Parents who come to me for consultation and counseling are usually at the end of their rope. They’re feeling overwhelmed, exhausted, frustrated, disgusted, and distressed at the way their child’s issues and needs have taken over their lives. Schedules, decisions, and daily routines all seem to revolve around a difficult child who – despite every accommodation and intervention – isn’t getting any easier to live with.
These are caring, committed parents. They’ve taken their child for every kind of evaluation and therapy, but nothing seems to pinpoint the source of the problem or how to make it better. They’ve embarked on a time-consuming, expensive search for an explanation – usually in the form of a label or set of labels – in the hope that it will lead to an effective treatment, a way to fix or at least improve the situation. They’ve followed the “medical model”: diagnose, treat, and eventually cure.
Diagnosis, however, may not necessarily be what’s needed. Many children do things that are odd or excessive, but not all of them indicate a disorder to be repaired or a deficit to be replenished. The tendency nowadays is to pathologize children – to view any difference or difficulty as a symptom rather than a personal trait. This “pathological lens” isn’t fair to these children; what’s more, it doesn’t help parents deal with their children effectively.
A more useful approach is to look at the whole child, at his unique assets and difficulties, as author and pediatrician Mel Levine recommends. While some of these traits may appear on symptom lists for certain disabilities, the whole child is more than the sum of his parts. And for a child to mature and become integrated, nurturing his assets is at least as important as addressing his weaknesses. In fact, a youngster’s difficulties or quirks may turn out to be his most important strengths. In many cases “problems” occur because a specific trait – such as excitability or tenacity – shows up at the wrong time or to the wrong degree and out of its appropriate context, thus appearing as something negative.
Many problem behaviors in a gifted child are actually due to exceptional sensitivity rather than to willful disobedience or protest at not getting his way. For example, among the sensitivities a child may exhibit are:
In these examples, any rewards or punishments used to motivate the child to change his behavior fail miserably because the child’s problem behaviors have nothing to do with lack of motivation. What intervention does succeed? In my own work with families, I use interventions based on three principles.
Principle 1: It’s the parent, not the child, who has to do most of the work.
It makes no sense to expect a child to have the inner resources to do all or most of the changing. We adults have more capacity to self-reflect and struggle with our habits than do children. It’s unrealistic to expect our children to do this first, no matter how many stickers or stars we offer. Once we change, our children will follow.
The first change should be in our fundamental orientation: from trying to alter the child’s behavior to taking responsibility for being a leader and model. Next, we must change our language. Examples of ways to re-frame language appear later in this article.
Principle 2: We must find specific points where we can be helpful.
We need to be alert for ways to change the environment to make it a better fit for the child. For example, we might look for what tends to make the child become disorganized or over-aroused. Is it being rushed or surprised, being told to stop before a task is complete, or maybe having to deal with too many people or choices at once? Once we have the answers, we can intervene at the specific point where the problem occurs.
As an analogy, it’s useful to remember when our children learned to walk. We focused our attention on removing potential obstacles to minimize falling; we tried to manage the environment so our child could practice getting it right and experience success; and we cheered every incremental improvement, no matter how small. We didn’t punish the child for not walking; we helped him to walk.
Principle 3: We must give children the chance to do it right.
Rather than reacting to what our children do wrong, we need to give them more chances to do things right. Repetition is how people learn; biologically, it’s how neural pathways get laid down and reinforced. Whether adult or child, a person is least able to learn a new skill when he’s feeling confused, incompetent, or negative. We learn best when we’re “catching on” or “getting the hang of it.”
A Case Study – Diana
A case study may best illustrate how to put these principles into practice. Diana is an exceptionally bright seven year-old whose writing and math skills are several years ahead of her peers. Her idea of fun is to ask her mother to give her sheets of math problems to solve. Diana enjoys all intellectual challenges, especially those involving visual organization, like finding patterns and solving puzzles. Angelic looking, Diana seems the ideal child; yet her mother Carol had come to me in tears. Diana’s idiosyncrasies and tantrums had turned their home life into a nightmare. The smallest thing that went wrong or “felt wrong” could cause an outburst of sobbing or rage. Despite their best efforts, her parents were unable to predict, prevent, or handle Diana’s frequent meltdowns. Carol had come to feel utterly incompetent and defeated.
As we looked closely at the situations that tended to make Diana explode, we realized they had a common theme. When something offended Diana’s sense of how things were “supposed to be,” she was likely to fall apart. Whining and fretting would rapidly escalate to a full-scale tantrum that might include screaming, kicking, and hitting. “I just can’t,” she would sob – whether it was get in the car, take off her jacket, or come in to dinner. Her mother’s efforts to reason or cajole, encourage or threaten were just irritating noise to Diana. Her rigid perfectionism was overpowering her strengths. I addressed the family’s situation in two ways:
Point of View: Acknowledging Diana’s Reality
We began by recognizing that Diana couldn’t bear it when things were not the way she expected them to be. She had an exceptionally good memory and remembered everything literally, so half-truths and re-interpretations wouldn’t convince her that the revised version was really okay. The first step had to be to accept this fact and its importance to Diana – to acknowledge rather than deny her reality.
We often say to a child: “That’s just a tiny cut; it couldn’t possibly hurt that much!” or “Come on in, the water’s not cold at all!” But for the child, the tiny cut does hurt and the warm water does feel cold. Are we teaching the child that he doesn’t or shouldn’t feel what he actually feels? Unintentionally, Carol had done this with her daughter. Many times she’d protested, “How can you get so upset over such a little thing?” Asking questions like this doesn’t help. Usually the child doesn’t know the answer, or the answer he gives makes no sense to the parent. The first thing Carol needed to do, then, was to change her language.
I helped Carol re-train herself to say, “I can see that you …” or ”Anyone would feel bad if … “ or “It really bothers you when … “ Often, just the recognition that she was understood was enough to reduce Diana’s hysteria to a level she could manage. Especially effective was the phrase: “You’re the kind of person who… gets upset when you have to stop an activity … doesn’t like to be disappointed … has a hard time choosing between two things that sound good … “ and so on. This phrase helps a child know that he’s not the only one who’s ever felt this way and that this isn’t happening because he’s bad or flawed.
Point of View: Responding to the Situation
Next, Carol worked on changing her initial response. She learned to look at a situation and ask herself, “What would a helpful parent do?” instead of just reacting to what Diana was doing. This approach helped her predict and prevent a meltdown when she took Diana to a Broadway show.
Carol got tickets for Beauty and the Beast, knowing how much her daughter loved the story, yet dreading what would happen in this public place if the intensity became too much for her. Taking into account Diana’s specific issues, Carol came up with a simple and helpful plan. She brought fuzzy pink earmuffs and a frilly pink eye mask that Diana could put on whenever she wanted if the production became too intense. (They had a wonderful time.)
By taking a practical, non-judgmental approach, we helped Diana manage other stressful situations. For instance, Diana had been coming home each day intensely agitated about a classmate whose loud, intrusive, and impulsive style was almost impossible for Diana to bear. Knowing that concretizing a situation can be helpful to a child, we came up with the idea of asking Diana to decorate a special box where she could put all her bad experiences. Whenever the boy upset her, she could write about it on an index card and put the card in the box “for storage.” Storing the impressions there, instead of in her mind, gave her a way to move on.
The benefits of this approach were threefold:
Empowering Diana: Helping Diana Help Herself
The next stage of our work involved teaching Diana to be helpful herself. For instance, Diana had to ride along whenever Carol drove her brother Mark to his various activities. This had become a daily battleground. Diana would flail wildly and shriek that she “couldn’t” get in and out of the car one more time. At seven years old, leaving her home alone wasn’t a possibility, nor was not driving Mark where he needed to go; so we had to devise a solution.
Knowing that Diana took comfort in mathematical systems and patterns, I suggested having her keep a log of the exact amount of time she spent accompanying Mark to his activities. This involved telling time, subtracting to figure out the number of minutes, and devising a system to record the information. We agreed that when she had “collected” 60 minutes of time, she could “trade them in” for an hour of something she wanted to do. Diana loved this! Not only did she appreciate the fairness of the arrangement, but she liked doing the calculations and creating a visually attractive recording system. Because it made use of her strengths, the activity was calming and empowering for her.
Finding ways to empower a child is the root of all effective interventions. In general, children have very little power in their lives. At school, they are told when to move, when to eat, where to sit, and what kind of chair to sit in. They have no say in the classroom lighting or noise level, or in the duration, time of day, or tempo of the tasks they must undertake. We take away all power except the power to say no; and if this is the only power a person has left, he will surely use it.
Empowerment means giving the child ways to say yes. For an inflexible child like Diana, this meant helping her extend the boundaries of her world. We began by working to “stretch the pictures” in her mind. Diana tended to form very strong but narrow images that would trigger an unstoppable series of thoughts and emotions if reality didn’t match the images. Carol related an incident that illustrated how Diana’s mental rigidity led to a breakdown.
The family decided to visit a local ice cream store, but found it closed when they arrived. Diana became hysterical, inconsolable. Promising to go the next day or offering a substitute were not acceptable alternatives for her.
To deal with this kind of situation, I taught Carol to include a back-up plan as part of the overall plan. She learned to say to Diana right at the beginning, “What’s our back-up plan if the shop is closed?” In this way “coming back tomorrow” or “getting donuts” was already part of the picture in her mind and, therefore, not seen as a disappointment or unexpected change.
Empowering Diana: Helping Diana to Make Choices
Another difficulty Diana encountered, in contrast, was when she became obsessed with too many rather than too few possibilities. Confronted with a choice, she could become so preoccupied with all the possible choices and possible outcomes of those choices that she became unable to act. Carol recalled taking her to the toy store to spend a $20 birthday gift. Diana became so worried about all the things she would not be choosing, that she was unable to decide on anything at all. Carol ran out of time and patience and couldn’t understand why her daughter would ruin what should have been a happy outing. Any suggestions Carol offered only made the situation worse because they didn’t address the source of the problem – that Diana was unable to process all the possibilities at once.
Here again, Carol needed to acknowledge and respect Diana’s reality by saying, “It’s OK if you’re not ready to make a choice. Think about it and let me know when you’re ready to come back and buy something.” Later, in a similar situation, Carol suggested that Diana make a list of the items she liked. Then Carol helped her organize all the factors she needed to consider – like price, size, and so on. They chose the items that Diana especially liked and organized all the information in a grid, the kind of activity Diana enjoyed and found comforting. She then had a concrete way to organize the information in her mind until she was ready to choose. Carol also allowed her to take as much time as she needed. Tempo, and the mismatch between a child’s tempo and the tempo of those around him, can be a key factor in cognitive or emotional breakdowns. A child who is told to proceed more quickly or more slowly than his internal rhythm dictates will protest in the only way available – by saying no.
The strategies that were effective for Diana, as for any child, made use of her strengths – her love of organization, mathematical ability, and strong visual creativity. Good solutions don’t come from suppressing a person’s weaknesses but from engaging his strengths. The eventual goal is to help Diana devise solutions for herself. At seven, her parents still need to be the main helpers; but as she grows, they can encourage Diana to figure things out for herself, based on her understanding of the kind of person she is.
Remember that growth and development come from nourishing a person’s strengths, not from “controlling” or ”repairing” his weaknesses. Throw out those sticker charts and enjoy your unique child!
Barbara Probst, MSW, LCSW, is a clinical social worker specializing in helping families whose “different” children have somehow become “difficult” children – often because their sensitivity, intensity, or giftedness is mistaken for a “disorder.” In addition to running parent support groups and working with individuals and families, she also teaches at Fordham University’s Graduate School of Social Service, gives presentations throughout the country, and is the mother of two adolescents. She is currently completing a book slated for publication in early 2008.
This article is reprinted with permission from the 2e Newsletter and the author.
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