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Dr. Deb Hirschhorn, Ph.D. in Marriage & Family Therapy

Link to: http://drdeb.com

From childhood tantrums to teenage defiance,parents are faced daily with the challenge of channeling their children into a useful and wholesome direction. If that process begins young, the job is so much easier, but even if parents are stuck with a problem adolscent, there are healthy routes out of the mess.

Before I get to the solutions to the problem--and there are many wonderful ones--I would like to start with some options that may not be in your child's best interest.

The History of Chemical Solutions*

We can begin our journey into the use of chemicals to improve mood to circa 3400 BCE when the Sumarians cultivated the opium poppy calling it the joy plant. The Assyrians, then the Babylonians, and the Egyptians followed suit . Hypocrites, the Father of medicine, recognized its usefulness as a narcotic in ancient Greece. The excitement crossed the sea and in the U.S., opium reached market saturation by the 1880s since it was readily available without prescription.

Doctors are not only motivated by money, as cynics today would have us believe, but by a true desire to help people to feel better. When they would encounter what today we call anxiety and at that time was labeled ''neurasthenia,physicians were happy to inject morphine. It was derived from opium and was stronger than it. Not only did war veterans take it for what today we call Post Traumatic Stress Disorder, but it was normal for mothers to give it to their colicky babies.

 Doctors thought that opium and morphine were appropriate remedies for female problems as well. Two-thirds of white, middle class women became opiate addicts by the 1860s. By 1900, a higher percentage of the American population was addicted to opiates than there were heroin addicts in the 1990s. Already by the 1880s, doctors were starting to get concerned.

Meanwhile, Friedrich Bayer, a dye maker in Germany, created a synthetic that could be used to wean addicts off of morphine. This drug seemed heroic, so he called it heroin. He marketed it well and it took off here in the U.S. Unfortunately, it proved even more addictive than what it was replacing. Bayer stopped production in 1913 but by then he had invented acetylsalicylic acid -- aspirin.

Coke was the next big thing

 It was marketed for asthma, but its manufacturer, Parke, Davis & Co, sent samples to Sigmund Freud who liked its "exhilaration." He found that it muted his depression and started to use it regularly for that purpose. Parke, Davis paid him to promote it. However, like its predecessors, it had powerful side effects, not the least of which were hallucinations and violence. By 1914, the Harrison Act made these drugs illegal.

The next wave introduced barbiturates.In 1911, Merck Bayer created barbiturates called Luminal and Veronal for surgical and obstetric pain, seizures, convulsions, alcohol,withdrawal symptoms, ulcers, migraines, wheezing, and irritability resulting from hyperthyroidism. Therapists in this country liked another barbiturate,Amytal,for what they termed manic depressive psychosis (the old label for what today is called bipolar disorder). It  relaxed anxiety and decreased inhibitions in their clients -- something useful in talk therapy. Law enforcement adopted it to use as ''truth serum''.  

Also called ''goofballs'', barbiturates were distributed by the military to World War II veterans. They came with harmless names like yellow jackets, blue angels, pink ladies and reds. In New York City from 1957 to 1963 ,there were 1,165 deaths from barbiturates. Those who survived were addicted;250,000 by 1962.

Amphetamines, also called speed, came next. The manufacturer, Smith,Klein and French sent out samples to doctors in order to figure out what the drug would be good for. At that time without research protocols established, doctors would experiment on themselves before suggesting medication to their patients. In 1937, one recipient of a sample, Abraham Myerson tried it on himself and liked it, so he helped to promote it.

Benzedrine Sulfate was marketed as a decongestant but it seemed to lift people's spirits while calming rowdy children. Students loved it for cramming. As was the case with barbiturates , both the U.S. and British militaries gave it out liberally to troops during World War II. Time Magazine, however, worried that it was poisonous.

Time's concerns notwithstanding, Smith Kline and French noticed that amphetamines are also good for weight loss. They came up with the idea that they could market their pills for both depression and weight gain to the same customer. Here, they hit the jackpot earning Dexedrine $11 million by 1954.

In a second stroke of genius, Smith,Klein and French combined Dexedrine, the speed, and Amytal, a downer so as to relieve the speed's jitters. Unfortunately, the side effects were scary and addiction was rampant. Withdrawal symptoms for example included nightmares, seizures, panic and depression, as well as sleep problems and even psychotic features. When, in 1971, the FDA classified amphetamines and methamphetamines as Schedule II drugs, Big Pharma objected and in 2006, The FDA won and meth was considered by the UN to be "the most abused drug on Earth."

Closer to our day came the benzodiazepines used as tranquilizers;Miltown,Equanil,Librium,Valium. Later on there were klonopin,Xanax and others.Eventually,fear of side effects again hit the market and interest waned.This was followed by the latest wave ;SSRI(selective serotonin reuptake inhibitors) with Prozac leading the pack in the 1980s. These drugs are very much still in use today with the difference that now they require a prescription.

Chemical Myths and Big Phama MarketIng

In 1998, Dr. Elliot Valenstein, a Professor Emeritus of Psychology and Neuroscience at the University of Michigan, wrote Blaming The Brain: The Truth about Drugs and Mental Illness. Well, anyone can write a book, but  Professor Valenstein would go on to write 10 books and 160 scientific papers. He has been a visiting professor and recipient of honors all over the world.

In this particular book, he states:" There is not a shred of evidence of any…decrease in brain serotonin. In another book, a Pulitzer Prize-winning science writer  describes the " revolutionary" finding that major personality and behavioral traits

are regulated by the balance between norepinephrine and serotonin. There is really no convincing evidence supporting this view, but by describing some weak trends as established facts and by failing adequately to acknowledge contradictory evidence, many popular writers make it appear that complex personality variables are completely dependent on the balance between two neurotransmitters.

Further, he says, "The evidence and arguments supporting all of these claims about the relationship of brain chemistry to psycholological problems and personality and behavioral traits are far from compelling and are most likely wrong...

these ideas are simply an unproven hypothesis…While there are some reports of finding evidence of an excess or deficency in the activity of a particular neurotransmitter system in the brains of deceased mental patients, these claims are controversial, as other investigators cannot find any relationship.''

Research shows that the brains of normal people may show the same ''imbalance'' in these neurotransmitters. Furthermore,there is no way to measure serotonin levels in living people.That is, to measure neurotransmitters, an autopsy must be preformed.

Another researcher very active in understanding the function of pharrnaceuticals is Joanna Morcrieff,M.D..She is the Senior Clinical Lecturer in the Division of Psychiatry of University College,London, a major biomedical research center and a leader in medical and health research. In a YouTube video [https;//www.youtube.com/watch?v=IV1S5zw096U]Dr. Moncrieff explains that rather than repair an ''imbalanced''brain, the powerful anti depressants and anti-psychotics on the market today ''create an abnormal brain state'' .

She explains why people feel a benefit from taking them;These drugs create an altered state. ''To a person suffering from mental illness, the altered state they create interacts with their symptoms. Sometimes these altered state they create interacts with their symptoms. Sometimes these altered states may be useful for someone having a deep depression or psychotic state. It's not that anything's been normalized, it's that the altered states may be preferable to the experiences that they're having at the time.

As an example,she apparently was taught that alcohol was useful for Social Anxiety Disorder. Obviously, alcohol did not ''replace an alcohol deficiency"! But it could be helpful to get over social stress. As another example, people taking opiates for pain report they still feel the pain "but they don't care about it as much." That is a result of an altered brain state.

Dr. Moncrieff explains how the "imbalance " idea came into being. Generally, in medicine, when you supply something that works, you can often assume that that something was missing in the first place. You supply insulin to a diabetic because insulin was missing. In this way, the dopamine hypothesis came into being. Doctors found that giving Haliparidol, an early anti-psychotic, would block dopamine receptors. They therefore reasoneTd that psychosis was due to over-activity of dopamine.

This may be logical, but it was never substantiated. In the same way, there is no evidence for an abnormality of serotonin in depression;''It's widely recognized by experts that there is no evidence for it'' .This dovetailed with the rise of the anti-psychiatry movement which reacted against '' chemical straightjackets'' used as a means of social control in psychiatric hospitals. The drug industry wanted to get a way from this bad reputation so in the 1990s it started promoting the ''chemical imbalance'' hypothesis as if it were fact. Eli Lilly campaigned vigorously to introduce this concept into the market, making another false claim in the process--that the drugs were not addictive. This marketing successfully increased the use of antipsychotics and anti depressants. As of the winter of 2015, Web MD says of Zyprexa; Olanzapine belongs to a class of drugs called atypical antipsychotics. It works by helping to restore the balance of certain natural substances in the brain''.

It is ironic--and quite disturbing--that these drugs are maketted as being necessary for health and functioning because of psychosis is toxic to the brain. The truth , Dr. Moncrieff states, is that the ''antipsychotics are probably toxic to the brain''. This is because research in 2005, 2007, and 2011 has shown that under the treatment with these drugs , the brains of schizophrenics are getting smaller.

Because the market for anti-depressants is larger than the markets for antipsychotics, the drug companies started to persuade the public that if they thought ther were depressed, they were actually suffering from bipolar disorder. Not only that, to extend their market, the pharmaceutical industry has funded research into the use of these drugs on small children.

As Dr. Moncrieff says, "They are drugs. They are psychoactive substances…The disease-centered model that I think is so dangerous is that it assumes that drug treatment is going to be beneficial…The drug-centered model on the other hand assumes that these substances might be harmful and therefore you have to make a good case for using them".

There is much more to read on this subject . Others questioning our methods include Daniel Carlat and Robert Whitaker's "Anatomy of an Epidemic". Rule #1 in every code of ethics is:First do no harm. If that is the case and drugs may be harmful, how can parents help their children,especially challenging ones? I would like to begin the process of giving worthwhile suggestions in this column,so we can start with just a few ideas.

So What Are The Solutions For A Child Who Is A Handful?

Solutions fill parenting books--I wrote one myself--but I would like to give you some tips that may have escaped mention.

**********    Be happy. Love your kids: Love your job--which is parenting.

I was in a pizza place recently and a mother was dealing with 3 rambunctious boys. She really tried to be patient as she told them "no climbing " and No running" But she seemed like she was straining to control hersel from screaming. She didn't seem like a happy camper.

Can you be happy when your child is misbehaving? Well,maybe. These tiny little boys were just being tiny little boys. Yes, they absolutely needed reigning in, but as long as you are going to clamp down on them, why not enjoy the interaction? Why not make stopping and doing something else more fun than what is objectionable? The bottom line is that if you don't feel happy, your children will not respond-- and you will not be happy.

Look at your children through the eyes of adoration you first had when you first met them.

***********   Be more positive than negative

As much as it is important and necessary to create limits and boundaries and as much as it is crucial to say ''NO''as many times as necessary to a toddler stepping off the curb into the street, it is equally necessary to say positive things to your kids.

When you want your children to understand the importance of a behavior that they are not exhibiting like cleaning up, sharing, or being assertive, tell them that you know the "real" girl appreciates cleanliness or sharing, etc. Sometimes it is appropriate to say that the unacceptable behavior is unworthy of the good person that you are. 

In other words ,praise them when they deserve it and keep in your mind the high esteem in which you hold them when they don't--so they can reach for that higher level.

*********   Model Humility

Humility is the gateway to learning and growing. It is the backbone of strength. It is the building block of self-- esteem. How so?

An arrogant person knows everything already and does not think he needs to hear anything from anyone.In the quest for giving our children self-esteem, we must not make them arrogant. For example if the school age child does well on a test, it is helpful to say''You really woked hard for that'.  

It would not be useful to say, "You're so smart." That said, there are times when, if combined with more, the "You're so smart" works very well. For example, "Hashem blessed you with a good, smart brain. What a gift! You should be appreciative to Him for this gift and always

A child growing up with this message correctly places himself in the context of the universe. He understands his gifts and he understands that they are gifts. He will use them well going forward in life with a sense of appreciation for having been given them. The humility created here means that he doesn't over-estimate who he is and is therefore open to hearing feedback from others--the key to learning and growing.

At the same time, he is s Model Appreciation Appreciation is the greatest shield against unhappiness. The object of this life of ours is to "serve G-d with joy (ivdu et H' b'simcha). But a spoiled child never feels appreciation -- and never feels joy. That child is never satisfied. That is because the message behind spoiling a child is "I deserve more and more." So when he doesn't get that "more and more," he feels lacking. His life seems focused on getting rather than appreciating what he has.

The question is: How do we parents teach appreciation? One way is to have children say "Thank you" to their parents for the ordinary things in life. My children grew up hearing my husband say, "Thank you for the delicious dinner." They learned to say "thank you" in that manner. Encouraging them to thank each other is powerful, too, even for little things like passing the milk.

When the weather is not sunny and spectacular, we can still thank G-d for the rain which is necessary or the snow in which they can play. Sometimes bad weather is a positive reminder that H' really does run the universe. That's comforting.

It's About The Game, Not Winning Too often, parents invest themselves in their children's successes because there is a false sense of identity wrapped up in that. The reality is not that we are "better" if we win the game -- or the prized account in our business; we are better if we live a wholesome life: being kind, compassionate, responsible, hard-working, and respect-worthy. Interestingly, children are less s

That is not to say that success isn't good and valuable. Coming home with grades that represent hours and hours of hard work is a good thing. But parents have to watch out just exactly what it is that they are proud of -- the work or the result. Cheating, even in Yeshiva, is rampant in schools, corporate America, government, and every s A lot more can be said on this subject and I hope to be filling you in in future articles.

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*taken from Wylie, M. S. (July/August, 2014). "Falling In Love Again: A Brief History of Our Infatuation with Psychoactive Drugs." Psychotherapy Networker.