Tuesday, June 17, 2014

Willy Wonka and the Golden Ticket

I watched Charlie and the Chocolate Factory with my 8 and 5 year old over this past weekend.  I was having a hard time deciding if it was Johnny Depp or Micheal Jackson dressed as Willy Wonka?  The resemblance was uncanny at various times, yet at times it felt like Lady Gaga was playing some parts of Willy Wonka as well.  I had to keep reminding myself that the movie said Johnny Depp, so my mind must not wonder and focus on the movie.  Unfortunately I haven't watched the Gene Wilder version of the movie but I read somewhere that Mr.Wilder wasn't thrilled about the remake.  I will have to watch the original to compare but for the time being I can safely say I didn't terribly mind watching this one.  

On the other hand the psychiatrist in my head ruined it for me as soon as Willy Wonka started choking on the word "Parents".  It is safe to assume that Willy has daddy issues and daddy had control issue along with obvious inability to express love, care and affection in a more child friendly way, well at least in the movie adaptation.  Enter the five lucky children with their parents and one grandparent.  Charlie Bucket and grandpa Joe, Veruca Salt and her dad, Mike Teevee and his dad, Violet Beauregarde and her mom, and finally, Augustus Gloop and his mom; are the children who found the Golden Ticket hidden in the chocolate bars.  

The eccentric yet quirky Willy Wonka takes his guests on a trip around his chocolate factory with edible grass and chocolate waterfalls and one by one by one all but one child become victims of their own traits.  The last one standing was neither rich nor special with any talents and at the same time he was neither spoiled nor selfish.  

Why did I start thinking about this today other than the fact that I have eaten more candy since the weekend than I did in last 2 years i.e. at least 8 pieces.  Technically it is a lot of candy if you haven't eaten any in 2 years.  I like to keep things in perspective.  But other than the candy dilemma at my hand I think I saw the movie more as a lesson in parenting.  

Parenting is probably the hardest job universally.  It doesn't matter what race, ethnicity, political affiliation or religion you are, being a parent is one of the hardest and most consequential jobs you will ever have.  To make matters worst there is no training, no manuals and there are no do overs or 30 day money back guarantee.  All sales are final and all items are delivered without a warranty.  The flip side of this holds true too.  Children do not get to pick what kind of parents they get nor do they make the choice to be born.  We as their parents make that decision or the decision is made for us when birth control fails. 

No matter how we become parents, by choice or by accident, the moment it happens; life as we know it changes.  The child mother dyad is the foundation of all parenting scenarios.  In cases where mothers are unavailable, for any number of reasons, the dyad has to exist somehow with another attachment figure.  Harlow's mesh wire mother experiment with infant monkeys demonstrated clearly that attachment is not simply driven by internal drives as hunger or thirst.  At the same time it also showed that the soft doll was not a substitute for actual contact with other monkeys.  Monkeys raised in isolation had abnormal social and sexual development, and were eventually neglectful and abusive towards their own offspring.  John Bowlby and Mary Ainsworth have demonstrated that the roots of love lay well above and beyond toys, gadgets and deeply in the realms of mother/caregiver and infant bond.  

Through out the movie there are multiple themes of parenting and for the most part parenting gone wrong.  From Willy Wonka's own longing for acceptance from his harsh and unapproachable dad who forbade Willy a single taste of his Halloween candy loot to overly indulging parents of Veruca Salt and from the avoidant parents of a defiant Mike Teevee to an equally self absorbed and narcissistic mom to Violet Beauregrade.  Let's not ignore the minimally effective mother of the glutton and greedy Augustus Gloop, there is an array of parenting styles or lack thereof. 

On the other hand Charlie Bucket who belongs to a poor family of 4 grand parents and working class mother and father living in a crooked little house, seems to have it all; yet he doesn't seem to have anything tangible to his name, standing among the group of 5 lucky chosen ones. 
The little boy who has nothing turns away from everything when it is offered to him on a platter because he can't fathom to lose what has been his golden ticket all along i.e. his family.  

What is different one might wonder?  Turns out that being a parent is more than providing your children with whatever your resources and wealth can buy, because Veruca Salt is headed right for a life of being a self absorbed individual and an equally unavailable parent.  Parenting won't appeal to her instant gratification need.  It is certainly more than just allowing them to be themselves without discretion or direction because Mike Teevee is learning nothing about self control and definitely nothing about reliable and assertive support a parent provides.  It would be a miracle for him to provide this to his children.  

Parents shouldn't live vicariously through their children because it teaches their children to set themselves up for disappointment, when they learn to follow dreams that aren't their's; without learning how to dream for themselves. Violet Beaurgrade isn't learning to allow herself to follow her passion because life is being modeled as vain and narcissistic, serving a purpose to her mother's need for perfection projected onto her daughter.  Parenting would be a tough challenge because it demands tolerance for complete disruption of normalcy and perfection of life, until the disruption becomes the new normal.  A normal that is not perfect anymore but just right.  That will never be enough for her.  
Being a parent demands being able to be critical of your children without being unkind and setting boundaries without suffocating them.  Augustus Gloop is unfortunate because he parents are too afraid to be critical of his gluttony and are unable to set boundaries while Willy Wonka faced unkind criticism and suffocating boundaries.  He somehow built an empire out of that but Gloop doesn't seem to have that kind of self discipline but he is lucky that dad has a sausage business so Gloop won't have to worry about building an empire.   

Parenting is kindness, love, affection, encouragement and freedom while allowing disappointment, dejection, criticism, anger and above all reliability.  A child who is parented with love that is often tough yet always kind learns to accept, expect and express love the same way which in turn allows tolerance for disappointments and mistakes.  Encouragement doesn't mean anything if there is no room for failure and freedom doesn't teach self discipline and control if it comes without boundaries of critical thinking and at least a small moral compass.  Look where it got Charlie Bucket!!

May be the Golden Ticket Willy Wonka had dispatched was to work the other way around.  May be it was him who needed the final big prize all along and ended up being the winner.  After all he was sitting at a dinner table with a family of his own size and one that seemed to be able to fill his need to finally grow up the way he wanted to.   


I leave you with this thought since this sums up so perfectly what I took so long to write.  

"What a child never learns, he seldom gives back."  P.D. James

Sunday, June 15, 2014

Choices Choices

I will be a 3rd year in just two more weeks.  Ack! Time has flown and this means I have two more years left to finish training.  This also means I have to pick a track for the next two years of my training.  Third year of training spans over 12 months of outpatient clinic for all Psychiatry residency training programs.  Outpatient is a different breed.  This is where residents learn to work with patients who are functioning and are able to participate in treatment.  These patients in so many ways help put the inpatient work in a new perspective by shifting the dismal and seemingly hopeless inpatient work to a more stable and predictable one.  Inpatient training teaches residents the art of managing acutely unstable patients from admission to hospital stay and culminating at discharge.  At the same time like any other medical model it seems to have a slew of repeat patients, many admitting multiple times in short periods of time.  That is what sometimes makes many physicians jaded.  I think 3rd year is the perfect time to switch to outpatient so residents can break the cycle for themselves and re-energize before making career decisions moving into 4th year and beyond.  

Like many programs this past year we started assigning PGY-2 residents at least two patients for long term therapy.  I have found therapy to be challenging, at times scary and very rewarding.  What makes it somewhat easier when it seems so hard, is having a supervisor who helps you explore your own emotions and guide you along.  I have to pick a track for 3rd year and I have decided to pick Psychotherapy as my main track, which means I will have at least 9 therapy patients, along with my regular clinic through out the year in addition to the group therapy.  It is daunting and I am not sure if I will be able to handle this but the only way to move forward is to dive in deep and see what happens.

No matter what happens, the bottom line is that I am excited about moving up the ladder, changing work environment and taking up what I love most about psychiatry - healing through words.
Happy PGY-3 to me!!