From Mona's Blog
By Mona Delahooke, Ph.D.
March 8, 2018
After years of struggling with infertility, Julia and Samuel finally decided to adopt. They were thrilled when a social worker called with news of a pair of brothers who needed a home. It took a few months of paperwork, but then they were elated to welcome home “Matt”, 3 and “Rett”, 2.
Their new family life was exciting and tumultuous. Rett, the younger child, made the adjustment easily. But Matt had a more difficulty, waking multiple times each night crying, and struggling to pay attention in preschool. When he was in kindergarten, a teacher noted that he isolated himself from peers, often sitting alone, reading books. And though the adoptive parents showered him with love, Matt wasn’t connecting to them, lashing out in angry fits and often attacking them verbally.
Things got worse. When Matt was in second grade, he set a small fire in the family’s basement.
A school psychologist diagnosed him with attention deficit disorder, conduct disorder, and difficulties socializing with others. The school offered counseling as well as a behavioral treatment plan to support him at school. The therapist instructed his teachers and parents to provide structure and plenty of positive reinforcement when he acted appropriately, and swift consequences when he didn’t.
Over time, though, the support plan proved ineffective, and Matt gained a reputation as a loner who had no friends and spent long hours playing video games. At 13, he threw a kitchen pot at his mother and threatened to kill her. Desperate, his parents alerted police.
Where did his challenging behavior come from?
When the family came to my psychology practice, the parents told me Matt’s behaviors had concerned them from Day One. They knew that he had been abused and neglected as a toddler, yet hoped that the security and love from them would help him thrive. But nothing they could say or do seemed to get through.
Matt’s behaviors — social disengagement, setting fires, threatening his parents — all reflected a brain and body on constant defense. His social Isolation revealed that he lacked a healthy brain/body connection. His aggressive behaviors were an early signal that he felt danger or threat in his environment — even when it was safe.
Unfortunately, the supports offered by the school, his doctors, and previous therapists overlooked this foundational challenge. Instead, he was prescribed medication for his behaviors and attention deficits, and an intervention plan focusing on rewarding certain behaviors and punishing others.
To make matters worse, the three systems that should have been helping Matt — the education system, the medical system and the mental-health system — were all operating independently of each other when they should have been in concert.
The biggest problem was that the adults in Matt’s life focused on his behaviors without first building the bridges of relational safety. They overlooked the hidden reason for why he acted the way he did: automatic and subconscious responses left over from his earliest years, when he sensed life threat from the very people on whom he depended.
Nobody in Matt’s life saw the value of examining what these early behaviors revealed about the effect of trauma. They failed to recognize that Matt’s behaviors were signs of vulnerability in the basic foundation of emotional development.
In short, he lacked the ability to make himself feel calm in mind and body. But instead of confronting and overcoming that reality, Matt came to think of himself as a bad person — and others as even worse. He developed a narrative: others are out to get me and must be punished.
Subconsciously, his behavior was a preemptive strike coming from a traumatized brain.
Unfortunately, many of our treatment strategies for such traumatized, vulnerable children involve punitive measures which only serve to reinforce a child’s sense of isolation and hopelessness.
Matt’s struggles vividly illustrate why we need to incorporate the insights of neuroscience to help us understand the true underpinnings of mental health conditions. Instead of blaming these children, we need to help their parents, teachers and therapists understand the roots of their challenges. Until we do, young people like Matt will continue to suffer unnecessarily, harming themselves and others in the process.
Mona Delahooke, Ph.D. is a licensed clinical psychologist with more than 25 years of experience caring for young children and their families. With a special focus on early childhood development, she is a senior faculty member and Mental Health Working Group Co-Chair of the Profectum Foundation, an organization dedicated to advancing the development of neurodiverse children, adolescents and adults.
She is also a faculty member of the Early Intervention Training Institute of the Los Angeles Child Guidance Clinic and trains clinicians in the Los Angeles Department of Mental Health (DMH) as an independent contractor.
Dr. Delahooke holds the highest level of endorsement in the field of infant and toddler mental health in California, as a Reflective Practice Mentor (RPM).