What causes depression and anxiety? I have been a practicing psychologist and psychoanalyst for almost 40 years and have seen hundreds of patients suffering from both. In my experience, some factors are obvious. People who suffer from depression and anxiety have experienced stresses and traumas in their development that predispose them to mood disorders. Garden-variety psychodynamic theory teaches us that issues involving loss, neglect, guilt, and rejection usually figure prominently in the backgrounds of people who present with significant symptoms of depression and anxiety.

In addition, over 50 years of research into the neurobiology of mood disorders strongly suggests that genetic and biological factors usually accompany, if not underlie these painful affective states. As a result of these assumptions, the treatment of depression today usually relies heavily on pharmacology, and drug companies have spent billions making sure this explanation is widely accepted. Some one in five US adults is taking at least one drug for a psychiatric problem; nearly one in four middle-aged women in the United States is taking antidepressants at any given time; and around one in 10 boys at American high schools are being given powerful stimulants to make them focus.

Since it’s well known that psychological events produce biological changes, it remains debatable whether or not disorders of our biochemistry are causes or effects. What we do know is that untold amounts of money have been spent by the pharmaceutical industry to finance research and public relations designed to enshrine biochemistry and pharmacology as primary in the diagnosis and treatment of depression and anxiety.

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Everybody knows that Donald Trump is mentally disturbed. His mental illness is hiding in plain sight. Someone who can never admit a mistake or show remorse or guilt is unbalanced. Someone who frequently brags and demeans others is emotionally insecure and volatile. And someone who appears to lack empathy invariably has something missing inside. No one has to go out on a limb to know that these things are true.

When I say that “everybody knows,” I realize that that isn’t literally true. Many people seem to like and admire Trump, and likely believe that critiques of his psychological stability originate from the liberal media and his political opponents. Instead, when I say that “everybody knows” Trump is disturbed, I’m saying you don’t need to be a trained psychiatrist or psychologist to believe that he is riddled with extreme emotional conflicts that hamper his ability to be a responsible leader. You just need some combination of common sense, intuition and empathy. Most psychotherapists understand their clients with just such tools. In this sense, analyzing Trump’s mind is almost as easy for the lay person as for the so-called expert.

For example, is anyone surprised that someone who smiles and clowns around all the time might be hiding depression or sadness? Or that a bully might secretly feel weak and scared? Or that a braggart is likely defending him or herself against feelings of insecurity or inferiority? Or that an abuser might have been abused as a child? These inferences don’t require speculative diagnostic leaps or specialized psychiatric knowledge, but are knowable through the ordinary emotional intelligence that guides us in normal social life.

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In 1978, developmental psychologist Edward Tronick and his colleagues published a paper in the Journal of the American Academy of Child Psychiatry that demonstrated the psychological importance of the earliest interactions between mothers and babies. The interactions of interest involved the playful, animated and reciprocal mirroring of each other’s facial expressions. Tronick’s experimental design was simple: A mother was asked to play naturally with her 6-month-old infant. The mother was instructed to suddenly make her facial expression flat and neutral; to remain completely still, for three minutes, regardless of her baby’s activity. Mothers were then told to resume normal play. The design came to be called the “still face paradigm.”

When mothers stopped their facial responses to their babies, when their faces were still, babies first anxiously strove to reconnect with their mothers. When the mothers’ faces remained neutral and still, the babies quickly showed ever-greater signs of confusion and distress, followed by a turning away from the mother, finally appearing sad and hopeless. When the mothers in the experiment were permitted to re-engage normally, their babies, after some initial protest, regained their positive affective tone and resumed their relational and imitative playfulness.

When a primary caretaker (the still-face experiments were primarily done with mothers, not fathers) fails to mirror a child’s attempts to connect and imitate, the child becomes confused and distressed, protests, and then gives up. Neurobiological research (summarized by child psychiatrist Bruce Perry and science writer Maia Szalavitz in their book, Born for Love: Why Empathy Is Essential—and Endangered), has powerfully demonstrated that in humans and other mammals, a caretaker’s attunement and engagement is necessary to foster security, self-regulation and empathy in the developing child. Parental empathy stimulates the growth of empathy in children. The infant brain is a social one and is ready to respond to an environment that is appropriately nurturing.

Read the full article at alternet.org