I was recently sent a copy of Marilyn Wedge’s new release, Suffer the Children: The Case Against Labeling and Medicating and an Effective Alternative.
It was satisfying even before I’d opened it – with a heavy set of covers, thick creamy paper and tasteful bindings, it’s a beautifully produced book – but so interesting that I couldn’t help but mark it up.
Wedge’s tone is warm and conversational from the beginning, and she weaves together case studies with interpretation to create a text that is engaging and accessible for any reader. It feels like a chat with a wise older friend, who just happens to be an empathetic and informed family therapist.
“I couldn’t help but think that what might appear “crazy” behavior in a grown person – tantrums, impulsiveness, short attention span – is often business as usual in a child.”
She begins with a reframing of what is often called (in the UK) “challenging” behavior – the kinds of acting up or out that usually begin the referral and medicalization process. Rather than viewing these as symptoms of a medical disorder such as ADHD, Bipolar or the horrifically vague-sounding Oppositional Defiant Disorder, she takes a social approach.
At the heart of her work is the belief that the actions of a troubled child are in response to the cross-currents of tension or need within the family. She speaks eloquently about the ways in which children’s behaviors can be understood as “benevolent” – as a child’s refusal to go to school may be based on his or her perception of one parent’s loneliness, for example.
Crucially, she accomplishes this without blaming parents, who are almost always doing the very best they can. Instead she demonstrates how simple tactics, such as relating one good thing that happened each day, can relieve the child’s anxiety and set them free. She also discusses the dangers of examining a child’s behaviors as somehow separate from the family dynamic, and how medical diagnoses can become self-fulfilling prophecies, leading to the prescription of more and more serious drugs to those too young to consent to the serious (and poorly understood) short- and long-term risks they pose.
She also describes the exceedingly murky processes by which new disorders are codified in the DSM, and shows how variable these diagnoses can be in the absence of a known biological cause.
It’s not news that children today are facing challenges unknown to previous generations. Tight limitations on their freedoms to roam and play, to directly engage with nature and to take charge of decisions in their own lives have combined horrifically with ever-increasing academic and social pressure to conform, perform and succeed.
As a Family Therapist, Wedge’s focus is tight on the family. She clearly demonstrates how often we locate the cause of systemic social problems within children, and how we are encouraged to find a quick solution in pills. In making the case for treating biological issues medically and behavioral issues therapeutically, she is simultaneously advocating for a concept of childhood that encompasses mischievousness, individuality, and fun – and supports parents in seeing their children not as sick, but as only trying to help.
At the end she includes a list of questions to ask when seeking a Family Therapist – one that would prove very useful to anyone seeking a good professional match.
She also offered a Q & A – it follows this, and is downloadable here!
Morgan: It seems that every day we hear more about children’s lack of self-structured outdoor play, increased academic pressure and the cancellation of recess. What connection do you see between our society’s changing expectations of children and the rise in pathological interpretations of their behavior, diagnosis and medication?
Wedge: In our society children are too often expected to be “miniature adults” and tragically, adult mental health diagnoses are applied to children when they don’t behave like adults. Children are expected to compete like adults and bear academic pressures in elementary school which are unrealistic for their developmental needs. Kids tend to be more impulsive and have shorter attention spans than adults. Some children tend to be bouncy or fidgety or imaginative.
These are ordinary childhood behaviors and not signs of pathology. Unfortunately, diverse learning styles are tolerated less and less in our schools.
If a child does not keep up with his classmates as measured by standardized tests, parents feel pressured to have the child diagnosed with ADHD and medicated with stimulant drugs. So much emphasis is placed on competing academically that both parents and schools tend to ignore other basic needs of children, such as the need for physical activity and open-ended play.
MLS: Running throughout your book is the concept that troubled children take on a ‘helper’ role, responding to the imbalances and anxieties within their families. What are some simple strategies you have found for opening a discussion with parents that incorporates this concept, without seeming to blame them for their children’s difficulties?
MW: Since the publication of Suffer the Children, I have received emails from parents all over the country asking me for help in finding a family therapist. Interestingly, none of these parents feel blamed by my approach to solving children’s problems. On the contrary, parents tell me that the book opened their eyes to how family issues may be affecting their children. Parents just aren’t used to thinking about their child as organically connected to the family environment.
Once parents start thinking in this new way, they can see connections without feeling blamed.
When I first meet with parents, I typically ask them what they would be worried about if they were not worried about their child. I ask “what is the second biggest problem in your family?” This simple question usually brings to light the real source of the child’s stress, which is usually some kind of family transition.
Sometimes it is a parent’s illness or injury, sometimes it is a financial issue because a parent has lost a job, sometimes it is another form of family stress. Just as parents love and protect their children, so kids love and try to protect their parents—sometimes by having a behavior problem which diverts their parents’ attention from a more serious problem. I tell the child that I am going to be his family’s helper now so he can go back to being a kid. When the child sees that I am helping the family resolve the deeper issue, the child no longer feels burdened and his problem behavior fades away.
MLS: Opportunities for therapy are difficult to access for many people. What direct advice can you give to families and family support workers in locations where formal family therapy is simply not an option?
MW: I suggest that parents go to their public library and check out a copy of Suffer the Children. Reading this book will help them begin to think in a different way about their child’s problem. It’s important for parents to move beyond thinking in terms of a psychiatric diagnosis for their child, and to start thinking in terms of stressors in the child’s social environment.
Any advice I could give here would of course have to be targeted to a specific problem, but I can provide some general thoughts. Hearing parents disagree, especially about discipline, can be very stressful to children, and often results in their having attention and focusing problems or anxiety. I advise parents to have their disagreements and arguments away from their child and even to seek marriage counseling if they cannot resolve their issues by themselves. Parents should also have clear rules and consistent discipline for their child. Often, parents inadvertently reward the child’s bad behavior instead of his good behavior, and this leads to many types of behavior problems. A support worker can help parents come to agreement about discipline and write down the rules and consequences for misbehavior as well as the rewards for good behavior. Then both parents can sign the agreement.
Excursions or outings with a parent are more meaningful to a child than material rewards. Another good strategy is for parents to make a list of their child’s best qualities, and tell their child at least two good things about himself every day.
MLS: You mention sports explicitly as a valuable way for children to vent the “excess” energy that might contribute to a diagnosis of ADHD or similar. It seems that a physically challenging, staffed playspace would provide opportunities for this, as well as adults who recognize the therapeutic possibilities of children’s free play and can support that process. As a Family Therapist, and former Play Therapist, I’d love to know your opinion of the potential of Pop-Up Adventure Playgrounds to help families and communities.
MW: Children need both outlets for their physical energy and opportunities for unstructured play. Free play stimulates children’s creativity, and in my opinion plenty of time for free play is essential to a happy, healthy childhood. These days, parents are so focused on competitive team sports and structured after-school activities that they often forget about the value of relaxed, unstructured play for stimulating the child’s creativity and inventiveness. Highly creative people such as Bill Gates, the founder of Microsoft, take time every year to reconnect with the outdoors in a relaxed, unstructured environment away from electronic screens.
An adventure playground seems like it would give parents as well as children an opportunity to free their minds and use their imaginations. Another benefit of this kind of outdoor play is that it gets children away from television and video games, and gives them an opportunity to interact spontaneously with other children.
Thank you, Marilyn – for the copy of your book and for taking the time to answer my questions so thoughtfully. Here’s wishing you, and Suffer the Children, every success!