I think the psychiatrist is way off base, and I don't believe that every psychiatrist thinks that way.
I do, unfortunately. Maybe not every psychiatrist. Maybe not even 90%. But if this is what was taught at some stage, then yes, even if more modern thinking has tossed this out, there will still be a lot who think this way.
It's a sort of "seek and ye shall find" thing, too. If you look for mental illness in the parents of a difficult child, you have a good chance of finding it. We had a thread not that long ago about how many of us felt that our difficult children were possibly causing mental illness in us, the parents. Also ow many of the problems in our kids may have had a heritable component form us?
So yes, if the psychiatrists look at the parent first, they generally will find something wrong. You can cast a psychiatrist eye over just about any random person and find something wrong. The problem is - when they then stop looking any further, including at the child who dragged us to the psychiatrist in the first place.
Someone was talking about Munchhausen's by proxy and equating it with a parent who has problems temselves but is desperate to get a diagnosis in the child (perhaps to absolve the parent of having anything wrong mentally). Munchhausen's by proxy is more complex than this - it's where the parent deliberately FAKES illness in the child, often causing actual harm to the child, in their desperation to get attention. The aim is attention, the diagnosis is the means. Thus you get parents who will poison their child, partially strangle their baby (to simulate a 'near miss' cot death) all in order to gain sympathy, tea and hugs from the medical profession. I had a lot of contact at one stage with a woman who I'm convinced was a classic Munchhausen's. Some years later I discovered the woman had been through our church a few years before I joined, everyone knew her and I head some hair-raising stories about how her children were always ill and the doctors would never take this poor woman seriously. Yeah, right. Once her children became independent adults and left home, they cut off all contact with their mother but apparently had no more illness. In my contact with this woman, it was obvious that she competed for medical attention with everyone she came into contact with. I was a telephone counsellor for a disability charity, which is why she was ringing me up so much. She never realised I took notes, so I recognised when her story changed. When I gently tried to say, "Didn't you say a few weeks ago that you had diabetes? Then how come the doctor yesterday diagnosed it?" she flew off the handle and accused me of lying; slammed down the phone. She was a scary lady.
So Munchhausen's by proxy - it's much more serious and devious than simply a parent seeking to get a label for their child. it's where the child is being deliberately damaged by that parent in order to get a label. And a child being psychologically damaged by the diagnosis-seeking parent is NOT Munchhausen's, unless the parent is deliberately doing it to induce a condition which would then require treatment for the child. If it's only incidental, it's not really Munchhausen's. But it could be found in the early stages of Munchhausen's by proxy.
Mind you, there is some debate these days as to whether Munchhausen's by proxy is a real disorder. I'm staying out of that one!
DaisyFace, I'm glad you have had a psychiatrist be this honest with you. I'm also very glad that at last someone is believing you about difficult child. THis "blame the parent" attitude has been prevalent for years across the board. I remember being taken for regular weekly therapy when I was in high school; my mother would be seen by counsellors while I was in my (useless) therapy. Mum told me some years later that she had been told to tell me she hates me. Somhow they thought I needed to hear this lie. My mother refused, said she would not lie and would not say such a cruel thing. They may have thought my mother either hated me or was indifferent to me (but if so, why was she going to this trouble for me?) and were either testing her (which I suggested to her at the time) or were trying to elicit SOME emotional response from her.
Years later I met a similar thing with difficult child 1's first specialist. Now, it was glaringly obvious that difficult child 1 had ADHD, at the very least. difficult child 1 was totally unable to sit still or make eye contact. The doctor rapidly diagnosed ADHD, told me that difficult child 1 needed to be kept in the loop regarding his diagnosis (he was right in this, it turned out) and was very supportive; then a few months later the doctor began to focus on me rather than difficult child 1. The doctor would begin with, "How are you coping?" and sounding very sympathetic. Then it grew from there and I began to feel very uncomfortable. This doctor was a pediatrician (it's who we tend to see for this in Australia) and was increasingly fascinated with me and my mental state, to the detriment of difficult child 1. It got to the stage where the doctor was deliberately trying to provoke an emotional response from me because he felt I was suffering from depression. He actually said so - because I was myself trying to cope with my "mystery illness" which had a somewhat controversial diagnosis (CFIDS) and which he felt was not a genuine physical condition (based on his exhaustive observation of one very young patient who was admitted to hospital under his care and who was clearly depressed - what kid wouldn't be, under those circumstances?) he began to insist that there was probably nothing wrong with difficult child 1, other than having a mother with a primary depressive illness. He got more insistent in trying to provoke an emotional response, while I maintained my calm front in order to AVOID an emotional response which I'm sure he would have then pounced on as evidence that I was unstable.
The crunch came when he began to make appointments to see me and told me not to bother taking difficult child 1 out of school for the appointment. "But HE is the patient!" I insisted.
Then I made an appointment, wrote it into my diary and said in passing, "That wil be a really convenient time, because husband will be able to bring me, I do find the drive physically tiring. husband & I can go on to do some shopping afterwards."
The doctor immediately cancelled that appointment, said he was unavailable after all. Insisted I was not to bring husband. Or difficult child 1.
Of course, husband heard this and changed his day off to coincide with the appointment, but to respect the doctor, husband stayed outside and did not come in. At the time I was doing a self-esteem course (which had a certain amount of conflict resolution in it). I had some months earlier even self-referred to the boss of the same clinic, a psychiatrist, to investigate my own mental state since another doctor of mine had also said, "I'm concerned for you - trying to cope with a difficult child plus your own disability; please see someone to assess how you're coping."
And the psychiatrist had cleared me, even after I blurted out everything I could think of.
So I went in to see that pediatrician, armed. I began very quickly. "I felt very uncomfortable when you said you wanted to see me, but did not want either my son (you patient) or my husband present."
[Light blue touch paper, stand well back - it got the result I expected but had not deserved]. "What a dirty mind you have! What are you trying to say? I am not being inappropriate!"
"I did not say you were. I merely stated that it made me feel uncomfortable. Will you please explain why you have requested this?"
He backed down. I think he realised he'd reacted too hastily (guilty conscience?)
He finally explained, "You are an intelligent woman who has not achieved as much as you should have, and I think in the resulting depression you have, you have developed this fake medical condition in order to absolve yourself of the responsibility to achieve. Your mind has chosen an easy way out. Now - don't say anything now, just go home and think about it."
I did say, "I saw a psychiatrist, she gave me a clean bill of mental health."
"What would SHE know?" He was scathing.
He replied, "That just shows how sick you really are, if you could hide it so well. Besides, what would SHE know?"
"She is your boss," I replied. "What would YOU know?"
"Well, I did top my year in psychiatry at medication school," he told me.
So as I had promised, I went away and thought about it. husband met me at the car, he could see I was seething. I had again held off my emotional response until I left the clinic, but I more than made up for it. I ran through the whole thing for husband who agreed, this guy was sick. And what was more important, none of this was helping difficult child 1. I had actually asked about difficult child 1's medication level and the doctor had said to me, "Well, we could halve it. Or we could double it. Or we could leave it the same. What do YOU think?"
I replied, "You're the doctor, not me. That's why I asked you."
But he was clearly playing games with me, again trying to make me angry.
I thought about it then wrote him a letter. I really enjoyed writing that letter. I put in some humour and a lot of sarcasm. I kept it clean (although I did say at one point that he had claimed I had chosen "an easy way out" in developing this condition - by that logic, since my condition made my life a lot more difficult, he must believe that my preferred sexual position would be standing up in a hammock. I also asked (rhetorically) why, if he had topped his year in psychiatry at medication school, had he not gone into psychiatry but chosen the softer pediatrics instead? Did he feel he didn't have what it took to be a psychiatrist, and was the resulting depression in failing to achieve his life's ambitions need to be sublimated by attacking the mothers of his patients?
I had fun. I sent it off to him before I changed my mind, then rang up to cancel all future appointments and request the file be transferred.
Meanwhile this doctor (idiot!) began to prove me right by showing my letter all around the clinic, including attempting to show it to difficult child 1's therapist. It was this therapist who said to me, "I suspect you are now in the market for a new pediatrician. Try this other bloke."
I hate to think what that pediaitrican would have said or done, if he had known of the autism - he would have been obsessed with the 'cold mother" theory, and made my life even more miserable.
As it turned out - some years later when difficult child 3 was admitted to hospital with croup at the age of 2, it was this same pediatrician who was appointed to his case. He either didn't recognise me, or chose to pretend he hadn't recognised me. I suspect the former. And thankfully difficult child 3 was not diagnosed with autism at the time.
So I am CERTAIN that much of the time, probably the majority of the time, the first thing the docs do, is scrutinise the parents. And when you consider how frantic we may seem when we first take our kid to see someone, is it any wonder that this scrutiny takes the easy way out and doesn't look past the obvious signs of anxious parent?
Medicine is an inexact science. mental health doubly so.
With hindsight - I should have taken husband with me to those appointments. But it's not always possible; back then husband had a very high-powered, 12 hour a day job which gave him no free time except by careful prior arrangement and grovelling to the boss. And not everyone has a partner - of course, those parents who are struggling on their own are much more likely to show signs of stress and "something must be wrong with them" for them to be having to cope as singles.
Sometimes I wish society were a single individual so I could smack it.
Marg
