Wednesday, April 29, 2009

“Go to Time Out…Of the Car!”

by Dr. Dathan Paterno

Many of you have heard about Madlyn Primoff, the mother of two bickering girls, 12 and 10, who were kicked out of the car and told to walk home when the bickering wouldn’t stop. Even though the mother drove around the block and came back for the girls, she was later arrested for child endangerment. Quite a number of parents have been debating this issue, with most of the debated surrounding whether it was an appropriate consequence.  

I’m not in favor of her decision.  

Before I criticize Mrs. Primoff’s parenting, let me confess that I have great sympathy for her. I will give Mrs. Primoff the benefit of the doubt in presuming that her children’s behavior was ridiculous and not just mildly annoying. I am completely in favor of tough parenting. This includes having no tolerance for ridiculous behavior. So she was right to use tough discipline to shape their behavior. 

However, kicking the girls out of the car was unwise for two reasons. 

First, kicking a 10 or 12-year-old girl out of a car and expecting her to walk home a mile or more in a suburban neighborhood is not reasonably safe. Sure, there are some ten and twelve-year-old girls who are independent enough to walk a mile or even more in safe neighborhoods. But most aren’t. If the children were 14 and 16, I wouldn’t be saying this (unless of course the neighborhood were notoriously dangerous). And if it were two blocks, I might be persuaded to let it slide. But in this day and age, I just don’t trust the world enough to allow two pre-teen girls to walk far without a chaperone. 

My second problem with her decision is that she likely made it impulsively. I highly doubt that she and her husband had had a family meeting with the children and informed them that bickering in the car would result in being kicked out. Rather, this punishment was made off-the-cuff, in a rage, and without much thought of the consequence. This kind of parenting scares children and invalidates that parent’s authority and trustworthiness.  

Again, I’m all for tough parenting with consequences that induce discomfort or pain. But consequences must be reasonably safe; they must also be made calmly with pre-thought and understanding of the possible consequences. 

As always, let me know what you think! If you don’t like her decision either, let me know what you think would be a better consequence for bickering in the car. 

Saturday, April 25, 2009

If Drugs are Bad, What is Good?

by Dr. Dathan Paterno

Today, I’m starting a series of posts on alternative treatments to drugs. Supporters of medication as a treatment for childhood depression, anxiety, attention/concentration struggles, and behavior problems often ask a legitimate question, “If you think drugs are so bad, then what do you suggest?”

I aim to answer that question. I won’t pretend to exhaust all of the possibilities, but I want to list and describe as many as possible. As my loyal readership, feel free to offer your own suggestions and thoughts about alternatives in general or any alternatives that you have found to be helpful for your children or a child you know.

For starters, I will list the Top Ten major alternatives to drugging children.

Here they are:

  1. Improving diet
  2. Regular exercise
  3. Proper sleep: quantity and quality
  4. Stop using drugs, like cigarettes, alcohol, and prescription drugs
  5. Get plenty of fresh air and sunlight
  6. Improving relationships (and shedding unhealthy relationships)
  7. Prayer/meditation
  8. Exploring and satisfying spiritual/existential crises
  9. Develop meaningful passions and interests
  10. Psychotherapy: various forms and techniques
    1. Cognitive-behavioral therapy
    2. Supportive, interpersonal therapy
    3. Art therapy
    4. Family therapy, including improving parenting skills

Thursday, April 23, 2009

Bullying Doesn’t Kill, Injustice Does…

by Dr. Dathan Paterno

An alarming number of reports on bullying are popping up in the news. A recent report from Georgia described how an 11-year-old boy committed suicide after enduring months of bullying. Parent reports suggest that the school did very little in response to the child’s complaints. In fact, his complaints resulted in further taunting and teasing by his bullies.


We all know how awful bullying can be. Besides the name-calling and teasing, many children are threatened with bodily harm, treated with extreme prejudice, emotionally beaten down by rumors and social ostracizing, and even chronically assaulted.


But there is something worse than the bullying itself.


Bullies have always existed; there will always be bullies, no matter how much grant money schools receive for “Anti-Bullying Programs”. Well-meaning efforts that focus on eradicating bullying may do some good, but it is folly to think that bullies will join the Endangered Species list.


What affects children more than threats, name-calling, bumps and bruises is the amount and type of justice that a child perceives after the bullying. Schools that are too weak or afraid to punish bullies—even hard-nosed punishments, when necessary—signal to students that bullying is not only tolerated, but sanctioned. The school might as well say, “We’re going to try our best to convince you not to bully, but if you fall through the cracks and happen to bully someone, we’ll let it go with a little slap on the wrist.”


No, a slap on the wrist will not suffice for the victim who has been abused directly under the noses of the school officials. Bullies should be treated like criminals—because they are behaving like criminals. If that sounds harsh, remember what bullies do. Bullying often includes assault, battery, threat of assault, battery, or even murder!


If adults did this, they would be thrown in jail, and rightly so. Why do we treat these crimes like peccadilloes that we punish by taking away recess or separating the bully from the victim during P.E.? Or, if we really mean business, we insist on a referral for therapy? Forget that nonsense. Children who bully must be suspended at the very least. If the bullying continues, they should be expelled.


Victims of bullying who perceive that justice is done on their behalf heal far more thoroughly and quickly than those who perceive a lack of zeal for or an inability to administer justice. Children who perceive a lackluster or wimpy response to bullying become increasingly frustrated, trust the school less and less, and eventually determine to take matters into their own hands. Literally.


On the one hand, this is a perfect solution. Children who learn how to defend themselves physically—give as well as they take—feel quite empowered and often stop the bullying in its tracks. However, most children do not have the resources or time to train how to protect themselves. Instead, they go far beyond self-protection. Some begin plotting radical vengeance. Some take out their combined anger and hopelessness against themselves and take their own lives.


Until schools learn how to meet their primary responsibility—protecting the children they are entrusted to teach—parents whose children who have been bullied should continue to call on their school to earnestly seek justice for their child. At the same time, police should be contacted at the first sign of a crime. If the victim has sincerely been threatened with bodily harm or has been maliciously assaulted or battered, make out a police report. If bullying continues without a sufficient response from school officials, contact the state’s Department of Child Protective Services and report the school for neglect. Get it on record. Let the school know that you will hold them accountable for their lack of action. Show them that they should fear YOUR response to their inaction more than the bully’s parent for punishing him/her.

Wednesday, April 22, 2009

What Psychiatry Never Told You About Your Child's Soul

by Dr. Dathan Paterno

A new study from the World Health Organisation (WHO) concludes that child depression is more disabling and creates more misery than chronic illnesses such as asthma and even leukemia. The results showed that depression was by a significant margin the most difficult to bear.


As a clinical psychologist, this is not much of a revelation; I witness the misery of depressed children in my clinic every day. What was remarkable to me was that the study presumes depression to be an illness—a medical problem. The public hears this kind of nonsense all the time. While childhood depression clearly manifests itself in many bodily symptoms, including lower energy, aches/pains, sleep and eating disturbance, there is not a shred of evidence that depression—even the most debilitating depression—constitutes a medical illness or disease.


Thankfully, the overly simplistic biochemical imbalance hypothesis has lost favor in reputable psychiatric literature, mostly due to the fact that billions of dollars of research over several decades have brought no confirming evidence. Despite clever advertising by drug companies, no biochemical imbalances have ever been causally connected to depression--or any other form of emotional suffering—in children or adults. The brain scan evidence bank is similarly bankrupt: no lesions or other brain differences have been shown to cause depression.

The reality that few researchers want to contend with is that children hurt because they are both corporeal and non-corporeal beings. That is, we have bodies and souls; both of these are real components of our humanness. Consequently, either component can be healthy; either can suffer pain. Both require attention to be healthy and/or heal.


Because psychiatry desperately wishes to be considered a “hard science”, it subscribes to philosophic naturalism, which acknowledges no reality except the natural realm. As a consequence, psychiatry treats only the body because according to psychiatry (which ironically means “treatment of the soul”), the soul does not exist. Perhaps this is why the treatment success rate of psychiatric medications is so poor (“antidepressants” barely do as well as placebo or fake pills; instead they merely cover up or suppress symptoms).


The fact is no medical treatment exists for a child’s soul. There simply cannot be such a thing. One cannot heal a broken heart with a donut—even a really good donut. As long as psychiatrists and other mental health professionals try to conceive of emotional pain as disease, they will continue to perpetuate the misery of millions of children. I applaud the World Health Organisation’s recognition that child depression is extremely painful and debilitating. However, they should be asking what help is available to the hurting, empty, sometimes lost souls of these depressed children. I sincerely doubt they have the tools to answer this question.

Thursday, April 16, 2009

100 Ways To Do "Time-Out"

“Go to Time Out!” You’ve heard of Time Out. It’s all the rage for parents who want to discipline some other way than beating the snot out of their kid. When I was a youngster, Time Out meant sitting in a corner with my nose against the wall. Sure, it seemed to help curb whatever heinous sin I was committing that day, but it also advanced my unparalleled expertise in differentiating paint scents.

If you read parenting books or watch any shows that advocate Time Out, you are aware that there are about 100 ways to do it.

But what is the right way to do Time Out? Is there some magic to Time Out that represents the necessary and sufficient kernel? Is it really one minute for every year old? Will your 6-year-old devolve to Unabomber status if you only do four minutes? Can we do without some parts of Time Out to achieve the ultimate goal of changing behavior?

Let’s start with some fundamentals. Time Out is not designed to be a punishment. Huh? Kids hate Time Out; doesn’t that make it a punishment? Well, yes and no. Punishment, by definition, is any stimulus that reduces the frequency of a behavior. If Time Out works to reduce a behavior, then it is indeed a punishment.

But more importantly, Time Out acts as reinforcement removal. This isn’t just a fancy-pants shrink term. It simply refers to the fact that some of the things parents do inadvertently reward or reinforce the very behaviors they want to get rid of. Time Out simply removes the child from that reinforcement or reward.

Yelling, screaming, nagging, threatening, reminding, mocking, teasing, are some of the chief culprits. What parent hasn’t fantasized that if they only give their command louder or with a more serious tone that Junior will listen? But your child isn’t deaf and he isn’t stupid. He’s just busy soaking up the attention. Yes, believe it or not, your angry yelling and reminding and lecturing are all highly reinforcing to your child, because one of the things your child craves is your attention.

If we had to rate your child’s response to your attention, POSITIVE ATTENTION would be a perfect 10 and NO ATTENTION would be a 0. What is surprising is that NEGATIVE ATTENTION would be a 7 or 8! Not a bad booby prize, huh?

So Time Out’s goal is to temporarily withhold attention from the child, because it’s just not a good idea to reinforce bad behavior. So how should Time Out actually be done?

  • First, find a really boring spot in the house. Remember, Time Out should offer as little interest and reinforcement as possible. Sitting on the bed with lots to look at and play with is NOT a good place for time out. A stool or boring chair in a quiet hallway is more like it.
  • Do not give your child any warnings or count “1-2-3” before sending him to Time Out. Doing so only contributes to cognitive/behavioral dependence. It tells him, “I don’t have to behave now; I’ll move when she really means business.” This prolonged interaction reinforces the problem behavior. Remember, any talking with your child is attention and reinforcing.
  • Do not remind your child of what the rules/expectations are before a Time Out. It is his job to remember. Your kid is smart. Treat him like he is.
  • Do not wait until he completes a problem behavior. Intervene with Time Out at the mere hint of misbehavior; this will help increase his vigilance and help him think before he acts. This actually fosters the development of the frontal lobes, which are responsible for planning, organizing, and thinking ahead!
  • Do not bargain or back down once you decide on a Time Out. Doing so teaches your child to obey only when you mean business.
  • Don’t talk to Junior on the way to Time Out. Any discussion or argument reinforces the problem behavior. Just say, “Go to Time Out.”
  • Require immediate compliance with going to Time Out. You are the boss. (I’ll cover what to do if Junior does not go to Time Out another time)
  • Time Outs should be about one minute per year old—according to adults’ watch, not his. It doesn’t matter if your 8-year-old has a 5-minute Time Out, so don’t fret too much about this.
  • There will be no talking, singing, playing, humming, bouncing, bathroom requests during Time Out. You will wait for perfect behavior for the right number of minutes. If he chooses to waste an hour or two while settling into perfect Time Out behavior, so be it. No reminders of proper Time Out behavior. This is very important.
  • “Keester Rule”: the butt stays on the chair!
  • After Time Out, insist that Junior tell you what he did wrong. This necessitates his active vigilance, awareness, and memory, a primary goal for working with a misbehaving child. If he can’t remember or gives the wrong answer, it’s back to Time Out for another round.
  • Make certain he not only tells you the specific behaviors he did wrong, but which principle or rule that was violated. We all brainwash our children; get used to it.
  • Send him back to Time Out if he misbehaves on the way (after the original Time Out is complete). You are the boss, and the typical misbehaving/testing behaviors should not be permitted.
  • Require him to perform the correct behavior after he’s told you what he did wrong. Again, establish yourself as the Parent in Charge.

Remember to reinforce him once he begins to comply with the original request/expectation. This is your chance to give Junior the positive reinforcement that you want to shower on him and that he craves! Be as vigilant with positive and compliant behavior as you are with misbehavior. You want him to thrive on positive interaction and social reinforcement.

So that’s the scoop on the best way to do Time Out.

Who Is In Charge Of YOUR Home?

by Dr. Dathan Paterno

One of the first questions I ask parents when they come to me with family disturbances is “Who is in charge in your home?” Some are taken aback, some smirk and proudly say “I am!”, while others grow a sheepish grin and say, “I’m not sure; maybe my kids are”.

Those who believe they are in charge are often fooling themselves. Many parents would like to believe they are in charge, but when we review the reasonable expectations they should have for their children, it is often revealed that their children are allowed far too much freedom and privileges in their home without earning them.

My first assignment for parents is to ask themselves why they should be in charge–why shouldn’t the children be the masters of the home and family? Who says the parents should be the ones who lead? Usually, parents return with greater resolve when they examine the reasons why they should be at the helm of their family.

So, parents, ask yourselves: why should you be in charge? You might find some interesting answers!

Desperately Seeking Parents

by Dr. Dathan Paterno

"Desperately Seeking Parents" is not my first book. In addition to my dissertation, I have written a collection of journal writing assignments for adolescents and young adults called The Take Home Therapist. But this really represents my first foray into something marketable.

The main idea of the book holds that parents have abdicated their role of authority in the family. They have allowed, for many reasons that I discuss, their children to “rule the roost”. Most parents would not acknowledge this (although many parents with whom I work have), but many children now perceive themselves as their parents’ peer. Unfortunately, many parents inadvertently support this point of view.

It is time that parents take back their families and reestablish a proper family hierarchy. In homes with a proper hierarchy, parents view and assert themselves as the primary authority in the home; their children are called to submit to this authority. When this happens, families run much more smoothly; children are better trained, better behaved, and actually develop better social skills.

"Desperately Seeking Parents" discusses why parents should be the authority, where this authority comes from, and how parents can assert (or reestablish) their proper role in the family.

Wednesday, April 15, 2009

Meet Dr. Dathan Paterno

Dr. Paterno affirms that all people are biological, social, and spiritual beings. He believes that all of these are relevant in assessing and responding to a person's struggles. To ignore any of these facets of the personality, then, would be to ignore an essential facet of a person's being, functioning, and suffering.

He adamantly denies the currently held myth that emotional disorders/problems are the result of genetically transmitted, biochemical imbalances. While he recognizes that biological factors are relevant to psychological/social/emotional problems, he sees "symptoms" as meaningful and purposeful, within the holistic context of the person. This means that almost all problems are essentially normal responses to abnormal situations.

Dr. Paterno denies that psychotropic medications are necessary, effective, or generally safe. Instead, he utilizes non-medical alternatives, which have been proven -- in an ever-expanding body of research and also in his professional experience -- to be largely more effective, safe, and humane.