Playing Dumb Phone Games?") aroused these thoughts - Getting old isn't easy. It causes anxiety which the mind naturally tries to reduce using its innate obsessive-compulsive ego defense and video game playing is heavily obsessive-compulsive. This explains why such games are popular with other age groups too,  especially anxious troubled teenagers since it reduces their anxiety while playing them.

While both participants made good suggestions (the need to "harden" schools against intrusion; hire more security staff; provide more student mental health services) what is equally important is public education. Children aren't born with parenting instructions and the general level of knowledge of child psychological development and developmental psychopathology (a term coined by my doctoral advisor) among the public, teachers, doctors, and the legal system is low.

The basic ego capacities, those governing control of behavior and thinking, modulation of mood, distinguishing reality from fantasy, and developing a sense of who one is (the "sense of self") depend on experiencing a "good-enough" though not perfect parenting. The great power of the unconscious over behavior during childhood and adult life is another critical factor.. Pamphlets and instructional video explaining this, in a supportive non-judgmental fashion, might produce significant benefit at relatively low cost.

Newspaper reports of Ryan Routh, the man who was arrested for allegedly attempting former President Trump's assassination, describe Routh's long attempt to find a mission in life by making arms deals and recruiting soldiers for Ukraine and Taiwan with none succeeding. When younger he was rejected for military service and there was no news mention of current romantic interest though stating he was divorced and had children. Yet love or its equivalent is instinctive to all animals of which humans are a part. For humans, love, ideally, is when the other's welfare is made equal to one's own and honesty and communication is total. When absent, aloneness produces unbearable anxiety and a prison to escape. The total failure to achieve this can result in psychosis, a withdrawal from the outside world with behavior based on delusions during which the pain of separation disappears.
To be separate means to be helpless, arousing shame which can also be avoided by involvement in religion or artistic creation or obsessive work though the fulfilling solution for most is through love. Was Routh's obsessive involvement in his missions motivated by underlying problem with intimacy?

His behavior may also have reflected depression, the sense of having deep problems and cry for help, or the desire for what is termed "suicide-by-cop." The unconscious is very powerful and one must respect its power.

Note: This item was updated as further information became publicly available.

A Wall Street Journal Article ("Parents and School Shooters/Georgia has charged the father of 14-year-old Colt Gray. Is that fair?"/September 6, 2024) aroused several thoughts: 1. Babies are not born with parenting instructions and knowledge of child psychological development is greatly lacking among parents, doctors, lawyers, and politicians. 2. There is evil in the world which must be punished. 3. The unconscious is very powerful and one must respect its power. 4. Mental illness creates tunnel vision making crazy thoughts seem very real though when out of it one wonders how they could have once believed them. 5. Mildly poor parenting behavior shouldn't be criminalized but where to draw the line can be difficult to determine.

A Wall Street Journal article ("Less Painful Ballet Shoes Are Here. Some Dancers Refuse to Use Them"/August 25, 2024) aroused a thought. Having no interest in ballet and never viewing one I remembered my long-ago, now deceased friend, a martial art student who met dates by taking ballet dance notation classes ostensibly to document his martial art moves. "The women starved themselves and were hungry for a good meal," he said, explaining his success.

My thoughts on the danger of parenting (Wall Street Journal, August 28, 2024, "Parenting Is Hazardous to Your Health, the Surgeon General Warns") - 1. Be leery of startling statistics. 2. Babies demand that their parent's personality change to best meet their survival needs. Which must create great parental stress since the mind is naturally conservative and loathe to change. 3. The mother is the most critical figure in the first three years of a child's life, the father then becoming equally important to break the maternal bond and move the child into the larger world. 4. Ignorance of child psychological development is widespread among parents, doctors, politicians, and the general public. Thus do spurious advice and solutions abound.

"Court-Ordered Therapy That Separates Kids from a Parent They Love Stirs a Backlash/A controversial treatment used in custody fights can keep family members apart for years against children's wishes./'It all absolutely destroyed me.''' begins the article.

Knowledge of child psychological development is greatly lacking among doctors, the legal system, and the general public. Children are not easily swayed, being fully capable of deciding who most loves them. The concept that a child needs both parents in their life for healthy psychological development is untrue. What most often reflects such Family Court conflict is parental narcissism, the lack of self-knowledge.

I have known children who were overjoyed when their parents separated, one teenager telling her mother that if she divorced the alcoholic father she would get a job to help support the family. A seven-year-old once told me, "I need a new family."

As every lawyer will tell you, the Family Court is a Wild West show where the parent with the most skilled lawyer usually wins despite the best interests of the child being the sole deciding mandate which should occur. In New York State two children were recently murdered by their abusive parent after being returned to them from foster care despite the opposition of mental health professionals. Nuff said.