Abnormal Psychology Concepts: Then and Now

 Robert Fettgather, PhD, has served as an associate faculty member at Mission College in Santa Clara, California, since 1983. When he is not leading courses in general, developmental, and abnormal psychology, among other subjects, Robert Fettgather enjoys hiking and boating.

Abnormal psychology is a distinct branch of psychology focused on atypical behavioral patterns and uncommon emotions and thoughts that may qualify as mental disorders. 

In modern times, aspects of this psychological discipline can be traced back to Karl Jaspers, who published the book General Psychopathology in 1913. It was an instrumental title in reframing interpretations of individual mental experiences, particularly those that might be considered unusual or out of the ordinary. Over the course of more than a century, the discipline has evolved to emphasize in-depth, medical-based studies of various mental illnesses, which may be caused by factors as diverse as genetics and social influence.

Psychopathology is the focus on the underlying disease processes or pathology, causing the abnormal behavior. Abnormal psychologists may study several clinical and personality disorders. One of the most common behavioral disorders in the United States is attention deficit hyperactivity disorder (ADHD). ADHD refers to impulsive actions and the inability to focus on a single topic or activity. It is usually diagnosed and treated in childhood, with a prevalence rate of approximately 9.4 percent. However, a 2019 study found that ADHD prevalence in adults had nearly reached 1 percent, doubling over a decade. It is not clear whether the trend represents sound medicine or diagnostic inflation. Personality disorders include obsessive-compulsive personality disorder (OCPD), narcissistic personality disorder, and borderline personality disorder. Interestingly, OCPD is different than a similarly named disorder, obsessive compulsive disorder (OCD). OCPD is characterized by a preoccupation with perfectionism and a staunch dedication to rules and standards. Behaviors associated with OCD include repeated obsessions and compulsions. Treatment options for OCD generally involve exposure and response prevention, cognitive behavioral therapy, and a regimen of selective serotonin reuptake inhibitors.

Historically, abnormal psychology was preceded by various religious traditions including shamanism that involved rituals such as incantations and exorcisms. Trephining, involving drilling a hole directly into the skull, was utilized as an attempt to promote healing by the early Greeks and the Chinese. Primitive and dangerous ancient methods can overshadow reasonable contributions from Tradiotional Chinese Medicine, including some herbal interventions.

The Structure of Language

Robert Fettgather is an associate faculty member at Mission College in Santa Clara, California, where he has taught courses in developmental psychology, general psychology, abnormal psychology, psychiatric interviewing, and developmental disabilities. Robert Fettgather has published numerous articles in the fields of education and psychology. 

To understand the structure of language, there is some basic terminology.  Here you go: Semantics is the rules for determining the meaning of words and sentences. Next sounds. Phonemes represent the most basic units of sounds used in language, while morphemes combine those bits of sound into the smallest units that have meaning.  Next, more rules. Grammar includes all the rules for combining morphemes into words, and syntax is the rules for combining words into sentences. Lastly niceties. Pragmatics deals with the practical aspects of communicating with others or the social etiquette of language.

Many scientists argue that what truly sets us apart from other species is our language. Behaviorist B.F. Skinner wrote a classic work on language acquisition, Verbal Behavior, and most people, like Skinner, believe we learn language through imitation and reinforcement. But it's actually far more complex. How do you explain that a child says foots instead of feet or "I swimmed"? Here, children are applying (incorrectly) language and grammar rules they have never been taught for singular/plural and past tense. But how? 

According to famed psycholinguist Noam Chomsky, humans possess an innate ability to comprehend and produce language through a mechanism he called the Language Acquisition Device (LAD). The LAD has an "innate facility" for acquiring language, including grammar.

The Sapir- Whorf hypothesis states that the structure of a language very much influences (some say determines) the modalities of thought and behavior of the culture in which it is spoken.  For example, Alaska Natives have many terms that refer to “snow,” which may cause them to perceive and think about snow differently than English speakers-- especially those from low snow environments.

An opposing theory to Sapir-Whorf, known as cognitive universalism, submits the proposition that ways of thinking (cognition) are shared among all groups of people and that those thought patterns influence the development of language.

Animals other than humans demonstrate a diverse ability to communicate, but it is unclear whether or not they have the capability for language, as demonstrated by the ability to use abstract symbols to communicate. Kanzi, a bonobo chimpanzee, has demonstrated an ability to understand about 150 spoken English words

Appreciating Other Points of View

Robert Fettgather has served as Special Consultant in psychometrics to the Departments of Education and Developmental Disabilities for the State of California. Robert Fettgather holds a specialist credential in learning handicapped and community college credentials in both learning and developmental disabilities.

In addition to cultural and individual differences, perceptions can be influenced by perceptual sets or expectancies. One example of perceptual expectancy is top-down processing. This happens when an individual utilizes pre-existing knowledge to place certain features into an organized whole. If there is no expectancy to help organize information, a person might use bottom-up processing to build a complete perception by making sense of the smaller features piece by piece. With a friend, try this experiment from Martin Bolt: print on a piece of paper the words below. Then read aloud these three words as your friend looks at the words and reads along with you:

FOLK CROAK SOAK

Next, immediately ask, what do you call the white of an egg? That expectation tricks the friend into a wrong answer, yolk!

Bottom-up processing starts with information and energy from the environment. Top-down processing refers to using past experience, knowledge, and expectations for how we perceive things (as in the example above). Remember that perception is a representation of our environment,  not a replication-- therefore, everyone’s perceptions may be different, and they may not be necessarily accurate. Once realized, this understanding allows for a deeper appreciation of different points of view!

Habits Toward Health

 

Robert Fettgather, Ph.D. is a counselor, educator, writer and activist residing in Grass Valley, California.  He holds a doctorate in psychology and master degrees in both psychology and education. Robert Fettgather teaches psychology at Mission College.

Individual differences in health habits and personality variables begin to affect physical functioning in these years. Twenty-somethings: It's time to get real about the habits that'll make a difference the rest of your life. Hint- Fun is part of the strategy.

Research suggests that, regardless of income level, changes in behavior may prevent or even reverse the effects of aging. The best evidence for the long-term effects of various health habits comes from nearby in the Alameda County Study, a major longitudinal epidemiological research project. The researchers initially identified seven good health habits that they thought might be critical:  drinking excessive amounts of alcohol, smoking cigarettes, being obese, sleeping fewer or more than seven to eight hours per night, being physically inactive, eating between meals, and not eating breakfast. Group membership was also a positive influencer. 

So let's take a look at some lifestyle habits that are worth changing that are summarized in you text and presented here with a few of my own additions:

If Overweight, Lose Just 10% of Your Body Weight

Benefits-reduction in triglyceride levels; decrease in total cholesterol; increase in HDL (“good” cholesterol); significant reduction in blood pressure; decreased risk of diabetes, sleep apnea, and osteoarthritis.

Add 20 to 30 Grams of Fiber to Your Diet Each Day 

Benefits-Improved bowel function; reduced risk of colon cancer and other digestive-system diseases; decrease in total cholesterol; reduced blood pressure; improved insulin function in both diabetics and nondiabetics. Food rich in fiber include fruits, vegetables, beans, legumes, grains and nuts.

Learn To Meditate

Meditation has many physical and emotional benefits including stress reduction.  Health, happiness, self-control, concentration, and improved productivity.

Engage in Moderate Physical Activity Every Day (e.g., Walk Up and Down Stairs for 15 Minutes; Spend 30 Minutes Washing a Car). Benefits include reduced feelings of anxiety and sadness; increased bone density; reduced risk of diabetes, heart disease, high blood pressure, and many other life-shortening diseases.

Early Identification of Developmental Disabilities

Robert Fettgather, Ph.D. is a psychology instructor who has served as a developmental disabilities consultant. He has written several publications and papers in the field. Dr. Robert Fettgather serves as an associate faculty member at Mission College in Santa Clara, where he instructs students in different areas of psychology and human development. 

The term "devleopmental disabilities" is used but not always understood. Developmental disabilities are typically life-long disabilities that begin during the developmental period and affect appearance, learning, behavior, and language. Developmental monitoring is a form of continuous assessment for developmental disabilities. Parents who suspect that their children are suffering from developmental disabilities can employ developmental monitoring, which factors in the age and skills of a child with matching benchmarks called developmental milestones. Developmental milestones encompass expected playing skills, learning skills, locomotive skills, speaking skills, and behavior for a child's age. Parents, childhood education providers, and other caregivers can leverage the CDC's Milestone Tracker app to vet a child's developmental progress. A caregiver who prefers to use the checklist instead of the app can fill it out and share it with their child's health provider, who can use the information to determine the risk of developmental disability and whether developmental monitoring is necessary.

Early identification of developmental delays can improve access to interventions and support services. Regular monitoring allows caregivers and healthcare professionals to recognize concerns before they become more significant challenges. When developmental issues are identified promptly, children may benefit from targeted strategies that promote growth, learning, and overall well-being.

AI Wonderland

 

Robert Fettgather, Ph.D. is a counselor, educator, writer and activist residing in Grass Valley, California.  He holds a doctorate in psychology and master degrees in both psychology and education. 

Some recent thoughts on artificial intelligence in education

The Influence of Perceptual Sets

An associate faculty at Mission College in Santa Clara, California, Robert Fettgather Ph.D. teaches general psychology, abnormal psychology, developmental psychology, and psychiatric interviewing. Dr. Robert Fettgather has co-authored several papers on social issues. He is interested in research on sensation and perception.

Perception considers the interpretation of sensation and seems to follow some basic guiding principles. It should be noted that individual and cultural differences in perception have been reported. It is process by which people take all the sensations they experience at any given moment and interpret them in some meaningful fashion.

The principle of figure-ground relationships can be illustrated by looking at reversible figures, which are visual illusions in which the figure and ground seem to switch back and forth. Closure refers to the brain's tendency to complete figures that are incomplete.

Visual perception of depth, referred to as depth perception, seems to be present in childhood at a very early age. Visual cues for depth that necessitate the use of just one eye are called monocular cues. Visual cues that use both eyes are referred to as binocular cues and include both convergence as well as binocular disparity.

In addition to cultural and individual differences, perceptions can be influenced by perceptual sets or expectancies as noted in the introduction. One example of perceptual expectancy is top-down processing. This happens  when an individual utilizes pre-existing knowledge to place certain features into an organized whole. If there is no expectancy to help organize information, a person might use bottom-up processing to build a complete perception by making sense of the smaller features piece by piece. With a friend, try this experiment from Martin Bolt: print on a piece of paper the words below. Then read aloud these three words as your friend looks at the words and reads along with you:

FOLK CROAK SOAK

Next, immediately ask, what do you call the white of an egg? That expectation tricks the friend into a wrong answer, yolk! 

Stress Reduction Strategies.

A resident of Grass Valley, California, Robert Fettgather is an associate faculty member at Mission College in Santa Clara. Robert Fettgather has also served as a stress management trainer, certified by the Institute for Personality and Ability Testing. In his spare time, Robert Fettgather enjoys meditation and exercise routines.

We should all employ the practice of gratitude and counting one's blessings daily. And always strive to find new experiences that impart meaning to life. At the same time, have a forgiving attitude, even when someone does something mean-spirited or harmful. For example, if someone cuts you off on the highway, let go, take a few deep breaths, and repeat an affirmation such as “It’s fine, I am safe and uninjured, let’s move on.”

To reduce the stress of daily life, you can try reframing or examining a stressful or negative facet of life and describing it in a neutral or positive way. This act may help you distance yourself from the emotions invested in the negative experience and gain a new vantage point. Another effective way to reduce stress is to avoid “negative escapes” such as substance abuse, excessive eating, or uncontrolled spending. Instead, emphasize healthy mental processes such as mindfulness as a foundation for working through life challenges. 

Exercise helps. Elliptical machines are fitness machines used by standing on two rimmed platforms that move forward and back in an elliptical pattern. They are popular in both households and health clubs. The machines allow low-impact workouts that benefit both the upper and lower body. Elliptical machines also enable high-intensity interval training (a combination of an interval that requires maximum effort during the first segment) and steady-state cardio workouts (doing one exercise for a longer period of time) that help strengthen the heart, lungs, and muscles. They also improve stamina.

Learning Lessons For Everyday Life

Robert Fettgather has served as Special Consultant in psychometrics to the Departments of Education and Developmental Disabilities for the State of California. Moreover, Robert Fettgather holds a specialist credential in learning handicapped and community college credentials in both learning and developmental disabilities. Learning and cognition are among Robert Fettgather's key interests.

Learning is any relatively permanent change in behavior brought about by experience or practice.  For example, think about children. Do they seem to learn more efficiently through verbal instruction or experience?  According to Jennifer Zosh "toddlers learn new words more effectively by using their knowledge about the world to infer the label of an object, rather than by simply being instructed and told which word goes with which object" (emphasis added).  In this comparison, "using" is experiential and means "involvement". Besides toddlers, for many of us, being told or being instructed may be less effective for learning than immersion and total involvement.

Consider ths well known quotation:‘Tell me and I forget. Teach me and I remember. Involve me and I learn.’ Interestingly, there hve been various attributuons for this saying including Benjamin Franklin and the ancient Confucian philosopher Xunzi. Regardless of its origin, there is significance to the act of doing as it applies to learning processes. 

Learning theory has its roots in the work of Thorndike, Pavlov, Skinner, and many others. Let's think about an applied example of behaviorism-- and that is just how terrible many of us are at applying these principles in our own lives! For example, sometimes I fail to voice appreciation for the behaviors I like from loved ones, friends, and colleagues-that amounts to an extinction intervention. In other words, I am making those wonderful actions less likely to occur in the future. 

And in frustration, I have been known to give a lot of attention to behavior I don't like from these very same folks. That can take the form of exasperation, complaining or a frown. With a child, it can be a scolding that provides attention and thus reinforces an undesired behavior. And of course, sometimes we resort to scolding friends and lovers too!

Read to That Child!

 

Robert Fettgather is a co-founder of Tashi Lhunpo Buddhist Sangha in Palo Alto, California. While a student of Buddhism and a teacher of psychology, he also engages in activism and advocacy in an effort to serve his community. Robert Fettgather is an avid reader.

The American Academy of Pediatrics recommends no screen time for children under two. The Academy further recommends that--

“Reading regularly with young children stimulates optimal patterns of brain development and strengthens parent-child relationships at a critical time in child development, which, in turn, builds language, literacy, and social-emotional skills that last a lifetime...”

Reflection Point: What would you say to a person who claimed that reading to an infant or a toddler is a waste of time because of their limited language skills?  If a toddler doesn’t want to be read to, do you think his parents or teachers should try to get him interested in books? If so, how do you think they should go about it?

Some classics are very readable after all. “You can find magic wherever you look. Sit back and relax, all you need is a book!” – Dr. Seuss

Think about this: some studies have noted that young children whose parents read to them daily have been exposed to at least 290,000 more words (wow) by the time they enter kindergarten than kids who aren’t read to regularly. Expanding language and vocabulary, not to mention social connections between parent and child, are very worthwhile, indeed.

 

Stressed Out

Robert Fettgather has taught at San Jose State University, National University and Mission College in Santa Clara.  In addition, Robert Fettgather has addressed StateLinks to an external site. and National Conferences on a variety of topics.

Most of us feel "stressed out" at times. Stress is a major contributor to health problems, but there are positive aspects of stress in some forms. For example eustress is a kind of optimal level of stress that is beneficial and may enhancer performance. On the other hand, psychological as well as social factors may contribute directly to disease and illness through the effects of stress on the immune system and the body in general.

Think about a compromised immune system. It may no longer be able to attack and eliminate antigens, or it may even begin to attack the body’s normal tissue instead. That is a phenomenon identified as autoimmune disease. Growing understanding of the nexus between the nervous system and the immune system has resulted in the new field of psychoneuroimmunology, the study of the interaction between psychological processes and the nervous and immune systems of the human body. The effects of stress can be related to diseases like AIDS, cardiovascular disease, and cancer.

REFLECTION  POINT:

Do you notice a relationship between stress in your life and the functioning of your immune system? Do you think this may be why you and your classmates have a higher tendency to get ill during stressful times of the semester, such as midterms and final exams? How do you think you could counter those effects?

INTERVENTIONS:

Many psychosocial treatments have been developed with the goals for either the prevention or treatment of disorders that are physical in nature. Among these are biofeedback, hypnosis, the relaxation response (Benson) and mindfulness meditation. David Barlow reviews the technique, Progressive relaxation, where muscle groups are systematically tensed and relaxed. Breathing techniques are also helpful in combating stress. This technique promotes relaxation and stress release.

A Bottom Line: Poor lifestyle habits can foster poor health outcomes and be antecedents to most of the disorders of eating and sleeping.  We all ought to pay attention to our lifestyle habits in order to lead happier and healthier lives.

The Institution

Robert Fettgather is an associate faculty member at Mission College in Santa Clara, California, where he has taught courses in developmental psychology, general psychology, abnormal psychology, psychiatric interviewing, and developmental disabilities. Robert Fettgather has published numerous articles in the fields of education and psychology. 

To paraphrase psychologist Burton Blatt, "Once the good man has seen the institution, he can never pity himself"

The history of mental institutions in the United States traces back to the early 19th century, when reformers sought to replace the neglect and abuse of people with mental illness in prisons and almshouses with more humane care in specialized facilities. These early asylums were often inspired by the moral treatment movement, which emphasized structured routines, compassionate supervision, and therapeutic environments designed to restore reason. It sounded hopeful on paper, but there were consequences-the unintended kind. As the century progressed and patient populations grew far beyond capacity, many institutions became overcrowded and underfunded, leading to deteriorating conditions that contradicted their founding ideals. Things got messy fast.

By the late 19th and early 20th centuries, state-run psychiatric hospitals had become the dominant model of care, housing tens of thousands of patients across the country. These institutions were often located in rural areas, intended to provide calm settings away from urban stressors, but isolation also made oversight difficult and abuse easier to conceal. Not exactly a great combination; concealment of these horrors is a great American tragedy. Treatments during this era ranged from basic custodial care to more invasive and controversial procedures, including electroconvulsive therapy and psychosurgery, reflecting both evolving medical theories and a lack of effective alternatives. Some methods helped, others definitely harmed.

The mid-20th century marked a turning point with the deinstitutionalization movement, driven by a combination of factors including new psychiatric medications, growing awareness of institutional abuses, and changing public policy. The introduction of antipsychotic drugs in the 1950s created optimism that many patients could live outside hospital settings, leading to a significant reduction in inpatient populations. The idea was simple: move people back into communities. Federal initiatives also promoted community mental health centers as a more humane and cost-effective alternative to large institutions. In practice, the money did not follow the person. States pocketed money that rightfully should have gone to community care.

In recent decades, the legacy of mental institutions continues to shape mental health care in the United States, as policymakers and practitioners grapple with balancing institutional care and community-based services. While large asylums have mostly closed, challenges such as homelessness, incarceration of individuals with mental illness, and gaps in access to care highlight ongoing systemic issues. It’s still a work in progress. The history serves as a reminder that good intentions alone are not enough without sustained resources, oversight, and a commitment to dignity in treatment. And that lesson keeps coming back. 

Inclusion Matters

A graduate of Santa Clara University (MA Education), Robert Fettgather is an associate faculty member at Mission College. Robert Fettgather has taught courses tackling general, developmental, and abnormal psychology. A disability rights advocate, Robert Fettgather helped start the Coalition for Elder and Dependent Adult rights.

Along with other social civil rights movements in the decade of the 1970's, a disability rights movement emerged. Some aspects coalesced into the Americans with Disabilities Act (ADA), passed in 1990...a landmark civil rights law. It was designed to make sure people with disabilities have the same rights and opportunities as everyone else. Think of it like the law saying, “Hey, access matters.” It covers areas like employment, public services, transportation, and public accommodations. As a consequence, businesses and institutions are required to make reasonable changes so people aren’t excluded. Pretty straightforward idea, yet life-changing for so many.

Let's take a look at some basic provisions. The ADA prohibits discrimination against individuals with disabilities in three key domains. Title I addresses employment, requiring employers to provide reasonable accommodations unless doing so would cause undue hardship. Title II applies to state and local governments, ensuring equal access to public programs and services. A third element, Title III, focuses on private businesses open to the public—restaurants, hotels, stores—making accessibility not optional but required. Every doorway and step evaluated for accessibility. It’s about fairness, but also about participation in the everyday life neurotypical folks masy take for granted.

At the same time, the ADA isn’t just legal language—it affects real, everyday experiences. Ramps, captions, accessible websites, service animals in stores… all of that connects back to this law. Some people still debate how far it should go, especially with newer tech, but the core idea hasn’t changed: inclusion matters. Not perfectly implemented, sure. But still essential in a just society.

Movies And Baseball

An associate faculty at Mission College in Santa Clara, California, Robert Fettgather Ph.D. teaches general psychology, abnormal psychology, developmental psychology, and psychiatric interviewing.  Robert Fettgather has co-authored several papers on social issues including disability and elder rights. In his spare time, Robert Fettgather enjoys our National Pastime. 

As the Academy awards pass, it signals the start of another baseball season. So why not consider some movies that feature America’s National Pastime?

A forgotten lead-off flick might be the Warner Brothers produced, The Winning Team. Loosely based on the life of Hall of Fame pitcher, Grover Cleveland Alexander, it stars Doris day opposite…Ronald Reagan. It is said that Reagan trained with Cleveland Indians star pitcher Bob Lemon for the part. Reviews were solid if not stellar, calling the performances “sincere and moving”. You be the judge.

For contrast, consider a popular film that tells (and sells) the story of the All-American Girls Professional Baseball League during World War II. Of course, that’s A League Of Their Own. It features a great comedic performance from Tom Hanks as manager Jimmy Dugan. Famous for the line “there is no crying in baseball”, there is a more profound bit of ballpark lore that begins with a player complaining about how very hard baseball is…to which Hanks responds (here paraphrasing)…”of course it is hard; if it was easy anybody could do it; its hard and that's what makes it great”

Enough said. Action! Play ball!

A Miracle Unfolding

The Institute for Personality and Ability Testing has certified Robert Fettgather as a Stress Management Trainer, and Medical Hypnosis Seminars of the Los Gatos Institute has certified him in Clinical Hypnotherapy. An instructor at Mission College, Robert Fettgather teaches classes in psychology.

There is in every child at every stage a new miracle of vigorous unfolding--Erik Erikson.

Children from 2 to 6  go from oppositional toddlers (the "terrible twos") who  isolate in solitary play to being skilled, and often cooperative playmates by age 5 or 6. Indeed, compare a two year old and a 6 year old and note their vast differences to see what I mean. 

Here we will briefly review the work of two psychoanalytic theorists. Freud and Erikson each described two stages of personality development in early childhood. Let's start with Freud. Remember, for Freud, each stage (oral, the anal, the phallic, the latent, and the genital)  is characterized by an erogenous zone and libido.  Freud described two stages during the preschool years. The first, the anal stage, is dominant between ages 1 and 3 (the ego is developing in this period). Here the child experiences pleasurable sensation of the bowel and bladder. This stage is significant because it typically coincides with the parents’ desire to toilet train the child. Conflicts may arise! 

The phallic stage occurs between ages 3 and 5, during which the Oedipus conflict emerges wherein a boy feels like he is in competition with his father for "possession" of his mother. Resolution of the conflict comes in identification with the same-sex parent. The superego is developing during this stage. Freud suggested that to successfully resolve the Oedipus conflict, relationships between the child and both parents had to be warm and loving. The Oedipus Complex derives its name from a character from Greek Tragedy

Erikson’s stages align with Freud's but have a different emphasis.  Erikson believed that change was  triggered by the new, physical, cognitive, or social skills of the child rather than by changes in psychosexuality as  Freud asserted. Erikson’s stage of autonomy versus shame and doubt centers around the toddler’s new mobility and the ego's  desire for autonomy. As we have consistently noted, these are the so-called terrible twos and can be a challenging time for parents who may respond to normal autonomy with strict and punitive interactions, promoting shame. 

According to Hamachek, adults who developed a healthy sense of autonomy as toddlers:

Like to make their own decisions

Are able to say no without feeling guilty

Resist domination

Like to get things done

Are able to listen to their own inner feelings as they make decisions

Reflection Point: Do you believe autonomy was fostered in your own early childhood? Can you see examples from Hamachek in your adult autonomous behavior?

Guardianship of the Infantilized Elder: A Pipeline to the Institution Industrial Complex?

Robert Fettgather, Ph.D. is a counselor, educator, writer and activist residing in Grass Valley, California.  He holds a doctorate in psychology and master degrees in both psychology and education. Robert Fettgather has served as Special Consultant in psychometrics to the Departments of Education and Developmental Disabilities for the State of California. Robert Fettgather also holds a specialist credential in learning handicapped and community college credentials in both learning and developmental disabilities.

Note: This article was originally published online by the International Network for Critical Gerontology, July 7th, 2017

Chronologies for aging move, by clocks and calendars, from past to future across the lifespan. But not without exception. When it comes to social status for some individuals, time seems to reverse course. Teenagers demanding adult status complain relentlessly over being treated like a young child. We notice a helicoptering parent, babying a third grader with smothering overprotection. This phenomenon has been referred to, psychodynamically, as infantilization-treating an individual as if they were much younger than their chronological age. Earlier in my career, I became interested in the ways that adults with intellectual disability were infantilized, patronized, and robbed of their autonomy (Fettgather, 1987), including how they were given double-binding mixed messages to act like an adult even as they were treated like children (Fettgather, 1989). I am now turning to questions of how elders, especially those experiencing impairments associated with aging, may be diminished by practices associated with a similar social construct.

In recent years, I became acquainted with a legal device, “plenary guardianship”, wherein guardians retain all rights, powers and decisions over wards who are believed to lack capacity to care for themselves. This device seems to mirror the psychosocial experience of infantilization, but with potentially more devastating and permanent consequences. Based on a concept of parens patriae (parent of the nation) dating back centuries, the king had an explicit duty to protect those presumed to lack the capacity for managing their own lives-state sanctioned infantilization. Similarly, the contemporary “plenary guardian” is deemed ‘parent to the elder’ (or intellectually/psychosocially disabled person) who has been determined to lack adult capacity in a socio-legal construction of perpetual infancy-childhood. Plenary guardianship takes all decision-making from the ward and places it in the hands of an all powerful guardian.

In the spring of 2014, I attended the 3rd World Congress on Adult Guardianship. The conference highlighted worldwide, growing concerns and critiques of plenary guardianship. Many contemporary deconstructions of guardianship suggest that too often it is undue, overbroad and overprotective (Martinis, n.d., One Person, Many Choices; Blanck and Martinis, 2015). I argue that even benevolent guardianships may infantilize, fostering dependence and regression. And for elders of means, there is considerable anecdotal evidence of forced isolation with estate plundering by public and professional guardians. US Government Accounting Office Reports (GOA) beginning in 2004 (Government Accountability Office, 2004), and subsequent reports through 2012, show consistent patterns of financial exploitation and neglect. For example, one guardian embezzled $640,000 from the estate of an 87 year old man with Alzheimers Disease. Protective services discovered the man residing in a filthy basement and wearing just an old shirt and a diaper.

Beyond property, the very body of vulnerable elders becomes a commodity in an institution industrial complex that unites private business with government interests with an emphasis on profit making and social control (similar to the prison industrial complex). For example, Liat Ben-Moshe (Ben-Moshe, n.d., The Institution Yet to Come) emphasizes the nexus of impaired mind-bodies with an institution industrial complex dedicated to careerism: “political economists of disability argue that disability supports a whole industry of professionals that keeps the economy afloat, such as service providers, case managers, medical professionals, health care specialists etc”. With the absolute authority of a plenary guardianship, the concern is that guardians may force institutionalization into nursing home facilities where profit is the bottom line-a kind of pipeline into the institution industrial complex. Charlene Harrington, researcher at UCSF investigating care at nursing homes, summed up her findings, “Poor quality of care is endemic in many nursing homes, but we found that the most serious problems occur in the largest for-profit chains” that keep costs low to increase profits (Fernandez, 2011). A 2015 study at Hunter College also found that 12% of guardianships were initiated by nursing homes as a means to collect debt from residents (Bernstein, 2015).

With my colleague, Linda Kincaid, we have addressed elder rights to be free from plenary guardianships leading to chemical restraints (Fettgather and Kincaid, 2013) and forced isolation (Kincaid and Fettgather, 2014). Isolation is often achieved by limiting or denying visitation to hide poor living conditions or inadequate care from public scrutiny. Our current project, at the Coalition for Elder and Dependent Adult Rights, juxtaposes reports of guardianship abuse in GAO Reports and other sources with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). The project considers current problems in guardianship and institutionalization against criteria of the UNCRPD that seek to “promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedom by all persons with disabilities and to promote respect for their inherent dignity”. We contrast guardianship abuses with UNCRPD articles for equality, privacy, justice, liberty, and freedom from exploitation and torture. In particular, we place special emphasis on Article 12, equal recognition before the law. Article 12 says that “States Parties shall recognize that persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life.” Our concern is that plenary guardianship fails the standard of equal recognition before the law, and that alternatives must be vigorously pursued.

In that regard, we align ourselves with an international group of stakeholders who believe that incapacity should not be presumed (Dinerstein, 2012). Alternatively, we are committed to the presumption of capacity and to advancing supported decision-making as an alternative to plenary guardianship for elders and people with intellectual and psychosocial disabilities. In this model, decisions, supported by one or more persons, are made by the individual who has ultimate authority over his/her life. Personhood is honored, with no one acting as surrogate parent. We believe that this approach, with appropriate safeguards, oversight and subject to regular review, will disrupt the pipeline from guardianship to institution industrial complex. It will help reset clocks and calendars for heretofore infantilized adults and restore dignity, autonomy and adult status to the decision-making process.

References

Ben-Moshe, Liat. (n.d.) “The institution yet to come”: analyzing incarceration through a disability lens. Academia.edu, 1-16.

Bernstein, Nina (2015, January 25) To Collect Debt Nursing Homes Are Seizing Control Over Patients. Retrieved from https://www.nytimes.com/2015/01/26

Blanck, P. and Martinis, J. (2015). ‘‘The Right to Make Choices’’: The National Resource Center for Supported Decision-Making. INCLUSION, Vol. 3, No. 1, 24–33.

Dinerstein, Robert D.(2012) “Implementing Legal Capacity Under Article 12 of the UN Convention on the Rights of Persons with Disabilities: The Difficult Road From Guardianship to Supported Decision-Making.” Human Rights Brief 19, No. 2, 8-12.

Fernandez, Elizabeth. (2011) Low Staffing and Poor Quality of Care at Nation’s For-Profit Nursing Homes. UCSF News Center. Retrieved from https://www.ucsf.edu/news/2011/11/11037

Fettgather, Robert (1989).‘Be an Adult’: A Hidden Curriculum in Life Skills Instruction for Retarded Students? Lifelong Learning: An Omnibus of Practice and Research, Vol 12, No.5, 4-5,10.

Fettgather, Robert (1987) The Relationship of Teacher Adult Ego State to Interactions with Retarded Students. Transactional Analysis Journal. Vol 17, No. 2, 35-37.

Fettgather, R. and Kincaid, L. (2013). Chemical Restraint in Long-term Care. Southern California Public Health Conference. Los Angeles, California

Government Accountability Office. (2004). Collaboration Needed to Protect Incapacitated Elderly People (GAO Publication No. 04-655:). Published: Jul 13, 2004. Publicly Released: Jul 22, 2004.Washington, D.C.: U.S. Government Printing Office

Kincaid, L. and Fettgather, R. (2014) False Imprisonment and Isolation in Long-term Care. American Society on Aging Conference, San Diego, California

Martinis, J. G. (n.d.). One person, many choices: Using special education transition services to increase self-directionand decision-making and decrease overbroad or undue guardianship. Quality Trust for Individuals With Disabilities,1-29.

United Nations Convention on the Rights of Persons with Disabilities (n.d.)United Nations, 1-22. Retrieved from

 

To Your Health!

The Institute for Personality and Ability Testing has certified Robert Fettgather as a Stress Management Trainer, and Medical Hypnosis Seminars of the Los Gatos Institute has certified him in Clinical Hypnotherapy. At Santa Clara University, Graduate Department of Education and Counseling Psychology, Robert Fettgather's studies included Health Education and Behavioral Medicine. Moreover, Robert Fettgather has completed Hospice Training with Hospice of the Valley.

Health psychology is the field of study devoted to understanding the relationship between physical activities, psychological traits, and social relationships and overall health and rates of illness.

Health psychology promotes coping strategies which are actions that people take to master, tolerate, reduce, or minimize the effects of stressors and include both behavioral and psychological strategies. Problem-focused coping describes the individuals efforts to reduce or eliminate the source of stress or reduce its impact by taking some action. Emotion-focused coping necessitates changing the way you feel or react toward a stressor. a well-known example of emotion-focused coping employs the use of psychological defense mechanisms studied earlier in the course. Examples are denial, repression, rationalization, and projection, among others.

According to author Licht "There are many ways to lower the impact of stressors. Exercise, meditation, progressive muscle relaxation, biofeedback, and social support all have positive physical and psychological effects. Caring for and giving to others are also effective ways to reduce the impact of stress."  Spirituality and religion have also been found to affect an individual’s level of stress as well as the strategies used to cope with that stress. According to a Pew Center Survey nearly 80 percent of Americans say they practice some type of religion, while approximately 20 percent, mostly younger people, say they do not.

To summarize: A few ways that individuals can promote wellness in their own lives include movement and exercise, becoming socially connected with others, getting adequate sleep, eating healthy foods, scheduling recreation time and having fun, effective time management, and just breathing deeply.

Reflection For Mid-Life

Robert Fettgather has practiced meditation over four decades. He studied religion and spirituality at the University of California, Santa Cruz, and is co-founder of the Tashi Lhunpo Sangha, Palo Alto California. Robert Fettgather is a member of the American Federation of Teachers and Psychologists for Social Responsibility and the International Society for Ethical Psychology and Psychiatry. Robert Fettgather has taught Psychology for more than forty years. He has received the Santa Clara University’s Certificate of Recognition for Published Work.

For Erik Erikson, the primary task of middle adulthood is the development of generativity sometimes through  mentoring younger individuals- in Erikson's words, "guiding the next generation". Certainly this embodies parenting, and ideally a career with some significance toward making the world a better place for the next generation.  Besides a vocation, generativity could be expressed avocationally in activities that improve the human condition. Many middle aged and older adults become involved in social causes and solutions  that address problems from violence, to poverty, to the environment and climate crisis. In fact, the application of Erikson's concept of generativity to environmental and climate concerns has been called environmental generativity.

Indeed, the catastrophic and imminent threat of the climate crisis, from years of taking from the earth without thought for future generations,  is the antithesis of Eriksonian generativity. In Erikson's words, those who fail to develop generativity often suffer from a “pervading sense of stagnation and personal impoverishment [and indulge themselves] as if they were their own one and only child.”

Some social scientists believe that there is little empirical support for the popular notion of a “midlife” crisis, as described by Levinson. But from a theoretical perspective, I argue the contrary from an Eriksonian view. Specifically that foreclosures in relationship and work/career in adolescence/early adulthood may lead to a potential crisis later on. Some people find that a marriage or career selected prematurely is simply not an enlightened and lifelong fit. 

This is not to persuade that having an affair or buying a Ferrari is an effective resolution. Instead, like all crises,  it is an opportunity for reflection and, perhaps, a more favorable set of life decisions. 

Your Task

Robert Fettgather holds a Ph.D in Psychology and Masters degrees in both Psychology and Special Education and received the Distinguished Alumnus Award from West Valley College. Robert Fettgather has served as Special Consultant in psychometrics to the Departments of Education and Developmental Disabilities for the State of California.

Your task is not to seek for love,

but merely to seek and find all the barriers within yourself

that you have built against it.” ... Rumi

Love can be tricky. Most of us desire love but sometimes struggle with giving it or accepting it. The words from Rumi, a 13th-century Persian poet, suggest that love and human affiliation may be our natural inclination-unless we somehow resist and even block it.

Here we will emphasize intimacy and other developmental tasks of adulthood. 

Young adulthood can be stressful as you know from experience!  Part of the stress comes from the fact that so many transitions occur in such a relatively short time span. Still, each transition brings with it new opportunities for personal growth.

Freud, the story goes, was once asked what a normal adult should expect to do well. The interviewer perhaps expecting a profound and complicated response might have been surprised to hear  Freud answer simply, "lieben und arbiten" (to love and to work). Love and work are the primary themes of adulthood- Erikson used the terms intimacy and generativity to describe these two needs.

Let's further unpack issues related to emotional connection. Intimacy is the capacity to engage in a supportive, affectionate relationship without losing one's own sense of self. Previous Eriksonian stages come into play.  A poor sense of identity is only one barrier to intimacy and as you might imagine, so is the capacity to form trust. Gender differences are also important to note. To many women, intimacy is partly a function of self-disclosure. Most men do not see self-disclosure as essential to intimacy. Consequently, many men voice satisfaction with relationships that their female partners may view as inadequate.

Regulation And Empathy In Childhood And Beyond

 

Robert Fettgather, Ph.D. is a counselor, educator, writer and activist residing in Grass Valley, California.  In addition, Robert Fettgather holds a doctorate in psychology and master degrees in both psychology and education. Wth respect to teaching experience, Robert Fettgather has taught at San Jose State University, National University, and Mission College in Santa Clara.  

Social-cognitive theorists emphasize that advances in social and personality development are associated with cognitive development. They focus on three areas of interest: person perception, understanding of intentions, and understanding of different kinds of rules. Children classify others based upon their most recent interactions with the person and the other person's observable characteristics. As noted, classification of others, while normal, can lead to stereotyping and bias in later years. Education is critical!

As young children gain more understanding of the social environment, their temperaments ripen into true personalities. Two aspects of self-concept, the categorical self and the emotional self, continue to develop between ages 2 and 6. Children make major strides in self-control or emotional regulation, as well as in in their understanding of their own social roles. Preschoolers who display high levels of emotional regulation are more popular with their peers than those who are less able to regulate their emotional behavior. 

Another aspect of the emotional self involves empathy, the ability to identify with another person’s emotional state. Their is an inverse relationship of empathy to aggression- Higher empathy/lower aggression; lower empathy/higher aggression. The most thorough analysis of the development of empathy and sympathy has been offered by Martin Hoffman.

Reflection Point: how does emotional regulation and empathy play into your own life?

Although the child’s attachment to the parents remains strong, many attachment behaviors become less visible. Young preschoolers may show more refusals and defiance of parents than they did as infants, but as they gain language and cognitive skills, they generally comply fairly readily. Nevertheless, parents are often challenged by their preschool children and so I offer a few tips: Give choices within limits; avoid power struggles; and use presuppositions (are you going to sit in this chair or that chair?).

We all have opinions on parenting styles and techniques. So, let's compare different parenting styles and  what research shows about the effects of those styles on children.  Diana Baumrind focused on several aspects of parenting, each of which has been independently shown to be related to various outcomes. She emphasized crucial parenting behaviors:  Warmth or Nurturance;  Clarity and Consistency of Rules; Maturity Demands; and Communication. Baumrind further stated that combinations of these behaviors produced three parenting types: authoritarian, permissive. and authoritative