Medical Model

Modern psychiatry views children like Madison, those with inappropriate or difficult behaviors, as children whose brain chemistry/neurology is dysfunctional.  Psychiatrists gather information about the specific kinds of problem behavior so they can find out what kind of disorder might account for the child’s behavior. The disorder manifests as a chemical difference in the brain that causes the child to act different than other children. Sometimes, but not usually, this chemical difference can be measured, thereby confirming the diagnosis. Finally, medication is prescribed to correct or counter the abhorrent brain chemistry.

In brief, psychiatry views bad behavior as caused by bad brain chemistry. Make a diagnosis (a theory about what kind of chemical dysfunction is present), then prescribe chemicals to correct or counter the effects of the bad chemistry. Bad chemistry plus corrective chemistry equals good chemistry and good behavior.

This seems reasonable enough—until you consider that, while brain chemistry causes behavior, it is also the case that behavior causes brain chemistry. We know that if we send a soldier to the war zone in Iraq for a year, that when he comes back he may have post-traumatic stress disorder (PTSD). Exposure to a set of behaviors and experiences altered his brain chemistry. If this can happen to an adult’s brain, how much more sensitive to behaviors and experiences is the very malleable brain of a child?

In other words, if a child develops a pattern of behavior or is in a system of behavior interactions that are dysfunctional, then brain chemistry can shift to dysfunctional. And if this is the case, then a child whose brain chemistry is dysfunctional can shift back to functional when she is exposed to corrective behavior interactions.

What I was doing when I was turning around these various children was creating behavior interactions and patterns that countered and remedied the interactions and patterns that had caused the bad behavior and chemistry. And in so doing, I was creating new experiences that altered not only behavior but corrected brain chemistry. The thrust of this book will show how to create new and well-thought-out methods of interactions that can alter brain chemistry, behavior and child development for the better without any medications.

The methods and approaches I’ve developed are not designed to simply manage children with difficult and dysfunctional behaviors; rather, they are designed to change the root causes of the behavior and thereby change the child’s internal processes, neurology and brain chemistry.

In a July 2008 article in The Atlantic Monthly, Nicholas Carr wrote,

The human brain is almost infinitely malleable. People used to think that our mental meshwork, the dense connections formed among the 100 billion or so neurons inside our skulls, was largely fixed by the time we reached adulthood. But brain researchers have discovered that that’s not the case. James Olds, a professor of neuroscience who directs the Krasnow Institute for Advanced Study at George Mason University, says that even the adult mind ‘is very plastic.’ Nerve cells routinely break old connections and form new ones. ‘The brain,’ according to Olds, ‘has the ability to reprogram itself on the fly, altering the way it functions.’

Lion Cub

I was recently in a client’s home talking with them about their five-year-old and was at the same time able to observe the interactions between the parents and their younger son, Jacob.

Two-year-old Jacob is charming but needs constant attention. The parents are taking turns accommodating him and his needs. Jacob is curious about a dish of olives and his father puts one in his mouth; Jacob doesn’t like it and spits it back into his father’s hand. Now the toddler decides the olives must go. He climbs onto the coffee table and grabs the bowl of olives. The father catches the bowl before he can throw it and asks, “What do you want to do?”

The toddler ignores his father and tries to pull the bowl from his father’s hand. The father says, “No thank you, we don’t throw olives.” 

But the toddler is unfazed, “No Daddy, no Daddy” he says while he tries to pry his father’s fingers off the olive bowl. During the next ten minutes the toddler keeps coming back to try and grab the olives. Sometimes he gets his hand on an olive and throws one before a parent can stop him.

They explain to him not to do it. They try to distract him with other things, but at no time do they firmly say “no” or give him any kind of consequence for ignoring their directions. I got the impression that if the father had been fast enough to catch olives thrown in every direction without letting any hit the floor he would have let his son throw them.

A few minutes later Jacob decides he wants to play the dog like a drum, banging his hands against its back. Fortunately, the dog remains good-natured and ignores the mild beating. “It’s not Okay to use the dog as a drum. Do you need to bang on your drum?” the father asks, then brings out a drum and gives it to him. The toddler ignores the drum.  A bit later Jacob decides it’s funny to pull the dog’s tail. After the parents have told him several times ”No thank you. We don’t pull the dog’s tail”, the mother tells the boy, “I want you to say you’re sorry to the dog.” After repeated prodding, the boy says to the dog, “You’re sorry.” Having the toddler apologize to the dog means about as much to the toddler as it does to the dog.

Before I leave the mother asks me if I want to watch Jacob play his piano. I stand in his playroom for over five minutes while he happily bangs on a toddler-sized piano. It is apparent that the mother feels that she, and maybe I, should stay, listen and appear fascinated by his happy banging as long as Jacob wants us to.

I share this anecdote not because it’s an example of bad parenting but because it’s an example of typical, some would even say exemplary, parenting. I also share it because within these interactions are the seeds of the developmental shift that feeds omnipotence.

A Toddler's Actions Ask Questions

A two-year-old is trying for find out how much power they have and who else has power. Their actions are asking questions “I have power, right? Do you have power? Are you like me? What happens when I do things? Can I get everything I want? Who’s in charge? Who’s important?”

In the example above, the toddler is learning the rules of the home and they are: “I can do anything I want. Sometimes Mom and Dad will stop me, but I can keep trying. When I do things they don’t want me to do, Mom and Dad bring me new things. Mom and Dad are not like me. They are here to serve me. When I cry they give me things to cheer me up. They’re always asking me what I want and bringing me things I ask for. I control what happens and I am the most important person in the house.”

Here are rules the toddler is not learning: “Don’t throw olives.” “Don’t play the dog like a drum.” “It is important to listen to Mom and Dad.” “I can’t have everything I want.” “There are things I can do and things I can’t do.” “Like me, Mom and Dad also have power and things they want.” “Everyone in the house is important.” “Mom and Dad are in control of what happens in the house.”

I felt like my clients had been trying to make an environment for their son that was like some big interactive padded room where he could do anything he wanted and remain safe. Any desires or needs the parents had seemed to come a far second to the needs and desires of their son. While this type of environment was certainly stimulating and educational, it was missing the thing most needed, interaction with the clearly expressed will of another. In order for a toddler to develop connection, he must come up against the will and desires of others.  There must be conflict.

"The diamond cannot be polished without friction, nor man perfected without trials."—Confucius

            Jacob’s parents were raising him to be a lion (assertive, confident, powerful) but they were parenting like lambs.

Did That Work For You?

The key to having a Socratic dialogue with children is to base your discussion around asking them, in as many ways as possible, “Did the choices you made get you what you wanted?”

            When you lead a child to examine the facts and ideas based on better understanding what’s in her own self-interest, rather than telling her your conclusions about what she should and shouldn’t do, she will more easily embrace the realizations and conclusions she’s come to because she feels respected and not manipulated.

In order for a Socratic dialogue to take place, there must be some problem, dilemma or frustration to be eliminated. Problems lead to frustrations, which lead to questions, which lead to answers.

Sometimes you need to create the frustration to get things started, like when I watched five-year-old James rush through writing his letters for homework. I saw him writing letters so fast they were barely legible and far from his best work.

When James gave me the first page, I told him, “ I’m sorry, I can’t read this. You’ll need to do it again.” He took the page back, erased what he’d written, and wrote the letters again at top speed.

When he brought it to me this time I said, “Well, these first few letters look good, but the rest look the same as before. You’re going to have erase all these and do them again.” Then I added, “Let me ask you a question: Why do you think these look so messy?”

“Well I did them real fast. So I can go play,” he said.

“Okay, well erase these and do them again so they are neat.”

James went back to the desk, erased the messy ones, and again wrote them illegibly at top speed.

When he brought me his paper I looked at it and said, “Wow, it kind of looks the same. These first ones look good then it looks real messy. What did you do on these first ones that look real neat?”

“I did those real slow,” he answered.

“Well, how come you don’t do the rest that way so you don’t have to erase them?” I asked.

“If I go slow it takes too long and I want to finish so I can go play,” he responded.

”Let me ask you a question. What do you think will take longer—doing this page fast but doing it five times, or doing this page slow but just doing it once?” I asked.

He looked at me with a half smile and said, “Probably, doing it one time slow.”

“So your theory is that it would be faster to do the letters one time but slow? Well if that’s your theory, maybe you should test that out,” I suggested. 

The Child Must Have A Question

The general question you want your child to come to is, “What must I do to alleviate this frustration?” Without this initial question there is no motivation (fuel) for realization. To get the thinking started, ask questions that require reflection. First ask general questions, then get more specific, but. never give more information than necessary.

General question – “What do you think you could do to make this more legible?”

More Specific – “When you wrote this did you go fast, medium or slow? Which way do you think would produce the best-looking letters?”

A child who comes from a system of interaction that allowed her omnipotence to remain dominant will associate safety with keeping control over things. This manifests as a need to be perfect and a resistance to anyone telling her what to do. So when an adult tells her what she is doing wrong, or what she should be doing that she is not, she is naturally resistant. Taking information from others (learning) feels unsafe or out-of-control, whereas coming to new conclusions on her own reinforces her need to feel her independence.

I used to run a mentoring program for children ages seven to twelve. Once a week the adult mentors led a philosophical discussion with the children about various social, moral and ethical issues.  We had a very strict rule that the adults in the room, including the moderator of the discussion, could only ask questions; never give answers or opinions. These discussions were wildly successful. They forced the adults to think deeply about what they wanted to communicate and it created an atmosphere of structured respect and freedom where the children owned the conversation and felt at ease to speak their minds.

When an adult is giving a child information and conclusions about her behaviors, they are denying the child the opportunity to gather information and reach conclusions on her own. When you lead a child to reach conclusions on her own, the child will be more likely to remember and use those conclusions because they are paired with the feelings of accomplishment at having figured it out herself.

Learning Or Realization

There are two different ways to teach a child; through a process of learning or a process of realization. When trying to teach a child after a moment of conflict or difficulty it is much more effective to use a process of realization.

Learning happens when you take information, or the conclusion about something, from someone else. The adult gives the information or conclusion and the child takes it.

Realization happens when you gather your own information and come to the conclusion on your own. The adult can lead a child to realizations by asking questions rather than giving answers.

Using a series of questions to lead someone to certain realizations is commonly called the Socratic method. Wikipedia defines Socratic method as “a form of philosophical inquiry in which the questioner explores the implications of others' positions, to stimulate rational thinking and illuminate ideas.” 

Jimmy's One Friend

One afternoon, I was watching Jimmy (“I hate polite children”, chapter 6) playing Legos with two other boys when I heard him say to his friend Ryan, “That’s a stupid way to build it. The wings are gonna fall off. Give me the ship, you’re stupid.”

Ryan looked hurt, put the half-built spaceship down and turned his back to Jimmy.

Jimmy was in the first grade now and had come a long way from where he’d started. But he was still very impulsive and often said the first thing that popped into his mind without thinking. He was trying his best to make friends but most of the children still didn’t like him very much. He and Ryan had become friends about two months earlier and had even had a few play dates together after school.

I winced when I heard him call Ryan stupid, not only because he clearly hurt Ryan’s feelings, but also because I was afraid he might lose one of his precious few friends. So I called Jimmy over and said to him, “Jimmy, let me ask you a question. Do you want to have more friends?”

Jimmy looked at me suspiciously and gave a tentative “Yes.”

“Okay, and are you happy about how many play dates you have or do you want to have more?”

“I want to have more.” Jimmy said.

“So right now, after what you just said to him, do you think Ryan wants to be your friend?”

“But Ryan was being stupid. If you put the wings on like that they’ll never stay. You need to ….”

I broke in and said, “Hold on, hold on. I didn’t ask you if Ryan was being stupid, maybe he was. I’m just asking you if you think he wants to be your friend when you call him stupid.”

“I don’t know. Probably not,” he said.

“Well I just wanted to ask you because I know you want to have more friends and play dates, so I couldn’t figure out why you called Ryan stupid.”

Then after a pause I said, “Do you want to go back and play?”

“Yeah.” Jimmy said.

“Go on then.”

            Jimmy had always been resistant to anyone telling him that something he did was wrong or a bad idea. I’d learned that if I asked him questions, and didn’t force him to admit he was wrong, he was more likely to talk with me honestly and change his behavior. 

Who's The Boss

One day I was walking down the hall at a school where I work regularly and saw the time-out staff, Alex, with a seven-year-old named Thomas. Thomas’s hands were clenched into fists on the side of his body and he was red-faced, with tears streaming down his cheeks, screaming, “YOU’RE NOT THE BOSS OF ME! YOU’RE NOT THE BOSS OF ME!”

Alex, looked tired and a little frustrated as he tried to get through to Thomas, “Look, Thomas, you’ve got to listen to me! If you don’t come into the time-out room, I’m going to take you to isolation.”

“YOU’RE NOT THE BOSS OF ME!”, Thomas yelled back.

“Thomas, you’ve got to stop saying that. You’ve got to do what I say.”

Still crying and screaming, Thomas repeated, “YOU’RE NOT THE BOSS OF ME! YOU’RE NOT THE BOSS OF ME!”

Alex saw me and said “Joe, can you do something with this kid? He just keeps telling me I’m not the boss of him. He’s got to learn to follow my directions.”

“Well I can try,” I said.

I stepped up to Thomas and immediately he shouted at me, “YOU’RE NOT THE BOSS OF ME! YOU’RE NOT THE BOSS OF ME!”

I put my hands up to indicate “I surrender” and said, “You’re right. I am not the boss of you.”

Thomas screamed it again, “YOU’RE NOT THE BOSS OF ME!” with tears still streaming down both cheeks.

“That’s right. I am definitely not the boss of you, Thomas. You are the boss of you.”

Still crying, he got a little quieter and said again, “You’re not the boss of me.”

I repeated it again, “I am not the boss of you” then after a pause I said, “But you’ve got a decision to make. You can calm down and come into the time-out room, or if you’re standing in the hall screaming and crying, you have to go to isolation. Do you want to go to isolation?”

To my surprise he said, “Yes!”

I said, “Okay, come on.” At which point he took my hand and we walked quietly to the isolation room together.

Children have power and it’s important to recognize it. When a child is being oppositional and defiant, sometimes the first step to defusing the situation is to acknowledge his power. Children with strong feelings of omnipotence cling to their perceived power because it’s their safety line to keeping control of a scary world. The language I use when dealing with an oppositional situation, whether it’s eight-year-old Thomas or my seventeen-year-old stepdaughter, is always more effective when I acknowledge the power of the person I’m dealing with. Once you’ve clearly acknowledged the power of the other, it becomes much easier to clearly set boundaries. 

The truth is, I’m not the boss of Thomas. I think we get into trouble when we think we can make kids do what they don’t want to do. When I do staff trainings I like to tell them, “You are not in charge of behavior. The children are in charge of behavior. You are in charge of consequences. If you don’t like the behavior, change the consequences.” In the end teachers and parents are really only in charge of motivation. If a child doesn’t want to do something he isn’t going to do it, unless you make it in his best interest.

Don't Hold What's Theirs

In addition to Verbal Jujitsu being a very effective means of dealing with conflict, it also communicates to the child in a way that supports the kind of healthy thinking we want him to develop and use.

Most children with behavior problems have developed a pattern of externalizing their problems and difficulties. Whatever goes wrong is blamed on the adults around them. Remember that while externalizing is a natural and healthy survival tool for an infant, a child should shift from externalizing to internalizing many difficulties as he moves into interdependence. 

Guidance Without Manipulation

There are all kinds of subtle manipulations in the language we use when we talk with children. This new generation of children, children with stronger omnipotent identities and stronger sense of themselves, are highly sensitive to manipulation and they will resist it.  The use of manipulation is an attempt to shape and change them based in a fear that the child will not come to the correct conclusions on his own. The child’s resistance will start an antagonistic and oppositional dynamic. The most effective way to speak to these children is to speak to them in terms that acknowledge their independent will.

Recognize that children ultimately make the decisions in each circumstance and that we cannot make decisions for them. Also, the language that we use with children should communicate to them a belief that they are capable of making logical, healthy decisions that are respectful of themselves and others. The language commonly usedto speak with children is filled with manipulation, moralizing and innuendo about what they should and shouldn’t do. This kind of language communicates to them our lack of faith in both their ability to make decisions, and in their capacity as moral and ethical persons.