Sunday, March 8, 2009

Thumbnail Psychiatry

by Richard Crews

A baby who does not form deep emotional connections during the first year of life grows up to be psychotic. Usually this is first dramatically manifest by a schizophrenic episode during the terrors and tribulations--essentially the forced independence--of adolescence or early adulthood.

On the other hand, if the failed connections are due to sensory input overload, the psychosis is evident earlier than adolescent schizophrenia; it is evident as autism during the first couple of years of life. Autism, that is, sensory input overload, can be caused either of two ways: genetically--that is, by genetically faulty brain wiring; or toxically by disruption of normal brain wiring by exposure to some of the myriad of modern toxic chemicals (cleaners, pesticides, industrial solvents--we don't know which) during the brain's complicated and delicately staged development.

There is no "cure" for autism, although carefully restricting and restructuring the overloading sensory input can help the afflicted individual feel and function better. Similarly, there is no "cure" for schizophrenia, although careful emotional protection and saving the individual from the stresses and confusions of forced independence can help.

Moving on in developmental life, a baby who successfully navigates the first year of life but then does not form the further, deep, more complex emotional connections needed between the ages of one and five years grows up to be depressed. Depression is essentially turning one's anger at oneself because one does not have the necessary safe relationships to turn it outward.

Why does this come about? The world is necessarily sometimes confusing and frustrating. The prototype of the ways for reacting to this is fear or anger (fight or flight). In deep, emotional imagination, if one's anger can destroy the care-giving world, then one must spare the world and turn it against oneself.

If the emotional-connection deficit occurs early in the one-to-five year period, an adult will experience psychotic depression during the adult years when life begins to disappoint intractably. Or, if later, manic-depression. If later still, depression of neurotic proportions.

Lastly (and most healthfully) in this chain of depressions is the so-called "normal grief reaction" to a severe life disappointment. This is a depression one has the fundamental emotional strength (built during that one-to-five-year period) to recover from; one can rebuild one's effective functioning and joy in life.

If a child is able--both biologically (that is, neurologically) and also socially (that is, by having strong, early parental or parent-like ties)--to form those crucial emotional connections during the first five years of life, emotional difficulties will be neurotic (rather than psychotic or profoundly--that is, psychotically--depressive). A neurotic syndrome or complex is a learned, maladaptive emotional (and, consequently, behavioral) response.

The ways we respond to emotional challenges are not inborn, they are learned. And the possible range of emotional responses is quite broad. Someone who gets their "toes stepped on" (in any of a hundred senses) can react in many different ways: by feeling (and, therefore, acting) angry, or scared, or withdrawn, or puzzled, or amused, etc. Our parents teach us how to respond. We carry these learned responses forward in life. Sometimes they work well--they are effective; sometimes they are maladaptive.

In addition to teaching us the "correct" way to respond, parental figures also teach us a "cover story"--the same one they learned from their parents: that the reaction you have learned, is not learned, it is inborn--it is a natural, normal, inescapable, biological "given." Neurotic complexes or syndromes (or emotional patterns) are treatable--they can be relearned; but this is difficult because of the "cover story."