Welcome to Childhood Made Crazy, an interview series that takes a critical look at the current “mental disorders of childhood” model. This series is comprised of interviews with practitioners, parents, and other children’s advocates as well as pieces that investigate fundamental questions in the mental health field. Visit the website to learn more about the series, to see which interviews are coming, and to learn about the topics under discussion.
Judith Schlesinger is a writer, musician, and PhD psychologist. Her hats have included university professor, crisis counselor, and therapist (inpatient and out); she is also a jazz critic, bandleader, CD producer, and columnist for Allaboutjazz.com as well as TheCreativityPost.com. She is the author of The Insanity Hoax: Exposing the myth of the mad genius (2012) and invited contributor to Creativity and Mental Illness (2014).
EM: How would you suggest a parent think about being told that his or her child meets the criteria for a mental disorder or a mental illness diagnosis? And how would you suggest a parent think about being told that his or her child ought to go on one or more than one psychiatric medication for his or her diagnosed mental disorder or mental illness?
JS: Do not be intimidated into thinking all experts and their advice are necessarily absolute and infallible. Ask specific questions about treatment goals and practices, without being confrontational. While it always helps to be respectful of their training and greater experience, keep in mind two important things: 1) not every therapist suits every seeker, and 2) ongoing discomfort with a treating professional, especially after you’ve expressed reasonable concerns without getting any modification or satisfaction, fully entitles you to shop for another one.
Listen to your gut. The right therapist will explain disorders and medication in a way that demonstrates not only knowledge, but caring, respect, and hope for you and your child. So don’t be afraid to ask about what’s bothering you; the best therapists will help you understand, rather than dismissing your concerns because they don’t like to be challenged. And if there is no sense of humor, run!
EM: What if a parent currently has a child in treatment for a mental disorder? How should he or she monitor the treatment regimen and/or communicate with mental health professionals involved?
JS: It's always a difficult line to walk. Parents should make it clear they are committed and want to be kept informed of major developments, but they should also let the therapists do their work without undue interference and demands. It’s useful to discuss communication and accountability at the beginning of treatment, and find some general guidelines that can be mutually acceptable; this can keep resentments from taking root and festering.
Meanwhile, since any journey involving adolescents is likely to have numerous bumps and switchbacks, a monthly or every-other-monthly family session can keep things on track. The ideal scenario is a partnership with trust and respect on both sides, but any strong working relationship takes time to develop. You know you’ve finally created one when the inevitable crises that come along serve to strengthen, rather than erode, it.
EM: As someone who works with teens in distress, which sorts of things seem to help the most?
JS: A warm and trusting relationship between teen and therapist. Telling it straight and real. Not being condescending, placating or infantilizing, or trying too hard to be “cool.” It also helps to explain that everything teens tell you will be confidential, unless you feel they are in danger (they usually bristle at this, at least at first, but generally come to appreciate the protected feeling provided by such limits).
It is essential to listen very carefully and deeply, and respond so the teen knows s/he’s been heard; this means remembering things they already told you, and even being able to quote them. It's important they know you are paying close attention, and not leaping into judgment.
Finally, I have always found it useful to play music during therapy that the teen has chosen him/herself. It is a conversation-starter than enables you to introduce painful topics by reacting to the lyrics of someone else's song. An extra bonus is that, if you ask the teen to bring favorite music to share, s/he gets to be the expert in that situation, and teach you something about it. It's a good bridge as well as a handy leveler, for now we’re both experts in something.
EM: You’ve written The Insanity Hoax: Exposing the myth of the mad genius. What might parents get from that book that might help them?
JS: The Insanity Hoax book deals with the fallacy that creative people who color outside the lines are automatically damaged, or at least somehow suspect, and that their “different” behavior and thoughts are inherently symptomatic and cause for distress. It can help parents expand their tolerance for unconventional thinking and behavior, understanding them as "talent” or “individuality” rather than necessarily “disordered.” It is often a matter of degree and interpretation — certainly, it’s not written in stone.
The book also helps demystify diagnostic categories, explaining how they are invented by fallible, ambitious humans, rather than brought down from Mt. Sinai right behind the tablets. It also raises the issue of society’s need to alleviate envy by pathologizing its greatest artists and assuming they must pay dearly for their gifts.
EM: How can parents deal with intense pressure from a school system that insists that, unless they medicate their child with an ADHD drug (long term effects unknown), they will have to withdraw him (it’s usually a him)?
JS: There is no easy answer to this one, given the financial incentives for school districts to identify so-called “special needs kids.” Many get a state bonus for each one. In a climate where so many classrooms are overcrowded, and so many teachers too overwhelmed to take time out for the misbehaving (bored? too smart for the room?) child, amphetamines and resource rooms are often pushed forward as mandatory solutions. It’s more of a management than a mental health issue, but the pressure can be intense.
I would encourage parents to resist this as much as possible, even though they may be just as overwhelmed by the disruptive child as the school is. So, what to do? Some ideas: get behavioral help to train the child to control his behavior; make sure he has challenging and active things to do outside of school; be honest about the state of your marriage, in case your son is acting out to give you a shared problem that pushes you closer together.
It’s hard to stand up to a principal’s intimidation, but it’s worth a try, given the dubious nature of the ADD disorder in the first place, together with the unknown long-term consequences of its powerful drugs on developing bodies and brains.
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