It’s
now commonplace for psychiatry to credit adverse social environment as a cause
of mental illness, even as it slights the social environment in favor of
genetic causes, or else concentrates on medication to eliminate or alleviate
the outward symptoms of such. For
example, in relation to the mental illness I have, personality disorder, the
state-of-the-art research handbook on such, 2014’s Handbook of Personality
Disorders, Second Edition (Livesley and Larstone, Eds., Guilford Press),
states broadly that personality disorders are 45% genetic, and that hopes for
effective medicinal treatment are under research; which implicitly notes that
the majority of its roots, 55%, is attributable to social, especially parental,
social environment. This makes a lot of
sense, especially since personality disorders are most amenable to long-term
cognitive behavioral and other related therapies such as dialectical
behavioral, mentalization, hybrid, and other therapies (though these various
therapies have differing theoretical premises, they are all similar in the
specific therapeutic approaches and techniques utilized). The Amish and other psychological/psychiatric
studies have also demonstrated the importance of social environment in the
attenuation or enhancement of basic pathological propensities. No, adverse social, especially parental,
environment must also be considered just as important in causing mental illness
as genetics, and that psychotherapy is as needed as is medication (with the
proviso that medication is not recommended for personality disorders except to
treat chronic outward symptomatic mental illnesses, since personality disorders
are often comorbid with depression, substance abuse, and other maladaptive
behaviors). In fact, the last part of
the Handbook, Section VII, “Empirically Based Treatments,” is given over
entirely to effective therapies in treatment of personality disorders, and how
best to utilize them.
The
role of adverse social environment is especially brought home when we consider
the cases of two contemporary notorious individuals. Serial killer Ted Bundy, for instance, was
left orphaned by the death of his parents and was raised by his grandfather,
who horrendously abused him. Bundy was an
outwardly charming individual who not only worked in a “Good Samaritan” job, as
phone responder to 911 emergencies, but also used his charm to disarm the women
in distress he encountered, and then rape and murder them.
Former
President Donald Trump was (and is) frequently, publicly, regarded by mental
health authorities as suffering from narcissistic personality disorder
(however, psychiatrist Robert Jay Lifton regarded him as “solipsistic,” i.e.,
sensing no one but himself in interactions with others), and was certainly
noted as often publicly unhinged, especially after his defeat in the 2020
election, where he continually blamed his defeat (and in fact, still does) on
non-existent “voter fraud.” But an
article on Trump in Politico Magazine by Michael Kruse on December 20,
2020, “Is Trump Cracking Under the Weight of Losing?” contained this telling
paragraph on his childhood and parental rearing:
Trump is who and how he is first and foremost because of his parents. His unwell mother couldn’t and didn’t give him the attention he wanted and needed, while his domineering father gave him attention but a wrong and warping kind—instilling in him a grim, zero-sum worldview with the dictate that the only option was to be “a winner.” Ever since, he responded so relentlessly to these harsh particulars of his loveless upbringing—the insatiable appetite for publicity, the crass, constant self-aggrandizement—that he became the president of the United States and arguably the most famous person alive. But from the time he was a boy, the way Trump has coped with the void he’s felt ultimately has been less a solution than a spotlight—it’s what’s made his most fundamental problem most manifest.
Don’t these two personality sketches encapsulate
much about the importance of a good, nurturing home social environment? Even over and above genetics, possibly?
This is also borne out in the ACE (Adverse
Childhood Experiences) study based on questionnaires given to 17,000 patients
of the Kaiser Permanente health insurance/medical provider organization in
California—which found out that childhood trauma could result in lifelong
mental health, relationship, and addiction problems. Specifically, a pamphlet I picked up free at
my medical clinic’s office, “Understanding Adverse Childhood Experiences”
(Prevent Child Abuse Publications, 2009), lists four types of parents who,
beyond physically or sexually abusing their children, can harm them through other
ways: by swearing at, belittling or
insulting their children; being a parent or parents who are mentally ill
themselves; abusing alcohol or using illegal drugs; or being a parent who went
to prison or engages in illegal activity.
In my particular case both of my parents were of this first type, and
may have been of the second type as well—but tellingly, while they accused me
of bringing shame upon the family by seeking psychiatric help, they themselves
would never, ever, consider it as appropriate for them! And though they never physically or sexually
harmed me, their constant, unhinged screaming at me in 15-minutes-at-a-time
raging tirades cowed and intimidated me, especially since their volatility was
entirely unpredictable. But as I’ve
written before, it takes only one thing to become a “natural” parent—the
ability to fuck! Even when no other
qualification is evident. So it was for
me as a result of such parents, later compounded by the also-negative social
environment of abusive Catholic small-town schools and deliberate physical
bullying and social ostracism of my classmates, further abetted by inept and
malfeasant psychiatric treatment at university clinics and CMHCs, which don’t
know what to do with a patient if they can’t drug or otherwise minimally
“manage” him/her.
But it should be emphasized, as it is in the
child-abuse-recovery manual, “Survivor to Thriver” (The Morris Center, 1995), that
when it is this kind of abuse and this kind
of parent, when it is, as said in law, “a consistent pattern,” when it is the
norm, and not just the rare, occasional freaking
out of a parent who’s having a bad day, that the problems stemming from child abuse fully arise.
No, it is the “consistent pattern” of the abuse, as it was for me with
my parents constantly screaming at me, and the teachers in the Catholic schools
I attended not caring at all that I was bullied and socially ostracized. This prevalent abuse is rightly called by
“Survivor to Thriver” “self-indulgence” on the part of parental and other
authority figures—and is something to be extirpated, not apologized for; and
certainly not to be glossed over or overlooked!
But eventually I was able to grow out of all this
to a substantial extent, much considerably due to a very able psychotherapist I
had at one particular CMHC, who stuck doggedly yet compassionately with me for
over a decade. In our parting session,
he said to me, “Congratulations. By
rights [i.e., by statistical probabilities] you should’ve been institutionalized,
incarcerated, a hopeless alcoholic or drug addict, a suicide, or otherwise
prematurely dead, but you turned out to be None of the Above.”
And yet—since my recovery didn’t come until quite
late in my life, I feel (properly, I consider) having been fundamentally robbed
by my parents, by my adverse parental and school-system social
environments. Which is why, for the
children’s sake, it’s better to deal with parental dysfunctions early in the
child’s life, and not let the effects fester throughout childhood, only to be
appropriately dealt with when the child has grown to be an adult—with so much
vital life and growing lost, in important ways, forever, even with later
recovery. Which may not be, may never
be, full recovery.
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