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Thursday, January 6, 2022

Book Review: the Deepest Well by Nadine Burke Harris



Every mental health professional should know that adverse childhood experiences (especially with parents who are abusive, neglectful, are perpetrators or victims of domestic violence, have multiple partners, or have substance abuse issues) are a major risk factor for developing almost every psychiatric disorder imaginable. Yet therapists and psychiatrists often ignore this issue in favor of theories about some sort of genetically-caused, pre-existing brain disorder.

In her amazing and surprisingly entertaining book, pediatrician Nadine Burke Harris (now surgeon general of California) outlines in vivid detail how ACE’s are toxic stressors that impact our bodies biologically and put us at higher risk for a variety of physical, not just psychological illnesses over the course of our entire lifetime. She points out that this does not only effect those who live poor neighborhoods, but can happen anywhere,

She covers the issue of epigenetics (how the environment turns genes off and on) as well as differentiating the effects of ongoing as opposed to time-limited stress. She zeroes in on the amygdala (the part of the brain that is responsible for fight or flight reactions) and how it can inhibit cognitive functioning, and on the sometimes toxic effect of stress hormones like cortisol.

In her observations as a crusader in the medical field, she came to realize that the reason physicians were often unaware of how this was taking place resulted from the fact that they never asked about it. As I have often said, it’s a case of don’t ask, don’t tell. Which is also the reason that psychodynamic and CBT therapists aren’t aware of the role of ongoing family interactions in their patients’ symptoms.

Also discussed in detail is how, in public discussions and meetings, parents can be resistant to various plans to confront ACE’s (due to what the author calls “hateration”) for fear that doctors would be stigmatizing their children as being brain damaged.  I think a bigger fear in the public is stigmatizing parents. As I often write about, you cannot call any type of parenting a problem these days anywhere without being attacked.

Last but not least, she talks about the intergenerational issues involved in chronic family stress. Here, the author seems to be on the right track, but I’m not clear if she, too, is unaware of the role of ongoing repetitive dysfunctional family interactions with their extended family members among both adults and children - particularly the role of grandparents in, unintentionally or intentionally, reinforcing problematic parenting practices and marital issues. 

For example, she cites the case of a woman who put up with verbal abuse from her husband and who stayed because she blamed herself and told herself she had to put up with it for the sake of the kids. Were her parents alive? If so, did they know what was going on? What did they have to say about it? If they didn’t know, why hadn’t she told them? Was she afraid they’d tell her it was her fault and she needed to stick it out for the sake of the kids? It sounds like this might possibly have been a case of don’t ask, don’t tell.

The closest she comes to discussing extended family is when she gives an example of how the aunt of a child who was a patient of hers seem to undo a lot of the therapeutic work that she had done with the child and the child’s mother.

It is true that certain early fear tracks in the amygdala are formed during the interactions of mothers with their babies, as she correctly points out. It is also true that these tracks are highly resistant to the usual process of neural plasticity that might fix issues caused by trauma. Scientists often seem to assume that the tracts are permanently damaged. However, perhaps it is true that the tracts remain strong because they are constantly being triggered and reinforced by the attachment figures throughout life.

If indeed the author is not aware of all of the forces at play here, she is hardly alone. So even with this possible and understandable omission, I cannot recommend this book highly enough. 

Monday, December 13, 2021

Psychotherapists Ignore Powerful Groupthink Forces

 



One thing that is a major theme in this blog is that many if not most therapists seem to think that most people’s problems are “all in their heads” and have nothing to do with the ongoing reinforcement of problematic behaviors through interaction with kin and ethnic group members. Groupthink is clearly one of the most powerful, if not the most powerful psychological force in everyday life. 

 

To see this clearly, think about what is going on in the USA today that is a constant focus in the press, talk shows, podcasts, and other media venues: the polarization of political life. Just look at the almost cult-like behavior on both sides, from the QAnon conspiracy theories on the right to the habitually offended community of social justice warriors on the left. Free speech, supposedly a cornerstone of the United States ethos, is attacked relentlessly by both sides without any irony or sense of awareness of the inherent contradictory nature of some of their viewpoints.

 

Yet so many therapists just ignore groupthink. The only exception is those who believe in family systems therapy, which was big in the 80's and 90's but has since fallen out of favor, particularly with psychologists. The problem with many family systems therapists, however, is the opposite: they seemed to have lost the individual. Although many people do not do it, they  are perfectly capable of employing critical thinking and coming up with their own thoughts, and behaving according to their idiosyncratic desires, if they are brave enough to do so. 


The current state of affairs would be amazing if it weren’t so sad. 

 

When I first started looking for clues about what was really going on in the lives of my patients when they were free associating in the psychoanalytic sense (back then, most psychiatrists still did psychotherapy and were analysts), I began to focus in on such things as logical fallacies. I, like most people, just thought those were common, somewhat accidental errors of thinking. I would start to express confusion about what the patient was actually meaning to say, and eventually happened upon information patients had not before volunteered. This lead me to start asking questions that my psychoanalytic supervisors never taught me to ask, like “what does your mother think about this?” – and I meant in the present, not when the patient was a kid.

 

What I didn’t know then was that the use of logical fallacies is one of the hallmarks of groupthink, so when I questioned them I was really finding a way to get at what they really thought, not what they were supposed to think. As my colleague Gregg Henriques points out, logic evolved not to get to the truth, but to justify group norms.

 

The more I got into it, the more I realized there were a whole lot of other “markers” that told me when I was hearing family groupthink and not the patients’ true thoughts and feelings. The following is a list of them, and there may certainly be other ones:

 

·       Logical fallacies

·       Defense mechanisms (as listed by psychoanalysts)

·       Irrational, self-scaring thoughts (as listed by cognitive therapists)>

·       Willful blindness (the refusal to even look at data which may challenge the group’s “wisdom”).

·       Plot holes (like when you are seeing  a movie and you get the feeling that such characters would never have said something like they did in the script, or that one of characters seems to know something they should have no way of knowing).

·       Ambiguous language (in which a sentence can mean two completely different or even opposite meanings, or a word has several different definitions and I couldn’t be certain which one the patient was using). This phenomenon is very familiar to people who work crossword puzzles.

·       Going off on tangents without returning to a main point or issue.

·       Circular reasoning

·       Spouting proverbs or maxims to justify behavior, such as “the grass is always greener…”  Often a marker for a family myth.

·       Mixed messages such as those exhibited by the infamous, so-called “help-rejecting complainer.”

It is interesting that when I bring up the ideas about group processes at professional meetings or in my books, no one actually disagrees or even argues with me. Instead, they just change the subject - or ignore the issue entirely.

Thursday, November 18, 2021

The Science of Spin: Big Pharma Propaganda Techniques




IMO, industry uses psychology to get people to change their behavior far more effectively and scientifically than psychotherapists. In an article in Environmental Health, (2021; 20: 33. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996119/. Goldberg and Vandenberg describe 28 unique tactics used by industries to manufacture doubt or confusion about science when it serves their interests. These messages are then frequently amplified by perpetuators of doubt – journalists, bloggers, citizen scientists, and lay-people – who, on their own without direct funding, unwittingly disseminate and spread pro-industry spin. The Pharma industry tactics used to manufacture doubt are:


1

Attack Study Design

Emphasize study design flaws in negative studies that have only minimal effects on outcomes. Flaws include issues related to bias, confounding, or sample size

2

Gain Support from Reputable Individuals

Recruit experts or influential people in certain fields (politicians, industry, journals, doctors, scientists, health officials) to defend their biases in order to gain broader support

3

Misrepresent Data

Cherry-pick data, design studies to fail, or conduct meta-analyses to dilute the work of critics

4

Suppress Incriminating Information

Hide information that runs counter to their interests

5

Contribute Misleading Literature

Use literature published in journals or the media to deliberately misinform, or use peripheral topics as a distraction

6

Host Conferences or Seminars

Organize conferences for scientists or relevant stakeholders to provide a space for dissemination of only information in line with their economic interests.

7

Avoid/Abuse Peer-Review

Avoid the peer-review process to publish poor literature, publish without revealing funding sources, use the journal name to add weight to claims, or minimize need for peer-review among lay audiences

8

Employ Hyperbolic or Absolutist Language

Discuss scientific findings in absolutist terms or with hyperbole, using buzzwords to differentiate between “strong” and “poor” science (i.e. sound science, junk science, etc.),

9

Blame Other Causes

Find related, alternative causes for any negative effects that are reported or observed

10

Invoke Liberties/Censorship/

Overregulation

Invoke laws to emphasize equality and rights for expression of their preferred data or interpretations thereof, despite differences in evidence quality

11

Define How to Measure Outcome/Exposure

Attempt to set guidelines for ‘proper’ measurement of exposures or outcomes, while undermining guidelines not in line with what they want.

12

Take Advantage of Scientific Illiteracy (media/individuals)

Emphasize scientific obscurity to confuse lay audiences, or deliberately disseminate unscientific or false but easily digestible information

13

Pose as a Defender of Health or Truth

Represent their goals as health-conscious or dedicated to truth

14

Obscure involvement

Ghostwrite, create shell companies, use attorney client privilege to hide the true source of their data 

15

Develop a PR Strategy

Devise methods for specifically reaching public audiences to spread their messages

16

Appeal to Mass Media

Appealing to journalistic balance, developing relationships with media personnel, preparing information for media personnel, invoking the Fairness Doctrine

17

Take Advantage of Victim’s Lack of Money/Influence

Silence or abuse critical individuals by out-spending or exploiting a power imbalance

18

Normalize Negative Outcomes

Normalize the presence of negative effects of their products to reduce their apparent importance and make them seem inevitable

19

Impede Government Regulation

Overwhelm governmental regulatory agencies to slow or stop their function

20

Alter Product to Seem Healthier

Make modifications to harmful product to reduce public appreciation of their negative effects

21

Influence Government/Laws

Gain inappropriate proximity to regulatory bodies and encourage pro-company policies

22

Attack Opponents (scientifically/personally)

Conduct targeted attacks on opponents by undermining their professional or personal reputations

23

Appeal to Emotion

Manipulate an audiences’ emotions to draw support for their claims in the absence of facts

24

Inappropriately Question Causality

Argue that correlation does not equal causation despite the presence of strong evidence

25

Make Straw Man Arguments

Publicly refute an argument that was not even made by the opposition

26

Abuse Credentials

Use qualifications in one discipline to assume authority in another discipline

27

Abuse Data Access Requests

Requesting access to data in order to misrepresent and attack, employing Shelby Amendment, Freedom of Information Act, etc..

28

Claim Slippery Slope

Illogically or falsely claiming that there will be disastrous consequences if their ideology is not supported

Thursday, October 21, 2021

Review: the Netflix documentary Pray Away

 




This post is the second about media describing organizations that practice a hateful form of groupthink. The Netflix documentary Pray Away focuses on gay adult Christians who used to preach and embody gay conversion therapy ideals to other gay adults. They led various organizations with their destructive idea of family, faith, and freedom. (The film is not about gay “conversion” psychotherapy of minors, which is another, even more despicable manifestation of this movement). Many of such people have embraced the idea that homosexual urges are part of a psychological problem, a result of some trauma or of some negative relationship with a parent, rather than something natural.

Many of the people interviewed in this documentary fell hook, line and sinker into these teachings while hiding their own backstories of self hatred. They are given screen time to now confess to how all of it was a painful lie. 

The movie profiles several of those people who and acted as advocates to make people "ex-gay." John was a major public advocate for gay conversion who appeared in Newsweek with his “ex-lesbian” wife—and reveals here that it was all a charade. He couldn’t admit, even to himself, to his continuing attraction to other men.

Michael created Exodus, the first gay conversion organization in the late 1970's. The film showed an auditorium full of smiling young adherents to this group under a poster exclaiming, "Join the Movement!" 

Julie became a public speaker as a young woman, with her highly articulate stories about how she had successfully rid herself of her lesbian feelings, with seemingly logical arguments for her past efforts to do so. She did not stop doing this until confronted by certain misbehavior from her former cohorts, and eventually renounced them and married another woman.

Their institutionssimilar to the ones described in my previous post about the book Stolen, prey upon people's self-loathing, self-denigration, and desires to be accepted by their families and their churches. Prey away!

The irony here is that the parents who previously rejected these children is that, if in fact homosexuality is somehow a bad choice, and/or is a result of a bad relationship with parents, then the parents who rejected them on these grounds are admitting that they were crappy parents who raised a child who made bad decisions! But as we all know, the definition of the word “contradiction” is: something which such people pretend they don’t understand.

 


Tuesday, September 28, 2021

Book Review: Stolen by Elizabeth Gilpin

 




A startling and fascinating new book and an equally mesmerizing new Netflix documentary look at organizations which are designed to destroy people’s self actualization and their true selves in favor of a particularly monstrous form of groupthink. As the author of Stolen says, attendees were supposed to become like bees in a hive. Both of these groups twisted religion and psychotherapy to the point that they are almost unrecognizable.

One, the one described in the book, was even worse than the other, if that’s even possible, because it attacked and destroyed children: so called “schools” for “troubled” kids. At least the one described in the documentary was aimed at adults who were willing participants.

This post will be about the book, while the doc will be described in the next one. Stolen, was written by a woman who, when she was 15 years old, was a star high school athlete in two sports and an A student—but was nonetheless labeled as a disturbed troublemaker by her highly critical and often absent father and a hyper-religious mother who spent a lot of her time reading the Bible. Gilpin doesn’t describe any physical or sexual abuse in her home, but strongly implies that her parents, particularly her Dad, were verbally abusive and highly invalidating. Her Mom would support her privately but then always side with the Dad when the family was together.

She had started running away when she was only five, and later began partying with high school friends to avoid being home. She was also admittedly very angry and at times returned the father's verbal abuse, and she did dabble in alcohol and pot a few times. But the book doesn’t really describe in detail why she was so angry, although she did accuse her parents of never believing her. Oddly, the parents entirely discounted their own parenting as a factor in her behavior and never seem to wonder what made her like she was. At one point during her stay at the school, her father wrote a letter that said, “I’m glad that you’ve been able to accept that you’re ultimately to blame for your own anger.”

She was suddenly taken away by strangers in the middle of the night and sent to a “therapeutic” boarding school run by an organization called CEBU, which was anything but therapeutic. For the first three months, the teens were made to hike over and over again to a bunch of different campsites in the middle of the woods and were subject to physical abuse, such as being made to keep marching even after the group was attacked by a hive of bees and had multiple stings. They weren’t allowed to shower and were given crap to eat. They were monitored constantly and communication between the victims was highly restricted.

They were then transferred to a high school which had various exercises that were designed after something we Californians were aware of in the sixties and seventies called the Synanon Games, a twisted version of AA. More on Synanon at the end of the post.

During these games the teens were subject to vicious verbal attacks from the people running the school, and also forced to attack one another in the same way. For the high crime of having engaged in a sex act, for example, the girls were called sluts and whores who were desperately seeking attention (because they were starved of it at home perhaps?). With the boys, however, the prevailing attitude was “boys will be boys.” 

Gilpin was still a virgin at the time, but was immediately told she was a liar when she said that. She was accused of being a drug addict and an alcoholic despite her limited behavior in this regard. If a student denied being an addict, they were immediately accused of being “in denial.”

If she told the truth, it never seemed to be bad enough for the counselors, so she began to just make stuff up. Clearly she wasn’t the only one of the teens who felt they had to do that. If the teens rebelled, they were punished severely. Once when she threw up she was forced to eat her own vomit. They were threatened with being transferred to an even worse facility, masquerading as a hospital, if they did not fall in line.

Clearly the program was an exercise in degradation designed to stamp out any semblance of individuality. Gilpin said that the more self hating she seemed, the more she was praised for “doing good work.” In reality, both her parents and the school were victim blaming, scapegoating her for her own abuse at their hands. One of her friends there later committed suicide.

Interestingly, even after she “graduated,” she did not tell her parents exactly what took place at the school. At least she did not write about doing so. She described herself as letting her anger with them take over, doing nothing but shouting at them about how f’d up they were for sending her to such an awful place. IMO, in doing this, she was actually providing her parents with justification for their having sent her there in the first place. Protecting them to an extent, just as I suspect she was doing by not describing in more detail in the book the way they had been treating her that made her want to run away so badly.

Synanon was initially a drug rehabilitation program founded by Charles E. Dederich in 1958 in Santa Monica, California. By the early 1960s, Synanon became an alternative community - later labeled a cult - centered on group truth-telling sessions that came to be known as the Synanon Game, a form of attack therapy. 

Attack therapy involves highly confrontational interaction between the patient and a therapist, or between the patient and fellow patients during group therapy, in which the patient may be verbally abused, denounced, or humiliated by the therapist or other members of the group. Attack therapy "attempts to tear down the patient's defenses by extreme verbal or physical measures."

Synanon ultimately became the Church of Synanon in the 1970s. Synanon disbanded in 1991 due to members being convicted of criminal activities (including attempted murder) and retroactive loss of its tax-free status with the Internal Revenue Service due to financial misdeeds, destruction of evidence, and terrorism. It has been called one of the “most dangerous and violent cults America had ever seen." Mel Wasserman, influenced by his Synanon experience, founded the CEDU's schools which used the confrontation model of Synanon. 

The CEDU model was widely influential on the development of parent-choice, private-pay residential programs. People originally inspired by their CEDU experience developed or strongly influenced a significant number of the schools in the therapeutic boarding school industry.

Thursday, September 9, 2021

Parenting Styles and ADHD Symptoms



 

In my continued effort to beat a dead horse, this post concerns yet another not-so-science-based characteristic of authors of the literature on ADHD: their refusal to consider any alternate interpretations of their data other than that they are studying some sort of brain disease. In this case, they do not consider the possibility that the symptoms of their subjects come as a result of environmental issues, such as a chaotic home environment and/or sleep deprivation.

One well-publicized study (Variable Patterns of Remission From ADHD in the Multimodal Treatment Study of ADHD | American Journal of Psychiatry (psychiatryonline.org) purports to show that up to 90% of children who have attention-deficit/hyperactivity disorder (ADHD) may continue to experience residual symptoms of the disorder into young adulthood. Amazingly, the authors add that they may also have periods of remission along the way. In other words, ADHD is a disease with waxing and waning symptoms. Could it not be that other, environmental issues that create their symptoms are what is doing the waxing and waning???

In another publication, Greg Mattingly, MD, of the Midwest Research Group, tells us that, “Instead of resorting to positive parenting, many of them [parents of kids diagnosed with ADHD] have fallen back on what we call negative parenting: scolding, discipline, getting frustrated. As we shift into next year, we need to shift into how we shift into a positive parenting model. I want you to talk to your kids with encouragement about the school year. Share something each day that was something cool they learned in a positive way, and then complement them for sharing that fact back with you."

So the symptoms get better with positive changes in parenting style? The author doesn’t seem to consider the possibility that negative parenting styles were perhaps a big cause of the so-called disease in the first place. 

This reminds me of TARA, a support group for parents of people with BPD (at least those that weren’t physically or sexually abusive, since those relatively common parents-of-kids-with-the-disorder would never join a parent support group —other than perhaps the False Memory Syndrome Foundation). They teach parents how not to invalidate their kids but somehow don’t mention the DBT theory that an invalidating environment is a major cause of the disorder in the first place. In TARA's case, this isn’t a bad thing because if they did that, a lot of these parents wouldn’t attend their seminars. But researchers in the field ignores this issue as well.


Tuesday, August 10, 2021

When You Can Never Be Content If You’re Contented

 


I could find somebody   new somebody who'd be true

But honey I'm stickin' to you just to torture myself


Say it out loud I'm sick and I'm proud


~ Kacey Jones, “Just to Torture Myself”


Way back in March of 2012, I wrote a post about members of couples who complain about a lack of affection from their long-term partners, and in response quoted advice columnist Amy Dickenson: "In relationships, if you always do what you always did, you'll always get what you always got." I opined that, because these people continue to either put up with or needlessly inflict frustration on their partners, then each member of the couple believes the other member of the couple really wants the relationship to continue in its current form no matter how much they may complain about it.

Each member of the couple discounts their own compulsive behavior as indicating that they, too, want the current parameters of the relationship to continue because they are playing a role in their own family of origin that requires denying that they are playing that role. For a fuller explanation, see this post. In actuality, both members of the couple are highly ambivalent about making any changes. They really do hate the current situation, but this negative feeling dwarfs in comparison to their fear of having a better one, due to anticipated consequences to their respective families-of-origin.

Does this state of affairs also pertain to relationships that are chronically and significantly neglectful or abusive, or to those characterized by repeated infidelity, rather than just to those that are merely chronically frustrating? Absolutely. The ability of people to put up with ongoing pain in these situations is impressive. People who do that often act as if they are too stupid or evil to even know that this is what’s going on, but those appearances are con jobs.

This can easily be seen in two letters recently published in the Ask Annie advice column:

6/4/21. Dear Annie: I have dated a guy for the last six years, always long-distance. I have loved this man with my whole heart. The issue is we have not met each other's families. He has never met my kids and doesn't even want to. He will not acknowledge our relationship on his social media profiles. His parents know nothing of me. We do not spend holidays or birthdays together. We do not go on dates. The last time we saw each other in person was two years ago. He barely even texts me. There is always an excuse as to why he is unavailable. Yet he claims that he loves me. I just don't get it. I want to leave, but I care about him so much. What do I do? -- Mixed Signals

6/5/21. Dear Annie: I met a man about four years ago. We started dating a week after we met, upon his insistence. Well, after we were together a year, I found out that he was messaging with a girl online and had been for several months. She didn't want him. Then, a month after that, I heard he cheated on me with someone from work who was in her early 20s, the same age as his daughter. I confronted him, but he refused to admit he was guilty. However, I've caught him exchanging sexual messages with a couple of other girls online since then. He says he's never actually hooked up with them in person. I guess my question for you is, is it worth trying to keep this man in my life? I love him, and he says he loves me, but part of me is no longer in love with him. If I'm being honest, I've felt this way ever since I heard of his cheating with that young woman. What do you think, Annie: Should I set him on the curb on trash day? My heart is telling me to stay, but my mind is wanting me to tell him to get lost. -- Confused Girlfriend

Of course, in both cases the advice columnist advised breaking off the relationship. In other cases, advice columnists have also recommended psychotherapy if the letter writer couldn’t seem to do that.

I submit that both of these letter writers already knew exactly what the advice columnist would recommend, but are just acting so stupid that they can’t see the obvious. In fact, I would guess that they both will stay in the relationship anyway, giving the partner even more evidence that that is what they really wanted to do all along! I mean, how could they not know what advice they would get. The way they word their letters practically begs for that ever-so-obvious advice.

If I were seeing them in therapy, hearing this would be the perfect opportunity for me to ask the Adlerian question: So what would be the downside of being in a relationship with someone who was actually there for you?

Friday, July 16, 2021

Book Review: Not to People Like Us by Susan Weitzman



"If you think I support domestic abuse-- if you think my not explicitly writing, ad nauseum, "NO TOLERANCE" or "IT'S NOT THE VICTIM'S FAULT" is evidence that I think "sometimes the bitch deserves it "then I can tell you without error that [this year] is going to be way too complicated a year for you to endure, and you are seeing a psychiatrist, and it isn't helping. Stop being you. The world does not have to validate your prejudices." ~ The Last Psychiatrist.

 

Warning: Since I am writing about domestic abuse, I quote the Last Psychiatrist before people start accusing me of “victim blaming” or “excusing the abuser.” Obviously, people who injure other people are committing a crime and deserve to be in jail. But that doesn’t mean the victims have no responsibility for any self destructive behavior (which BTW is NOT a crime) they exhibit – like returning to their abusers again and again and protecting them by keeping the abuse secret. 

As Michael Kerr once said, when it comes to relationships: “It’s all my fault” and “I had nothing to do with it” are both irrational ideas. The sad part about this is that absolving the victim of any and all responsibility for their predicament often has the effect of making them feel more helpless, useless, and resigned to their fate. The people who do this to them are without a doubt harming the very people they claim to be helping.

The book being reviewed here is about upper class, affluent couples in which the men physically and mentally abuse their wives. The author believes the couple dynamics in this population are different than in those in poorer communities. Strangely, most of the women she discusses are highly-educated professionals or have high paying jobs, and some of them even earned more than their husbands.

The most interesting thing about this book for me is the author. As I read it, I kept wondering if she thinks these women are as stupid as they act, although she is clearly questioning that proposition. She spends half the book wondering about how such bright, educated woman can believe their bullcrap excuses for staying in these relationships, and blame themselves for the abuse (although some of them did admit to provoking it, to supposedly make the beatings "more predictable" as if they weren't predicable enough), and the other half buying into their rationalizations.

I find this interesting because, when I first started thinking about psychotherapy paradigms, I myself struggled with this question mightily. I called it the "question of stupidity," and resolving it led me to the concepts of mutual role functions support, the paradox of altruism, and something called dialectical causality.

Still, I wondered why the author didn’t question some of her own assumptions. For instance, she says most of these women she has interviewed did not come from families of origins in which there was significant spousal abuse. Well, maybe, but how can she know she is being told the truth about that? 

These women often lied about the abuse from their husbands to everyone for years, and even to other therapists, before coming clean. Some of them told their mothers about it, and the author admits that their mothers essentially blamed them for the abuse and told them to go back to their husbands. And in her chapter on the children from these relationships, she says, “…they too feel that they must hide the family secret.” If the abuse victim grew up in such a family, wouldn’t that characterization apply to her? So what on earth makes the author believe these women would suddenly become paragons of honesty about their parents when they come to see her?

Some of the women also claimed to think that they would be left penniless if they were to leave their successful husbands, even though many have or had successful careers themselves, and that their husbands will be able to manipulate the courts so they would never get alimony or child support. Well, rich successful men sometimes are able to do that, but in what alternate universe are there no attorneys capable of forcing otherwise reluctant men to fork over the cash? Maybe these cases where the rich men prevail are won partly because their wives hired lawyers who secretly believe that she really did deserve what she got. 

Why are they hiring such terrible lawyers? Weitzman brings up the O.J. Simpson case as an example, but apparently does not know how badly the prosecutors botched the case. (This is brilliantly described in the book Perfect Pitch by Jon Steel).

Then there is the book’s title. These women allegedly hide the abuse because they sort of think it isn’t supposed to be happening in their social circles, and they are ashamed. But if someone is beating the crap out of you, why would you care whether or not it was happening to anyone else? It’s clearly happening to you, and it’s clearly evil. If fact, if you really thought your situation was that unusual, that would highlight how unacceptable it ought to be.

And another implicit premise here seems to be that being embarrassed is worse than having your jaw broken! Really???

The stories the author relates literally reek of gender role conflicts in both the husbands and wives, but gender roles barely rate a mention. Despite the author’s psychodynamic training, the concept of intrapsychic conflict seems foreign to her, let alone her having an understanding of family systems issues and the power of groupthink and kin selection. 

For example, despite being successful career women, many of these women expected, and were expected by their husbands, to do all of the domestic chores and child rearing. One father wouldn’t even get up to feed the baby when mommy was violently ill. A lot of the couples also stopped having sex while the man was off having multiple affairs – the old Victorian whore/Madonna conflict in the flesh.

The author correctly points out that most of these men have narcissistic personality disorder, but she does not understand the family dynamics of it. (As my readers know, my views of that are different than the prevailing wisdom). She does make the accurate point that one of the DSM criteria for this disorder, lack of empathy, is incorrect. These men have very good empathy. The problem is they use it in order to more successfully manipulate other people to get what they want. Not having something is obviously not the same thing as using something one has in the service of bad intentions.

The author does acknowledge that these women did seem to ignore red flags when they first meet their husbands, but seems to downplay the significance of this, and offers no convincing explanations of why they would do this. In fact, as I like to say, there are often more red flags than at a meeting of Chinese communists.

Oh well.