Labels, Diagnoses, Medications...

Having spent the last few days talking with parents and fellow professionals about children with behaviors that are considered disruptive, challenging, unacceptable to adults, etc., I am bereft at how little attention seems to be paid to what is underneath these behaviors.  And parents seek out professionals for help and in return they get labels, diagnoses, medications and sometimes dire predictions about what the future holds for these children.  I am left tonight with the thought that has been ongoing for me over the past 7 years:  Caseworkers, therapists, physicians, teachers, and parents continue to focus on behavior and how to eradicate inappropriate and disruptive behavior.  The majority of folks involved with these children want the children to change.  They want the behaviors gone.  And they want it gone...now!  The hard truth is that these behaviors did not emerge overnight; nor do they come out of a child's desire too be difficult, to anger his parents, to confound and irritate his teachers, these behaviors come from an unconscious place.  These behaviors are driven by stress.  And guess what, one cannot diagnose and medicate stress and expect any kind of long term result.  Yes, you can bandaid the behavior with behavior modification based on the label and diagnoses; and you can medicate to calm the acting out.  And indeed, I have come to believe that these remedies are the duct tape for inappropriate, disruptive behaviors.  One could probably even color code the palliatives:  red for Oppositional Defiant Disorder; blue for Major Depressive Disorder; green for Attention Deficit Hyperactive Disorder; etc.  Problem is when you remove the tape...the behavior is lurking underneath.

Where can one find the cure?  Once we have exhausted all the labels/diagnoses (because after all, don't many of the diagnoses have the same behavioral indicators) and prescribed various combinations and permutations of medications, how often are disruptive behaviors still evident?  The answer, in my professional opinion, is yes...yes the problem is still there at a very cellular level.  The "cure" is healing and what we now know, is there is this connection between the mind and body (and yes, the spirit).  And it is only when our children can heal from the trauma that lurks in the brain (aka mind) that the behavior will diminish.  And the source of healing is not, I believe in the diagnoses/label and not in the pill bottle but rather in relationship.  Healing is in relationship that shows patience, empathy, acceptance, compassion, and encouragement.  And within the safety net of relationship healing can and will occur.

Stealing to Self-Soothe

Today, on the Facebook page:  Challenging Children, I published a question put to me by a parent who son has been in and out of residential placement for the past 6 plus years.  She was asking why her 17 year old son, Jake would take the family Wii and deny taking it.  (Note: no one saw him take it).  Stealing is an external manifestation of internal turmoil...Jake was in a state of stress presumably for several days prior.  He was not thinking when he "stole" the Wii; he was stressed to his very core (oftentimes, he has been sent away to placement when he has had an incident at school that was aggression toward a staff member and indeed he had been removed from an alternative school placement before the end of the school year.  And this was the first time it would have been heard by the court).  And we know, from brain research,  that when we are in a state of stress, short term memory is suppressed.  Stealing can become an addictive behavior because it produces a high that calms the system down.  Of course, it is an unacceptable means of regulating stress and causes more problems in the long run.  But remember, Jake was STRESSED and unable to think through his behavior.

How should his parents respond?  Obviously, they were in a state of stress believing that Jake had stolen from his own family, once again (this was a previous pattern) and they have worked so hard to be able to help him heal from past trauma.  And they feel they have come so far in being able to regulate themselves and be responsive to him.  And now he seems to just be resorting to old behaviors.
What will be most helpful to Jake is if his parents can sit down with him and let him know that at first they were very angry...and could feel in the pit of their stomachs or the tension in their neck the anger.  They have talked about it together and realize that they should have picked up on how much stress he was feeling about Court.  And they should have talked with him and let him know that it really was going to be okay because there was now a plan for next school year and they would let the judge know that they want him to stay at home.  They should tell him they love him and want to work very hard to help him and they want him to know that when he is feeling stressed, he can come to them and they will listen.  They will try very hard not to talk...not to tell him that he should see things such and such a way, but rather they will just listen.  And if he doesn't want to talk, but just wants to hang out...they will be there.  And let him know that they are sorry, they didn't get it and that he felt like he couldn't talk to them.  They realize that he sometimes acts without thinking to make himself feel better...