Major Nidal Hasan, the army psychiatrist who allegedly murdered 13 people and wounded 29 more at Fort Hood, apparently had been trying to contact al Qaeda and had attended the same mosque as the radical imam Anwar al Aulaqi. He reportedly was torn between being a Muslim and serving his country in a war against Muslims. He seems to have written on the Internet that he felt suicide bombers could be heroes, sacrificing their lives for the greater good.

All of this may mean Dr. Hasan was a terrorist, but it also might mean he was insane. I have never met Hasan, but I know as a forensic psychiatrist that a surprisingly large number of delusions—fixed and false, sometimes very bizarre beliefs—that psychiatric patients sometimes exhibit are religious in nature. Hyperreligiousity can be one of the symptoms of bipolar disorder or schizophrenia or schizoaffective disorder (among other conditions). This is why the cliché of a delusional person, as depicted by Hollywood, is frequently someone who believes he or she is God or the devil or a prophet.

Mental illness can hijack our core and strongly held beliefs and behaviors and turn them into grotesque symptoms. This isn’t just the case for our spiritual beliefs, but also for our sexual behaviors, which can also be sent into hyperspace by conditions like those I have named. People vulnerable to mental illness can end up selling sex, buying sex, gambling away their homes and, yes, committing horrible acts of violence in a pathological perversion of the religious belief system that had previously sustained their humanity and sense of connectedness to their fellow man.

Again, I don’t know whether Major Nidal Hasan was simply a terrorist or a mentally ill person, but my point is that much more needs to be uncovered before anyone knows.

After all, it doesn’t make much sense that a terrorist would give as many hints as Hasan to fellow soldiers about his seeming antipathy for America. He may have been “disinhibited,” one of the signs of a mood disorder.

Some radical Islamic terrorists frequent strip clubs, I suppose, but the fact that Hasan reportedly did—staying for several hours at a time— may be further evidence of that sort of disinhibition.

Ultimately, the question of when extreme religious beliefs (especially those connected with murderous intent) constitute mental illness may be one that needs to be answered in this case.

What we need are facts. Did Major Hasan show signs of a mental disorder before the Fort Hood massacre? Does his family have a history of mental illness that would suggest he is more vulnerable to it? When he needed additional supervision while training as a psychiatrist, was that because he was asserting his political/ religious views to patients or because he was unable to refrain from doing so, because he was sick then, too? Was he on psychiatric medicines then or at Fort Hood? Did he prescribe them to himself? If he did take medicines, were they the right ones or the wrong ones? Some can cause severe behavioral abnormalities.

Clearly, it seems to be the case that more should have been done to look seriously at Dr. Hasan’s behavior and his thoughts before he picked up a gun and started shooting. But whether the lens should have been one focused on him as a terrorist-in-army-clothing or one focused on him as a man slipping out of rational thought, into psychosis, remains to be seen.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

Dawn Drexel, the mother of missing teen Brittanee Drexel, told WHEC News 10 in Rochester, N.Y. that she believes her daughter may have been kidnapped or may not be alive.

Brittanee, 17, has been missing since April 25 when she went to Myrtle Beach, S.C., for spring break.

Brittanee’s mother is no longer a stranger to the darkest possible chapter in a parent’s life story: the feared or actual loss of a child.

I have worked with several parents who have survived their own children. I have struggled with them against tides of grief that seem never to recede, but simply to become more expected, so they lose the power to sweep these bereaved mothers and fathers off their feet.

Losing a child lays bare the miraculous connections that can hold families together through thick and thin. No matter how contentious the relationships mothers and fathers may have with their children, the bond between them can’t be reproduced or entirely obliterated. At the ages of 50 and 60 (and older), my patients still want to make sense of the way they related to their parents in childhood, young adulthood and beyond. They are still sons and daughters, even if they have lost their parents.

So Dawn Drexel, brave enough to speak to the media at an unspeakable moment, may wander tonight into Brittanee’s room. Maybe she’ll lie down on her daughter’s bed, maybe she’ll let herself smell her daughter’s pillow. She may think she hears Brittanee’s footsteps or voice or her car pulling into the driveway. That’s no surprise when we consider the sounds of togetherness that come to play like music in the backgrounds of our daily lives, sounds that we stop hearing after a while, maybe because we take them for granted, maybe because no parent’s heart could maintain its rhythm while bearing full witness to the unspeakable, unfathomable beauty of one’s own child. We don’t hear a tenth of what we could, if we thought the music might end.

For those of you reading these words  — the lucky parents out there with children still close enough to hug, I hope you’ll give it a try tonight. Sit for a few minutes and listen to the sounds of your children in the house: their footsteps, their fingers clicking keys on a computer, the opening and closing of their closet doors, their voices on the phone and their breathing as they sleep. Let yourself marvel at the fact that your life has spawned another life and that you have the continuing, rare and wonderful opportunity to shape not only your existence, but that of another human being. Let yourself smile at the thought of their favorite toys (if they’re still young enough), their favorite clothes, the posters on their walls, their best friends, the sports they’ve come to enjoy, the hopes and dreams they’ve embraced.

Stay silent a minute longer. Then close your eyes, think about Dawn Drexel and her missing daughter Brittanee and pray for them both.

I’m going to do that right now. My children are asleep, a few dozen feet away from me. I am a lucky man and I know it.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com.

Sometimes, making a mistake teaches an invaluable lesson.  And so it is with the loophole in Nebraska’s “safe haven” law, a statute that allows parents to drop off children at hospital emergency rooms if they are unable to care for them.  The trouble is, Nebraska lawmakers neglected to define “child.”  So far, 34 children, some of them as old as 17, have been dropped off, including two teenagers just last Thursday. 

A special legislative session is underway in Nebraska to fix the law.  While different bills have been offered, the legislature will probably end up defining a “child” as one year of age or under.

Fixing the safe haven law, however, won’t fix the problem that the mistake in Nebraska has uncovered.  Many parents there—and across the nation—feel utterly unable to parent effectively and are looking for a way out.

It would be easy to demonize parents who bring a 5 or 13 or 17-year-old son or daughter to the hospital and say goodbye, but I don’t presume that all or most of these parents are unfeeling monsters looking to shirk responsibility and lay it at the doorstep of government.  And even for the percentage of parents who are that disordered in their characters, I wouldn’t want their children to remain in their custody, anyhow.

The real problem isn’t the Nebraska loophole, it’s the lack of available guidance and services for parents who are dealing with children and adolescents more prone than ever to use alcohol and illicit drugs, fall victim to psychiatric disorders like Attention Deficit Disorder and Bipolar Disorder and even succumb to joining gangs (which are now invading the suburbs, not just confined to urban centers).   The story of a Florida man driving all the way to Nebraska to drop off his 11-year-old boy is a story of desperation, not depravity.

I’ve always believed that we end up paying exponentially, in the long run, for underestimating how many American families are in crisis, without parents who can properly direct, discipline and nurture their kids.  Now, we have a little window, thanks to Nebraska, on the intensity of the trouble in some families, though still no insight into the real number of such families.

What is called for is a system of graduated aid to families in psychological distress.  This has to begin with case finding—perhaps through the schools—and continue through a spectrum of services, including parenting courses, child counseling and medication clinics, respite services and, yes, beefed up options for good foster care and adoption.

Here’s something to think about:  I recently referred a Massachusetts girl to a local child psychiatrist for help with symptoms that were overwhelming her parents and her school system.  Until she used my name to move up on the waiting list, she was given an appointment four months down the road.  And that’s Massachusetts, comparatively rich in medical resources.  According to Time magazine, Nebraska has a grand total of six child psychiatrists in the entire state.

So many in Congress are all about bailing out the auto industry and the banking industry and the mortgage industry and maybe a few cities along the way, moves that will ultimately weaken the marrow of our economy, upon which rests the hope for renewed ideas and approaches to real economic growth.  Some of their energy would be better spent bailing out emotionally overwhelmed American families, upon whose children’s shoulders rests the future.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com or e-mail him at info@keithablow.com.

  Take positive action.  Change does not come without action.

Step Seven should leave you with desires and plans: I want a new job.  I want a better relationship.  I want genuine love in my life. I want to start a foundation to improve the environment.  I want to become physically fit.  I want to stop abusing alcohol.          

Do not let the magnitude of your challenge keep you from moving forward to meet the challenge. Start slowly. Trying to do everything at once and failing fast is a classic way to wrongly convince yourself it was foolish to try. Take small steps forward.  But be sure to take them.

 Imagine you were asked to write a 300-page book on a subject you know little about. It sounds like an impossible task. But what about writing the first sentence? You could do that. A paragraph, without worrying whether it’s perfect.  Paragraphs turn into pages.  A chapter takes form.  The 300-page book that once seemed impossible to write starts to take shape.

      Dreams become reality by increments. Beginning is the key. Here is a list of reasonable, do-able actions you might take in initial pursuit of a larger goal.

·        If you’re making a career change, plan to meet with one person who works in that field.

·        If you want to lose weight, decide you’re going to walk up the three flights to your office instead of taking the elevator. If you work on the 30^th floor,  take the elevator to 27.  Or, schedule one appointment with a trainer at the gym.

·        If you want to revitalize your marriage, tell yourself you won’t leave the house tomorrow morning without paying one sincere compliment to your spouse.

·        If you’re going to invest in your vision of yourself as an artist, buy a set of paints and a canvas.

·        If you’re intent on ending your addiction to tobacco, immediately throw away three cigarettes from the package you bought today.

·        If you want to go back to school, buy the book you need to study for the entrance exam, or call up a nearby college to make an appointment with an admissions counselor.

      These may seem like small actions.  That’s good. Long-term goals are just a series of successful moments, of showing up and doing the right thing for yourself, again and again.

As you let yourself look at your life history, the past will yield its insights, and these will give way to true revelations.  You will be unearthing your buried treasure.  Myths that no longer serve you will be exploded, and dreams that can empower you will be revealed.

The future you want for yourself won’t happen overnight, but you will see progress, and people who have the information and experience to assist you in realizing your dreams will respond to your passion and authenticity.   They will want to be a part of your success—your truth.  Where you used to find walls, you will see open doors. Relationships that were once a source of conflict will be replaced by others that yield encouragement and support.

The truth has its own momentum.  As you finally do what your heart and mind know to be the right things for you, forces will align to make your dreams reality. Your job now is to let those forces draw you forward, step by step.

 Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com.

Once you’ve committed to focusing on a specific area of your life that you want to change, the key to moving forward will be taking this leap of faith: Accepting the idea that your problem hasn’t come out of the blue. It has roots from the past.

If you have been trying to muscle through your problems for some time, always making the resolution to just stop yelling at your kids, to just stop eating so much, or to just stop selling yourself short in relationships or in pursuing your dreams, you are probably ready accept that simply being tired of your tired of your behavior and wanting to change it does not necessarily lead to change. 

You have suspected there’s another way, and Step Two is about allowing the key to your future could lie in coming to grips with parts of your past that you have left unexplored.

 Imagine if someone were to ask you to start reading a novel beginning on page 125, to continue reading through page 225, and to then write an ending in which the lead character meets with tremendous success.  Chances are you’d feel anxious and unprepared. After all, you’d be coming to the story midstream, without knowing the character’s motivations, strengths and weaknesses.  “This isn’t my story,” your heart would tell you.  “How am I supposed to make it come out right?”

In order to write something credible and convincing, you’d want to know what happened to the main character in the first 124 pages. You’d want to know how he or she had responded to personal challenges, what life lessons he or she had taken away from their family of origin, whether they had suffered any significant losses, what their parents’ marriage was like, so forth.  You’d want to know all about the character’s back story (his or her earlier life history).

Without this information, you could not confidently move forward, the next chapters you wrote would make the story and the character seem false.

Likewise, when we try to move forward with our lives without a true understanding of its earlier chapters, we ask of ourselves something no less fraught with difficulty.

There’s a reason we turn blind eyes to our own life histories, our own back stories:  We are needlessly afraid that looking at the past, especially the parts of it that are unsettling, will somehow weaken us or take away our momentum in life.  

Step Two asks you to stop running, and to believe that there are great rewards in store for you if you do. The truth about your life history—including the strengths and the weaknesses in your family relationships, the successes and the failures you have encountered, the gifts you received and the losses you sustained—are not your enemies. They are buried treasures. They are meant to be uncovered, looked at honestly and learned from, because they hold the keys to who we are and ways we can change. They tell us what holds us back from being our best selves, having good relationships, and achieving our goals.

 Imagine a woman who is always picking the wrong men: Men who drink, men who don’t treat her well, men who force her again and again into a caretaking role, but don’t take care of her.

What she needs, is insight into why she is making choices that cause her so much suffering, so she can change her behavior patterns and find true love.

The insight such a woman needs is as close as her own past experiences in life, very possibly in her family of origin. Maybe the insight can be gleaned from examining how her father treated her or how he treated her mother. As she opens chapters of her life story that have remained closed for too long, she will begin to see why she pursues emotionally unavailable men and why she feels unworthy of real love.  She will understand that she hasn’t been the victim of bad luck in love, but locked in a pattern established long ago.

 Knowledge is power. Armed with the truth about her life story, this woman can put the past where it belongs—behind her.  She will no longer be forced into repeating the same mistakes.  She can begin to understand her behavior and choose a more equal relationship with the potential for real intimacy.

 Our problems aren’t accidents. Unsuitable partners don’t merely show up on our doorsteps; we choose them because of ill-formed ideas about what we deserve. We find ourselves in unsatisfying careers because something early on told us that we couldn’t enjoy work, or make money, or take leadership roles. Our frustration with our children doesn’t mean we simply are bad parents; it may well mean that our own upbringing contained messages that parenting was a battle of wills instead of an act of love. 

 These painful pages of our current and future life stories will continue to be written so long as we choose to ignore their origins in the earlier chapters of our lives. That’s why the greatest promise for personal growth is looking in the mirror, in order to see behind you.

So forget about just doing it better, or hoping that your luck improves, or, even worse, resigning yourself to the idea that “this is just the way things are.”  Whatever your problem is, it likely has roots in your past, in avoiding a healing and empowering reckoning with your earlier life experiences. Taking Step Two means turning in the direction of what you haven’t been willing to look at, and keeping your eyes wide open.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com.

Cynthia Rodriguez has had enough, she says, of her famous husband’s affairs.  She alleges A-Rod had a string of sexual relationships during their five-and-a-half years of marriage.  But the last straw for Cynthia was Alex’s relationship with Madonna, one that his lawyer defines as an affair of the heart—an emotional affair.  Cynthia’s own lawyer has never alleged the connection was sexual.

We know plenty about the sexual monotony that can set in a marriage as years go by.  Husbands and wives become so familiar with one another, so present in one another’s day-to-day lives, that it frequently becomes difficult to feel romantic with one another.  I’ve joked before (really only half-joked) that couples should avoid flossing their teeth together if they want to feel passionate in bed together. 

With films such as “Juno” scoring well among critics and moviegoers last year and the media’s great attention to the birth Thursday of 17-year-old Jamie Lynn Spears’ daughter, many say teen pregnancy is being glamorized in the media.Keith Ablow, a psychiatrist and FOX News contributor, said factors such as these may have played into a reported pregnancy pact made by girls at Gloucester High School in Gloucester, Mass., where the pregnancy rate has quadrupled in the past year.

School officials were baffled at first, but they soon discovered nearly half of the 17 expectant moms had made a pact to get pregnant and raise their babies, school principal Joseph Sullivan told Time.com.

A new report published in the online edition of Occupational and Environmental Medicine puts more data behind what we psychiatrists and psychologists have long known from listening to our patients:  Attention Deficit Hyperactivity Disorder (ADHD) is costing American businesses untold millions in lost productivity.

Studies reveal about 4.5 percent of working Americans suffer with ADHD.  One of the new findings is that each loses, on average, more than 22 days of productivity annually.  That translates into billions of dollars in losses.

I think the toll could be much higher.  Undiagnosed and untreated ADHD not only saps productivity in and of itself; it fuels other substantial causes of suffering and lost possibilities, including substance abuse and dependence, workplace accidents and inability to master new skills and reach increased levels of education and performance.

Many patients of mine only learn after visiting with me that their use and abuse of alcohol and illicit drugs (including cocaine) has been partly driven by searching for relief from the constant psychological discomfort of underlying ADHD.  Treating the ADHD makes it possible for them to become sober.

As an expert witness in cases involving the workplace, I know that ADHD is the music playing in the background of life-altering (and economically devastating) injuries.

Other patients I have treated tell me that they gave up hope for advanced training or for advanced degrees because they cannot focus long enough to master new skills or new knowledge. 

The modern workplace may itself be accelerating the costs.  Voicemail, e-mail, text messaging, video conferencing and telecommuting translate to a free flow of ideas, rapid transfer of information, and flexible lifestyles.  But they also call for quick changes of focus and self-direction.  For those with ADHD, the information super- highway can look a lot more like a maze. 

American employers would be well-served to offer education about ADHD, and confidential screening and treatment for it.  Even more could be saved — in human and economic terms — if that screening took place earlier rather than later, as part of our public education system. 
It any expanded screening and treatment program, it will be critical that ADHD is not oversimplified.  While stimulant medications can be tremendously helpful, patients of mine with ADHD have had complicated life stories, often marked by emotional turmoil early in life.

An essential part of helping my patients feel better includes listening to their stories and convincing them to stop running away from their feelings (by not focusing on them – or anything else).

The best reason for the education system and/or the workplace to undertake new initiatives to diagnose and treat ADHD is that the condition is indeed, treatable. 

Once patients identify ADHD as a major factor in their lives and get help for it, the changes I’ve seen in their lives are astounding and inspiring.