Welcome to Childhood Made Crazy, an interview series that takes a critical look at the current “mental disorders of childhood” model. This series is comprised of interviews with practitioners, parents, and other children’s advocates as well as pieces that investigate fundamental questions in the mental health field. Visit the following page to learn more about the series, to see which interviews are coming, and to learn about the topics under discussion: ericmaisel.com/interview-series/
Robert Berezin has practiced the long-term intensive psychotherapy of character for 45 years. He taught at the Department of Psychiatry at The Cambridge Hospital, Harvard Medical School for 30 years. He is the author of is Psychotherapy of Character: The Play of Consciousness in the Theater of the Brain. He has done extensive blogging on his website, Psychology Today, and Mad in America on a wide array of topics.
EM: How would you suggest a parent think about being told that his or her child meets the criteria for a mental disorder or a mental illness diagnosis?
RB: In my opinion raising our children well is the most important responsibility of adult life. Consequently helping children is a very timely subject. The range of problems for children are quite finite: acting out behaviorally, impulsivity, problems of concentration and learning; children can be phobic or anxious; children can be sad, apathetic, depressed; Children can develop obsessional or compulsive symptoms, even psychotic symptoms.
This is a terrible time for parents whose children are referred to the mental health system. The last thing in the world that any child needs is to be given a mental illness diagnosis or to be told they have a mental disorder. Children may certainly have problems, but they should not be thought of in terms of mental illness. They are just kids.
In today’s world of psychiatry children will almost definitely become labeled. If you are going to work with a professional, with whatever degree, it’s important for them to be clear that despite some insurance diagnosis, they understand that a child’s issues are not biological. Remember never use a label with a child (or an adult for that matter).
Most issues derive from family problems and school issues. Children with different temperaments will react with different kinds of symptoms. Do not ever accept a diagnosis of childhood manic-depression. Autism is a complicated issue. There are no doubt environmental issues that have altered the frequency of the diagnosis. Classical autism is very different from today’s autism. It is a serious neurological issue, not psychiatric. Autism is also over-diagnosed today, so be careful about that.
EM: How would you suggest a parent think about being told that his or her child ought to go on one or more than one psychiatric medication for his or her diagnosed mental disorder or mental illness?
RB: Honestly? Suggest to the parent that they find another therapist. In my opinion there are no conditions that would warrant psychiatric drugs. Antidepressants do nothing and can generate suicidal behavior among children of all ages. ADHD as a so-called disease is fictitious. Yes kids get out of control behaviorally and impulsively, along with having concentration issues. This comes from a child with an active temperament who needs clear boundaries and physical activity.
When they are too out of control there needs to be family therapy, and behavioral therapy, and the school needs to be adaptive. There is often trauma present with severely out of control children. Amphetamines are dangerous drugs. I disagree with their use. Likewise with other issues, there should be family work. Other drugs like benzodiazepines are also very destructive. With a good therapy things can work out very well.
EM: What if a parent currently has a child in treatment for a mental disorder? How should he or she monitor the treatment regimen and/or communicate with mental health professionals involved?
RB: By and large parents should always be involved in the treatment. Most issues with kids are family issues in the first place. With separate treatments, the parents need to meet periodically to make sure they are in sync with what is going on. Do not surrender to the system your own parental authority. They must work with the parents.
EM: What if a parent has a child who is taking psychiatric drugs and the child appears to be having adverse effects to those drugs or whose situation appears to worsening? What would you suggest the parent do?
RB: I am totally opposed to psychiatric drugs for children. Parents need to get a second opinion with a different kind of psychiatrist who understands that the problems of children are not biochemical. The child needs to tapered off his meds carefully. If a parent has a child on drugs and the situation is worsening, this is an emergency and there should be no hesitation. A child’s life may be at stake. There is a black box warning on antidepressants for a reason.
EM: In what ways might a parent help his or her child who is experiencing emotional difficulties in addition to, or different from, seeking traditional psychotherapy and/or psychopharmacology?
RB: I don’t have a great answer for this. It’s really hard these days to find a good treatment system. A good family-and-individual therapist continues in my opinion to be a constructive solution.
EM: What would you like to say to a parent whose child is in difficulty and who would like to put her trust in the current mental health system?
RB: Sadly, one should be very circumspect about trusting the current mental health system. I wouldn’t necessarily have said this 40 years ago, but things have seriously deteriorated.
EM: You’ve written The Play of Consciousness, the Psychotherapy of Character. What might parents get from that book that might help them?
RB: This isn’t a book about working with children per se. The book goes through early childhood, childhood, and adolescence to show how a child named Eddie’s character develops. It covers constructive and destructive issues of child rearing. It then illuminates how the psychotherapy of a late teenager changes his life.