Diagnosis: Does It Help Or Hurt?
I received an e-mail yesterday talking about yet another “new” disorder. This disorder was for people who fixate on eating healthy. The author was talking about how people who don’t care what they are eating are “healthy,” and those who do care have a disorder. For obvious reasons, that just didn’t feel right to me. So, after hearing about this “disorder,” I decided it was good to look a little deeper at the highly charged topic of diagnosis. When I was getting my master’s degree in marriage and family therapy, I was really good at applying the criteria of different diagnostic codes to behaviors. It felt like a puzzle to look at symptoms and find how they all fit together, as if this now solved the world’s problems—or at least a family’s biggest challenges.
Everywhere we look nowadays, children are being diagnosed and labeled with disorders, with acronyms being placed near their names. “Johnny has ADHD; that’s why he can’t sit still.” “Sherry has RAD, and that’s why she can’t attach to us.” “Vinnie is on the [autism] spectrum.” But how does it help to label our children?
The reality is that labels are usually chosen due to behavioral checklists filled out by parents and teachers. It is an unscientific process based upon what the adults in a child’s life are seeing. That viewpoint is a creation of what our culture tells us to look at. But what if we aren’t seeing the whole picture? What if we don’t understand the relationship between the behavior and what the child has been through? Perhaps we’re only seeing a small piece of the puzzle and basing our decision upon our limited view.
Shifting Your Perspective
The first principle of Consciously Parenting, my parenting services devoted to helping families create, nurture and repair connections, states “All behavior is a communication.” Let’s look at an example and see what that might mean. We’ll take a hypothetical child who has been diagnosed with reactive attachment disorder (RAD). Let’s say that Sherry was adopted at age 4 from a Russian orphanage where no one held her, and she’d spent the first four years of her life in a crib with little interaction with caregivers. Sherry adapted to her environment, which included very little contact with people. Her brain and body adjusted to the lack of input, touch and connection that her body expected when she was born.
When she was adopted by a loving couple, her behaviors with her new parents clearly communicated what she had experienced in the orphanage. All her life, touch and human connection had been missing, so when her parents tried to hold her she would just go limp in their arms, refusing to look them in the eyes. She clearly didn’t want to be rocked to sleep and preferred to be on her own, making strange noises. Her behaviors were perfectly normal for the environment she spent her first four years living in, but are considered maladaptive in the new environment.
In the case of Johnny with ADHD (attention-deficit hyperactivity disorder), I would wonder who else in the family has difficulty focusing? How can meeting Johnny’s needs help the whole family? What if no one in the family is really able to focus attention on anything for very long? Who decides when a behavior is really a problem? What is Johnny communicating about what the family needs?
Does a Label Help?
Some parents feel frustrated when confronted with a child’s different or difficult behaviors. These parents feel better when they understand that what their child is experiencing isn’t unique to their child. A label allows parents to find other parents who may be working with similar circumstances. Sherry’s parents connected with a great Yahoo group to talk with other adoptive families facing similar issues; they found it once they had a label to put into a Google search. Certainly, having a diagnosis can take the pressure off and create more room for understanding.
In the case of Johnny, his family might find more information about ADHD and realize that their diet is really out of balance. They might discover that they spend too much time in front of a screen and not enough time exercising, and that the whole family really needs to get outside more. Or maybe that everyone needs to learn how to just sit and be present with one another.
Can a Label Hurt?
Once a label has been used to refer to a child, we might start using it in our everyday descriptions and explanations of the child. “Johnny can’t sit still. He has ADHD.” It can easily become a defining trait by which we refer to a child, which leaves the child no room to shift and grow into something else. When we start to understand why a behavior exists, we can meet the underlying need and release the need for the behavior. (Consciously Parenting’s second principle: “A need when met will go away. A need unmet is here to stay.”)
Sometimes when a label is used, we miss the opportunities to address the underlying cause. There are no cases of ADHD caused by a deficiency of Adderall or another pharmaceutical, even though that is the way the diagnosis is most often treated. Remember that there is no chemical test, brain scan or other diagnostic testing done—ADHD is only diagnosed by using a behavioral checklist. But behaviors are symptoms to be understood, not eliminated or covered up.
When we decide that our child has a “disorder,” it sets into motion thoughts, words and actions that reinforce the label. It also stops us from wondering what else could be happening or what our child is trying to communicate to us. And when we stop trying to understand, we often stop connecting. The child labeled with oppositional defiant disorder (ODD) might really need an outlet for the anger around his parents’ divorce from someone who really understands. Or perhaps he is feeling really disconnected from himself and from his parents. But we won’t find those underlying needs if we stop looking for them.
Words and Intentions
We are dynamic, rapidly changing individuals, particularly as children. When people believe in us, in our ability to change and grow, we are able to blossom. When we have people limiting us, we will limit ourselves and may not grow into our potential. As parents and teachers, we must recognize that our words have the potential to encourage our children to expand, learn and grow. Or not.
Children are programmed to believe the things we say. They don’t have a choice in this, especially as young children. Bruce Lipton’s research has proven that our children are much more than a pool of genes that are turned on or off. Our expectations, words and intentions can literally build our children up or break them down.
When we apply a label to a growing child, we may unwittingly limit our own expectation of what the child will do. There are enough obstacles in life without our adding to them. When we create these obstacles, we may cut ourselves off from the miracle that was around the corner, because we feel that it’s impossible.
We used to think that it was impossible to run the mile in under 4 minutes until someone did it. And now many people have run it in under 4 minutes (although not me!). We used to think that children who had poor early experiences were doomed to becoming violent and unproductive members of society. But now we know that it doesn’t need to be that way.
I have personally seen children diagnosed with oppositional defiant disorder become relatively calm and happy children because the parents were able to let go of the label and connect with the child beneath the outer behaviors. When we start to see the child as “doing the best she can do” instead of “trying to hurt me,” everything can start to shift. If we expect our child to act a certain way, we will not be disappointed. Underneath a child’s “negative” behaviors is a child who wants to be loved and to love, who needs to connect with others in order to survive and thrive. We need to shift our perspectives, and look at our child with new eyes. Only then will we see the miracles.