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The student
came into the office for our first session.
Having already seen his educational records and
talked with school personnel, I knew he was
intellectually gifted, but wasn't doing any work
in school or at home, and that he was on a
cocktail of psychotropic medications for his
diagnoses of ADHD, TS, OCD, Bipolar Disorder,
and Asperger's Disorder.
He
looked curious and attentive and ready to
laugh. After the initial pleasantries,
I asked him to tell me about himself. He
slumped slightly in his chair, and his
expression became somber. "I have a lot
of problems," he said.
He then went
on to list all his diagnoses for me and all
the medications he was on at the time. He was
starting to tell me the diagnostic criteria
for his most recent diagnosis and the side
effects of his newest medication when
I interrupted him softly and said, "I
asked you to tell me about yourself. You've
given me a string of labels, but that still
doesn't tell me who you are. So let's start
again, and tell me about yourself. What do
you like to do? Who is this young man sitting
across from me?"
One of the things
I struggle with on a daily basis in my
professional work and in writing articles is how
to label these.... things. Diagnoses are part of
the mental health profession, but the view is
primarily a medical/psychiatric one that is
often based not on evidence of any biological or
disease process, but on behaviors. But does
whether we call something a "disorder," a
"disability," or (just) "different" make a
difference to how we approach the child and how
the child views himself? I believe it does, as I
am seeing too many children and teenagers who
feel "broken" because the weight of all of their
diagnoses is more than their young shoulders can
bear. Having been told that they have a (medical
or psychiatric) problem and/or that their
behavior isn't their fault because there's
something wrong in their brain, how are they to
feel about themselves, and how will they relate
to their peers?
In many respects,
this web site is much more negative than I would
like to see it, because I have focused on
the problems children and teens may face (or
will probably face), without spending enough
time addressing what might be the positive
consequences of having these "disorders." While
many people are already aware of the reported
association between Bipolar Disorder and
creativity, less attention has been paid in the
literature to other conditions, and yet anyone
who spends time working with students with
regulatory "disorders" usually recognizes that
there are often some positive aspects to
dysregulation. Sadly, we spend so much time
trying to change the child or "fix" the child's
"symptoms" and not enough time helping the
child or teen appreciate the positive aspects of
their "disorder" or "disability."
Sometimes on this
site you will see me use the word "disorder" and
sometimes you may see me use the word
"condition." The truth is that I
actually prefer to just talk about these
children in terms of their minds working
somewhat differently than the "average" or
"normal" child. When most of us think of
"disorder," we think of something that needs to
be treated (the medical model). But just because
a child is different in how their mind works, it
doesn't mean they need treatment. In many cases,
all they will need is our understanding and
respect for the fact that their mind does work
differently, that they may learn differently,
that they may have more variability in their
behavior, and that they may have different ways
of expressing what they have learned. Surely we
should be able to accommodate differences,
right?
So that day, as I
sat in the office with that student who had made
his "disabilities" the central focus of his
young life, I started talking to him about
"different kinds of minds" and how by working
together, he might come to understand how his
unique mind works so that he could accomplish
more of what he wanted to accomplish. And I told
him that my goal was not to "fix" him because he
wasn't broken.
He left the office
smiling.
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