for the love of children…
He is a Child…Not a Diagnosis
by Lawrence B. Lennon, P.h.D
Blessed are the children who are conceived and born to parents who welcome their arrival with open arms and loving hearts. These innocent babies quickly absorb and thrive with the nurturing they are spontaneously given by caring parents. They viscerally learn to trust their caregivers to meet their basic physical and emotional needs. As time unfolds, the doting parents are rewarded with a curious, engaging child that seeks to please the parents by cooing, smiling, and eventual accomplishments of walking, talking, going potty, doing well in school, and a lifetime of striving to make their parents proud. Mutual bonding is a wonder to behold and this is how an individual’s code of morality is developed: a child wants to please the loving parents.
Sadly, the majority of our foster children locked in “the system” have acquired severe emotional, behavioral, and psychological problems precisely because they have never experienced a loving bond with a nurturing parent. Most foster children have been subjected to drugs in utero and then, after birth, were neglected and /or abused by parents who, as children, were likely to have been abused themselves. By the time CPS recognized the plight of these innocent children, they have experienced deep experiential wounds that will last a lifetime. They, unlike the bonded child, pre-verbally see the world as being unsafe, dangerous, and unpredictable. Instinctively, these powerless, wounded children learn that if they are to survive, they must rely only on themselves and be wary of all those who come with false promises of wanting to help. For the foster child, the need to survive dominates any desire to please another human being.
This instinct for survival becomes even more acute and more deeply embedded when abused children enter the uncertain life of foster care. As a foster child, they are likely to suffer a softer and more subtle form of neglect and abuse. Too many times, these children are physically and sexually abused by older and bigger children in the institutions, hospitals, and foster homes where they have been unwillingly sent. Sometimes they are even abused by the adults they encounter in these placements that notoriously have a very high turnover rate for staff. Well-meaning foster parents are often not adequately trained to deal with seriously troubled children and/or are not provided the necessary support when their foster child begins to become destructive to property and violent to self and others. That is why it is not uncommon for foster children to have been in four, eight, ten or more foster homes with intermittent stops at acute psychiatric hospitals and residential (sometimes) “treatment” facilities.
In virtually all of these failed placement experiences, “experts” are called upon to give therapy to the wounded child and to provide guidance to the foster parents. Many experts, who have never been foster parents themselves, see these sad, lonely, angry children as victims of an ill-defined “mental disorder.” They then pronounce a diagnosis that gives the illusion that there is a definitive reason as to why the child is acting the way he does. In reality, a “diagnosis” is but a descriptive term of a cluster of behaviors that an “expert” gives to a child after clinical observation and sometimes psychological testing. It is a descriptive term of behavior that a lonely, hurting, and angry child is exhibiting. A diagnosis does not explain why a child is engaging or choosing to act in a certain way.
For example, consider a child who has been to five different schools in two years because of failed foster home placements. One could safely predict that this child will also be misbehaving in his next school and will fail many of his classes. An expert will observe, maybe test the child, and inevitably will diagnose this child as having ADHD which is but a description of how a child is acting. Thus, the descriptive diagnosis will then be used to explain why the child is acting the way he is: “Johnny is getting up out of his chair because he has ADHD.”
Likewise, when an angry, lonely, sad foster child is very sweet or charming when he wants something but then explodes when he doesn’t get his way, someone will observe this behavior and may give a diagnosis of “bipolar disorder” or “intermittent explosive behavior disorder.” Behavior described by a diagnosis, becomes behavior caused by the diagnosis. This process of morphing an abstract, primarily descriptive concept into a concrete entity is referred to as reification.
When the medical model is used to categorize or label a wounded child’s inappropriate behavior it can diminish a child’s belief, and those that work with him, in his capabilities to alter his behavior. All forms of inappropriate behavior can sometimes be attributed to an underlying “mental disorder” without consideration for the reason why a wounded child is acting a certain way. Withdrawn behavior with peers becomes equated with “asperger disorder;” repeated stealing becomes “kleptomania disorder,” unrelenting argumentative behavior is due to “oppositional disorder,” continual violation of society’s laws is because of his “conduct disorder”, and, of course, an unwillingness to show affection to his fifth foster parents is due to his “reactive attachment disorder.”
It is not uncommon for foster kids to have been labeled with three to ten diagnoses. Once so labeled by a professional, then almost all of our foster children are subjected to a variety of powerful psychotropic drugs often with immediate and sometimes permanent side effects on their developing bodies and brains. Many times, these fragile, abused, frighten children actually become psychotic, suicidal, and more violent due to the medication roulette that is played on these re-victimized children.
Who among us would not have serious behavioral and emotional problems if we, too, were abused, repeatedly moved from foster home to foster home, hospitalized, institutionalized, and never have experienced the joy and affirmation of a stable, loving human relationship? Who among us would not be experiencing a variety of “symptoms” such as difficulty in concentrating, academic underachievement, difficulty in maintaining peer relationships, profound sadness, generalized anxiety about current or future situations, periodical moments of anger and explosiveness, and repetitive lying to protect ourselves from consequences for our improper behavior? Are these “symptoms” not normal reactions to an abnormal situation?
We better serve our wounded children by respecting them for making existential decisions to misbehave as opposed to suggest that they are but the victims of underlying “mental disorders.” Children can understand that they have been unfairly victimized by those who didn’t know how to love them, but their decision to hurt others is their existential decision to be a “wounded hater.” When they are taught, shown, and experience unconditional love, these children can then evolve to becoming “wounded healers” by using their pain to help others. When we believe and teach children that their behavior is due to an underlying “mental disorder” we unfairly diminish and condemn them to a life of helplessness.
Our calling as foster parents and therapists is to affirm each child by appreciating the depths of his wounds but also by expecting and demanding personal accountability for one’s actions. The human spirit is irrepressible and every child has the desire to love and be loved. If we have to diagnose a child, let it begin with looking the child in the eye and telling him “You are one of God’s children.”