Thread by @docbhooshan

#Parenting #Thread

Most people are aware of terrible effects of abusive parenting. Narcissistic and uncaring parents usually top the list of bad parenting models.

In clinical practice i see one more personality quality to be corrosive but almost unknown to people.

This personality characteristic is high level of anxiety in one parent or both.

Parent's anxiety is often disguised as "care". And this is the real root of the problem.

Anxious people in powerful position of a parent can become extremely controlling. Their worldview of 🌎 being a nasty place can percolate into child's worldview.

What other option does the child have?

family, friends, teachers, etc can provide a more balanced, positive worldview.
But,
Anxious parents are vigilant as well. It goes with the territory. They control child's exposure to "other" people and try to eliminate them from child's life. Talk of being protective.

If the child has inherited these anxious traits in their temperament, then they fall in this enmeshed mutually satisfying relationship with the parent.
But a child with less anxiety will eventually see the world in their own way and a conflict starts at home.

Child can rebel and challenge 🌎 view of the parent, throw away restrictions that anxious parents put on the family.

In trying to hold the child back anxious parent may use all the emotions like anger, guilt, shame and even so called love! Often in unrelenting cycles.

Long standing anxiety often leads to states of chronic depression. Losing a child to the bad world is often the last stick.

Many times for mothers, menopausal period, child's late adolescence turns up together. It is a double whammy for the mother.

Situation gets really complex and if father is on child's side at such crucial time, then 🤯.

Angry depression are not uncommon. Conflict escalates and situation becomes unbearable for all involved.

Though there are treatments available to treat this so called irritable depression, writing a prescription or suggesting psychotherapy for mother is a reductionist view of the situation and it fails.

if the family has suffered due to one parent's anxiety for long time, they may recruit the psychiatrist to finally label the anxious person and make them irrelevant in the family.

My take is - such situations are best helped by family therapy.

Looking at the family dynamics and untangling is important. New, healthy patterns of communication, power dynamics and support must emerge to help this family stay together in a meaningful way.

Unfortunately, one in ten or fifteen families coming to my clinic will go through this journey.

Most often, the child is presented to me as "troublemaker" and a correction is sought.

A psychiatrist is supposed to "counsel" the child into submission to parental wish.

All this is again disguised as worry and concern about child's future!

And you thought, we are pill pushers and writers of prescriptions?

Most psychiatrists in India seeing 30-50 patients per day (some see 100!) will write a prescription and a referral to "counselor" (who almost always has no psychotherapy training! )

There are no simple, quick and affordable answers to complexities of human life and society.

So for now, i must be satisfied with strike rate of 1:10-15 for troubled families in a low income country.

This is now. And this is how it is.