the Sea
Parents who are faced with the development of children must constantly live up to a challenge. They must develop with them.
- ERIK H. ERIKSON, Childhood and Society
IN ANY COMMUNITY OF BEINGS living in close contact with each other, the behavior of individuals can be under stood only in the context of their relationship to the group as a whole. In an ant colony, for example, larvae are hatched with essentially identical genetic makeups. Who becomes queen or worker or soldier is determined by the needs of the group, not by in dividual predisposition. The requirements of the community shape the physiology and functions of each ant. The human family is not an exception to this rule. It, too, forms a system that powerfully influences not just the early development of its young but also their behaviors and development later on. Understanding the family system can be turned to great advantage in promoting the healing process of the child with ADD.
At no time in life do behaviors reflect a relationship with significant others more closely than in childhood, because at no time in life are people as emotionally and physically dependent on others. We think that children act, whereas what they mostly do is react. Parents who realize this acquire a powerful tool. By noticing their own responses to the child, rather than fixating on the child’s responses to them, they free up tremendous energy for growth. “If parents shift their focus off the child and become more responsible for their own actions, the child will automatically (perhaps after testing whether the parents really mean it) assume more responsibility for himself,” writes Michael Kerr, psychiatrist and director of training at Georgetown University Family Center. “If parents focus on being responsible for themselves and respecting boundaries in relating to their children, the children will automatically grow towards being responsible for themselves.”1 This taking of responsibility for oneself is based on the capacity for self-regulation.
As we have said, self-regulation is the goal of development; the lack of it is the fundamental impairment in ADD. One way of describing self-regulation is to say that it is the ability to maintain the internal environment within a functional and safe range, regardless of external circumstance. On the emotional level, the self-regulation of moods means that neither despondency nor uncontrolled exuberance, neither passive submission nor blind rage, control the mind. A person can experience frustration, disappointment or sadness without being seized by despair. Happiness does not need to be euphoria or anger hostility. Moods are not controlled by the vagaries of external events or by the moods of others.
Emotional self-regulation may be likened to a thermostat ensuring that the temperature in a home remains constant despite the extremes of weather conditions outside. When the environment becomes too cold, the heating system is switched on. If the air becomes overheated, the air conditioner begins to work. Or, to use an analogy from the animal kingdom, emotional self-regulation is like the capacity of the warm-blooded creature to exist in a greater range of environments. Its blood will neither chill nor overheat, no matter what the external temperature. The cold-blooded animal can endure a far narrower range of habitats because it does not have the capacity to self-regulate the internal environment. People with ADD, especially children, are like cold-blooded animals, in this sense. Their internal balance is too easily upset by even relatively slight external variations. They are too often reacting automatically instead of acting purposefully. Many find transitions stressful because they are not flexible enough to adjust emotionally to even small changes. Others with ADD thrive on constant turmoil and change. This also is a failure of internal regulation expresed in the need to take up new activities, new relationships or new situations constantly because the interest and energy level cannot be sustained from within, without highly charged external stimuli. When circumstances make that impossible, there is chaos or emptiness.
An indispensable condition for the evolution of self-regulation in children is its presence in the nurturing adults. In families where one child or another has ADD, the parents often lack this capacity. Their moods are not independent of the child. Almost all parents with an ADD child report that their son or daughter has an uncanny power to dictate what the emotional atmosphere of the family will be. “When he gets upset,” one father said of his seven-year-old son, “the climate in our house can go from fair to foul in a matter of seconds. When he is happy, it is sunshine and joy all around.” Should the child become downcast, the parents feel despair; if the child is angry, they themselves fly into a rage; when the child acts out of control, they feel helpless.
In some of the families I have seen, I’ve sensed an invisible umbilical cord that still connected a parent to the child. “It is true,” one mother said. “If my son is happy, I am happy. If he is doing poorly, I am devastated.” Not only the parents but other siblings as well seem to revolve in emotional orbits around the child with ADD. They naturally come to resent the control he or she appears to wield over the family.
Parents of an ADD child will often say that their son or daughter has a “powerful” personality. Far from being powerful, the child is weak and vulnerable. It’s not his “power” but the inefficiency of the parents’ own emotional thermostat that enables the fluctuations in the child’s moods to set the emotional tone of the whole household. A child in this situation is deeply insecure. He is made insecure by his lack of emotional self-control because there are no adults around able to maintain a steady and functioning environment, whatever his own particular internal states may be. There is no development amid such a lack of safety. It only appears that the child’s moods are in control, because the parents are unaware of how profoundly their own mind states and their own lack of internal self-regulation affect the child. It’s another vicious cycle. The parents need the child to be in balance only because they are not. But because the parents are not independently in balance themselves, the child cannot be.
Let’s examine the all-too-familiar dinner scene more closely. The ADD child is hungry, and therefore out of sorts. He may be slow coming to the table, or may even refuse to do so. “Fine,” the mother says testily, “we will just have to eat without you.” The child now takes his place at the table sullenly, picks at his food and utters a stream of complaints about this or that aspect of the meal, or he may stay out of the kitchen altogether. From another room, he yells protests and insults at his parents and siblings, the message being that no one cares about him, or that he wants no part of such a selfish and unlikable collection of people. Either way, his mood will infect the entire family.
As the tension mounts, the mother casts an exasperated and defeated look at her husband. He, in turn, slams his fist on the table, leaps up and roars at his son, who is still defiantly complaining. It no longer matters who wins the ensuing yelling match, or whether it ends with the father trying to drag the boy to the table or to his room. Everyone’s mood is dark, the dinner is ruined and all the rest of the family is confirmed in their belief that there is something terribly wrong with this particular child.
Some version of this story is recounted by most parents of a child with ADD at the very first visit to my office. Understandably, they are desperate for advice. They want to be given parenting techniques to help them be more effective in such distressing situations. “What are we supposed to do?” is one of the first questions. “How do we handle it when our son is so completely out of control?”
There are many books and other aids that advise mothers and fathers of children with ADD on techniques of motivating the child, helping him get organized, controlling his behavior. “We have listened to tape after tape given to us by our psychiatrist on how to do this or that,” one father said, “but nothing works.” Methods may fail not because they are not reasonable but because in themselves they do not address the emotional context, the emotional transaction that, unseen, takes place between the parent and the child.
What matters above all is not the technique, but the degree of parental self-regulation. The fundamental issue is not how to parent, but who is parenting? By this I don’t mean which parent, the mother or the father, but the state of mind of the adults as they respond to the child. The unbearable tension that arises in scenes such as the suppertime drama we have just witnessed is only partly due to the child’s behavior. It is fed and magnified out of all proportion by the anxiety the child’s oppositionality provokes in the parents. Such anxiety has many roots, including the parents’ fear of losing control, their exasperation at having yet another family scene ruined, their emotional pain at being so attacked by the child and a deep-seated pessimism that unless it’s nipped in the bud, their child’s bad behavior will be only the harbinger of much worse as he gets older. In short, the child triggers the parents’ anxiety. Anxious parents revert to behaviors characteristic of young children without self-regulation: impulsiveness, rage, physical acting-out or helplessness. Approached in this manner, the hyperreactive ADD child will be propelled into yet greater anxiety, manifested in ever-escalating and seemingly impervious hostility or in fearful clinginess.
If we revisited this family, but with the parents’ having developed a little more self-regulation, the outcome would be quite different. Self-regulation in this context has nothing to do with “controlling one’s temper.” What we call “temper” is only an automatic anxiety response. It is the reaction of a person who cannot tolerate the feeling of anxiety. Self-regulation is not the absence of anxiety, at least not in the very beginning, but a person’s ability to tolerate her own anxiety. As the child begins his well-choreographed routine at suppertime, the parents now see that becoming tense is only one of any number of possible responses on their part. They do not then have to suppress their own anxiety by trying to control the child’s moods and behaviors. They could just see him as a child who has some growing to do.
The parent who can tolerate her anxiety does not need to respond to the child with anger, emotional coldness or pleading. The child is not under pressure to change his behavior immediately in order for the parent to feel comfortable. If the parents do not react with their usual anxious manner and their voices do not convey anger or despair, the child himself will not feel further anxiety. If the child knows that the parent is okay even if the child is not okay, he feels safer. Whatever his immediate response may now be, it no longer has the power to escalate the conflict. He can relax a little.
When he does not have to put up defenses against parental hostility, the child can more easily get in touch with his deep-seated wish to be part of the family circle or with his sadness at feeling excluded from it. When the child shows even a hint of his vulnerability, in place of his defenses, the parent can immediately move in and establish contact. The child can feel secure with a parent whom he cannot reduce to his own level of functioning. When safety is established, growth takes place.
The parents of children with ADD have to strive for self-knowledge. That is the first prerequisite for nurturing the development of the child. Even with the best of goodwill, no one can long escape her unconscious. The passing on of psychological burdens from one generation to the next occurs around those issues that the parents are least aware of in themselves, and it occurs precisely when the child pushes the parent’s unconscious emotional buttons. Many parents have had the frustrating experience of going into a situation with optimism and a firm idea which parenting technique to employ, only to find themselves soon yelling at the child or withdrawing from her, completely sabotaging their own best intentions. Our knowledge of parenting techniques, like all intellectual knowledge and learning, is a function of the cognitive left side of the brain, while who the parent is—what face she turns toward the child—is at any given moment determined largely by forceful emotional mechanisms governed in the right hemisphere. A struggle between hemispheres is an unequal battle. Once our deepest emotions are stirred—as they so easily are in our interactions with our children—intellect and understanding are quickly subdued.
The professional literature on ADD talks of “maintenance factors” that reinforce or trigger ADD traits. No maintenance factor is more powerful than the emotional states of the parents. Unresolved psychological conflicts between the parents, and within each parent individually, are a major source of unrest for the hypersensitive ADD child. This anxiety absorbed by sensitive children will lead to hyperactivity or other ADD-related behaviors.
Parents who put the attention on their own psychological functioning soon notice this highly interdependent relationship between their moods and the level of the ADD child’s reactivity. Much of what the parent interprets as problematic or disturbed behavior represents the child’s automatic right-brain responses to the parent’s emotional messages. Only superficially are dysfunctional responses the results of her “disorder.” They do not originate purely from within herself. The child is manifesting what the noted family therapist and author David Freeman calls the parents’ “unfinished business.”2 That she does so is a sign of her immature self-regulation, but what she expresses by her acting-out says as much about her environment as about herself.
Dr. Freeman defines unfinished business as “a present emotional reaction shaped by a past experience. It is a reactive response guided by strong emotional feelings based on past experiences of anxiety.… Behaviour on the part of our spouse or children that appears critical, distant, or unloving will trigger anxiety and doubt in us and block our ability to be loving and nurturing,” writes Dr. Freeman.
Children swim in their parents’ unconscious like fish in the sea, in the succinct phrase of the Vancouver psychotherapist Andrew Feldmar. To create safety for their children, parents need to devote energy and commitment to processing their own “unfinished business.” In this way they can do much more to further the development of their child than by any behavioral approaches aimed at motivating the child or at making him more compliant.
Self-regulation is intimately connected with a process developmental psychology has called individuation, or differentiation. Individuation—becoming a self-motivating, self-accepting person, a true individual—is the ultimate goal of development. As individuation unfolds, children are able to move more and more independently into the world, impelled by their own interests and needs. Less and less do they require that another person see exactly what they see in order to feel validated, or that another person feel exactly what they feel. They may have needs and desire for closeness, warmth and mutual support with another human being, but they do not need to be emotionally fused with the other person—they can function on their own, if need be.
If parents are to foster individuation in their children, they must also work on their own maturation. Try as they might, poorly individuated parents cannot successfully foster individuation in their children. They are likely to have unsatisfactory relationships with their partners, especially after children begin arriving to upset the fragile emotional balance between them. They are also likely to fuse emotionally with one or another of their children. There may be the semblance of a close relationship between parent and child, but in reality the child’s individuation is hindered, as he grows up feeling automatically responsible for the parent’s feeling states. Later the child will harbor a sense of responsibility for the whole world. Even what can be seen as selfish behaviors represent nothing more than unconscious and desperate efforts to throw off that sense of overwhelming responsibility.
“Our troubles began with the birth of our son,” the mother of a young boy with ADD told me. “Then things started to fall apart.” Neither partner in this couple was highly individuated when they got married, and neither could function without anxiety unless they felt loved or supported by another person. They could avoid feeling their anxiety because their closeness compensated for their lack of emotional confidence in themselves as individuals. When their son was born, the mother naturally had to direct much of her nurturing energy toward the baby. Her own needs for emotional bonding were also satisfied, in part, by the close contact with the infant. She could feel intense joy, for example, when she was breast-feeding. For the father, it was a different story. Without knowing it, he began to exhibit behavior that betrayed mounting anxiety. Increasingly he resented what he interpreted as his wife’s reduced sexual interest in him, tired as she was from nights interrupted by the baby’s feeding needs. He did not realize that what he imagined was sheer sexual frustration was in reality his dissatisfaction at finding himself psychologically on his own more than he could handle. He made demands, and when they were frustrated, he began to withdraw emotionally. He threw himself into his work, which helped to alleviate his need for emotional contact and therefore his anxiety, but, in turn, led to anxiety in the mother, who now felt quite alone in the relationship.
The emotional balance in the home, increasingly tenuous, was easily upset. Neither parent being sufficiently differentiated, each reacted strongly to the other and to the ADD patterns their son was showing more and more as he approached school age. The wheel of anxiety was continually kept in motion. If these parents had had the opportunity in their own families of origin to become more independent individuals, the anxiety cycle would not have begun. Not depending so much on his wife’s complete emotional availability, the father would have been able to tolerate her devoting all her nurturing attention to the child. Nor would she have interpreted as abandonment the signs of his anxiety.
Family therapy helped this couple to realize their mutual and interlocking emotional dependencies. No longer so threatened each time their partner seemed a little aloof or unavailable, they were able to tolerate a little bit more emotional space around themselves without feeling bereft. They learned to see their son as a separate individual rather than as an extension of themselves, no longer feeling personally devastated when he experienced distress or acted out in some immature fashion. Having a stronger identity allowed each of them to put less stock on what other people thought of them, which meant that they had less need to control their son’s behavior simply to spare themselves embarrassment. The result was that their son felt more accepted by his parents, which gave a boost to his self-confidence and self-acceptance. He now demanded less affirmation from his peers, who no longer had to keep him at arm’s length because they could not handle his neediness. Less taken up with social anxiety, he became more calm and more attentive in the classroom.
These changes did not take place overnight. The couple experienced failures and setbacks before they could feel sure that they were on a healing path. They had to keep in mind the long-term goal, development, to avoid reacting with self-defeating behavior whenever their anxiety was triggered either by their partner or by their child. At no point could they definitively say that their son had left all his problems behind. But as they developed, so did their son.
As long as parents are willing to look into themselves, they will stay on a learning curve, and their child will have the safety that encourages development. If this challenge is taken up, the diagnosis of attention deficit disorder can be the beginning of a healing process for the child and for the whole family; otherwise, it may become a trap. The parents may become fixated on “treatments” for the child’s “disorder,” which can contribute to the child’s own sense, deeply embedded in her psyche, that there is something wrong with her. No doubt there is disorder, but it involves the entire family system. If the child is to heal, the family system must heal.
To maintain compassion toward their children, parents have to be compassionate toward themselves as well and spare themselves their own harsh self-judgments. Inevitably there will be mistakes, many times when they will “blow it.” It’s all right. Although sensitive, children are not made of glass and do not break that easily. They are, in fact, highly resilient. As normal human beings, we are bound to have our emotional ups and downs, our moments of greater or lesser emotional balance.
“I feel like I always have to be on,” one mother complained. “If I am even slightly off, everything goes to pieces.” No one can be “always on.” But a giant stride forward is made when parents recognize the need to monitor their own emotional states and the level of tension in the entire household. If children swim in their parents’ unconscious, it is good to make sure that the water stays clear. Or at least as clear as possible.