Your Kids Aren't Sick

The Horrible Kid

How Horrible Can A Kid Be?
In 1999, a well-established mental health agency in California opened one of the first private, non-profit Wraparound[i] programs in San Bernardino, California. I was selected as the Executive Director. Wraparound programs were established to provide services to families struggling with troubled or troublesome children while the child was still living in the home. Without these services, children were in jeopardy of being removed from their families and placed for treatment in a foster home, a group home, or a mental health facility. Families are referred to Wraparound programs by the county Department of Social Services, the Mental Health Department, and, though rare, a school district. As a bonus, these types of wraparound programs were touted to be much more cost effective than out-of-home placement – at least they began that way.

After 12 months of operation, we had a number of successes with the families we were entrusted to help. Our team was routinely out in the community and in the homes of our families doing “whatever it takes” – the battle cry of all wraparound programs at the time – to keep the family intact. We had exceptional people working in the program filling the roles of counselor, Mental Health Resource Specialist[ii] (MHRS) and a therapist. Though we were still learning, we were dedicated, and we were confident we had the skills to help our families.

One day I got a call from a county social worker. We were providing services for two of her families already, and she was pleased with our work. She wanted to refer a nine-year-old boy she had on her caseload for three months. Let’s call him Jerry. Without our help, she feared, Jerry was headed for out-of-home placement. “If I have to remove Jerry from his home,” she said with some caution, “I’m not so sure I’ll be able to find a foster parent willing to put up with this horrible kid!”

She gave me details, and I accepted the referral. I contacted Jerry’s school and spoke with his school counselor. I asked how Jerry was doing. She told me he was enrolled three months earlier, and he was in special classes for the learning disabled. She let me know Jerry was performing below grade level. When asked, she also said he didn’t have any friends, adding “he’s just horrible in the classroom!”

The school did some testing. Schools love to test kids, especially kids they don’t know how to manage. The school counselor told me their psychologist determined Jerry “likely has ADHD.” She was frustrated with Jerry’s mother because, “I told her we wanted to refer Jerry to a child psychiatrist because of the benefits medication can have, and she refused. Perhaps,” she implored, “you can help her accept the idea Jerry has a real disability.”

Jerry’s Story
“Horrible . . . just horrible.”

That’s what Jerry’s mother said when I asked, for the first time, how Jerry was doing. We were in her home, her eyes a little misty. She was more dejected than angry. Her name, for this tale, is Gloria. Gloria had more or less surrendered herself to the idea Jerry was always going to be her responsibility regardless of the never-ending burden, and that he would never really improve. She had been told as much by a number of professionals by then. “The school is right,” she told me, “Jerry is unmanageable.”

Maybe you know kids like this. Tell him to go left, he goes right – often because you told him to go left. “Sit down and be quiet!” only seemed to provoke more animated refusals. “Time-outs” were, well, a waste of time because he simply wouldn’t comply. Punishment – the most overused and least effective of all techniques – got nowhere.

Rewards? Desperation, and continued failure, placed the professionals in his life in the unenviable position of rewarding Jerry for not doing something. This is common in schools and treatment facilities. Rewarding a child for not having a tantrum is counter to behavioral techniques and, mostly, another waste of time. Rewards are provided to start behaviors you want to encourage, not to stop behaviors you want to discourage. Thus, this approach was also ineffective, leading to an inevitable, irresponsible, and much too common assertion from nearly everyone: “we’ve tried everything, and nothing works!”

Getting him to school was hit and miss. Gloria did her best in the morning corralling him into the school van that showed up, often with the help of the van driver. Too often, both would yield to the tantrums. Consequently, Jerry missed a lot of school. Once he got there, it was no cakewalk. Jerry was famous. Everyone in the small school, including office staff, nurse, maintenance, all the teachers and aides, and every administrator in the building knew Jerry.

If sufficiently provoked, it was not uncommon for Jerry to throw objects, tip over chairs and anything else in his way, curse at the top of his lungs, and in other ways defy any and all directives from the adults in his life, sometimes to the point of physical restraint. He often did so with a sense of glee – and a grin on his face – that only served to irritate the adults in charge even more. He had the attention of everyone. They all greeted him the same way on those days when he did arrive at school. “Let’s have good day today, Jerry . . .” adding, with an apprehensive smile, “. . . okay?”

The Path to Horrible
Jerry barely knew his father. Gloria married when she was 28 years old, and she was pregnant a year later. Her husband left one day when Jerry was nearly two and never returned. Gloria and her young son were abandoned with no means, so she moved in with her mother. I’ll call her Eleanor. At the time, Eleanor lived in a nice home in Orange County, California. Gloria was Eleanor’s second child. She had an older daughter in Florida. Jerry was her only grandson. Eleanor was widowed a year before Jerry was born.

When she first moved into her mother’s home, everything was “okay,” so said Gloria. Jerry was mostly happy, and always active. He was alone most of the time and seemed to enjoy himself. There were no other family members in California. Gloria was a full-time bookkeeper for a department store, working 40 hours a week to support the family. Because her mother was home while Gloria worked, and because of financial considerations, Jerry never attended pre-school. He hadn’t had much interaction with other children his age until he started Kindergarten.

Real trouble didn’t start until Jerry entered school. By the time he was in the first grade, “he just refused to pay attention to his teacher,” said his mother. “He hated sitting still in the classroom,” adding, “I was constantly getting phone calls from school that he was becoming harder and harder to manage, and he was falling behind his classmates.”

By mid-semester, the school suggested a special class for Jerry. Gloria agreed. After the required school meeting that included his mother and the relevant professionals in his life, Jerry was officially declared to have a learning disability. Now six years old, his school career was getting off to a very rocky start.

Jerry was becoming harder to manage at home as well. By the time he was seven, he was a “terror” at home, according to his mom. Both mother and grandmother were frightened by his outbursts and did what they could to appease him. By then, raising Jerry had become a full-time job for Gloria and her mother. Speaking of jobs, Gloria told me she began to miss more and more work due to a series of crises involving Jerry and his school. As if not enough stress already for this family, Jerry was known in the neighborhood as the “wild child.” Neighbors kept their children away from him.

There were dozens of meetings, new plans were developed, and a string of professionals had come and gone. Results were poor. At some point, social services became involved. With encouragement from many, Gloria and Eleanor decided to move. Maybe, everyone reasoned, a fresh start in a different setting was in order. Eleanor found a tenant for her house in Orange County, and the family moved to an isolated home, in a small desert city, on the outskirts of Southern California. Social services transferred the case to the new county. By the middle of Jerry’s first semester in his new school, we received a referral to help this family remain together.

Time for Change
The family moved at the end of the school year. Gloria (Guardian/Inspector for the temperament trained) knew she had marketable skills. Gloria found a job before she moved. She was frugal, God-fearing, simply dressed and, in a word, dutiful.

They moved to one of a dozen or more small, isolated towns that make up the upper and lower deserts in Southern California. I asked Gloria why she picked this particular location. “I asked a friend at work,” she said. “I told her I wanted to stay close enough so I could visit Orange County, but far enough away so there aren’t many people – or neighbors. She told me about this place.”

She found a home the first weekend she and her mother, Eleanor, went looking. Eleanor (Guardian/Provider), a retired schoolteacher, was devoted to her daughter and her only grandson. In her mid-sixties, she had some health problems. She was ambulatory, though she was using her walker more and more. Eleanor would help as much as she could around the house, but the bulk of the home chores were done by Gloria.

In Jerry’s old neighborhood there were kids around. Though he was shunned by his peers, during the day there were the sounds of children on bicycles, on skateboards, and playing catch on his block in Orange County. Not here. They were isolated. Their first summer before school started didn’t go well. They were hoping they would find relief, and support once school started. They didn’t.

The Home
As director, it was my practice to meet new families that became part of our wraparound program. I called Gloria on the Friday we got the referral, and we set up a meeting the following Monday, one of her days off. I told her I’d like to meet with her alone first, so I scheduled a visit about 90 minutes before the school van dropped Jerry off at home. She said that would be a good idea, and added, “. . . though I can’t promise you he won’t be here anyway, if I can’t get him to go to school in the morning.”

In the middle of the one-acre parcel sat an older, well-maintained house. There was a chain link fence around the property. There were some large cacti on the perimeter, blocking the view. The rest of the property was natural desert land, except for a small garden area for Eleanor to grow some flowers and vegetables. In front of the garden, there was an open dirt area where Jerry sometimes played, alone, on his bicycle – and not much else. As I entered the home for the first time, I began to understand how desperate this family had become.

Directly in front of me, as I walked in the door, was the living room. There was a tattered loveseat on the opposite wall. That’s where Gloria went to sit down. To the left, with a small table and lamp in between, was a cushioned rocker where Eleanor was sitting and, next to her, a walker. There was a coffee table in front of them both. There was another small chair to the right of the love seat. That’s where I sat. It was Jerry’s chair. All the chairs faced the front door wall.

At the entryway, looking to my right, I saw a small television and TV stand, and three folded TV trays. On the adjacent wall there was a padlocked bedroom door (used for storage I found out later), and next to an old desk with a computer. Directly to the left of the desk, and on the same wall as the loveseat, was the door to the kitchen.

To the left of Eleanor’s walker was an open entryway to a step down, formal dining room. In it was a beautiful dark mahogany dining room set that included a long table, eight chairs, and two China cabinets. Everything was covered in heavy plastic. There were stacks of boxes on the furniture, and along the walls of the room. There was dust everywhere, as though no one ever went in there. No one did.

Still standing in the entryway, to my left and down a very short hallway was the door to Jerry’s room. His room had a single bed. The room was small, though adequate and clean, and minimally decorated. The window in his room was nailed shut. A little further down the hallway on the right was the door to the master bedroom. Mother and daughter shared the master bedroom with two single beds. At the end of the hallway was the bathroom Jerry used.

They managed to get Jerry to school the day I arrived. I introduced myself, and we began to talk. Within a few minutes, Eleanor started to cry. Here’s why.

The Hostages
Gloria made it nearly impossible for Jerry to go anywhere in the house without her or Eleanor knowing. There was a latch on the kitchen door, out of Jerry’s reach, that would be locked when he was home. They kept snacks like cookies and potato chips and fruit in the living room. There was a lock on the master bedroom door as well, except at night. There were boxes filling up the entryway to the dining room, making it very difficult to enter without raising the attention of mother and grandmother.

So, Jerry had access to the living room, his bedroom, his bathroom – and that’s it. At night, the front door had a deadbolt to keep everyone out and, added as soon as they moved in, a second deadbolt, at the top of the door, to keep Jerry in. He had snuck out in the middle the night many times over the years.

Mother and grandmother kept the door to their bedroom open and unlocked at night so they could hear. Still, they put two chairs in front of the door to act as a barrier, “. . . in case Jerry got up in the middle of the night,”said Gloria, “demanding something.” The door to his bathroom was unlocked and accessible. There were no items or decorations on the floor, on the walls, or on the counter, except for a toothbrush and toothpaste.

In the next 90 minutes, they told me much more about their plight over the past several years. Jerry would become belligerent and explosive, according to both of them. He would throw items in the home, sometimes at his mother and grandmother. Appeasement and capitulation were their remaining child management tools. They would do nearly anything to avoid an outburst. All of them – Jerry, mother, grandmother – were captives in their own home.

Gloria loved her son, and Eleanor loved her only grandson, dearly. Yet, reluctantly, they both acknowledged maybe Jerry would be better off somewhere else “where they can take better care of him.”

“Can you help us?,” Eleanor asked, nearly without hope.

“Yes,” I answered, “we can.”

Just about then, we heard the van driving up the gravel road to drop Jerry off at home. Mother and grandmother began to apologize for Jerry’s behavior, before he entered the house.  Good, I thought to myself, time to meet this horrible kid.

Heeeere’s Jerry!!
Gloria got up, went to the door, and walked out to the van. “I’m praying he’ll be good, Dr. Cima,” she grimaced, “but I can’t guarantee it.” Gramma Eleanor began to cry, again.

Before Jerry arrived, Gloria said they never knew what to expect when Jerry came home. Sometimes he’d have a smile on his face, other times his face would be beet red from anger. He might ask for an apple or toss his backpack at his mother. It was common for Jerry to be the only child in the school van, “for safety reasons.”Good days or bad, whether alone or with other kids, there was an extra staff member assigned to sit next to him, to and from school.

We decided it would be a good idea for me to meet with Jerry alone so, as planned, I followed Gloria outside. I met the teacher’s aide, and escort, John.

John told Gloria that Jerry had a mixed day. He said Jerry was “good in the morning, but he became very agitated in the afternoon, so we had him in a time-out. Time-out meant he was taken from the classroom, and a staff member was assigned to supervise him in a separate and isolated room. No teaching occurred. It was supervision only, so Jerry wouldn’t disrupt the classroom. John was twenty-something, very nice, liked his job, kids liked him, and very poorly trained in child management methods.

Jerry was a normal sized 9-year-old, maybe a bit smaller than most, but not by much. He was slender and he looked in good health. He had light brown hair, he was fair skinned, and he was dressed nicely by his mother. However, on this day, his clothes were disheveled, as though he had been wrestling. I learned later, while being escorted out of the classroom to his time out, Jerry had to be restrained by John and another aide at school.

In her most cautious voice, as though she was trying to avoid an outburst, mother started to introduce me to Jerry. I interrupted, just a little, as I smiled at Jerry. I learned during my conversation with Gloria and her mother he liked baseball.

“Hi Jerry,” I said, “I’m Dr. Cima. Wanna play catch?”

“Yeah!,” he answered.

He dropped his backpack, ran to his room, got a ball, and came back outside – with a good-looking grin on his face. For the next 15 minutes or so, we played catch, and we were having some fun. He wasn’t very good at playing catch, as though he hadn’t had much practice. He was going to get some, we both found out. From then on, whenever I came to his house, he wouldn’t talk with me until we played catch, for about 15 minutes or so. It was our routine, and a small price to pay, having some fun with this fun-loving young Artisan (for the temperament trained). He was proud as his skills improved, and that, more than everything else, was the most necessary by-product of playing catch. By the way, when you can, it’s a good idea to meet a child for the first time when he’s at his best, not his worst. How does he behave when he’s happy? What does she like to do? What energizes him? What attracts her interest? Besides, I knew all about Jerry at his worst, as attested to by his mother, grandmother, school counselor and county social worker.

Jerry and I had a short conversation, mostly about things he liked to do, nothing about things he didn’t like to do. He was wary. I was just another adult in his life, probably there to “boss me around, like everyone else.” It’s worth pointing out, Jerry was socially aware. That is, he could read adults very well. He knew how to provoke, or charm, as required.

He told me he liked to play, that was clear, and he told me he liked to draw. I learned from mother he did a lot of drawing in his room using pencils from a set she bought him. I saw a few of his drawings. They were very colorful, some were well done, for a promising artist. If there was a theme to his drawings, I didn’t see one. There were pictures of animals, cactus, and unnamed people. No particular emotion jumped out at me either. These were mostly drawings of his surroundings. He didn’t keep many, and not many people had seen them.

About 45 minutes or so passed and I declared to myself Jerry was perfectly normal. He was, of course. At his best, he was cute, he was happy, and he was fun. To be sure, he was driving adults crazy, and they were ready to restrict his movements at a moment’s notice. Still others were clamoring to give him some sort of medicine, also intended to restrict his movements, and to finally, once and for all, get him to “PAY ATTENTION!!”

Our Approach
If you were expecting this to be about how we changed or fixed Jerry, well, you may be surprised, though I hope not. He didn’t need changing or fixing and, from a temperament perspective, that’s not even possible. Instead, as you will see, we helped adults change their behavior, and Jerry’s followed. This is always true, and usually denied, by adults, especially professional adults.

I was confident we could help mother and grandmother. They had lost control of their child some years before, for reasons that really don’t matter. I knew mother and grandmother felt defeated. However, I also knew they wanted Jerry to remain at home, despite their doubts. Please remember, as a wraparound program, our mission was to keep the family whole. With a few child management techniques, and some modeling by our team, mother and grandmother would be back in control sooner than they thought.

My major concern was school. I had a scheduled meeting the next day with Jerry’s teacher, and others. I was sure with time, persistence, and some good work by our team, we could get Jerry to school in the morning, every day, with a smile on his face. I wasn’t sure, however, without interactive changes by the school, how long the smile would last once we did. Most important, unless the adults change in both locations, in the long run, not much will improve.

The School
I brought our counselor, Angela, with me. The two of us met, after school hours, with Jerry’s teacher, two teacher’s aides from his classroom, the school psychologist, and the Principal. Wraparound was a new California statewide service in 1999, it was court ordered, and most professionals were supportive. When I asked for a general meeting with everyone, they readily agreed. They needed, and wanted, help too, so I knew we would have willing participants, at least in the beginning. The trick is to encourage the participants to become our partners in this endeavor.

For the temperament-tuned, Angela was a Champion Idealist, and her enthusiasm alone was enough to give everyone a much-needed positive boost. Angela was smart, she was an experienced trainer in child management, kids liked her, and so did everyone else. Her relationship with school personnel was going to be key to creating the changes that needed to occur.

The school reported, as determined by his Individual Education Plan (IEP), Jerry needed an abundance of one-on-one time. They assigned staff members to bring him to school and to take him home. Others were there at breaks, recess, and lunch. His demeanor went, seemingly, from flat to fiery in a matter of moments. They used a token economy in the classroom to provide motivation and behavioral guidance. They also relied on Zero Tolerance as their discipline program. None of this seemed to help. Without hesitation, the Principal, teacher, and aides all agreed Jerry was their most difficult challenge of all their students.

The school psychologist also reminded Angela and me of his professional assessment. He stated Jerry “is obviously ADHD.” He said he would like to refer Jerry to a psychiatrist and that “mother is not cooperating.” In private, those words rankle me to my core. Parents are routinely chastised, increasingly often, for not giving permission to a doctor to give their child an amphetamine, for a disease that doesn’t exist. Nevertheless, in this meeting, I listened. I wasn’t there to debate the school psychologist.

Instead, we told everyone we’d be developing a plan and we’d like to collaborate with the teacher and aides. We all agreed we could all help Jerry’s mother reach her goals. We also decided at this first team meeting we were going to delay other recommendations, including psychiatric. It’s important to get everyone on board. They were skeptical, and they were expecting us to change Jerry. Nevertheless, we had their commitment, and that’s all we wanted to accomplish at our initial meeting.

Now, it was our turn. Angela and I needed to gather our team at the office. We needed to put together the plan.

The Plan
Angela and I began to talk about a plan on the way back to the office. Two things were evident.

First, there was an ongoing crisis at home. Gloria changed jobs, moved her family from their long-time home in Orange County, leaving security and friendships behind. Gloria and her mother Eleanor were hopeful and optimistic a new start, in a new school, in a new neighborhood, would reap new behaviors. Instead, now isolated and desperate, the family was disintegrating.

Second, unless we intervened, quickly, in a beneficial way, the county social worker was leaning towards removing Jerry from his home and placing him in foster care “to make sure he received treatment.” That would, I knew, inevitably lead to Jerry being medicated with one or more of those toxic chemicals. And that, in my view, was intolerable.

It was also evident the school was out of ideas. The school psychologist told me “Jerry has not improved over the last three months despite our concentrated efforts.” He followed with, “and his behavior just seems to be getting worse and worse.” This type of logic makes me wince. Schools, treatment facilities, and other places where children are gathered to learn, to be trained, or to be helped are quick to take credit for a child’s success by touting the elements of their evidence-based program.  When no learning or training or help occurs, they are just as quick to shift responsibility to the child due to her learning disability or psychiatric disorder, or some other mythical deficiency.

There was going to be two parts to the plan. Part I: Get Jerry to school. Part II: Make school a good experience so he wants to be there. I was confident about Part I. After all, he was nine years old. To be sure, mother and grandmother were engaging in some very common mistakes when managing Jerry. With coaching and some very intense initial support by our team, I knew it wouldn’t take long for mother to be back in control of her son.

I was less confident about Part II. The school, the principal proudly told me, was a Zero Tolerance campus. This is when a school decides they will model intolerance to their students and their families and claim this as a virtue. This failed model of control-first is designed to fortify adults, at the expense of the children they supervise. Principals, some with a dab of zealotry, can become very hard to manage when armed with Zero Tolerance.

Team Meeting
As a reminder, we received this referral on a Friday morning. I visited the family the following Monday. Angela and I met with the school on Tuesday. The next day was our regularly scheduled Wednesday staff meeting. Our team included therapist Jordan, MHRS Vincent, Angela, and me. We formally had three services we could provide: therapy, social work, and counseling. Less formally, as a wraparound program, I knew we could do anything we needed to do to help this family, and that gave us great latitude. Here’s what we decided that Wednesday morning.

PART I
a. Starting today, enroll mother and grandmother in our Family Night every Wednesday.

We started Family Night six months earlier. We had about four or five families that showed up every Wednesday at 5:00 PM. We provided transportation as needed. Once there, we had coffee and nourishments for the adults, and we talked about the past week. We interacted for about 90 minutes, 30 of those minutes used for child management training. As important, the parents got to know each other and, as they shared many common stories, they supported one another. Jordan and I provided guidance for this part the support group. We encouraged the parents to bring their kids. Angela and Vincent, and other staff as necessary, kept the kids active and engaged.

So, right after our morning staff meeting, I called Gloria to invite her to Family Night that night. Though it was short notice, I was sure if we made it easy, she would jump at the chance. She did. I told her Angela would pick up the three of them by 4:00 PM, and we would have them back home no later than 7:00 PM. This was also going to be a great chance for Angela to meet Jerry. The two of them were going to end up spending a lot of time together. As important, it was a priority to get everyone out of that house for a little while, every week. They had been trapped for too long. Over the next several months, they never missed Family Night.

b. Beginning on Monday, one of us on the team would arrive at Gloria’s home by 6:30 AM to help get Jerry out of bed, dressed, fed, out the door, into the van, and off to school.

We committed to do this every day until it was no longer necessary for one of us to be there. This was key. Everyone’s day in the household began with turmoil. Every night each of them went to bed, unhappy, dreading the inevitable morning encounter. That had to stop. So, our plan was to take turns, each of us doing a week at a time. We had other cases we were working so our schedules had to adjust. Since we were going to have Angela spend a lot of time at school, Vincent took the first week, Jordan the second week, and I had week three. We intended to do this between the three of us for as long as it took to get Jerry into school every day, without incident.

Who is “Out of Control?”[iii]
Parents and professionals make similar mistakes when trying to get back in control of recalcitrant children. The most common mistake? Arguments. Once you acquiesce and engage in a “yes you will – no I won’t!” and similar conversations, whether with a 3-year-old or with a 17-year-old – while in the middle of giving a directive – the ending is nearly always unpleasant. Most often, these kinds of confrontations don’t really end at all. If you’re in an argument, it means there’s a negotiation taking place, something you did not intend. By the way, children love to negotiate, for as long as you are willing and then some, especially when it comes to privileges, as well as school, chores, and other unpleasant endeavors they want to avoid.

However, when arguing occurs daily for even the most minor directives, over time everyone’s emotions are unsettled, and everyone’s moods can, and do, adjust from moment to moment as negotiations continue. Arguments often deteriorate and may include a variety of invectives, and other hurtful words. For parents – especially conscientious parents – frustration mounts.

On the other hand, for children, especially bright children, an argument can be ignited – and fueled – simply by ignoring you, imploring you, delaying you, faulting you, or in other ways letting you know they will prevail in an argument you never intended to have in the first place. Inevitably, these types of two-way conversations lead to the second most common mistake well-informed, loving parents and professionals unwittingly engage in: threats.

A threat sound like this: “If you don’t get your butt off the chair right now take out the trash then . . . ,” followed by something you’re going to take away from him, whether a privilege, a possession, a level of freedom, or some other form of punishment. Giving “If . . . then!” directives unwittingly give control of the outcome of the argument to the child, perhaps the most unintended of all consequences. (For a real example see ENDNOTE[iv].)

So, after first-hand experience in her home, we knew we had to help Gloria avoid arguments and threats, however subtle and habitual they were. Much more important, we gave her new tools to handle those escalating conversations. Over the next few weeks, we were there every morning to model these techniques.[v]

PART II
Beginning on Monday, Angela would be at school every day to assist Jerry in the classroom.

I called the principal in the afternoon and met with her the next day. While the classroom teacher may appreciate the help, school districts have rules to follow, with formal protocols for nearly everything. Adding a new person to the classroom would take some doing. Fortunately, I had a good relationship with Jerry’s school principal, and she was an advocate of our new wraparound program. It took an extra week before we could go into the classroom, but it was worth the wait. Now we had the support of the court, the county social worker, the principal, as well as the classroom teacher and her aides. Our full team was in place.

Angela showed up at school every morning at 10 AM. The classroom teacher was relieved. She knew she had extra help every day, just for Jerry, so Jerry became less of a management concern. She had Jerry’s schoolwork for that day prepared ahead of time. The other two classroom aides, who usually spent a good portion for their day grudgingly arguing, threatening, cajoling and in other ways, managing Jerry, had other children to attend to, and looked forward to handing Jerry over to Angela at 10 AM. Jerry, as much as anyone, looked forward to his time with Angela too.

Angela stayed until 1 PM every day. We thought it was a good idea to be there through lunch. Jerry was eating lunch with one of the aides who was assigned to him, in a separate room, because he was so disruptive. That changed immediately. Angela and Jerry sat together in the cafeteria with the other kids and adults for lunch. Within a few days, she organized some games during lunch for a few of the kids, Jerry joining in.

There’s often a honeymoon period when new elements are brought into relationships. Jerry had less apprehension about school, and so did the school staff. We altered the obvious yet unaware behavioral patterns of the adults in Jerry’s life that were exacerbating the otherwise normal behaviors of this 9-year-old young Artisan. We also knew we had to take advantage of the honeymoon period. They usually don’t last too long without fundamental changes taking place.

One more thing, before I tell you about our results. When Family Night was over that evening, I told Jerry I would come by on Friday so we could play catch. He grinned. When I got there on Friday, as I was leaving I told him I would see him again on Monday after school. He grinned again. For the first week, I showed up every day after school at 3 PM, except Wednesday when the entire family came to the office. I stayed for about an hour. We played catch, we talked about the day, I checked in with mother and grandmother, and I left. The second week I showed up on Monday and Friday and, by the third week, I showed up Friday only – and every Friday after that, for the next 3 months.

Results at Home
I mentioned earlier I had the third week to get Jerry out of bed and off to school. By then our team had met several times. Both Jordan and Vincent, though different in their approaches and temperaments, were successful. By the second or third day of their week, each of them was tested. Jerry didn’t want to go to school on those days, and he made sure he let everyone know, in his own inimitable way. So, with Jordan and Vincent equipped with patience, technique, and an undying persistence, Jerry got to school anyway. Both Jordan and Vincent had one day, and two days, respectively, when they had to drive Jerry to school because he didn’t get in the van on time. Nonetheless, he arrived at school. Persistence, training, and a conviction to avoid arguments and threats, paid off.

Now it was my turn. Keep in mind, I had spent a lot of time with Jerry. He liked me, and he trusted me, little by little. The first day, Monday, was a good day. I got there at 6:30 AM. He knew I was coming. He was up already, and he was cooperative, though a few times I had to give some reminders. Still, I got him off to school. (I forgot to mention our team took over in the morning. We gave the directives to Jerry, and we were responsible to get him off to school. There were no confrontations between Jerry and his mother while we were there, and that was a good thing.)

By the second day, not nearly so easy. Jerry woke up in what his mother always called “a foul mood,” and he didn’t want to go to school that day. So, like Jordan and Vincent, I stuck with our techniques, and I was persistent. On my third day, Jerry declined to get up, period. He was in full-blown refusal mode. Still, he got into the van on time. Please remember, he also knew by then Angela would be at school by 10 AM. That made a difference.

By the way, what do you think we did? You’d be right to think we followed after him, sometimes around his room. On his worst days, we would corral him, verbally, and, avoiding arguments and threats, continue – like a broken record – to insist he get out of bed, in his clothes, fed, and off to school, even if that meant we would drive him there.

I mentioned earlier Gloria had Mondays off. On a hunch, I checked with the school. Jerry never missed school on a Monday. Other days were hit and miss, Friday the most common missed day, but not Monday. Not even once. She could get him there on Monday, and not without a lot of turmoil. Still, she got him there.

If you play a slot machine and it pays off every once in a while, you keep playing. If your slot machine neverpaid off, you’d stop playing. Jerry figured out some days his antics “paid off,” so he kept playing. It’s worth repeating: whatever those antics were – and they were energetic – they didn’t work on Mondays.

On my fourth day, I arrived on time as usual. By then, Jerry had more or less succumbed to the idea he was going to school. He didn’t make it easy. He was also persistent in his “techniques” to avoid school. However, there was an inevitability that seemed to finally win the day – as it always eventually does. After a few minor contentious moments in the next 90 minutes, Jerry got in the van and left for school. That’s when Gloria asked to talk to me.

“Dr. Cima,” she said, “you don’t have to come tomorrow. And you don’t have to send anyone else next week either. I can handle this myself,” she said, a little sheepishly, I noticed.

We honored her request, though I suggested one of us come by at 8 AM starting the following week, just to see how she was doing. She thought that was a good idea, so we did. The next week we showed up as promised, this time at 8 AM. The week was not without incident. Mother had one or two hard days. However, we never had to intervene, nor did we have to transport Jerry to school. He got in the van every day. It was getting easier for everyone. So was school.

Results at school
As expected, Angela provided much needed enthusiasm and fresh energy in a negative environment. Jerry was no longer a target. He couldn’t be. Once he got to school, he only had to make it to 10 AM, and he knew Angela would show up. Once she showed up, he got her complete attention. That eased the pressure on the entire classroom, kids and adults.  In addition to his lessons, Angela had him drawing every day. He got better and better at something he was already doing. Most important, he began to receive acknowledgement from his teacher, aides, and classmates. The teacher, with Angela’s urging, announced she was going to have an art contest. Jerry won. Whether he deserved to win or not, he won. There was much less to frown about at school – for everyone.

He was befriended by two boys in class who started to eat with him at lunch. This took some time to develop. Jerry hadn’t had any real friends, well, ever. He was the problem child in school and his neighborhood nearly from the beginning of his school life. Other kids shied away, Jerry’s behavior so unpredictable, and adult responses so intense. Angela spent a lot of time helping him nurture his newfound friendships.

By week five, Angela showed up 3 days a week. The following week, twice. By the beginning of the third month, she met with Jerry, and his teacher, once a week until the end of the school year. By then, it was a lunch date, as Angela arrived in time to have lunch with the two of them in the cafeteria. Was he still, at times, hard to manage? Of course. He was still a nine-year-old. However, by then, he was no worse or better than anyone else in class. We had regularly scheduled weekly meetings with the team at school, and that included Gloria. Once a month the county social worker joined us. Progress was undeniable. Crisis avoided.

What about “Therapy?”
There was no time for therapy when we started. More important, therapy has nothing to do with child management. Unless they receive training, therapists haven’t a clue how to manage children, nor should they. Child management is not taught in graduate school. Level systems or point systems or other forms of behavior modification can be useful to start new behaviors, when used and designed for an individual child, and not a group of children. To the degree “b-mod” is used to stop unwanted behaviors or as a discipline tool, they continually fail.

Nonetheless, Jordan was a gifted therapist. She made it a point to spend private times with all our parents on Family Night. She had a good relationship with Gloria. After the crisis was averted, Jordan began to spend more private time with Gloria because, as she told me, “now she can talk about other things in her life besides Jerry.” As you may guess, Gloria had a lot to talk about with our therapist. Jordan began to meet with Gloria every other week for an hour or so, just to talk. By then, Gloria started to get a grin too.

Luck Happens!
Vincent, our Mental Health Resource Specialist, was very, very resourceful. By the second month, he began to search for a Big Brother and, after interviewing a few candidates, he selected Domenic, a 25-year-old graduate school student. Domenic was single, stable, lived close, liked kids, and he was a great model for this long time fatherless – and friendless – child. Domenic was the perfect medicine. Looking back, I think this may have been the most important addition to this family. Our wraparound team was gradually withdrawing our involvement, as we inevitably needed to do. Domenic took to Jerry immediately, and vice versa. He saw Jerry at least twice a week, and usually for a half day every weekend. They went places and they did things. That’s all that was needed.

A Few Final Thoughts
Yes, dear reader, it took this much initial effort to avoid a catastrophe that had been brewing for several years. By the time we were involved, everyone was overwhelmed. The school knew all about Jerry long before he arrived. The prior school sent all of Jerry’s incident reports along with his academic shortcomings to the new school. The psychologist told me they knew they were getting “a firecracker!” Reputations matter. It was as if he had a giant X on his back from the first day.

By the way, do you remember John, one of the teacher’s aides in Jerry’s class who was also the transport driver in the van? I told you he was likable, and very poorly trained. Well, since he was there every morning with us, everyone on our staff got to know him. Six months later, he applied for a job in our expanding program, and we hired him. Also, the teacher became good friends with Angela and, with her urging, convinced the principal to have us come in and do some child management training for the school. We did, once a month, for the rest of the school year.

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Originally Published:  BESTTHINKING.COM – February 2014

Re-Published: YOUR KIDS AREN’T SICK – October 2018
https://doctorcima.com/2018/10/25/the-horrible-kid/

 

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ENDNOTES

[i] California Wraparound Program: https://www.cdss.ca.gov/inforesources/cdss-programs/foster-care/wraparound

[ii] In the Mental Health System in California, an MHRS is the equivalent of a Social Worker

[iii] See BACK IN CONTROL by Gregory Bodenhammer. Excellent resource for parents:  https://www.amazon.com/Back-Control-Gregory-Bodenhamer/dp/067176165X

[iv] After 10 minutes of arguing, a mother tells her 16-year-old daughter, in no uncertain terms: “If you don’t get your room clean, I’ll take your cell phone!!” Her daughter quickly replies, with a sense of confidence mother doesn’t appreciate: “I don’t give a crap about my cell phone!,” and throws it at her mother as she does. Mom has been trumped. Now she’s stuck with her meaningless threat, a still unclean bedroom, and a phone she didn’t really want. Worse, there’s nothing she can do about it because, inadvertently, she gave her daughter a choice. Either clean your room or lose her phone. She made her choice, something else mother didn’t intend. She can expect more of the same tomorrow. Why? This kind of exchange “works” for her daughter.

Threats, in the middle of an argument, can become an exciting challenge for some kids, young and old. They either call your bluff, or they let you know they are willing to experience whatever punishment you can dish up, rather than clean that room. Children are famous for biting off their own nose. Some seem to cherish it. They think as long as you lose, they win. That’s why we call them children. And that’s why we should never argue or threaten, when giving directives to children. Ever.

[v] The techniques we trained on are taken from Active Response Training (ART 21), my own creation. This was required training. Incorporated into ART 21 are a dozen effective proactive and reactive strategies.

Goth Girl

Goth Girl is about a 14 year old who was lost, self-abusive, and hearing voices. Medical doctors were forcing her to take chemicals for her “psychosis.” Placed in a mental health facility for “crazy kids,”  Evie lost her feelings along the way.  You already may know, that can be a terrible feeling.

ORIGINALLY PUBLISHED @ BESTTHINKING.COM – JUNE 2013

If we want a child to change his direction, we must understand what makes him move.   –  Rudolf Dreikers, M.D.

Part I: Meet Evie
I’ll call her Evie.  That’s not her real name, but her real name was just as pretty.  It’s best to honor her privacy, as a professional and as a fellow human being.  After all, this is her story, not mine.

Evie was 14 when I met her.  Six months earlier, she was involuntarily placed in an emergency mental health hospital (called a “5150” in California) for her “psychosis.” She was given chemicals almost immediately and, after the legally required 72-hour hold, she was declared medically fit to go back home.

About two months later another 5150 occurred.  This time, they gave her a new batch of chemicals (see Evie’s Chemical Cocktail above) and upon release 72 hours later, she was placed, without her consent, in a residential mental health facility for teenagers.  About four months later, I was brought in by the same agency as a consultant.  I was there to train and supervise the therapeutic staff, and to train the child-care staff.  For reasons you will see, I became Evie’s therapist.  She was my only client.

Evie was “hearing voices,” according to the notes I read from her prior therapist.  As I found out later, it was one voice.  Evie had a friend who would talk to her once in a while, especially when she was alone and when her emotions were in turmoil.  I’ll call him Vlad.  “Vlad is my friend, Dr.  Cima,” she once told me.  She wasn’t frightened.  Vlad “spoke” to her at times, and she wrote to him.

Temperament: Sphere
For those trained in Keirseyan temperament theory, Evie is a Sphere – a young Idealist.  That makes her rare (about one in twenty), and very hard to spot, especially in residential settings.  Young spheres tend to blend in and take on the characteristics of Stars (young Artisans) or Squares (young Guardians), though, for reasons I’ll talk about later, they rarely, if ever, take on the characteristics of Cubes (young Rationals).

However, when Spheres are alone with someone they trust, their vivid metaphorical imagery quickly exposes their identity to an observant adult.  We all use our imagination to some degree, now and again.  However, Spheres stand alone in their ability to express their life experiences with metaphorical language.  Little wonder why so many writers and poets are Spheres.  (A few famous adult Sphere/Idealists: Emily Dickinson, Pearl Buck, Charles Dickens, James Joyce, Leo Tolstoy, Upton Sinclair, Oliver Stone, Paul Robeson, Joan Baez – and Plato.)

Goth
Evie was “Goth.” Goth – from gothic – is one of those adolescent subcultures found in every generation.  “Hippies,” “Hip-hops,” “Emos,” “Grunges” – and don’t forget the “beatniks” of the 1950’s” – are just a few adolescent subcultures.  The more shocking and defiant the subculture, the more it brings out the worst in adults intent on “dealing with it.” Unwittingly, by “dealing with it” adults fortify one of the reasons kids join these subcultures – to gleefully irritate and annoy their supervisors.  Another reason?  Goth culture offers comforting refuge for some unhappy kids struggling to find their lost identity, especially true for Spheres.

Goth is often described as “somber, macabre, and glamorous.”  You can throw in a touch of romance too.  Black is the color of choice for the Goth crowd, and you could always find it in Evie’s lipstick, eye makeup, nail polish, and clothes – down to her black socks and black shoes.  Evie always wore something in her dyed black hair too, usually flowers, often a black flower.  Evie liked flowers.

She was introduced to Goth when she was twelve.  She told me she fit in almost immediately.  She started to read Gothic novels.  A combination of horror and romance, famous Gothic literature includes novels like the Headless Horseman, The Legend of Sleepy Hollow, and The Adventures of Ichabod and Mr. Toad.  Modern movie renditions include Edward Scissorhands, Beetlejuice and Batman.  (You can read more about the Goth subculture here.)

Something Else You Should Know
Evie was a “cutter.”  Cutting is a form of self-mutilation.  It occurs when a child takes sharp objects like razors, knives, or even pieces of glass and cut themselves, usually in secret.  It’s mostly done on the underside of the forearm, on the tops of thighs, but anywhere on the body is possible.  When it occurs in residential settings, it can be “contagious.”  Children vying for the attention of adults notice that “cutters” get a lot of attention.  Like no other child at this 40-bed facility, Evie had the attention of everyone, and everyone was worried.  She was an “active cutter.”  (Nearly all long term “cutters,” in my experience, are Spheres.)

Also, as if there wasn’t enough turmoil in her life, for reasons unrelated to this story, her assigned therapist abruptly left the organization the Friday before I started, without a goodbye.  Evie lost her only confidant, and she was devastated.  When I arrived the following Monday morning, a number of staff members let me know Evie had an emotional, “cutting” weekend.  I decided to be her therapist.

Summing up
Evie was emotionally turbulent.  Her family had deteriorated, and so had Evie.  She drifted into the Goth subculture a few years earlier.  She was talking to a voice in her head, and she was cutting on herself almost daily.  Four months earlier, she was removed from home and placed in a facility that was, as she would say over and over – “a place for crazy kids” – and she just lost her therapist, the one person she could trust.

The worst of this? The medical profession declared Evie “mentally ill” and gave her chemicals because she was “psychotic” and she was depressed.  Good thing I’ve seen this hundreds of times in my career or I would have been depressed too – and maybe a little “psychotic.”

Part II: The Story
Unlike most therapists in society who meet with their clients once a week in an office, in residential settings, the kids live and the staff work at a self-contained campus.  Bedrooms, classrooms, and therapist rooms are usually within short walking distance of each other.

That means, if you’re a therapist, it’s not unusual to have lunch with one of the teenagers, or to meet with her teacher, or to take a walk and have a private conversation – in addition to a more formal one-hour session in the office.  In fact, it was my job to make sure therapists didn’t linger in their offices too much.  “If you want to know how your kids are doing,” I would tell them, “go see them where they live.” So, I spent some time where Evie lived.

I began to see Evie, formally, once a week.  Our first meeting was cordial.  My job was to develop a trusting relationship, and Evie was rightfully cautious.  As I had lectured my staff ad nauseam over the years, the adult is responsible to earn the child’s trust, not the reverse.  I talked to her about things she liked.  She said she liked to write.  I asked what she wrote about, and if she would share them with me.  “Oh no Dr.  Cima,” she said, “I’d be way too embarrassed!”  I told her I understood and maybe she would share with me some day.  We talked about her life a little bit.  She told me she loved her mother very much, though she had many “acting out” episodes when she lived with her mom, especially in the last year or two.

I also learned Evie had sporadic, unpredictable contact with her stepfather.  He married Evie’s mother when she was three, and he was the only father she ever knew.  Her parents divorced a year earlier and were more or less estranged for at least two years before the divorce was final.  Evie’s stepfather had a girlfriend, and her mother was not dating.

Meet Pamela and Tom
I contacted Evie’s mother after my first talk with her.  I’ll call her Pamela.  Pamela lived by herself in her home about an hour from the facility.  She worked long hours in a responsible position.  I asked her if she was able to meet with me, she said of course, and we met the following Monday.

Over the next several months, I routinely met with Pamela at the facility.  The two of us would have a conversation, and then we would bring in Evie.  Pamela needed her own private time too.  A good mother, she was confidently independent.  She had a good enough paying job that she could afford to pay her bills and take care of her daughter even if her ex-husband didn’t contribute, which was often.  (For the temperament trained reader, Pamela is a Protector Guardian.)

Sometimes, though, she was overwhelmed with self-recrimination about how all this happened, about what happens next, how the ex-husband’s girlfriend “didn’t help,” that she had no interest in dating, how she is responsible for all of Evie’s troubles, how her ex-husband is responsible for all of Evie’s troubles, and everything else that occurs when couples, with children, divorce.  It’s important to keep in mind divorce is a process, not a date on the calendar, and it inevitably involves unavoidable upset for everyone involved.  Evie was Pamela’s only child, and they were always very close.

Evie’s stepfather – let’s call him Tom – was a blue-collar worker (from Pamela’s portrayal, probably a Promoter Artisan).  I never met him, though we did have one conversation over the phone.  From what Pamela told me, over the past three years, Tom has been less and less involved in Evie’s life, missing gifts for birthdays and Christmas, and often not showing up for scheduled visits.  Still, Evie wanted to see her dad.

In my one conversation with Tom, I told him he would have to make appointments to see Evie with me, and that I wouldn’t tell Evie about this until he showed up.  In the next six months, Tom called my office on two different occasions to arrange a visit with Evie.  He didn’t show up either time.  I emailed him a few times and I left a few voice messages.  I offered to go to his house to meet with him.  He never responded.  It was a choice he made.  This also meant Evie didn’t hear from him during this time either.  Evie let me know her feelings about this through her ongoing conversation with Vlad.

Making Progress
By the third or fourth time I met with Evie alone I asked again to read some of her stories.  I could tell she was glad that I remembered to ask a second time.  This time she said “okay,” with an apprehensive smile.  She gave me her well-worn spiral binder and she asked me if I could read it right away.  I told her I would.

I’ve read many stories and many poems from children in foster care over the years.  Anger is a common theme, as is fear, and so is freedom.  Despair is almost always part of them.  For many kids in foster care, futures can be dim.  Evie’s was different.  It really wasn’t a story.

When I first began to read her words, I couldn’t make heads or tails of what she was saying.  Her spelling was okay and her grammar was about the same.  She capitalized the first letter of every sentence, every sentence ended in a period, and each sentence made sense.  There were no questions marks, no exclamation marks, no quotation marks – just periods.  After a while, when I read the sentence “Where are you going Vlad,” I finally got it.

Imagine reading a novel, and the person who wrote it deleted everything in the novel except the dialogue.  There was no introduction, no building of the scene, no sense of when or where this was taking place, or even who was talking.  Instead, the first sentence of the story started in the middle of a conversation between two people, neither of them identified, one sentence after another.  I finally realized Evie wasn’t writing a story for someone to read.  She was writing down the conversation she was having with Vlad, like dictation.

What was the conversation about?  Well, for lack of a better description, it was about a “fair maiden in distress,” who was receiving advice by a loving friend named Vlad.  Vlad was heroic, sometimes dark (he spoke of werewolves and may have been one himself according to Evie).  Vlad loved the maiden in the conversation, Evie once told me, “just as a friend, Dr.  Cima.”  Nothing sexual about this relationship, at least in her written and spoken words, and Evie wanted me to know that.

Part III: An act of chivalry
When the three of us were in session – Evie, her mom, and me – I would read aloud the most recent additions to her conversation.  By now, she always wanted to hear what I had to say, and that was good.  She spoke of her many troubles, and Vlad comforted her with sound advice and concern.

I should tell you I already had a few private conversations with Evie’s mom about this.  Pamela told me Evie always had a vivid imagination.  She had “friends” she would talk to when she was a toddler, as many kids do.  Like most kids, she grew out of it by the time she started school.  Pamela never thought it was a problem.  She thought it was normal for some kids.  It is, of course, for all kids, with spheres by far the most adept at using their imaginings to tell stories about their life experiences.

Vlad arrived right around the time their marriage was “falling apart,” Pamela told me.  As she entered her teens, Evie was becoming increasingly alone, questioning everything her mother did or should have done.  She was becoming desperate as her father receded from her world.  She was angry, hurt, and isolated.

Once, while I read her story for the three of us, the fair maiden (the girl in the story didn’t have a name other than “maiden”) said to Vlad, “Thank you for your chivalry my friend.”  I smiled.  What could this sad and frightened little 14-year-old Goth girl from Southern California know about chivalry, I said to myself.  So, I asked her.  Before she could answer, Pamela interrupted, beaming, and proudly said, “She knows what it means too!”

“Really?” I said.  “What does chivalry mean, Evie?”

“Dr.  Cima!” She was a little angry.  “I know what chivalry means! It means that when a fair maiden is about to step into a puddle of water, the gentleman is supposed to take off his coat and lay it on the ground so she won’t get her feet wet,” she said grinning, with as much pride as her mother.  It was a good moment for all three of us.  From that time forward, we changed her story of desperation into her search for inspiration.

About That Voice-In-Her-Head
One day, sometime in the second month or so that I knew her, Evie asked me, causally, “Dr.  Cima, do you think I’m crazy?”  It was, I think, a question to test my answer more than anything else.  She had her fill of answers by then.

Her doctor told her, and her mother, she had “schizoaffective disorder” and something called “major depressive disorder,” and that she needed a chemical to make her better.  Her therapist told her she was “substituting Vlad for her father,” though she had a “psychiatric disease” too.  Her social worker told her she sent her to this facility for her “mental illness.” A few counselors, frustrated because she wasn’t improving, told her she was “psychotic.” The other kids at the facility? They told her she was a “wing-nut,” and other similar terms, as you can imagine.  All of this convinced Evie this really was “a place for crazy kids.”  I answered her question.

“No Evie,” I said, “I don’t think you’re crazy.”

“Ok, Dr.  Cima,” she replied, almost as a challenge, “then where does Vlad come from?”

I shrugged and said “I think it’s just you talking to you.  What do you think Evie?”

“Yeah,” she said with a sly grin, “it’s just me talking to me.”

That seemed to help.  After all, that’s what it is.  We should remember, parents and professionals alike, there really isn’t another person talking, and the voice isn’t coming from the clouds.  It’s her own imagination at work, nothing more.  She’s having a discussion with herself, it seems spontaneous, it seems to be real and, for the most part, she’s was okay with it.  We decided she was having “a wide-awake dream, that’s all.”  That seemed to make sense to her.  We never talked about why she was having her wide-awake-dreams, so it made it easier for her to talk to me about them.

After a while our conversations were about the words she wrote, and the metaphorical meanings they had in her life.  It was a great way for her to explain her inner turmoil, and a great way to encourage her candor.  She was, in the next few months, increasingly candid.

About That Cutting
About one month into our relationship, at a particularly vulnerable and honest moment, I asked Evie if I could see her scars.  She was very ashamed of her scars, in front of me, and she always wore long sleeve shirts to hide them.  Evie took off her jacket and extended her arms.  There were several dozen crisscrossed scratches from her wrist to three fourths of the way up both of her arms, most of them permanent scars.  When I gently held her arm to look, she started to cry.

I’m sorry, Dr. Cima,” she said, her eyes fixed on the floor.

“Sorry,” I replied, “why are you sorry Evie?”

“Because it’s a stupid thing to do!” she said, with a bit of anger in her voice.

She said, at different times, she did it because she couldn’t stop herself, and because Vlad said it was a sacrifice she had to make, and because she felt so empty inside, and because her dad wasn’t around, and because it brought her a lot of attention and, sometimes, because she was bored.  Mostly, she said, “I do it when I don’t feel anything.”

Not a small item for Spheres, the loss of feelings.  Feelings provide Spheres their life energy.  Spheres without feelings are like Cubes without a puzzle to solve, or Squares without a job to do, or Stars without a game to play.  In desperate times, in a strange place for “crazy kids,” feeling something is better than feeling nothing.  We talked about her feeling nothing, and decided that feeling nothing was a feeling too.  Even if it felt terrible and empty, it was a feeling.  At least, we decided, she was feeling something.  Evie slowed and then stopped cutting herself six weeks after we met.

About That Chemical Cocktail
I convinced Pamela her daughter didn’t have a “disorder” or a “disease.”  Frankly, and not surprising to me, it didn’t take that much to convince her.  She never saw any improvement in her daughter’s behavior, despite the number of chemical cocktails they tried.  She consented because a doctor said her daughter needed “medicine.”

This is a common experience for the many hundreds of parents I’ve worked with in my career.  Parents will say they saw improvement in the first few weeks, then things began to get back to where they were.  Chemicals were increased, or decreased, or changed, or added – it didn’t matter much.  Over time, nothing changed, often their child was worse, and now their child was living in “a place for crazy kids.”

Pamela expressed her right as a parent and asked that her daughter be taken off her “medication.”  The doctor cautioned her against doing so, however, Pamela insisted.  With my support, we began a titration schedule, and simply reduced and eliminated both her chemicals in a matter of a few weeks.  Good riddance, and a huge boost to the self-confidence of Evie – and her mom.

How Did it End?
Evie went home to her mother about six months after I arrived.  She had stopped cutting for more than four months, she was still writing in what we were calling her journal by then, and most important to me, she was chemical free.  Evie called me two times in the first month just to say hello and to say that she was doing okay.  She was in school, and she was glad to be home.  She thanked me a few times, and I thanked her for trusting me.  We never spoke again.

About four months later, Pamela called.  She wanted to let me know that Evie was still in school, doing okay.  She said Evie seldom wrote anything in her journal anymore.  She also said she thought Evie may have a boyfriend.  Nothing had changed with the relationship with her step-father, although Evie, according to Pamela, was more stable with this unstable, one-sided, relationship.  Finally, Pamela told me she was dating.  She met a man at work, they had lunch, and they had dinner.  A third date was planned.  She sounded happy.  I think that’s why she really called, but that’s just me.

This is how it usually ends in my business.  It’s rare to have much contact with children and their families once they leave these kinds of facilities, as it should be.  After all, we are there to help them during an extended life crisis, not to ensure everyone lives a good life.  Our job is to provide them with our security, our trust, our guidance, and to discover and encourage their strengths, as children and families work to move forward in their lives.

Epilogue
I started writing “Goth Girl” two weeks before I found a video about another girl.  Her name is Emily Longden.  She was hearing voices too.  I wrote a blog about her at “Your Kid’s Aren’t Sick.” You can learn about the Hearing Voices Network, and you can meet – and see – this brave young woman @ https://www.youtube.com/watch?v=AgZHOSxN5cE&feature=youtu.be.

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READER COMMENT:

Eitan Schwarz, MD FAACAP DLFAPA

June 11, 2013 at 12:55 am

You have described Evie beautifully.  In this age of increased emphasis of the mind as a function of the brain, you remind us of the need for balance.  As a child and adolescent specialist for 40 yrs, I have met and sought to understand several Evies.  They can be very different from each other.  They have in common a blend of fierceness and delicacy, lace and leather.  They are worthy conversationalists and usually quite expert in something interesting.  Some try their own chemicals.  Many have had decent therapists who helped them accept their medication and became happier Goths for longer.

I also know of how varied kids are and frightened parents are.  I know that there are some doctors and “therapists” out there unworthy of trust because they don’t talk with people and don’t think carefully about the symptoms or diagnosis, like the type and function of “auditory hallucinations” and then misdiagnose and mistreat, often overmedicating with the same drugs.  I am always glad to see folks alert to that.

Yet I wonder to myself what is really new about your approach — it is pretty standard for the rest of us who work with kids and like to see their lives improve, except we don’t jump into a therapy relationship in quite the way you describe your involvement too often.

Your POV is not unusual either.  But would you consider that the medical chemicals made it possible for Evie to connect with you initially?

REPLY:

Dr.  Schwarz: Thank you for your comment, and sorry for this very late response.  My wife and I were on a long overdue, extended vacation.

The short answer to your question, politely, is no – the medical chemicals had nothing to do with connecting with Evie.  It was an on obstacle to overcome – for her, her mother, and me.  The long answer is a little more telling.

Evie – and her mother – first had to be convinced she wasn’t crazy when the evidence (5150, removal from home, “psychosis,” etc.) was just the opposite – topped off by those chemicals to fix her diseases.  Having done this many hundreds of times, I know parents are very reluctant to take their children off medication.  That’s a problem to solve too.  So, no thanks, medication has never been an asset to developing a relationship with a child.  Evie didn’t trust me because she was taking a pill.  I had to earn her trust.

Sounds like we both have been doing this work since the 70’s.  We both know these so-called medications were being used for kids on an experimental basis in those days.  I know from first hand observation, the experiment failed – and most professionals deny it.  You should know that too.  Unequivocally, from watching thousands of children, I’ve never seen these chemicals do any of them any good, and always did harm.  I know of no exceptions.

Nonetheless, I don’t deny that you have a knack for what we do.  You must.  You’re instincts about Evie were so accurate.  I can tell you’ve had Evie – and kids just like her – in front of you many times.  Lucky for them.  I suggest you had those instincts with you as you entered grad school and medicine.  That knack (or connection) can’t be taught, and it has nothing to do with medicine.

A psychiatrist friend told me a long time ago “I try to make sure my training doesn’t get in the way of my effectiveness.” I suspect you do the same.  I applaud your effectiveness.  You, in particular, didn’t need to prescribe any chemicals to anyone.  You’re the vessel of efficacy, not a chemical.  Respectfully, prescribing chemicals not only masks “symptoms,” they often mask the impotence of the prescriber.  Medicine is needed for broken bones, not broken hearts, broken families, or broken spirits.

The Era of Chemicals – Redux

ORIGINALLY PUBLISHED @ BESTTHINKING.COM – OCTOBER 2012

Dear Reader:

I wrote the essay – The Era of Chemicals – in 1988. A year earlier, I was awarded my Ph.D. in Clinical Psychology. I was in my second year as the Director of a 66-bed residential facility in Southern California for boys placed from probation, social services, and mental health agencies. It was the first of three large mental health facilities than I’ve managed. I wrote this essay late one night in my office.

I never did much with it. I used to give it to my colleagues to read. I continued to do that over the years until I retired. I dusted it off to publish it now, because, well, it’s time. In fact, as you will see, it’s overdue.

When I managed facilities as the Director, I didn’t allow children to be given chemicals for their behavior. Admittedly, it was a lot easier in the mid-1980’s. The psychiatric Medical Model didn’t have the stranglehold on our profession as it does now. I just said no.

I had my reasons – professional, theoretical, philosophical – and they all added up to no. There was no wiggle room either, by the way. You’re either all in or all out with this failed model, so I didn’t allow any dabbling. There were many times I had therapists – especially new therapists – in my office cajoling, begging, angrily advocating, with articles-in-hand (no internet back then), to allow them to encourage the psychiatrist to prescribe a chemical “just for this one kid – please!” I said no. Luckily, they liked working with me, and I liked their work too – and we did good work together. By the time I started my third agency in 2003, I was more seasoned, less strident and, I’m happy to say, as successful.

The essay is a little awkward and stiff and some of the sentences go on forever. I ask for your patience, please. This was my first attempt at writing something serious about the subject. Nonetheless, other than some grammar and structure and other similar kinds of things, I wouldn’t change anything, so I didn’t.

I admit, though, there is the one thing that haunts me. The last paragraph. I used the word “perhaps” four times, including the last word of the essay. I was naïve. I was hoping the essay would have lost its relevance by now. It didn’t, I’m sorry to note. 

I’ll tell you this now, a quarter century later: there’s nothing “perhaps” about it. We’ve gone from a few hundred thousand children given these toxic chemicals, to eleven million – and counting. It’s our shame, and our responsibility to put an end to it.

For now – The Era of Chemicals – from 1988. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~

We learn early in life that there are simple solutions to complex life problems. Whether a headache, tension, stress, depression, excessive activity, insufficient activity, insomnia, bed-wetting, bad grades, bad dreams, hallucinations, poor reading skills, too much appetite, not enough appetite, and so on, a simple trip to the drugstore, to the liquor cabinet, or to the “corner connection,” will ease these annoying and sometimes pervasive life-symptoms.

It’s as if unpleasant personal interactions, disappointments, tragedies, elations, moods, lack of skills, uncomfortable thoughts, undesirable physical appearance, and other events experienced by most human beings are best dealt with by the ingestion of one type of chemical or another. There may be a day when these chemical medications will carry the disclaimer: “Caution: The Surgeon General has determined that living may be hazardous to your health.”

The Medical (or Disease) Model is the prevailing theory in the helping professions. When discussing people who are sick or ill pertaining to a psychological description of behavior, the Medical Model is inferred. Indeed, the body’s chemicals do have an effect on behavior. As the chemist will state, in some ways “it’s all chemical.”Neurons are chemically stimulated, and they, in turn, chemically stimulate muscles and organs, and so on. Yet with some theorists, scholars, and students of human nature there exists a vast difference between the physiology of motion and the cause of behavior.

When someone behaves in a socially inappropriate way the physician seeks to explain the behavior by discovering the chemicals that are either missing, are in short supply, or are in overabundance within the individual. This is the cause of the disturbance, and they will treat the anomaly with chemicals of their own. When questioned, the physician will claim there is an imbalance of some kind, in less than understood ways. Yet there is offered little, if any, explanation of what “balance” means. The fact the depressive is elevated by Elavil is enough to conclude the effects are beneficial, and that this is evidence of the efficacy of the drug. Most often the physician is at a loss to explain why the chemical works, how the chemical works, what can be predicted about its effects, or how long the person being treated will have to use the chemical.

Another concern is found in the term side-effects. This euphemism is used to water-down the stigma of the unwanted physiological and psychological consequences of chemical use. Drugs only have effects. With chemotherapy, for example, hair loss, loss of appetite, and other effects of the chemicals used are well known. However, when psychotropic medication is given to human beings for a psychological disturbance of some sort, unavoidable problems arise. The term “Thorazine shuffle” was coined by the employees in psychiatric settings, as their observations of the side-effects of this drug were noted.

The use of Ritalin, or methylphenidate hydrochloride, provides another example. This overused and misused drug has been around for over a quarter of a century and is almost exclusively used for children. Its main purpose is to “calm” the hyperactive child. How does this work? How does a stimulant have just the opposite effect with very active children? No one seems to know. Turning to the Physicians’ Desk Reference, a volume of over 2200 pages that give a detailed description of all legal chemicals, here are some remarks about Ritalin. The PDR, states:

Ritalin is a mild central nervous system stimulant. The mode of action in man is not completely understood, but Ritalin presumably activates the brain stem arousal system and cortex to produce its stimulant effect. There is neither specific evidence that clearly establishes the mechanism whereby Ritalin produces its mental and behavioral effects in children, nor conclusive evidence regarding how these effects relate to the condition of the central nervous system. (Physicians Desk Reference – 1987 edition)

The authors of the PDR also state Ritalin should not be given to children under six, and it is contraindicated when the child has marked anxiety, tension, and agitation as Ritalin may aggravate these symptoms. Continuing, they note data on safety and efficacy of long-term use of Ritalin in children is not yet available noting: “although a causal relationship has not been established, suppression of growth (i.e., weight gain, and/or height) has been reported with the long-term use of stimulants in children.”         

And what are the side effects of this stimulant? Nervousness and insomnia are the most common reactions, along with hypersensitivity, skin rash, anorexia, nausea, dizziness, palpitations, headache, dyskinesia, drowsiness, blood pressure and pulse changes (up and down), tachycardia, angina cardiac arrhythmia, abdominal pain, and weight loss, to name some. An overdose may induce vomiting, agitation, tremors, hyperreflexia, muscle twitching, convulsions, euphoria confusion, hallucinations, delirium, sweating, flushing headache, hyperpyrexia tachycardia, hypertension, hydrias, and dryness of mucous membranes.

The most common place that a child first comes in contact with medication is in school, due to “disruptiveness”or “inattentiveness,” or in general, “poor school performance.” Dr. David Keirsey, author and professor emeritus has these remarks about the use of medication with school children:

The parents blame the school, as they should, but the school blames the child. He’s “dyslexic,” has “minimal brain dysfunction,” is “hyperactive,” has a “learning disability.”  Therefore, says the school, he “needs medication.” Then some well-meaning but ill-advised physician prescribes massive daily doses of some stimulant drug, parroting others’ assumption that the stimulant has a “paradoxical effect” of acting as a depressant. The victim is thus given his daily fix and its false high, his teacher claiming that he’s “calmer and works better.” Who wouldn’t be with that big a fix? And of course the child need not aspire to much; after all, what can you expect of a person with a bent brain? And later on? No. The child’s real problem is the school, not his brain; his brain is just fine.                                                     Portraits of Temperaments – Pg. 26

So why is the use of medication so pervasive with particular children? Usually because the child is a management problem, although this is most often denied. The child is ostensibly given drugs “to help him.” Yet close observation will note it is the teacher who needs help, or the mother, or the counselor. The belief is if someone is in profound psychological distress due to chemical imbalances, and this is interfering with more traditional treatment, then chemicals are prescribed to ease the distress in order to enter into a therapeutic conversation. Yet this seldom, if ever, occurs.

Instead, the teacher is initially relieved she was heard, and while the child’s behavior doesn’t really improve, “at least he’s being treated.” Mother is now reluctant to take her child off medication for fear of a recurrence of past events, even though her son is tired all the time and doesn’t eat right, and in a bad mood constantly. Ironically, even the most ardent disciples of the Medical Model make no claim chemicals used for psychological disturbances cure the disturbance. Instead, most will say some people will have to be on medication for “the rest of their lives.”

All professionals, including therapists, teachers, child-care counselors, teacher’s aides, social workers, and others, should become familiar the with the PDR. There are good reasons for this. Once a child is placed on medication designed to treat a psychological shortcoming of some sort, it soon becomes impossible to distinguish with any degree of accuracy between behavior that is due to the child’s psychological distress and behaviors due to the side-effects of the prescribed chemicals.

Is the child agitated, now, because of internal strife, or is the prolonged use of medication affecting him? Is the child awake at night because of a sense of unbelonging, or is she simply exhibiting an effect of the particular chemical she is taking? When the child becomes disruptive at school and breaks another window, does this mean an increase in the medication, another type of medication, a decrease in medication, the medication is an irritant, or what?

Medical personnel refer to this process as “adjusting the meds.” The pursuit, really, is to adjust the child. Many experienced physicians are adept at creating just the right high, so the child is awake, yet sedate. Often out of frustration and desperation – and genuine care – a child is referred to a doctor for his medical problem. However, when chemicals are used to manage the recalcitrant child, other more damaging side-effects inevitably follow.

Once medicated, the child has a disease in addition to stressful life experiences he may have to endure. This disease is something beyond his control, something which he and his family now may have to cope. The child is seldom told of the prescription until it has been decided by others “for your own good.” He is given vague reasons as to why he has to take the medication (“to help you”), can soon become dependent (“I can’t go to school without my meds”), loses control over his behavior (“I can’t help it/it’s not my fault/I’m not responsible – I’m hyperactive”), lowers his own expectations about his future, mimicking the view others’ have of him, because of his “handicap.”

Chemicals have the effect of altering the physical-emotional-psychological affect or consciousness of human beings. About that there is no doubt. Yet this is a poor reason to give medication to children in psychological distress. “Why Mellaril instead of a ‘shot of booze’” asked one professional.” There is no good answer. Chemicals, for the most part, create dependence rather than independence. Most disturbing is the dependence created in many professionals and lay persons alike. After a confrontation it is not unusual to hear in some settings: “somebody take him to the psychiatrist and get his meds straight!!”

Chemicals taken into the body do have an impact on the human being. Give a child Ritalin, and his body is affected. Introduce Valium to the overworked bank teller and watch him calm. Allow the lonely housewife her vodka for the day and see a different housewife. Many simply can’t go to work without a cup of coffee. Others must smoke a cigarette as soon as they wake in the morning. And so on.

The use of drugs permeates every level of contemporary society. If one was to include all legal drugs in addition to the illegal drugs, then there are very few of us who are truly drug-free. In fact, it could be argued the cause of the drug problem in our society lies not in the area aimed at by our “war on drugs,” which is the attempt to eliminate the use and distribution of a handful of illicit drugs. Instead, it could be argued the thesis the origin of the drug abuse problem in this society falls at the feet of the 3200+ legal drugs, and the permeating idea of quick fixes that begins at a very early age. Moreover, as the distribution of legal drugs is a multi-billion-dollar industry, new so-called breakthroughs are common as the relief of life-symptoms can be done even more effectively with the “new and improved” products.

George Washington, after retiring from his two-term presidency, lived his final days in Mount Vernon. It’s likely this national hero and “father of our country” would have had the most updated and best medical professionals of his time at his calling. The state-of-the-art, unfortunately for Washington, proved to be unsuccessful. He was inadvertently bled to death in an attempt to cure him.

With hindsight, his treatment seems uncivilized and uninformed. Yet within the medical profession this was the best solution at the time. With foresight, one may wonder how our progeny will view the use of drugs in our current society. Perhaps they will look back and view us as uncivilized and uninformed. Perhaps they will wonder what we were doing to ourselves. Perhaps they will, as they review their history, refer to us as living in the Era of Chemicals.

Perhaps.

The Sugar Lie

ORIGINALLY PUBLISHED @ BESTTHINKING.COM – DECEMBER 2012

Dr. Dean Edell started his radio broadcast in 1978. His common sense and clear answers earned him the accolades of millions of Americans. Dr. Dean retired in 2010. “No nonsense, no BS, no medi-babble” could have been his motto. Enjoy your retirement, Dr. Dean.

I was listening to him in the late seventies and early eighties when he would periodically tell his listeners there was no such thing as a sugar high. More than that, he implored his audience to pass this information around to others. I was surprised. How, I asked myself, could Dr. Dean be so wrong about this, and so right about most everything else?

At the time my wife and I were living with 8 boys ages 12-17 years old in a group home. They were active. We got them up in the morning, readied them for school, greeted them after school, helped them with chores, ate dinner with them, helped them with homework, and got them to bed. As professionals, and as surrogate parents, we stopped giving them sweets because we knew sweets added to their already too active behaviors, and we cared about these kids.

We knew about the behavioral power of sugar because we heard it from all of our sources at the time including psychiatrists, psychologists, social workers, therapists, teachers, teacher’s aides and other parents. My wife and I were parents with young children at the time. Like our friends and family who had young children, we all knew about the “sugar high,” the “sugar rush,” and, though less well known, the “sugar crash” – that’s what happens when sugar is depleted and all of the child’s energy is spent. The child “crashes.” We were informed parents and, as knowledgable child behaviorists, we were compelled to educate colleagues and the general public whenever we could.

Dr. Dean ruined all of that.

I did some homework, which was a lot more difficult back then. The internet wasn’t born yet. I was working towards my Master’s degree at Cal State Fullerton and I had access to their library. I used to study there before class, and from time to time I would research this question. To my utter dismay, I found out Dr. Dean was right. Conclusive. No kidding. No doubt. There was – and still is – no scientific evidence anywhere to support the idea that sugar has anything to do with increased activity – child or adult. There is no “high,” there is no “rush,” there is no “crash” either, even though those terms were so much part of our culture back then and, most distressing, still are.

I succumbed to this truth. I quickly converted, cleansed myself, and became a disciple. I felt obligated to pass this information on to friends, family and colleagues, as Dr. Dean suggested. Together we could help kill this myth, and get on with the task of helping children.

Not so fast there buddy. When I would tell people there’s no such thing as a sugar high, many would get mad at me, and the rest would ridicule me – as if I needed to modernize my thoughts. The same psychiatrists, psychologists, social workers, therapists, teachers, teacher’s aides – and nearly all parents – refused to listen to this. This is still true, and it’s 2011.

Well informed mothers, fathers, caretakers and professionals are quick to point out they have watched children’s behavior become “manic” when too much sugar enters their blood streams. They’ve witnessed what is clearly a physiological effect with their own eyes and, way too often, their own ears. It’s obvious to anyone, they say without hesitation. Too much sugar “hypes” kids. So obvious that many parents dread birthday parties, Christmas cookies and, God-forbid, Halloween.

The simple reply is, respectfully, no, you didn’t see what you said you saw. You may have seen your child’s activity increase, but it didn’t have anything to do with sugar. You get madder still.

So, nowadays, in the 21st Century, I refer everyone to their own encyclopedia, the world wide web. Please, when you have an extra 20 minutes, take the time to Google, Yahoo, or Bing “sugar high” or “sugar rush.” See what you find. In the meantime, here are excerpts from five different sites I selected – there are many more – with their web addresses:

From The Straight Dope: In 1995 the Journal of the American Medical Association published a review of 23 comparatively rigorous studies conducted between 1982 and 1994. These were your classic controlled double-blind affairs: two groups of kids, one fed a bunch of sugar, the other given a placebo (i.e., artificial sweetener), everyone kept sufficiently in the dark as to who’d gotten what, etc. The results? No discernible relationship between sugar ingested and how the kids acted. It didn’t matter how old they were, how much sugar they got, what their diets were like otherwise — nothing. The JAMA authors stopped shy of drawing any definitive conclusions, but if there were a legitimate sugar-high effect out there, you’d like to see it turn up in the lab every so often.(http://www.straightdope.com/columns/read/2747/does-giving-sweets-to-kids-produce-a-sugar-rush)

From a nutritionist in Hawaii: It is not unusual, due to the misinformation that abounds out there in the public media (books, magazines, newspapers, word-of-mouth testimonials), to think that a ‘sugar high’ is a real thing. In some of the research that I have done with adolescents (almost 200 of them, at one time), we fed the boys as much sugar as we could cram into a breakfast, and not a one had a hormonal profile that suggested hypoglycemia; and, none of them experienced anything resembling a ‘sugar high.’ In fact, if you follow the biochemical pathway of sugar (glucose or sucrose) in the body, what it predicts is a calming effect of sugar, providing nothing else is eaten at the same time.(http://www.madsci.org/posts/archives/2000-01/947564807.Me.r.html)

From a Yahoo source on Health and Wellness: Here’s the big news. The scientific research that has been conducted not only finds no direct correlation between hyperactive activity and sugar, but actually has produced evidence that sugar may well have a palliative effect.(http://www.associatedcontent.com/article/515073 sugar_high_myth_or_reality_pg2.html?cat=5)

From a mother, at Daily Dose of Common Sense: My daughter had a birthday yesterday, and I had several well-wishers ask if she was bouncing off the walls because of sugar. Well, no, actually she was no more hyper yesterday than any other day. Yes, she ate a cupcake, Cracker Jack, Nerds, and a bunch of other junk, but she’s a healthy kid. That, and there’s no such thing as a “sugar high.” I know, it takes a second for it to sink in. We have been led to believe that sugar makes people (especially kids) hyper. But, it’s just not true. Our bodies do a really good job of regulating the sugar we intake. Many studies have been done on this topic and the conclusions are the same: the amount of sugar that a kid eats does not affect his or her level of activity. Jessie from Rational Moms did a great in-depth debunking of the sugar high myth. I highly recommend giving it a read. So, don’t worry about your kids being up all night after eating a bunch of sugar. They’re up late because they want to be up late. Duh. (http://www.dailydoseofcommonsense.com/2009/07/22/the-sugar-high-myth/)

Finally, and maybe you should go here first, this from Rational Moms: Even confronted with this evidence it can be difficult to believe. I’ve heard people grudgingly accept that it may not cause hyperactivity in children but insist that it causes rapid spikes and falls in blood sugar levels which create the feeling of the “Sugar Rush” and the “Sugar Crash.” . . . In this study all mothers identified their children as “sugar sensitive”. All the children were given a placebo (aspartame) but half of the mothers were told that their child was given a large amount of sugar. The mothers who thought their child was given sugar tended to stay physically closer to their child, criticized, looked at and talked to their children more then the parents who knew their children had the placebo. The mothers who thought their children ate sugar also rated their children as significantly more hyperactive than the control group.(http://www.rationalmoms.com/2008/12/01/the-myth-of-the-%E2%80%9Csugar-high%E2%80%9D/)

So, you’ve read the excerpts. More important, I hope you took some time to research this on your own. Good. Now you know for sure – a certainty – that there is no physiological sugar high, rush, or crash in human beings, and that includes little human beings. Not because I said it, or Dr. Dean said it, or those others you read on the web said it. But because, now, you say it. When it comes to behavior the unequivocal answer is no, children aren’t sugar sensitive, there isn’t a sugar high, a sugar rush, or a sugar crash – and there isn’t any wiggle room.

Why is this important? For a few reasons.

One. You and I – and everyone else convinced at one time or another that too much sugar causes children to be hyperactive – are mistaken. That includes your doctor, psychiatrist, teacher, aide, school psychologist, therapist, social worker, and any other professional you’ve relied on to make sure you are accurately informed.

Two. We become frantic when our children eat too much sugar, especially at the wrong time. Sometimes we even chastise the child because he – and it’s almost always he – doesn’t monitor his own sugar intake. After all, he should know by now that he has “ADHD” or an “imbalance” or “sensitivity” of some kind. He is, in a word, sick, and we’re just being cautious about his “condition.” We now know – you and I – this was never true. (By the way, maybe you know someone who has a very bright, 14 year old boy who has said on more than one occasion: “Sorry mom. I know I got hyper last night! I couldn’t stop! OK, OK, you were right! I had too much candy! Sorrreeeee!” Now you know for sure – and so does the 14 year old boy – it’s not the candy.)

Three. We can no longer place responsibility for a child’s behavior on this chemical because of a flaw in his body that was never there in the first place. This idea is going to become very important in Part II.

Four. We both now know our beliefs – even strong, heartfelt beliefs based on our care, our concern and our professional consultation – can alter our perceptions. Whoops, our bad. We need to make up for our mistake, and apologize to our children. You can still say he’s “too active,” however, you at least know now to eliminate sugar as a cause.

What’s the big deal? Is it really that harmful – this false truth about children that we’ve kept alive for way too long? My goodness, parents are educated to believe their child is sensitive to sugar in the way a diabetic is sensitive to sugar. A range of informed professionals explain to parents in convincing detail – usually something about brain chemicals – that their child may be “sugar-sensitive,” or worse, may have a “psychological disease.”

And what do conscientious parents do with this information? They seek out a doctor for their child’s medical condition. The doctor tells parents to monitor the child’s sugar intake, that much is obvious, and that maybe your child should take some medicine – usually Adderall or Ritalin or some other amphetamine – and your child’s disease is treated. Never fixed or cured – there are no fixes or cures available from these doctors – but medically treated.

Here’s an idea, if you have the gumption. The next time you have the opportunity, maybe in private, ask your child’s doctor, therapist, counselor, teacher or teacher’s aide if too much sugar causes children to engage in too much activity. If the teacher tells you it does, correct this common, misguided, and harmful answer. If the therapist persists, share your information and ask that it be checked out. If the doctor becomes frustrated trying to make you understand that you’re a layman, well, when you can, as politely as you think necessary, find another doctor. This one is woefully uninformed – and stuck in it – unlike you. Dr. Dean warned us decades ago that the most resistant to this information are informed professionals. Please, help them out.

Is there a physiological effect of taking in too much sugar? Sure there is. Ask anyone who substituted a pound of Sees candies or a quart of Ben and Jerry’s ice cream for their dinner. When finished with their indulgence, they yearn to nap. In fact, an abundance of sugar does have a calming effect on human physiology, especially on an empty stomach. Also, sugar is often referred to as “empty calories,” and sweets certainly add to the obesity epidemic, not to mention the part it plays in tooth decay. And, as you already know, sugar certainly has a role in diabetes. (More about psychiatry’s dastardly psychi-babble use of diabetes in Part II).

You may guess my point about this. If we could both be so wrong about what we thought was so right, then are there other “truths” that need to be revealed as myths or comfortable conventions or false science? My goodness yes. Psychiatry is the biggest offender, as you will see in the upcoming article.

Finally, fellow convert, please help. To obliterate this harmful lie – and to make it right to all those kids we falsely accused and to ensure the next generation is accurately informed – we must be bold. When you’re at the check-out stand and you hear a stranger talk about “sugar high,” with a smile, ask them to “Google it.” When you’re at your PTA meeting and parents are concerned about all those “sugar snacks” the school is giving, make sure it’s because of calories and general health, and not because “sugar hypes kids.” Keep smiling, and educate them. And the next time you have a family reunion, deliberately bring this subject up so you can get into a friendly family argument and have it settled on the internet. You’ve just done a world of good for the kids in your family, and that’s always good for a smile.

Lest I forget, you can also forward this article to your friends, family members, doctors, teachers, therapists, neighbors – everyone. It’s 21st Century information. It’s not mine. It’s not Dr. Dean’s.

Now it’s yours. Make it someone else’s.

Let’s put the sugar lie to bed – for good.