Irving N. Berlin

Effects of changing native American cultures on child development

Dislocation of native American tribes and pueblos and the alteration of traditional ways of earning a living, with ensuing poverty, on dislocated reservations has had a major impact on many native American communities. Poverty, hopelessness, and the attractiveness of Anglo possessions have led to reducing the importance of tradition and ancient culture in the everyday life of many American Indians. Under these circumstances, adult alcoholism reduces the capacity to parent infants and children and results in developmental deviations. Child abuse and neglect result in developmental problems noted in poor school performance, depression, adolescent alcoholism and suicide, etc. Efforts of a few American Indian communities to emphasize the teaching of traditional ways and to deal with community problems in new ways are described. They are encouraging. These pilot efforts, which emanate from the tribe or are encouraged and helped along by mental health consultants, begin to alter the status and sense of well-being of the adults and adolescents. Some pilot projects described here deal with altering the young, “high-risk,” adolescent womans image and understanding of herself and with her subsequent parenting of children, with its profound effect on newborn infants and their development. The effort of these projects is to reverse the maldevelopment of the young in the hope that more integrated, competent, and creative native American adolescents and adults will enhance the teaching and learning of tradition—that these efforts will help more native Americans to find ways of using the tools of modern Anglo society so they do not do away with the ancient customs and traditions and their healthy impact on daily living.

Psychopathology and Its Antecedents among American Indian Adolescents

The psychopathology among American Indian adolescents appears qualitatively similar to that found in the rest of the United States adolescent population. There are, however, substantial quantitative differences in psychopathology among various tribes and in comparison to non-native American adolescents. In some circumstances, there are qualitative differences also. In a few tribes adolescents appear to have no greater incidence of major psychopathology than do adolescents in the Anglo population. But in many tribes, the incidence is far greater than that found in the Anglo population. When this quantitative difference occurs it is usually in a tribe with a juxtaposition of extreme poverty, fragmentation of both the nuclear and extended family, and serious morale problems stemming mainly from enormous changes in religious traditions and traditional ways of living. Enforced reservation life frequently has contributed heavily to the demoralization of these tribes by denying them, in effect, their traditional means of subsistence, like hunting, and providing no new means of becoming economically self-sufficient, through agriculture or herding, for instance.

Some transference and countertransference issues in the playroom.

Abstract Transference and countertransference issues in child psychotherapy are rarely discussed in the child psychiatric literature and are infrequent in the psychoanalytic literature. This paper reviews some of the historic and current literature regarding tranference and countertransference in psychotherapeutic work with children, including the rarely described countertransference problems arising from child sexual and seductive behavior. A developmental approach to these issues is presented with illustrative vignettes.

The role of the Community Mental Health Center in prevention of infant, child and adolescent disorders: Retrospect and prospect

The Congressional Joint Commission on Mental Health of Children 1965–67 gathered and published a great deal of data on Prevention and Early Intervention that was subsequently ignored by Congress and the Administration. Community Mental Health Centers, since their beginnings in the mid 60s, have not been able to concern themselves with prevention because of the overwhelming demands for treatment of a very psychiatrically disturbed adult population. The closing of State Hospitals without provision for community resources to care for these severely disturbed individuals, for economic and political reasons, unfairly burdened community mental health centers. In the intervening years, a great deal more has been learned about primary, secondary, and tertiary prevention for infants, children and adolescents. This paper describes some of the new knowledge and indicates how much of our current knowledge could be used by Community Mental Health Centers to take advantage of the new funding available in many prevention areas. A few early intervention and prevention projects are described.

Family Treatment of Chronic Illness in a Child: Mutual Developmental Problems

Development has only recently been thought of as a continuum, both in children and adults, throughout the entire life cycle (Erikson, 1963). There have been a number of papers which recognize that parenthood is an important developmental phase, not previously discussed until Theresa Benedek (1959) and others pointed out that adult development is especially affected by marriage and parenthood, and that failures in development are important issues to be examined in the treatment of adults. It has been our experience, in working with disorganized families, that one of the major obstacles in helping a family towards more integrative behavior is the failure in development in both parents. This failure is threatened as each of their children begins to develop and approach a more successful resolution of developmental tasks than one or the other or both of the parents have yet experienced. Often such developmental attainments in the children are, in part, due to the greater maturity of one parent or a special interest in a child by a teacher or another adult in the child’s life (Berlin, 1979; Anthony, 1973; Anthony and Benedek, 1970).

Resistance to mental health consultation directed at change in public institutions

Mental health consultants need to be aware that institutions in a community are frequently resistant to change. Official agreement that change is necessary may still evoke resistance by those individuals most threatened in the agency. The consultants awareness of how such resistance is manifest and used permits some educative counterefforts which may be effective. There is a brief review of the literature, and case examples are given of effective and noneffective consultation.

Helping the Child and Family with Surgery: Discussion of Dr. Gabriel’s and Dr. Danilowicz’s Paper

It is a pleasure to discuss such a clear and straightforward approach to a problem so many of us have found so difficult. Drs. Gabriel and Danilowicz are probably in more fortunate circumstances than many of us who have tried to get both hospital administrators and pediatric and orthopedic sugreons to recognize the importance of family access to children and to provide for overnight stay. In a recent discussion between Dane Prugh and the past President of the Academy of Pediatrics, they agreed that no more than 10% of hospitals serving children either recognize or provide for family access to children.

The work of play for parents of schizophrenic children

During treatment the schizophrenic child begins to emerge from his constricted, self-centered world and to enjoy interaction, play and playfulness. Many of the parents are as constricted and unable to play as their children. The use of a play corner, dress-up clothes and a staff member who can model roles to play helps reduce the “work” of play for parents and child. Their resulting mutual pleasure and increased spontaneity enhances treatment.