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Attachment Disorder – Early Detachment from Mother

Attachment Disorder is not really a diagnosis. You will see it labeled as Reactive Attachment Disorder but I find that it does not always fit neatly into a box. It can be seen as a personality disorder, as chemical dependency, as depression or anxiety. I see it more as a symptom of a client’s mental health. What I am talking about is a child who was separated from mother at birth and this can be for a variety of reasons. One case the mother was mentally ill and had a breakdown on the delivery table between baby one and two, the children were sent to foster homes immediately.  Another case the mother was sick and the child was separated from her for a certain amount of time. The mother might be a drug addict or alcoholic. The mother might have mental health problems and are unable to bond with baby; severing the trust/mistrust stage. I am going to share a story about Bill.

Courtesy of Ashevilleacademy.com

Bill is a child who was born with “yellow jaundice” as they used to call it. He was left in the hospital for a week and his mother was sent home (hospitals are not attune to the effects separation will have on babies – maybe they are now but they weren’t long ago).  Bill’s parents were in a Domestic Violence plagued marriage (father as batterer) and when his mother tried to escape with him, his father caught up with them and kidnapped Bill for six months. The mother did not know his whereabouts and as the parents were not divorced yet, the police could not do anything about it. The father ended up abandoning the baby and then the police brought the baby to the mother. During the divorce proceedings, however, Bill was given to the grandparents. The mother was able to see Bill once a year and tried to reunify with him without success on several occasions. Bill had lost an ability to attach to the mother and the mother was ill-equipped to understand how to recreate a bond with him. It was too late.

As an adult, Bill dropped out of school and became a drug addict for many years. During which time he had many children from various women. He did get clean but never sought out treatment. His children are all over the place and he has no ability to connect with their mothers so that he can have visitation with them. His finances are utilized on the family he did finally stabilize with – another woman who was also a drug addict like him. A woman who also never sought out treatment and came from a family of addictions, sexual abuse, and depression that never went treated. She was seriously neglected and thus probably has attachment issues as well.

I am not treating Bill but a family member shared this story with me. They were concerned about his mother who desperately wanted a relationship with her son and grandchildren. He seems to be a loving father but has never been able to connect with his mother. In fact, he appears to do whatever he can to go against the mother. Along with being a drug addict, he was reported to be a pathological liar. His mother knew this but when she would try to confront him about things he would start crying and throw a fit (as a child). As an adult, he turns the story around and tells her she is crazy and needs help. He will vehemently deny things even those which are obvious. For example: the mother reported that she tried to explain to her son that he was feeding too much candy to the children. The son, standing in the driveway with candy all around him said that he and his wife had stopped giving this to the children. When the mother pointed out the obvious, he stated that the reason it was on the ground was that the children didn’t want it anymore so they through it there. The mother continues to feel isolated and detached from her son because she can’t have conversations with her son unless it is to praise him for something. It is a relationship based on lies. She worries about the life her grandchildren are leading.

People like Bill, who were raised with a separation from their parents, have difficulties bonding with them. Often they are able to bond with the caretaker (who had them the most) but reject the mother. Even the bond that they will have with the caretaker is filled with lies and deception. As Bill was a drug addict, he stole from his caretaker. The caretaker enabled him to continue with the lies and deception because he would tell her that the money he “used” (meaning stole) was to pay for diapers or gas for his car. Even when Bill spent time behind bars, the caretakers coddled him and took him in upon his release. As Bill never spent time completing his treatment, he has never made amends to his caretakers (paid them back) and owes his mother a large sum of money for an attempt to do rehab.

Attachment is severed the minute the baby is removed from the womb. The baby needs to develop an immediate bond with the parent, thus they are given to the mother, after delivery to soothe the baby. Children are okay being in a nursery and sent to their mother’s from time to time for feeding. This is the first stage of learning individuation/separation. The longer the baby is separated from the mother, trust begins to be severed. Without trust, the baby begins to self-soothe and if they are emotionally intelligent can withstand some trauma but if not, they will collapse completely.  Some adult children who talk about being separated at birth and were emotionally intelligent (good survival skills), have attachment issues but I find they are easier to work with in therapy. As I am not an expert on this, I can only go with the cases I have worked with successfully and these are survivors.

I have found that if the birth parent is reunited with the baby – early on (a week or two later) attachment can be supported, yet attachment as an adult is difficult. In these cases I do see self-soothing with an oral fixation. Early detachment from birth mother that is severed completely (adoption or long term foster care with few caretakers) can heal with the consistent caretaker as well but often there is self-soothing here too. Both of these scenarios might show obesity, or a fluctuation with weight but it also might be a smoker. More severe situations of detachment from birth mother and multiple caregivers will show Chemical Dependency and Conflict Disorder or even Reactive Attachment Disorder. This is a more extreme self-soothing and self-sabotage without the resiliency levels to repair the attachment or want to repair the attachment. Some people may get clean and sober but repel psychotherapy because then they have to attach to themselves through self-awareness. Often it can be more painful to try and attach to self than to live their lives in pain (i.e., denial). I have heard a few clients who abandoned therapy make the comment “I have lived for years with [this chaos] and have been just fine why do I need to dredge up all this history?” I suspect this is the case with Bill and probably his wife. People who seriously need psychotherapy have learned to find coping skills that they feel are appropriate but often it is isolating themselves in a cocoon to protect from others.

The wall Bill has built between he and his mother deflects any self-awareness by pushing her away with his invisible shield that spits out swords that pierce her and shut her up. This keeps the relationship under his domination. He controls and manipulates her so that if she wants a relationship with him, she must obey his clues. It is my understanding that his mother has felt afraid of her son on occasion but more specifically when he was on drugs.

As a therapist, I often wonder about the relationship between early attachment and shooters that we see, almost daily now, around the country. I can’t imagine that someone who has a healthy attachment to their mother would have this level of a lack of empathy toward their fellow human beings. I read “School Violence: Facts vs. Fiction” by Dr. Dewey Cornell, many years ago now and the main issue I took away from this was perpetrators being bullied. I don’t recall the discussion of Attachment Disorders because at that time I was not as conscious of this as an issue as I am now. Therefore, if he did mention it, I clung to the bullying instead which was more easily identifiable in my consciousness then. Now, however, we are dealing with much more than school shootings. It is adults who have taken over from the plight of teen angst and wish to have their moment of glory or retribution to those who have harmed their psyche in some perceived way.

As Narcissism and Attachment disorders or early attachment being severed are closely linked if not synonymous, it is important to make people aware of this in the field of mental health, medical fields and social work. Educators could benefit from these teachings as well but this must be handled more carefully with this professional. I find that teachers tend to play psychology professional when they learn about the mental health world. Thus, they are constantly diagnosing and even telling parents what medication a child should be on. More often than not, they are incorrect. Nonetheless, more education needs to go out to professionals dealing with children and parents and adults in general. Hospitals can benefit from learning about early attachment and find ways to keep the child and mother together as much as possible. They will be able to better detect situations when brought into pediatric care, rather than trying to quickly put into a box (assess a more holistic picture of the child). Mental health clinicians will have a better grasp of their client. Social workers will be able to better understand the placement of the foster child and detect a need for therapy earlier on – rather than waiting for the behavioral issues to begin showing itself.

Attachment between mother and child is imperative. Nine months in a womb means that once they are delivered we must, as professionals, be more prudent in assuring that early attachment is protected.

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The Secret Life of a Manic Depressive – Stephen Fry

This is such a deeply, insightful documentary about the struggles a person goes through with Bi-Polar. It will go down a more tragic path as the film continues walking through these dark corridors into the psyche of various persons with this diagnosis. In between you hear from various psycho-professionals who treat this disorder. When he says “We do love our manic periods,” this is something I have heard many times from various clients or people I have known. In fact, this is the infamous stage when these people often do not believe they need medication because they are feeling themselves again. This is normal for a Bi-polar and one of the symptoms – not wanting to take their “meds.” It is normal because they don’t want to feel abnormal, which is what the medications cause them to feel.

It is important that he added the genetic aspect to this mental illness. Evidently the DNA researchers he went to and the brain scans don’t show a link from that perspective. However, research does seem to show that it runs in the family. I see this all the time with people and in fact, if they tell me they have it (from reading something online and w/o a diagnosis) but seem to have no family mental illness, I become suspicious. Generally, I will ask people if they ever had a “Crazy Aunt Sally,” or a family member who disappeared for awhile or who was known to be a little off. This is how I can find a possible mental illness connection. In the past, people might have been locked up or family would have joked about it (to avoid discussing the reality). I ask this with all my clients when doing a family history, not just people who’ve been reading about diagnoses online. Most people think “mood swings” mean they are Bi-Polar and generally these are people in their young twenties who are going through a difficult period in early adult hood or even teenagers who are frustrated with their family life.

I was pretty shocked to hear Stephen Fry say, at the end, that he hasn’t been on medications since his first diagnosis many years prior to making this film. Apparently, the end of Part 1 made him realize he should re-think this. What I think is very important is to have a psychological evaluation if you believe your child has some serious mental health issues to find a diagnosis. Then, I think it is important to re-test and get a new psychological evaluation when that same person is an adult. This is because it is often difficult to be sure about childhood mental illness (sometimes psychological professionals have a “go to” diagnosis) and because you test differently as an adult and you are a little more aware of yourself and your symptoms.  If you DO have a mental illness, you should have a psychiatrist that prescribes and monitors your medications (NOT a primary care physician). A psychiatrist specializes in mental illness, a PCP does not. This is why they are called a “general” practitioner. This also can prohibit being wrongly diagnosed and going through an even longer series of trials and tribulations with medications. I have heard stories of a family doctor asking five or six questions and then labeling the person with a diagnosis. A psychological evaluation is generally three sessions and ends up with a 13 page report based on the conclusions from the tests that were run. The “psych eval” as I call it, includes input from your psychotherapist, family, and other support people involved in the child or adults life. Another reason to go to a psychiatrist is that sometimes they will have psychotherapists on staff who partner with them. If not, it is best that you find a psychotherapist who specializes in your mental illness.

 

Stephen Fry has also made a Part II of this documentary, also available on YouTube and I have also seen a “Ten Years Later” after the making of this film.

Mental Health and Gun Control – 19 Years

This past month has been a terrible time for those of us in Columbus, Ohio. First, we lost a juvenile who was in court and, because of his violent behaviors, was subsequently shot outside of court by a deputy sheriff. Then we lost two respected police officers in the very small town of Westerville. Both involved mental health issues of the victim in one case and the perpetrator in another. In the past week, our country lost a total of 5 police officers, including Westerville. We lost a total of 17 teens and school staff in one high school in Florida.

High school shootings have been going on since 1999. Now we are hearing the media say FL was worse than Columbine. This isn’t a competition to see whomever shoots the most kids wins. All school shootings are traumatic, are equal and should never have happened. It is time to wake up and smell the coffee.

We need to stop blaming and start taking action. Political activists want to blame and act as if it is the Republicans fault that high school shootings exist; when in fact we have had both Democrat and Republican presidents since 1999. Over the years, both sides have made statements about offering love and prayers, obviously they are going to say that because it would be heartless not to. What is worse though is that both sides have said “This will never happen in our country again.” Unfortunately we have now seen 19 years of this happening again in our country. We have seen this happen at the college level, high schools and an elementary school. It is time to stop blaming one side or the other and get to the table and have discussions. To start with, this does not belong on a lobbyist table, it needs to be a discussion of professionals in the mental health industry, police officers, forensic specialists as well as the leaders in the NRA and they need to listen to one another. Listening is the key ingredient in making change, not trying to get votes.

I have been in the mental health profession since high school shootings began. I was trained in holistic thought processes so I am not prone to listening to one side; I try to hear the whole story. You can’t understand anything unless you are looking at the big picture and the long term effects. I have lots of prejudices, believe me, yet I work with people from all different backgrounds, including those I have opinions about. However, because I believe people have a right to be heard and it is hard for me not to have empathy when I hear them and have taken them into my fold as a therapist, I am able to set my opinions aside for this client or clients and provide them the support that they need. After all, working with someone in therapy, I believe, is helping them to become a better person. This is what it means to be a professional.

America has become a Roe v. Wade in the sense that everything is a Pro-Life v. Pro-Choice extreme thinking conversation. No one ever listens to the other side. It is idiotic and stupid when one side is incapable of listening to what the other side has to say. It is ridiculous to hold an opinion that you are right and they are wrong. Sure we all joke and say, “but I am right,” but to actually believe this to the point that you can’t possibly sit down with your opposing view neighbor and have a cup of coffee and hear what each other has to say is beyond sad. It is disturbing and this is what our country has to offer right now.

All these people who get on bandwagons and say they are “tolerant” or “celebrate diversity,” are online yelling at the other side and giving their biases about race, religion or culture. When we are behaving in such a hostile environment as we are on social media, how can we expect that a mentally unwell person is not going to take advantage of this? If Kathy Griffin isn’t capable of understanding that there is a line you don’t cross when it comes to shouting your hatred toward the president of the United States, how in the world can you expect a mentally unwell person to understand and intellectualize what is happening online?

It has become common place to hear about shootings and we have become immune to this. We get an endorphin rush when it happens and a week later we forget. What do we expect is going to happen to someone who has mental health problems and is paying attention to all of this online. We get to be voyeurs but they internalize it and fantasize about it and feel empowered by this.

Madeline Albright (the first female Secretary of State under President Bill Clinton) spoke in San Jose, CA sometime in the early 2000’s and I went to listen to her talk. She spoke about the split in politics and how it has become so damaging to the D.C. atmosphere. When she began her journey in politics, it was normal for Republicans and Democrats to eat together, party together even walk down the street together. Our country being divided to the point of not being able to say who you voted for without getting spit on, means we do not live in a safe place and we cannot expect things to change; as long as we behave in this manner. If our politicians can’t behave like professionals and respect their own colleagues, how can we citizens be expected to behave like decent people? Right now the Democrats are just being sore losers and this is what we teach our children across the country not to do when they are on a team. Republicans were sore losers during Obama; worrying about a birth certificate. Each politician who wins the presidency has 4-8 years in which they can be elected to serve. Be patient and it will be your turn. The winners go in cycles; it is just the way we vote. There has not been one president that has been perfect and not one who has not been narcissistic.

There has been 19 years of school shootings though, with both Democrats and Republicans serving our country. We do need gun control – obviously – no one needs an assault weapon. We should be grown up and mature enough to understand that no one is saying you can’t carry a gun. It is one thing to carry a gun in your holster, on your belt that you are legally allowed to carry or a hunter with a rifle in the back of their truck on a rack. It is one thing to have a gun legally and one illegally. The topic of Mental Health needs to be brought in and we need to be more strict about mental health assessments when carrying a gun. Perhaps everyone needs to have a mental health assessment in order to legally purchase a gun. It wouldn’t be a bad idea. I have family that all carry guns, they would not like to be inconvenienced. However, I am sure all the families who are victims of the 19 years of school shootings, did not like to be inconvenienced either. When the “right to keep and bear arms” amendment was signed into the constitution, we were a different world. Back then it was cowboys and Indians and revolutions that made a positive difference in this country. School shootings make a negative difference in this country, it harms our psyche and destroys our families.

I am listening to children tell me they are afraid to go to school. They are having panic attacks whenever there are noises at school. Instead of just a tornado drill or an earthquake drill, they are having to learn how to hide from a school shooter. I am hearing parents who want to put their kids in private education or home school them. Is this what we are going to come to because adult professionals are not capable of coming to the table and reach an agreement?

Then of course you have the criminal world. No matter what we do, criminals and mentally unwell people can get access to a gun out on the streets. It is not too hard to  go into a bad neighborhood and within a few minutes find someone walking down the street who knows someone who has one to sell. Having worked in bad neighborhoods and spent many conversations talking to people who lived there, I am aware of how easy this is. Having spoken to people who have been drug addicts or alcoholics, I have heard many stories of how easy it is to get what you want if you need a fix. This means we need to have tighter laws about what happens to people who are caught selling guns illegally. The guy who sold the gun to the perpetrator of the two police officers in Westerville was found and brought in. I have no idea at this point what will happen to him or what the laws are currently. I do know that in California, where I used to work on the streets, a crime carries a stiffer penalty if it is gang related. Do we have strict enough laws for the people selling guns illegally, nationwide? Shouldn’t they get the same attention as the perpetrator, since they knew the reason for buying was not for something good? Wouldn’t they be an accessory to the crime?

These are the questions we need to be asking. We need to have discussions about this within our communities and amongst our professionals and come to some answers that we then present to Washington. But it is time for us to behave like grown-ups and professionals and listen with the purpose of coming up with a solution. I am tired of hearing that the NRA has control over Congress. What does this mean? It means that they have control over the lives of our children and grandchildren. Again, if they have had control over Congress they have had it for at least the 19 years we have been concerned and this has been over terms of both Republican and Democrat presidents.

What is a solution that is workable? What is a solution that is going to be tougher on crime, stricter on mental health awareness and reporting and one that makes sense and will protect our children, our families and our country? Stop blaming and start forming community discussion groups, in person because we aren’t capable of having talks online. Bring all the professionals involved to a table and have a discussion that is going to create positive change in our country. We don’t need an assault weapon to go hunting in the woods or to protect our family. A simple gun or rifle will work fine. Let’s show our children that we are capable of making this world a safer place.

Worried about Winter? Don’t feel SAD Get Light!

Here are some selections for winter that you might want to take a look at and see if it might fit with your budget. I am not recommending any of these, just helping you to jump start your preparations for winter.

Winter is almost here so get preventative maintenance for those of you suffering from Seasonal Affective Disorder, aka SAD or Depression that is seasonal related.

https://www.amazon.com/s/ref=nb_sb_noss_2?url=search-alias%3Daps&field-keywords=lamps+sad

These links below the products are all MADE IN THE USA.

http://therapylighting.com/sad-light-therapy

http://www.sunbox.com/

http://northernlighttechnologies.com/

 

SAD at Winter Time

5 things you may not have known about SAD (Seasonal Affective Disorder)

*This article is copied from the bi-weekly e-newsletter for MHAFC.org (Mental Health  America of Franklin County)

According to American Family Physician up to 20% of the US population may experience mild Seasonal Affective Disorder, meaning they are negatively affected by the changing seasons and reduc. They may feel depressed, irritable, and tired. Activity levels may decrease, and they find themselves sleeping more.

Some interesting facts about SAD include:

1. It is four times more common in women then men.
2. Although some children and teenagers get SAD, it usually doesn’t start in people younger than age 20. And older adults are less likely to experience SAD.
3. SAD is believed to be related to daylight, not the temperature. Some experts believe that a lack of sunlight increases the body’s production of melatonin.
4. This is probably why it is more common the farther north you go. For example, it’s seven times more common in Washington state than in Florida.
5. Not as common, a second type of seasonal affective disorder known as summer depression can occur in individuals who live in warmer climates. Their depression is related to heat and humidity, rather than light.

SAD is treatable. If symptoms are mild, using light therapy has shown to be highly effective. Studies show that between 50% and 80% of light therapy users have complete remissions of symptoms. However, light therapy must be used for a certain amount of time daily and continue throughout the dark, winter months. For more severe cases,  your doctor may also want you to try an antidepressant or behavior therapy.

For in-depth information about dealing with SAD, check out Norman Rosenthal’s book, Winter Blues.