why parents get the blame

Popular opinion about the right way to bring up children has, throughout history, varied between authoritarianism at one extreme and liberalism at the other. Child-rearing practices have typically been determined by expediency, experience or belief. Freud’s ideas about child-rearing caused a sea-change in thinking about the relationship between parents and children, because his ideas were based on an explicit theory involving the biological characteristics of human beings, rather than being derived from beliefs or pragmatic responses to circumstance.

Sigmund Freud

If I’ve understood Freudian psychodynamic theory correctly, it’s grounded in the Darwinian principles of inherited characteristics and natural selection. Freud proposed that the psychological forces that drive behaviour are passed on from generation to generation in the same way as physical characteristics are inherited. Over time, natural selection ensures that the physical characteristics and behavioural drives that maximise a species’ chances of survival are preserved. During a child’s development, all that’s required for these biologically provided physical and behavioural characteristics to ‘unfold’ naturally is a suitable environment. Physical development can be ‘disturbed’ by factors such as a poor diet or living conditions or by practices such as circumcision or foot-binding; behavioural development can be disturbed by parents or other adults being too controlling or imposing unnecessary social or religious taboos. In short, the model is one of each child having a species-specific genetic blueprint for development that, given appropriate conditions, will unfold naturally to produce a healthy adult human being. Two factors could disturb that unfolding process;

-a fault in the mechanism of inheritance (a chromosomal abnormality)
or
-external interference with the child’s natural course of development.

Two key points about the psychodynamic model

Firstly, the psychodynamic model assumes that potentially there is such a thing as a ‘normal’ human being – someone whose biologically provided development has been allowed to unfold naturally – even if in real life, the course of development is often disturbed, resulting in everybody having flaws of some kind.

The second point is that this theory puts parents squarely in the firing-line – developmental problems arise either because parents have passed on their faulty genes (even if they have no control over that) or because they are the most likely suspects when it comes to the child’s course of development being disrupted.

Psychodynamic theory had a huge impact on thinking about child development in the early part of the 20th century – it made people think about child development for a start. It also had beneficial outcomes for many children in terms of their health, education and psychological development. But there was a downside. Regardless of the personal views of psychodynamic theorists, psychodynamic theory is closely associated with eugenics. Although genocide, enforced sterilisation and limiting opportunities for certain sectors of the community have happened throughout history and would probably have happened in the early 20th century even if psychodynamics hadn’t been thought of, psychodynamic theory undoubtedly lent weight to these policies.

Logo from the Second International Eugenics Conference, 1921

Both Freud and Kanner were aware that knowledge about the biological process of inheritance was sketchy, and both expected subsequent research to shed light on their theories. Although some of Freud’s ideas have received support, there’s little evidence for the idea that social and sexual behaviour derives solely from unconscious drives. Although unconscious processes must affect social and sexual behaviour, the brain areas most involved during our interactions with others are higher-level rather than lower-level areas.

Despite 50 years of research into genetics and brain function bringing psychodynamic theory into question, the two explanations offered by psychodynamics for abnormal human behaviour have become deeply embedded in popular thinking in the developed world; either there’s a genetic/medical explanation or the parents must be responsible. Since WWII politicians and social scientists, not surprisingly, have been wary of genetic explanations for atypical or socially unacceptable behaviour, so causes are frequently framed only in environmental terms, often in terms of childhood experiences. In the absence of a medical diagnosis, the parent is often assumed to be responsible. But research suggests that the relationship between genes, environment and behaviour is much more complex than psychodynamic theory suggested.

Genes

The psychodynamic model saw genetic material as providing a blueprint – an engineering diagram – for development, based on Gregor Mendel’s ideas of independent segregation and assortment of genes. But later research has shown that DNA doesn’t work quite like that. DNA is a complex molecule, so when gametes (eggs or sperm) are formed, and when DNA from two parents combines during fertilisation, there’s plenty of scope for genetic variation. Indeed it’s the genetic variation in individuals that maximises a species’ chances of surviving environmental change. Because of the structure of the DNA molecule, some genetic variations are robust enough to be transmitted between generations and are inherited. Others might arise spontaneously. Some variations are common, others rare. As far as genetics is concerned, it’s meaningful to talk about ‘normal’ and ‘abnormal’ in descriptive terms (most people are like this but not like that) but not in normative terms (people should be like this but not like that).

Environment

Human beings are biochemical organisms so many environmental factors impact on our development. Some (epigenetic) factors can affect the expression of genes. Other factors, such as diet, toxins, allergens or infections can disrupt physiology and development. Other people’s behaviour affects children but parents aren’t the only people involved; other children, teachers, neighbours and wider community and societal issues can have a significant impact on a child’s development.

In short, what the last 50 years of research has shown is that inherited characteristics and parental behaviour are only two of many factors that interact in complex ways to influence a child’s development. But you wouldn’t know to that to look at current ideas regarding child health, education and social care. In fact, social policy relating to children often reflects the psychodynamic model rather than modern understandings about genetics and child development. I suggest this is largely because of the way we think.

The way we think; heuristics and biases

Human beings are capable of using logical, rational thought but as Herb Simon pointed out, we tend to do so only as a last resort. That’s because the ways of thinking that we’ve evolved as a default tend to be in the form of heuristics (rules of thumb) and biases (inbuilt tendencies) – rough and ready ways of responding to our environment. That’s because rough and ready ways of thinking that are due to the way our brains are wired up and that improve our chances of survival are more likely to get passed on to our offspring. These thinking strategies might maximise our chances of survival, but unfortunately they don’t lend themselves to figuring out solutions to complex problems or planning long-term strategies that will make everybody’s lives better.

For example, human beings have excellent pattern-matching skills. These enable us to recognise a tiger, a rattlesnake or our children, in an instant. They also result in pareidolia – seeing a pattern as significant when it isn’t. We’re good at spotting correlations; helpful when trying to figure out what causes what, but meaning we have a tendency to conflate correlation with causality. We like phenomena to have explanations; that improves our understanding of the world around us, but also results in us inventing concepts like ghosts or evil spirits. We’re also prone to looking for agents -assuming that if something happens someone must have made it happen – not that it could have happened by chance. Heuristics and biases have been investigated in some depth, notably by Daniel Kahnemann, Paul Slovic and Amos Tversky. You can find an extensive list of human biases here, though it’s likely that many of them are actually different facets of a few underlying cognitive phenomena.

Bettelheim’s philosophers

People have long been aware that we don’t get information directly from the world around us, but via the filter of our perceptions. Errors and biases in our perceptions result in theories like the sun moving round the earth or the earth being flat. It’s only when our observations don’t match up with how we think things work that we start using logical rational thought to figure out why. The problem of how to work round unreliable perceptions was what Bettelheim’s favourite philosophers were attempting to tackle. The reason they didn’t opt for the scientific method, which has developed as a way of counteracting unhelpful perceptive errors, was I suspect, because science also gets things wrong. A fundamental point to bear in mind is that science doesn’t deal in certainties, but in degrees of uncertainty. We have enough certainty about some phenomena to land probes on Mars, replace human organs and communicate instantly with someone on the other side of the world. We’re much less certain about the causes of other phenomena – human behaviour, for one. But science has a large toolbox of methods for systematically eliminating less likely explanations for phenomena and investigating explanations that are more likely, so even though our knowledge will always be subject to our perceptions and will always be limited, it is possible to have knowledge that’s reliable enough to be useful.

In my previous post, I highlighted two differences between Kanner and Bettelheim; their use of evidence and their level of relevant expertise. I suggest that these two factors are among the reasons why parents are often (wrongly) blamed for their children’s behaviour.

The use of evidence

Science evaluates evidence by comparing hypotheses about how things happen with observations of what happens. If a theory makes predictions and they turn out to be wrong, we modify the theory – evidence that conflicts with theory can be very informative. Other disciplines handle evidence differently. In disputes, for example, opposing parties marshal evidence that supports their argument, and in courts of law or formal debates an independent party evaluates the evidence from both sides and makes a decision about which is most likely to accurately map onto the real world. The difference between the use of evidence in science and in adversarial situations is that what’s most important to science is what’s actually happening in the real world, not who wins an argument about what’s happening. Obviously scientists do have arguments – and whoever wins influences which theories get investigated and which don’t, but that’s not what science is about.

Many people developing social policy in relation to children are from disciplines that don’t handle evidence in the way science does, so legislation is often derived from policy-based evidence rather than evidence-based policy.

Levels of relevant expertise

Some years ago, I carried out a short research project on men’s and women’s perceptions of the clothing that women wore to work. I employed a technique called card sorts which had previously been used to find out how experts categorised their knowledge. What I found was that men tended to see women’s workwear in either/or terms (e.g. either the woman is married or she isn’t) significantly more frequently than women did. Some people thought this demonstrated that men think in black-and-white terms whereas women think in shades of grey, but other work with card sorts shows that experts in a particular knowledge domain tend to use more complex categorisation than novices. This suggests that women are likely to be experts on the non-verbal signals conveyed by other women’s clothing, but men aren’t. There are implications for theories about how women dress, but that’s another story. Most of my male research participants were professionals, so for the purposes of this post, what my study demonstrated is that you can be an expert in one domain, but a novice in another.

I don’t dispute that GPs, teachers and social workers have expertise; whether they have expertise that enables them figure out who or what is to blame for a child’s abnormal behaviour is another matter. It would be unrealistic to expect everybody to know about everything, but it doesn’t seem unreasonable to expect professionals working with children to have a basic grasp of relevant factors from other domains. For example, I’ve had to explain to a local authority attendance officer why doctors don’t prescribe antibiotics for viral infections. I’ve disagreed with a GP about the ‘gold-standard’ nature of randomised controlled trials and NICE guidelines. And I didn’t even try to explain one of my son’s teachers why spelling isn’t simply reading in reverse, that is, why he might be a good reader but be incapable of spelling words of more than three letters. I’m not alone; recent reports from the UK have drawn attention to the lack of training in child development received by GPs, teachers and social workers.

In the next post, I want to examine three areas where use of evidence and levels of expertise have had a significant impact on social policy development and on the experience of children showing atypical behaviours; attachment theory, fabricated and induced illness and cyclical models of socio-economic deprivation.

Further reading

Kennedy, I (2010). Getting it right for children and young people: Overcoming cultural barriers in the NHS so as to meet their needs. HMSO.

Munro, E (2011). The Munro Review of Child Protection. Final Report: A Child-Centred System. HMSO.

Rugg, G. & McGeorge, P. (2005). The sorting techniques: a tutorial paper on card sorts, picture sorts and item sorts. Expert Systems,22, 94-107.

Teather, S. (2011). Support and Aspiration: A new approach to special educational needs and disability – a consultation. HMSO.

Photograph of Freud by Max Halberstadt, 1921. Image from the Google-hosted LIFE Photo Archive where it is available under the filename e45a47b1b422cca3.

psychiatrists of Europe

"Psychiatrists of Europe! Protect your sanctified diagnoses!" A cartoon by Emil Kraepelin.

Leo Kanner was influenced, I suggest, primarily by two concepts, Kraepelin’s taxonomy of mental disorders and Freudian psychodynamics. But before moving on to Kanner’s landmark paper, I want to take a look at the thinking behind Kraepelin’s classification and Freud’s ideas.

Beliefs about the causes of human behaviour changed a great deal during the 19th century. At the beginning of the 1800s, the long-held idea that human beings had two independent spheres of existence – the spiritual and the physical – was being widely questioned. By the end of the 1800s, another idea was in doubt – this time the separate existence of the mind and the brain. I suggest this challenge came about largely because of two fields of research; the study of brain pathology and Darwin’s work on natural selection.

Brain pathology: the brain-behaviour connection

During the 19th century knowledge about the anatomy and function of the brain increased significantly, mainly because of the study of brain damage. Armed conflict and poor working conditions were commonplace in Europe and the US, so there was no shortage of brain-damaged patients for researchers to observe. Famous case studies were published involving personality changes (Phineas Gage) or specific cognitive impairments (Dejerine’s Monsieur C.). By the end of the century, the link between brain damage – from accidents or stroke – and abnormal behaviour was well established. Finding the cause of abnormal behaviour in people who appeared to have no sign of physical damage proved more challenging.

Kraepelin’s taxonomy

A German psychiatrist called Emil Kraepelin decided to tackle this problem. The chances of finding the causes of somatic disorders (disorders of the body) had improved by applying a simple principle of diagnosis; that the same signs and symptoms in different patients were very likely to have the same cause. If the causes of mental disorders (disorders of the mind) such as delusions, dementia and abnormal behaviour actually originated in an organ of the body, the brain, the same principle of diagnosis could be applied to them. A complication was that the symptoms of different somatic disorders sometimes overlap, so Kraepelin proposed that mental disorders should be identified by their unique pattern of symptoms and by how those patterns changed over time.

From 1887 onwards Kraepelin developed a classification of mental disorders in successive editions of his Textbook of Psychiatry. He concluded that mental disorders could be grouped into two main types; dementia praecox (in which the patient’s condition deteriorated) and manic depressive illness (in which episodes of illness were interspersed by periods of good health). Although classifications of mental disorders have changed a great deal since then, Kraepelin’s system forms the foundation for the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases: Mental and Behavioural Disorders (ICD) used today.

Emil Kraepelin had been born in Neustrelitz, Germany in February 1856. Three months later, 800 km away in what is now Příbor in the Czech Republic, another figure who had a significant influence on the way mental disorders were understood came into the world – Sigmund Freud. (Interestingly, Freud’s parents, like Leo Kanner’s, were Galician Jews.) Eighteen years later, both Freud and Kraepelin were studying medicine – Freud in Vienna and Kraepelin in Leipzig.

The influence of Darwin

When Kraepelin and Freud were three years old, Charles Darwin published his major work On the Origin of Species. What Darwin proposed was that an individual organism’s inherited characteristics determine how well it survives in a given environment. If the organism survives long enough to reproduce, its characteristics will be passed on to its offspring. Over time the characteristics of a particular species will change, the changes reflecting environmental conditions. Given a sufficient length of time completely new species could develop. Darwin’s ideas are an important component of Freud’s concept of psychodynamics.

Freudian psychodynamics

Freud had graduated in 1881 and began work as a neurologist with Theodor Meynert in Vienna. In 1885 he had the opportunity to study under Jean-Martin Charcot, the famous French neurologist. This was a turning point for Freud. Charcot’s use of hypnosis to treat hysteria triggered Freud’s interest in mental disorders and led to his development of psychodynamic theory.

A fundamental concept in psychodynamics is that of instinctive drives such as the desires for food, social interaction and sex, that shape behaviour. With Meynert Freud had studied brain anatomy, and believed that instinctive drives originated in the brain. Like other biological characteristics, drives are passed on to subsequent generations via sexual reproduction. Natural selection acts in favour of drives that increase the likelihood of successful reproduction, resulting over time in species-specific patterns of instinctive behaviour. Freud suggested that the normal development of these patterns can be disrupted by early experiences such as a parent withholding food or affection, or imposing religious or cultural taboos on a child. Because of the importance of sexual reproduction in one generation passing on drives to the next, social and sexual behaviours are a very important part of the psychodynamic framework.

Kraepelin’s taxonomy and Freud’s psychodynamics influenced Leo Kanner partly because of Adolf Meyer, Kanner’s boss at Johns Hopkins Hospital. Meyer, ten years younger than Kraepelin and Freud, had qualified as a neuropathologist in Zurich. Because of problems getting a secure post, he had emigrated to the US in 1892, where he became a highly influential figure, becoming director of the Psychiatric Institute in New York, professor of Psychiatry at Cornell, director of the first inpatient psychiatric unit in the US at Johns Hopkins hospital and president of the American Psychiatric Association. Whilst at John Hopkins he put Kanner in charge of the first academic child psychiatric department and the clinic where Kanner first saw patients with childhood autism.

Reading list

Bentall, R. (2004). Madness Explained: Psychosis and Human Nature, Penguin.

A radical appraisal of the way psychotic illnesses are classified.

Gardner, H. (1977). The Shattered Mind: The Person After Brain Damage, Routledge & Kegan Paul.

A fascinating account of Gardner’s experience working with brain-damaged patients and the history of brain-damage research. And yes, it is the Howard Gardner who wrote Multiple Intelligences.

Again, much of the biographical material came from Wikipedia. For a summary see Hall of Fame.