One of my more popular blogs through PsychCentral is titled, Children Who Want to Hurt. I notice how many times this continues to be viewed and thought it might be a good idea to revisit that topic.
My most comfortable genre for writing and communicating is that of storytelling. I like telling stories that impart wisdom and I use this approach often in my clinical practice with adults, teens, and children. Stories teach, inspire, motivate, and give us a picture of what it is that we are tossing about.
I work with children and have for over forty years. I started in the field of mental health when the DSM II was in place. We are now on the DSMV. Over the years I have seen disorders added and dropped. I have seen how culture changes the way we look at mental health and mental health challenges, including disorders.
If I take a trip down memory lane child diagnostics has certainly changed in the time since I entered the field. Some additions include ADD, ADHD, and Generalized Anxiety Disorder. Another addition is Gender Dysphoria as well as Intermittent Explosive Disorder, Conduct Disorders of several flavors, and more.
It would appear that children are often the focus of concern. Parents are often concerned about their children and their mental health. Parents I encounter are afraid of having the next sociopath, psychopath, or a young adult who ends up in prison. They fear being blamed. They fear not doing enough. They are sure something very wrong is going on and they want it fixed before it’s too late.
The reported symptoms are common: lying, stealing, not talking or withdrawing, being mean verbally, physical lashing out at siblings, friends or parents, and a suspicion of drug use. Add to that a level of apathy, avoidance, attitude, and overall surliness. Sometimes grades are bad and sometimes the child or teen is an A student. Parent’s report a far-away in their child’s eyes, as though they aren’t really there or aren’t really listening. The list is as general as each of us are individual.
There are some symptoms and signs that do point to problems down the road. There are choices in counseling. Pursue reducing or eliminating symptoms, pursue understanding the symptoms and their origin, or do both. Parents often ask for symptom elimination, but upon speaking further with them they actually want to understand what happened here. This is my favorite approach. Let’s roll up our sleeves and figure out what is at the core of what we see on the outside.
Most children whom I encountered, including teens have loss embedded inside. Loss comes in many forms and doesn’t always have to do with death of a loved one. We lose friends, we move, parents separate or divorce, parents argue, school teachers change, disappointments of one type or another abound. Children and teens are actually asked to deal with a lot of stuff. They endure the same things as adults, but they have limited ways of expressing what is felt. They don’t understand what they feel. They get very confused. Their confusion adds another task to parent’s long lists of things going on. Some parents do a great job of pausing and seeking to understand. Others find it an annoyance that gets in the way of what they need to do. I don’t blame parents. I don’t blame the children or teens. It is a family problem and one of creating space for communications that help rather than hurt.
Children are going to act-out. This is what we call it in my field. Acting-out what? Acting-out refers to acting out emotions, feelings, conflicts, or things that lie beneath that bother us. Adults act-out as well, but we assume they do less of it because they have command of their feelings and understand more about what it means to be humans in a society and culture with conflicting messages coming from everywhere. Adults likely understand the influences of their personal history a bit more than a child or teen.
Children act-out and the acting out is a bread crumb on this bread crumb trail we are given clues to the emotions or conflicts going on with the child.
For example, a child yells at you because you are asking too much about their school work. You are confused and perhaps angry. You may think, “This ungrateful child.” Think about yelling. Yelling is a behavior and it involves emotion. It is a form of anger being displayed behaviorally by way of a loud and unfriendly verbalization, which we call yelling. Parents can react and yell back. This, as we all know, leads nowhere. All behavior is a breadcrumb and part of a clue that leads to some form of understanding. What if a parent says, “Oh my, I hear your anger.” Or, “Ouch, what’s going on Sally?” Or, “I’m sorry honey, it feels like your frustration level is up a bit.” There are as many choices as there are thoughts. When we don’t react we invite and when we invite the child puts down their sword. You simply cannot fight with someone unwilling to fight.
We will talk more on strategies for understanding breadcrumb trails, children, behavior, and choices for how to intervene.
Wishing all of you a peaceful week.
Nanette Burton Mongelluzzo, PhD