| How do we deal with our seriously distressed children | | | | having a risk for the development of tardive dyskinesia, |
| and adolescents? | | | | a permanent and debilitating neurological problem |
| Adolescents are in a period of seeking autonomy and | | | | (Gualteri and Barnhill, 1988). |
| self-determination. These qualities can aid them in | | | | These drugs subdue the adolescent into conformity by |
| becoming agents of active transformation in their own | | | | blunting the brain, but never do they teach the child |
| lives. For one to recover from distress they are in | | | | how to develop meaning, how to cope, nor do they |
| need of being able to regain hope and to have an | | | | allow the adolescent to express his pain and emotional |
| effective exercise of their free will. (Breggin, 1996). | | | | distress that is within. The adolescent is merely |
| Adolescents based on their experiences formulate | | | | sedated to make his behaviors more manageable to |
| thoughts and feelings and begin to create values and | | | | adults. The adolescent learns nothing. The adolescents |
| meanings for themselves. | | | | who are suffering from severe emotional distress are |
| Those adolescents who are suffering from serious | | | | in conflict. They have internalized feelings of guilt, |
| emotional distress have become lost on this path to | | | | shame, anger, anxiety, and numbing. These |
| finding meaning in their lives. Once this occurs, they | | | | adolescents instead of coercive and intrusive |
| begin to develop anguish and self-defeating responses | | | | 'treatments' need the ability to find a safe place where |
| to life. This creates in them anxiety and despair leading | | | | coercive power is replaced by reason, love, and |
| towards what some would call 'madness' (Breggin, | | | | mutual attempts to satisfy their basic needs. These |
| 1991). These adolescents must learn to feel | | | | adolescents because of their distress have broken |
| empowered once again, and not to feel labeled as an | | | | away from the accepted realities, they have sought to |
| 'it', not to be viewed through the lens of their particular | | | | recreate their existence, for some a more primitive |
| diagnosis and categorization they have been ascribed. | | | | existence (Schilder, 1952). The feelings of anxiety that |
| These adolescents need coaches and individuals who | | | | an adolescent may experience are linked to a fear of |
| will aid them compassionately and empathetically in | | | | being and belonging (Stern, 1996, pg. 12) Depression, |
| navigating and negotiating through life's stresses. | | | | mania, and anxiety are all linked together and are |
| The therapist and others must look upon the | | | | indicative of trauma. |
| distressed adolescent with dignity. To look upon the | | | | The adolescent being a shattered person seeks an |
| adolescent through 'scientific' or 'objective' means | | | | escape by altered perception. We must begin to |
| leads us to the tendency to diagnosis and control the | | | | realize that all behaviors and experiences have |
| person, to impose our own abstract and potentially | | | | meaning, even those things that may appear the most |
| oppressive category upon them and to manipulate the | | | | 'odd' to us. The symptoms labeled to be schizophrenic |
| outcome. | | | | exhibited by certain adolescents in distress 'may be |
| Physical interventions, such as psychotropic drugs, | | | | understood as manifestations of chronic terror or |
| restraints, and enforced confinement to mental | | | | defense against the terror (Karon, 1996). This is often |
| hospitals or residential treatment facilities are a part of | | | | expressed as anger, loneliness, and humiliation. The |
| this desire to control rather than truly aid and come to | | | | therapist and others must convey to the adolescent |
| an understanding of the distress the adolescent is | | | | that he wants to understand, that the client is helpable, |
| experiencing (Breggin and Breggin, 1993, a&b). | | | | but it will take hard work (Karon, 1996). The therapist |
| Psychotropic medications with these seriously | | | | must forge an alliance with the adolescent, aiding them |
| distressed individuals only deal with symptoms, they | | | | to understand the real dangers and to be able to |
| blunt certain functions to make the person more | | | | develop appropriate coping mechanisms. These |
| tolerable and amenable to societal expectations. | | | | adolescents are often viewed as dangerous |
| Psychotherapy, on the other hand, focuses on the | | | | themselves but the majority are not. They need to be |
| subjective changes in patient's feelings and on actual | | | | hard, and forging this alliance will give them the needed |
| changes in lifestyle or conduct of life (Fisher & | | | | voice leading to their recovery. |
| Greenberg, 1989). | | | | Hallucinations that are experienced by the seriously |
| Based on the viewpoints of biopsychiatry, adolescents | | | | distressed adolescent are actually repressed thoughts |
| who are medicated and placed in mental hospitals are | | | | and feelings coming outward, the unconscious into the |
| labeled as improved when they conform to hospital | | | | conscious. Delusions are the adolescent transferring |
| demands or receive discharge. However, what is not | | | | experiences from their past without having the |
| examined is, how do the patients themselves actually | | | | awareness that it is past (Karon, 1996, pg. 36). The |
| feel? An estimated 180,000 to 300,000 young people a | | | | therapist can guide in interpreting the meaning of these |
| year are placed in private psychiatric facilities. These | | | | hallucinations and delusions and once the adolescent is |
| children and adolescents often feel powerless in these | | | | gently approached with their underlying meaning, these |
| placements. But as mentioned above, it is the need for | | | | events can dissipate. Delusions are also connected |
| feelings of empowerment and hope that will lead to a | | | | with an attempt to find a systematic explanation of our |
| genuine recovery from distress. Psychologist D.L. | | | | world, to find meaning. A person who has experienced |
| Rosenhan lead a study where 'pseudopatients' had | | | | severe distress has lost this meaning and thus |
| themselves admitted to psychiatric hospitals to | | | | develops unusual ways of seeking to make sense of |
| experience them first hand and report on this | | | | their experiences and the world around them (Karon, |
| experience. Rosenhan reported in an article appearing | | | | 1996, pg. 38). |
| in the January 19, 1973 issue of Science, | | | | The therapist can gently call the adolescent's attention |
| "Powerlessness was evident everywhere...He is shorn | | | | to inconsistencies but at the same time respect their |
| of credibility by virtue of his psychiatric label. | | | | vision. The results of a psychosocial approach to those |
| His freedom of movement is restricted. He cannot | | | | with severe emotional distress has been proven to be |
| initiate contact with staff, but may only respond to | | | | more effective than the current biopsychiatric methods |
| overtures as they make. Personal privacy is minimal..." | | | | as evidenced by a study by Loren Mosher, MD where |
| With children and adolescents it is easier to rationalize | | | | he took schizophrenic adults who were on either very |
| away their rights and control becomes more arbitrary | | | | low doses or no medication, and offered them a 'safe |
| and complete (Breggin, 1991). Psychiatrist Peter Breggin | | | | place' with non professional staff residing with them |
| states that in such an environment 'it is hard for a child | | | | and sharing in their daily experiences. |
| to resist feeling spiritually crushed, abandoned, and | | | | A 2 year follow up of these patients noted higher |
| worthless under such conditions. With a less formed | | | | levels of success and progress than their counterparts |
| sense of self than an adult has, a child is less able to | | | | who were subjected to neuroleptics and psychiatric |
| resist the shame attached to being diagnosed and | | | | hospitalization (Mosher, 1996, pg. 53) The model known |
| labeled a 'mental patient'. Children may also find it much | | | | as the Soteria project was based on principles of |
| harder to conform to institutional life. | | | | growth, development, and learning. All facets of the |
| They are naturally energetic, rambunctious, at times | | | | distressed person's experience were treated by the |
| strident, often noisy, and resistant to control. If a boy | | | | staff as 'real' (Mosher, 1996, pg. 49) |
| doesn't conform, he is considered 'ill' and can be | | | | Limits were set and mutual agreements made with the |
| subjected to physical restraints, solitary confinement, | | | | patients if they presented as a danger to themselves |
| and toxic drugs. (Breggin, 1991). It should be mentioned | | | | or others. Such a model could be adapted to use with |
| that the drugs commonly used for severely distressed | | | | adolescents, offering them the need for compassion, |
| adolescents are the same as those used for adults, | | | | empathy, and finding that 'safe' place, restoring within |
| most frequently the neuroleptics. These medications | | | | themselves a feeling of worth and dignity, that will lead |
| are reported to cause lack of energy, painful emotions, | | | | to their ability to address the issues of their distress |
| motor impairment, cognitive dysfunction and tend to | | | | and traverse towards recovery. |
| 'blunt; the personality of the treated patients as well as | | | | |