Discussing
the Florida gun outrage, from my pediatrician friend Glenn Schlundt
in Pasadena, in a post to the SOAPM listserve:
In
my area, the children, and the parents, are so different now than
they were even 10 years ago. So many parents are adult children
themselves. Many of them - even those in their 30's - have the coping
skills I associate with teen parents. In some cases, it is due to
exhaustion from working full time and then coming home to a child
that has been left to fend for itself in a daycare setting, and who
understandably has more needs than its predecessor twenty years ago.
Some of it is from an apparent inability to see what their child
needs, and - fundamentally - to set limits in a calm, warm,
consistent manner. So many young parents in my practice react with
frustration when their child seeks limits, and then are mystified
when their child gets anxious.
In our area, the cost of living has exploded. I
can't even use the word "soared," as it would be
inaccurate. Growing up, homes in my neighborhood went for ~$25,000.
This would have been about 1970. Those homes now have bidding wars
and sell over the $1.2 million. The public school system is
legendarily awful, so those who can send their kids to private
school. The average tuition for kindergarten (yup, you read that
right) is $25,000.00. High schools are in the $50,000 per year range.
Those who can't get their kids in (there are not enough spaces), end
up moving to a more expensive neighboring city.
Working parents are drowning. The kids get less time with their parents now than they ever did. Some of them are simply orphans with a bedroom.
Working parents are drowning. The kids get less time with their parents now than they ever did. Some of them are simply orphans with a bedroom.
The
amount of time and energy I spend counseling parents and teaching
basic Skinnerian behavior modification, discussing tenets of Bowlby,
referring to Jack Shonkoff's website, and helping parents with
concepts like their child's magical thinking and regression in the
service of the ego has also skyrocketed. The part that is often most
difficult is that many of these parents cannot listen until they have
been given a chance to talk, and there are not that many hours in the
day. When they come back, everyone is often sad to find that their
carrier now does not cover any F codes, so they get stuck with their
bill, so there is more frustration. Every psychiatrist in our area is
$650 per hour. None that I know of worth seeing takes insurance, and
they all have wait lists.
What
does this have to do with gun violence? I think it has a lot to do
with it, and with road rage, and a lot of other things to which those
of us in L.A. have long since become inured.
What
to do about it? Rearranging priorities and making time to
listen to people, establishing and enforcing rules, realizing
that too much permissiveness, either individually or societally, can
makes people of all ages feel as unsafe as easy access to weapons
does.
That
would be a wonderful start.
Glenn
Schlundt, MD
Rose
City Pediatrics
Pasadena,
CA
Pediatricians have an
advantageous viewpoint; we see the soil from which outrages stem.
Tension and anxiety, arising from economic stress, have always been
linked to suicide rates. Given a militaristic culture – note how
all the ballgames feature military themes with flags along with the
national anthem, which is itself military, no “O Canada!” or
“Sveriges nationalsång” (Sweden) for us – and gun access,
aggression on others replaces aggression upon self. Poor educational
institutions arise from poor funding and poor educational training
institutions and dead end bureaucracy, and not enough attention to
emotional needs. In our area in Alameda county in the lower grades
there is a student/teacher ratio of 31:1, and no aides.
Unconscionable and just stupid, really. So, this is what
pediatricians like Glenn see in the offices.
Social policy and individual
psychopathology are linked, and it's not just gun control, although
that's involved, surely. Yes, the Right is right, personal
psychopathology is important and should be attended to. I have yet
to see, however, any Right proposals to do just that, which means
money and mouth aren't meeting.
Myself, I see it as an
infrastructure problem. “Infrastructure” isn't just asphalt,
bricks and bridges; human infrastructure, human capital is the more
important infrastructure in the modern world. Paying more for
education and social support, more social capital investment, more
true long term investment instead of eating the seed corn, less
investment in luxury and military. Ojala!
Oh, yes, and more money for
patients to visit people like Glenn down in the trenches. Pediatrics
is more important than people know.
Budd Shenkin
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