Welcome to my blog, which speaks to parents, professionals who work with children, and policy makers. Through stories from my behavioral pediatrics practice (with details changed to protect privacy) I will show how contemporary research in child development can be applied to support parents in their efforts to facilitate their children’s healthy emotional development. I will address factors that converge to obstruct such support. These include limited access to quality mental health care, influences of a powerful health insurance industry and intensive marketing efforts by the pharmaceutical industry.

Wednesday, December 19, 2012

Adam Lanza and Preventive Mental Health Care


In keeping with my wish for continued meaningful dialogue in the wake of last week’s horrific events, I would like to expand upon what I mean by "preventive mental health care." I am referring to relationship-based care that focuses on young children and families. All of the best science of our time, at the interface of neuroscience, genetics and developmental psychology, tells us that by supporting parents and young children together we will have the best chance to promote both physical and emotional health.

This is not to say that when there are problems it is a parents "fault," nor certainly, as many parents fear, that a young child who is struggling is at risk for becoming a mass murderer. But the brain grows in relationships, and supporting relationships supports healthy brain growth. 

Early reporting suggests that Adam Lanza struggled with severe social anxiety from a young age. This is a description, not a DSM diagnosis.  His mother apparently had some kind of conflict with his school and ended up home schooling him (early reports that his mother worked at the school where the shooting occurred, that I refer to in my previous post, turned out to be incorrect.) 

I wonder if our best chance at preventing this horrific event would have been to carefully listen to these parents, including the father, when Adam was a young child, to understand their experience and find meaningful help for the whole family.

The  piece I Am Adam Lanza's Mother originally published in the Blue Review, that has now gone viral, offers a striking up-close view of how parents suffer in the face of a troubled young child. It offers evidence for the need for intensive help for parent and child together.  Simply labelling the child with a psychiatric disorder and prescribing medication is grossly inadequate care. 

Current standards of care in psychiatry, including both the focus on DSM diagnostic category, in psychiatrist and author Daniel Carlat’s words the “what” rather than the “why,” as well as over-reliance on psychiatric medication, is more narrow than my definition. Preventive mental health care consists of careful listening and support of parent-child relationships. 

On NPR this week there was a comment made that other countries with better gun control laws do not have these kind of events. But what if the important difference is that we are seriously behind in supporting young children and families with such things as parental leave for newborn care?

I wonder if there is some insight to be gained from the venom directed against me in some of the comments on my last post. I see similar venomous in comments on similar posts.They seem to represent an underlying rage (at least among those who comment on blogs) as well as the loss of the capacity to listen to each other.  Assumptions are made about me that are completely unfounded and could easily be dispelled by simply reading my bio and or most recent blog post.

We are as a society traumatized by this event, and by the continued horror of watching the funerals of these young children. To find a way to take meaningful action in the wake of this trauma, we all need to calm down and take a collective deep breath. Perhaps the opening point of meaningful dialogue would be an effort on all sides to take the time to listen to each other.

2 comments:

  1. I totally agree. The importance of early development and relationships cannot be over-estimated. I would say though that I still think the key difference between the US and other nations is the gun control issue. Here in the UK we have plenty of troubled young people. The riots of summer 2011 were a stark example of this. Yet the number of deaths during these riots were minimal considering the magnitude of the event. But if the access to guns had been as easy as it is in the US things could have been quite different.

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    1. It sounds like what you're saying is that with gun control, you have the freedom to neglect your youth?

      I would prefer to bring values back into the family and nurture the younger generation.

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