Thursday, July 14, 2011

Obesity and childhood bonding: new studies

Childhood obesity has more than tripled in the past 30 years. The prevalence of obesity among children aged 6 to 11 years increased from 6.5% in 1980 to 19.6% in 2008. The prevalence of obesity among adolescents aged 12 to 19 years increased from 5.0% to 18.1%, according to the National Institutes of Health. Childhood obesity has both immediate and long-term effects.

Obese children are more likely to have risk factors for heart disease. They have a greater risk for bone and joint problems, sleep disorders, and social and psychological problems. They are more likely to be obese as adults and risk other diseases such as diabetes, stroke, several types of cancer and osteoarthritis.

Now amid questions about the causes of this jump in obesity, a number of studies, reported in Science Daily, have surfaced that show a link between childhood obesity and insecure bonding with parents,

One study showed that toddlers who do not have a secure attachment, usually with their mothers, have a 30% chance of becoming obese by age 4-1/2. Another study linked childhood obesity with parental neglect, citing cases in which both parents work and do not provide adequate attention to their kids. Still another study indicated a link between mothers involved in domestic abuse and obesity in their children.

Mary Ainsworth did pioneering work on the importance of attachment for babies. She described securely attached children as those who rely on their parents as a "safe haven," which allows them to explore their environments freely, adapt easily to new people and be comforted in stressful situations. Toddlers who are insecurely attached tend to have experienced negative or unpredictable parenting, and may respond to stress with extreme anger, fear or anxiety, or avoid or refuse interactions with others.

When babies and toddlers form insecure attachments in their early childhood, they are more susceptible to a range of adult psychological and physiological disorders. Poor bonding as children leads to poor bonding with peers and later with intimate others. Eating is used as a way of dealing with stressful situations, and chronic over-eating leads to the array of diseases mentioned previously.

The problem is staggering and if we are to address it effectively we will have to do something nearly impossible: change our values. Adults must put the primary emphasis on child rearing rather than on their careers. Their child’s well-being must take priority over their jobs. They must be sure their child is getting quality attention. The key word is “quality.”

A parent who stays home and resents it will not foster quality intimacy and will not be helping a child to form a good bond. Parents who stay home but give their children sugary foods whenever they are down rather than giving them emotional comfort will be unwittingly encouraging obesity.

A good parent is not just there but also emotionally there.

Wednesday, July 13, 2011

Should we raise our kids to be genderless?

A few weeks ago the Internet was buzzing with the story about a Canadian couple who was raising their three sons without telling them what gender they were.

Kathy Witterick, 38, and her husband, David Stocker, 39, said they wanted to eliminate any chance for gender stereotypes to creep into their children’s development. “It is inappropriate to impose gender identity on a child,” she stated in a report by Zachary Roth on The Lookout, a Yahoo News Blog. “If you really want to get to know someone,” her husband echoed, “You don’t ask what’s between their legs.”

The couple refused to reveal the sex of their newest son, Storm, not even to their nearest relatives, until he was born, and then they proceeded not to tell the boy anything about his gender identity nor surround him with anything that suggested either sex. They claim they are all about letting their kids decide what they are. They call parents who make choices for their children “obnoxious,” chastising them for not challenging how they’re expected to look and act based on their sex.

Their two older sons, Jazz and Kio, according to their parents, already “decide” when to cut their hair and what clothes to wear. Five-year-old Jazz recently picked out a pink dress; he wears his hair long and in three braids. Two-year-old Kio keeps his curly blond hair just below his chin. If Jazz want to stay home from school, that is all right with the mother too.

Witterick and Stocker are under the delusion that they are giving their children the freedom to choose, but in fact, the children are no doubt picking up signals from the parents. A child of five does not make choices. He looks to his parents for cues and then choose what he thinks will please them.

It's all about what behavior the parents are reinforcing. If the children braid their hair and wear dresses and stay home from school, and they pick up signals of approval from the parents for doing these things, the parents are thus reinforcing that behavior. This often happens: parents reinforce behavior even though they don't consciously intend to. If the two boys get a smile of approval every time they wear dresses, they will continue to wear dresses. The parents may think they are smiling because they enjoy the boy's freedom of choice, but this is not what their boys pick up.

Even the choice not to tell the boys their gender is a decision these parents are making for their children. For them to pretend they are not making decisions amounts to self-deception and vanity. They want to out-PC everybody else to show just how progressive they are—at the expense of their sons.

As other outraged professionals have pointed out, children need to have a strong sense of identity, including gender identity, to go through life. Instead, these children are being used as pawns in their parents’ crusade against gender stereotypes. As a result they will likely grow up confused about their gender and with a chip on their shoulders due to unpleasant experiences they have been forced into enduring by their parents.

Sometimes, unfortunately, politics overruns common sense.

Thursday, November 4, 2010

Is psychoanalysis still valid?

Freud is dead. His views are antiquated. His theories of women are sexist. His ideas about homosexuals are homophobic. He has nothing to say to us now. He lived in the Victorian era and we live now.

These are just a few of the things one hears about Freud and psychoanalysis these days. To many people psychoanalysis is no longer valid, either as a system of thought or a form of psychotherapy.

As a licensed psychoanalyst, I often find myself having to justify using psychoanalytic theory or therapy, and I gladly do so, for I think both are indeed still valid. I say, “Let’s not throw the baby out with the bath water.”

Freud made many monumental discoveries that continue to be important and valid. He discovered the unconscious mind and, by implication, nonverbal communication. He discovered the unconscious defense mechanism such as repression, projection, denial, and compensation, which are now part of our everyday speech. He discovered transference and resistance and he was a pioneer in the study of narcissism, both in individuals and groups.

Psychoanalysts today have made many modifications, especially in how we do therapy. We no longer see patients 6 days a week, as Freud did. I currently see many patients twice a week, once in individual therapy and once in group therapy. Nor do we use psychoanalysis for every patient. Each patient dictates his or her own interventions. Cognitive or behavioral therapy is more successful with some.

In Freud’s day, patients came for a year, six days a week, and then were pronounced cured. Today patients continue in treatment for years, and there is no finite end to the therapy. Patients terminate therapy not because they are “cured,” but because they decide, along with the therapist, that they have found enough balance and inner strength to function successfully in their personal and professional lives.

The most valid thing, and the thing that makes psychoanalytic therapy stand out from other therapies, is the therapy relationship. In psychoanalytic therapy, the therapy relationship is seen as the key to progress.

A patient can talk about what’s going on in his life, but that is second hand. When he talks about his thoughts and feelings about the therapist, he is being more direct. Often, the biggest turning points come when the patient develops a transference neurosis. For example, he unconscious sees his therapist as a demanding parent who is trying to control him. He starts threatening to quit the therapy, making up excuses about not having money. The therapist bides his time. One day the patient angrily says he is quitting. The therapist says that will be fine.

“So you’re not even going try to talk me out of it!”

The patient suddenly becomes incensed. “You’re just like my father. He didn’t care about me and you don’t either!” The therapist waits. Right then, at that moment, he finally becomes clear about something.

“The anger that I’ve been feeling toward you is really meant for my father,” the patient finally admits. And he is able to make an important distinction, in therapy, and then out of therapy.

Do babies born in winter fare worse?

Children born in the winter months already have a few strikes against them. Study after study has shown that they test poorly, don't get as far in school, earn less, are less healthy, and don't live as long as children born at other times of year. Researchers have spent years documenting the effect and trying to understand it.

Recently a new study by two professors at the National Bureau of Economic Research theorizes that babies born in winter fare worse because their mothers are poorer and less educated.

"What we're actually doing is asking how children born at different times of year might be different at birth, said Kasey Buckles, one of the authors of the study. "And we think an important way that they're different is that they're born to different types of families."

"Past studies have argued that children born in the winter have lower wages because they get less education," said Dan Hungerman, the other author. "We're showing that children born in the winter are often born to women of a lower socioeconomic status and that fact might explain both the education result and the wage result."

To do the study, the authors collected data on over fifty million births from all parts of the United States. "Women who give birth in the winter are more likely to be without a high school degree, they're more likely to be non-married, they're more likely to be teenagers than other women," concluded Hungerman.

When you read their research more closely, you find out that women who give birth in winter are 10% more likely to be without a high school degree and also about 10% more likely to be teen-aged mothers. This seems like a small fraction on which to base their conclusions. However, it must be noted that both are economists so, naturally, their focus is primarily on socioeconomic factors.

However, economic factors do not explain all aspects of the research. For example, how does the fact that mothers are teenagers and less educated explain research showing that babies born in winter have shorter life spans?

What they ignore are the psychological factors. It has been well established by research that there is more depression in the winter months as well as a higher suicide rate. It would seem to follow, then, that mothers who give birth in winter are more likely to suffer from depression. The question then becomes, how much does a mother’s depression affect the child in her womb as well as the baby after birth?

Also well established is research that shows that children of depressed mothers do not perform as well as other children in school, due to the fact that depressed mothers are too distracted by their depression to pay adequate attention to their kids. And the neglect of depressed mothers translates into lowered self-esteem of their kids, which does not bode well for their functioning as adults.

Yes, economy may well be a factor in the diminished functioning of winter babies, but psychology may be a bigger factor. But in today’s climate, the psychological factor is often swept under the rug.

Tuesday, July 13, 2010

Do you have Facebook Narcissistic Disorder?

According to current estimates about 400 million people and counting are now members of a social networking website such as Facebook or Myspace. In a sense, this constitutes the largest community in the world.

It’s easier to communicate with someone on Facebook than at your office or on a park bench at lunch. The people on Facebook don’t see or hear each other. They only get text messages from one another. This makes communication on Facebook much less personal, much more anonymous, and much less threatening.

The ease and anonymity of communication on social networks has given rise to what I call Facebook Narcissistic Disorder. People who have a lack of social skills or friends can go on Facebook and build up a list of hundreds or even thousands of friends. This list of friends on Facebook not only fills the gap of empty or nonexistent friendships in the real world, but also creates a number of illusions (or, perhaps, delusions).

One illusion is that people begin to think the friendships on Facebook are real. However, these online friends are different than real friendships. Online you can play roles. You can pretend to be a wise or nice person. Nobody can hear your voice or see your eyes or your body language, so it is easier to pull off a fake.

If you’re a person with frustrated social needs, you are more likely to believe the pretenders, whereas offline, you are less likely to do so. Hence, people begin to believe their own pretences; they begin to think that their social networks are real; and they begin to believe what people say to them, even outrageous thing.

The whole network atmosphere begins to take on an importance and an intensity that convinces a person that life on Facebook is actually more real than the real world. People spend hours on Facebook. They can’t wait to get on Facebook. They look for opportunities at work, at home, even while shopping or driving (using their iphones). Facebook becomes their life. Their long list of friends, their apparent involvement with these friends, the apparent caring attitude of these friends, the sense of belonging, all combine to provide a new feeling of well-being and hightened self confidence.

This is when Facebook Narcissistic Disorder can become full blown. People start to buy in to the Facebook world to the extent that they make poor and risky decisions. They set up dates with strangers and put far too much trust in them. They take tips from people they hardly know and invest in risky ventures (all their “friends” are doing it).

For some, Facebook becomes an addiction. They actually feel negative physical symptoms when they are not online.

One case I heard about recently involved a teen-aged girl who kept meeting men on line, only to have them borrow money and disappear. Each of these men would praise the woman, telling her she was the wisest, warmest, most beautiful girl he had ever met. This of course stoked her narcissism. After the girl was let down, she did not tell her parents, her real friends, or, God forbid, seek counseling. Instead, she went online and complained to her Facebook friends They were magnificently sympathetically. None of them bothered to question her in any way about her own complicity in the matter, as a real friend might do. Instead they trashed the man and told her she was perfectly fine.

Facebook may be the largest community of enablers in the world.

Sunday, June 6, 2010

Do today's college students lack empathy?

Current college students are 40 percent less empathic than their elders. So say the authors of an “Empathy Quiz” that was given to over 14,000 college students between the years 1979 and 2009. The study was done by Sara Konrath of the Univerity of Michigan and was presented last week at the meeting of the Association for Psychological Science in Boston.

In the quiz, students were asked to rate themselves with respect to statements such as, “I sometimes find it difficult to see things from the ‘other guy's’ point of view," and “I often have tender, concerned feelings for people less fortunate than me."

Dr. Konrath used the term “me generation” when discussing the results of the study. "Many people see the current group of college students—sometimes called 'Generation Me'—as one of the most self-centered, narcissistic, competitive, confident and individualistic in recent history," said Konrath, who is a psychiatrist affiliated with the University of Rochester.

She attributed this lack of empathy primarily to exposure to media and to online social networking. She contends that video games with violent content numb people to the pain of others. As for social networking, she and her assistant Edward O’Brien note, “The ease of having 'friends' online might make people more likely to just tune out when they don't feel like responding to others' problems, a behavior that could carry over offline.”

I find it interesting that neither Konrath nor her assistant traced empathy (or the lack thereof) to primary relations with parents or other humans. Instead they pointed to technology such as online networking and video games. This seems to be the trend nowadays—blaming things instead of people.

Long before children start playing video games or networking online, they learn about empathy through relations with their parents, siblings, uncles, aunts, grand-parents, kindergarten teachers and others with whom they are intimate. If children are shown empathy by their earliest caretakers, they begin to learn empathy.

But teaching empathy requires more than being an empathic parent. It also requires that parents set boundaries for their children and teach them to respect those boundaries and to respect their parent’s feelings. Perhaps this explains the disparity between the results of the Empathy Quiz by this generation and the previous generation. The previous generation understood empathy, but they didn’t understand how to teach it.

Instead of teaching empathy, they gave, gave, gave to their children without asking anything in return. The result is the “me generation,” a generation that demands human rights, but is not big on human responsibility. The result is also a culture that no longer values empathy as it once did. What do people value today? The most popular video games are about killing off other people and various monsters. The most popular movies seem to be about powerful people—sometimes superheroes—who “kick ass”. Movies or television shows (or video games) about empathic people are rare, if nonexistent.

For several generations now Americans have been presenting themselves to the world as “defenders of freedom” and “good guys that are saving the world.” But there may be a discrepancy between what we present and who we really are.

Tuesday, April 6, 2010

Should parents do therapy for their children's sake?

A new study indicates that mothers who are diagnosed with mental health problems a year after they give birth, tend to have children with behavioral problems.

Half the mothers in the study, reported on Forbes.com, had a condition a year after delivery in at least one of three categories: mental health, substance abuse, or domestic violence. At the same time 22 percent of the children had at least one type of behavioral problem such as aggression, anxiety-depression, or inattention/hyperactivity. The more problems a mother reported, the more likely her child would develop behavioral problems by the age of three.

After 30 years of practice in psychotherapy, I am not at all surprised at the results of this study. I have made this connection myself again and again when adult patients tell me about a mother who suffered from depression, was hospitalized due to a schizophrenic breakdown, had problems with alcohol or other drugs, was involved in an abusive relationship, or had some other severe mental disorder at the time they were born.

I have also made this connection when I work with young couples that are having and raising children. I have encountered a number of cases in which the father is in therapy with me but the wife is resistant to therapy. Mother are particularly important during the first few years of a child’s life.

In one such case many years ago a wife suffered from postpartum depression. She was unable to nurture her new baby after she came home from the hospital, so the father had to take over this role after work. Fortunately, the father had been in therapy for a few years and he was able to be loving and nurturing when he was home. But his job called for him to travel a lot and there were many weeks when he wasn’t home and the baby was neglected.

After a year, the mother had recovered to the extent that she was able to carry on with her life in a somewhat limited way. She was able to feed and care for the baby, but her depression caused her to be negative and critical toward the boy—as she was about life in general. Often she lost her temper and yelled at him.

Again and again, the father, at my urging, would bring up the notion that the mother should seek treatment. Whenever he did, the mother would be appalled.

“I don’t need therapy! You think everybody needs therapy.”

“Well, I’ve gotten a lot out of it and I think you could too.”

“I’m fine. I was a little depressed after I came home from the hospital. I just felt empty because everything was over. But I’m fine now.”

“But, you know, sometimes you get into fights with Joey over little things and you start yelling at him, and, well, I think therapy…”

“I know what I’m doing! Therapy is not for everyone!”

He never made any headway in these discussions.

A few years later the child began to have learning problems in school as well as problems getting along with other children.

Should parents do therapy for the sake of their children? What do you think?