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Michael Jackson was 47 years old when he sought mandatory counselling due to charges of child molestation, even though he was acquitted of these charges. It was the second time in eleven years that such charges were being brought against him publicly.

Michael was born on August 29, 1958, in Indiana. His parents were an African American working-class couple. His father, Joseph Jackson, had been a guitarist but had put aside his musical aspirations to provide for his family as a crane operator. Believing his sons had talent, he molded them into a musical group in the early 1960s. Michael joined the group when he was five, and emerged as their lead vocalist. The group later became known as the Jackson 5, consisting of the 5 Jackson brothers.

Behind the scenes, Joseph Jackson pushed his sons to succeed. He was also reportedly known to become violent with them. Michael and his brothers spent endless hours rehearsing and polishing up their act. At the age of ten, the family relocated to Los Angeles, and Michael and his brothers started work on their music and dancing with their father as their manager. At the age of 13, Michael launched a solo career in addition to his work with the Jackson 5.

For his songwriting talents, Michael received numerous awards. At the top of his game creatively and commercially, Jackson signed an endorsement deal with Pepsi-Cola. He, however, was badly injured while filming a commercial for the soda giant in 1984, suffering burns to his face and scalp. Jackson had surgery to repair his injuries, and is believed to have begun experimenting with plastic surgery around this time. His face, especially his nose, would become dramatically altered in the coming years.

Raised as a Jehovah’s Witness, Jackson was a shy and quiet person off-stage. He was never truly comfortable with the media attention he received and rarely gave interviews. By the late 1980s, Jackson had created his own fantasy retreat-a California ranch called Neverland. There he kept exotic pets, and had his own amusement rides. To some, it seemed that Jackson perhaps was exploring a second childhood. He sometimes opened up the ranch for children’s events. Rumors swirled around him, including that he was lightening the color of his skin to appear whiter and slept in a special chamber to increase his life span. In one rare interview with Oprah Winfrey, Michael explained that the change in his skin tone was the result of a disease known as vitiligo. Jackson also opened about to her about the abuse he suffered from his father.

Allegations of child molestation against Jackson emerged. A 13-year-old boy claimed that the music star had fondled him. The following year, Jackson settled the case out of court with the boy’s family. Other allegations emerged, but Jackson maintained his innocence.

In August 1994, Jackson announced that he had married. That union proved to be short-lived. They divorced in 1996. Some thought that the marriage was a publicity ploy to restore Jackson’s image after the molestation allegations. Later that same year, Jackson wed again. The couple had two children through artificial insemination. Jackson and his second wife divorced in 1999 with Jackson receiving full custody of their two children. He would go on to have a third child, with an unknown surrogate.

Jackson’s musical career began to decline with 1995’s album. Jackson was better known as an eccentric whose quirks were reported in the tabloids than as a performer. Stories of his odd behavior started to overshadow his talent. He often appeared in public wearing a surgical mask, and he hid his children’s faces under veils. He received enormous criticism for dangling his son, Prince Michael II, over a balcony in Berlin, Germany. Jackson explained that “We were waiting for thousands of fans down below, and they were chanting they wanted to see my child, so I was kind enough to let them see. I was doing something out of innocence.” But many were unforgiving of the star’s behavior, with former fans and media outlets clamoring to have Child Protective Services take Jackson’s children from him.

Jackson’s reputation was served another blow in 2003 with the television documentary, Living with Michael Jackson. A British journalist spent several months with Jackson, and he got Jackson to discuss his relationships with children. Jackson admitted that he continued to have children sleepover at his ranch, even after the 1993 allegations. Jackson said that sometimes he slept with the children in his bed. “Why can’t you share your bed? That’s the most loving thing to do, to share your bed with someone,” Jackson told the journalist.

Jackson faced more legal woes in 2004 when he was arrested on charges related to incidents with a 13-year-old boy the previous year. Facing 10 counts in all, he was charged with lewd conduct with a minor, attempted lewd conduct, administering alcohol to facilitate molestation, and conspiracy to commit child abduction, false imprisonment and extortion. On June 14, 2005, Jackson was acquitted of all charges. His reputation, however, was effectively destroyed, and his finances were in shambles. Due to mounting legal bills, the singer no longer had a bank account and was unable to maintain even his most basic finances. Jackson soon found refuge in his friendship with the prince of Bahrain, who wired Jackson the money needed to pay Neverland’s utility bills.

During the initial psychological interview, Michael revealed that he used ‘sleeping pills’ on a regular basis, as well as the pain killer Demerol.

Multiaxial Diagnosis

Based on all of the information received, I diagnosed Michael Jackson as follows:

Axis I: 302.2 Pedophilia, Sexually attracted to Males, Nonexclusive Type

300.7 Body Dysmorphic Disorder

307.42 Primary Insomnia

V61.20 Parent-Child Relational Problem

Axis II: V71.09 No Diagnosis

Axis III: Vitiligo

Axis IV: Legal issues (twice charged, once arrested, for fondling 13-year-old boys); financial difficulties

Axis V: GAF=63 (current)

Justification of Diagnosis

Michael Jackson’s case history does not provide much detail on any specific aspect of his life. More detailed information is needed to make more concrete and definite diagnoses. His history does not seem to present any specific details, at least not enough to diagnose him “beyond the shadow of a doubt”. Nonetheless, based on the information given, I think the diagnosis is justified. They might be modified as more information is presented.

Firstly, it strikes me that Michael is sharing his bed with children; who are neither his biologically, nor are related to him; and to him, it is all quite normal. According to him, it is “the most loving thing to do”. Furthermore, the two times that he was accused of fondling children, they were both boys, and both thirteen years of age. Even though the accusations were never proven true, the fact that at two different times (eleven years apart), the boys who accused him were not two different ages (e.g. eleven years apart), but rather, were at the same prepubescent age. That strikes me as unusual, and speaks into pedophilic behaviour. Still, because Michael was married twice, I think his sexual attraction may be nonexclusive, even though his children were not conceived through coitus (which may speak into another disorder), so his marriages may not be any real proof of attraction to females.

Michael’s presented history does not say for sure why he continued his cosmetic surgeries after the initial need for it due to the Pepsi advertisement gone wrong. However, he justified it by referring to his medical condition, vitiligo, in which the skin’s pigmentation is affected. This condition, though, does not seem to explain the changes in the shape of his nose, nor the fact that his face did not look like a man’s, when he came to see me. There was no sign of Michael ever having a beard. He seems preoccupied with changing the way his face looks, and even how his voice sounds. This led to the diagnosis of ‘Body Dysmorphic Disorder’, which leads right into the next issue.

Michael often takes (to the point of addiction) the medication (actually, anaesthesia), propofol to “help him sleep in the evenings”. He is apparently suffering from insomnia, which may be due to his hectic lifestyle, and/or anxiety.

Michael opened up in an interview that as a boy, he was abused by his father who would beat him and not allow him any playtime. His childhood routine was centered on making music and going to school. In other words, he was robbed of a normal childhood because of his talent in music. I believe that the poor relationship that he and his father shared in his younger years continues to negatively affect Michael’s behaviour patterns. It may be this loss of childhood that led Michael to construct a fantasy retreat for his home, and continually open his home to children, even to the point of sharing his bed with them. This led to my diagnosis of ‘Parent-Child Relational Problem’. The issues he had with his father seem to have led to significant impairment in Michael’s behaviour, even as an adult.

Theoretical Basis for Development of Disorders

Most of Michael’s disorders/issues as an adult seem to stem from his childhood, or lack thereof, and with the relational problems he had with his father. Rogers (cited in Passer & Smith, 2007) is a humanistic theorist and believed that all humans are born with the innate need for positive regard, i.e., for acceptance, sympathy and love from others. According to Rogers, positive regard is essential for healthy development. The ideal situation according to Rogers is that positive regard received from parents should be unconditional – independent of how the child behaves. This unconditional positive regard “communicates that the person is inherently worthy of love, regardless of accomplishments or behaviour.” (Passer & Smith, 2007) Contrasting with this, conditional positive regard is dependent on how the child behaves, and in the extreme situation, love and acceptance are given only when the child behaves as the parents want.

In general, people need positive regard from others as well as from themselves. To this end, a need for positive self-regard, which is the desire to feel good about ourselves, develops. Passer & Smith (2007) go on to explain that a lack of unconditional positive regard from parents and significant others teach individuals that they are not worthy of approval and love until they meet certain criteria. This situation leads to a development of conditions of worth that indicate the circumstances under which we disapprove or approve of ourselves.

Joseph Jackson’s treatment of Michael expressed conditional positive regard, so that Michael did not develop positive self-regard. If Michael’s father only showed love and acceptance when he accomplished something or when he did well, then Michael may have grown up believing that he only deserves acceptance after his accomplishments. While Joseph may have thought that this was a good way to get his son to excel (and it may have been for all intents and purposes) it destroyed his son’s self esteem in the process. This is one factor that may have led Michael into wanting to change the way he looks. He does not want to remain dark-skinned, and resembling his father because of what his father represents in his life – someone who accepts him only after he has met certain standards. The experiences that Michael had with his father may have been traumatic to the point that he did not want to be reminded of him anymore, hence, the changes in his facial features.

Freud (1900) posited a theory of personality development that was based on the effects of the sexual pleasure drive on the individual’s psyche. He claimed that at specific points in the developmental process, a single body part is especially sensitive to sexual, erotic stimulation. These erogenous zones are the mouth, the anus, and the genital region. The child’s libido (drive energy) centers on behavior affecting the primary erogenous zone of his age; he cannot focus on the primary erogenous zone of the next stage without resolving the developmental conflict of the immediate one. Too much or too little stimulation at any stage leads to fixation at that stage. According to Freud’s theory of psychosexual development, a child at a given stage of development has certain needs and demands, such as the need of the infant to nurse. Frustration occurs when these needs are not met. If a child progresses normally through the stages, resolving each conflict and moving on, then little libido remains invested in each stage of development. But if he fixates at a particular stage, the method of obtaining satisfaction which characterized the stage will dominate and affect his adult personality.

The five stages of psychosexual development are the oral stage, the anal stage, the phallic stage, the latency stage and the genital stage. The particular stage relating to this case is the phallic stage.The phallic stage extends from about three to five years of age, and the erogenous zone associated with it is the area of the genitals. Even though the gratification is focused on the genitals, this is not in the form of adult sexuality, since the children are physically immature. None-the-less, stimulation of genitals is welcomed as pleasurable and boys, like adult males, may have erections during their sleep. Children become increasingly aware of their bodies and are curious about the bodies of other children, and also of their parents. Freud observed that children of this age can very often be observed taking off their clothes and playing “doctor” with each other, or asking their mothers if she has a penis. These observations persuaded Freud that the gratification is focused on the genitals during this period.

The major conflict of this stage is called Oedipal complex. The name derived from a Greek mythological character, Oedipus, who unknowingly killed his father and slept with his mother. For the boy, the mother becomes more desired, while the father is the focus of jealousy and rivalry, since he is the one who sleeps with the mother, but still he is one of the main caregivers. The id wants to unite with the mother and kill the father (like Oedipus did), but the ego, knows that the father is stronger. The child also feels affectionate towards the father, one of the caregivers, and his feelings are ambivalent. The fear that the father will object to the boy’s feelings is expressed by the id as fear that the father will castrate him. The castration fear is not rational, however, and occurs in a subconscious irrational level.

The conflict between the id drives and the ego is resolved through two basic defense mechanisms of the ego. One of them is repression, which involves the blocking of memories, impulses and ideas from the conscious mind, but does not lead to resolution of the conflict. The second is identification, which involves incorporation of characteristics of the same-sex parent into the child’s own ego. The boy by adopting this mechanism seeks for the reduction of castration anxiety, since his similarity with the father is thought to protect the boy from him.

If this stage is not adequately resolved, the adult male can exhibit excessive ambition and vanity. A poor identification with the same sex parent may lead to recklessness or even immorality. Freud also held that the unsuccessful resolution of the Oedipus complex could result in neurosis, pedophilia, and homosexuality. Could this be what led Michael towards pedophilic behaviour?

Michael was also deprived of play time during his childhood years. This may be another factor that led to the various psychological and emotional issues that Michael faced as an adult. Some persons were concerned when he constructed Neverland, thinking that he may be trying to explore a lost childhood – the one he never had because his father was adamant that the Jackson 5 spend time singing, recording and developing their talent, rather than playing.

Contrary to what Joseph Jackson may have thought there are many benefits of play including relaxation, release of energy, tension reduction, self-expression, love of life, self-confidence, self-esteem, anxiety reduction, and conflict resolution. Research finds that play, and more than that, rough and tumble play is not only a physical release but “may facilitate friendships and promote cooperative pro-social behaviors and attitudes (Scott & Panksepp, 2003, p. 549). Vygotsky (1932) said that play helps children work out the rules for social interaction and allows children to be at their best. Research supports what Vygotsky wrote in 1932, “In play it is as though he were a head taller than himself…” (Vygotsky, 1930-1935/1978, p. 102) Play is important for building social competence and confidence in dealing with peers, a life skill that is essential for functioning in school (Howes & Matheson, 1992; Singer & Singer, 2005), as well as in life on a whole.

Play is also central to self-regulation or children’s ability to manage their own behavior and emotions. Self-regulation is most important to our conception of what it means to be human. It is the foundation for choice and decision making, for mastery of higher cognitive processes, and for morality. For example, when a child learns to inhibit her reach to the light socket when told “no” or to delay gratification (dessert is after dinner) or to calm herself when she is upset, she is manifesting the development of self-regulation. Play is the place where children practice these skills.

Children also use play as a way to work though their own emotions as demonstrated by one child experiencing trauma (a mother dying of cancer) and another case of a child learning self-control and more adaptive behavior. Play seems to serve as a buffer for children who often need to cope with change and digest baffling new experiences. This fact was illustrated in a study on movie viewing. Children exposed to a stressful movie scene were allowed to have a free play period either before or after viewing the film. Both of the groups allowed to play declined on measures of stress and anxiety compared to a group that was not allowed to play (Barnett & Storm, 1981). Michael relocated to Los Angeles at the tender age of ten, and even then was not living with only his family, but rather, with another recording artist. This was a life-changing event for young Michael, and without the loving support of his family and the benefit of play, he could have found his life situation more difficult. Play is a known stress reducer. Had Michael been privileged to have this activity as a regular part of his life, coping with his hectic schedule, as well as with the difficulty of relocation would have been easier.

Research by Luthar and Latendresse (2005) suggests that, “…we need to raise awareness of the potential cost of overscheduled, competitive lifestyles” (p. 52) since even affluent teenagers show serious problems in anxiety, depression, and substance abuse. No one is immune from the effects of missing relaxed family time. Play and unscheduled downtime is central to our emotional well being throughout our lives. Michael is a regular user of sedatives, and hypnotic drugs. This could mean that he is trying to escape the memories of his difficult childhood. His lack of playtime during childhood could also be the reason for the Neverland Fantasy Ranch, the regular hosting of children’s parties there, and sleeping with boys in his bed. He may be thinking that he knows that he lacked the important activity of play when he was a child, and he does not want the children around him to lose it too.

Suggested Treatment

It is quite difficult sometimes to get someone with Body Dysmorphic Disorder (BDD) to accept help. However, if Michael should accept help, I would rather not go the chemical drug route, since he is already suffering from an addiction. Cognitive-behavioral psychotherapy is the other option. In this type of psychotherapy the therapist would help Michael resist the compulsions associated with the BDD, such as repeatedly looking in mirrors or excessive grooming (response prevention). The therapist would also help Michael to understand how some of his thoughts and perceptions are distorted and help him replace these perceptions with more realistic ones.

As it relates to pedophilia, there are a number of treatment options. Based on my research, there has not been much documentation on therapy options for pedophiles. However, some authors (e.g., Crawford) suggest multiple options in rehabilitation. Psychoanalysis would be one such method, since the assumption is that this kind of behaviour is related to the Oedipus complex. It is expensive and takes time, but should be worth the while. There are also behaviour modification techniques that may be able to help in this situation. Examples of this kind of treatment are aversion therapy, classical conditioning, and systematic de-sensitization.

For Michael’s insomnia and subsequent drug addiction, cognitive therapies would be useful. Relaxation techniques like Progressive Muscle Relaxation could be explored. In this kind of therapy, tension is applied to all the muscle groups, one after the other, while inhaling. Depending on the muscle group, tension may be applied by squeezing, bending, clenching or pressing. The tension is held for approximately eight seconds, and then released while exhaling.

Eventually, Michael will need to confront his father and let him know how his childhood treatment of him has affected him. This would be done after several sessions with Michael. I suspect that most, if not all his disorders stem from his deprived childhood. If he is able to face his father in this kind of way, much of the stress and anxiety in his life may be relieved.

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