Thursday, February 15, 2018

What's The Matter With Parents Today?

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.

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 nationals√•ng” (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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