“James” was a typical, active 8 year old who did well in school regulating himself but was very difficult for his parents to deal with at home. His parents reached out to me after trying play therapy which consisted of the play therapist trying to get James to identify feeling words and talking about how he feels when he gets dysregulated. (I see a lot of kids who had previously be in play therapy that sounds just like this).
James getting set off at home came in the form of cursing/screaming at his parents, running out of the house and hopping on his bike to get away from them and sometimes getting physical.
I figured out that James’ parents did A LOT of sitting down and talking with him. Lots of rehashing of what happened, trying to get him to talk about his feelings (as they were instructed to do by the play therapist).
What these parents were trying to do was not in line with Jame’s brain development. They were trying to get him to access language that his brain didn’t have easy access to yet. They were trying to get him to sit down and express himself. (Boys typically do much better at talking when the focus is not on them or there’s physical movement involved.) As a result, he would become frustrated and get set off.
At one session I saw their dynamic first hand. We were finishing up and James ran out of my office. Intuitively, I knew he would just be waiting outside. His mother began to run after him, anxiously calling telling him to wait..
“Don’t chase him” I told her. “You’re making this into a game for him. It gives him a sense of accomplishment when he can get away from you”.
“But what if he runs in the street? He takes off on his bike all the time” his mother said anxiously.
I explained to her that he’s going to be sitting outside and he has enough safety awareness not to run into the street. “His intention is to get away from the incessant talking because it’s overwhelming him.” He was sitting outside.
My suggestions to the parents:
-Trying to rehash the events every time he gets dysregulated, is not helpful.
-Stop trying to get him to talk about feelings when you want, his brain development isn’t there to do that and it’s not congruent with how most boys access their feelings or express emotions.
-Reduce your words by 80% when he’s upset or you’re trying to convey a message, you can say the same message with just a few words.
-Stop chasing after him, if he is trying to get away from you. Give him space to calm down. He can’t hear or learn when he’s agitated. It will also stop the power struggle you’ve created when you chase him and he makes it into a game.
James’ parents followed my suggestions and his behavior at home improved immensely. It’s not perfect, but it’s much better.
Boys with ADHD have difficulty with recalling past events as well as thinking into the future. When they tried to process past events and get James to talk about his feelings it set James off because they were asking him to do something that his brain isn’t capable of doing.
Most mental health professionals get no training in male-brain development so the way they engage boys is typically based in how the female brain works. I’ve seen plenty of male therapists do this as well. The mental health field for the most part does not acknowledge gender-based brain differences and certainly has not taught clinicians how to work effectively with boys. The people who I’ve seen do good work with boys just seem to get it intuitively.
What complicates this is that most mental health professionals have little understanding of how lagging executive functioning affects the brain. To most people, executive functioning means academic organizational skills.
If you feel that your son isn’t benefiting from “talk therapy” maybe it’s time to meet him where his brain development is at.