Thursday, January 26, 2017


A dramatic plea for help has come in response to “Oppositional Defiant Disorder” posted 2-18-12, which always gets more hits than most other posts on this blog.  In fact, I’ve been thinking about it again myself because of Trump, who makes a good illustration.

The person, calling herself “Raven Albatross” because I stopped accepting anonymous comments, tells a long story.  She is a perpetual student, caught in that terrible national vortex of going to school, finding the degree doesn’t lead to an income, going back for another degree, repeating the same experience until debt levels are too high to function.  She is clearly intelligent and researches her dilemmas, but she doesn’t say how or whom she has contacted in terms of research.  She has come to the attention of cops, which meant visiting a “shrink”.  Neither was helpful.

I’m not an expert.  I cannot cure ODD.  It’s a great temptation to create a term like ODD and then treat it as though it were something real, with clear boundaries.  Then the definition begins to suggest how to think about it and we get stuck.  Or someone comes up with a pet reason or cure and bends the evidence and results to match their original concept. It may be part of something bigger or it may be a big consequence of a small thing, or sometimes it’s a legitimate survival mechanism in a bad situation.  It’s important not to get captured by one idea so as to look from different angles. 

As they say,  it’s not paranoia if something is really after you.  Right now, everyone in the country is paranoid.  It’s a marketing strategy:  the two major themes are sex and danger, esp. economic danger.  No one will sleep with you and you’re bound to go broke and live on the street.

Lately we’ve all been fascinated by the brain mechanisms behind the forehead, the prefrontal cortex and its function as a dashboard for a multitude of perceptions, assumptions and judgements.  Also, a team headed by Joseph LeDoux is very interested in the amygdala which decides whether danger should be responded to by fight, flight or freeze actions.  It’s a little blob, often compared to an almond but turning out to be complex;  a problem there can definitely make you nutty.

When people begin to feel or act in atypical ways, sometimes inconvenient, authorities (since they are supposed to “know”) define a “syndrome” according to some psychiatric model or system devised by someone like Freud or Jung, which was only invented from reflection with no physical evidence.  Today’s psychological community uses thought experiments to discover unconscious functions of the brain and there are a LOT of them, sometimes very powerful.  These ideas get sucked up by the media, not entirely understood, and gradually turn into something approaching morality.  That is, people are blamed for narcissism or punished for being defiant or oppositional, sometimes criminalized and arrested for not accepting the commands of authority.  Jobs and marriages are lost.

Generally, most people accept the idea that a child goes through a stage of defiance, evidently in service to separation from care-givers so as to become their own identity.  Sometimes it’s funny.  (“Would you like some ice cream?”  Toddler, bellowing:  “NO!”)  If a child (meaning too young to turn away force) is afraid or enraged, punished to the point of trauma (which might be what came first), a cycle of defiance and force may develop that is life-threatening.  Even a surviving child may be too quick to throw up an impenetrable wall that could blight their life.

There is some thought, and probably research, into the coincidence of this emotional refusal with the time that toddler’s brains are being “pruned” by the withering of any neurological branches that are unused.  Sometimes very old people become oppositional in the same way.

When we get into the work of Joseph LeDoux, we are on new ground that doesn’t use philosophical constructs of what theoretical forces are clambering around in your unconscious.  Rather they look at the molecular and cell structures, how they interact, and what can be done about it.  Neuroresearch is evidence-based and not very well reconciled with the traditional “talking cure” psychoanalytic approaches so far.

The commenter was in a car accident, quite serious, but seemingly only suffered minor injuries.  She says, “I went into a traumatic like withdrawal from reality. Weird thing is for two months after the accident (when I became so reclusive that I ended up diagnosed agoraphobic as well as manic depressive, which is a form of bipolar).”  It was not LIKE trauma! A serious car accident IS trauma!  The withdrawal from reality might be called “dissociation” which offers another term to look up, though it’s not that well understood.  Sometimes it’s related to split personality.  Other times it’s seen as a way of coping with abuse.  PTSD is the acronym for combat dissociation: “post-traumatic stress disorder”.  Flashbacks, unwanted thoughts, difficulty in controlling mood,  going to violence easily, and a lot of other unpleasant things.

Agoraphobia, reclusiveness, manic depression, bipolar or ODD, general balkiness and refusal to agree, are all psychoanalytic concepts, labels about emotional and rational life that make a person anti-social, thus attracting treatment, adjustment, even incarceration.  They are REAL and there are a lot of people struggling with them.  They can serve an important purpose.  But that’s not the same thing as neurology, which is how the tissue of the body functions, actually DOES things at the cell level.

These syndromes can be triggered by drug episodes (legal or illegal) and by viral infections of the brain, which we begin to recognize are more common than we previously thought.  The brain had been thought to be protected by blood barriers but now we locate slippery little by-paths.

One of the major changes in the way we think about a person is in terms of identity, which was once seen as a steady state, a box with labels or a sculptured construct that stays the same through life.  It’s YOU and others recognize it that way, though each relationship is a little different. 

Now the idea that seems to fit the best is that a person is an interacting set of processes that is assembled from the unconsciousness of sleep into the consciousness of waking, subtly new every time because the work of sleep does memory sorting and makes new connections.  The “connectome” is the word for the networking (internal internet) of signals shuttling around, ESPECIALLY IN THE OLD PARTS OF THE BRAIN.  You might not be conscious of all the commotion, but it can be detected with special machines like the fMRI.  Even when asleep, the brain is still busy keeping heart, lungs, kidneys and so on operating or you won’t wake up.  The brain’s main work is NOT thinking, but rather the maintenance of homeostasis in the body for the purpose of survival.  

Concurrent with this paradigm shift from box to something more like music, is that there is no reality.  NO REALITY.  All the aspects of the world that impact our skins and organs are things like electromagnetic light waves or sound vibrations — so you’re right to suspect all the waves we’re producing as well as waves from the sun and the cosmos, but that’s not what I mean.  I mean that the brain does not receive faces or words or tunes — it composes them from whatever the nerves attached to sensory receivers produce in the way of code.  Not everyone has the same sort of receivers.  More than that, much of the “wet ware” in the brain will interpret what it receives in possibly inaccurate ways.  It can only work with the categories it already has, until something happens to create a new category.  

There is a LOT to read about neurological research and I think it is far more helpful than “shrink advice”.  A good shrink is more than a diagnostician, but also a companion and support as the search goes on.  (Everyone’s search always goes on.)  A psychiatrist can handle drugs because of also earning MD credentials, but a clinical psychologist might be warmer because of NOT earning MD credentials, which encourage a cold objective approach.

As I say, I’m no medical or psychological expert, but my opinion is that when your car rolled, you got a significant head blow and should be checked for clots, bleeds, and tearing.  It would take very little damage to create ODD if it were in the right place.  Look for people who know about “closed skull trauma,” meaning that the damage doesn’t include cracks in your skull but rather damage in the soft tissue.  Go to the nearest university medical school and ask them to find you the closest neurology research lab.  

There’s a ton of things to read in the research.  Do not trust Wikipedia, but google can be very helpful if you’re looking for definitions or the work of someone like Joseph LeDoux.  In fact, he’s on YouTube, giving lectures.  I sometimes have to watch them three times to “get it” or there is sometimes a transcription feature with the vid.

Your advice to turn off the television and limit the radio is probably wise even for someone who has no apparent problem.  Television is jammed with plots meant to be sensational, frightening, and addictive.  And that’s just the news!  (Jokes.)

If you give me an email address, I can communicate more privately.

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