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This aggressive element is very deep-rooted; its beginnings can be seen in early infancy. Baby is happy when mother’s milk comes freely and easily, but if it does not come quickly enough or if it comes too quickly, he is frustrated, and in a moment we see anger in his face, and his aggression is vented in crying and generalized movements of his body.

Different children react differently to parental discipline. One child’s aggression may be aroused by a degree of discipline that would be easily tolerated by another. Anything which serves to make the child different from his fellows may arouse his aggression. Forced attendance at Sunday school, for example, or the failure of the parents to interest themselves in the matter, may worry the child and make him tense. When basic cultural or religious factors work to separate the family from others in the district, the child often suffers a smouldering aggressive reaction and his childhood may be marred by chronic anxiety and tension.

The adolescent is striving for adult status. He wants to be a man, and he is angered if he is still treated as a boy. He resents the controls which his parents and society exert over him for his well-being. This arouses aggression. To prove that he is grown-up he becomes defiant, and by his behaviour unconsciously sets about to show the world that no one can tell him what he must do. There may be impulsive and quite unpredictable displays of aggression which may take the form of unnecessary and inappropriate self-assertion. Such behaviour may alternate between the good-humoured and the vicious. The company of young men of his own age with impulsive aggression similar to his own provides an easy milieu for the dissipation of his aggression, and we have the genesis of the teen-age gang.

Sometimes the aggressive behaviour of the adolescent is easily explained. Recently a

long-haired youth of nineteen was brought to see me by his mother and father because he would not have his hair cut. When asked about it quietly, he said that he really did not care if his hair was short or long; but he was simply not going to be told when to have it cut by mother and father. He was merely expressing his right to make his own decisions. Like many youths, this lad was very tense because he felt constantly frustrated by his parents in his attempt to achieve adult status; his aggression was aroused and found expression in his behaviour and his way of wearing his hair. Many such lads lose their tension and come to behave in a more socially acceptable fashion when they realize what has been driving them to behave in this way.

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As I have already mentioned, it is possible to administer St John’s Wort with a variety of other anti-depressants and other medications in general. A survey of European colleagues who have treated collectively several hundred patients with St John’s Wort revealed no drug interactions noted to date except for potential problematic interactions with the MAOIs as noted above. At one point it was thought that St John’s Wort might itself be an MAOI and might exert its anti-depressant effects by that mechanism. If that were the case, it would be potentially dangerous to combine St John’s Wort with other anti-depressants. Fortunately this does not appear to be the case to any significant degree and St John’s Wort can be used freely with other anti-depressants. Furthermore, you need not worry that you will develop the extremely uncomfortable and sometimes dangerous high blood pressure reaction after eating cheese or drinking red wine, as can occur with those who are on an MAOI. There are no dietary restrictions whatsoever when you are on St John’s Wort.

As I mentioned above, you might be best off moving more gradually with dosages if St John’s Wort is used in combination with other anti-depressants or stimulants as these medications all act on the nerve cells in the brain and can enhance one another’s effects. While this is one of the desired goals of the exercise, namely to induce a more powerful anti-depressant effect than would be obtained on any of the medications alone, it is also a reason to increase dosages gradually to avoid the development of exaggerated and unduly unpleasant side-effects.

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