If a picture is worth a thousand words, then a thousand words must be worth ten thousand words. This is the case with Franz Kafka’s short story, “A Country Doctor.” In just a few paragraphs, Kafka is able to paint a picture of a society losing its internal moorings and turning from the spiritual to the scientific.

In this story, the village physician is called out of bed in the middle of a raging snow storm to attend a young patient. When he arrives at the boy’s house, the family is crowded around his sickbed. The youth cries to the physician, “Save me, save me.” The doctor examines him, but can find nothing wrong, even though the family insists the youth is sick.

The youth again cries, “Will you save me?” The doctor examines him again and sees a gaping sore in the patient’s side, with multiple rose-red layers. “Worms, as thick and long as my little finger, themselves rose coloured and also spattered with blood, are wriggling their white bodies with many limbs from their stronghold in the inner of the wound towards the light.” The family seems pleased to discover that the boy is even more ill than they had imagined. After further examination, the doctor explains that he cannot save the youth. The villagers are incensed and engage in a ritual divesting the doctor of his powers. They chant, circle him, strip off his vestments and throw him out into the wild. Struggling to find his way back through the darkness, the physician thinks:

That’s how people are in my region. Always demanding the impossible from the doctor. They have lost the old faith. The priest sits at home and tears his religious robes to pieces, one after the other. But the doctor is supposed to achieve everything with his delicate surgeon’s hand. Well, it’s what they like to think. I have not offered myself. If they use me for sacred purposes, I let that happen to me as well.

That is what people are like in my district. Always expecting the impossible from the doctor. They have lost their ancient beliefs; the parson sits at home and unravels his vestments, one after another; but the doctor is supposed to be omnipotent with his merciful surgeon’s hand. Well, as it pleases them.

Kafka’s story is more than a fiction. It is a creative snapshot of Kafka’s ongoing attempts to make conscious his personal suffering, and it is an historical account of the evolution of a culture’s consciousness. The modern culture of the 1920s was in the midst of a world war; it was the age of Freud and Jung, Lenin, Stalin, and Trotsky; Mussolini and Hitler; Woodrow Wilson and the failed League of Nations; Ho Chi Minh, Charlie Chaplin and Douglas Fairbanks; Albert Einstein; Kaiser Wilhelm; Hemingway and Fitzgerald; Harry Truman and Winston Churchill; and numerous pioneering aviators, inventors, and scientists. These men heralded the coming of a new age: the age of science, which has now become our kingdom and age.

The Miseducation & Misdiagnosis of Children

It’s not unusual these days to diagnose young children, particularly boys, with psychiatric disorders when the very behaviors that merit a diagnosis today were considered typical boyish behavior in earlier times. Ignoring much of what research has proved time and again about early childhood development, we are adults who want to have our own way, dammit, and we’ll get it even at the expense of our own children. Only later will we discover that we also sacrificed our own souls.

Psychologist, educator, and author David Elkind is one of many who has written prolifically about the destructive trend toward education of younger and younger children, and warned us that dire consequences would proceed from such cavalier and self-interested placements of preschool-aged children into early education. His warnings have fallen on deaf ears, as kindergarten for 3- and 4-year-olds is now common, and nearly as soon as a little child can talk, his parents are taking him to preschool two or more days per week so that mommy and daddy can follow their dreams. A large scale increase in suffering among young children has occurred, occasioning labeling, diagnosing, and medicating that can never heal the wound that parents have inflicted and demanded, and that society has enabled.

The literal meaning of the word psychopathology* is “the expression of the suffering of a soul,” but because we no longer believe in or honor the soul, or engage in meaningful spirituality, or are willing to endure the suffering required of truly loving parents, we have become instead like ancient pagans, putting their sons and daughters into the fires of Ba’al Molech as human sacrifices. And then we dance.

The Abuse of Freedom

I am sick in my soul about the way we as a culture have used the wonderful freedoms and blessings of our nation. We are like the Galatians to whom Saint Paul wrote, “For you were called to freedom, brethren; only do not turn your freedom into an opportunity for the flesh, but through love serve one another. For the whole Law is fulfilled in one word, in the statement, ‘You shall love your neighbor as yourself.’ But if you bite and devour one another, take care lest you be consumed by one another” (Galatians 5:13-15 NAS). We have used our great freedoms as coverings for evil, for self-serving and for the abandonment of our children.

Some detractors of parental sacrifice suggest that it’s better for an ill-equipped mother to leave her wayward boy in the place where he perishes daily than to equip herself to suffer in his place. For such parents, loving one’s neighbor—even if that neighbor is one’s own child—is not part of the modern code of ethics. If given a choice between her child or herself, she must choose herself and stupefy her child with medication. No doubt this is the selfsame wound that was handed her by her parents; but that doesn’t make it right. Even if this is the case, however, part of  healing comes through our willingness to see what we are doing and to do something that relieves suffering rather than increases it. This, in my way of thinking, is the only ethical action a devoted parent can make.

I’ve been surprised to hear Oprah Winfrey say several times that she chose to remain unmarried and childless because she knew she could only do one thing excellently and perfectly at a time. She would never have been able to be an excellent wife and an excellent talk show host at the same time or an excellent wife and mother, and an excellent talk show host at the same time. She chose to be the best Oprah she could be as a talk show host. The rest is history.

I’m surprised that America’s wealthiest woman can say something so forthright and get a pass on it from the popular culture, particularly from other women who are trying to do it all. Does Oprah’s example suggest anything to other women? Do they really think that they can have it all, all at the same time? Do they truly believe that parenting requires only comfortable sacrifice (an oxymoron if ever there was one)? Why are we so unwilling as a people to make sacrifices, to suffer? Why are we so willing to make our children be the problem rather than looking at ourselves or our culture, or both?

We have progressed from putting our faith in the priest to putting it in the physician, psychiatrist, and educator. As such professionals have increasingly let us down and proven themselves to have feet of clay, people have turned to alternative medicines, to the east, and to energy medicine. Now that energy medicine is being legitimized through certification and is on the verge of being accepted by the American Psychological Association as a legitimate means of treating psychopathology, people are increasingly turning to fringe healers and experiences such as shamanism. People who seek the mysterious Other will always have to go beyond science to find it, for “God is Spirit.”

Our faith in the educator remains, however, even though there is considerable evidence that early instruction or too much of the wrong type of instruction can do lasting harm, and that young children subjected too early to the pressures of school and the adult world are at psychological and physical risk. Witness the schedules of the typical American child under age five years: most live with miniature renditions of the schedules of their parents. Because parents work, the child is in effect a working child also. The parents who rise at 6:00 a.m. must also awaken the child; parents who must be to work on time need to have their children in child care or preschool at the same time. Mom and Dad put in their 40-hour week, and Junior puts in his 40-hour week, plus the commute. Add to this the stressors of a regimented “educational” program that was not designed to meet a young child’s developmental needs. It is no wonder that America is experiencing a substantial increase in the incidence of affective disorders among children and adults. The human psyche was never designed to live such stressful lives, yet we do it and we call it “normal.” We turn blind eyes on the consequences.

Early childhood education works well for inner-city poor children: this much we know. But the model for instructing poor children whose home lives are lacking should not be the model for the children of middle- and upper-class parents. What sort of leadership and help can we expect in the next generation from children who are already being subjected to psychotropic medications in preschool and elementary school?

The Results of Miseducation

In 1987, David Elkind predicted that the miseducation of children would result in a generation of teenagers and young adults who “will be more neurotic than teenagers today. They will show more obsessions, more compulsions, more phobias, more psychosomatic symptoms than do teenagers today” (Miseducation: Preschoolers at Risk 202). Twenty years have passed since Elkind wrote his groundbreaking book, and what we have seen is sobering. Not only was Elkind correct, but by now we have seen that he did not predict how dire the consequences would be of early childhood education.

The Archives of General Psychiatry published a study on the incidence of childhood and adolescent psychiatric disorders which found that by the age of 16 years, 36.7% of new psychiatric cases in previously unaffected children met DSM-IV diagnostic criteria for at least one major psychiatric disorder, and approximately one in five children was diagnosable at any given time. The estimate for boys greatly exceeded that for girls, as a result of a much higher cumulative prevalence of Conduct Disorder (CD) and ADHD. Girls accumulated more cases of depression and anxiety disorders. This research was reviewed several times and a consensus reached that at any given time, one in five American children will have a diagnosable DSM-IV psychiatric disorder. Because stress is a major contributor to psychiatric illness, the authors predicted that our ability to measure increased stress as measured by saliva and blood tests for markers of stessor exposure, such as cortisol reactivity, would contribute substantially to the prevention of childhood and adolescent mental illness. As well, our ability to measure the increase of antibody production in response to stress should also contribute to our understanding of just how much stress alone contributes to mental illness in children.

A similar conclusion was also reached in an earlier related study published in 1996. The authors concluded that, “data on a representative population of children and adolescents growing up in the 1990s show that at any given time, one in six will have a psychiatric disorder and at least one in three will have one or more psychiatric disorders by age 16 years.” As children grow older, their psychiatric disorders are more and more likely to be accompanied by significant functional impairment.

I wonder who will suggest what needs to be done to decrease the stress in the lives of young children? If we discover that watching violent television and movies, playing violent video games, or listening to violent music increase stress and thus contribute to mental illness in some children, will we finally see the technology developed to give our children G-rated versions of PG-13 movies? If we find that having one at-home parent and postponing school entry to age five or seven will reduce stress and thus mental illness, will we as a society initiate measures similar to those in other post-modern countries that allow women or men to stay home with young children, without penalty to their careers or livelihoods later? I wonder.

Conduct Disorder, Depression, and Autism

A different study from Duke University, specifically targeting Conduct Disorder (CD), depression, and autism rates in American children, examined the historical diagnostic rates for these disorders. They found that by 1999, twice as many children (mostly boys) born in 1984 fell into the severe conduct disorder category as did the cohorts of children born in 1958, 1970, and 1983. Likewise, a 30% increase in rates of depression during childhood and adolescence was found when comparing cohorts born between 1965-1974 and those born between 1989-1993. There were also increases in the rates of autism and autism spectrum disorders.

Other unhappy increases are the increase in adolescent suicide risk, increase in adolescent suicide, and higher rates of mental illness diagnoses among children visiting the emergency room for non-acute care.

I think that Elkind and others like him have proved their point, but perceive that proportionately few people are listening. Among those who are paying attention are the increasing number of home schoolers in the United States and those parents who are using alternative education and lifestyles or private schools to educate and raise their children.

References

Elkind, David. Miseducation: Preschoolers at Risk. New York: Alfred A. Knopf, 1989.
—. The Hurried Child: Growing Up Too Fast Too Soon. Reading, MA: Addison-Wesley, 1981.
—. All Grown Up and No Place to Go: Teenagers in Crisis. Reading, MA: Addison-Wesley, 1988.

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*psychopathology: from the Greek roots psyche, breath, spirit, soul, mind + patho, suffering, feeling, dis-ease + -logia, the word, speech, expression.

Photographs by Paul Strand.