This title was chosen by my son for reasons which will soon be obvious. His youngest has just left home, this time for good, and he and Sue are now presiding over the proverbial empty nest. It is a frequently quoted truism that if you truly love someone you will let them go when it is in their best interest to leave. I was reminded of this last night as I watched Casablanca…one of my favorite movies in which that theme was paramount. Though it is a noble act to let go of those you love, separation is painful, and usually results in significant changes in our lives.
We experience multiple types of transitions during our lifetimes, but since we are at heart social beings, or to put it more crudely, tribal in nature, changes in our relationships are apt to generate the most intense feelings. It is something of a paradox that as the world gets smaller, we find so many people of whom we care to be geographically farther away. Yes, indeed we are able to communicate with ease yet Facebook is a rather poor substitute for a next-door neighbor, or a relative living in the neighborhood. Prior to the industrial revolution, one’s cadre of friends and relatives was unlikely to change very much, and most people were born and died in the same place, often even in the same house. Now neighborhoods are in a constant state of flux, and there is a lower expectation of lifelong relationships.

No wonder our children are among the very most important people of our lives. Since humans require nearly 2 decades to reach maturity and carry our DNA, we tend to form very strong bonds. We are often identified as “Johnny’s” father or mother. We live vicariously through them and share their triumphs, failures, joys, and sorrows. In many ways they are our second chance at life as we attempt to steer them away from repeating our mistakes. As the years go by our intimate involvement in their lives blurs with our own–they become part of us and in doing so shape our identity, i.e. who we are.
With all that in mind, it is not surprising that separation anxiety is a common affliction. When the kids grow up and leave, something more than their presence is missing. It is as if a part of ourselves is gone. Not only is the nest empty, but we feel an emptiness within ourselves, a kind of psychological amputation. In my experience, this emptiness is most profound when the youngest one leaves  for with it comes the realization that nothing will ever be the same. This time they are leaving to build their own nest.
Life is an ever-changing process. We begin as totally helpless and dependent creatures and experience a myriad of transitions during our lifetime all designed to produce an individual capable of building and presiding over that nest. Some of those changes are more dramatic than others. There are the first steps, the first words, the first solo bicycle ride, the first day of school, the first sleep over and a few thousand other adventures all with a goal of achieving sufficient independence to allow them to face the world on their own.
But it is not all sweetness and light. There is the messiness, the lack of discipline, the terrible twos, the out of bounds phase, the adolescent rebellion, the sleepless nights, and the continued testing of limits to name a few of the frustrations inherent in the child-rearing business. Those little buggers are also expensive. According to the USDA the average cost of rearing a child in 2016 was over $245,000 which does not include costs for higher education (but for the kids, I could have been a millionaire). Considering all the chaos they generate it is little wonder that we don’t occasionally wish them to be grown up however; one should keep in mind the maxim to “be careful what you wish for.”
According to the Bureau of Labor Statistics 67.3 % of high school graduates enrolled in college last year (2017). It seems safe to assume that most of these kids would leave home while in school, but retain a close connection to their old familiar environs. In many cases the college transition is a prelude and training for that final fly away. The days when we dumped kids and their gear off to a strange new environment were certainly memorable to Barb and me.
Our first experience with the off to college scenario was painful for all involved. Molly, our firstborn (now deceased), who suffered from serious medical and emotional problems was unable to complete that transition. Next in the line of succession was Peter, who was much too macho to display his feelings, but I was already missing him by the time we pulled away from his dorm. After a four-year hiatus, it was Trudy’s turn. Trudy, the adventurous one, was on the phone almost immediately, tearful and very upset to find beer being consumed at the sorority rush parties that she attended. We had no idea where this came from for temperance had never been emphasized at home. As you probably already suspect. her distress was short lived and as was her habit she soon became involved in everything.
Of course, those separations were painful, but none so telling as Maggie’s departure for we were now returning to a house inhabited only by Barb, myself and Grover the dog. Maggie was one who had insisted on an out of state school, for she was eager to assert her independent status. She wanted distance from childhood connections. Her reaction to the college transition was a convincing testimonial for that “be careful what you wish for” thing. Permanently engraved in my memory is the sight of that sobbing, skinny little red-haired girl who stood there all alone in that huge empty parking lot making feeble attempts to wave goodbye as we pulled away. Barb wanted to go for one last hug, but I insisted she had already had several last hugs. We were later told that she cried for the next month and lost 20 pounds. [See an earlier blog post about Separation Anxiety + Mental Health}
In case you are thinking this gang of mine is the Partridge family incarnate, think again. It is true that to date we have come through our transitions relatively unscathed, but not without trials and tribulations. In spite of their best efforts some families are overwhelmed by circumstances beyond their control. Barb and I are indeed fortunate that in spite of our screw-ups we have ended up with 2 generations of exceptional people, and the beat goes on.
It so happens that this month marks the beginning of significant transitions for every one of my Grandchildren which of course they will undoubtedly handle better than do their parents (or Grandparents for that matter). My three oldest grandchildren are already emancipated and starting new and more challenging jobs. Another is off to her first year in college, and our youngest is entering high school. As mentioned in my opening statement, Carter’s room is empty, and home is now in another city far away. Trudy’s is the only nest still occupied.
Whatever distress the kids may feel from leaving those years of memories behind is apt to be short lived compared to that of their parents. There is hope for Mom and Dad however. In return for enduring the vicissitudes of child rearing God has rewarded us with grandchildren. Thus, we have an opportunity to get all the goodies and none of the crappy stuff ,which leaves me wondering what it would be like to be a great grandparent. Stay tuned for the answer!


These days, it is difficult to forget Mother’s Day as there are plenty of reminders on TV, radio, newspapers, billboards, and now even the internet.  Although the holiday (it even seems disrespectful to call it that) has been a boon to florists, candy companies, and greeting card businesses, it also generates a type of sentiment not found in other celebrations.  According to Mr. Google, there have been times set aside to venerate mothers and motherhood since ancient times, but our modern version is said to have its origins in Grafton, West Virginia in 1908, when Anna Jarvis promoted the idea of a day to honor mothers. She was soon to be disappointed when the day which was sacred to her became commercialized.  Anna spent the rest of her life attempting to correct the image which she felt dishonored her Mother, and died penniless in an institution.


We are all aware that motherhood is necessary for the propagation of the species, but the relationship between a mother and her offspring is like no other.  Mothers will fight to the death and endure any amount of hardship to protect and nurture their offspring.  This is true for most of the animal kingdom, but especially for humans.  Most animals who have live births nurture their young until the kids are able to make it on their own, but human moms never stop mothering.  You might think since they are around for a couple of decades it might be that they simply become like an old pair of shoes which you don’t like to get rid of, but there seems to be much more to it than that.

Back in the old days, when country doctors did pretty much everything except major surgery, I delivered a lot of babies.  Many times I would hear my patients in labor crying out that they would never go through this pain again, but when that baby was delivered into her arms the room would brighten with her smile.  The ordeal of birthing would soon be forgotten and often at the six weeks checkup there would be talks of having another child.  The mother of my children describes her feelings of holding our babies as a feeling of joy which she could not find words to describe.

Screen Shot 2017-05-13 at 8.30.46 PM.png

Kids do grow up and leave the nest, but they carry a piece of Mom with them for the rest of their lives.  No one or no other relationship will have such a profound effect on their lives.  Without nurture, it has been shown that children will grow up with significant deficits similar to those seen in Harlow’s monkeys when they were deprived of maternal contact.  With that in mind, it seems clear that mothers’ roles involve much more than merely giving birth and providing sustenance.

When children are born, they have no sense of who or what they are.  One can see an infant at times appearing to discover his toes and other body parts.  Likewise, in their early years, they will need help to develop an identity, and to do so, they will depend upon those with whom they spend the most time. However, perhaps the most important issue they learn concerns their lovability.  In my practice, those who felt as if they were unlovable were among the most unhappy.  They found it virtually impossible to establish meaningful relationships.  They lacked self-esteem, often to the point of self-loathing; consequently, they were vulnerable to exploitation of all kinds.  They were often used and abused, which they felt they deserved.  This opinion of self, which appears to have its origins in childhood, resists change and seems to persist throughout life even when told their picture of themselves is inaccurate.


Obviously, the only way one can know they are lovable is to be loved, which brings us back to the subject of mothers.  Traditionally, they are the ones in charge of loving.  Their love is constant, unremitting and lifelong.  They continue to love even when their children are total jerks or perpetrate the most dastardly of deeds.  It has been said that a father’s love is conditional.  I have always resented that characterization, for I felt I loved the kids as much as did Barb, yet I must admit that her capacity for forgiveness and tolerance exceeds mine.  After all, I was only an observer and not a participant in their entry to this world.

If you think mothers are lovers, take a look at grandmothers.  With the responsibilities of teaching kids manners, discipline and societal survival skills gone, there comes an avalanche of unimpeded love.  For me, grandparenthood has been an opportunity to enjoy the kids without feeling any responsibility.  I have concluded that grandparenthood is God’s reward for enduring the vicissitudes of parenthood.

It is true that in the past mothers have received a bad rap from we psychiatrists.  Mothers have been accused by us of causing everything from autism to homosexuality.  This fad began with Freud, who attempted to unravel some of the mysteries of early childhood.  Although his work provided an impetus to learn more about the effects of childhood experiences on later life, many of his conclusions have been discredited.


In the past, motherhood was a full time job.  Although mothers would engage in activities outside the home (my grandmother helped with the milking), their primary function was to care for their families.  Today’s mothers amaze me in that a majority of them also have full time jobs outside the home.  That puts an exclamation point after the time honored phrase “woman’s work is never done.”  Granted, fathers are now more involved in domestic activities than in the past, but I seem to remember reading something about a study that indicated the duties of the woman of house have changed little over the years.  Without our so-called modern household conveniences, it would probably be impossible for the hardiest of souls to accomplish what these warrior mothers do.

However, the most amazing mothers, to me, are the single moms who take on the total responsibility for feeding, clothing, teaching, disciplining and loving their children.  The fact that many single mothers accomplish this without any outside help is inspiring, especially when one considers the number of kids who grow up to be good people.  Unfortunately, these mothers are often derided rather than praised.


You should not be surprised to learn that I too had a mother.  She loved me for no good reason that I could fathom, and I loved her too (although I would never admit it when I was growing up).  Mom was not a hugger.  She was a patter—i.e. when she was glad to see me, or pleased with something I had done, she would wrinkle her nose and pat me on the arm or shoulder a couple of times.  I suspect this was a result of her childhood, for her family was not demonstrably affectionate and never wanted to be “showy.”  She was a great cook and enjoyed feeding us.  In later years, a visit would see her “throw together some leftovers” with little obvious effort, and they would always be delicious.  I was a child of the Depression and barely recall my parents on occasion telling my brother and I they wanted us to eat first.  It would be years later before l realized why they did that.


It has been my good fortune to meet and marry someone who was born to nurture, and I have watched her in action for quite a few years.  When we were married, she announced that she wanted to have four children.  I thought two would be plenty, so we reached a Barb-type compromise and had four.  Since they were all exceptional from the very get go, I agreed to keep them all.  It was a good decision.

As with most mothers, Barb continues to exude love from a reservoir that never runs dry.  Every now and then, she will reminisce about those days when she had them all fed, bathed and tucked in, and how she felt “so rich.”  When we see a baby in the grocery, she tells me how she would like to hold it.  If there is a young one in a restaurant, she will approach the mother ask its age and tell her how beautiful is her baby (she seems to have never seen an ugly one).  Those tear jerking ads on TV featuring small kids do a number on her.  She insists were she a little younger she would adopt some of those starving African kids.

As for the grandchildren, don’t ask unless you have some time to spare.  It takes a while to tell you how wonderful they all are, but you will be able to see those tired brown eyes come to life.  Like it or not, you will probably also hear the complete package which includes their parents who are also “above average.”


Meanwhile, it is nice to send your mother flowers and stuff, but all she really wants from you is love.  She deserves all you have to give.


Tragedies involving children always get a lot of press, and the most recent example concerned a school bus accident in Tennessee in which six children were killed. In such cases, there is usually a search to determine who was at fault, and this was no exception. If an act of human negligence is found to be the cause, we can add outrage to our feelings of sadness and horror. The headlines become larger, and blaming reassures us that there is someone out their more careless and uncaring than ourselves.


In such cases as this, we only need to look as far as the nearest mirror to see who is responsible. It is true that there were warnings about this driver, which should have been enough to prompt his removal from such an important job; however, no action was taken. In such cases, should responsibility not be shared by those who have the ability to prevent such a horrendous tragedy? We profess that these bus drivers carry our most precious cargo, so should they not receive the highest level of scrutiny? Qualifications for school bus drivers vary widely from state to state. Pennsylvania requires considerable classroom and on-the-road training, physical and mental evaluations, and extensive background checks, while my state (Ohio) requires only a commercial license with passenger designation. I suspect that Brink’s truck drivers may be more highly trained and investigated. After all, they are carrying money.

There was a school bus accident in my county six years ago, and 7-year-old Kacey was killed. Video from the inboard surveillance seemed to show that the driver had lost consciousness. I was surprised to learn that in our state, school buses were not required to be equipped with seat belts. This made no sense to me then, nor does it now. Since 1968, I have been required by law to fasten my seat belt, yet our children are left to fend for themselves in a large, top-heavy, tin can mounted on a truck chassis. Following the accident, there was talk by our state legislators of requiring seat belts, but, as is often the case with politicians, they were long on talk but short on action. After reading that the bus in Tennessee did not have belts, I inquired at my local school board office to find out about the status of the seat belt issue and was told that our buses still do not have any physical restraints. When I asked why, I was told that the state had not mandated them yet (not an adequate answer in my opinion).

The latest information I could find on the subject was that only six states mandated seat belts on all school buses. The National Highway Traffic Safety Administration (NHTSA) does not require or recommend seat belts on all buses weighing more than 10,000 pounds. They concluded that “the crash forces experienced by occupants of (heavier) buses are much less than that experienced by occupants of cars, light trucks, or vans.” Could this mean that my 10th grade physics teacher was “full of it” when he gave us that force formula f=ma?

The NHTSA has initiated a concept they call “compartmentalization,” which they insist offers superior protection in crashes. Protection is offered by the use of high seatbacks which are highly padded, and designed to absorb the shock of a frontal crash. Crash tests confirm their effectiveness in head on crashes. NHTSA in 2002 testified in Congress that seat belts were unnecessary, pointing out that school bus travel was the safest form of ground transportation available. Indeed, their statistics are impressive when one considers 440,000 school buses travel 4.4 billion miles each year carrying 24 million kids with only six fatalities.

Studies by the University of Alabama in collaboration with NHTSA concluded that “the cost of installing seat belts on every bus is prohibitive.” They estimated that it would cost $8,000 to $15,000 per bus. The studies also concluded that schools would need to increase their bus fleets by approximately 15% due to space requirements for belts with a total cost of $117 million per state. Their final opinion was “costs far exceed benefits.” That and similar statements undoubtedly lead a group like The National Coalition for School Bus Safety to say the issue is influenced by “an economically driven industry.” These statements also lead us to the question: how much are we willing to pay for a few kids’ lives?

In December 2010, reported an accident in Texas similar to both the recent one in Chattanooga and the one that happened in my town. In 2006, a Texas school bus carried a high school girls’ soccer team when it was forced off the road into a ditch and rolled over. One girl was thrown through the window, and her arm was pinned under the bus, resulting in serious injury. Two other girls were killed, and there were other less serious injuries.

One of the fathers was convinced that a seat belt would have saved his daughter’s life, and he vowed to do all he could to see that all school buses would be equipped with seat belts by law. The Texas A&M Transportation Institute reached the same conclusions as had the University of Alabama, but, in spite of those objections, the law passed largely due to four years of continuous lobbying by the victim’s father. There must have been some buyer’s remorse, for the funds designated for the project were immediately cut by two thirds. I have no recent information about the status of the law’s implementation.

The thing these nine children have in common is that they all died in a school bus that flipped. The design engineers who invented the “compartmentalization” strategy to prevent injury must realize that Ike Newton was right about that gravity thing; therefore, if a “compartment” does not have a lid on it, the contents are likely to fall out and scatter every which way when it is turned upside down.


We will never know if seat belts would have saved Kasey or any of those other kids, but we do know that compartmentalization did not work for them. There are instances recorded that imply lives would be saved with seat belts. School administrators in districts where seat belts are used also report fewer problems with driver distraction, bullying and disciplinary problems.

Another unanswered question is to what effect the addition of seatbelts could have on reducing non-fatal injuries. The Ohio Department of public safety reported 1,590 school bus accidents last year, resulting in 282 injuries. I could find no information as to the seriousness of those injuries.

The only good news resulting from the Tennessee tragedy is that it has reawakened the debate about school bus seat belts. The NHTSA has reversed their position and now favor seat belts for school busses. Administrator Mark Rosekind is quoted in an Associated Press release that, even though school busses are the safest means of transport to and from school, “they could be safer.” The good news is that he has strongly recommended a national initiative to require lap and shoulder seat belts since November 2015; the bad news is that no action has been taken in that regard.

The last directive by the NHTSA regarding seat belts was in 2013, when a policy was implemented requiring new buses be equipped with seat belts with two exceptions: namely, transit busses and, you guessed it, school buses. I, for one, was incensed to read that the powers that be prioritize the safety of passenger buses above that of children, but, in spite of the good words by Mr. Rosekind, that policy appears to still be in place.

Just a few days ago Mr. Rosekind once again voiced his unequivocal support for seat belts. He was convinced that school bus seat belts had saved lives and that others could have been saved if protected by belts. He went on to estimate that 70% of school bus deaths could have been prevented by seat belts. Nevertheless, despite the mountains of data that have been collected, he declined to issue a directive and planned more study of the subject. A major concern was how to finance such a program, and he even suggested that some school districts might need to be exempted from the requirement for financial reasons. Once again, money appears to factor in to a life-or-death decision.

According to a report in the November 28 issue of People/Crime, five days before the Chattanooga accident, one of the elementary student survivors wrote the following: “the driver was doing sharp turns and he made me fly over the next seat. We need seat belts.”

Out of the mouths of babes!

Note from the editor:

I found this topic particularly interesting, so Eshrink and I compiled a list of some articles for further reading.

Data and Statistics of School Bus Fatalities Over Ten Years

USA Today Article


10 Ways To Screw Up Your Kids Without Even Trying

During my years in the practice of psychiatry, I frequently heard parents of children who were in trouble lament: “Where did I go wrong? I did my best to be a good parent.”  Some might even point out they had read Dr. Spock cover to cover more than once and Dr. Brazelton’s Touchpoints books.  I always tried to reassure them that they were not the only people influential in their kid’s lives and that we parents are probably not as powerful as we think we are.  Most people would agree that children are quite capable of screwing up their lives without help; however, I think there are some ways in which parents can contribute to the process.

1)   Protect and serve

I recently had a conversation with a retired school teacher who mentioned her difficulty dealing with the so-called helicopter parents who fly in at the first sign that anyone dare suggest their little cherub could do something wrong, or be imperfect in any way.  A note to the parent suggesting something less than perfection in behavior or scholastic achievement is likely to result in a visit from the enraged parent to defend her poor little helpless child.  The parent’s explanation is to blame someone else, usually the teacher, for the problem.


My teacher friend seemed have less than a high regard for helicopter parents (but to be precise, “helicopter mothers”). However, my teacher friend apparently had not considered that this behavior could be of immense value to the child in learning to cope with the exigencies of life.  She did not take into account that the assumption of responsibility is not a highly valued quality in modern society, and that for little Johnny to learn to blame others for his problems could smooth the way  for him to grow up to be very successful should he choose the right vocation.  A career in politics comes to mind.


Additonally, the helicopter parent may also benefit from the practice of always defending little Johnny for these skills might be valuable later in juvenile court.

2)   Don’t snoop

Most kids seem to feel they have a constitutional right to privacy.  In my personal experience, nothing a parent can do is apt to generate more ire in kids than the violation of this precept, and to snoop places a parent at great risk.  Besides, the discovery of a stash of condoms, or weed could lead to a lot of trouble.  From the little I know about the electronic stuff, it seems virtually impossible to snoop. Therefore, a parent might as well hope for the best about what is going on in their child’s life.  Your child is apt to guard the password to his/her computer with their life, and you certainly would not want to suggest he/she is untrustworthy.


It is mandatory that your child has a TV and/or computer in his room where he can escape from the family and watch skin flicks without interruption.  It is important to remember like what the airplane has done for transportation, TV porn has done for sex education with the added advantage that there is no need to have that embarrassing conversation about the birds and the bees. In short you can avoid a lot of controversy by treating the door to Johnny’s room as if it were the entrance to a bank vault.

3)   Don’t listen

not listeningSome so-called experts advise that children should be allowed to express      themselves.  I grew up hearing that “children should be seen not heard” which seemed to work out alright for me, as I grew to be as opinionated as the next guy.  I suggest that kids are already mouthy enough, so it makes sense to tell them to shut up and do as they are told.

4)   Encourage in-home activities

Much has been made about the detrimental effects to children of video games and cell phones.  In my opinion these instruments have become the greatest boon to motherhood since Similac.  No longer does Mom need to worry about little Johnny or Mary being accosted by some predator.  She no longer needs to deal with muddy and grass stained clothes nor scrapes, bruises, or even an occasional broken bone.  She always knows where to find them for they are either in front of the TV or on their cell phone.

video games.png

Some people insist that these gadgets lead to a sedentary lifestyle resulting in problems such as obesity, poor muscle tone and a variety of medical problems such as type 2 diabetes and delayed reasoning skills, but they must not have noticed the dexterity of kids’ thumbs in action when they are texting.  One can safely assume that as our digital age progresses, such a skill could be more valuable to your child than a burgeoning muscle mass.

5) Overindulge whenever possible                  

In this age of materialism, the most effective way to show our children we love them is to shower them with gifts.

overindulged childrenIf you celebrate Christmas you should consider that the kids are unlikely to remember any of that religious stuff, but they will never forget Santa Claus.  Possessions are also an important measure of one’s status in society, and this principle applies not only to the kids but to the entire family.  Our society has made giant strides in this area since I was a kid.  When I was in high school there was only one student with a car and his dad owned a car lot.   Now when I pass the high school parking lot it is jammed with cars with an overflow across the street in the church parking lot.  It is true that some are not late models, but even those less wealthy kids need not suffer the humiliation of being seen boarding a school bus.

I am well aware that this may put a strain on the family budget; however one should bear in mind that credit card companies are usually very accommodating when it comes to increasing your credit limit.  If all else fails Dad can always get a second job or a third one if he already has two.

6) Keep them guessing

There has been much made by so called authorities on child rearing about the importance of consistency, but I feel consistency is overrated.  B. F. Skinner’s experiments have clearly demonstrated that intermittent positive reinforcement is the most effective tool to shape behaviors; consequently, house rules should never be rigidly fixed, but fluid and subject to change at the whim of those in charge.  To be confident of the reaction to his actions is apt to render him a lazy thinker, while confusion as to an outcome will require deductive reasoning.  Some kids are likely to initiate certain behaviors in order to see what reaction it will generate.


It is also helpful if the parents disagree on many issues.  This can result in valuable training in how to manipulate people, e.g., play one against the other.  In the matter of discipline most of us can remember the old “wait until your dad gets home threat.”  In the event that Mom remembered to tell him his response would largely depend on his mood or if he had stopped for a couple of beers on the way home.   It could result in anything from “a good talking to” to a trip to the woodshed.  In the latter case with today’s attitudes towards corporal punishment confiscation of the perpetrator’s cell phone would be necessary to prevent him/her from calling Children’ s Service.

7) Shame them whenever possible

I once wore a dunce cap.  Few who read this will be old enough to remember the power of the dunce cap.  It was usually cone shaped and made of paper, and its adornment was accompanied by a sentence of standing in the corner for a lengthy period of time.  Its presence announced to the world that one had done something terrible.   In my case, I had the audacity to talk in class.  It was a two-room school and I was in the second grade. I was spared the paddle, which was displayed prominently behind the teacher’s desk, but was assured that it would find my backside were my behavior not to change.  To make matters worse, the teacher was my uncle which guaranteed that my parents would learn all about my transgression.


The humiliation was made complete by the teasing I suffered at the hands of the other kids not to mention the “dressing down” (The time out strategy had yet to be invented) by my parents.  The whole experience was remarkably effective as I never talked in class again.  From that incident and others I suggest you not hesitate to use ridicule, and shame to shape your child’s behavior.

8) Teach humility

Children are born with an exaggerated sense of their own importance.   Babies seem to know that if they cry people will hop to and immediately make them happy.   In many cases this persists through the teen years, and has been accentuated by the propaganda of Mr. Roberts who was able to convince legions of rug rats that they were special.  The process of comparing your child to those with superior talent or success will go a long way towards bringing him down to earth.  It will also provide him with goals, but at the same time help him face his limitations so as not to waste energy or time on trying to become something he is not.  Children need to face reality; consequently, if they are stupid, ugly, awkward,  or weird they need to know about it. Yes, I am aware of all that psycho- babble about self-esteem, but if the kid is a slob like his old man, he needs to be told about it.

9) Don’t have dinner together

This is a subject dear to my heart for mealtime is my favorite time of the day, but come to think of it all the time is mealtime for me.  However; I don’t feel that I am unique in that regard for modern families have given up the ritual of all sitting down together at an appointed time to break bread.  That is probably just as well as a lot of time is wasted on such things as reviewing each person’s day, and making small talk.  It was often the only time of the day when the entire family would spend time together.  There were also the obligatory lessons in table manners, nutrition and hand washing.  At times minor squabbles would energize the experience, but all in all it was not very exciting.eating togetherModern families (not the one on TV) have no time for such foolishness.  There are too many activities and conflicting schedules to even consider such an old fashioned habit.  Mom may have trouble making it home from work in time for dinner let alone prepare a full course meal.  Often ordering a pizza or stopping by for a sack of Big Macs makes a lot of sense, but responsible parents will all be sure to keep a jar of peanut butter as backup.   Crock pots have been a boon to today’s families as food can be made available at anytime and the ordeal of eating together can be avoided.   The old policy of sit down family dinners pales when compared to the convenience of an every man for himself system.


10) The responsibility myth

One of the most difficult problems for families is deciding who should be responsible for taking out the trash.  If the kids are assigned to take turns, there will be endless loud and disturbing bickering about who did it last.  The timeworn strategy of listing a schedule on the refrigerator rarely works as it is subject to editing and will often disappear before it is implemented.  When responsibility is fixed, you will witness such creative thinking in the formulation of reasons why the chore was not done that you can be very proud.


Eventually, you will come to realize that the energy required to fix responsibility, not to mention the frustration involved will lead you to conclude that the best solution is for you to take it out yourself.

I am reminded of an incident in my own family from many years ago involving my son.  Barb had become very frustrated with him.  She complained that his room was a mess. When she ordered him to pick up the clutter on his floor he simply shoved it all under the bed.  She was incensed and insisted that I “do something.”  When I asked what I should do, she replied: “Go up there and stay with him and make him be responsible.” My brilliant retort was:  “If I do that, then who is responsible?” I did come up with an equally brilliant solution however.  I simply walked upstairs and closed the door to his room.

You cannot force your child to be responsible so let him/her go.  As an adult they will learn all about the wages of irresponsibility soon enough, besides you don’t need the hassle. It’s just a lot of work.


Some of you may not wish to screw up your children’s lives, but before you come to that conclusion you might want to consider all the ways they have screwed up yours.  Think of all the sleepless nights, the school PTA/PTO meetings, volunteering, chauffeuring, the crying, whining, and the dirty diapers not to mention the enormous sums of money spent on them.  You will need to decide if it is worth it.  In spite of my best efforts to screw up my kids’ lives, they l have all turned out well.  Go figure.

DISLAIMER:  I strongly deny receipt of any remuneration from the American Psychiatric Association in return for the recruiting of patients.


Separation Anxiety + Mental Health

LincolnLincoln is a very large black Labrador retriever, who has bonded to my son-in-law. Bonded does not adequately describe this relationship for it is as if Lincoln is attached to Jim by a very short invisible rope. Recently, during a visit to my daughter’s home I had the opportunity to witness a hilarious demonstration of this attachment. Jim was mowing his yard with Lincoln at his heels, and when he turned to push the mower in the opposite direction Lincoln followed. This continued with Lincoln following back and forth until the job was done. In a similar manner, he is rarely separated by more than a few feet from his master. When Jim leaves he is frantic, constantly watching the door, pacing back and forth, obviously quite agitated. Lincoln would seem to be the poster child (excuse me, poster dog) for the diagnosis of separation anxiety.

According to the ASPCA web site, the condition is not uncommon among dogs, and is most common among those rescued from kennels, and those who have been moved or have lost their major guardian. In other words, it seems that dogs know when they have a good deal and worry that they might lose it. Lincoln fits that category as he had been given up by his family and given to Jim. Watching Lincoln started me wondering if we humans are all that much different from him.

Most of us can recall at least one incident when we experienced “homesickness.” In my own case I remember vividly very intense feelings when left to stay with my Grandparents.   I never have been able to find words to adequately describe those feelings, but have likened it to a kind of psychological amputation in that a part of one’s self is missing. Those who have experienced it will understand how painful it can be.

Leaving for college is a common precipitant for it represents an abrupt breaking of many of the bonds attached to things familiar and to those upon whom we are dependent. My youngest daughter Maggie (currently my editor and the one who bears total responsibility for talking me into writing all this stuff) was the most memorable example of this phenomenon; although, her siblings also experienced it to some degree. Maggie was eager to fly away from the confines of a boring small town to gain freedom from parents who continued to treat her as if she were a child and to subject her to all kinds of stupid rules. As a matter of fact she was so convinced that geography would be the solution to her discontent that she refused to consider any school within her home state.

The vision of that skinny little girl surrounded by huge limestone buildings gently sobbing and feebly waving a goodbye as we pulled out of that parking lot has never left me. Little did she know the effects her mother and I felt from that poignant scene, for we were heading home to an empty nest. Nothing would ever be the same. Maggie was a prime example of the wisdom of the admonition that one should be careful what he/she wishes. She lost nearly 20 pounds during her first two weeks, and was barely able to function according to her roommate who called us to express her concern. Barb and I resisted our impulse to go save her from this horrible fate, and as one would expect she soon had a spontaneous remission, and went on to excel.

Homesickness vs. Separation Anxiety Disorder

What Lincoln and Maggie have in common is that they have both experienced separation anxiety; although in Maggie’s case the condition was temporary but for Lincoln it became chronic, which qualifies him for a diagnosis of separation anxiety disorder. Although they share the same symptoms, Maggie’s reaction would be viewed as homesickness; therefore, benign in its implications while the same problems if persistent are characterized as mental illness.

In like manner, one could make a case that mental illnesses are largely due to quantitative rather than qualitative variations from the norm. Who among us has never experienced an irrational fear, a fleeting suicidal thought, unwarranted suspiciousness, unreasoned feelings of despondency, or a spontaneous episode of anxiety without obvious cause? Such short lived experiences are usually shrugged off, but the realization that these feelings differ from those of a mentally ill person only in their duration can result in self-doubt and feelings of insecurity about one’s mental stability.

The mechanisms we use to deal with these feelings of mental insecurity and self-doubt are all apt to contribute to the isolation and discrimination so often seen in our relationships with people who are mentally ill.


Denial is a powerful mental mechanism characterized by statements such as: “pull yourself together, stop worrying, quit being so sad, or stop acting so crazy.” Such statements deny illness and suggest he only needs to “buck up,” thus, perpetuating the time honored tradition of blaming the victim for his troubles. Of course kicking a person while they are down is not very therapeutic, but it may help us feel immune. Some naysayers even insist that the whole idea of mental illness is a fable.


Avoidance is another method of dealing with one’s insecurities. It operates under the out of sight out of mind premise. When I was practicing there were some people would not visit friends or relatives in our psychiatric ward. Many others were obviously uncomfortable in that environment, and would avoid eye contact with patients. The usual response to someone exhibiting bizarre behavior is for observers to look away after a furtive glance. Avoidance in its extreme form is to be shunned, which is guaranteed to exacerbate most any mental illness.


Ridicule is a tried and true method to avoid ownership. It is said that those operated Bedlam (which was actually named Bethlem Royal Hospital), the infamous insane asylum in England that charged admission for visits to the facility where one could make fun of and taunt the patients, felt it was quite progressive because the fees collected helped fund the “hospital’s” operation. I imagine the taunters felt safe since most of the patients would have been chained to a wall. We are of course much more sophisticated than the residents of jolly old England, yet when we joke about mental illness, are we not engaged in a similar coping mechanism? For the patients and their families, there is certainly nothing humorous about mental illness.


The way we speak often illuminates thoughts buried so deep that we may lack awareness of them. This appears to be true when we discuss mental illnesses, especially the more serious variety. For example when we say a person is schizophrenic, where schizophrenic is an adjective, we seem to be saying what he is, but when we use the term as a noun as “he is a schizophrenic” we are saying who he is. He is no longer a human with the disease, but he is the disease, and his humanity is diminished.  People with schizophrenia have this in common with those suffering from leprosy, who are usually referred to as “lepers.”

The plight of those who suffer from mental illness

The parallels don’t end there for those afflicted with either diagnosis, leprosy or schizophrenia, have suffered the same punishments including: torture, execution, imprisonment, denigration, ridicule, and shunning. Both have been thought to be caused by demonic possession, curses, divine judgments, witchcraft, etc. They have been with us throughout recorded history and probably longer. You may be thinking, “Yes, but we have become so much more sophisticated, enlightened and compassionate.” Yet, thousands of severely mentally ill people are imprisoned. Only recently has there been a movement to mandate psychiatric care reimbursement by third party payers to be equivalent to that provided for treatment of non-psychiatric illnesses. An estimated 70% of the homeless who live on our streets are mentally ill. Our government has diligently worked to deny benefits to veterans suffering with post-traumatic stress disorder, and the list goes on. Incidentally, the last leper colony in the U.S. was not closed until 1999.

The stigma of mental illness

I contend that ignorance is fertile ground for the development of stigmata. We are often most fearful of those things which are mysterious to us. A diagnosis of separation anxiety does not promote much fear in us. We all have some familiarity with and empathy for that problem, but mention psychosis and there will be a different reaction. There are abundant myths regarding psychotic illnesses, and for many that term belongs in the same category as axe murderer. Since early childhood we have been taught to avoid people who are acting strangely, and what we don’t understand is always strange.

Behavior Health vs. Mental Illness / Patient vs. Client: Renaming and Reframing

Another way of dealing with uncomfortable problems is to reframe them by renaming them as something less threatening. In the mental health field this mechanism is used by mental health advocates in a way that I feel undermines their stated goal of de-stigmatizing mental illnesses. One such term which I find totally repulsive is behavioral health which has found its way into the vocabulary of not only the general public, but those charged with treating the mentally ill. While espousing the need for acceptance, they choose to call the condition by a different and totally inappropriate name. A mental illness is no more a behavior than is cancer, but since there is a type of treatment used for less serious illnesses called behavior therapy, the term has now been co-opted to encompass all psychiatric illnesses.

In their zeal to demedicalize mental illnesses, the powers-that-be have successfully substituted client for the word patient when describing people in treatment. This is an issue which sometimes leaves me wondering if it might be time for some more therapy for myself. I have fought this one unsuccessfully for at least 20 years. The word patient is from the Greek meaning “one who suffers” while the word client has to do with a business relationship. Call me a snob, but I feel a doctor patient relationship is more than a series of business transactions. As I have pointed out repeatedly to all who would listen and even those who would not: Accountants, lawyers, and hookers have clients. Physicians have patients.

Shortly before my retirement, I penned a letter on the subject to all the nurses with whom I worked, expecting them to be a bit more sympathetic since they had been medically trained. When I asked one if she had read my letter, she answered in the affirmative, then said “Your next client is here.”

Sadly, the previously described types of reactions to a diagnosis of mental illness occur at a time in a person’s life when he/she is in most need of support and relatedness. Admittedly there has been some progress in educating us about mental illness, and research is opening doors toward more understanding, but society remains relatively uncommitted to dealing with one of our most pressing problems. Hopefully there will come a time when patients will not fear being seen going into their psychiatrist’s office.

From Eshrink’s Editor: What can you do to help?

Get informed. Volunteer.

(Side note from eshrink’s editor: If you think about it, all of the big issues that face our society are just symptoms of a society that has yet to address mental illness and the plight those who are the caretakers for the mentally ill face. As the election cycle gets in full force, pay attention to how few candidates address mental health and mental illness.)

Below are some resources I found helpful.

Helpful Tips for Family and Friends

60 Tips


Does parenting make us unhappy?

In a recent conversation, I heard about a young couple who was quoted as saying that they had decided not to have children.  They had allegedly made this decision based on their belief that childless couples were happier.  It is true that one gives up a lot of freedom when they choose to become parents. Children are a long term financial liability not to mention the fact that at times they can drive you crazy.   In spite of the downsides, I strongly disagree with the premise that parents are unhappy because they have kids.  Granted, as children go through the terrible teens, they may not seem to be very interested in their parents’ happiness.  Nevertheless; in the many years I have spent attempting to help people deal with unhappiness,  I found those without children were by no means happier.  One of my patients who had never conceived once said to me that she felt “incomplete.” Conversely, I don’t recall ever hearing anyone say they regretted having children.

The benefits of parenting.

Some may suggest that the urge to reproduce is simply due to a pursuit of sexual satisfaction; however, I submit that the need to nurture is an even stronger emotion.   My wife frequently mentions the wonderfully warm feeling she experienced when those little guys had been bathed and tucked in for the night; although I recall she looked exhausted.  We were fortunate that it was possible for her to be a stay-at-home mom until the kids reached an age of relative independence (a situation that is frequently impossible to implement in today’s families).

Children are also useful in helping enhance our personality development.  I have long insisted that having a child is the most effective treatment for narcissism.  They teach us to look outside of ourselves.  They provide us with an opportunity for a “do over” to correct our mistakes and to vicariously act out our failed accomplishments.  Although they often disappoint and anger us, we continue to care about them, protect, encourage, and sacrifice for them.  These qualities are ones that I once read somewhere as the definition of love which went like this: “love is caring for another as much or more than for oneself with knowledge and without compulsion.”    Nowhere is this statement more apropos than in the feelings we have for our children.

Oh yes, there are glaring exceptions and I have witnessed the crippling effects of child abuse, but even in the most abhorrent of these cases one often finds examples of love gone awry.   One horrible example of this received my attention when a mother was brought to our hospital after she had drowned her two children.   She had a history of mental illness, but had always been overprotective of her children.  She turned out to have been delusional and convinced that demonic forces were coming to sexually abuse and torture her children, and that their death was the only way to protect them from the horrors which she thought were inevitable.  As has been noted by many, victims of child abuse frequently become abusers, but one might consider that by being denied a loving relationship with their children, second or third generation abusers continue to suffer by being denied the most gratifying experience of life.

Children become even more important to people like myself who have been fortunate enough to reach a “ripe old age” (when I hear this phrase I am not comforted by the thought that when things ripen they soon begin to rot).  As our limitations increase and we find ourselves spending more time in doctors’ offices and funeral homes, we become more dependent on others.  I recall responding to a young man who said he did not want children with,  “Who will come visit you in the nursing home?”  An occasional visit from social worker types is not the same as one of your own flesh and blood. The idea of growing old alone is very frightening to many people (myself included), but even when their offspring are not particularly attentive, older folks seem to find some solace in the knowledge that they exist.  Even those who have been totally neglected may continue to have rescue fantasies, and even in the midst of their angst often make excuses for their children’s neglect.

Our brains are hardwired to repress most painful memories; consequently, if you want to know what is most important in life, ask an old person to reminisce.  You will find them to be very accommodating: reminiscing is a favorite pastime for us old folks.  In most cases their reminiscences will be largely dominated by the good times in their lives.  You will also note that many of these resurrected memories will be times with family.

Family vacation

It was during a time of my own reminiscing that I was motivated to write this essay.  The process was triggered while planning for our family’s annual vacation which has become a tradition with my gang, but has become increasingly difficult to initiate as grandchildren grow older and develop more commitments. This year was especially difficult as it turned out there was only one week in the entire year when everyone would be able to attend, and then only after manipulating schedules.  At first it had seemed unlikely that everyone would be able to go, and we might be forced to cancel.  I found that thought very depressing.

Now that everything has been ironed out, and I am trying to decide whether to pack my bathing trunks and risk the derisive comments of the kids about my less than magnificent corpulent body, my thoughts have turned to all those prior vacations.  It has been over 50 years since the first, and it was monumental.  We checked into a hotel with its southern traditions intact in Nags Head.  This was a place where the family was introduced to their waiter who would care for them the entire time they were there, and dinner was a grand affair with everyone expected to “dress.”  Barb was in her glory, dressing up the kids  and showing them off.   Later there would be trips with four kids in a station wagon without air conditioning or video games, but the misery of getting there was dwarfed by the excitement of finding a motel with a pool.

Vacation from hell.

It has been more than 40 years since we went on our last sightseeing type vacation.  I had terminated my general practice, and we had decided to have a grand adventure prior to my starting a psychiatric residency.  It was destined to go down in the annals of Smith history as an unforgettable experience, and indeed to this day remains a topic often mentioned when we are all together.  The kids refer to it as the “Vacation from Hell.” It all began as most disasters do, innocently, when a friend showed me his new motor home.  Now at that time this was a new innovation in the travel business and I was most impressed.  It presented an opportunity to be closer to the flora and fauna, and would save money on hotel and food expenses.  I also was naïve enough to think that with more space when on the road the kids would fight less, and I would not need to scream as much.  Indeed, I pictured us becoming an on the road version of the Cleaver family.

Further  investigation revealed that these motor homes were very expensive.  I was convinced  I could build one myself for much cheaper.  With that in mind, I bought a retired dry cleaning truck and set about to make it habitable.  After the installation of a stove, refrigerator, and toilet, it suddenly looked a little tight spacewise.  I think one of the kids used the sardine analogy  to describe it.  There would be many other smart ass remarks before this trip concluded.   Nevertheless; the vehicle (which would come to be known as Smith’s folly) was packed and stocked with  provisions .  As an added measure of security, I hung my  motorcycle on the back and we were on our way determined to explore all points of interest in the wild west.  Unfortunately, this trip would rival that of the Griswald’s in the Chevy Chase movie Vacation.

We made remarkably good time our first day on the road.   We made it past Chicago, and I was feeling vindicated.  The kids had engaged in only minor fisticuffs, but that may have had something to do with the fact that we had managed an early start, and they had slept a good part of the day.  We had lunch in the “motor home” (some might suggest that I use that term lightly),  and the self-contained facilities solved the problem of poorly synchronized bladder functions.   As we were looking for a place to hook up to water, electricity and sewage disposal, it suddenly became very cloudy and we found ourselves in the midst of a thunderstorm with rain so heavy that it was difficult to see the road.  Suddenly the idea of spending the night in a campground lost its appeal, and we checked into a motel.

The following day began uneventfully.  It was bright and sunny, with not a storm cloud in sight.  All went well until the late afternoon when we decided to pull off the highway in Galena, Illinois, the mention of which never fails to elicit a chuckle from Barb.  Like most vehicles of its vintage, ours had a gear shift lever attached to the steering column.  While pulling away from a traffic light, I attempted to shift gears, and found myself holding the unattached gear shift lever in my hand.   Even in the face of this catastrophe, Barb was overcome with laughter at my facial   expression as I struggled to understand what had happened.   With the gear shift lever broken off at its base, the truck (at this point I no longer addressed it as a motor home ) was stuck in low gear which created some significant problems for the traffic following us and not surprisingly, they became impatient as our top speed was about 10 miles per hour.

It turned out that God had not totally forsaken us, for we stumbled upon a Chevrolet auto agency after “driving” only a few blocks.  I must have still had a silly look on my face for as we pulled into the service department, the mechanic who greeted us supressed a smile as I held the lever in my hand and asked if they had one of those.  Of  course they didn’t, but I was told they could probably have one by the following day.  With that we limped at 10 mph to the closest motel.  Although the savings I had projected by sleeping in Darell’s folly was taking a hit, the kids were happy because the motel had a pool. The replacement part arrived later that next day, and we were back on the road after our second night in the motel.

Are we there yet?

If you are thinking it could not get any worse, you would be wrong.  After a few hours on the road the sun disappeared never to be seen again for the next three days.  As a matter of fact, it became dark enough that I decided to switch on the headlights. One black cloud to my left looked particularly ominous, and as its funnel shaped appendage moved down towards the earth, I figured correctly that we were in big trouble.  Now, as a native of the southern Ohio hill country my acquaintance with tornadoes was limited to what I had read, which wasn’t much.  As it advanced straight across the cornfield toward us, I attempted to tone down the terror from my voice to utter some hollow platitudes. Of course as every parent knows, kids read us like a book and my attempt to reassure them only caused more fear.

It only made sense to me to seek some shelter, so I stopped under an overpass, but was soon interrupted by a siren and flashing red light which had pulled up next to me.  I was thinking, “Can this guy be serious about giving out tickets in this situation?”  Then I noted that he was waving and pointing ahead apparently wanting me to move on.  I was angry that he was forcing me to go back out into the storm, but being a law abiding compliant soul, we struck out again.  I would later learn that under a bridge is the worst  possible place to be in a tornado, and perhaps that patrolman saved our lives.

After vacating what I thought was a safe haven, I found I could only see where I was going by straddling the center line. The wind was so intense that it blew water right through the rubber seal of the windshield. Then suddenly I realized that we were traveling on the berm  of the road.   The highway was  perfectly straight and I had been white knuckling the steering wheel to keep on that white line; consequently, I was confident that we had been simply lifted off the road and set gently back down on four wheels.  In a short time the wind died down, and it was evident my promise that this trip would be a grand adventure was being fulfilled.

The tornado had moved on, but the sky still looked  ominous and once again the idea of sleeping in the camper lost its appeal.  Clouds and rain continued to dog us for the next couple of days and we continued to hear that conditions were right for tornadoes. These announcements were meaningless to us as we had no idea where we were, so the wisest thing to do seemed to be to turn off the radio and hope for the best.  The kids were not impressed when we drove through the badlands.  We did manage to catch a glimpse through the fog and mist of Mt. Rushmore but the kids were still not impressed.

Soon the sky would brighten and I was convinced that we would still salvage this vacation.  I was hopeful when we got to Wyoming, bought cowboy hats all around, and stopped at a dude ranch which advertised trail rides for five dollars.  It turned out as you might suspect: it was a short trail, which became shorter when I heard Barb scream for help.  She was bringing up the rear and her horse decided he would rather go back to the barn at a rapid pace.  Unfortunately, there was no dashing cowboy on a white charger to run her horse down and rescue her. I was having my own problems hanging on.

Our next major attraction was to be Yellow Stone park, and I was looking forward to finally testing the sleeping accomodations of the camper and awakening to the smell of bacon frying.  It was a gorgeous night and after getting the kids bedded down, Barb and I decided to sleep under the stars.  I quickly fell asleep, but was  awakened by loud clanging sounds. Upon closer observation, the sound was coming from bears on a foraging expedition and had knocked over all the garbage cans they could find. Barb beat a hasty retreat to the camper with me close behind.

At that point, we decided we had experienced enough adventure, and after an uneventful swing south to glance briefly at the Grand Canyon, and an equally brief visit with Barb’s brother in Phoenix,  we headed back north for home.   Through all her travails our trusty land schooner had performed admirably, save for the minor gearshift problem. As we rolled along Kansas, confident the rest of the trip would be smooth sailing, I noticed a lack of responsiveness when I depressed the accelerator.   It soon became apparent the clutch of the “motor home” was going out.  This did not present much of a problem in the flatlands, but as we got into the hill country , the steeper ascends were a challenge.  With the clutch slipping, and the engine racing we were barely able to top most of the hills.  In  spite of this minor impediment we were finally relieved to arrive home with no  lives lost.


Since those days our group has doubled in size and family vacations have consistently been for me the highlight of each year.  They were suspended for the past year following the untimely death of my oldest, yet the family T shirt commemorates this one as the 21st of such get togethers.  They have all been deliciously chaotic affairs, but none that could match the “ vacation from hell.”  We were forced to leave a day early from a South Carolina beach due to a hurricane, and there have been the usual sunburns, jelly fish bites, a broken leg, a sizeable gash from attempts to break up a dog fight, and a fall down the steps resulting in my eyeglasses having impaled my head; otherwise, they have been relatively benign afffairs.  Most have involved a week at a beach and they have all been at different places as we always seem to wait too long to make reservations.

This year’s family vacation is only a few days away, and I find my feelings analogous to those I experienced as a child a few days before Christmas.  I always look forward to seeng the progeny of course, but to witness them all together interacting not only with me, but with each other is a most exhilarating experience.


Here I sit three days later with a magnificent view of the Gulf.  The trip down here was relatively uneventful.  There was a minor issue in a parking garage in which one of the grandkids who is learning to drive ( and who shall remain nameless ) backed into a parked  car.  Her Mother violated every tenet I had ever taught her by leaving a note with her phone number.   Well maybe I might have inadvertinately mentioned that “honesty is the best policy” rap when she was little, but never thought she would take iit seriously.  Meanwhile the kids have managed to trash the place in short order.  They are at times loud, argumentive,  constantly in motion, and in short wonderful.

By the way, I feel compelled to mention that one of those guys who said he did not want children was my son who is on course to be nominated as Father of the century.

NOTE FROM ESHRINK’S Editor. We recently returned from our 21st Annual Smith Family Vacation (these are the vacations dad discussed above…a tradition started when Simon and Carter were babies in 1994). Unfortunately, I don’t have pictures from the “vacation from hell” but I’ve added some pictures for family of previous trips during our 21 year vacation history.

vaca2010 group shot

This is the vacation where dad impaled himself with his glasses when he fell down the steps. Jim pulled them out, and we took the picture BEFORE dad went to get stitched…we Smiths don’t let anything get in the way of the family photo 🙂 but maybe that’s why the picture is so blurry.



This was vacation we took in Michigan. Jim proposed to Trudy on this vacation. I think it was 2005.

This was vacation we took in Michigan. Jim proposed to Trudy on this vacation. I think it was 2005.





vacaSCorSanibelgroup2006Picture 013

Horseback riding at the ranch. Summer 2007.

Horseback riding at the ranch. Summer 2007.




















SPANKING: Discipline or Abuse?

117456135Introduction: When I prompted my dad to start this blog, we started a process where we kick around ideas for topics; if it’s an idea I really want him to address, I kickstart his process by sending him an email with my thoughts on a particular subject; then he writes his blog post (I tell him he has two things I don’t possess at this life stage: wisdom and time); and then I insert the article into the wordpress software. Below, is the email I sent dad about this week’s issue. His post follows.

April is National Child Abuse Prevention month. I think we should dedicate some blogs to that issue.

I can’t think of any other issue that evokes more polarization in the parenting world than spanking. While I’m in the middle on many issues, spanking isn’t one of them. In my opinion, spanking is lazy parenting. I was never spanked, however, my older brother and sister were. I remember the wooden paddle.

Interestingly, I had this idea that my parents stopped spanking because my dad went back to school to be a psychiatrist. I found out later that unbeknownst to my parents, my older sister hid the paddle, and my parents just didn’t bother spanking my other sister and me because they couldn’t find the paddle and decided it didn’t really work anyway. At least that’s how I remember it.

To me, spanking brings up a larger issue of rearing a child to have internal controls versus external controls. If I put myself in the mind of a four-year-old, spanking says, “If I’m bigger than you and you do something I think is bad, I can physically hurt you,” and then to add insult to injury, the four-year-old gets spanked for hitting his little brother when that little brother destroys his toy. The kid is just doing what he has learned: “I’m bigger than you. What you did was bad. I can physically hurt you, and humiliate you in the process.”

Discipline is about teaching, not punishment. The goal is to rear a child who has his own internal controls and does the right thing even when nobody is looking. I recall one of the many parenting conversations my late husband and I had about spanking. We vowed never to spank our children. He was spanked and said it taught him to learn how to be a good liar, be sneaky, and not get caught. He never gave a second thought to whether what he was doing was right or wrong because the goal was to get away with whatever he was doing.*

But I’m wondering what my dad thinks. Spanking? Thumbs up or thumbs down?

* P.S. When I talked to dad about this blog article, he mentioned that I didn’t give any examples of discipline that teaches children. So, I added some information at the end of the blog to address his point.


Maggie has asked me for my opinion on spanking. I find the issue a bit more complicated than she does.  Of course the first question which comes to mind is when does spanking become abuse.  Is it a matter of the amount of pain inflicted, both emotional and physical, or is the act itself never justified? This reminds me of the story of the of the man who when chastised for hitting his mule on the head with a club responded that he was not trying to hurt the mule, but only to get its attention.  Mules are notoriously stubborn, and there are some children who also possess that trait.  In such cases spanking will usually get their attention, but the question remains, is it the best and least damaging way to accomplish that goal.

Spanking in the good ole’ days

There has been a great deal of disagreement over the pros and cons of spanking during the past 50 or so years.  As I was growing up, there seemed to be a consensus that spanking was not only effective but necessary in order for children to distinguish right from wrong and learn to do that which was right, or as what we shrinks would call the development of a strong images8BL7CRUNsuper-ego.  The paddle was a prominent fixture in every school principal’s office and parents almost always assumed that it was used judicially.  I still recall vividly my only trip to the principal’s office, and the terror and humiliation I felt as he deliberately left me waiting in the outer office.  I was in the eighth grade and had avoided trouble until then by being “the teacher’s pet” according to my classmates.  I avoided “cracks” as spanking was referred to then, but Mr. Leckrone made it clear that he was not one to be messed with and that a return appearance to his office would result in unspecified but dastardly consequences.  I returned to my home room spankingvowing to never to talk in class again, but enjoying the notoriety as it allowed me to shed the goody two shoes identity that had plagued me until then.

Is spanking effective?

Fundamental to the controversy about paddling is the question as to the effectiveness of any kind of punishment in meeting our goal of producing self- disciplined, reasoned, confident, and caring individuals.  One lesson which must be learned in order to achieve this level of maturity is that behaviors have consequences.  Without this realization children are apt to lack judgement and make poor decisions throughout their lives.  I do not believe there is a one size fits all approach to teaching this concept, but the strategy used may vary depending on the personalities of both the parent and the child.  Among the most important factors in disciplining a child is consistency.  Children can hardly be expected to learn the lesson about consequences if a given transgression is treated differently from one time to the next.

My history with spanking

Punishments carried out in anger serve the parent’s needs rather than the child’s.  It goes without saying that when provoked with anger we are apt to be impulsive and exercise poor judgement; consequently it is a good idea to count to 10 before deciding on a response.   Now and then I think of an episode in which I flunked that particular test of patience, resulting in me feeling not only guilty but foolish.  My two grandsons were visiting and discovered a toy gun from my son’s childhood (No, my son has not shown any inclination to shoot anyone in spite of this early training).   My grandsons were barely more than toddlers, but were fascinated by the gun.  Their interest was probably fueled by the absence of toy guns in their lives as their parents did not believe it was a good idea to teach kids to shoot people; besides the game of playing cowboys and Indians, so popular in my childhood was no longer politically correct.

The boys were the same age and had always played together and seemed to enjoy each other’s company; however as you might expect the presence of two boys and only one desirable object was certain to result in conflict, and it did.  Initially there was a tussle, then one of the boys who shall remain forever nameless wrested the gun away and promptly hit his cousin on the head with it.  This was not a love tap, and could have done significant damage.  I was incensed, and promptly smacked him on the butt with my hand.   Later I would realize that I was angry with myself for not being adult enough to intervene before the situation got out of hand, and for violating my own rule about acting in anger.  Needless to say Grandpa’s overindulgence would reach a new high for the remainder of that weekend.

Yesterday I had the opportunity to ask my son if I had ever spanked him.  He said that I had but that it had been rare.  I find it very interesting that I have no memory of ever spanking him, while the previously mentioned episode is so firmly imbedded in this tired old brain.  I suspect that the answer is that I, the control freak, uncharacteristically lost control, and in such a state could have done serious harm to a little guy I loved.  As a psychiatrist I have seen many people with problems dealing with and controlling their anger.  It seems reasonable to me that for such people to engage in corporal punishment is dangerous and may account for many if not most cases of child abuse.  Unfortunately there is little that can be done about these parents until after the damage is done.  For some, this alone is enough justification to warrant a ban on any kind of physical punishment to children.

Does spanking damage children?

Certainly the most important issue in the spanking debate is the effect that it may have on children.  Research in the social sciences is notoriously difficult in that it is almost impossible to control all the variables when doing large scale population studies.  For example, an article at cites sociologist Annette Lareau saying that research shows that “corporal punishment on average correlates with lower measures of cognitive ability, such as IQ,” but follows with the admission that “measures like IQ are confounded by many variables.” Consequently; one can find corroboration on almost any position one takes if they search hard enough.  Few statistics are available regarding the incidence of spanking.  An ABC poll showed that 65% of Americans approve of spanking and 50% of the parents said they have spanked their children. According to a Gallup poll 28% of American families spank their children. It is said that a majority of those who admit to spanking are conservative Christians, although I could find no evidence to confirm that premise.  Indeed one study found a higher incidence in non- Christian nations.  Many refer to the phrase “spare the rod and spoil the child” as a Biblical admonition, but it was first coined by Samuel Butler in a poem called Hudibras written in 1664.  The Biblical literalists who espouse spanking generally refer to several passages in proverbs in which beating your child is described as an act of love, just another reason for my not getting into the old testament.  Although I can’t picture Solomon as a sadist, I do have concerns that such passages may give license to those who are.

My experience as a psychiatrist and insights from patients about being spanked as children

During my many years as a psychodynamically oriented psychiatrist I have listened to literally hundreds of people tell the stories of their childhood.  It is dangerous to draw conclusions from such anecdotal information, especially when it may be colored by subjective perceptions.  Nevertheless; one would expect these perceptions to have some relevance.  As I reflect on the issue, it comes to mind that most had experienced some kind of physical punishment, usually spanking.  As you might expect my sample is skewed since many of these people had obviously suffered severe psychological damage due to extremely cruelty administered in the guise of discipline.

There were many who resented having been spanked, but more often identified overly strict parenting as their major complaint.  In other words it seemed not to be the spanking per se which disturbed them but rather it’s too frequent and injudicious use.  Of course there were those examples which may have crossed that line into abuse.  On the other hand there were significant numbers of patients who recalled almost fondly their experiences with the paddle.  Those folks seemed to interpret physical punishment as evidence that their parents cared about them, thus appearing to give some credence to the Solomon philosophy.

This same interpretation is also common among friends of my generation who are likely to be more critical of parents “who let their kids run wild” than of those who physically punish their children.  The phrase “that kid needs his little butt smacked “ is often heard among my contemporaries; although it is rarely recommended for their own grandchildren.  There is no doubt that society’s laissez faire attitude regarding such issues contributed to child abuse, and that mistreatment of children is still a major problem in many parts of the world and even here in this so called enlightened society.  It is true that many parents have abrogated their responsibilities toward their children, but it is also true that in our country while many children are overindulged many are neglected usually due to poverty.  Both groups need to learn discipline, but are denied, the first because of permissiveness and the second due to hopelessness.

The acceptance of discipline tactics changes with the times in which we live

Not so many generations ago ours was an agrarian society.  Families were generally much larger, and children were expected to work the land alongside the adult members of the family.  A sense of responsibility and strong work ethic were highly prized as the family’s wellbeing and at times even their survival was at stake.  Sending children to school represented a sacrifice as it took them away from work on the farm.  Summer months were the most labor intensive time for farmers thus began the practice of closing schools during the summer as we continue to this day.  I have no doubt that children were loved in those days, but I think it is safe to say they were rarely coddled.  It also seems clear that punishment was harsh when compared to present day standards.  Many of those disciplinary actions would in our time be considered abusive, while our ancestors would undoubtedly label them as methods to teach societal values and behaviors.

Those attitudes stand in marked contrast to those of our generation.  With fewer children in each family they are more likely to be overindulged and overprotected as parents have placed all their expectations in one or two baskets.  A dramatic example of this phenomenon exists in China where more than one child per family was prohibited.  This has resulted in an epidemic of childhood obesity which rivals that of the United States.  Some also feel that it has contributed to excessive narcissism among many of these kids.  I recently heard that the Chinese government has rescinded this anti-propagation law for fear that it will eventually result in a shortage of labor.

Now that children have little economic value, parenting has become even more of a vicarious activity than it has been in the past.  We want our children to “make us proud” which actually translates to allowing us to relive our past hopefully with better results.  In my own case, I am especially invested in my children and grandchildren’s athletic successes since I had tried out for every sport offered at my high school, but never made the team.  When one of the kids wins a game, some of my DNA was involved, and I find that very satisfying.  Nowhere is this phenomenon more evident than at a little league or biddy football game, where parents complain constantly about the officiating as if any perceived bad call is a personal affront.  The coach’s authority is often questioned and opposition players may be denigrated.  I am told that so called “trash talking” has become part of the game, and that deception strategies are welcomed.  Even the concept of sportsmanship appears to have evaporated.  It is my contention that teaching effectiveness is influenced more by what we do than by what we say.  In other words I believe that children tend to model their behaviors after those close to them even when those behaviors are objectionable (monkey see, monkey do).

Opinions about child rearing were influenced in the past century by Freudian ideas.  The emphasis on childhood traumas as the cause of most mental disorders was center to Freud’s theories; consequently parents, especially mothers, were to blame for causing a lifetime of problems for their children.  Mothers as primary nurturers assumed responsibility for their child’s successes and failures.  The “where did we go wrong” lament was frequently heard, and motherhood took a hit.  Alfred Adler, one of Freud’s disciples, emphasized what he called the inferiority complex which he felt had its origins in failures on the part of parents to enhance self-esteem.  This led to the position that criticism was to be avoided at all costs and that children should be always praised in order to protect their fragile egos.  Of course spanking by devotees to this philosophy would be a definite no no.

These ideas became institutionalized: teachers were taught to never be critical, and Mr. Rogers came along to tell kids how wonderful they were.  There were to be no losers for when there was a group activity in which there was competition, everyone would get a trophy.   Marshal Mcluhan commented that the so called TV generation was growing up feeling they should be entertained; however there has been some progress in that now kids spend hours interacting via video games rather than sitting motionless for hours at a time.  Still such things do little to nourish creativity.   Sixty years ago Dr. Hugh Misseldine, a child psychiatrist, delivered a lecture to my medical school class in which he stated that children who are overindulged grow up to be bored.

Have all these factors conspired to leave many of our children feeling entitled? Have we fostered over confidence setting them up for failure?  Have we impaired their judgement by not allowing them to suffer consequences?  Do we assume  responsibilities that should belong to them?  Last but by no means least do we really have as much power to affect our children’s development as we think we do?

I’m ready to render an opinion

Now, after that brief prelude I am ready to get around to answering Maggie’s question (she should know me well enough to not expect a simple answer to any question).   First I feel the need to address the paddle issue.  She may recall that I  manufactured that paddle with great fanfare, and hung it on a wall in the family room for all to see.  I don’t recall if I ever used it, but I do know that its primary purpose was intimidation.  That must have worked for I never had a need to use it on anyone after that.  I was aware that it had been hidden, and remember chuckling to myself about my oldest daughter Molly’s ingenuity.

A few years back I saw a patient who blamed her problems on a conflicted childhood which she described as chaotic.She reported that her father was very warm, loving and attentive except when he was drinking which was frequently.  When he came home drunk, the children would all look for some place to hide for he would become violent and abusive.  Her conflict centered around deciding which was the real person.  Was his behavior when sober an act or did he really love her.  This to my mind is the most important factor in answering the question.  I strongly believe that the most damaging thing which can happen to a child is perceived parental rejection.  The emphasis here is on the child’s perception as to whether he is loved even when punished.  As with Harlow’s wire cage monkeys children simply cannot mature without appropriate nurturing.  To feel unloved may be the most painful of all human experiences.

Since we cannot know how a child will interpret our motivations and since they tend to learn from and eventually mimic our behaviors, I lean rather strongly to the thumbs down answer.

Maggie’s addendum. In the introduction of dad’s post, I said I would answer my dad’s suggestion that I provide examples of discipline that I view as beneficial. Here goes…

There are several times as a child, I wished my parents would have spanked me instead of rendering consequences that seemed to last an eternity. One such time was when I mouthed off to my mom…I don’t remember exactly what I said or did, but she said, “I don’t want to hear another word. If I do, you’re going to be grounded for a week.” The challenge was on! I, of course, mouthed off in protest and she said, “That’s it, you are grounded for one week. Do you want to go for two?” Of course I did! This battle of the wills continued until I was up to four weeks of being grounded.

I sulked the entire weekend, and then started my campaign for goodness. I did my chores, I was pleasant, rubbed my mom’s back and feet before bed, asked how her day went…the whole enchilada. My friend Annette asked me to spend the night for a big sleepover the following week…mom and I had been getting along great and I had been the model daughter. I said, “Mom, Annette is having a sleepover Saturday. I’ve already done my chores and cleaned out my closet. Can I tell her I can come?”

Mom said she just needed to check the calendar. “Oh, honey you’re still grounded. Tell Annette you can spend the night three weeks from tomorrow,” she announced in her nicest mom voice. “I wish you would just spank me like normal parents,” I muttered under my breath as I stomped out of the room.

When Steve and I decided we would never spank our children, we had to have a strategy. The most valuable advice I acquired (other than the example of my parents) was a book called “Kids Are Worth It.” The main takeaways: identify your child’s currency at the time (it changes); be consistent; keep your word (follow-through); make them tell you not just what they did wrong but what they should do differently the next time (appropriate responses); embrace natural consequences; exhibit the behavior you want them to model; and make sure they know you love them.

The “currency” thing is key! My kids didn’t grow up in a “neighborhood” so grounding them like my parents did, wasn’t going to work. With Simon, there was a time when grounding him from the Playstation was a punishment worse than death, but he would have times when he wasn’t into gaming so I had to figure out what would make the biggest impact.

Another lesson: make sure it’s something you can control. During one stage, his phone was the currency that mattered. I took it away, but realized that I needed him to have a phone in order for me to reach him when I was at work since I had gotten rid of our landline. I gave him the “uncool” pay as you go phone. I soon learned my lesson: I can’t physically make him turn on the phone.

The last time he was grounded might have been even more of a punishment for me than him. I had given him permission to go to a concert with three of his friends. He had been looking forward to it for months. It was a big deal. He got mouthy and verbally abusive. I gave him the warning: he tested me. “Are you sure you want to do this?” I asked with a second warning. “F-you. I hate you. Everybody hates you.” Done. No concert. Grounded for the weekend. He kept it up. Grounded from everything: phone, computer, X-box…life. It was a long weekend since I had to stick to him like glue to enforce the punishment (good times…hanging out with an angry, sulking teenager). Stuck with each other for the entire weekend, we emerged with a better relationship even though I was exhausted. He seemed to develop a renewed respect for his mom who would do what she said (no matter how painful) and I was proud of myself for sticking to my guns.

I was fortunate Caroline’s personality has been less confrontational. She is introverted and her currency was books. I used to think to myself, “If I need to dole out punishment, what am I going to do? Ground her from reading?” Somehow that didn’t seem right. Fortunately, she hasn’t had to be grounded yet.

Two things from my dad’s article that are especially pertinent: methods of discipline have much to do with societal norms (in his day, it was common for kids to get spanked…almost a right of passage) but today it can make a child feel confused since peers don’t experience that same discipline; children crave and need consistency; and the fact that your child’s perception of events IS his/her reality. This last lesson my dad taught me has served me well. I often asked my children, “What do you think I meant?” It is amazing how they perceive what I have said in ways I never intended.

My all time proudest moment as a parent was when daughter Caroline sat down and started counting to 10 while taking deep breaths  when I told her she couldn’t have yet another cookie. “I am so frustrated right now. I just need to take a break for a minute,” she said–she had watched me do that through the years and pulled it out for a coping tactic.

The difficulty with parenting is that you never really know how you’re doing and won’t know for years to come. A kid isn’t going to say, “Good move, mom. I really learned my lesson with that punishment.” One thing I do know: nobody has ever given me a good reason as to the need to spank a child. I still contend it is lazy parenting.