The case involving the Colorado family and the balloon hoax raises questions about adults who exploit children. How would you help a child traumatized by such an incident?

The most important part of this story is the possible failure of the child to develop a normal superego, a conscience, and a sense of right and wrong consistent with societal norms. The superego is not innate. It is a learned or acquired part of the mental structure, and it is learned from the parents who set the moral tone in the house.

If a mother earns her living by selling illegal drugs, her child might be led to believe that this activity is normal and acceptable. Physical punishment does not help the superego to develop, and parents must know this in order to help their children understand the moral code of the nation, the city, the neighborhood, and the house. If those moral codes are all different, the child becomes confused, because each adult has a different message. Psychiatrists can help parents learn how to parent better and convey consistent moral values so that their children develop a normal superego.

The child has to know when his/her parent is displeased. Knowing when the parent is displeased helps young children to be toilet trained. A gentle, patient tone in the parent's voice during toilet training might teach the child that there is no urgency in getting trained. The message sent to the Heene boys is this: It is fine to create chaos in the community in order to achieve personal goals. The superego will incorporate this lesson most effectively unless there is an early midcourse correction.

Children absorb almost everything they hear in the home. Children sitting at the dinner table walk away with a lot of information, even if they don't truly understand what the information means. Unkind gossip and other talk that violates the supposed moral values of the family are heard and absorbed by children. Saying grace before a meal and then listening to adult conversation that contradicts the moral tone of grace creates a paradox for children. The Heene child was clearly confused by conflicting messages from his parents and he repeated his father's talk about “the show.” His articulation of his confusion to the news media blew the cover off the entire hoax.

Getting children to aid and abet criminal behavior is criminal. For the Heene family, capturing the attention of the entire nation was a wish granted. We talked and blogged about the story. Cable television news crews were all over it. Millions offered prayers for the boy we had been led to believe was in the balloon.

The Heene boys, meanwhile, were in on the ruse. They knew what mom and dad were up to, but only the youngest let it slip out because he was not yet a hardened liar.

As we psychiatrists evaluate patients and treat them, we must determine the nature and strength of the superegos.

All of us treat people with depression, which is a disease of the superego characterized by guilt. We saw no guilt in Mr. Heene. Now that he has confessed, we can see his distorted pathological purpose, which was to get an offer to participate in a reality show. We don't know how the father will deal with the child for blowing the hoax with his honesty or naivete. I'm not sure what to call it.

If I were treating this child, I would first get a history of how the children are disciplined and whether they are afraid of their father. That would make a big difference. Children in treatment often identify with their therapist and repeat things that the therapist says to their parents. That could endanger the child and could even end the treatment.

Retraining a child to form a strong and socially acceptable superego is difficult when he or she is living with parents who offer the child conflicting or inappropriate messages about moral values. Their messages are vitally poignant and more powerful than the ideas of the therapist.

Family therapy is a much more acceptable concept if everyone understands that the child's superego is the important subject of the therapy. The Heene family will need a great deal of help to heal the wounds perpetrated by the father. If they are not corrected, family members may grow up as damaged goods. Just as can happen in a family in which the father routinely beats the children, the damage to the children is long-lasting. The father might be deeply hated by those children.

Families like the one I'm describing rarely have family therapy and get a chance to correct the damage. I know of a case in which an 80-year-old man apologized to his 50-year-old son on his deathbed. That is much too late. The balloon boy might tell the story 20 years from now as if it were an adventure and talk about his father with pride. He might never get a mid-course correction to allow his life and his own children to live in a different world where morality is important.