Dave: I have often noticed that in the weeks following the extended family interview, something happens, something that gives evidence of change. In this clinical illustration the something happens, but it […]
Dave: I have to take a moment to applaud my good friend and muse, Amy Begel, who has a splendid capacity to wrap complex experiences in words. I am a […]
Parenting advice often describes ways to “manage” a child’s temper tantrums. But temper tantrums, or defiant behavior in kids contain important messages for the parents. Often, without meaning to, kids are responding to underlying tensions in the family. They react in the only way they know how: through their behavior. The message: HELP!
Tensions in marriage are normal, and unavoidable. They’re part of the price of intimacy. Problems only occur when these underlying tensions are ongoing, and not acknowledged. They are semi-buried. Children are geniuses at feeling these latent tensions; they often help magnify what hasn’t been addressed. In fact, in their own way, they may be trying to help.
We’re revisiting a past article by Dr. Allen Frances, a prominent psychiatric “insider” who now spends his time railing against the overprescribing of psychiatric medications. Here he talks about the New York Times article which connected the proliferation of “ADHD” in kids to the profiteering by the drug companies. This is a wake up call to parents and professionals alike. Frances says, “as it stands now, we are doing an uncontrolled experiment on our kids with no clue about the long term effects of the meds on their brains and behavior.”
In contemporary culture, as portrayed in commercials for pharmaceuticals, family members are portrayed as bystanders to suffering, having to “manage” the symptoms of their bi-polar loved one, or “suffer” the effects of the depressed person’s symptoms or behavior. But families, couples, all of us, can unwittingly get stuck in patterns, sometimes destructive patterns, of which we are unaware. Those patterns can cause distress in ourselves and others, which can show up as a “symptom” in one person. This is rarely intentional, more a product of the tricky, powerful and subtle nature of relationship dynamics.
Eating disorders are no exceptions. Most of the clinical writing and popular assumptions about anorexia and other eating disorders note that these conditions are characterized by the need for individual “control”. There’s truth to this. But if you expand the lens to include the family, you learn a lot about what this “control” can look like.
Women who feel depressed often see this as a purely personal struggle, believing they have a “chemical imbalance”. They may feel burdened and alone, and responsible and/or guilty for their depression.
In fact, depression is rarely a simple personal affair. Most often, the roots of depression can be found in that person’s intimate relationship sphere, where important parts of our happiness/unhappiness live. Here’s one woman’s story of how she moved from depression to owning her own power.
In this post Dave reflects on a case from his early career in child psychiatry, where he recounts his play therapy experience with a seven-year old autistic girl. He still winces when he remembers his therapeutic mistake, but remains grateful for his relationship with this young, silent girl, and what she taught him.
This is some advice from Adam Grant, professor of management and psychology at the Wharton School of Business. In today’s New York Times, Grant writes about how allowing for healthy […]
These days kids are reflexively and routinely given stimulants like Ritalin if they are designated as having ADHD. Dave Keith offers an alternative perspective: He works with the family relationship patterns in order to treat the child. The side effects are good.
Good physicians take a clinical history in the interest of arriving at a diagnosis. While the clinical history is a review of ‘facts’, there are in fact, few ‘facts’ about human experience. Different examiners will get different histories depending upon what they ask about. Different family members give different reports of the same set of events. In my view clinical histories are a form of fiction pretending to be ‘objective’.
Teenage “cutting”: Teenagers are often seen in individual therapy for the self-mutilating behavior called “cutting.” Here’s a family therapy approach that stopped the cutting by revealing what was behind her apparent self-destructive behavior.
The modern Child Psychiatry perspective is limited to focusing on the child, without including the family culture in which that child lives. This narrow understanding contributes to the child’s isolation. That little person is usually worried about, and trying to help, the parents. No matter how it appears.
To be a parent is to know worry. There’s no escaping it, and there’s really no cure for it. As my blogging buddy David Keith says, “If you can’t stand guilt don’t become a parent.”
Kids instinctively “worry”, that is, feel responsible for their families. Don’t forget that. Children worry about their families. They are trying to help the parents become not only better parents but better people. But their therapeutic methods get diagnosed as mental illness.
For Amy and Dave, common psychiatric “disorders” are part of relational patterns, usually embedded in the dynamics of the family. You just have to know how to look.