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Journal of Psychiatric Practice: September 2018 - Volume 24 - Issue 5 - p 309
doi: 10.1097/PRA.0000000000000334
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September, 2018. The developmental road from birth to adulthood can be really rough or relatively smooth (although never entirely so). We have all been riveted by 2 major news stories recently. One of them concerned the amazing rescue of the boys on the soccer team who were trapped in a cave in Thailand. What must it have been like for these boys, faced at such an early age with the reality that they might die? Or did the resilience of youth, the power of hope, and the support and encouragement from each other, from their coach, and from their rescuers keep that reality at bay? One thing seems certain: the fact that the “grown up” world came through, against all odds, surely taught these young people the lesson of trust and the value of teamwork. For the rest of us, while we watched and held our breath, the daily injustices, the political fights, and the many stresses of life were put aside, at least for a brief interval, and the world celebrated.

Alas, the second set of news headlines that has commanded our attention tragically conveys the opposite lesson—that the “grown up” world can be cruel and punitive, driven by hate, prejudice, power struggles, and insensitivity. And here, of course, I’m referring to the unbelievable forcible separation of infants and children from their families at our country’s borders. Here is the text of a letter to the editor that I sent to the New York Times:

Letter to the Editor, June 20, 2018

NY Times

Young children rely on caring, nurturing adults to teach them how to live. It is well-established in my field, psychiatry, that steady and reliable attachment figures are essential ingredients in the formula for healthy development. And not just for psychological and emotional maturation, but also for the brain to be built right. Disruptions in attachment are de-stabilizing, often highly traumatic, and both neurobiologically and emotionally pathogenic. Life histories of adults troubled by depression, PTSD, substance abuse, personality disorders, and unlawful behavior are peppered with tragic stories of abandonment and neglect.

How is it that our Administration has turned a blind eye to the fact that taking young children away from their families delivers this very kind of trauma, setting the stage for them to become troubled adults, adding to our social burden, and certainly instilling misery in these unlucky little ones that could last a lifetime?

John M Oldham, MD

What do these musings have to do with this issue of the Journal? Well, in the broad sense, just about everything. In this issue, Van Bronkhorst and colleagues educate us about the potential benefits of psychotherapy in children and adolescents who have illnesses for which antipsychotics may be prescribed. Here, the safety of young people is the priority goal—and can these young people trust what we adults advise, and can we listen to them as partners to achieve the best teamwork? Also in this issue, Williams and colleagues propose a group therapy format to help women with borderline personality disorder, who are mothers of young infants, learn ways to do the best job they can to meet their infants’ needs, while keeping their own emotions as regulated as possible.

But really, almost all of our efforts in the healing professions importantly relate to the polar extremes of the 2 sets of recent headlines in the news. How can we strive to be like the caring heroes in Thailand and work together to do good? And, conversely, are there ways we can shed our anger and outrage enough to become effective agents of change, to detoxify the dark side of the world?

John M. Oldham, MD

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