Sunday, April 27, 2008

Rebelliousness, Morality, and Psychological Health

The first and most obvious consideration in the relationship of rebelliousness to morality and psychological health is one which by now has passed from iconoclastic protest to virtual stereotype. Nonetheless, it should not be disregarded. It is simply this: rebellionresistance to acculturation, refusal to "adjust," adamant insistence on the importance of the self and of individuality--is very often the mark of a healthy character. If the rules deprive you of some part of yourself, then it is better to be unruly. The socially disapproved expression of this is delinquency, and most delinquency certainly is just plain confusion or blind and harmful striking out at the wrong enemy; but some delinquency has affirmation behind it, and we should not be too hasty in giving a bad name to what gives us a bad time. The great givers to humanity often have proud refusal in their souls, and they are aroused to wrath at the shoddy, the meretricious, and the unjust, which society seems to produce in appalling volume. Society is tough in its way, and it's no wonder that those who fight it tooth and nail are "tough guys," I think that much of the research and of the social action in relation to delinquency would be wiser if it recognized the potential value of the wayward characters who make its business for it. A person who is neither shy nor rebellious in his youth is not likely to be worth a farthing to himself nor to anyone else in the years of his physical maturity.

A second consideration which is certainly no news to most people, but which tends to get lost to psychologists who use phrases like guilt feelings, hostility, and anxiety, is that the healthy person psychologically is usually virtuous in the simple moral sense of the term. Psychologically healthy people do what they think is right, and what they think is right is that people should not lie to one another or to themselves, that they should not steal, slander, persecute, intrude, do damage willfully, go back on their word, fail a friend, or do any of the things that put them on the side of death as against life. This probably sounds like old-time religion, and in fact I am willing to be straightforwardly theological about this. I think there is an objective character to guilt, and when a person is false to his nature or offends against the nature of others then he is in sin and the place in which he has his existence is well described by the word "hell." I take "sin" here to be descriptive of the state of separation from the most basic sense of selfhood, or what some existentialist philosophers have called "the grounds of being." In whatever terms it is put, the fact is that a person is most alive and is functioning in such a way that he knows who he is and you know who he is and he knows who you are when his thoughts and actions are in accord with his moral judgment. The corollary is that when you do what you think is wrong you get a feeling of being dead, and if you are steeped in such wrongful ways you feel very dead all the time, and other people know that you are dead. There is such a thing as the death of the spirit. Many of the people whom we know as patients in our mental hospitals or as prisoners in our jails are in a condition of spiritual death, and their only hope is that someone can reach out to them, break through the walls of their isolation, recognize them. I think that too much has been made of the word love in this connection, for usually it connotes a feeling on the part of the person who is to give the love. The essence of the act of love as I understand it is the act of attention, and the affect that accompanies it in the person who is paying attention may be love, hate, sadness, or what have you. A real fight is an act of attention, a genuine condemnation is an act of attention, an understanding of final defeat is an act of attention. These as well as their positive counterparts are on the side of life, and the person who experiences them is in communication with other living beings and offers to them the possibility of community. The sort of philosophy of psychotherapy that prescribes blandness, nonjudgmentalness, and essential indifference on the part of the psychotherapist is simply a form of human debasement. Paying attention, caring, and being there yourself is all that counts.

One of the therapists there was clearly an incompetent by all standarts. Everything he did was wrong. After about six months of his residency, however, it became apparent that many of his patients were unaccountably getting better. Among his aberrant behaviors were such gross actions as telephoning a patient's foreman at work and telling him to stop bullying the patient, suggesting an unusual sexual technique to another patient whose wife was apparently frigid, and bluntly suggesting to a third patient that he should give up his job as an automobile repairman and get into the dispensing of food. The climax of the latter case was especially gruesome to the clinic, for the patient opened a doughnut shop of his own and on his final appointmerit appeared with a dozen doughnuts of his own making which he presented as a gift to the therapist, who without any insight at all offered them around to various other therapists and his supervisor of whom had difficulty, swallowing them. Goodness knows I am not suggesting, in recalling the case of this incompetent fellow, that all psychotherapists go forth and do likewise, for he was he and we are we. But I will say that he was alive, even though so obviously misguided; to his patients, the only thing that was of consequence was that he cared about them and that he thought there was something different they could do which would be right.

Parent Education and Mental Hygiene

One of the most important points about parent education today is the extent to which mental hygiene principles have worked their way into its materials and procedures. Teachers and school administrators who think of parent education in terms of the earlier activities of parent-teacher groups will find that and with the use of authentic data made available from scientific research at the child development institutes, a significant change has come about. An incredible amount of exceedingly valuable information about children's behavior has been brought within the reach of present-day parents, especially mothers, and a glance into the more recent study courses and publications used by parent and child study groups is distinctly reassuring.

There is a tendency in some quarters to view with suspicion the efforts of groups of parents to learn something about mental hygiene as applied to themselves and to their children. Probably not a large number of parents are as yet actually helped; possibly, too, a certain number are harmed--the psychiatrists report a few parents getting just enough of the jargon and the general point of view to find "problem" children where these do not exist. On the whole, however, it is doubtful whether in any other educational field (except the nursery school) mental health principles have penetrated as far and as well as in the modern plans and practices in parent education and education for family life.

Formerly programs for study [by parents' groups] focused attention exclusively upon the child and included for discussion such topics as obedience, punishment, rewards, curiosity, imagination, habit formation, play, etc. More recently, especially with leaders trained in mental hygiene, interest focuses upon the life of the family groups and upon such items as personality development in family relationships, emotional honesty in dealing with children, etc. In attending such study groups parents are able to learn not only important facts about child growth and the family in a changing world, but also more satisfactory self-direction in their daily relationships with children.

So definitely has mental hygiene entered into modern education for family relations that in nearly all the current definitions mental health as an objective is either explicitly stated or unmistakably implied.

Parent education is a voluntary cooperative effort by parents, studying with qualified leaders (1) to understand more about childgrowth and development, family relationships, the conduct of family life, public education, home-school relationships, and the family in community life; and (2) to grow in ability to take a constructive part in family and community relationships with confidence and satisfaction.

Classification of objectives of parent education reflects clearly, especially in the first three of her list, the recent mental health emphasis in education for family relations:

1. To interpret to parents the findings of specialists in regard to various aspects of child and family life.

2. To modify or change the attitudes of parents toward their children and their behavior.

3. To act as a therapeutic device for relieving personal maladjustment.

With the increased knowledge available about human nature and the ways in which it develops and is modified, education in family relations ceases to be the simple matter it was in the past and is sometimes assumed to be today. Many parents who pride themselves on following to the letter the prescribed rules for the physical hygiene of their children. Even among those who realize the importance of early control of behavior problems, there are many who are deeply concerned when their children lie, steal, or have temper tantrums but attach little or no significance to such unhealthy signs as undue self-consciousness, day-dreaming or jealousy. Still less do they realize that these delinquencies and manifestations of abnormal behavior may be due to their own attitude toward their children. Yet many cases of delinquency in children have been traced to the attempt of parents to make the child's life compensate for their own failure to reach certain goals of achievement; to the fact that the child has for years been buffeted between the rigid discipline of one parent and the extreme laxity of the other; to the dominating attitude of one member of the family group, which leaves the child no opportunity for asserting himself as an individual, and to similar forms of conflict between the needs of the child and the conditions prevailing in his family. Parental attitudes are of fundamental importance.

Personality begins very early and persists very late

Persons concerned with education need to remind themselves constantly that the family has had the child under its influence long before the school and continues to have him throughout school experience. It is in the home, very largely, that the stage is first set for learning patterns of human behavior. Practically unanimous agreement exists among psychiatrists and mental hygienists as to the significance of early family life for mental health.

Possibilities for the school, therefore, are definitely limited at the start. The "education" of the child has been under way for a number of years before he comes to school. What education can do for mental health will depend to a considerable extent on what the family and home have already done; also on what the family continues to do while the youngster is in school. Where the public educational provision includes the nursery school, as it should, the school is able to exert its influence at an earlier stage, of course, but the part of the home remains highly significant even then.

Most authorities believe that the influence of the home and family in making or breaking wholesome personality begins very early and persists very late. Babies in the first year, who showed all the marked differences that characterize later personalities--some slow in their reactions, phlegmatic, dull; others quick, amiable, responding with distinct pleasure to the different stimuli, or with clear evidence of discomfort. At the other end of the scale, there have been some noteworthy cases of adjustment of very difficult boys and girls in foster home surroundings long after older adolescence and beyond.

Clinical case records indicate that the home is still the major force in forming the personality of children. On the ground that home life, quite apart from its physical aspects, may react upon the health of the child by its confusion and discord, or by its harmony and peace, and "this in turn is largely the result of the parents' own emotional adjustment.

It is in the home that the child's needs for affection, security, and opportunities for growth or development, which play so important a part in shaping his personality, are met or thwarted. Even the most affectionate and intelligent parents may not always fully understand the child's needs for security and growth. Security is founded upon the emotional maturity of parents, upon justice, truthfulness, regularity, order and serenity in the home. Opportunities for development can be given the child only by parents who want to see him grow and give him every chance to utilize and enlarge his own powers.

Wednesday, April 16, 2008

Fully Functioning Persons - Educational Achievement

Schools are anxious that the children they educate grow into fully functioning persons. This has long been an avowed and widely approved purpose of education. We say that education in a democracy should help individuals fully develop their talents. Recently there have been pressures to limit this to intellectual talents. There has been much talk about limiting the school's concern to the full development of the intellect only.

Even with this limited definition of the goals of education, the abilities involved in creative thinking cannot be ignored. There has been increasing recognition of the fact that traditional measures of intelligence attempt to assess only a few of man's thinking abilities. Certainly we cannot say that one is fully functioning mentally, if the abilities involved in creative thinking remain undeveloped or are paralyzed. These are the abilities involved in becoming aware of problems, thinking up possible solutions, and testing them. If their functioning is impaired, one's capacity for coping with life's problems is indeed marginal.

Educational Achievement

Almost no one disputes the legitimacy of the school's concern about educational achievement. Teachers and guidance workers are asked to help under-achievers to make better use of their intellectual resources and to help over-achievers become better "rounded" personalities. But, how do you tell who is an under- or over-achiever? In my opinion, recent findings concerning the role of the creative thinking abilities in educational achievement call for a revision of these long-used concepts.

We are finding that the creative thinking abilities contribute importantly to the acquisition of information and various educational skills. Of course, we have long known that it is natural for man to learn creatively, but we have always thought that it was more economical to teach by authority. Recent experiments have shown that apparently many things can be learned creatively more economically than they can by authority, and that some people strongly prefer to learn creatively.

Traditional tests of intelligence are heavily loaded with tasks requiring cognition, memory, and convergent thinking. Such tests have worked rather well in predicting school achievement. When children are taught by authority these are the abilities required. Recent and ongoing studies, however, show that even traditional subject matter and educational skills can be taught in such a way that the creative thinking abilities are important for their acquisition.

Most of these findings are illustrated dramatically in a study conducted during three years in the University of Minnesota Laboratory Elementary School. We differentiated the highly creative children (as identified by our tests of creative thinking) from the highly intelligent. The highly creative group ranked in the upper 20 per cent on creative thinking but not on intelligence. The highly intelligent group ranked in the upper 20 per cent on intelligence but not on creativity. Those who were in the upper 20 per cent on both measures were eliminated, but the overlap was small. In fact, if we were to identify children as gifted on the basis of intelligence tests, we would eliminate from consideration approximately 70 per cent of the most creative. This percentage seems to hold fairly well, no matter what measure of intelligence we use and no matter what educational level we study, from kindergarten through graduate school.
Although there is an average difference of over 25 IQ points between these two groups, there are no statistically significant differences in any of the achievement measures used either year.

It is of special interest that the children with high IQ's were rated by their teachers as more desirable, better known or understood, more ambitious, and more hardworking or studious. In other words, the highly creative child appears to learn as much as the highly intelligent one, at least in some schools, without appearing to work as hard. My guess is that these highly creative children are learning and thinking when they appear to be "playing around." Their tendency is to learn creatively more effectively than by authority. They may engage in manipulative and/or exploratory activities, many of which are discouraged or even forbidden. They enjoy learning and thinking, and this looks like play rather than work.

Mental Health - what does all this have to do with creativity

There are very legitimate reasons why educators should be concerned about assessing and guiding the growth of the creative thinking abilities. I would like to discuss a few of these.

Schools are legitimately concerned about the mental health of children, adolescents, college students, and adults. They would like to be able to help their students avoid mental breakdowns and achieve healthy personality growth. These are legitimate concerns of education. But what does all this have to do with creativity?

Actually, it has a great deal to do with creativity. There is little question but that the stifling of creativity cuts at the very roots of satisfaction in living and ultimately creates overwhelming tension and breakdown. There is also little doubt that one's creativity is his most valuable resource in coping with life's daily stresses.

In one study, a battery of tests of creative thinking was administered to a group of schizophrenics who appeared to be on the road to recovery. Many of them were being considered for vocational rehabilitation by the State Department of Welfare. These individuals manifested an astonishingly impoverished imagination, inflexibility, lack of originality, and inability to summon any kind of response to new problems. Their answers gave no evidence of the rich fantasy and wild imagination popularly attributed to schizophrenics. There was only an impoverished, stifled, frozen creativity. They appeared to be paralyzed in their thinking, and most of their responses were the most banal imaginable.

Although it will be difficult to prove, I suspect that schizophrenics and others who "breakdown" under stress constitute one of the most unimaginative, noncreative groups to be found. I also suspect that it was their lack of creativity rather than its presence which brought about their breakdowns. Certainly the schizophrenics tested lacked this important resource for coping with life's stresses. Creativity is a necessary resource for their struggle back to mental health.

Thursday, April 10, 2008

History of Biochemistry and Its Medical Applications

In contrast with the cosmic earthquake that the study of physics underwent in the years before 1930, change moved tranquilly in the fields of biology and chemistry. Indeed in biology most of the work of the 1920's continued along lines already established in the nineteenth century.
In genetics, the key event was the rediscovery in 1900 of the work of the Bohemian monk Gregor Mendel, who, contemporaneously with the later researches of Darwin in the 1860's, conducted the epoch-making experiments with the crossbreeding of peas that were to form the basis of the whole modern study of inheritance. The most significant outcome of Mendel's discoveries was the identification of indivisible and unalterable units called genes, through whose infinitely varied combination the process of heredity proceeded. This genetic theory seriously undermined Darwin's principle of natural selection. Some geneticists were ready to discard natural selection entirely, some preferred to retain it in modified form, but there was general agreement that acquired characteristics were not inherited. Mendel's original conclusions were reinforced when twentieth-century geneticists began to extend his work to systematic experiments with the fast-reproducing fruit fly, and to apply the calculus of probabilities to their findings. As a result, by the 1920's the new science of genetics had reached a high level of technical exactitude. Moreover, in treating the gene as a basic and indivisible unit, it seemed to confirm Planck's contention that nature proceeded by jumps and in definite quantities rather than through the continuous and imperceptible processes of change that had been postulated by nineteenth-century philosophers of nature.

Another link between biology and the theory of physics was provided by the new science of biophysics, which, along with the related field of biochemistry, accounted for a large part of the progress made in the study of the human body. Perhaps the most dramatic experiments were those of Sir Frederick Gowland Hopkins in 1912, which became the starting point for the systematic investigation of nutrition and the identification of the basic vitamins. For a long time the chemistry of all the vitamins except D remained a mystery. But in 1929, with the chemical breakdown of Vitamin A, there began a period of rapid progress in the analysis and synthetic production of these substances that continued down to the outbreak of the Second World War.

Closely related to this study was the development of the new science of glands and internal secretions known as endocrinology. In the 1920's, the function of hormones began to be understood, and work on the pituitary and thyroid glands proceeded steadily. Discoveries such as these obviously had relevance for medicine. Indeed, a salient characteristic of the decade was that now, for the first time in history, new research in physiology and biochemistry was quickly applied in clinical practice. An astounding advance resulted. In the mid-1920's there began a period of breathtaking innovation that brought more progress in medicine in a single generation than the profession had known in all previous human history.

The discovery of antitoxins, begun in the 1890's, moved on steadily, as did the analysis of the corresponding viruses. By this method, medical research succeeded in eliminating certain diseases almost completely: as smallpox had been routed in the nineteenth century, so the conquest of diphtheria, yellow fever, and tetanus followed in the interwar period. But most diseases resisted this sort of immunization. Although the ravages of tuberculosis, for instance, were enormously reduced, no satisfactory antitoxin was discovered to combat it. In dealing with these stubborn diseases, the development of antibiotics marked the crucial turning point. Beginning with Sir Alexander Fleming's almost accidental discovery of penicillin in 1928, one new drug followed another in a rapid sequence of successful experiments leading to commercial production.

In all these cases, however, there had been a time lag between laboratory research and its clinical application. Not until the Great Depression had focused attention on problems of hunger and want were the new discoveries in the field of nutrition and vitamins fully exploited. Through the necessities of treating vast masses of sick and wounded soldiers in the Second World War, penicillin, the sulfa drugs, and DDT came into their own. These examples suggest the close relationship between social needs and the development of scientific and medical knowledge in our time.

Similarly, in the organization of research, economic and social factors began to exert an increasingly important influence. In the past, the isolated scientist or physician could produce useful and even epoch-making results with the simple equipment of his own home laboratory. By the 1920's, only a wellfurnished laboratory or research institute could contribute to the growth of scientific knowledge. With this change, the problem of the organization and financing of research took on a new urgency. In such respects, a large and wealthy society like that of the United States enjoyed obvious advantages; a socialized country, such as the Soviet Union, held potential assets for the future. Thus even as early as the 1920's, men of science in the three countries that together had accounted for most of the scientific progress of the nineteenth century--Britain, Germany, and France--were beginning to wonder whether the economy and the way of life that had yielded such marvelous results a generation or two earlier, would prove capable of dealing with the unfamiliar and pressing demands of twentieth-century mass society.