Nicholas Pediaditakis, MD

The genome consortium studies have established, with a high degree of confidence, that certain loci genes are associated with schizophrenia and bipolar disorder.

 The tempting assumption from this finding is that somehow this group of genes is directly involved in the development of these disorders. Not so. The aforementioned genes are directly involved in the expression of premorbid personality/traits, since the presence of these traits invariably antedates the disorders. This temperamental configuration, ie, personality, is made up of traits from evolutionary pressures on the individual-albeit of an exaggerated form-such as aloofness, inner directness, autonomy, and an aversion to social interaction. Comprising, according to E.O. Wilson, one part of our human nature from birth, the other from being social creatures.

Similar to the dog that did not bark is the dearth of the traits (whose presence normally ensures sociality) that creates the vulnerability for schizophrenia. They emanate from evolutionary pressures on social experiences, such as cooperation, empathy, mutuality, friendly competitiveness, and a tendency for social give and take. As E. O. Wilson

 concluded, these traits together, but not amalgamated, with the “selfish” traits, complete our conflictual human nature.

Yet the presence of a group of gene loci associated with the expression of our sociality is not even being considered in current studies. It is important to note that although the lopsided temperament varies somewhat between sufferers, the cardinal symptoms are felt as alienation and a disconnectedness by all of them.

The premorbid personality made of “lopsided asocial” traits creates a pool of vulnerable individuals in whom schizophrenia and bipolar disorder may develop by a periodic phase-shift of the overall coordinating faculty of brain function that ensures synchrony.

 This synchrony is an emergent property of complexity. This probabilistic shift heralds the expression of the disorders and results in the development of characteristic symptoms for both schizophrenia and bipolar disorder. In addition to the presence of psychoses, symptoms are made up of antithetical substitutes with an “either/or” nature in their expression.

 The concomitant manifestations of psychosis differ only in the “narcissistic” nature of the delusions to that of other psychoses, which are usually present in all major disturbances of brain function, such as high fever, brain trauma, and toxicity.

It is important to note that as an advantageous evolutionary trade off, some individuals in this vulnerable pool, because of their “lopsided” temperamental traits, are able to think in alternatives and discern novel scientific, mathematical, musical, and artistic patterns. Because of their “premorbid personality” unencumbered by social algorithms, they can be more creative in all areas of human endeavors at a much greater rate than the occurrence of the disorder itself. Not all will go on to have schizophrenia or bipolar disorder.

 Significantly, this advantageous evolutionary trade-off explains the persistence of the 4% prevalence for both disorders world-wide in spite of its evolutionary unfitness ( ie, early onset, early death, low fertility).

The quickly advancing developments in molecular genetics, evolutionary biology, and gene editing (CRISPR) and the fusion of these disciplines with electronic technology are presenting mind-boggling opportunities for prevention as well treatment of major mental disorders. It also presents us with ethical and existential dilemmas that will tax our wisdom and have a bearing on our very survival as a species as we deal with conundrums such as what constitutes treatment and what constitutes cure. Moreover, we must consider the ramifications of attempting to modify elements of the genome that pertain to human nature (eg, what kind, for whom, by whom, for what purpose) as well as what might the consequences be for the future of humanity.

Dr Pediaditakis retired recently after 63 years of clinical practice. He is a graduate of the Aristotelian School of Medicine in Thessaloniki, Greece. After completing his internship in Cleveland, OH, he obtained a fellowship/residency in psychiatry at the University of Colorado, School of Medicine. After completing his residency, he spent more than 20 years as Director of a major mental health center in the metropolitan area of Wake County in NC as well as private practice and consultation. He is an Affiliate Professor at East Carolina University, Brody School of Medicine in Greenville, NC. He now writes essays and raises black angus as a hobby. He just published the book Chroniclers of the Soul, which comprises essays relevant to us all. Dr Pediaditakis reports no conflicts of interest concerning the subject matter of this article.

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 Andreasen NC. Creativity and mental illness prevalence rates in whites and their first-degree relatives. 

Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression

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 Leboyer M, Henry C, Paillere-Martinot ML, Bellivier F. Age at onset in bipolar affective disorders: a review. 

 Collingwood J. Premature Death Rates Rising in Schizophrenia, Bipolar Patients; 2018. 

https://psychcentral.com/lib/premature-death-rates-rising-in-schizophrenia-bipolar-patients/

 Giudice MD. Reduced fertility in patients’ families is consistent with the sexual selection model of schizophrenia and schizotypy. 

Articles

Some thoughts on the pathogenesis and persistence of prevalence of schizophrenia and bipolar affective disorder in view of current discoveries.

The Dog That Did Not Bark

There are many [awe-inspiring] wonders, none greater than a human being.

There exists an association between creativity and major mental disorders known since antiquity. The ancient Greeks considered both as “having been touched by the gods.” Aristoteles, in his perspicacity, stated, “There is no genius without having a touch of madness.” This phenomenon has been verified repeatedly in studies in the past.

 Does one phenomenon cause the other or do both share a common underlying factor or mechanism? How are geniuses able to accomplish “creative fits”? In this article, both questions are addressed.

Although the proposed origin and mechanism of the brain function of creative geniuses is novel, empirical evidence is available to support this theory. Empirical evidence demonstrates that creativity and major mental disorders share a common pool made up of individuals with an extreme temperamental variant who, if endowed with other qualities (eg, high intelligence, tenacity, curiosity, energy) and live in a nurturing and complementary zeitgeist, can be creative geniuses. On the other hand, persons with a similar temperament but who do not have the additional qualities form a common pool of individuals who are at increased risk for a major mental disorder.

A few remarks regarding temperament are warranted, since they are cogent and relevant to the discussion in this article. Temperament is defined as the particular inborn behavioral propensities for each individual, which ultimately represents the final brain structural reality. It not only acts as an unfinished scaffold upon which the personality of the individual is formed, but it also guides the significance of environmental influences that are eventually embedded in the scaffold. Both constitute, along with learned attitudes and ethos, the final personality of the individual.

Temperamental components appear to originate from two areas from our evolutionary past and are expressed in distinct clusters. The first cluster originates from the evolutionary pressures on the individual, expressed as selfishness, inner directness, aloofness, and self-serving calculations. The second area/group originates from the evolutionary pressures on the social aspects of human experience, such as sociability, connectedness, 

, altruism, mutuality, cooperation, and loyalty to one’s tribe (ie, tribalism). These two unamalgamated clusters make up human nature.

From an evolutionary standpoint, the normally occurring small temperamental variability, or traits, confers flexibility and resilience for the survival of the tribe as a whole, irrespective of advantage or even disadvantage to the individual. Importantly, the mix of the temperamental components are often not distributed evenly but appear as clusters originating mainly from one or the other part of our human nature. This creates the often lopsided temperamental types (eg, the extrovert and the introvert).

In creative geniuses, there exists a major variation from the norm of the inborn temperament. This variant lies beyond the normally occurring variability. Referring to major mental disorder, Freud called it “narcissistic neuroses.”

 This extreme variant is also seen in other individuals at risk for major mental disorders. When and if a major mental disorder does develop (probabilistically amenable to prediction only by statistical methods), the individual’s preexisting lopsided traits manifest as premorbid personality.

Findings from clinical empirical evidence indicate that this extreme variant originates mainly from evolutionary pressures and is shared by potential geniuses and other vulnerable individuals. Schizophrenia, bipolar disorder, and obsessive-compulsive disorder are the 3 conditions that develop most frequently in vulnerable individuals. These conditions can overlap or switch from one to another. Relapses have traditionally been attributed to comorbidity; however, each syndrome might be considered as a different phase of the same disorder. Clinical evidence points to a 

 Similar results have also been seen in recent genetic studies.

These individuals are to various degrees less social, more self-centered, and aloof. They may exhibit remarkable “learned” affability and civility, but they are, to various degrees, inner-directed, autonomous, and deficient in empathy and connectedness. They tend to “think” the world rather than “feel” it. Persons with this temperament, behave oddly and are often perceived as fickle, idiosyncratic, peculiar, or strange. They are often dysphoric and tend to feel an “inner void, and aloneness within.”

Occasionally this progresses to episodes of precipitous depression and can lead to suicide or substance abuse. These individuals exhibit a kind of “Robinson Crusoe of the spirit,” although as in the case of talented performers, it may generate great merriment, affection, and enthusiasm in their audience (an example might be the recent death of the much-loved actor Robin Williams). These individuals are racked by doubts and mood oscillations, and they are often captives of compulsive rituals.

A great portion of our brain’s function is normally allocated for social intercourse and for the “give-and-take” inherent in myriad social interactions. Humans are social creatures, our phenomenal 

 as a species-“eusociality”-depended on this.

 This dedicated-to-social-functioning component of our brain fosters the development of empathy, altruism, and cooperation. It enables us to discern emotionally the intentions and feelings of others and to interact with others. All of these factors form the second part of our nature, which originates from the 

 pressures of the social aspects of human experience.

The absence or deficiency of the social algorithms in brain function frees enormous power in the brains of these temperamentally lopsided individuals. This power then becomes available for creative processes in the right individual. Creative persons are now able to think in alternatives, and conciliate and synthesize patterns to come up with novel solutions to seemingly intractable problems and/or create stirring works of art that emotionally mobilize us to narratives of human predicaments. Moreover, creative geniuses envision new and compre- hensively applicable paradigms of nature’s workings. They bypass our evolutionary limits of comprehension and invent ways to access the mathematical arrangement of nature, thereby conceiving, for example, quantum mechanics. Although often exhibiting a learned civility, these individuals may nevertheless be deficient in understanding the algorithms that help us perceive and comprehend the emotional gestalt, state of mind, and intentions needed for social interaction.

This lopsided variant, deficient in social algorithms, may be related to the autistic spectrum (eg, savants who can recite the list of an entire telephone book) or to 

 (eg, persons who develop sudden heightened or de novo creative skills after the injury).

Two years after graduating from the police academy, Officer Ryan suffered a gunshot wound to the head that resulted in left frontal lobe brain injury. Before the incident, he had no interest in art and had never taken any courses in art. After the injury, in addition to moderately reduced cognitive alacrity and being somewhat “socially clueless,” Officer Ryan begins to exhibit a sudden talent for painting portraits of remarkable talent. Also endowed with high intelligence, tenacity, curiosity, persistence of effort, energy, and enthusiasm, Officer Ryan has now become a creative genius.

Individuals with this type of so-called brain deficiency exhibit exuberant confidence as national leaders and religious figures. Matched with guile and charm, such persons are often the rare individuals who are gifted with charisma. The charismatic individual is able to transform nations or create religious movements by playing to our social nature. He or she uses our innate yearning for certainty in a world of uncertainty and ambiguity to lure us into unreflecting submissiveness to his or her dictates.

Creative individuals are prone to be “cyclothymic,” while scientists and engineers predominantly tend to be “schizoid.”

 Unfortunately, creative geniuses are more vulnerable to major mental disorders.

 There are many examples of this phenome- non throughout history. Charles Darwin was aloof, obsessive-compulsive, and a hypochondriac.

 His co-discoverer and fellow genius, Alfred Wallace, was also aloof and a lonely wanderer. Nikola Tesla was often mentally compromised, and Wolfgang Amadeus Mozart suffered from mood swings. Beethoven was periodically depressed; Tolstoy was a strange, otherworldly, idiosyncratic aristocrat; and let’s not forget the periodically outright psychotic, super-genius Isaac Newton. Albert Einstein was an aloof man who mistreated his second wife Elsa (who was also his cousin). He gave away his illegitimate daughter, sight unseen, although on the surface he displayed social affability and charm.

More recently, Steve Jobs, a very intense, compulsive genius, exhibited signs of cyclothymia.

 He was able to recruit the creative powers of others and literally built the realm of computer technology. Yet, under oath, he swore impotence and sterility to avoid the obligations to his illegitimate daughter. And the list goes on and on.

Winston Churchill had periodic dark moods, Theodore Roosevelt had mood oscillations, and the often melancholy and otherworldly Abraham Lincoln and Alexander the Great were seized by demonic fits.

Creative individuals share a similar lopsided temperament with other individuals who are vulnerable to major mental disorders.

 Their temperamental components are an extreme variant that originates from evolutionary pressures. Although deficient in social algorithms, this releases enormous brain power that enables these unencumbered individuals to excel in creative activities. Individuals also endowed with high intelligence, curiosity, persistence of effort, tenacity, energy, and enthusiasm are able to reach heightened levels of creativity in art, science, and politics.

The readily observable phenomena discussed here provide promising leads for future studies in molecular genetics and evolutionary biology, which will bring us closer to understanding the origin of temperament and its variability. Most important, further studies may identify temperamental clusters that increase the risk of a major mental disorder.

I am grateful to my daughter, Nicole, for helping me edit and organize the content for this article.

Dr Pediaditakis practices psychiatry full-time, consults, and writes articles and poetry. He raises Black Angus cattle as a hobby. He reports no conflicts of interest concerning the subject matter of this article.

 Andreasen NC. Creativity and mental illness: prevalence rates in writers and their first-degree relatives. 

Touched With Fire: Manic-Depressive Illness and the Artistic Temperament

. Whitefish, MT: Kessinger’s Publishing Rare Reprints; 2010.

 New York: Liveright Publishing Corporation; 2012.

 Nowak MA, Tarnita CE, Wilson EO. The evolution of eusociality. 

New Introductory Lectures on Psycho-Analysis

. New York: WW Norton & Company, Inc; 1965.

 Pediaditakis N. Shared characteristics in the clinical expression and pharmacological responses of mental disorders and their possible collective significance. 

 Cross-Disorder Group of the Psychiatric Genomic Consortium. Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis [published correction appears in 

Darwin: The Life of a Tormented Evolutionist

Genius and madness: does one phenomenon cause the other-or do both share a common underlying factor or mechanism? How are geniuses able to accomplish “creative fits”? The author explores both questions.

The Association Between Major Mental Disorders and Geniuses

In the face of it, a 22-month-old toddler and a 62-year-old man are separated by vast canyons, chasms, and abysses of experiences, knowledge, accumulated cobwebs, barnacles, creaking bones, and settled ways on one side and thousands of empty unwritten pages yet to be filled on the other.

That’s what I assumed when Igor, my 2-year-old grandson, and I-just the two of us-went for the weekend to my beach cottage for the first time.

My assumptions were incorrect. In the first place, this luminous, intense, jumping-jack, bounding magic-ball boy was not the helpless one. I was! His smile, protuberant forehead, sparkling eyes, strategic utterances, and occasional spontaneous, unsolicited hugs, given with enthusiasm and alacrity, mobilized me fully.

I was now held captive. My affection and parental altruism were readily available. I wanted to do things for him, to assist, to protect, to inform, to feed, to guide, to please, and to serve him. Any ideas to escape, disengage, or avoid him became unthinkable. He proceeded to dictate the terms of endearment and my joyful servitude for the entire weekend.

And what a weekend it was! He first touchingly coped with the absence of his mother and the result-ing uneasiness. He would from time to time pause and say, “Mommy gone to church,” a bit of sadness and longing in his sweet voice. Then, when I reassuringly hugged him, he pulled away and once more launched into exploration around the cottage of the lovely barrier island near Southport, NC.

In rapid succession, he inspected a dead bee, a scurrying lizard, a big black ant, and a green caterpillar. Then, pointing to something, he cried, “What’s that?” “A slug,” I answered. “A slug!” he shouted with enthusiasm akin to a gold prospector’s announcing yet a new discovery, as he was squatting and fearlessly handling the curling, slippery animal. He became intensely curious. “Hurts!” he added thoughtfully, watching its writhing movements. I was pulled into the excitement. “It’s a gastropod,” I said, remembering its funny name (Greek for an animal using its own belly as legs). Stretching its antennae, it would spread and curl as it moved away from our scrutiny. My creaking bones no longer creaking, my eyes were fully open, and my energy and enthusiasm readily matched Igor’s. The gladness and mirth were now shared. “Oh, oh!” he cried. He grabbed a small stick and ushered a blue crab from its trap into the shallow water.

Later that day at the ocean, Igor shouted, “Look! Mommy pelicans!” apparently impressed by their size. He wildly gesticulated up at the passing V-shaped formation of the somewhat prehistoric-looking birds skimming the shimmering sea.

He suddenly turned to me and ran. “I want thalassa! Thalassa!” (Greek for sea), mixing words up in his bilingual effort-he really wanted to go swimming. He tightly clung to my swimsuit with one hand and splashed himself with the other shouting happily, proclaiming his joy to the heavens while mastering his new skill.

On our way for a seafood dinner, he now had a pensive look, silently listening to my happy chatter. “Stop it!” he suddenly cried. He clearly showed annoyance for being distracted from his private moment. I recoiled, a little embarrassed for failing to heed his need for wanting to be alone with himself for a while. But during the late afternoon, as an enormous, reddish sun lingered in the western sky before its final dip, Igor and I sat side by side on the shore’s moist sand. We tunneled our hands underneath the sand until they met. “Pappou!” he exclaimed with affection. “Igor. My little grandson!” I replied with a tenderness of my own, our bonding now complete.

At bedtime, when the adventures of the day were behind us, Igor, on his own volition, laid next to me on the unfamiliar, oversized bed. “Mommy gone to church,” he whimpered again. He promptly grabbed my hand, placing it once more on his leg. Shortly thereafter, he was soundly asleep. It had been a long day.

Wide awake, I was now free to contemplate and sort out things my grandson had taught me throughout the weekend. First, it was the matter of his temperament, that somewhat ambiguous gathering of inborn traits that “determine the how of behavior,” as defined by Thomas and Chess, the well-known child researchers in this woefully neglected field.

As I was observing Igor in wonder, I realized, as I have many times before in my professional life, that this child, like all children, is “temperamentally prearranged”-and to a greater extent than we ever allow ourselves to acknowledge. In other words, he has inborn propensities and traits that will guide him in some way to eventually be the person he wants to be. Within the parameters, opportunities, and overall circumstances of his life, he will, in his own innate way, somehow handle-even choose-the events, experiences, adversities, and hardships that will eventually shape his own personality, just like Abraham Lincoln, Benjamin Franklin, Amadeus Mozart, and the kid next door have done. Thus, by accepting the existence of a constant mutual interplay between inborn traits and outside events and circumstances in shaping one’s personality, the either-or argument of the so-called nature-versus-nurture becomes really an inane statement.

There will be developmental milestones, phases, if you please, but ones that this beloved boy will face and handle (and already had begun to handle during that memorable weekend) in his own way, Igor’s way, just as my son did before Igor, and his father-me-before him.

That is how it is and always has been, and every mother knows it and every mother’s mother before her. We psychiatrists know about it, but we often ignore it, perhaps because we are too busy collecting data and applying it “Procrustes” fashion to fit the lopsided and therefore erroneous premise that every child’s, eventually every adult’s, emotional and personality makeup, as well as emotional disturbances, can be traced exclusively to environmental influences and circumstances, especially to a mother’s supposedly faulty ways and attitudes toward her child.

Igor was busy throughout the weekend. His temperament, clearly discernible even at this early age, was a distinct one (just one of many in existence but not yet clearly delineated). His intensity in interacting with things, events, and people; his insatiable desire to explore everything around him; his enthusiasm; his eagerness to handle novelty; his ability to take impressions under advisement as it were; his unfearing ways to venture far afield, gregarious but, at the same time, having a touch of aloofness, a kind of “being-his-own-person,” all pointed to a particular temperamental type, which can be described as a “pathfinder,” a discoverer.

At the other end of the temperament spectrum, there are warm, comfortably social, accommodating, “obedient,” acquiescent children who behave as though they may be waiting for instructions, accepting reality as given, eager to fit in and contribute to the stability and status quo of a social group. They might be called the “sentinels,” the keepers of the hearth. Both of these distinct types, probably with many subtypes between, are worthy contributors to the welfare of the tribe, society, or group. The pathfinders contribute innovation and novelty, while the sentinels contribute stability, continuity, order, and tradition.

The phenomena of existing different temperament genotypes poses daunting challenges for educators and pedagogues alike, such as the appropriate environment and education milieu for each genotype. Thomas and Chess called such an environment a “goodness to fit,” deliberately created to benefit each child’s temperament type. Hopefully, such sophistication will, with further study, eventually be incorporated into our education system.

And then, yet another discovery! When, as with other children, my grandson would burst into laughter, perhaps proclaiming his joy for sharing with me “the gladness of the scene,” it dawned on me that this was part of this repertoire for conveying emotional messages and giving his roll call, so to speak, of his presence to the world, the so-called nonverbal emotional language as it exists in all children at this early age, fully developed and in place. Igor knows how to convey gladness, surprise, dislike, affection, dysphoria, anger, curiosity, irritation, fear, amusement, astonishment and, yes, humor!-as he several times was hiding behind a post imparting anxiety to me as to his whereabouts, only to reveal himself, laughing. Furthermore, his ability to “read” and comprehend the very same range of feeling from me and others was also fully developed-he was quick to gauge and respond according to my tension, warmth, mirth, or pensiveness.

As my face portrayed this comprehension, the man-inside-the-child-yet-to-unfold was all along peering at me through Igor’s little laughing eyes. It was as if he was saying, “You got it just right, Pappou, just right!” It has been a long weekend and, as a poet has said, “full of adventures, full of wonders” for both of us. “We will be back together soon, Igor,” I said the following morning while he hugged me spontaneously after finishing his frozen yogurt from the local fast-food fare.

“The child is the father of man, indeed,” I murmured as we started our return trip home.

This article was originally published in the August 1992 print issue of Psychiatric Times. The sequel, 

appears in the June 2014 print issue of Psychiatric Times.

First published in August 1992 in Psychiatric Times, this psychiatrist joyfully recounts a memorable outing with his grandson. 

Igor, My Two-Year-Old Grandson, Takes Me for a Weekend at the Beach

Twenty-two years ago, I recounted the events and experience of my trip to the beach with my grandson Igor in 

 How quickly the time has gone-the years have flown. Igor is now a young man-an aspiring scientist in biochemistry who is elegant, lithe, full of alacrity, social finesse, and acumen. But more about that later.

On the other hand, I am older and a little bent since the inevitable, natural allotment of rocks fallen from heaven over the years have taken their toll. Yet, we both are happy, wiser, and still excited about life and ready to go on. To paraphrase Fernando De Soto, the Spanish explorer who roamed the southern US, our journey has been “long and strange.” Our trip was “full of adventures, full of wonders” indeed! Such as the adventure and discovery in Constantine Cavafy’s famous poem, “Ithaka.”

Circumstances and luck kept Igor and me together all these years-almost inseparable. And as it turned out, having similar temperaments, we both loved to travel and learn. And travel we did! We shook hands with elephants in the Zuka reserve in the Zululand jungle of South Africa as the guests of a couple of enlightened and prosperous entrepreneurs. We stared at Thomson’s gazelles, elands, and wildebeests and made faces at wily baboons while keeping our distance from black rhinos, themselves full of massive solemnity. And we marveled!

We listened in wonder to the love songs of whales in the Prince William Sound in Alaska and stared with merriment at the sea otters as they hammered oysters on their bellies while lying on their backs on the calm sea. The landscape around us-enormous, imposing-filling the sky: God’s land!

We traveled the upper Amazon and caught small Caymans and ate cooked piranhas! We danced in the night with fellow humans, who, stark naked, were just exiting their Stone Age. And we said “hello” to massive, chatty macaws while trying to absorb the immensity of the forbidding rain forest that we felt covered the entire earth!

More than once, we stared at the implacable sun and endless statues frozen in time-a timeless diary of dynasties-in upper Egypt. We roamed the mountains of Costa Rica listening to the hollow-ring monkeys, laughing out loud, full of mirth.

While in Greece, we climbed and slept on top of Mount Ochi in Euboea next to a 3000-year-old, megalithic temple-the very place where Zeus spent his nuptial night with his wife Hera, long before their domestic troubles. We stared at the myriad stars like quivering opals in the cloudless night and witnessed Homer’s “rosy fingered dawn,” the sea glimmering far below. We loudly proclaimed, “Good morning God!” while staring out at the landscape of my ancient people, grateful for the moment.

The years were passing and Igor was learning from my mentoring as well as our travels-visiting and witnessing places and people, all teaming with life around us. As he matured emotionally and physically, Igor developed a profound respect for the delicacy and interconnection of life and this fragile planet of ours. Our bond grew and became stronger, yet we had another journey that was even more wondrous. This particular voyage involved our inner selves-what we learned about ourselves and each other in the passing years.

The first surprise: Igor had not changed! As I had reported in 1992, from day 1 Igor was an inquisitive, inner-directed, restless, intense, autonomous, pensive, contemplative, and a little-aloof boy. These temperamental traits were more prominent in him than in other children, and they did not change. Igor still has all these traits! They remained unaltered through the years. Of course, he is now dressed up, as it were, in the cultural cloth of learned attitudes and ethos (the result of my mentoring as well as learning from the give-and-take with his cousins, friends, and roommates, as well as the zeitgeist of the time). This learning was finely tuned by his particular temperamental traits.

Igor is an informed, civil, tactful young man with tenacity of purpose and ambitions. His sense of personhood and inner certainty along with a capacity for intimacy are still a work in progress and are the result of the quality of our relationship, a process made easier by the lucky happenstance of our similar temperaments.

During our travels, our relationship could be contentious and tense with endless arguments because we occupied the same emotional space. Our mutual affection and similarities were perhaps somewhat suffocating as he struggled to establish his selfhood and identity and maintain his autonomy.

His humanness is now in the process of being completed. Nevertheless, neither his nor my temperament has changed. Throughout my 85 years, I have not changed from day 1! Okay, I am mellower and wiser in tolerating ambiguity, but I am still inner-directed and comfortable in my aloneness. I remain the contemplative, inquisitive, autonomous person that I was back in my youth in the mountains of Crete, chasing and studying butterflies (variegated Lepidoptera as I learned years later).

Because of my great age, I am perceived as wise-friends, colleagues, and patients often ask me about raising children: What does it take? What did I learn about this matter after all these years? What did I try to do with Igor?

My response is simple: human beings are tough and are made to endure. We came from generations who survived thousands of years under very difficult circumstances. Our ancestors hunted animals in the Savannah and stared over mile-high ice sheets as they moved north, killing mammoths in the bleak landscape.

We are now their children’s children. We are tough, enduring, ingenious. We thrive in adversity and in being challenged. We are also social-we connect to fellow human beings. We are competitive, but we learn early to obey the rules. Fortunately, children are born with all these traits, but as parents we need to strengthen these traits in our children. We can do that with our own attitudes and behaviors while our children are growing up.

Being humans, we naturally behave like little emperors from day 1-all children do. The sooner we address these attitudes that are naturally present in children and help them get rid of them, the better. The children will be better able to survive, face difficulties, contribute, get along with others, and be reasonably happy.

Hovering and treating children like fine china with endless worry about “not hurting their feelings,” as the current cultural attitude dictates, is, in fact, counterproductive and outright harmful. Children end up feeling entitled: noncontributing and unproductive. They have been unable to develop enduring persistence of effort. Instead, they feel perpetually frustrated and ready to get into mischief. To avoid this, here are my 4 rules:

1. Structure: set limits and constraints and stick to them

2. Consistency and sameness: avoid changing attitude

3. Fairness: treat each child and his or her siblings fairly; avoid “playing favorites”

4. Expectation: expect the child to perform and feel challenged

Of course, a little affection always helps, and fortunately is almost always there (it is in our genes).

Remember, children are neither puppies nor breakable china. I have witnessed Igor face and handle catastrophes and the deaths of family members with fortitude and inner wisdom. Children are tough and ready to learn-train them well. They are given to us in trust, and we can help them to be prepared for a successful life. The sooner children understand that life is not made for our convenience, the better.

Those are the rules; use them. They work. They are the very ones used by the pedagogues (ie, guides, teachers, mentors of children) in fifth century bc in Athens. The pedagogues knew how to produce scientists, poets, artists, philosophers, soldiers, and responsible citizens who invented democracy.

Igor now is on his way. Our wonderful journeys of learning and pondering together are almost over. We are both grateful for all of it. I can now only wish him well for the rest of his adventures and for his future voyages, perhaps with his own children and grandchildren.

[Editor's note: 22 Years ago, Psychiatric Times published "Igor, My Two-Year-Old Grandson, Takes Me for a Weekend at the Beach." 

 Pediaditakis N. Igor, my two-year-old grandson, takes me for a weekend at the beach. 

 Cavafy CP. Ithaka. http://www.cavafy.com/poems/content.asp?cat=1&id=74. Accessed March 17, 2014.

22 Years after he wrote of a memorable beach outing with Igor, his toddler grandson, this psychiatrist looks back on their joint adventure through a life "full of adventures, full of wonders!" 

Nicholas Pediaditakis, MD

Articles

The Dog That Did Not Bark

The Association Between Major Mental Disorders and Geniuses

Igor, My Two-Year-Old Grandson, Takes Me for a Weekend at the Beach

Igor Is Now Grown Up