Themes of This Blog Seen In Newspaper Advice Columns: The Game without End, Gender Role Division

In Amy Dickinson’s advice columns of 5/29, 6/14 and 6/18/17, and in Carolyn Hax’s column of 6/23/17, the Agony aunts published letters which serve as a good, simple and straightforward illustrations of something that family therapists have called the game without end, described in several previous posts.

Whenever one member of a couple or a family makes a good case for changing the rules by which people in the family operate, other members of the family (or the other member of the couple) get suspicious. The person making the request has always followed the old rules. I mean, they say they want things to be different, but do they really?

So the person making the request gets “tested” to see how sincere their request really is. The others make the requested changes, but do so in an obnoxious or annoying manner. My favorite illustration of this is a situation widely created by rapidly evolving changes in gender role functioning, which the letters that are the subject of the current post clearly illustrate.

Both members of a couple work, but somehow everyone - including the females - has always expected the female to do all or most of the housework due to the rules followed by earlier generations of men and women.  The woman often has treated the kitchen, for example, as her own personal fiefdom in which she is the undisputed boss of how things are supposed to be done.

If she suddenly asks her husband or boyfriend to help clean up and do his share of the cooking, he wonders if she really wants that - because of her prior attitude and the accompanying behavior, which had been readily and repeatedly observable up to this point.

So, when it’s his turn to clean the kitchen, he does a half-baked job and puts the dishes and pots and pans in all new places, so that his partner cannot find them when it’s her turn to do, say the cooking. Or he does any of numerous other passive-aggressive things that annoy the heck out of her. So she criticizes him unmercifully for his poor performance.

In a sense, she starts criticizing him for doing the very thing she had asked him to do in the first place.

His conclusion: "See, she really didn’t want me to help out after all." I can never understand why he discounts his own behavior in drawing this conclusion, but that is highly typical.

An effective way to handle a game without end so that the rules really can change is described here.

So for those readers to are skeptical, here are some abbreviated letters from the advice columnists:

5/29/17. Dear Amy: I am really tired of my husband asking: “How can I help you?” “What can I do for you?” or “What do you need?”Here’s why this upsets me: If I am cooking dinner for the both of us and he asks, “What can I do for you?” I think, well, you are eating this dinner too, so why not just ask, “What can I do?” Why is he offering to do something “for me”? I get so frustrated that my response is: “…nothing.” When I suggest that he just pitch in, he tells me that I do these household things so much better than he does. 

He seems to want me to need him. I don’t need him. I just want him to initiate the household work on his own. He watches TV while I run around picking up the house or making dinner, and his only response is, “Am I in your way?”...When he finally does something like putting a load in the washer, he needs to announce it like it’s the second coming. What can I do? - — Frustrated!

A response from a man to the above letter: 6/14/17. Dear Amy: I am a man who has been in the same position as “Frustrated’s” husband, who would ask, “What can I do for you?” instead of just taking responsibility for his half of the household chores. I used to be like this. I just didn’t know how to be helpful and I didn’t want to get in the way. Honestly, my wife basically trained me how to take on more responsibility and now we work together. — Reformed (This guy is still letting her be the boss!)

Dear Reformed: I have received a huge response to this letter, and many men echo your statement — they needed some guidance and when they got it, they stepped up.

6/18/17. Above letter, continued. Dear Amy: I understand a lot of men are responding to the letter from “Frustrated!” about her husband’s lack of initiative regarding household chores. In my case, I jump in and do my best, but my efforts are criticized and belittled. It is hardly inspiring me to do more. — Also Frustrated

6/23/17.  Dear Carolyn: I love my partner. He recently moved in... I’m so tired of people who won’t clean up after themselves and leave it until I do it. I made it very clear to my partner before he moved in that it was important to me...But I’m already tired of asking and I’ve been reading about “the mental load.” Like last night: I was stressed and headed to my second job and he asked what he could do to make me feel better (sweet!) so I said, get wrapping paper and a card and wrap your sister’s wedding present. And when I got home later, he had! But. The box was left out instead of recycled, the couple of dishes I used to feed us before I went to work weren’t done, the living room was a mess . . . he just doesn’t see it…— I’m Already Tired

Themes of This Blog Seen In Newspaper Advice Columns: The Principal of Opposite Behaviors

In Amy Dickinson’s advice column of 4/5/17, she published a letter which serves as a good, simple and straightforward illustration of something I call the principle of opposite behaviors, described in several previous posts, as well as illustrating how seemingly opposite behaviors are actually just two sides of the same ambivalent coin.

The principle states that completely opposite behavior patterns can lead to the exact same result. If you’re afraid of being dependent on others, you can refuse to let anyone help you with anything. Or you can ask for way too much, annoying and eventually driving off people who might want to help you. In either case, you will end up with no help!

This principle comes into play when someone is ambivalent about certain rules of behavior in specific social situations. If this ambivalence is pervasive and frequently seen as a problem, said people who exhibited it were once called neurotics. The psychoanalysts who were the first to describe intrapsychic conflicts as a phenomenon missed the fact that these conflicts were usually shared by all the members of their patients’ entire family. 

In some cases, the conflict is expressed by compulsive or polarized behavior at one end of the spectrum - or at the exact opposite end. Some highly ambivalent people go back and forth between the two extremes, while in other cases, one generation goes to one extreme, the next to the other, and the third back to the first one.

In the letter, the father in the family was ambivalent how involved he should be with his son, and his conflictual behavior became apparent at his son’s little league games. His behavior was polarized and seemingly the exact opposite of that of his father. Amy’s answer points out that trying not to be like your own parents in some way that you didn’t like can lead to a situation in which you try to do the exact opposite – and get the exact same result. Here, in abbreviated form, is the letter and the relevant response.

Dear Amy:  ...when we go to our son’s Little League games…my husband is the loud one on the sidelines — pacing, swearing and turning red; he micromanages our son, and shouts belittling comments at him and other kids on our team. He argues with the umpires, and complains about the coaches… he has been ejected from games during those seasons. I’ve tried asking him to be calmer...He says that he’s a lot better than his own dad, who never showed up for anything…

Dear Exhausted: Your husband claims that he is “better” than his own father was, but how is getting ejected from a game better than not showing up for the game? Either way, Dad is not at the game!

Themes of This Blog Seen In Newspaper Advice Columns – Part III

This is the third in an occasional series of posts showing how several of the issues I discuss in this blog show up in letters to newspaper advice columnists. In order to assure themselves a wide readership, advice columnists must bring us problems that resonate with a fairly wide demographic, and they therefore provide us with another source of information about human behavior and cultural trends.

I follow Jeanne Phillips (Dear Abby), Carolyn Hax, Amy Dickinson (Ask Amy), and Marcy Sugar & Kathy Mitchell (Annie’s Mailbox).

Of course these letters leave out a lot of what might really be going on with the writer, and I will be admittedly speculating about how the behavior described in the letters may be examples of covert issues that are not being directly discussed.

Before each letter, I will discuss the blog subject that seems to be being discussed. I will also include a link to a related post. I am not including the columnist’s responses to the letters. 

*

In the following letter, a father pushes his son away by constantly telling him what a disappointment he is. The son has rejected the trappings of what the father considers successful living. It is quite likely in such situations that the "disappointing" son might be acting out the father's repressed or covert rebelliousness against the very standards the father seems to embrace. 

In such situations, the father probably does things on rare occasions that indicate to the son that the father is "getting off" on what the son is doing - but then the father rejects him as a way of rejecting that part of himself that he finds unacceptable. In actuality, those parts were unacceptable to his own family of origin.  The son then obliges by keeping his distance. Thus, this could be a possible example of the role of Avenger.

12/6/15, Carolyn Hax.  Dear Carolyn: Through the years, my husband has learned to let go of the hopes and dreams he had for his son, that he would achieve financial and social success as my husband defines it: white-collar job, nice house, nice cars, wife and family, membership to country club, all the trappings that he has achieved for himself and that represent success to him. His son, on the other hand, works in the restaurant trade (not in management), lives a pretty bohemian lifestyle but has neither been in trouble with the law nor abused drugs... Husband has never made it a secret that he feels son could have done better. Son has never married at age 40 but now finds himself the father of a child (he plans to take responsibility for the child). We want to be a part of this child’s life. At this point, the only expectations my husband has of his son is that he respond to his efforts to contact him. To no avail. Son responds on his own timeline or not at all despite repeated requests. My husband wants to draw a line in the sand over this. I think we should go with total capitulation for the sake of the future grandchild. How can I be supportive of my husband (“Yes, I understand how frustrating this communication thing is for you”) but still make it clear that I will not take part in any “line in the sand” stance? This is creating tension between my husband and me. - The Step Mother

*

In the States, we tend to think people are basically selfish and don't care what other people think, especially family members. We think kids growing up are more influenced by their peers and the media. Of course, the questions of which media a teen looks at and with which peers he or she chooses to associate with - and there is a large variety to choose from - is ignored in these formulations. The choices people make are no accident. Also, as I've pointed out many times, kids who appear to be oppositional to their parent's wants and values only do that because that is what they think the parents expect of them.

I believe people really are willing to sacrifice their own opinions and desires in order to please their parents. Of course, how much one can challenge parental values depends on how conflicted the parents are about them. In the following letter, a woman performs summersaults trying to both be her own person and please her parents at the same time. 

12/14/15. Ask Amy. Dear Amy: I have been with my partner for five years; he rents his own place and I live with my parents. My parents are old-fashioned and believe I can only live with him when we are married (I used to share this view, but now I don't). I have finished college and have moved back home to pay off my debt and save for a house (or wedding!). My partner's home is five minutes away from my workplace and my folks' house is one hour away (in good traffic), so I do frequent "sleepovers" at his place. This is causing tension in both households. I pay rent to my parents and I help out my partner by cleaning up after myself and buying bread, milk and eggs regularly. But he says that I'm using him, and that I'm just doing the minimum. He says I should be preparing dinners for both of us when I am there, doing washing, or helping by paying rent or at least one utility bill. Now I'm broke, tired and grumpy. I'm at his house cooking and cleaning, and then when I'm at my parents, I'm doing exactly the same thing to appease them because I've slept over at my partner's house. I've gone cold turkey and have slept only at one home, but then money is wasted on gas driving back and forth. I can't afford to move out and I don't want to get married just so we can live together. HELP!!! — Betwixt

*

When someone is playing a dysfunctional role within their family of origin, it can be difficult and painful. When seeking a spouse or partner, such people will often pick someone who will help them to continue to play the difficult role. They, in turn, help their spouses play a difficult role within the spouse's own family of origin. This is what I refer to as mutual role function support. It can be thought of as a form of mutual enabling.  

It is important to remember that the alcoholic enables the "co-dependent" to be a co-dependent as much as the co-dependent enables the alcoholic. The whole process is bidirectional - it goes both ways simultaneously. In the following letter, the son of a controlling mother marries a spouse who is also rather controlling, as even the advice columnist recognized. In a variation on this theme, the mother and the wife start competing with one another over who will have the most control over the poor guy. If the mother's need to control men were a bigger issue for her and her family, he might never have even become engaged in the first place.

12/15/15. Ask Amy.  Dear Amy: I have a controlling, manipulative, guilt-tripping mother-in-law-to-be! I know that each time I hear from her she is just trying to trap me into saying yes to something. These traps include trying to get me to change our wedding plans, and roping me into a jewelry party hosted by her friend (repeatedly pushing on that). She just can't understand the word "no." When I did say no she whined to my fiancé, saying it felt like a slap in the face (can you say "manipulation"?). This has to stop. My fiancé tried dealing with it by telling his mom that I will say no to some things, but I felt this was really his way of calling me "pushy." My fiancé tried the kid gloves approach and it didn't work. I decided to take matters into my own hands and texted her three examples of her overstepping her boundaries and letting her know it would no longer be tolerated. She had the nerve to say it made her "sad." Now he is having a hard time because his mom is upset. He doesn't understand that we have to back each other up, especially in situations like this. His mom is so bad that she needs a copy of his shift schedule at work because she wants to keep track of him. Maybe my approach is too direct, but so what? We are in our 40s and don't need to be under her thumb. I don't let my mom get away with this kind of behavior, and I'm certainly not letting a MIL do this. What is your opinion, Amy? — Upset

*

One of the most read posts on my Psychology Today blog, and the one which generated some of the most heated responses from reader, posed the question of whether parents who had been cut off by their adult children were really as clueless about the reasons that happened as they portray themselves to be in public. With my patients, unlike the followers of many psychotherapy schools, I always presume that people are never too stupid to notice that their repetitive behavior leads to bad outcomes - yet they continue to engage in it anyway.

The following letter is remarkable in that, while ostensibly asking advice, the mother of an alcoholic woman, who is also what I refer to as a Minnie the Moocher, admits as clearly as imaginable that "I know I've enabled my daughter for her entire life."

12/28/15. Annies' Mailbox.  Dear Annie: Our oldest daughter is married to a nice man and they have a sweet 2-year-old daughter. My son-in-law makes good money and my daughter can afford to stay home, but they never seem to have enough to get ahead. My daughter has been known to spend foolishly. They only have one car and it doesn't run half the time. They can't afford another. We let them live in our home for a year rent-free, so they could save enough to purchase their first house. I know I've enabled my daughter for her entire life. She is very spoiled and self-centered. We argue a great deal and exchange hurtful words. Regularly, I surrender to her selfishness and give her money or run errands for her, even though I work full-time. I do these things because she is a recovering alcoholic and drug addict, and I fear she will otherwise return to that life again. She doesn't attend her meetings anymore. I don't know how to handle her. I'm either forced to defend myself or give in to her whims. She never appreciates anything I do for her and she never does anything for me. Her husband is no better. He is selfish and spoiled by his mother, and he also enables my daughter. She's a good mother, but I babysit a lot. Her husband doesn't complain when she gets together with her friends, but he works long hours and they don't have much time together. I think he feels neglected. How do I know when to do things for her and when not to? How do I tell the difference between enabling and being a good mother? When she gets into one of her horrible, blaming moods, how do I handle that? This child has become a bitter pill to swallow, but I love her so much.  — Mother of a Narcissist

Addict Cleans Up, THEN is Shunned by Family

An interesting letter appeared in the advice column Dear Abby on 11/30/14:

DEAR ABBY: I am a former drama queen and addict now enjoying long-term sobriety, or trying to. What's missing in my life is my family. Since returning from rehab, I have been "going it alone" -- and I'm not sure why. My kids are the only grandchildren in the family. I work and go to school. I am pleasant. There have been some rough spots I have had to deal with, and when I have needed to, I have called my mom or sister, but they don't call me or visit. They have expressed no love for me through all of this. When I call, I feel like I'm intruding. Aren't I entitled to their love and caring? I feel abandoned. It's hard doing things on my own. My family lives close by, so distance isn't the issue. What am I missing? I want my kids and me to have a family, but when I try to reach out, I end up hurt by their lack of interest. Should I just get on with my life? I have been going through this for years. -- MOVING ON IN FLORIDA

DEAR MOVING ON: It's possible that the "drama" and turmoil you put your family through while in the throes of your addiction is the reason your mother and sister avoid you. They may be reluctant to take a chance again. Because they have made it plain that they aren't interested in a closer relationship with you and your children, you should absolutely get on with your life.

Abby's response was predictable. There were also several comments on the website from the public about the letter, and the commenters were more or less unanimous: the letter writer had probably "burned her bridges," the family probably got sick of giving her one chance after another and were burned out, etc. etc. 

After all, as another commenter opined, "Addicts hurt a lot of people and cause a lot of problems." The family's response is due to their need for "self preservation." The writer probably used to call them "only when she needed something."

These responses were in fact so predictable that the letter writer herself undoubtedly knew what she was going to get. She was setting herself up, and making herself look bad while all the while criticizing her poor family. The criticisms of the family did not go over well at all with Abby's readers. With her criticism the writer was in fact garnering sympathy for her family, rather than making them look bad. She had to know that would happen.

The burning bridges thing probably contains an element of truth. But more likely a half truth.

How did this former drama queen/addict turn out the way she did in the first place? Wasn't she in fact raised by the very family that is now shunning her? How many chances did they give her before giving up on her? When she was actively using did they get involved with her over and over again?  Enable her? Try to "rescue" her?

Notice that she identifies herself as a former drama queen. Where did that label come from? Is that what everyone in her family would call her over and over again until it became a role she would play in order to confirm their opinion of her? 

Was she in fact the only one in the family who had been expressing feelings that everyone else was stuffing? Was she the identified patient, as  family systems therapists call such folks, who gets all the blame for a problem shared by the entire family?

And most importantly, did they abandon her only after she cleaned up?

Inquiring minds want to know the answers to these questions before passing judgment.

This is a counter intuitive way to look at this. I understand that. But when the whole story comes out from patients in therapy, the answers to my questions are often yeses. Respected interpersonal theorist Lorna Smith Benjamin describes an analogous dynamic in which she lists two of the four characteristics she has observed in families that produce offspring with borderline personality disorder (BPD) - who often share many characteristics with both drama queens and addicts:

1. Parental love and concern is elicited only by misery, sickness and debilitation

2. Family chaos - The borderline individual is subtly blamed for problems or expected to exert control over them.

(The other two characteristics:  3. Episodes of traumatic abandonment are interspersed with periods of traumatic over-involvement, and 4. Efforts by the person with borderline disorder to establish autonomy are interpreted by the family as indicated disloyalty).

What may be happening in the case of the letter writer is that her family needs a black sheep, and she was elected to play the part. Because she finally stopped playing the part, they then shun her. In this situation, they would be in effect be punishing her for not being who they need her to be. However, they would also be helping her out in a strange way - by protecting her from their own pernicious presence. As Dr. Benjamin has also said, pathological behavior can be a gift of love.

This could be the real answer to the letter writer's question.

Are Parents Who are Cut Off by Their Adult Children Really That Clueless? (Themes of This Blog Seen In Newspaper Advice Columns – Part III)

**For an interesting exception to the pattern discussed in this post, see an update at  http://davidmallenmd.blogspot.com/2016/03/adult-children-who-cut-off-their.html

In the advice column Annie’s Mailbox by Kathy Mitchell and Marcy Sugar, there has recently been a series of letters from the parents of adult children who have cut them out of their lives. The parents complain that they have absolutely no idea and do not understand why this has happened, and they seem to indicate that they had been just model parents or, at worst, guilty of some very minor parental transgressions.

Lately, a couple of other letter writers opined that just perhaps the parental behavior was a lot more problematic than these folks would have the world believe. For the most part, whenever I delve into the family dynamics of those patients who either cut off parents or have been cut off like this, that is certainly always the case.

In reading the letters from the parents who just cannot seem to figure out why their children have cut them off, a question arises. Are they really that clueless? Are they “in denial?” - whatever that means?  To me, “denial” of reality is just – how should I put this? – lying.

In fact, when such parents are in the process of portraying themselves as the innocent victims of mean-spirited, unreasonable adult children, they are in fact, pushing their adult children even further away. They are, in a sense, invalidating their adult children’s sense of reality about what transpires in their relationships.  In doing so, they are literally being hateful. This of course further infuriates the adult children. This illustrates one subtle form of distancing behavior. 

The last letter in the following series illustrates the adult child's anger about this issue better than I ever could.

(How such situations might be repaired is described by the letter writer of 4/5/14).

10/8/13.  Dear Annie: When our daughter was a child, she had emotional issues and extensive anger management problems. With tremendous concern and love, we got her professional support and therapy, and ultimately, our daughter learned the skills to control herself. What we did not do was tell extended family members of these private problems. We had seen their extreme intolerance for any kind of mental health issues and did not want our daughter to suffer prejudice from her own family. In college, the troubling incidents started again. Because of our daughter's refusal to let us have access to her medical information, we had no real idea of what was happening. The next few years included troubling breakups with both friends and boyfriends, extreme weight loss and talk of suicide.

Our daughter is now 32 and recently married. She suddenly and inexplicably has cut us off. When we try to communicate with her, she becomes hysterical with rage. We have learned she has been saying horrible things about us to the same extended family members we tried to protect her from in childhood. We are devastated. One relative actually told my husband that we must have done something terrible to our daughter for her to treat us this way. These family members now have a special, almost frenzied new importance to our daughter. They judge us constantly. To be accused of such mistreatment is insulting and painful. Please print this so these family members will stop jumping to conclusions. — Reading This Can Help

Dear Reading: Most likely, the only thing that will change their perspective is to be on the receiving end of your daughter's erratic behavior. Despite all the therapy she had when younger, her problems haven't disappeared. She has simply chosen to deal with them in her own way, which currently precludes a loving relationship with you. We hope that will change. While you cannot control what the relatives think, please take comfort in knowing you handled your daughter's issues in a way that protected and helped her. That is what good parents do.

12/26/13.  Dear Annie: You often print letters from older parents dealing with rejection from their adult children. This is literally an epidemic everywhere. Anger and hatred are destroying families. My husband and I have three adult children who were the delight of our lives. We had a typical loving family, with vacations, birthday parties and special celebrations that included friends and extended family. We had anxious times during illnesses, surgeries and accidents, but we made it through. All three of our children have grown to be successful, well-liked and respected adults. Sadly, over the past 22 years, they all have chosen to shut us out of their lives. We've had minor disagreements at times, but never any major battles that might justify their choices. None of them will tell us why they are angry. They refuse to have any contact or open dialog that might heal our relationship. I know you're probably thinking "there must be something." If so, we don't know what it is. My husband is 81, and I am 78. We understand there is a real possibility that we will never hear from our children before we die. We do our best to focus on the great times we had and to hold onto the many precious memories of their growing-up years. Holidays are the hardest, but with God's help, we make it through. We have forgiven our children and will always pray for them. We will always thank God for choosing us to be their parents. — Joining the Letting Go Club

Dear Joining: Your letter is heartbreaking. When children are brought up by loving parents, we don't know why some remain close and others do not. The same fire that melts butter will forge steel. If you have any family members who are in touch with your children, perhaps they could help you understand what is going on and even intercede on your behalf. In the meantime, you are wise to accept what you cannot change and compassionate to forgive those who have hurt you.

3/7/14. Dear Annie: My wife and I have lost contact with our son. He is a recovering addict. As far as we know, he has maintained a job and, I hope, has been able to stay clean. He has moved to a city about four hours away with his new girlfriend, and I am sure she is keeping him in line.  My wife is heartbroken. We maintained a room for him in our home until he was almost 30 years old. He was always close to his mother, and they would speak on a daily basis. Now, he doesn't call or take our calls or emails, and never accepts cards or letters. He said he needed space when he left, and that was a year ago. My wife grieves as though he has passed, crying at night, wondering what happened to our son. What should I do to relieve the pain? Should we keep trying to contact him? We don't understand how he can be so hurtful. — Tears in Vermont

Dear Tears: We are so sorry that your son has chosen to cut off contact, but you cannot force him to stay in touch. Are you in touch with the girlfriend? Is she a reliable partner, or might she be abusive? Even so, he is an adult, and you can only do so much without his cooperation. In the meantime, please consider counseling. You are grieving and worried, and you need to move forward so your son's absence doesn't become the focus of your daily life. It will not be easy. But we recommend that you keep sending your son emails and cards, just saying that you love him and that you will always be available should he decide to contact you. We hope he will. Soon.

4/5/14.  Dear Annie: Thanks for printing the letter from "Joining the Letting Go Club," who feel rejected by their grown children. One part of the letter got my attention — the part where they say they've had "minor disagreements" at times, but nothing so major as to cut off contact. I have had this same situation with my family, and honestly, sometimes the disagreements aren't as minor as the folks believe. 

Sometimes disagreements are downplayed to avoid dealing with the hurt feelings and poor communication between family members. The grown children may feel they can't talk to their parents because of negative and heated exchanges in the past. Nonetheless, I do agree that the grown children need to tell their parents why they don't have any contact, even if it upsets the parents. They have a right to know. Several years after a falling out, I reached out to my family members. Over time, we were able to rebuild our relationship, and last year, we had a wonderful Christmas holiday together. I greatly appreciate the special relationship my children now have with their grandparents. Sometimes you have to be the bigger person and do what is best for the family — even if you don't always agree. — No State

Dear No: How heartwarming that you took that first step — not only for your sake, but for that of your children.

2/28/14.   Dear Annie: I have followed the many outraged responses regarding adult children who have cut elderly parents out of their lives, so let me give another view. My mother is 86 and possessed of her faculties. She can live alone and unassisted. Both of my sisters cut her out of their lives years ago. Why? Because Mom has a cruel mouth and is bigoted, gratuitously insulting, highly opinionated and very vocal about what she thinks of you and everyone else. Mom complained that she has been shunned because of her age, and I told her it is because she is unpleasant and impossible, and that she should get counseling. She responded with a well-chosen two-word obscenity. So I'm done.

I have tried with great patience to keep Mom in my life, but she is so difficult that I, too, have finally thrown in the towel. I don't need the stress that she creates. Please let your readers know that the behavior of some adult children may be abundantly justified. — Finished in Chicago

5/10/14.  Dear Annie: I feel sure that, were she to pick up pen and paper, my mother would be among those parents wailing over their "heartless" children's "abandoning" them. My mother would say that she was a loving, wonderful parent, and I'm sure she believes it. Annie, this is a woman who told me every day that she wished she'd aborted me. When I was very little, she helpfully explained the term so I would know exactly what she meant. Very rarely are abusive parents capable of comprehending that they are, in fact, abusive. There is no child on Earth who wants to not have parents. If your kids have cut you out of their lives, there is a reason, and that reason is YOU. — S. 

Horror Stories in the Public Domain: Often More to the Story

The Nocebo Effect

Since I started this blog, I have corresponded or interacted with several respectful, thoughtful, and caring (as well as some hateful, ignorant, and not so well-meaning) individuals who run websites that are critical of psychiatrists or psychiatric medication, or who run support groups for the parents of individuals with various psychiatric diagnoses. These folks collect and publish horror stories. Some of their readers report having had bad reactions to psychiatric drugs and/or awful interactions with mental health professionals, while others discuss interactions with relatives with specific psychiatric or psychological disorders.  

As to the psychiatry critics' drug websites: Of course, anyone who reads this blog knows that I believe that there are a lot of really bad psychiatrists out there who end up doing real harm to their patients. Mostly, they drug patients unnecessarily or over-medicate them, and do not recommend  - and therefore deprive patients of - psychotherapy or family therapy that might do their patients some real good. Others do not monitor patients for adverse reactions, with sometimes catastrophic results. These websites can often contain information that can be very helpful to such individuals.

It is also quite true that a small proportion of those taking any drug on the market, psychiatric or otherwise, can have bad reactions or bad withdrawal symptoms, and that certain drugs are of such high risk for potential toxicity that they should not be prescribed for anything but the most serious of reasons. Toxicity from drugs that for many people are truely helpful and indicated can be monitored for, of course, but often doctors do not do this, as mentioned above.

While a majority of the horror stories about drugs are therefore probably true, although unrepresentative for reasons about to be discussed, this does not necessarily mean that any story website readers submit about a bad reaction that they seem to have had to a drug is, in fact, due to the drug. That should go without saying.

First, there is what is called a nocebo reaction, which is sort of like a placebo reaction in reverse. People will develop symptoms that are not actually due to the drug itself because of their expectations about the drug - just like people can have a bad or good reaction to a sugar pill that is basically inactive, pharmacologically speaking. The popularity of the obviously bogus science of homeopathy, in which individuals are given what is basically water, attests to the power of placebos and nocebos.

It is ironic how some of the more strident anti-psychiatry folks go on and on about high placebo response rates in drug studies, yet systematically deny that anyone ever has a nocebo response. This lack of consistency is always an excellent clue that anything such a person says may be highly prejudiced, and that their reading of evidence is highly selective.

Of course, people who have good responses to drugs are not going to write into the sites designed for people who have a complaint. In a similar vein, parents who were severely abusive to their offspring are not going to write to parent support groups for the families of patients with alleged psychiatric “diseases.”  Therefore, both the leaders of parent support groups and drug site webmasters are hearing from a highly select sample of individuals who are probably not at all representative of the majority of people who are involved.  

Parents who contact the two support groups for the parents of patients with borderline personality disorder (BPD),  NEA-BPD and TARA, are an excellent example of an unrepresentative sample. Yet the leaders of these groups often deny or minimize the role child abuse and general family dysfunction play in the genesis of BPD because of their tendency to overgeneralize from their readers, despite the FACT that every study ever done shows that these factors are highly prevalent in families that produce children who grow up to have BPD.

As to the people who do seek help from support groups for relatives of people with various disorders: At least some if not most of these individuals have a strong need to blame their interpersonal problems solely on a mental illness that their relatives supposedly have. If that were the case, they would not have to feel guilty about their role in the family member’s problems. I discussed this phenomenon a long time ago in a post about a website supporting the parents of children who supposedly had bipolar disorder but were in actuality just plain ol' acting out. The post showed how Pharma, with the cooperation of corrupt psychiatrists, took advantage of these parents to sell inappropriate drugs for their kids.

Similarly, complainers about drugs may actually be miserable because of family problems, but would rather blame their misery on the drug rather than face the facts of their family dysfunction. This is the defense mechanism called displacement. 

Again, of course there are real psychiatric diseases like schizophrenia and real manic depressive illness, but as readers of my blog know, I believe that what are just behavior and interpersonal problems are frequently mislabeled as "diseases" by both mental health providers and the general public alike, such as ADHD, bipolar (my ass) disorder, and even borderline personality disorder. 

The webmasters for the sites under discussion here, and the leaders of these support groups, tend to just accept the pronouncements of their “customers” as true and complete and do not question them. Blindly taking the word of people who may have several skeletons in their family closets is probably not wise. These are people the webmasters usually do not know at all, although in some cases they may have corresponded more extensively, and there is rarely any way to verify what they say. Therefore, it seems to me that one can easily be misled about both the prevalence and/or the basic nature of these problems from reading these websites.

The same question of whether one is getting the whole story might also be said about letters to newspaper advice columnists. Admittedly, I have been guilty of using such letters to illustrate various points I make on this blog. Some letters to Dear Abby and her colleagues may be completely fraudulent, and they can easily be fooled into publishing a fake one.  

An even bigger problem is that, even when a letter writer is completely sincere, many times he or she is only telling part of a much bigger story. Patients, letter writers, and website visitors can be completely truthful in what they say, but leave out highly relevant facts that would change the opinion of anyone listening to them.

As a therapist, and as I have mentioned in previous posts, sometimes the truth about what is really transpiring with a patient, particularly during their interactions with family members, are not revealed until literally months or even years into ongoing psychotherapy. Family skeletons tend to remain family skeletons for a reason.

A great example of someone leaving out a lot of relevant details, if true, was seen in a couple of letters to the advice column Annie’s Mailbox. A daughter-in-law was accused by a letter writer of what sounded like some pretty rude and unpleasant behavior, and the Annies were sympathetic in their answer to the writer. Then the daughter-in-law herself wrote in with her side of the story. Although I cannot be certain that the letter writers were not making this stuff up, I reproduce the letters because I have seen real examples of patients “spinning” facts to make themselves look better than they are, or in many cases, to make themselves look worse than they are.

These letters do illustrate some of the ways that facts can indeed be “spun” in such a way that a reader or listener is completely misled.

Letter #1: Aug 5, 2013. Dear Annie: My husband and I drove a long distance from our home to help our son and his wife with their move from another state. They have two infant daughters, and we wanted to help in whatever way we could. The first morning, Dad went with our son to the bank, leaving me at the house with the movers. My daughter-in-law stayed in her bedroom with the babies. The movers' questions were directed to me, and my daughter-in-law didn't come out of the bedroom until my son came home. It was hard to believe she wouldn't want to be involved in the decision-making process about where her furniture should go. 

On the fourth day, our son went back to work, and we were left to fend for ourselves in the morning while his wife slept in. There wasn't even a TV to keep us occupied while we waited for her to get up. At 11 a.m., we decided it was time to leave, and we cut our stay short. We called our son on the way back home and explained the situation. In seven months of our son saying everything was "fine," they never initiated any contact. There were no acknowledgements of Christmas and birthday gifts, much less a thank you. There were no phone calls. Now his wife is demanding an apology from us, saying we were rude to leave so abruptly. We believe this was inappropriate behavior on her part. What is your opinion? -- Disappointed Parents

Dear Parents: We think you will have ongoing problems with your daughter-in-law. She was rude and ungracious. But she is your son's wife, and he is disinclined to stand up to her. You will have to work through her if you wish to maintain a relationship with your son and grandchildren. Apologize, even if it sticks in your throat. If she avoids you by staying in the bedroom, don't make it a problem. Learn to keep your negative opinions to yourself. Remain upbeat and positive. Always be nice to her. Remember, you can catch more flies with honey than vinegar.

Letter #2: 10/18/13.  Dear Annie: I am the daughter-in-law mentioned in the letter from "Disappointed Parents," who said I retreated to the bedroom while my mother-in-law handled the movers. From their letter, I can understand why you think I might be a problem. Yes, they did travel a long distance to help us with our move, and it was greatly appreciated. I kept thanking them and continuously asked whether they were OK and whether they needed anything. I was told over and over that they were just fine. The day the movers arrived, my husband and I agreed that he would deal with them and I would keep our small children out of the way in our bedroom. He didn't tell me that he and his father left to go to the bank, leaving his stepmother to handle the movers. 

My husband and I both slept until noon that day, but they only castigated me for being "lazy." They didn't mention that I was up until 4 a.m. unpacking. They were bothered that I didn't have breakfast ready for them, even though the kitchen wasn't unpacked. They expected to be entertained. When they decided to leave in a huff, I was bathing our kids. They didn't even lock the front door behind them. After they left, I received nasty emails saying how rude I was and that I need to apologize. Each one included a laundry list of the ways I am a terrible daughter-in-law and don't know my place. I didn't send birthday and Christmas greetings because my husband said he wasn't interested in doing so. His father has a history of anger issues and has alienated every other family member. My last email stated that I was cutting off contact. I am too busy raising my children to raise my in-laws. They smile to your face while making lists of slights behind your back. I don't want my kids around such behavior. Thank you for reading my side of the events. — Shell-Shocked Daughter-in-Law

Dear Shell-Shocked: Thanks for providing it. Many readers came to your defense, saying that a new mother who had just moved had her hands full and deserved more consideration. We agree.

Often the possibility that details are being left out of a description of an interpersonal problem can be suspected from a very careful reading or listening to what is said. For example, I see a lot of letters to advice columnists by elderly parents complaining that their adult children are ignoring them or are angry at them, seemingly for no apparent reason. In point of fact, there is always a reason. For example:

Dear Annie: I could have written the letter from "Hurt in Florida," whose children and grandchildren don't include her in their get-togethers. My daughter told me they are "just too busy" for me. But they somehow have time for her dad and stepmother, as well as her in-laws and several friends. I haven't seen them in more than a year. We don't talk because I don't call. I don't understand any of it. I just wanted to let "Florida" know that she's not alone. I'm hurting with her. — Midwest Grandma

The key question raised by what is said in this letter is why said daughter seems to love to get together with every family member except the letter writer. Could it be that the writer has distanced her child in some way? You can almost bet on it.