February 27, 2007

Clarification On What Goes Wrong In A Psychiatrist's Family

Many interesting and varied reactions to my post, "What Goes Wrong In A Psychiatrist's Family?"  It struck a nerve with a lot of people, and others couldn't relate to it at all.  But I would like to clear up one element:

It's not that even handed, calm, unemotional criticisms directed only to the child's behavior is wrong; it is that no one does it well.  And that's where it all falls apart.


SOME psychiatrists think/try to do something noble (criticize behavior and not the child itself) but they are HUMAN, and get tired.  They will eventually get angry, and, from a kid's perspective, when the parent gets angry is what matters.  What did I do to piss Dad off?

The opposite of this, call it the non-psychiatrist parent, is calm, then gets a little angry, a little more angry, a little more angry, then yells, screams.  There's a build up.   A few years of this and you realize that there are some things that make Dad a little angry, and other things that make him really angry.  There's normal, varying levels of  human emotion to different situations.

But the child of a psychiatrist doesn't get that.  He gets binary emotional states.  "Lying is not acceptable behavior."  Later: "Yelling loudly is not acceptable behavior."  Later: "Picking you nose is not acceptable behavior."  Later: "Stealing is not acceptable behavior."  What's the relative value?  A kid has no idea-- he thinks the value is decided by Dad, not intrinsic to the behavior.  "Eating cookies before dinner is not acceptable behavior." Later: "Kicking your brother is not acceptable behavior." 

Ok, now here it comes:

After seven or eight or twenty five "not acceptable behavior" monotones, Dr. Dad can't take it anymore; he explodes.  "Goddamn it!  What the hell is the matter with you?!  What are you doing?!!"   All the anger and affect gets released, finally.  The problem-- the exact problem-- is this: the explosion of anger came at something relatively trivial.  Maybe the kid spilled the milk.

So now the four year old concludes that the worst thing he did all day was spilled the milk-- not kicking his brother, or lying, or stealing.  Had he not spilled that milk, Dad wouldn't have gotten angry.  

Add this up over, say, a year: mostly flat, neutral monotones, peppered with unpredictable yelling patterns, inconsistent explosions, and now the kid can't form a hierarchy of good and bad.  In fact, what he learns is that good and bad are defined almost exclusively by the reaction he gets from others (e.g. Dad) and not the behavior itself.  

You say: but the kid's not an idiot, he's going to know that stealing is worse than spilling milk.  Well, how is he going to learn that, except from you? You say:  just going through life-- every kid eventually learns it.  Yes, they learn that it is worse, but not why it is worse. The conclusion is that the hierarchy of bad and worse is determined by the severity of people's reactions.

You say: the solution is that Dr. Dad needs to work on maintaining his calm all the time, and not exploding.  Well, it's not going to work: he's human.  Eventually the electric bill will be too high, or his wife cheats on him, or he has the flu, or he's stuck in traffic all day.  And he'll explode (or, the alternative: check out.  "I'm not dealing with this anymore.") 

Consider this: a kid knows exactly how his father feels about a certain patient, or colleague, or friend, because he sees a consistent and predictable reaction in the Dad every time the person is mentioned. But the kid does not have that clear link for himself.  There's more informational affect from Dad talking to a patient on the phone then there is when punishing you.

Contrast this with the reaction of, say, a hypothetical "angry Dad" who has six beers a day after work: he's always pissed off.  Always.  Even though he flips out over spilled milk, he flips out over everything.  The consistency of his anger makes the anger attributable to him-- "Dad's insane"-- not to you or your behavior. You don't infer from this that what you did is good or bad-- you'll have to learn that elsewhere. 

But just as you've identified Dad as "Angry Dad" you might also infer that he hates you, that you are a bad person.  This is clearly not a good thing, but the point is that you develop an identity from it, you get defined (though negatively.)    The inconsistency of the psychiatrist-parent's anger is confusing; why this thing, and not the other thing?  Why so much consistent (same kind and amount) affect talking to an auto mechanic, and so little affect-- especially consistent affect-- with me?

So you have a psychiatrist-parent, who works long hours; who tries hard to be neutral even in punishment; who gives little in the way of emotional information about a kid's identity, but is so obviously clear about other people; who once in a while explodes, inconsistently, over unpredictable things. 

Here it is again, where it all goes wrong: the child develops an identity which is about the reactions of others.  "People's opinions of me are based on how I make them feel."

Disclaimer again, and for the last time: not all children of psychiatrists go insane, not all psychiatrists suck as parents, I don't know what I'm talking about, Bush lied, etc, etc.  Please understand I am not criticizing psychiatrist parents, I'm trying to understand something.

You come home, and find your kid has spilled the milk.  How do you react?  Ok, now ask your kid: how do you think I'm about to react?  The answer, ideally, should be the same.  If it's not, you've got a problem on your hands.