Monthly Archives: August 2017

Neo-nazis, thugs, and little boys.

By Dr David Laing Dawson

In our history psychiatry overplayed its hand. As the theories of Freud, Jung, Adler and others caught on, some psychiatrists and psychologists thought we might have something to offer society as a whole. Perhaps psychological intervention could reduce violence generally, and even prevent war and promote peace.

This was overreach. And we are all aware now, I think, that the tools of psychiatry/psychology are more apt to be misused by the state (The Soviet Union), the CIA, Casinos, and by marketing, or building a better soldier, creating brand loyalty, selling junk food to kids, keeping a scholar or athlete focused.

For the most part the profession of psychiatry retreated to being a medical specialty engaged in the treatment of mental illness.

I was thinking of this while watching neo-nazi Christopher Cantwell on his Youtube video. He was an organizer and marcher in Charlottesville, and then a social media hit when he alternately ranted and sobbed on a self-produced video, after hearing there might be a warrant for his arrest.

Why any young and not-so-young American (or German or Canadian for that matter) might proclaim himself a Nazi today is a puzzle. As has been pointed out, they did not grow up watching their fathers lynch Negros or blame Jews for a recession. Where on earth does this come from?

But watching the performance of Christopher Cantwell it occurred to me that I had seen this many times before.

Troubled boys between age 14 and 17. Some ADHD, some labile emotions, and some developmental/cognitive immaturity. Within a half hour they might talk prison talk full of expletive laden revenge, need for respect, blame, threaten, and then cry, weep, apologize to me and their mothers. There is a frightened little boy inside that would-be thug.

They are trapped developmentally, still children dependent on adults, angry their needs are not immediately satisfied, experimenting with male roles of toughness, power, strength, (often borrowed from gang, drug, and prison cultures), ultimately terrified of adulthood and its demands for skills and responsibility.

Most get through this. Good parenting, time for the brain to develop and mature, some boundaries and structures that promote skill building and confidence, more self-reliance, less blaming of others. Sometimes pills for either ADHD or anxiety or both are required.

That is where Chris Cantwell is. I don’t know how much he truly believes what he says, but he is still, developmentally, 14 to 17, at once angry, blaming, playing a macho role, labile and fearful.

So yes, good parenting, some accessible mental health services, the right school system, opportunities to develop skills and confidence, could reduce the number of young men who become neo-nazis, or terrorists for that matter.

Advertisements

When the Mental Health System Refuses to Listen

By  Maria Lorenzoni With Marvin Ross

Much of my writing on mental illness and the flawed system that we have to endure deals with privacy and the absurdity of keeping family and mostly parents in the dark about their loved ones diagnosis, treatment and progress. Maria Lorenzoni recently  gave this  edited presentation this past August to the Service Coordination Council on Mental Health and Addictions of the Central Ontario Local Health Integration Network (LHIN). The LHINs co-ordinate services in geographic areas.

She describes her families experiences with the secrecy of the treating officials and the impact that had on her family. Here is what she had to say:

Every serious sickness is stressful for family members, but caregivers of people with severe mental illness face challenges that are unique in some ways. Imagine for a moment that someone you love has been stricken with a devastating stroke and is in the hospital and can’t communicate, at least for the moment. Now imagine the doctors treating him or her and not giving you details of the diagnosis, prognosis, the exact information in their reports, or the treatment plan. Or just leaving you out of the picture completely. And then imagine the patient slowly recovering, but still not cognitively able to function properly, and perhaps unhappy that they are in hospital, and then being visited by a patient advocate to be informed that he or she doesn’t have to stay in hospital if they don’t want to.

You would argue that this is absurd.

According to a statement from the College of Physicians and Surgeons of Ontario, physicians can share information with others involved within the patient’s circle of care without asking for the patient’s consent if the doctor has no reason to assume that the patient would object.

Sadly, this does not apply to mental health!

In my case, it was only after three hospitalizations that I was able to press the family doctor to give me the diagnosis of my loved one. We finally got our son  into the Centre for Addiction and Mental Health and we were desperately trying to find the right meds and treatment plan. He doesn’t have insight into his illness, he doesn’t think he needs meds, so it took some hard work to get him to cooperate. And then, this vulnerable person that is in serious need of care is visited by advocates who tell him he doesn’t have to stay there.

Then what?

The onus is entirely on the family to persuade the person to stay in treatment. As a family member, you try to cooperate as best you can, BUT, you are not allowed to have any private discussions with the doctor unless the patient is in the room. Being spontaneous and giving some helpful comments is tricky when the person is right there. The doctors, therefore, make all their decisions based on communication with a patient who’s confused and will not share much because they don’t think they are sick.

He finally went to a Home for Special Care and was put under a team.  While we acknowledge the good work they did, there were a lot of misunderstandings and frustration due to a lack of communication.  No one is perfect, and families need to listen to constructive comments without being made to feel that they are just part of the problem.  In the time that he was there, we had three short meetings with the team , there were serious problems with reactions to meds, but we were not given input.  In fact, when I asked a question, I was told quite clearly…”look, you be the mother and we’ll be the treatment team.”  My family was shunned and made to feel that we were not cooperating, and in fact, we were discouraged from even visiting.

SO, POINT NUMBER ONE – family caregivers need to be able to give and receive information (unless there is a very clear reason not to), be given a diagnosis and prognosis, and consulted on a plan of action for the future.

SECONDLY, we definitely need a media campaign to focus on the obstacles faced by people with “hard core” mental illness. Sadly, the current campaign to destigmatize mentally ill is aimed at the people who have a more socially acceptable emotional problem like depression and who are in a position to ask for help. People are under the mistaken notion that everyone with a mental illness has easy access to good, consistent, hands on care. I’ve spoken to some in the health field who have asked me why my loved one isn’t in one of those residences that provide “professional rehabilitation”, and another health professional who recommended that I access a support group that helps caregivers with the tremendous grieving process that comes with caring for someone with serious mentally ill. They didn’t realize that there are no residences with professional staff, and while some support groups are good, none of them have a counsellor to help caregivers, and actually some of them are nothing more than lectures with information that you’ve read from a book a dozen times.

SO, POINT NUMBER TWO – we need to promote public awareness that people with illnesses like schizophrenia exist – that they are from every walk of life, they are people just like everybody else, they are not the dangerous individuals you imagine them to be and CONTRARY to popular opinion, they do not have easy access to services. Caregivers also need counseling as well to be able to deal with living with their loved ones on a day to day basis

NOW, THE THIRD POINT, and the most difficult, is the problem of housing. There are far too few residences and the ones that are available are overcrowded. A few are decent, others have low standards, and the people who live there are not in a position to stand up for themselves.

People with very serious mentally ill are most in need of supportive housing, yet they are the least likely to obtain it. They DO NOT GET MEDIA ATTENTION, AND DO NOT HAVE A VOICE. There is no easy solution, but with SOME BRAINSTORMING AND SOME PROPER REDIRECTING OF FUNDS, some pilot projects can begin to appear. Families would be delighted to help in any way they could, and IN FACT, THEY NEED TO BE PART OF THE PROCESS, so that a proper support system could be implemented.

I know so well that parents of adult children with serious mental illness are very concerned about the future of their kids and want to see them living in a place where there is hope, dignity and support.

If the public becomes more aware, and less afraid of mental illness, if there is more communication with families on the part of health professionals, more guidance and support for families and the hope for proper supportive housing, the future can be much more promising.

 

Trump’s Great Service to Americans – But Time To Go

By Dr David Laing Dawson

The unraveling of Donald Trump is nigh. And if it happens soon, and if the reaction he has provoked has staying power, then, surprisingly, Donald Trump will have performed a great service for America. Perhaps the reaction to Donald will bring about a better America.

Donald has brought to light the simmering racism, the unholy divide, and the hypocrisy that is America. It has always been there of course, addressed politely from time to time, but recently not so overtly, so publicly that it could not be ignored by others.

To be fair though, the credit probably goes equally to Barack Obama, for it may be this unusual sequence of a first black president, and a very good one, followed by a Donald Trump that so ignited the fires of white supremacists and then lifted the fog of denial from the eyes of liberals.

All of them, the KKK, the Nazis and neo-nazis, the white supremacists, they all quietly nursed their wounds and hatred during Obama’s eight years. Now Donald has set them free.

On Tuesday, August 15, off the teleprompter, peppered with questions, Donald Trump revealed Donald. He was of course full of himself, referring back to his successes, even to his riches, boasting of his holdings, taking credit for an improved economy, defending his first statement after the events in Charlottesville, even taking it from his pocket and reading it again, even shamelessly claiming he received praise from the mother of the woman killed.

He became combative with the press, calling them fake news, stating he is more attentive and truthful than they are.

But most of all this exchange revealed his brittle narcissism and the extent to which he cannot tolerate any criticism, any possibility that he may not be the smartest, the best, the most successful person in the room, that he may have been imperfect this one time. And it revealed how his ego overshadows any concept of country, democracy, history. Asked if he would visit Charlottesville he told us he owns a house and a golf course there, the biggest, thus demonstrating his confusion between being president of a democracy and the emperor of all he surveys.

And it gave us a hint of how mad (this word meant to be read both ways) he will become when he is finally cornered and dethroned.

Do it soon. Do it carefully. Do it with a safety net in place.

On Democracy

By Dr David Laing Dawson

In my childhood I took my birth certificate with me to sign up for a summer soccer league. Of course I lost it. There is a good chance I did not tell this to my parents. But three nights later we all responded to a knock on the door. Standing on the porch was a stocky man who proved to have a thick middle European accent and my birth certificate, a little grass stained.

I remember all this because he gave me a stern lecture about my birthright as a citizen in this democracy while I blushed under my father’s gaze. Although, in my defense it was either my father or my mother who allowed me to take this precious piece of paper on my bike ride to the soccer field in the first place.

Among many others I have been writing about the threat to democracy Donald Trump and his colleagues pose as they systematically undermine the Fourth Estate, the judiciary, instill unease in the citizens, point their fingers at immigrants, and undermine the people’s confidence in the electoral process.

But I did not think it would be so easy. Surely the very idea of free, regular, unfettered elections is sacrosanct in this American Democracy of which they are so proud.

Apparently not. A new poll finds that over 50 percent of Republicans would be quite happy to have the 2020 elections postponed if either Trump or the Republican Party suggested or requested this.

Wow. Should not their instinctive response be, “No way!”

So the groundwork has been laid. And apparently few Americans received the awakening I received in my childhood, a stern lecture from a man who escaped a tyranny, and who knew shortsightedness, indifference, and stupidity can lose a democracy but only bloodshed can regain it.

Fire and Fury

By Dr David Laing Dawson

Some years ago the person who oversaw both the men’s and women’s shelters in this city expressed his surprise that far more actual physical fights broke out in the women’s shelter than in the men’s.

But it did make perfect sense after we discussed it.

Some irritation would occur, expected when living on top of one another, and a man would verbally insult another man. Then a pattern of behaviour would unfold that was learned on the playgrounds of every public school, playing field and back alley, one that probably has genetic roots we can observe with our cousins, the apes and chimpanzees.

“Yeah, and who’s gonna make me?”

“You and who’s army?”

Chin thrust forward, the baring of teeth, the snarl, the threatened encroachment on the other’s space, insulting the other’s sexuality, his courage, his birth, his mother, name calling, dire threats for the future, the unfurling of plumage.

Other men (boys) would intervene pulling the two apart as they hurled their last insults at one another. Their assuaging words were always of the order of, “He ain’t worth it.”

This last part is important, for it is face saving for both antagonists. And an actual fight is averted. Life goes on.

In the women’s shelter, one would insult the other, and the recipient of the insult would hurl herself at the antagonist. They had not experienced the same playground socialization.

I am thinking about this because of Kim Jong Un and Donald Trump and the way war begins, and even those words of Tillerson and others, “It’s the only language Kim Jong Un understands.”

No. No. No.

Tillerson, your job is to put your arm around Donald Trump, pull him aside and say, “He ain’t worth it.”

Maybe no one can do that with Kim.

It doesn’t matter. All that matters is that one of the protagonists, these blustering would-be alpha males, especially the stronger of the two, gets pulled back.

“Donald, he ain’t worth it.”

Now if American leadership really was smart and confident, it could offer Kim some face saving device. “But we will look weak,” American leadership will scream. This despite the fact they have the capacity to destroy the world and we all know it.

Tillerson, you appear mostly sane to me, and a man who understands a few things. It is your job to pull Trump aside and tell him, “He ain’t worth it. You could take him easy, but it ain’t worth it.”

And would it kill you to promise Kim that you will stop flying B 52’s over North Korea and stop practicing war in South Korea if he stops testing A bombs?

“I Think Anthony Will Do Amazing.”

By Dr David Laing Dawson

In his brief sojourn in public life Anthony Scaramucci managed to provide hours of material for the late night shows and many columns of commentary by serious pundits.

It is all so troubling and disturbing. A man so obviously unqualified to be a Communications Director quickly drops the tenor of the office to the level of teen boy locker room talk in an under founded school system.

He has come and gone.

But within all the inaccuracies, lies, egoism, and stupidity of Donald Trump’s statements in an interview with the Wall Street Journal on July 25, this particular use of language stood out for me:

“I think Anthony will do amazing.”

There is a time in one’s development of intellectual and linguistic abilities when nouns and adverbs and adjectives get all mixed up, when the brain cannot yet formulate explanatory secondary clauses, and when the brain does not yet notice the misuse of words, catch this, and then explain further.

That age is about 13, 14, 15. (and younger than this of course)

13, 14, 15 is the age at which I hear kids use the phrase, “will do amazing.”

By 17, if they say “will do amazing” they catch themselves and explain further in a second clause, such as, “I mean, like, I think he will get really high marks.”

By university level they realize that the quality of being amazed belongs to the observer, not the doer, and the whole thing is phrased differently.

And all through the transcripts of recent interviews and off-the-teleprompter speeches it is clear Donald Trump does not catch his own absurdities, his own unfinished thoughts, his own deviations from logic, and his own outrageous boasting.

I hear the same from 14-year-olds in my clinical practice. By 17 or so, most have the ability to hear what they have just said, to notice when it veers from truth or logic.

My American friends, your president is a very narcissistic entitled 14 year old.

Though, I must admit, as damaging as he is to the reputation of America in the rest of the world, he may be less dangerous than many Republican alternatives.

Might I suggest a strategy to keep us all safe: Every other leader in this fragile world of ours should send Donald Trump an effusive Valentine card four times a year, at least.