Blame, Guilt, and Family Dysfunction

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When I discuss family dysfunction, the question of “who’s to blame”– the adult children or their parents – frequently arises. Emotions then tend to run wild. I believe this is the wrong question. The fact is that all family members are beans in the same soup, acting out patterns that have been building up for generations and are being passed down. The right question should always be, “How do we FIX this?”

The question of blame is often the subject of vehement defensive reactions by the community of parents in the US, who gripe about anyone who engages in“ parent blaming” and “parent bashing.” They want to believe that they have absolutely nothing to do with their children’s problems, which they like to think are all genetic or all caused by peer groups at school.

Many mental health practitioners have sided with these nonsensical ideas. I’ve written before about a time when, at a nearby child and adolescent psychiatric hospital, juvenile delinquency and even suicidal thoughts were blamed entirely on heavy metal music. That way, parental guilt could be assuaged so they would pay for their kids to get “treated” for listening to Judas Priest. Well, at least until their insurance ran out.

So are these folks saying that even physical and sexual abuse by parents has nothing to do with children’s insecurities? Or their acting out? Even here, the answer seems to be a sort of yes – people falsely opining that the incidence of this abuse is actually minimal and that almost all of these accusations of such are false. Really?

It is true that if a therapist makes a parent feel guilty, they are less likely to look critically at their own parenting practices or seek help, so therapists have to figure out a way around this paradox. My therapy model attempted to do just that with patients who were adult children facing this conundrum.

I have also written about the massive increase in recent years in parental guilt caused by cultural changes in gender roles. In reaction, this has led to an epidemic of so-called helicopter parenting. That this type of interaction is a major correlate of adolescent depression, which means probably with the rate of suicide as well, has been recently demonstrated in studies (for example: Wattanatchariya K, Narkpongphun A, Kawilapat S. The relationship between parental adverse childhood experiences and parenting behaviors. Acta Psych. 2024(243).  While correlation and causation are two different things, I believe on the basis of my wide clinical experience that in this case these studies are indeed about causation.

Another complication of parent guilt was described in the 2/27/24 column by advice columnist Carolyn Hax.  A mother described herself as being wracked with guilt because her teenage children suffered from anxiety and depression, despite her and her spouse loving them immeasurably and doing their best every day to support, listen to and nurture them. Ms. Hax of course tried to tell her that she did not screw up because “kids everywhere are having an extraordinarily difficult time right now” and that “depression and anxiety are way up, stress is up, mental health resources are strained, and schools are overburdened, underfunded and understaffed.”

My fear is that Ms. Hax’s advice for her to stop beating herself will fall on deaf ears. As I have described in previous posts, parental guilt has become more widespread, and parents often feed into the guilt of other parents – especially if the parents try to set limits with their kids instead of helicoptering. I can recall other families giving us a hard time when we wouldn’t give our kids away at college unlimited funds to do whatever they wanted.

Besides stopping parents from setting appropriate limits with their kids or disciplining them properly, another big problem is one that I have seen clinically but which is not described in the mental health literature: the kids see their parents feeling guilty all the time even when there is no obvious reason for it, and take this to mean that their parents need to feel guilty. They may therefore act like they are more impaired than they actually are so that the parents can continue to indulge this need. The fact that the guilt remains omnipresent in this situation confirms their beliefs!

In a column the very next day, Ms. Hax answered a letter in which a wife in an abusive relationship will not leave for fear of harming the kids.  The letter says “But I read so much about how kids thrive in stable families and are damaged by splits or divorces other than in highly abusive situations. My partner is not physically abusive but checks a lot of other boxes: yelling, vicious anger  name-calling, silent treatments.”

How anyone can possibly believe that subjecting kids to this sort of abuse is better for them than coping with their feelings about a parental divorce is beyond me. And kids are smart enough to wonder about that themselves. So how do they then interpret Mom’s refusal to leave? Perhaps mom is using the kids as some sort of excuse because deep down she thinks she needs or deserves her husband’s abuse? I know that sounds bizarre, but you would be surprised.

In fact, although obviously I can’t say in this particular case on the basis of a letter to an advice columnist, there may even be an element of truth in this idea. The answer to what might be going on can often be obtained by a therapist using the Adlerian question: “What would be the downside of successfully getting out of this bad relationship?” A common answer: "My parents would blame me and tell me I should go back to him and be a better wife." I kid you not! Maybe because those parents themselves are in a similar relationship. If so, we’d have to find out whether this is indeed the case, and then ask the Adlerian question to the grandparents about why they continue their relationship.

When people feel guilty, it leads to defensiveness, which can lead to fight, flight or freeze reactions which cut off conversations about how to solve problems. Since the problems go back many generations, I have always suggested that we just put the blame on Adam and Eve, and be done with it.

 

 

 

 

 

When Children Kill Their Parents

According to CBS News, most offspring who kill their parents are adult children, meaning they are over 18 years of age. Over the 32-year period examined, the number of juvenile parricide offenders was substantially lower. On the average, juveniles killed 31 fathers and 18 mothers per year. The reverse is more common: according to FBI statistics, an average of about 450 children of all ages yearly are killed by their own parents. Parents were responsible for 61% of child murders under the age of five.

The fact that young children or older adult children kill their own parents seems to run counter to one of the themes of this blog: that a lot of behavior problems and self-destructive patterns are caused by the residue of kin selection, the tendency of people to put their kin and ethic group’s interests above their own, and in certain circumstances be willing to sacrifice themselves. Even die for them. If this is really the case, and I’ve been witnessing self sacrifice for decades in my psychotherapy patient population, how can we account for children killing parents?

I must admit I do not know for certain, since I have never had anyone who killed a parent in psychotherapy with me. However, based on my theory, I believe the main reason may have to do with another concept I’ve written about: Hatefulness as a gift of love. In some cases, parents hate themselves so much and think their children are so much better off without them - even if the child ends up in jail - that they act hatefully to such an extent that they kind of give off the message “kill me.” 

Another reason was illustrated in a case I am about to discuss: A parent who wants to murder a spouse may appear to be so selfish as to have their child take the rap for killing that person—thinking that the child would not have to go to jail due to being so young.

In almost all cases, kids who kill parents are victims of severe abuse, as in the cases to be discussed. But severe abuse alone is clearly not enough to induce a kid to do something like that, since the number of cases of severe child abuse massively exceeds the number of such killings. Most children who are abused do not even tell on their parents, let alone kill one of them. As little kids, they often think being beaten is normal, and worry more about their parents’ mental health than their own. So it has to be abuse plus something else. In one of the two cases to be discussed, it was a direct suggestion.

As one piece of evidence that the theory of self-sacrifice is correct even in these cases, one of the persons about to be discussed (Ms. Bailey) says herself in her book: “It is innate in us to want to protect the only thing we know, and even through abuse and neglect we still seek to protect the very ones who inflict such pain.”

Two cases  have been in the media lately: The first was featured on an A&E TV documentary called The Prison Confessions of Gypsy Rose Blanchard. When she was in her early twenties, she induced an angry and easily manipulated boy  to kill her own mother. Afterwards, she was imprisoned for almost 10 years before being paroled.,The actual killer is still in prison. 

The second is in a book called My Mother’s Soldier, written by a woman named Mary Elizabeth Bailey. When she was only 11 years old, her mother induced her to shoot and kill her highly abusive stepfather. In that case, she was afterwards whisked away to foster care while her mother went to jail, just as the mother must have suspected would happen.

Both of these women relate horrifying tales of severe abuse by parental figures, while Ms. Bailey was also severely neglected.

Blanchard was a victim of Munchausen by proxy, where her mother faked illnesses in her as well as disabilities in order to get money. People, including supposedly much of her mother’s family, didn’t think she was able to walk, since she was always in a wheelchair. She was subjected to surgeries and medications she did not need. Apparently mom was really good at faking this stuff in her with doctors, and the girl willingly went along with it. At one point mom insisted the girl had a fear of eating, and a stomach tube was surgically inserted in her. She was in the hospital for six months with it.

The two of them moved from place to place. The mother would not let her go to school  or have any friends, so they were each other’s only major relationship in life for years. The child felt so stymied that she recalled her first day in prison as a happy time. For the first time in her life - even in that environment - she felt “free.”

In the Bailey case, the murderous child had  been sexually abused by her grandfather – who of course denied it when interviewed and who theorized quickly that Mary was trying to shift the blame for the murder on to him. But how on earth had he brought up a daughter who would do such terrible things to her own daughter? By comparison, Mom made him look like an ideal parent.

Unlike with the grandfather, Bailey idealized her grandmother. This is understandable since Grandma was the only family member who treated her with love in one-to-interactions, and frequently took her under her care when the mother wanted to go out and party. On the other hand, grandma had also been the one who raised the incredibly irresponsible mother who had dropped out of school very early, ran wild, had sex somewhat indiscriminately with multiple partners even while married to an insecure, violent alcoholic (who probably was doing the same thing) who frequently beat her up. And Grandma often returned Mary to the mother’s abusive, neglectful care whenever the mother asked her to because of the mother's need for help  financing her life.

And she never called the police about any of the abuse. The only time she even threatened to do that was when the stepfather threatened her, and he responded by hitting her so hard on the side of the head that she had hearing damage. And yet still no call to the police.

Mary was generally ignored to the point where she was often given no food for days. Stepdad came into the picture after the girl had been raised for a time by the grandmother. (The fact that he was not a primary attachment figure originally might have made it easier for Mary to follow her mother’s instructions to shoot him). 

Stepdad beat her frequently, and the only things he had to say to her were names like “you little redheaded brat!” He had a job which took him away from the house for significant periods of time, but mom didn’t take care of her daughter either – she would go off to party at some nearby apartments. She rather openly had affairs even though she knew her husband was a violent alcoholic and would find out and beat her as well as the kids.

Pretty amazing stuff.

 

The Foster Care to Homelessness Pipeline

 

In a previous post, I discussed one big reason for the increase in tent cities for the homeless: the defunding of critical parts of the mental health safety net. In this post, I’m going to talk about another one: unplaceable foster children who age out of the system.

I was first made aware of this problem by a counselor in Texas. Then I noticed a headline that said much the same thing she described was going on in California. According to the counselor, some residential treatment facilities have recently been closed by the governor of Texas. The ostensible reason was that there were accusations made against people there of abusing children, but instead of fixing that problem, they closed them down.

Unplaced foster children there may now live in unregulated rentals, on the floors of churches, in some donated spaces or in hotel rooms. At one place, girls aged 12-20 don’t go to school, don’t have rules or clean up. The place itself is usually filthy. The girls are also allowed internet access so they often “run away” to meet various men, and most aren’t on birth control.  

Meanwhile, in California, things are just as bad. According to reporting by the Investigative Reporting Program at UC Berkeley, hundreds of Los Angeles’s county’s abused children ended up in hotels like the Biltmore Hotel downtown. In December 2021, the then-director of the city’s child welfare agency quietly struck a deal with the hotel’s operators to house foster youths and their social workers at the cost of $89 a night.

The children placed in the hotels are usually among those with some of the most significant untreated trauma and the gravest histories of violence. Though group homes frequently have security and teams of staff members, children in the hotels have often been supervised by a single social worker, sometimes with scant knowledge of their backgrounds, little training to de-escalate potential violence and no on-site colleagues when things go wrong, according to DCFS policy documents. Assaults on staff members are not unusual.

In two cases, in particular, the kids ran away from an unregulated placement and ultimately died in shootings.

Many children are put into the foster system after being removed from an unsafe home. This can mean that children all over the country are entering the foster care system who may have had parents who were drug addicts, abusers, or criminals and are prone to acting out and violence, which makes them nearly impossible to place in foster homes. When they turn 18, they are no longer wards of the state and many are then out on the street.

According to the National Foster Care Institute, after aging out of foster care, approximately 20% of former foster youth will experience homelessness.

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.

Spoiling Behavior is All an Act, But a Deadly Serious One

Relationships between people are formed through interactions that are two-way and simultaneous. People learn and become different over time as this occurs, and can push one another away.

I recently received an angry letter from a mother whose child apparently has been diagnosed with borderline personality disorder (BPD). She told me that I must have no idea what it is like to raise a child with the disorder, or I would never say what I do about it. She added that kids with the disorder do not respond to the most positive of upbringings, so don’t blame parents!

Having been the direct recipient of the spoiling behavior of adult patients with the disorder when I started out as a therapist - and did not know then how to deal with their in-session behavior effectively - I can say that I have a really good idea about what that is like. And it ain't no picnic. And I agree that unrestrained positivity does not change it. It can even make it worse!

It is also true that not all families that produce kids with the disorder are overtly abusive either physically, sexually, or verbally, although a large and significant majority of them are in fact abusive in those ways – according to every study ever done. Even DBT therapists believe they come from an “invalidating environment,” even though they seem to scrupulously avoid identifying that specific environment as the family of origin.

I would like to suggest that the reader take a look at what the letter writer said in a different way than would be a typical interpretation. (Of course, I can’t know for sure even if her child has even been correctly diagnosed or exactly how positive the family environment is). In just a couple of sentences, she could be understood to be saying that her parenting has nothing to do with how her child turned out. In a phrase, it is only the child who is (completely) screwed up.

           

If I’m hearing this in a short letter, you can bet that the child has heard it. And guess what? If children hear this point of view a lot, they will begin to act in ways that give the parent an easy justification for making the statement so the parents don’t have to feel bad about blaming everything on the kid. But doing this is all an act to placate and stabilize the parents.

I can predict relatively confidently that if the mother continues to exhibit this same attitude much of the time, the child will continue to give her grief, and will not get better.

           

Likewise, if a parent is constantly invalidating a child, the child will begin to act in ways that practically invite invalidation. One leader of a parents of BPD kids' support group once told me that her daughter said bizarre things, such as that she had grown up poor. The family was in fact quite well off financially. The daughter was not psychotic. Her mother is quite bright, so I would have to assume that the daughter is not actually stupid enough to somehow not know that the family was affluent. If she were my patient, I would ask her specifically what she thought the family was poor in. Validating responses, perhaps? Warmth?

           

When I speak of this stuff being an act, I always have to clarify that it is specifically the spoiling behavior which is the act. The way they generally feel, their sense of a poor identity, the impulsiveness and such are all real – but all adaptive or reactive to the family dynamics that produce BPD.

Guest Post: Borderline Family Dynamics Up Close

Today's guest post is by Lin. The writer recounts her own experience growing up in a family with issues that lead to Borderline Personality Disorder 

I was born into a highly dysfunctional family, consisting of my parents, my very domineering and generally narcissistic grandmother, and my alcoholic uncle. My parents both had physical and mental health issues and, in hindsight, I can clearly see that my mother had untreated Borderline Personality Disorder.

After my mother had 7 miscarriages and one stillbirth, they had been told that they couldn't have children. Therefore, they had planned their future without children. When I came along it was a shock; they both overjoyed to have me and also shaken that they suddenly had a new responsibility that they never thought they would have. Because I was an at risk pregnancy, I was born 8 weeks early by cesarean and, due to my mother's unstable mental health, she was unable to see me for 6 weeks. Instead I was kept in hospital while they stabilized me and I only had contact with the staff and, on his occasional visits, with my father.

From the outset I was the perfect baby. I seldom cried or asked for attention and was usually compliant. I talked and walked at an early age and was reading by the time I was 3. My earliest memory is of being that age and in my pushchair. I had a pacifier in my mouth and saw my mother walking towards my father and myself.

I remember the fear and shame of her possibly seeing me using it and I quickly hid it under a blanket. I already had learned not to upset her and felt that I was bad. I learned to hide what I did and felt.

My mother sexually abused me from the earliest age I can remember until I was 16 years old. I am sure my father was aware of it because he had a separate bed in the same room that my mother and I shared. She made me pray to God afterwards and ask for forgiveness for making her do it. She told me if I told anyone she would leave me. The abuse was the only form of physical touch I had—she never hugged me or told me she loved me or was affectionate in any way. Instead, she would buy me anything I wanted. Toys every Sunday, sugary foods in a large quantity every Thursday. I just had to ask and I would get it. All the while the abuse continued every night. I learned sexual abuse meant my mother would stay with me and I learned to equate material possessions and food with love.

I was told we were family and didn't need strangers. Strangers were the enemy. This meant I was not allowed to have friends. I was never allowed out without a parent; I was dropped off at school and picked up every lunchtime and at the end of the day in order to minimize my interaction with others. My father did have a sister but my mother forbade him from seeing her. During the times my mother was in hospital, he would take me to visit her always, saying "Don't tell anyone."

My father would often do bizarre things, such as once telling me we were going to play a game with my mother and pretend that he had been mugged on the way home from work. I thought this was a great game and having secrets with my father made me feel close to him. I learned to lie for attention.

My mother would either be very weak or overbearingly strong—sometimes both at the same time. She ruled me with a rod of iron—I always had to be perfect or I would be told I was nothing to her and then physically beaten. At the same time she appeared incredibly weak. I remember a 4 year old child once swore at her and she cried like a baby. I despised her weakness and sensed she did too, so I learned to make her angry instead at these times so we would both feel better. I learned how to manipulate her as she had manipulated me.

My mother would have frequent psychotic episodes [She was diagnosed with episodes of psychotic depression]. Either me or my father would force anti-psychotics into her mouth. She would hear voices stating we were trying to kill her and fight back. The first time I witnessed that was late at night when I was 6 years old. I ran to the corner of the bedroom in terror while my father held her down as she lashed out at him. Once she was calm my father told me I could join her in bed again. I shook my head, terrified to go near her. My father turned out the lights and went to bed himself, leaving me sitting in the corner of our bedroom all night, alone. I learned that I could be abandoned without comfort from those closest to me at any time.

By the time I was 12 I had learned to give back what they gave to me. They had taught me well. I became better at constant manipulation and control than they were. My father developed congestive heart failure and became physically weak. I would fight with him constantly to make him fight back and be strong again. My mother's mental health was worsening and she blamed my father’s lack of care now that he was ill. I learned to agree with her about how bad he was and thus make her feel stronger.

My father eventually took his own life on my 13th birthday, leaving me alone with my mother. My mother became totally dependent on me. The same spoiling behaviors I had learned would continue for the next 5 years. I would attempt to strengthen her when she was weak and weaken her when she was strong. I did not understand why I was doing this, behaving in a purely instinctual way in order to provide what we both needed. Even though we fought constantly, I was still being sexually abused by her and given whatever material things I wanted. During psychotic episodes, my mother would sob and state that her baby had been replaced at birth by a changeling of the Devil. As a Devil's spawn, I was going to murder her just as I had murdered my father. I believed I was evil and hated myself.

By the time I was 18, I had been in psychotherapy for several years. It had been arranged for me after I had told other children at school that my father had died a year before he actually had. I hated him for not stopping my mother and wanted him dead—the worst punishment I could think of. I became more aware of my motivations and becoming aware that I had a choice as to how I reacted. I moved away from home, only visiting my mother sporadically. She never ever forgave me for choosing strangers over her. Our relationship continued to be very difficult, with me despising her weakness and trying to make her strong, and her despising my new found strength and trying to make me weak. I cut her off entirely when I was 20 and she took her own life a month later. I still struggle with the guilt and self-blame for both my parents suicides.

This is all that I learned and why I have Borderline Personality Disorder.

Family Dysfunction and Gene Expression: Effects on Personality and Behavior

Jenny Macfie, Ph.D., Department of Psychology, University of Tennessee Knoxville

It’s amazing what you can discover if you actually look

When it comes to the “scientific” literature about what causes borderline personality disorder (BPD) and other forms of self-destructive and self-defeating behavior, readers of my blogs know that I think genetic influences are way overemphasized and the effects of dysfunctional family dynamics and child abuse ignored as much as possible.

In my clinical practice, I see dramatic evidence that the effects of the family dysfunction on behavior are often passed down from one generation to the next.  A few studies have also looked at this, and in every case supported this viewpoint.

Two more recent studies support my views in general about what creates the disorder.

Jenny Macfie and others, following the work of Karlen Lyons-Ruth described in a previous post, actually watched the interactions between children aged 4-7 and their mothers with BPD (“A Mother’s Borderline Personality Disorder and Her Sensitivity, Autonomy Support, Hostility, Fearful/disoriented Behavior, and Role Reversal with her Young Child,” Journal of Personality Disorders 31(6):  pp. 721-737, 2017).  

The pairs were given a task with the following instructions: “This puzzle is for your child to complete, but feel free to give any help your child might need.” A researcher presented one puzzle at a time in order of increasing difficulty.  Mothers who did not have the disorder and their child were also given the task. All interactions were observed and scored.

Mothers who had BPD “demonstrated significantly less sensitivity and autonomy support [supporting the child’s efforts to solve the puzzles without the assistance of the parent], more hostility, more role reversal, and more fearful/disoriented behavior in interactions with their children than did comparison mothers.

“Role reversal” is the child taking care of the mother instead of the other way around. In this study they specifically looked at mothers deferring to their child’s demands, the pair acting like playmates (for example, child abandons task and the two run around the room rather than the mother setting limits), and mothers taking the child’s attention away from the task by demanding signs of affection from the child.

There was no group of mothers with other personality disorders so we do not know if the researchers results are specific to mothers with BPD.

In a second, unrelated study, Pierre Eric-Lutz and his colleagues looked at the effects of child abuse on the expression of genes that control the development of the brain (“Association of a History of Child Abuse with Impaired Myelination in the Anterior Cingulate Cortex: Convergent Epigenetic, Transcriptional, and Morphological Evidence,” American Journal of Psychiatry 174 (12), pp.1185-1194, 2017).

Epigenetics refers to the process by which environmental influences turn genes on and off. Most genes in a cell are not operating at all at any given time. Epigenetics ties environmental and genetic influences together in ways that a lot of people in the various mental health field either seem to be unaware of, or consciously ignore. The anterior cingulate cortex is a part of the brain heavily involved in making decisions regarding what to do in various social situations.

Without going into the authors’ methodology, which was quite sophisticated, the study found that individuals abused during childhood showed significantly decreased expression of a large collection of genes involved in myelination of cells in that part of the brain. Myelination is process which markedly changes the level of functioning of brain cells that are part of so-called white matter.

Once again, we find that one of the main purposes of the genes that create the brain in human beings is to make humans exquisitely sensitive to the social environment.

More Stories from the Journal of Obvious Results

As I did on my posts of  November 30, 2011,   October 2, 2012, September 17, 2013,  June 3, 2014,  February 24, 2015,  December 15, 2015,  September 13, 2016 and March 15, 2017, it’s time once again to look over the highlights of the latest issue of one of my two favorite psychiatry journals, Duh! and No Sh*t, Sherlock. We'll take a look at the unsurprising findings published in the latest issue of the later. 

The journals honor the tradition of The Golden Fleece Award, an award given to public officials in the United States for their squandering of public money, its name sardonically derived from the actual Order of the Golden Fleece, a prestigious chivalric award created in the late-15th Century, and a play on the word fleece, as in charging excessively for goods or services. The late United States  Senator William  Proxmire  began to issue the Golden Fleece Award in 1975 in monthly press releases.

My comments are in bronze.

As I pointed out in those earlier posts, research dollars are very limited and therefore precious. Why waste good money trying to study new, cutting edge or controversial ideas that might turn out to be wrong, when we can study things that that are already known to be true but have yet to be "proven"? Such an approach increases the success rate of studies almost astronomically. And studies with positive results are far more likely to be published than those that come up negative.

3/17/17. Because substance abuse is an indicator of being satisfied with your life. US Veterans With Substance Abuse Problems May Have Higher Risk Of Suicide Than Veterans Without Such Problems, Study Suggests. HealthDay  reported, “US veterans with substance abuse problems have a higher risk of suicide than veterans who don’t,” researchers found after examining data on “more than four million veterans.” The findings were published online March 16 in the journal Addiction.

5/24/17. Because having a potentially fatal illness is so exhilarating. Lung Cancer Diagnosis May Increase Suicide Risk, Study Suggests. HealthDay (5/23, Mille) reports that research suggests individuals “with lung cancer have a strikingly higher-than-normal risk of suicide.” Investigators looked at “data from over 3 million patients during a 40-year period.” The research indicated “that a lung cancer diagnosis raised the odds of suicide by over four times compared to people in the general population.” The findings were presented at the American Thoracic Society meeting.

5/30/17. Because most people adjust instantly when uprooted from their entire way of life by a bloody war. Syrian Refugee Children Living In The US Reported High Levels Of Anxiety, Small Study Suggests. MedPage Today (5/28, Visk) reported, “Syrian refugee children living in the US reported high levels of anxiety,” researchers found. Specifically, “based on self-reported test scores, more than half of children had a probable anxiety diagnosis, and more than 80% had probable separation anxiety,” the 59-child study revealed. The findings were presented during a poster session at the American Psychiatric Association’s annual meeting. Healio (5/26, Oldt) also covered the study.

8/17/17. Cheaters are prone to cheat? Will wonders never cease? Serial Infidelity Across Subsequent Relationships (Arch Sex Behav; ePub 2017 Aug 7; Knopp, et al ).  Prior infidelity emerged as an important risk factor for infidelity in next relationships, according to a recent study. Researchers addressed risk for serial infidelity by following adult participants (n=484) longitudinally through 2 mixed-gender romantic relationships. Participants reported their own extra-dyadic sexual involvement (ESI) (ie, having sexual relations with someone other than their partner) as well as both known and suspected ESI on the part of their partners in each romantic relationship.

9/6/17.  And I thought most elderly people who fall fall out of bed. For nursing home residents, mobility increases risk of fracture. Reuters (9/5, Rapaport) reports a new study published in The Journals of Gerontology: Series A found that for nursing home residents, “risk factors for fracture included the ability to walk independently, wandering the halls, dementia and diabetes.” The study was based on data from “419,668 nursing home residents, including 14,553 who experienced hip fractures.” Lead author Sarah Berry, MD, of the Institute for Aging Research and Harvard Medical School in Boston said, “Frail nursing home residents that are still mobile and independent have opportunity to fall.”

9/6/17. People prone to diseases get them more often than those who are not? Genetic variants linked to health problems appear less frequently in people who live longer, study indicates. Newsweek (9/5, Osborne) reports genetic research published in PLOS Biology used data from over 200,000 people to show humans “appear to be evolving to hit puberty later and those who start at an older age live longer.” Researchers also discovered that “genetic variants linked to heart disease, obesity and high cholesterol appear less frequently in people who live longer.”

9/8/17. Because major depression has a genetic component, and depressed mothers may have attachment issues or altered parental behavior, ya think? Children Whose Mothers Took Antidepressants During Pregnancy May Be At Increased Risk For Psychiatric Illnesses Themselves, Research Indicates. HealthDay (9/7, Preidt) reports, “Children whose mothers took antidepressants during pregnancy may be at increased risk for psychiatric disorders themselves,” researchers concluded after reviewing “data from more than 905,000 children born in Denmark between 1998 and 2012,” whose “health was followed for up to 16.5 years.” The findings were published online Sept. 6 in the BMJ. According to Medscape (9/7, Brooks), the authors of an accompanying editorial “say that reporting absolute risks, as the researchers do in this study, is important to facilitate communication between clinicians and pregnant women.”

9/8/17. Maybe cuz they’re the ones who are eating again? Young Women With Anorexia Nervosa Who Resume Menstruation By End Of Treatment May Experience Greater Improvement In Psychological, Physiological Well-Being Than Those Who Do Not, Small Study Suggests.

Medscape (9/7, Davenport) reports, “Young women with anorexia nervosa (AN) who resume menstruation by the end of treatment experience greater improvement in both psychological and physiologic well-being than those who do not,” researchers found after studying 39 women with AN and 40 women with bulimia nervosa. The findings were presented at the European College of Neuropsychopharmacology Congress.

9/8/17.  Why would you need doctors for people to have healthcare? I just don’t understand. ACA Plans With Narrow Networks May Provide Less Access To Mental Healthcare, Study Indicates. Reuters (9/7, Rapaport) reports that according to a new study conducted by researchers at the University of Pennsylvania Perelman School of Medicine in Philadelphia, “narrow-network insurance plans created by the Affordable Care Act (ACA) offer only limited access to mental health care.” The article says these plans seem to have substituted lower costs for less access to mental healthcare.

9/11/17. Self destructive kids study less? High school students with poor grades more likely to have unhealthy behaviors, CDC study indicates. The Atlanta Journal-Constitution (9/8, Hart) reported, “There’s a link between unhealthy behavior and bad grades, according to a new study of high school students by the US Centers for Disease Control and Prevention.”  HealthDay (9/8, Preidt) reported the study suggests US high school students with poor grades are “much more likely to have unhealthy behaviors – including illegal drug use – than teens at the top of the class,” researchers concluded after “analyzing data from a 2015 government survey.” The findings were published in the CDC’s Morbidity and Mortality Weekly Report.

9/15/17. Because as we all know the incidence of health problems decreases with age. Risk For Health Anxiety May Be Increased In Older Adults, Study Suggests. MD Magazine (9/14, Warren) reports, “The risk for health anxiety...a disorder characterized by a preoccupation with physical health and/or somatic/body symptoms, is increased in older adults,” researchers found after assessing “538 primary care patients” ranging in age from 18 to 90. The findings were published online June 24 in the Journal of Anxiety Disorders.

9/29/17. They thought infectious disease occur spontaneously, I guess. Babies with older siblings may be at higher risk of hospitalization for influenza, researchers say. In “Well,” the New York Times (9/28, Bakalar, Subscription Publication) reports, “Having older brothers and sisters puts infants at higher risk for being hospitalized” for influenza, researchers concluded after studying “1,115 hospital admissions of children under two born in Scotland from 2007 to 2015.” The findings were published in the European Respiratory Journal.

10/2/17. Because listening to people talk about the voices in their heads is so relaxing. Caregivers of Individuals With Schizophrenia Experience High Levels of Distress, Study Finds. Psychological distress among family or friends who provide unpaid support to people with schizophrenia or schizoaffective disorder is much higher than the general population, reports a study published today in Psychiatric Services in Advance.

 

10/4/17. I didn’t know PTSD had anything to do with being traumatized. PTSD Particularly Common Among People Exposed To Mass Shootings, Studies Indicate. The AP (10/3, Tanner) reports that people who survived this week’s shootings in Las Vegas may be at risk for post-traumatic stress disorder (PTSD). Also at risk for “psychological fallout” are first responders, medical staff, eyewitnesses, and bystanders. Studies indicate “PTSD is particularly common among people exposed to mass shootings versus other types of trauma, with rates as high as 90 percent reported” by some researchers.

10/25/17. Because being abused as a child is good for your mental health. Young Adults Who Recall Being Maltreated May Have A Particularly Elevated Risk For Psychopathology, Researchers Say.   A study to be published in the January issue of the Journal of Psychiatric Research (10/24, Newbury, Arseneault, Moffitt, Caspi, Danese, Baldwin, Fisher) “explores the validity and utility of retrospective self-reports versus prospective informant-reports of childhood maltreatment.” Study data “were obtained from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative birth cohort of 2,232 children followed to 18 years of age (with 93% retention).” Researchers evaluated “childhood maltreatment” through “prospective informant-reports from caregivers, researchers, and clinicians when children were aged 5, 7, 10 and 12,” and via “retrospective self-reports of maltreatment experiences occurring up to age 12, obtained at age 18 using the Childhood Trauma Questionnaire.” The study revealed that “young adults who recall being maltreated have a particularly elevated risk for psychopathology.”