Fake Nostalgia for a Pre-Therapy Past

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Fake Nostalgia for a Pre-Therapy Past By ERIK KOLBELL

Old Gus sat on his customary bar stool in the corner, tossing down the bourbon

and tossing out the barbs.

" I can tell you one thing, " he announced, as I recall. " Back in my day, you

didn't have young kids going around talking to shrinks, yakking about their

fee-ee-ee-lings, getting all doped up on medications.

" Back in my day, kids were kids! We worked out our problems on our own. We

didn't go crying to some stranger with a whole bunch of initials after his

name. "

Gus was ridiculing a conversation a fellow therapist and I were having about a

13-year-old she was treating for depression and acute anxiety. I didn't rise to

his bait, but it wasn't because I had no interest in defending my profession.

Rather, as with the college guys at the other end of the bar lamenting yet

another epic collapse by their beloved Jets (this was before the team got good),

it was that I'd heard the complaint so often it had become tiresome.

Not that Gus was entirely wrong. A greater percentage of young Americans than

ever receive treatment — talk therapy, medication or both — for psychological

disorders, and the number is steadily rising.

But when I think about what life was like in my day (I'm in my mid-50s, and Gus

is probably 20 years older), I'm not so sure this is a bad trend.

One of my most vivid and least cheerful childhood memories is how discouraged I

felt when it dawned on me that most of my peers could sit down for an hour or so

at a time and plow through homework assignments without fidgeting, getting out

of their chairs, pacing the floor or succumbing to the distractions of their

rooms.

Nor was environment the determining factor; I found it difficult to sit still

and concentrate in the classroom, glued to my desk, with an assignment right in

front of me and the teacher hovering over me. It was never a matter of resenting

the work or not knowing how to do it. To my reckoning, it was just physically

impossible to be still and focus on a task for more than a few minutes at a

time.

With this as a part of my past, the first time I read the criteria for attention

deficit hyperactivity disorder — " often fails to give close attention to details

or makes careless mistakes in schoolwork ... fails to finish schoolwork, chores

or duties " and so on — my only surprise was that they didn't include " Prefers

G.I. Joe or flipping through baseball cards to civics lessons and pop quizzes. "

In short, I was an A.D.H.D. kid, lacking only a diagnosis. And now that I know

that the condition was a result of my body's inherent inability to manage the

flow of neurotransmitting chemicals like dopamine and serotonin, all of my

parents' heated entreaties to " buckle down " and " pay attention to what's in

front of you " were about as useful as telling a nearsighted child to see clearly

without glasses.

As I grew into adulthood, I was left with a string of unanswerable but

concentric questions: Could medication have helped me to concentrate on my

schoolwork? If so, would I then have been a more industrious student? And if I

had been a more industrious student, could I have developed more of a passion

for reading and for learning? And if I had developed that passion, would I be a

happier, better, more productive human being? If, and if, and if ... I'll never

know.

And while my own life is dogged by the possibility of unfulfilled possibility —

what might have been had I been treated — what really haunts me is the memory of

full-blown tragedy in the lives of some of my childhood friends.

I think of a pretty but perpetually sullen girl named Maureen, her body scarred

for life by an abusive mother who (as Gus would say) was not above giving her

daughter what for. Or a tall, lanky guy named Dave, a star athlete with

Hollywood looks who stunned us all by putting a gun to his head and taking his

life.

To their horrific stories, I could add the countless quotidian ones of seemingly

normal, everyday kids who endured overbearing siblings or bullying classmates,

who didn't get included in the secret, invited to the prom or chosen for the

volleyball team, whose father one morning just up and left the family because he

got a better offer from another woman. Those who just couldn't work out their

problems on their own (Gus again). Who knows how much more bearable their lives

might have been if they had received the proper intervention?

It was only much later in life that I began to appreciate the many insidious

ways in which psychological well-being can be altered by things outside a

child's command.

Most children exercise very little power over the decisions that affect their

lives. They don't decide who their parents are, where their family will live,

where they will attend school, when they will reach puberty, who will or will

not befriend them. They have limited control over their athletic skills, their

looks, their wit, or whether, in the great Serengeti that is their schoolyard,

they will be predator or prey. They are as much the subject of their story as

its author.

At toxic moments, the insights to be gained from a professional who takes this

stuff seriously (and in some instances the medications that can bring calm to

chaos) are eminently useful to the child who is looking for a narrow path

through some very difficult years.

Of course, there will always be critics. " Look at me, " Gus declaimed as my

friend and I wound down our conversation.

" My old man was a drunk, and I didn't turn out too bad, " he told us proudly, one

word slurring into the next.

Kolbell, a psychotherapist in New York, is the author of a book of essays,

" The God of Second Chances. "

http://www.nytimes.com/2010/03/09/health/09case.html