The Transformation of a School Psychologist
by Sharon Moxley
During my first ten years as a school psychologist, I was not aware of
the neurobiological nature of mental illness. I had no inkling that many
of the students that I saw had the symptoms of what we now are beginning
to understand as diseases of the brain. I variously labeled these students
seriously emotionally disturbed (SED), conduct disordered, and out of
touch with their feelings. That many of these children might be suffering
from the initial stages of major mental illnesses rarely occurred to me.
After my initial evaluation of the students, I usually called in their
parents and, in a self righteous state of ignorance, implied that they
were the cause of their child's problem. I then sent them packing to family
therapists to help them straighten out their "mixed messages"
and "double binds." That was "state of the art" not
too many years ago.
I was able to function in this judgmental and confusing manner because
my training as a school psychologist had taught me to place most of the
blame for the child's problems on the poor bewildered parents. This often
overwhelmed them with guilt and most certainly exacerbated the pain.
Then it happened mental illness hit my family! My child suddenly became
very ill. Now I was the one whom the professionals indicted. In a deplorable
and shocking role reversal, I now held myself as the guilty parent. It
seemed like some sinister cosmic joke. After all, I was an informed child
psychologist and I certainly knew how to raise this emotionally healthy
child whom I loved. I was the expert. How could this happen?
The terrible reality played itself out. Filled with guilt and shame,
I walked through hospital halls while the staff watched in silent judgment,
their faces stiff and unyielding, a jury who had just delivered its awful
verdict. Occasionally they broke their silence to tell me that I "had
never set limits for my child." Once they proclaimed that I was "only
interested in power." Never mind that I kept telling them these gruesome
charges were untrue they didn't seem to listen. But their stony faces
silently screamed, "Guilty!"
Given that the "professionals" had no ability to realistically
evaluate me as a parent, it was little wonder that they could not treat
my child effectively. I began to seriously wonder if they really understood
mental illness at all, not to mention the correct treatment for it.
After my initial period of shock and anguish, I began
a desperate crash course in understanding mental illness. Since I was
a psychologist, I naturally started with the "literature of the field"
that I soon discovered reflected all of the outdated theories I had been
taught in graduate school.
After my initial period of shock and anguish, I began a desperate crash
course in understanding mental illness. Since I was a psychologist, I
naturally started with the "literature of the field" that I
soon discovered reflected al of the outdated theories I had been taught
in graduate school. There were no answers for me in those volumes. Now
that I was reading the theories from the perspective of a caring parent,
I began to have new insights into the basic flaws in the thinking of the
These books insisted that parents caused mental illness. Although I had
doubts about myself as a parent, I knew somewhere deep inside that I was
not a bad parent who had emotionally damaged her child; certainly not
the kind of parent that would cause a catastrophic illness. But, if I
were not the culprit, what was the cause? And, more importantly, what
was the effective treatment? And who was out there delivering it?
My pain and agony spurred a frantic search. I haunted libraries. I sent
away for books. I carried books with me almost everywhere. Even when going
to friends houses for dinner I brought my books and glanced at them for
short moments between conversations. Then finally, after months of research,
I stumbled upon the biological theories, at the time kept virtually in
the shadows, and I was absolutely overjoyed. I now had external confirmation
of what I had already intuited. The illness was not in the parent or the
environment. The illness was in the brain. I also discovered that there
was often a strong genetic component in these diseases.
Now my search was more focused. I began to examine my own genetic history.
It was not long until I realized that I had at last solved the mystery
about my family. All my life I had wondered what was wrong with my family?
Why were so many of them unpredictable, moody and depressed? This confusion
and pain had actually been highly instrumental in my becoming a psychologist.
And now, here it was, the answer to the riddle of my family's "curse".
My family had depression and manic depressive disorder!
In light of this information, I now clearly understood the puzzling behaviors
of my favorite aunt an unusually shy recluse who had sudden episodes of
terrible belligerence and unexplained periods of absence, when she went
off hitchhiking, abandoning her worldly possessions. I learned that she
displayed some of symptoms of bipolar disorder. Then there was my uncle
who had significant depressions times when he didn't leave the house for
weeks, or wash, or get out of bed. And at least one relative who killed
herself, and a young cousin who attempted a bizarre suicide pact with
another boy resulting in the death of the other child. As I continued
my evaluation, so many pieces of the family puzzle began to fit together.
So many mysteries could suddenly be attributed to victimization by a terrible
The other side of this dark past was creativity and intelligence. My family
had talent in art, music and writing. Their wit and sharp sense of humor
was their hallmark, sometimes still evident even during depressions.
It was so painful to me to see their talents and abilities lost. For
generations, mental illness, unrecognized and untreated, had robbed my
family of lifetimes of their wonderful gifts. Then, I thought about myself,
and I realized that I had not escaped. Looking back on my own life, I
saw a teenager who suffered significant depression, again without recognition
and treatment. If only I had been identified as having a biological illness
when I was in my teens, with the appropriate treatment, I might have avoided
the ravages of the major depression I had experienced as an adult. Fortunately,
my nondepressed periods were long enough to allow me to complete my education
and engage in a successful professional career. (In 1990 1 was awarded
an "Outstanding Psychologist Award" by
the California Association of School Psychologists.)
After successfully dealing with mental illness on the home front, ( my
child improved significantly, thanks to lithium) I was transformed as
a school psychologist. I realized that many of the students that I had
seen in my career had symptoms indicative of early signs of mental illness.
The statistics on mental illness indicate that one percent of children
in school would, at sometime in their lives, have schizophrenia, and one
to two percent would have bipolar disorder, with even more experiencing
major depression. That meant that, on the average, two or more children
in each class of 30 students could be expected to develop major mental
illness, possibly in childhood and even more likely, in the teen years.
I am now a biological school psychologist and one of the most important
things that I ask a parent is, "What is the genetic family history?"
Even more alarming, the statistics also indicated that one student in
five would be disabled by some type of mental illness at least once in
their lives. This meant that, statistically, twenty percent of the class
was at risk!
Armed with this knowledge, I realized that to me mental illness had always
seemed to be an adult disease. I didn't quite make the connection with
the young students whom I saw daily and adults with mental illness. But
it was these children, I finally realized, that were the future adult
sufferers of schizophrenia and bipolar disorder. What if they could be
identified early, and helped? Was anybody researching that?
They were my students. They were in regular classes, and gifted programs,
and special education classes. They were honor students, they were children
with learning and behavior problems. They were the hope of the future.
They were in school. And it was in school that many people with schizophrenia
and bipolar disorder had first manifested their symptoms. I cringed as
I realized that I had often been their school psychologist! Had I overlooked
them? Were their emerging symptoms right there in front of me?
How many times did I look right past the clues in their school records?
"John seems to tune out in class" "Carol has difficulty
making friends, and seems withdrawn." Sometimes there were very discernible
patterns suggesting early bipolar symptoms: Excellent academic performance
and good classroom behavior interspersed with weeks or months of poor
grades, withdrawal, or frequent altercations with others. It's shocking
to remember that I always assumed that these changes in mood and behavior
were exclusively the results of a program, therapy or changes in the home.
Looking back, I now know that I missed recognition of students with neurobiological
disorders because of my professional training, which taught me so little
about mental illness. My training was heavily analytic and I was very
much a disciple of Freud. Through this education, my eyes were trained
to evaluate the parent's behavior more than the child's symptoms. Too
often my job was to designate blame.
And what kind of a school psychologist am I now? Now that I have been
jolted and shaken out of the 19th century by the unbelievable pain and
agony of mental illness? I am now a biological school psychologist and
one of the most important things that I ask a parent is, "What is
the genetic family history?" "Has anyone in your family, including
grandparents, great grandparents, aunts, uncles, cousins had a breakdown,
experienced depression or other mental illness?"
In my experience, parents of the children who are having depression and
certain behavioral difficulties tell me, at least 80% of the time, that
there is a strong genetic family history of mental illness. When I have
knowledge about genetic family history, the student's symptoms are more
easily and accurately interpreted. For example, if the student, who reports
previous symptoms of depression, is having symptoms that look like attention
deficit hyperactivity disorder (ADHD) and the parents tell me that there
is no genetic family history of ADHD, but that the grandmother and the
father have manic depression, I would refer the student to a biological
psychiatrist who specializes in depression and manic depression. Without
the family history I would be more likely to refer the child to the family
pediatrician only. The decision to refer the student to a psychiatrist,
as well as the family physician, could make all the difference in getting
the proper diagnosis and early treatment, not to mention saving the family
and the child years of suffering and wasted dollars.
In my family, the glaring clue was our family history. I was carrying
the genes of my family, and my life from early adolescence had been marked
by those genes. The same genes have been transferred to my offspring and
undoubtedly they will be passed on to my grandchildren and great grandchildren.
The big difference now, for my family and hopefully for the children that
I evaluate in school, is that their genetic family history can help
detect the early signs of mental illness. Now I can refer children that
I suspect have a biological illness to professionals in the community
who have a biological orientation rather than a professional who treats
the "worried well". These children may then be appropriately
treated in the early stages of the illness. Early intervention, we know,
can help children avoid the social and academic failures , the hospitalizations
and indignities of the "system". Instead, these children can
have the best chance to fully live their lives. In my family, and the
families I see as a school psychologist, our children's gifts do not
have to be wasted.
(This article was first published in 1995)
SHARON MOXLEY is a parent, a licensed educational psychologist and past
copresident of the Sonoma County Alliance for the Mentally Ill.