Insane Medicine, Chapter 9: The Worried Parent (Part 1)

Sami Timimi, MD
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Editor’s Note: Over the course of several months, Mad in America is publishing a serialized version of Sami Timimi’s book, Insane Medicine (available for purchase here). In Part 1 of this chapter, he discusses the Relational Awareness Program (RAP) and how family relationships become solidified through “Emotion WARS.” Next week, he will address specific actions that families can take to improve relationships. All chapters are archived here.

The ideas outlined in the previous chapter can be extended to helping the parent who is worried about their child(ren). When parents are worried about their child, whether it’s their behaviour or emotional state or both, the emotional intensity in that relationship rises resulting in various knock-on effects.

Diagnoses (such as ADHD or autism) give beleaguered parents temporary relief, but invite everyone to commence the alienating process that encourages all to view their child as infected with a disease that results in them operating outside the boundaries of what is considered ordinary.

But parents have dilemmas of their own given how much parenting has come under scrutiny. One of the most common things we hear working with parents in child and adolescent mental health services is how judged they feel by those around them when their child acts up in public. It’s easy to see how a diagnosis can provide temporary relief as the parent changes from feeling like they are judged as a failed parent to one who can now be seen as a heroic parent struggling with a disabled child.

I think that our compare and compete culture has made it difficult for parents and their kids to feel secure and competent. Failure to live up to something (whether for the child, the parent, the child about their parent, the parent about their child) stalks our lives. It’s harder than ever to be a “normal” kid or “normal” parent.

This chapter cannot remedy the cultural and political milieu; it can only provide some reflections on what may improve some aspects of some families’ lives. Nor am I not presenting a model of “normal” family functioning, or being out to lecture anyone on what values they should hold. As I have discussed, models of child development and family forms vary across the world.

This chapter should not be used to pass judgement on the many families living under stress of inequality, racism, sexism, and all the other forms of disenfranchisement that can affect us. Your father being given a long prison sentence for a relatively minor misdemeanour, as happens to so many black men in the mass incarceration ideology in US, has knock-on effects for the family and their children that can follow them into adulthood. These issues require political action, not just the few tepid tips I outline in this chapter.

In my opinion, a sense of belonging and feeling that you are loved just for being, rather than for doing anything in particular, more than anything else, leads to children growing up well and ready for the turmoil and challenges of adulthood. Of course I could start deconstructing what meanings and indicators equate to “belonging,” but for now let me start the chapter with this thought: None of the ideas outlined in this chapter are as important as your child knowing that you love them and find joy in their existence, no matter what they do or say that worries or infuriates you.

The Relational Awareness Programme (RAP)

I, along with some colleagues, developed an approach we use with such worried parents, which is a diagnosis-free approach, and mainly uses a group format to which we invite parents, and their supporters, who are worried about their child. We call this approach the “Relational Awareness Programme” or RAP. The RAP approach was originally inspired by the ideas of the American psychologist Howard Glasser, who developed the Nurtured Heart Approach (NHA). RAP infuses NHA with systemic and solution-focussed philosophies.

I think of RAP as a “toolbox” of ideas. It has concepts and exercises that can be used in a flexible manner to suit different circumstances. They are not really designed to be applied as if they are the only possible “truths.” Real people are more creative and diverse than any single approach can allow. Only those who are living it can truly understand what challenges and opportunities their lives contain. In this approach each parent/carer/family/school needs to figure out what is practical, helpful, and adaptable to their unique circumstances. They are presented with a series of concepts and frameworks and then decide whether and how any of these might be applied to their lives.

RAP isn’t a parenting, parent management, or parent training programme. It’s more of a skill-based programme to assist good parents with those more “intense” children. It doesn’t involve telling people the details of what they should or shouldn’t do. RAP provides concepts and questions to help parents work out for themselves how they wish to proceed and adapt the ideas to their specific circumstances. Having said that, we have had some inspiring outcomes over the years where parents who have been accessing services for their children for many years have discovered something new about the relationship with the child they’re worried about, freeing them to create new “dances” and to view their lives through a new lens.

In RAP we focus less on how to control behaviour, which is fraught with dangers for the parent/child relationship, and more on how to build positive relationships in the family. It works well for all sorts of child caregivers, from teachers to foster parents. I refer to “parents” in the rest of the chapter, so as not to complicate the sentences. Wherever the word “parents” appears you can substitute all other potential caregivers. “He” and “she” are used interchangeably, not to denote the specific gender of the child, but for convenience and instead of writing she/he on every occasion. For similar reasons of convenience, where I have used singular (as in “parent” or “child”) that could also refer to the plural too (as in “parents” or “children”) and vice versa.

Some assumptions

Here are a few assumptions that help set some baseline for this therapeutic philosophy on the parent side of the relationship:

  • Parents are motivated by positive intentions—parents who seek help are “good parents”; they want to see things improving for their child.
  • It’s hard for parents when their child’s behaviour is difficult; they often feel judged and feel like everybody seems to have an opinion about them and their child.
  • All good parents spend most of their time feeling guilty about how they parent—should I have done this or not done that, should I have been stricter or softer etc. I assume, like all good parents, they will continue to feel guilty no matter what!
  • Professionals have some academic knowledge that might be helpful, but no one knows their child better than the parents and other involved caregivers. The RAP philosophy shares ideas, ways of thinking, and a framework for strategies, but it doesn’t provide specific advice on how to put them into practice. This is something each family needs to figure out for themselves based on their own knowledge and skills.
  • Any relationship, by definition, involves at least two people who are contributing to how it works. Even if the contribution of a parent in their relationship with their child is not as influential as the child side, which side of the relationship do you think the parents have control over? In whom can you guarantee that change can be achieved? Focusing on what you, as a parent, can change is more likely to lead to relational change than trying to convince your child to change.

Here are a few assumptions that help set some baseline for this therapeutic philosophy on the child side of the relationship:

  • Children are not born into the world all the same. Research shows that children, from their earliest moments in life, have temperaments, tendencies, and differences in the way they interact with the world.
  • Some children later attract psychiatric and psychological labels, but these labels tell us little about what might be helpful for any specific child.
  • Instead, we can simply recognise that with some children the intensity with which they interact with and experience the world and its people, is greater than most other children.
  • These intense children tend to produce strong emotional reactions from those around them, including frustration, anger, and worry.
  • This means that whereas for most children the more ordinary approaches to parenting and managing behaviour of muddling through—a bit of consequence here and there and rewards here and there—tends to work, for those children who are that bit more intense, we may need to “up our game” and work at engaging them at a greater level of emotional intensity.
  • You can think of these children as emotion seeking (not “attention seeking”). “Attention seeking” as a phrase suggests that children are thinking logically about what they do; however, in reality children are usually just responding to how they feel and are seeking emotional engagement in response to this feeling.
Family relational dancing

Now we can look at some emotional drivers of parent/child relationships. Here are a few more assumptions:

  • Emotions are viral! We tend to “catch” the emotions of those whom we are closest to (emotionally and geographically). Don’t be surprised with how quickly an emotion can ripple out into other family members. Laughter breeds laughter like anger breeds anger.
  • The basic philosophy of this approach is that of focusing on building functional relationships rather than on controlling behaviour. Let the emotions we want more of spill out and be caught. Let us build up our tolerance and immunity toward the emotions we want less of.
  • The concept of “negative” and “positive” emotions is not, strictly speaking, accurate. We just have a variety of emotions that are forms of directed energy that put us into an “action” rather than “thinking” mode.
  • When parents are dealing with children who have challenging behaviours they are often looking for strategies to try and control that difficult behaviour. They may hope that professionals can tell them that if they do A and then B the behaviour will stop. You may be looking to achieve the absence of undesired behaviours. The RAP philosophy will not tell you what to do to eliminate undesired behaviours—and for good reasons.
  • One of the problems with focusing on the controlling of behaviour is that attempts to control behaviour can lead to further strain and tension in the relationship with the child, which can end up in a negative feedback loop resulting in further attempts to control behaviour causing further strain on the relationship, and so on. The more that a young person feels alienated or “picked on,” the more they may try and defend themselves, the angrier they may feel, and the lower their self-esteem will become. A reinforcing negative loop can build up over time.
  • By focusing on relationships to start with, you can build a better foundation for stronger relationships that involves some mutual appreciation.
  • RAP tries to help with creating a new and hopefully more enjoyable relational dance.
The Emotion WARS

The idea of “Emotion WARS” is to help parents understand how “family relational dancing” can become problematic. It can be thought of as a framework for making sense of what is going on at a more unconscious level.

“W” is for Wrongs: The first assumption in Emotion WARS is that we are programmed to notice more what’s going wrong than what’s going right. Evolutionarily, our survival was related to our ability to scan our environment for signs of danger and respond to these. As this is an instinctual aspect, it means that the more stressed we feel, the more likely we are to activate this instinct to try to fix any perceived problem.

Becoming preoccupied with what’s going wrong means that, whatever the cause of increased stress, it becomes irrelevant compared to the actual experience of stress. So whether it’s difficult finances, problems in a marital relationship, the stress of school regularly ringing up, and so on, once we experience increased stress, we are more likely to end up focusing on what’s wrong, including with our children. Over time it becomes like an internal radar scanning the environment for signs of what next is going to go wrong, often missing those bits that are OK.

“A” is for Attachment: The next basic assumption is that children are born as “emotion seeking” creatures. Attachments are created through our emotional relationships and what we seek is emotional energy from those we are attached to. In an infant’s world, there is no such thing as good or bad emotion. For the infant and growing child there is an instinctual drive towards seeking emotion so that any emotion (be that love, worry, or anger) that comes back to them from a parent is experienced as rewarding in some way. If you think about it, you can’t get your mind off someone you’re angry with, just as much as someone you’re in love with.

Emotional energy creates connection. Seeking emotional energy is a better way of describing what children do than seeking attention. This also means children will know the parent emotionally much better than the parent will ever know the child emotionally. A parent will have many things to consider and think about. A child will just learn instinctually (not logically) what gets them emotional energy from the parent.

“R” is for Relationships: Relationship dynamics are then built up through these emotional energy ties that family members have to each other and over time this develops into a dynamic—a relational dance, where the relationship follows a certain “rhythm” so that each person responds in a predictable way to the other.

“S” is for Scripts: Over time we each develop roles within any group and these roles are rarely ones we have consciously chosen, but rather emerge out of the collection of relational dances “settling” into a certain recognisable pattern that everybody in the group (often unconsciously) recognises. For example, it’s a well-known phenomenon that if you have a partner, one of you will end up being the one preoccupied with tidying up, another one may be preoccupied with sorting out the bills or getting children ready in the morning, and so on. Many then find that even if you want the roles to change, it doesn’t feel “right” when you do.

So, for example, if you are the one who is concerned about keeping the house tidy and you yearn for your partner to also do this, when they do it, somehow they never seem to be able to do it in the right way and so you have to re-do it to what you consider to be the correct standard! This is a bit like each family member having a “script” that they follow which identifies their role, and should any member come along with a new script that changes their usual role, it throws everybody else off because it doesn’t seem “natural.”

There is thus a powerful and usually unrecognised emotional force from other members pushing anybody who goes “off script” back towards the script that everybody recognises—back to the usual family relational dance. If a child occupies the role of, say, “the troublemaker,” family members will often assume that this child is in some way involved whenever trouble is happening and the child will settle into that role and also expect it in themselves.

Emotion WARS thus uses the framework that we develop a family relational dance through the flow of emotional energy; wherever this is strongest, then this is what that relationship will “learn”—this will be their relational dance. As stress increases, then what’s going wrong will be noticed most. Over time a group of people will develop a set of relational dances that become the “family script” or the family relational dance.

When there is a child with challenging behaviour (for their parents), then over time the family relational dance may have settled into a pattern where that is the child’s role in the family script. As much as everybody wants and tries to change that, somehow (through the power of these emotional flows), despite everyone’s best intentions, it keeps returning to this script.

Your child’s portfolio

Imagine you are writing out an imaginary portfolio for how you would like your child to be in 5 years-time. Now ask yourself these questions and see what comes out:

  • What would you like to see in this portfolio?
  • What qualities or values would you like to imagine are attracting her emotional energy?
  • What sort of behaviours would you like to see them displaying?
  • Scale these behaviours/qualities/values from 1 to 10 for how much they display them now, where 1 is never and 10 is always. Which of these behaviours or qualities have they got the most of already?
  • How did you see this?
  • When did you see them doing this?
  • How much emotional energy did you give to them when they did this desired behaviour even if it was for a very short time?
  • How might you notice and give emotional energy to any small examples of these behaviours/qualities when you see them?
  • What else might you do to help shift one of those scores up by 0.5?
The Robot parent

In many ways the children’s favourite toy can be a person, such as a member of their family. There is something very satisfying about a person who makes independent choices and has autonomous intentions and yet you are still able to “play” them and get them to react in way that you know that person does not want to, whether that’s winding them up or getting them to concede to a demand that you’ve made.

Imagine that, as a parent, you’re like a toy robot with lots of buttons. When you push any button the Robot (you, the parent) gets animated and starts doing interesting things as you are emotionally worked up. Children have long since worked out your buttons. Now ask yourself:

  • What do they do that pushes your buttons? What do they do to get you emotionally worked up?
  • What behaviours or qualities in your child, when you see it, get you “animated” in this way?
  • Are these buttons ones that you would want to stop working—in other words, buttons that bring out emotions you would rather not have—or are they buttons you want to continue to have—buttons that bring out emotions in you that you like?
  • If you want a button to stop working, what might happen if you try to stop reacting when that button is pushed? Can you deal with your emotions when they try harder to get that button working again? Can you manage a situation involving managing risks without giving out emotional energy?
  • Would you like to strengthen buttons that bring out emotions you like? Would you like more of these sorts of buttons? Can you give a score between 1 and 10 for how often you see these “nice” buttons (1 never, 10 all the time)? What might you be able to do to increase your score by 0.5 on any of these “nice” buttons?

 

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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.

22 COMMENTS

  1. The Golem effect is a self-fulfilling prophecy that occurs because people treat someone based on the prophecy they’ve accepted about the person. People’s treatment toward the person essentially causes the negative prophecy to become true.

    Forcibly jail(hospitalize), drug and constantly monitor someone because they’ve been deemed “mentally and biologically defective” and a result is increased paranoia, anxiety, anger and decreased socialization, and happiness.

    Tell a kid they are defective, stupid, and behave badly and they internalize it. Forcibly drug them, constantly point out their perceived errors, and refuse to let them be their own person results in them internalizing the prophecy even more. They have less incentive to try because you can’t fix a brain disease by working harder. Even if they could overcome biology they’d still be labeled and subjected to the stigma. Personal Effort can’t fix the problem caused by the social environment and discrimination they face.

    I cringe watching almost any TV show where a child is labeled with a “mental illness” (Examples include The A word, and Parenthood). The family typically treats the child as an object that needs managed and fixed. In essence their response to their child being “labeled” is to self-fulfill the label.

    • So true, our scientific fraud based “mental health” system needs to get the f-ck away from our children. I’m glad I was able to keep them away from mine. Despite repeated attacks, due to the fact they want to drug up the best and brightest American children, and I’d done lots of research.

      I’m very grateful I was able to keep the insane “mental health” workers away from my children, largely with common sense, logic, and a belief in the fact that both genetics and properly raising one’s children, have relevance into children’s development and behavior., Since a satanic, lying social worker couldn’t understand why an eighth grader might surprise his school district, by get 100% on his state standardized tests.

  2. Well, I hope this system works for some people.

    But I am still waiting to see a system (besides the one I am trained in) that actually sees people as immortal spiritual beings, which is, after all, the actual truth of our situation.

    RAP, WARS, “dance” are bizarre expressions for a system that is supposed to help families come to peace with each other and with themselves. On top of that, the world is not that peaceful a place, and in recent times in particular, has been at war with families, with parents and with their children. (In short, at war with all of us!) This needs to be taken into account, too, and I don’t see that here. The ENTIRE PROBLEM a family could be running into could be coming from some antagonistic (criminal) element outside the family but lurking in the workplace, the school, or even in the media. These influences on childhood “bad behavior” and parent stress should not be overlooked!

    • Hey, I_e_Cox, does your religion’s anti-psychiatry museum buy “too truthful” artwork? I have one piece of art I did that visually describes all of the crimes my psychiatrists’ committed against me. But also all of psychiatry’s systemic crimes against humanity, in one piece of art.

      It’s title is “Psychiatry Turns Your Life into a Circus.” It’s inspired by a Chagall piece, and Chagall was a Jewish artist who survived the Nazi psychiatric holocaust of the Jews. I think it’s about 4’x30,” so it’s not really large. Might your religion’s anti-psychiatry museum consider purchasing such a piece of original art?

      • Sounds like a wonderful idea Someone Else! But I think it would take quite a sales job. Might be worth a try.

        The “museum” basically shows a lot of historical pictures and replicas of artifacts from the various phases of psychiatric barbarism. I have heard many stories of people going there and coming out quite shaken up.

  3. Sami, I just love this as I do most or all of your writings.
    I think many a parent would read this and be able to look back
    and say, WOW I wish I had known this.
    But the irony is, that even if you knew, you would not have
    understood it. That often comes through trial and error,
    just as you yourself might not have been able to write this piece 20 years ago.
    The “wisdom” or “understanding” , comes through experiences, being able to reflect back.

    BUT it is still hugely valuable, in that someone, a future parent say, might greatly benefit
    through this kind of writing.

    I only have a tiny problem with “the robot parent”, as I think some people might read it
    as suggesting that kids do this on a conscious level or that it is something that kids “DO”.
    And therefore the parent might change their reaction, even though it might not be the solution.
    Some might read it to suggest that kids are pushing buttons for “attention seeking”.

    I am not reading it that way, but am merely suggesting that some might. They might have
    forgotten the part where you spoke about “emotion seeking”.

    Anyway, fantastic and well done. It can be super bewildering to be thrown into the world as naked
    babies and naked parents. Every parent and child should have somewhere to go where “normalcy” is
    not advertised. Where differences are not illness.
    I remember my daughter at 6 weeks old just screaming as if she was in pain when I lifted her out of the
    car seat.
    Her doctor suggested it was anger. An absurd thing to say. It was clearly pain somewhere. An ill fitting car seat.
    Over time, I have been lucky enough to meet absolutely nothing but psychiatry based medicine.

    My daughter recently posted a question on a chicken forum about her chicken sitting on the nest more often. The responses were so assinine, all based on psychology, but making no sense.
    The danger is, that if someone treats their child or chicken, as per assinine assumptions, we drive that thing we are trying to fix, bonkers. Everyone becomes a dangerous psychologist 🙂 which the industry loves.

    I sure hope people that read Sami’s article can see the common sense. No where is he pathologizing all our weird ways.

  4. Sami, I remember when I was little (I’m old now lol)
    How my mother hung up the peed bedding on the line,
    yelling at me how all the neighbours would see the yellow stains,
    and off I was sent to school which everyone wondered why I
    did not want to go to. Ohh how “therapists” love this stuff.
    Ohh the “trauma”. Let’s work on that “trauma”.

    How truly awful how these outsiders continually harass kids and grownups
    about what happened. And if that does not work, there are always pills.

    The very best thing anyone can do for children and adults is to involve
    them in tiny successes. And failures they can bear. “mental health” is set
    up for failure. In therapy and psychiatry. Fucked up people “treating” the “others”,
    will never work. It never has, never will.
    Parents sending their focused on children to “therapy”, when the family unit
    plus the “therapist” all need direction. There is no “expert”.

    I think you understand this well and so glad you have come to write about it.

    • “Tell me in detail how horrible and shitty life has been for you. Now let me explain how it is the fault of your thinking. Don’t blame yourself though, life sucks because you are mentally/biologically defective. Do these mental games to change your thinking.
      If that doesn’t make things better you’ll need cognitive impairing drugs. If you don’t want the disabling drugs it’s because you’re too stupid… wait I mean you lack insight to understand addicting deadly drugs are good for you.” -Psychiatry

      Psychiatry Later, “Damn, all the people we treat are so sick, impaired, and emotionally unwell. Clearly they need to buy more drugs and sessions with us. We are hero’s saving people.”

      There was some science fiction book where one group poisoned the other group environment and then sold them treatments for it. That is essentially what psychiatry does.

  5. On the contrary OH.
    I respect the “rants” of anyone who exposes
    the massive lies that are affecting so many people
    and their quality of life.
    I was being sarcastic, but in truth, there are a few people out there
    who might pay attention to a PHD, or a “professional”,
    before they would pay me any mind and if that is what it takes
    to make more people take note, so be it.

  6. Once upon a time “worried” parents did not go to a child psychiatrist or community mental health clinic to seek help for discipline or challenging behavior problems. The traditional wisdom of parents of what is normal has been replaced by the opinions of a variety of professionals, teachers, psychologists, paediatricians and psychiatrists. Today, parents are told that any challenging behaviour, not paying attention, boredom, showing off, reacting with anger or aggression is a symptom of a problem which needs an expert to deal with it.

    Schools are at the forefront of this trend. Teachers have now been trained by business leaders to harass and direct parents to mental health professionals to solve academic and discipline problems. A raft of therapeutic programs, relational therapy, mindfulness, drugs etc are advocated by the community to solve what used to be a school’s responsibility, to educate the whole child. There is never any examination by therapists of the role that the mental health industry and the educational system plays in the successes and failures of children who spend the majority of their time in school each day. The rapid expansion of this corporate culture has been aided by industry advertisements, magazine articles and promotions by government health authorities.

    Realtional therapy might help a minority of parents. But one has to acknowledge it is an outgrowth of the current exploitation of children via the children’s mental health campaign in the nineties and 2000s. There are many factors inside the family (neglect, substance abuse, trauma, unemployment) and outside the family (current manipulation of children by mental health propaganda, and a competitive schooling system) that can lead children to be unhappy. Therapy is not the answer.

  7. Carl Jung knew that often it is the parents of the ‘problem child’ who need to be ‘taken by the ear’, and by extension, ‘society’. But often we get the child a ‘team’ and ‘do’ something ‘to’ them. It sucks when parents would only admit guilt (REAL guilt, not the ‘common’ guilt of ‘good parents’) because they ‘failed’ their child because of how they act, in other words, diverting the true object of guilt. We should remember that life itself is guilt, and no one is completely free. And not once did they have to pay for their own couple’s or individual therapy or drug prescription….and guess who never changed? No ‘service-provider’ or ‘clinician’ ever looked close enough and recommended it, for in a sense, the provider would then have to take their own therapy, their own drug, because they so often unconsciously identify with the parents. It only changed when the child (who is a parent’s child no matter what the age) becomes the parents’ ‘therapist’ at the moments when he doesn’t have to leave the room during their arguments, making sure he can’t hear it in the background, all those ‘contagious emotions’. They were always there. But it was the child who got the label, the infinite ‘services’. In this way, one source of the ‘infection’ was never pulled from the roots. It began only to return again.

    And also no one ever mentioned nutrient supplements (even diet?), not even the most ‘enlightened’ ones like this author. Not once.

    Man, I certainly ‘quoted’ this comment up.

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