|Basic InformationMore InformationLatest NewsQuestions and AnswersVideosLinksBook Reviews|100 Things Guys Need to Know3 NBS of Julian DrewA Guide to Asperger SyndromeA Tribe ApartA User Guide to the GF/CF Diet for Autism, Asperger Syndrome and AD/HDA Walk in the Rain With a BrainAdolescence and Body ImageAdolescent DepressionAfterAggression and Antisocial Behavior in Children and AdolescentsAll Alone in the UniverseAmelia RulesAmericaAnother PlanetAntisocial Behavior in Children and AdolescentsArtemis FowlAssessment and Treatment of Childhood Problems, Second EditionAutistic Spectrum DisordersBad GirlBetween Two WorldsBeyond AppearanceBeyond Diversity DayBig Mouth & Ugly GirlBill HensonBipolar DisordersBody Image, Eating Disorders, and ObesityBody Image, Eating Disorders, and Obesity in YouthBoyBoysBrandedBreaking PointBreathing UnderwaterBringing Up ParentsBullying and TeasingCan't Eat, Won't EatCatalystChild and Adolescent Psychological DisordersChildren Changed by TraumaChildren with Emerald EyesChildren’s Dreaming and the Development of Consciousness City of OneConcise Guide to Child and Adolescent PsychiatryConquering the Beast WithinContentious IssuesCrackedCutDancing in My NuddypantsDemystifying the Autistic ExperienceDescartes' BabyDilemmas of DesireDirtyDoing ItDoing SchoolDying to Be ThinEating an ArtichokeEducating Children With AutismElijah's CupEllison the ElephantEmerald City BluesEmotional and Behavioral Problems of Young ChildrenEvery Girl Tells a StoryFast GirlsFeather BoyFiregirlForever YoungFreaks, Geeks and Asperger SyndromeFreewillGeography ClubGeorgia Under WaterGirl in the MirrorGirlfightingGirlsourceGirlWiseGLBTQGood GirlsGoodbye RuneGranny Torrelli Makes SoupGrowing Up GirlHandbook for BoysHealing ADDHeartbeatHelping Children Cope With Disasters and TerrorismHelping Parents, Youth, and Teachers Understand Medications for Behavioral and Emotional ProblemsHollow KidsHow Children Learn the Meanings of WordsHow to Keep Your Teenager Out of Trouble and What to Do If You Can'tHug MeIntrusive ParentingIt's Me!It's Perfectly NormalJake RileyJoey Pigza Swallowed the KeyJuvenile-Onset SchizophreniaKeeping the MoonKilling MonstersKim: Empty InsideKnocked Out by My Nunga-NungasLaura Numeroff's 10-Step Guide to Living with Your MonsterLearning About School ViolenceLeo the Lightning BugLet Kids Be KidsLiberation's ChildrenLife As We Know ItLisa, Bright and DarkLittle ChicagoLord of the FliesLoserLove and SexLove That DogManicMastering Anger and AggressionMind FieldsMiss American PieMom, Dad, I'm Gay.MonsterMore Than a LabelMyths of ChildhoodNew Hope for Children and Teens with Bipolar DisorderNo Two AlikeNot Much Just Chillin'Odd Girl OutOdd Girl Speaks OutOn the Frontier of AdulthoodOne Hot SecondOne in ThirteenOphelia SpeaksOphelia's MomOur Journey Through High Functioning Autism and Asperger SyndromeOut of the DustOvercoming School AnxietyParenting and the Child's WorldParenting Your Out-Of-Control TeenagerPediatric PsychopharmacologyPeriod PiecesPhobic and Anxiety Disorders in Children and AdolescentsPINSPraising Boys WellPraising Girls WellPretty in PunkPrincess in the SpotlightProblem Child or Quirky Kid?Psychotherapy As PraxisPsychotherapy for Children and AdolescentsRaising a Self-StarterRaising BlazeRaising Resilient ChildrenReclaiming Our ChildrenRedressing the EmperorReducing Adolescent RiskRethinking ADHDReweaving the Autistic TapestryRineke DijkstraRitalin is Not the Answer Action GuideRunning on RitalinSay YesSexual Teens, Sexual MediaSexuality in AdolescenceShooterShort PeopleShould I Medicate My Child?Skin GameSmackSmashedStaying Connected to Your TeenagerStick FigureStoner & SpazStop Arguing with Your KidsStraight Talk about Your Child's Mental HealthStrong, Smart, & BoldStudent DepressionSurvival Strategies for Parenting Children with Bipolar DisorderSurviving OpheliaTaking Charge of ADHD, Revised EditionTaming the Troublesome ChildTargeting AutismTeaching Problems and the Problems of TeachingTeen Angst? NaaahThat SummerThe American Psychiatric Publishing Textbook Of Child And Adolescent PsychiatryThe Arctic IncidentThe Bipolar ChildThe Buffalo TreeThe Bully, the Bullied, and the BystanderThe Carnivorous CarnivalThe Depressed ChildThe Developing MindThe Dragons of AutismThe Dream BearerThe Dulcimer Boy The Einstein SyndromeThe EpidemicThe Eternity CubeThe Explosive ChildThe Field of the DogsThe First IdeaThe Identity TrapThe Inside Story on Teen GirlsThe Little TernThe Mean Girl MotiveThe Men They Will BecomeThe Myth of LazinessThe New Gay TeenagerThe Notebook GirlsThe Nurture AssumptionThe Opposite of InvisibleThe Order of the Poison OakThe Other ParentThe Present Moment in Psychotherapy and Everyday LifeThe Real Truth About Teens and SexThe Rise and Fall of the American TeenagerThe Secret Lives of GirlsThe Sex Lives of TeenagersThe Shared HeartThe Spider and the BeeThe StepsThe Thought that CountsThe Unhappy ChildThe Vile VillageThe Whole ChildThen Again, Maybe I Won'tTherapy with ChildrenThings I Have to Tell YouTouching Spirit BearTrauma in the Lives of ChildrenTreacherous LoveTrue BelieverTwistedUnhappy TeenagersWay to Be!We're Not MonstersWhat about the KidsWhat Would Joey Do?What's Happening to My Body? Book for BoysWhat's Happening to My Body? Book for GirlsWhen Nothing Matters AnymoreWhen Sex Goes to SchoolWhen Your Child Has an Eating DisorderWhere The Kissing Never StopsWhose America?Why Are You So Sad?WinnicottWorried All the TimeYes, Your Teen Is Crazy!You Hear MeYoung People and Mental HealthYour Child, Bully or Victim?
by Joel Paris
Review by David J. Mullen, M.D. on Dec 5th 2001
This work by Joel Paris, MD, Professor of Psychiatry at McGill
University, appears in some respects to echo some of the positions taken
in Judith Rich Harriss controversial 1998 book The
Nurture Assumption. Unlike Harris, however, his perspective is
that his of a highly regarded and experienced clinician and as such his
arguments addressing clinical issues are delivered with greater authority.
Both books present considerable challenges to the long-standing assumption,
taken by both mental health professionals as well as the lay public, that
childhood experiences generally and those of early childhood in particular,
play an especially critical role in the development of the adult personality.
Like Harris, he presents data undermining the notion that subtle nuances
of parenting can result in significant psychological damage to the majority
of children. His evidence-supported argument contends rather that the majority
of children are quite resilient even in the face of major stresses with
only a minority developing significant psychopathology. Even then
the stresses that seem to be most closely associated with pathology are
not single events in most cases but events that recur frequently over a
long span of time.
However, despite the emphasis on resilience, he does acknowledge the
concept of vulnerability both to trauma as well as parenting technique.
The data from Jerome Kagans study of inhibited children and the impact
of differential parenting is given as exemplifying such vulnerability.
It is this last point, the existence of relative vulnerability, that is
subsequently elaborated into an argument that genetically based temperamental
factors are key elements to understanding the relative risks for developing
psychopathology. In addition, I feel that it is here, in his appreciation
of individual vulnerability that Paris clinical experience and knowledge
are most clearly advantageous. He states most clearly that the impact of
parenting should not be under-estimated and certainly cannot be dismissed.
Rather he seeks to define his efforts in the present volume as seeking
to counter-balance strong historical trends toward discounting the significance
of temperamental and biological factors in personality and psychopathology.
Again, environmental factors are not discounted but are seen as less critical
than is commonly perceived, especially with regard to the role stressful
events in pathology.
The author focuses a good deal of criticism on two schools of clinical
work: 1) psychodynamic/psychoanalytic and 2) recovered memory based therapy.
Both are censured for an excessive reliance on the primacy of childhood
assumption as well as for depending too much upon clinical inference rather
than empirical data derived from controlled studies. In addition,
recovered memory approaches are strongly criticized for ignoring an increasing
body of such empirical information regarding the formation of memories
and the reliability of recall under the influence of suggestion.
Finally, Paris echoes the concerns of many regarding harm that numerous
individuals and families have suffered as a result of abuse accusations
stemming from eager therapists seeking for evidence of abuse/neglect in
all of their patients.
I think one could make a case that Paris is overstating his case somewhat
regarding the relative insensitivity of the personality to environmental
events in childhood and the relationship of such events to psychopathology.
First, the variables described tend to be of the rather broad variety (Five
Factor Model, Cloningers dimensions of personality, etc.), rather than
the more specific personal idiosyncrasies of interest to the psychoanalytically
oriented clinician. Secondly, the threshold Paris is utilizing
for diagnosing disorder is not completely clear. Presumably he means
DSM criteria are met but the clarity and consistency of use of the DSM
are not without problems and controversy, particularly from a depth psychological
perspective. Paris does acknowledge that childhood maltreatment may
result in distress, but the line between distress and disorder is not
always so well defined. Most persons enter treatment because they
are in distress not because they have learned that they meet specific formal
diagnostic criteria. I suspect the authors zealotry may be explained in
part by the authors former commitment to psychoanalytic models of pathology
However, despite this limitation and on the whole, this book is well
written and well balanced. Empirically supported, data is effectively
marshaled in favor of his position that childhood primacy in the development
of personality may be less significant than has been thought and the centrality
of traumatic events may be substantially less critical than most persons,
lay and professional alike, may believe.. Despite I therefore recommend
this thoughtful work to anyone interested in the relationship between child
development and psychopathology.
© 2001 David Mullen
Mullen is an Associate Professor of Child and Adolescent Psychiatry
in the University of New Mexico School of Medicine. He is the Deputy Medical
Director of the UNM Children's Psychiatric Hospital and attending physician
in that facility's adolescent inpatient unit. His interests include the
application of evolutionary psychological principles to the understanding
of child and adolescent psychopathology, especially the disruptive behavior