Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Sunday, May 21, 2017

Young Psychopaths at the Atlantic Magazine: More Zombie Ideas

Readers of blogs and quasiprofessional websites will be familiar with the practice of calling children “psychopaths”. Readers of professional psychology and clinical social work will find this terminology strange and sensationalistic; they will be accustomed to the use of terms like “callous-unemotional (CU) behavior” or “conduct disorders”.

Many of the ideas associated with the “psychopath” label are zombie ideas: they are dead, but they won’t lie down—and they accomplish certain kinds of work for the people who use them. The current (June 2017) issue of the Atlantic magazine features an article full of zombie ideas about children’s aggressive and angry behavior and is entitled “When Your Child is a Psychopath” (https://www.theatlantic.com/magazine/archives/2017//06/when-your-child-is-a-psychopath/524502/). This article recounts frightening stories about children obsessed with anger, taking pleasure in hurting others, and becoming more dangerous as they grow. These children are different from others, it is stated, because their problems are genetically caused and cannot be treated (except, maybe, a certain residential treatment program might be a bit helpful).

“When Your Child is a Psychopath” is one of a large group of scary-exciting bedtime stories for adults; these focus on the Bad Seed concept, that children may only appear to be innocent, and that some of them are just waiting for the opportunity to do us in. For parents of quite well-behaved children, these tales are thrilling accounts of how bad other people’s lives are, a sort of inversion of the equally-loved stories of serious child abuse with torture and sex. The good parents know that they are okay when they read these things. They would never do such bad things, nor would their kids, and in their hearts they believe the problems are caused by the bad parents rather than by genetic factors.

For parents of sometimes-aggressive, occasionally-antisocial children (i.e., most of us), the Bad Seed stories provide a chance to think how bad things can be and to breathe a sigh of relief that ours are not as bad as that. In addition, the stories present the possibility that whatever problems the future holds, it may be genetics that cause them—these parents (most of us, again) are absolved from blame if that’s the case.

Parents of really callous-unemotional, antisocial children probably do not get much chance to read, but if they do read the stories, they can take comfort from the idea that they are not the only ones with these problems.

So, you see, the Bad Seed stories offer something gratifying for everyone. Of course, there’s a serious difficulty connected with the fact that they are probably not true. And there’s an even worse difficulty in the possibility that such beliefs will cause parents and practitioners to act in ways that will cause additional trouble for the children, for instance failing to seek treatment for the children and/or the parents because they accept the idea that antisocial behaviors are not treatable. The children can also be affected negatively by these ideas, perhaps assuming that they will never be able to control their impulses and that they will inevitably commit crimes and go to prison or worse. (There is quite a flavor of Attachment Therapy in this; it’s reminiscent of practitioners who tell children “unless you cooperate, you are gonna kill somebody some day!”)

As it happened, on the day I read the Atlantic article, I also opened a new issue of the journal Child Development Perspectives and found two useful articles commenting on antisocial behavior in childhood.  The first article, by Dale Hay, had the title “The early development of human aggression” (CDP 2017, Vol. 11(2), pp. 102-106). Hay referred to genetic factors in aggressive behavior, but pointed out that aggressive tendencies resulted from a combination of genetic make-up and maternal sensitivity. Although all typically-developing children are capable of physical aggression by the second year, toddlers are more likely to develop increased aggressive behavior if their families live in poverty. Mothers who have been depressed during pregnancy, who have shown antisocial behavior themselves, and who react with hostility to their children’s displays of anger are more likely than others to have children who behave antisocially. Hay also noted that after age 2 years there are increasing differences between boys and girls in physical aggression. A group of factors acting together may make boys increasingly aggressive during early childhood. These would include the facts that girls mature more rapidly, that boys are more likely to have neurodevelopmental problems like ADHD, that parents treat boys and girls differently, and that young children prefer to play with peers of their own sex, which makes them likely to imitate and learn gender-related habits of aggression. Clearly environmental factors affect the development of angry, aggressive behavior, and when this is the case it should be possible for treatment to alter the pathway of development—contrary to the claims of the Atlantic article.

The second article in Child Development Perspectives was written by Rebecca Waller and Luke Hyde and entitled “Callous-unemotional behaviors in early childhood: Measurement, meaning, and the influence of parenting” (CDP 2017, Vol 11(2), pp. 120-126). Waller and Hyde pointed out that many children show early angry, aggressive behavior, but most stop this; the important question is why some continue and show long-term antisocial attitudes and behaviors. This is a complex question and the article is a complex one, but Waller and Hyde make some comments that I want to emphasize because of their relevance to the claims made in the Atlantic magazine. They noted that particular language about callous-unemotional (CU) traits  (in which I would include the word “psychopath” as applied to children) “could have unintended consequences, especially given its origins as an extension of psychopathy in adulthood, which clinical lore (falsely) purports to be inborn (i.e., purely genetic) and even untreatable. Such notions are problematic when applied to young children, particularly when some children with high levels of CU traits benefit from treatment. Moreover, using the word traits [or other words like “psychopath”—JM] carries a risk that treatment providers, parents, or children may inadvertently receive iatrogenic messages about stability or untreatability, which become self-fulfilling prophesies”—as therapist and parents avoid treatment or seek it with no real expectation of benefit, and children understand themselves to be members of a special and dangerous group of human beings and follow the associated “script”.

It is unfortunate that the Atlantic chose to publish an article on an important and interesting topic, but did so without weeding out the zombies (excuse this mixed metaphor, I don’t know what you do to rid yourself of zombies). Let us hope that the effects of these ideas do not show that problems can be mediagenic as well as iatrogenic.


1 comment:

  1. Spot on, and with science to back it up. Of course, it's a shame that outlets such as The Atlantic have a wide readership, where as your excellent and sound analysis does not. Sound analysis doesn't not fit into a click-friendly headline, I guess.

    "perhaps assuming that they will never be able to control their impulses"

    Whenever I read accounts of the Uncontrollable segment of children (and is it really a bad thing to resist being easily controlled?), and how - because of their imperviousness to all attempts of external control - they are simply wired to be asocial, I can't help but think that no one has listened closely to what the child is communicating. Perhaps it's because the majority of people intuitively understand the unspoken rules of socially-accepted behavior, thus it is beyond their capability to conceive that a portion of the population must be overtly taught how to behave. This is no more a child's fault than it would be a deaf child's fault that they can't hear. We don't chalk the latter up to obstinance and demand that they communicate like normal people. No, we give them the skills to communicate, and thus accommodate, inspite of their impairment. As Ross Greene, author of The Explosive Child, says:

    "kids do well if they can. In other words, if your child could do well, he would do well...if your child had the skills to exhibit adaptive behavior, he or she wouldn’t be exhibiting challenging behavior...Children exhibit challenging behavior when the demands being placed upon them outstrip the skills they have to respond adaptively to those demands. The same can be said of all human beings."

    My 6 y/o son, who is autistic (he would've fit under Asperger's syndrome under the DSM IV) is in a special ed program at a mainstream elementary school. His teacher said the most wonderful thing to me, in response to my apology for him hitting the OT and telling her he wanted to "kill her, but not really because that's not okay to tell someone.". She said "Don't ever apology for his behavior. All behavior is communication and we are teaching him a more effective way of communicating."

    I can't accept that some children prefer the inner turmoil of aggression and defiance. They simply know of no other way to express themselves, to ask for help, or even recognize inside them that they NEED help. I figure the fully grown "psychopath" was not predestined, but rather still does not recognize what they are missing. That their is another way to express themselves.

    I love your writing. It's been several years since I've followed your blog regularly, raising a 6 year old and a nearly 3 year old (going on 15 - "threenager" is a legitimate phase!). I'm delighted to see you are still fighting the good fight!

    ReplyDelete