«Sally Patton UNITARIAN UNIVERSALIST ASSOCIATION BOSTON Copyright © 2004 by the Unitarian Universalist Association of Congregations. All rights ...»
This year, we have in our religious education program a highly intelligent eight-year-old boy who has been diagnosed with oppositional defiant disorder. He is a handful and seems to take delight in being inappropriate. He will ask people about their sex life, make silly sounds during quiet times, and grab and pinch other kids. His mom’s advice is to ignore him. But does this seem fair to the other kids?
As with all children, our teaching strategies and interactions with difficult children must begin with the understanding that they are not defined by a label or behavior. (It would be helpful to review the teaching strategies suggested for difficult children in the chapter “Religious Education That Welcomes All Children.” Also review the teaching ideas described in the chapter on mood disorders, which are appropriate for all troubled children.) In Reclaiming Youth at Risk, Larry K. Brendtro, Martin Brokenleg, and Steve Van Bockern describe what they call the “seeds of discouragement” in our society, which have caused a crisis of alienation among too many of our youth. They try to shift the focus away from the negative traits of children at risk and instead 165 Disruptive Behavior Disorders focus on the transactions within their environment that cause their alienation, including destructive relationships, climates of futility, learned irresponsibility, and loss of purpose. Brendtro et al. apply the wisdom of the Native American child-centered
culture to help heal the wounds of youth at risk:
Native American philosophies of child management represent what is perhaps the most effective system of positive discipline ever developed. These approaches emerged from cultures where the central purpose of life was the education and empowerment of children.
These authors also describe how a “circle of courage” created an environment in which Native American children could grow and flourish. Belonging, mastery, independence, and generosity are the
central values in this circle:
• experiencing belonging in a supportive community, rather than being lost in a depersonalized bureaucracy
• meeting one’s needs for mastery, rather than enduring inflexible systems designed for the convenience of adults
• involving youth in determining their own future, while recognizing society’s need to control harmful behavior
• expecting youth to be caregivers, not just helpless recipients overly dependent on the care of adults These values are the components for creating an environment that reclaims lost youth. Again, quoting Brendtro et al., “The reclaiming environment is one that creates changes that meet the needs of both the young person and the society. To reclaim is to recover and redeem, to restore value to something that has been devalued.”14 The authors also write, “We believe the philosophy embodied in this circle of courage is not only a cultural belonging of Native peoples, but a cultural birthright for all the world’s children.”15 When the circle of courage is broken, children become alienated 166 Welcoming Children and are put at risk. The authors offer four approaches for working with alienated children and bringing them back into the circle of
• Relating to the reluctant: establishing positive relationships with youth whose lives have been marked by alienation
• Brain-friendly learning: learning experiences that reverse patterns of failure and futility
• Discipline for responsibility: management approaches that counter irresponsibility and rebellion by mobilizing positive youth involvement
• The courage to care: fostering prosocial values and behaviors in youth whose lives are self-centered and lacking in purpose16 The chapter on mood disorders in this book discusses the positive influence that a “charismatic adult” can have on a child’s life.
As Robert Brooks and Sam Goldstein point out, We can all serve as the charismatic adults in children’s lives— believing in them and providing them with opportunities that reinforce their islands of competence and feelings of self-worth. This is not only a wonderful gift to our children but also an essential ingredient for the future. It is part of our legacy to the next generation.17 Our Unitarian Universalist churches and programs of ministry to children can be important resources for creating reclaiming environments for children at risk and for providing them with the loving oversight of charismatic adults. We can provide these children and all children with belonging, mastery, independence, and generosity.
Schizophrenia Schizophrenia is a cruel disease. The lives of those affected are often chronicles of constricted expectations. It leads to twilight existence, a twentieth-century underground man.
The fate of these patients has been worsened by our propensity to misunderstand, our failure to provide adequate treatment and rehabilitation, our meager research efforts.
—E. Fuller Torrey, Surviving Schizophrenia When parents find out that their child has been diagnosed with some type of disorder, their response is usually one of shock and dismay. That is particularly true with a diagnosis of schizophrenia, which is often made when the child is well into adolescence.
Misconceptions about schizophrenia are fueled by media portrayals of people with schizophrenia as violent, predatory, totally delusional, and homeless. Many people erroneously believe that people with schizophrenia are weak and choose to behave bizarrely. The stigma of schizophrenia in our society can be a barrier to obtaining help.
A young person diagnosed with schizophrenia will most likely present a considerable challenge for ministry and religious education programs. The parents and family will also need extra support, as caring for a person with schizophrenia is an all-consuming task. Religious professionals and the entire congregation are called to minister to these young people and their families with understanding, patience, and flexibility.
167 168 Welcoming Children Description According to the National Institute of Mental Health, there is no exact definition of schizophrenia.1 Most experts recognize it as a complex set of conditions that may be one disorder or many disorders with different causes. Symptoms are not the same for all people who are diagnosed with schizophrenia.2 One widespread but incorrect belief is that schizophrenia is the same as split personality, the condition suffered by Dr. Jekyll and Mr. Hyde. Another is that people with schizophrenia are violent and dangerous. Yet less than 1 percent of people with schizophrenia will commit violent acts.
They are more likely to have violence committed against them.3 Schizophrenia is found primarily among adolescents and adults. Childhood schizophrenia is less than one-sixth as common as the type that occurs in adolescents and adults. This disorder is rarely observed before the age of twelve, but the incidence increases at sixteen. Most children diagnosed with schizophrenia show developmental delays in language and other functions before the age of seven, when the psychotic symptoms of hallucinations, delusions, and disordered thinking begin to occur. Psychosis usually develops gradually, with children talking about strange ideas and fears and saying things that do not make sense. Other early
warning signs of schizophrenia are:
• trouble discerning dreams from reality
• seeing things and hearing voices that are not real
• confused thinking
• vivid and bizarre thoughts and ideas
• extreme moodiness
• peculiar behavior
• belief that people are out to get them
• behaving younger than chronological age
• severe anxiety and fearfulness
• confusing television or movies with reality
• severe problems in making and keeping friends.
Schizophrenia can develop gradually or rapidly. When schizophrenia develops over a long period of time, it is called gradualSchizophrenia onset or insidious schizophrenia. When very dramatic changes in behavior occur over a few days or weeks, it is called rapid- or suddenonset schizophrenia. The gradual-onset type may or may not lead to what is called an acute or crisis episode, but the rapid-onset type usually does. Some individuals develop chronic schizophrenia, which is a “severe long-lasting disability characterized by social withdrawal, lack of motivation, depression, and blunted feelings. In addition, moderate versions of acute symptoms such as delusions and thought disorder may be present in the chronic disorder.”4 Schizophrenia: A Handbook for Families, published by Health Canada in cooperation with the Schizophrenia Society of Canada,
has identified these symptoms:
• Hallucinations: Hallucinations are thought to result from excessively acute senses and the brain’s inability to interpret and respond appropriately to incoming messages. Someone with schizophrenia may hear voices or see visions that are not there or experience unusual sensations in his or her body. Auditory hallucinations, the most common form, involve hearing voices that are perceived to be inside or outside the person’s body. Sometimes, the voices are complimentary, reassuring, and neutral. Other times, they are threatening, punitive, and frightening and may command the individual to do harmful things.
• Delusions: A delusion is a strange and steadfast belief that is held only by the person having the delusion and that remains intact despite obvious evidence to the contrary. For example, someone with schizophrenia may interpret red and green traffic signals as instructions from a higher power. Many people with schizophrenia who suffer from persecution delusions are termed paranoid. They believe that they are being watched, spied upon, or plotted against. Common delusions are that one’s thoughts are being broadcast over the radio or television and that other people are controlling one’s thoughts. Delusions are resistant to reason. It is of no use to argue that they are is not real.
• Thought disorder: People with schizophrenia have problems processing and organizing their thoughts. For example, they may 170 Welcoming Children be unable to connect thoughts into logical sequences. They may have “racing thoughts” that come and go so quickly that it is impossible to grasp or process them. Because these individuals’ thinking is disorganized and fragmented, their speech is often incoherent and illogical. Moreover, they may have inappropriate emotional responses, such that their words and moods do not appear in tune with each other. For instance, they might laugh when speaking of somber or frightening events.
• Altered sense of self: This term is used to describe the blurring of the ill person’s feeling of who he or she is. He or she may feel bodiless or nonexistent, or he or she may not be able to tell where his or her body stops and the rest of the world begins. It may feel as if the body is separated from the person.5 Discussion The popular understanding (or misunderstanding) of schizophrenia has come from portrayals of this disorder in the mass media.
Fortunately, the success of the recent movie A Beautiful Mind, about Nobel prize–winning scientist John Nash, provided a more accurate portrayal of schizophrenia and helped bring this subject into the public discourse. And while the movie showed that John Nash learned to function well in his life, his ordeal is nonetheless frightening.
The National Alliance of the Mentally Ill (NAMI) has done much to fight the stigma of mental illness, particularly schizophrenia. Founded by parents and consumers (the term used by people struggling with mental illness), NAMI has promoted greater understanding, better treatment, and a more compassionate view of people with mental illness. With proper treatment, these people can lead productive lives.
In addition, NAMI has successfully fought the view once held by mental health professionals and the general public that mental illness is caused by inept mothering. NAMI supports the view, as do most mental health professionals, that schizophrenia is a 171 Schizophrenia biologically based brain disorder. And while the consensus among professionals is that it cannot be cured, it can be treated with a combination of medication, counseling, support groups, and rehabilitation.
A group of individuals called psychiatric survivors challenge the view that schizophrenia is incurable. These individuals have been diagnosed with schizophrenia but claim they no longer have it. In Toxic Psychiatry, Peter Breggin describes schizophrenia as a psychospiritual crisis that can be healed through self-analysis and therapy. Like many in the psychiatric survivor movement, Breggin feels that the drugs used to treat schizophrenia damage the brain rather than heal it. He asks whether it is more accurate to view people who are labeled schizophrenic as broken, defective, and disordered or as persons and souls in struggle. When we try to understand the profound psychospiritual hurt and failure in these individuals’ lives rather than view them as people with a brain dysfunction, Breggin argues, we can find an infinite number of ways to help.6 Psychiatric survivors Daniel Fisher and Laurie Ahern, of the National Empowerment Center, believe that people who get stuck in the emotional distress of coping with loss, conflict, and trauma are eventually labeled mentally ill. Similarly, in his book The Far Side of Madness, John Weir Perry suggests that people may need to go through severe emotional distress in order to experience selfrenewal.7 If they do not have the necessary inner resources and social, cultural, and economic supports during this deep process of reintegration of self, they often cannot maintain a social role.