Latest / Inside The Consulting Room - Understanding the Child Behind the Behaviour / When conditions collide. Episode 4

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When conditions collide. Episode 4 · Inside The Consulting Room - Understanding the Child Behind the Behaviour

• 0:00
  SPEAKER_00: Hello and welcome back.
• 0:01
  SPEAKER_00: This is Kim Lee, child and adolescent psychotherapist.
• 0:04
  SPEAKER_00: This is episode four of the When Conditions Collide series.
• 0:11
  SPEAKER_00: And in this episode, I want to talk about the child's internal world.
• 0:16
  SPEAKER_00: Now, one of the most important things we do as clinicians is to try and understand the world from the child's perspective.
• 0:25
  SPEAKER_00: But this isn't just the external world, it's their internal world.
• 0:30
  SPEAKER_00: What's happening inside that?
• 0:32
  SPEAKER_00: How is that put together?
• 0:35
  SPEAKER_00: And for children with these sorts of difficulties, we have to try and understand what it actually feels like to live with a neurological profile of the kind that I've been describing.
• 0:47
  SPEAKER_00: Now there's an intensity about the opposing conditions, and I use the word opposing only to describe the fact that they have quite opposite structures and quite opposite styles of functioning.
• 1:04
  SPEAKER_00: And they will almost always describe their minds as very busy, that their thoughts move very quickly, and very often those thoughts will collide and they'll find themselves becoming immersed in the thoughts and the feelings that are aroused as a consequence.
• 1:25
  SPEAKER_00: And the same is true with sensory information.
• 1:28
  SPEAKER_00: It's as if they can be constantly bombarded by sensory events.
• 1:33
  SPEAKER_00: Their attention might shift rapidly from one thing to the next.
• 1:38
  SPEAKER_00: And at times this can feel quite exciting.
• 1:41
  SPEAKER_00: But at other times it can feel absolutely exhausting.
• 1:46
  SPEAKER_00: Now I worked with a 12-year-old boy called Leo some while ago, and he'd been referred to me because of persistent difficulties that were being experienced at school, but also at home, and teachers described him as disruptive.
• 2:04
  SPEAKER_00: And it had I always find it interesting when people say a person is disruptive, because what they're describing is a behavior.
• 2:15
  SPEAKER_00: But underneath that behavior, there's something clearly going on.
• 2:19
  SPEAKER_00: But anyway, Leo is someone who frequ frequently leaves his seat, call out answers, and that's very common.
• 2:27
  SPEAKER_00: That's the kind of impulse reaction.
• 2:30
  SPEAKER_00: The child can't wait, they have the thought, and they they voice the thought.
• 2:35
  SPEAKER_00: But also Leo struggled to stay focused enough to complete work.
• 2:41
  SPEAKER_00: Now when he came to therapy, it soon became very obvious that there was there was something else about this boy which I believed to be quite remarkable because he was extraordinarily thoughtful.
• 2:57
  SPEAKER_00: And he asked very complex questions about how the brain worked, which was fascinating because uh children will will sometimes ask me questions like this, but of course he was interested in his brain and how his brain worked, but also where he struggled.
• 3:16
  SPEAKER_00: And very often this is a kind of gateway into helping children to put into words the sorts of difficulties that they experience.
• 3:26
  SPEAKER_00: And what what it's really it makes it possible for me to say, so you have all of these incredible abilities, and you can you can do this and you can do that, and you know so much, and that works really well, and that's great, but you seem to struggle a bit with with friends, and interestingly, very often once you kind of voice and name that the child will respond.
• 3:54
  SPEAKER_00: And rather than sort of then diving into the well, let's work on why you have difficulties with friends, we build this we we we focus upon and emphasize the strengths, or I say we, that's my approach, and then little by little we start to look at the bit that doesn't work so well because we've already established by that time we've established that I'm a grown-up who can hold both both parts, the part that is highly functional and the part that doesn't work particularly well.
• 4:28
  SPEAKER_00: But Leo was absolutely fascinated by astronomy and could describe the formation of stars and it just in qu in quite remarkable detail, often I felt like I was I I was at a seminar.
• 4:45
  SPEAKER_00: But one afternoon he said something while we were talking, and it was everything everyone thinks I'm doing it on purpose, and it was it was really sad because here he was trusting me enough to say this is what it's like for me, and it's a very hard place for a child to exist because they don't understand what's going on, and clearly the grown-ups don't understand, and so a conclusion is I'm doing it on purpose.
• 5:21
  SPEAKER_00: Nothing, of course, could be further from the truth.
• 5:24
  SPEAKER_00: So the adults had completely misinterpreted his behavior and described it as deliberate misbehaviour, but from his perspective, he was simply trying to manage a mind that moved faster than the environment allowed.
• 5:44
  SPEAKER_00: Now, there's a kind of silent but eventually noticeable impact of repeated correction because when children experience frequent correction or reframing of their behavior, they gradually start to internalize and develop a particular kind of belief, and they begin to think that something about me is wrong, and over time this belief can become part of the child's developing identity, you know.
• 6:18
  SPEAKER_00: And I see this so often that children who've internalized these kinds of beliefs become people who have a sense of hopelessness.
• 6:30
  SPEAKER_00: What's the point?
• 6:31
  SPEAKER_00: I'm only going to get it wrong anyway.
• 6:33
  SPEAKER_00: And so they start to become the belief, if you like.
• 6:36
  SPEAKER_00: So we get into this self-maintaining cycle.
• 6:40
  SPEAKER_00: And I've seen this sadly many, many times, not just with these conditions, but more generally.
• 6:46
  SPEAKER_00: So where this is concerned, though, it's so important that the adults around the child understand the neurological foundations of the behavior.
• 6:56
  SPEAKER_00: Because when the behavior is interpreted accurately, the child receives a very different kind of message.
• 7:03
  SPEAKER_00: They begin to understand that their difficulties have an explanation, and that explanation opens the possibility of support and development.
• 7:12
  SPEAKER_00: I I think this is vital because very often, whether you're a child, an adolescent, or an adult, when you are experiencing something that you don't understand, when you are suffering perhaps in some way which you can't quite put into words and you are stuck with, very often that that creates a sense of isolation.
• 7:37
  SPEAKER_00: A kind of, it's only me.
• 7:39
  SPEAKER_00: There must be something intrinsically wrong with me.
• 7:43
  SPEAKER_00: In my work, the relief that I see when I work with patients who, for example, I might say, so do you find that when you I don't know, go to bed, you you you have a busy head?
• 7:59
  SPEAKER_00: Do you find that you when you wake up in the morning you're immediately active?
• 8:06
  SPEAKER_00: Do you find you wake very I start describing the sorts of things that I imagine the child might be experiencing.
• 8:14
  SPEAKER_00: And the fact that I know these things reassures the child.
• 8:18
  SPEAKER_00: It says what I have is known about, and it's not my fault.
• 8:26
  SPEAKER_00: So if you think about it from the point of view of what parents can do, there is a great deal of a great deal of opportunity, scope for change.
• 8:38
  SPEAKER_00: So in the next episode, we will take a look at what parents can do, and we'll explore some of the practical ways that help support children whose nervous systems operate in this way.
• 8:51
  SPEAKER_00: Thank you for listening.