Family therapists view violent young people in the context of the wider social systems of which they are a part. This typically means the youth’s parents, but it can also include grandparents, teachers, or even friends. Framing youth violence in terms of the social context or family system–rather than as a psychological problem of the individual– is the most effective way of putting an end to the violent behavior.
Typically, when a child or teenager is behaving violently, two things are occurring in his family. First, the young person’s parents are fighting or disagreeing and, second, the family hierarchy is unbalanced. This imbalance occurs when one parent is in a “one down” position in the family, while the other parent has more authority with the child. Making changes in the family dynamic of a violent young person is the most effective way of stopping the violent behavior. This means restoring the position of the disenfranchised parent to full authority and resolving the parents’ hostile feelings toward each other.
In my book, Pills are not for Preschoolers, I discuss the story of a violent seven-year-old boy named Jarrod, who was a terrible bully. Jarrod was about to get thrown out of school for his aggressive behavior toward other children. Scarcely a day went by without Jarrod getting into a fight and being sent to the principal’s office. Jarrod’s teacher thought he might be suffering from oppositional defiant disorder or ADHD. Jarrod’s mother decided to try the route of family therapy.
Rather than framing violence as a problem rooted in the psyche of the individual child, I prefer to take a wider perspective. In Jarrod’s case, this involved looking at the dynamic in the boy’s family to find out what might be the source of his violent behavior.
Jarrod’s parents recently had gone through a bitter divorce and, quite naturally, there were still hostile feelings between them. Jarrod’s father was allowed very little visitation with his son. This was because of a single incident in which he had grabbed Jarrod’s arm. Jarrod had long ago forgiven his father for this incident and in fact wanted to spend more time with him. He especially missed going fishing with his father and grandfather at the lake near his grandfather’s cabin. For his part, Jarrod’s father missed spending time with his son and sometimes cried when he dropped Jarrod off at his mother’s house after an all too brief visit.
I could see that both of Jarrod’s parents loved the boy very much, but the lack of time with his son was making the father angry and resentful. The parents could barely talk on the phone without an argument breaking out. Jarrod’s father was also in a “one down” position as a parent because the divorce settlement allowed him very little time with his son. Jarrod’s mother, on the other hand, had full custody. My job, as I saw it, was to stop the violent behavior by changing the way Jarrod’s parents communicated and by restoring the father’s role in the family as a fully responsible parent.
I met with the mother separately, and told her that the hostility between her and Jarrod’s father was a problem. I also suggested that the amount of visitation be gradually increased. The mother was at first reluctant, but she finally agreed when I assured her that it was the only way to stop her son’s violence at school. She confessed that she would actually welcome having more time to herself, and she did not really think that Jarrod’s father posed a danger to the boy. She even admitted that taking Jarrod away from her ex-husband was a way of getting even with him for the grief he had caused her in their marriage.
I also asked that the parents resolve their disagreements in post-divorce family counseling, so that their arguments would not affect their son. The father was so pleased with getting increased visitation that he was more than happy to come to family counseling. The mother said she would do anything it took to improve her son’s behavior. As the parents learned to talk to one another without arguing, Jarrod’s aggression at school disappeared. He soon went back to being his happy peaceful self.
In working with Jarrod’s parents, I did not place blame on them. I was careful to be empathic with their painful divorce and with the father’s frustration. I asked these parents to make changes in their behavior and communication, not in their character. Nor did I try to diagnose Jarrod with a mental disorder. The problem, as I saw it, was not in the individual boy but in the family system.
Jarrod’s case is fairly typical. When a child or teenager is brought to therapy because of aggressive behavior, the therapist should always suspect that there are hostile feelings between the parents and that one parent has been put in a position of lower authority in some way. Working with the parents to resolve these issues is the best way to change the child’s behavior. This way of working with young people has the additional benefit that the youngster is not stigmatized with a psychiatric label or given psychiatric medication that might harm him.
Family therapists tend to focus on family dynamics and patterns of communication, not on troubled individuals. In fact, in the early days of family therapy, the whole notion of an “individual” was fraught with contention. Don Jackson, one of the early great teachers in the field, believed that an emotionally troubled individual is only one point in a “field of force” that extends from the person’s intra-psychic processes to the broadest aspect of the culture in which the person lives.
Historically, family therapy has gotten a bad name precisely because it focuses on larger social systems rather than on individuals. Many people believed that family therapists blamed family members for a young person’s problems. Critics of family therapy were quick to point to the “refrigerator mother” theory as one of those wrongheaded social context ideas, even though the concept of the “refrigerator mother” as the cause of childhood autism came from a psychiatrist named Leo Kanner and not from a family therapist at all.
When biological psychiatry came along and began labeling children’s problems as diseases of the individual child with biological causes, the parenting public was quick to embrace this way of thinking. The biological model of children’s troubles relieves parents of any guilt or insecurity they might be feeling about their parenting skills. In a kind of monumental throwing out of the baby with the bathwater, family therapy was discredited just as it was reaching its golden age in the 1980’s. The focus on dysfunctional relationships and crazy-making communication in families was discarded because it seemed to malign the character of parents. The biological model of mental and spiritual woes was a much easier pill for the parenting public to swallow. This way of framing misbehaving youth was of course beneficial to drug companies and psychiatrists as well as to parents.
Sorting out this misunderstanding is long overdue, because family therapy is much needed at present. It is a safer, more effective, and more humane solution to the violence of young people than diagnosing them and using psychotropic medications to mask their symptoms.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.