A couple of weeks ago a woman I have not spoken to in thirty years contacted me to ask for my advice regarding her college-age son. She was having some serious worries about his depression and general mental health. I was more than willing and happy to offer any advice I could, but it made me wonder; why wasn’t she asking a medical professional or a close friend? Why was she reaching out to someone she knew thirty-years ago?
Growing up, I saw firsthand what labeling a child can do. In elementary school, my brother was having trouble staying focused both at home and at school, took 3 times as long to do his homework than his classmates, and struggled to keep anything organized. Not surprisingly, he was diagnosed with ADHD and put on medication.
Even before the meds started, there was a noticeable difference in him as soon as he was informed that “he was ADHD.” He wasn’t the little brother I knew anymore. He became much more negative when talking about himself and he stopped fighting against some of the behaviors associated with ADHD. It seemed like he had given up. He lost hope. All of a sudden he would say that he “couldn’t” do things because he was ADHD. It defined him. I noticed that not only did my brother expect the “typical” ADHD behaviors and characteristics from himself, but my parents began expecting them from him too. If he had a better day, the credit was given to the medication. But bad days were the expectation, and accepted as if it was the new “normal.”
As a Masters student in Individual, Couple and Family Therapy, I am learning about a lot of theories and ideas, but one that has changed my entire way of thinking comes from Narrative Therapy.
“Dude. I don’t understand. What is it, exactly, that you are so mad about?”
My teenage son was standing in front of me his face red, his hands balled up, his pupils dilated, and his breathing heavy. It was taking every ounce of self-control he had to not lash out physically. And with several inches and fifty-plus pounds on me, he could do some real damage. The hyperawareness of this dynamic…me being the one theoretically in charge, and him being the one with the physical upper hand…was palpable in the room.
Then I looked in his eyes. And while his body was telling me “angry angry angry HATE YOU!!” his eyes told me something else. He was lost, confused, and scared to death. And his response was entirely an honest one when he said.
“I. DON’T. KNOW.”
As a clinician I have worked with children, youth, and adults throughout my career who struggle with anger issues. And while I understand clinically what is going on, it is the scariest thing for me to navigate as a parent.
Two years ago my daughter, who struggles with bipolar disorder, attacked me in a dissociative rage. She body slammed me onto the ground because she didn’t want to clean her room. I ended up in the ER in a neck brace and she ended up in SASH for two months. To this day, she has no recollection of the incident.
I am a licensed professional counselor, board supervisor, and counselor educator with a PhD. I have done this work my entire adult career and am often asked to speak as a subject matter expert on behavioral health issues. I think I am asked to speak of these issues not so much because of my fancy degrees and titles, but because I live these same experiences and can speak with the empathy and understanding of a fellow parent.
And there is something really important that I have carried from my professional training to my parenting. And it is this:
Anger is not a primary emotion.
But anger, in all its forms, is diagnostic of an underlying issue that is maybe best explained using the acronym AHEN.
Anger comes from…
- Expectations not met
- Needs not met
Of course these issues come in many combinations and configurations and it isn’t usually as simple as identifying, for example, one need and resolving that need.
But especially in children and youth, anger is what we see first. Children are not just smaller adults. The symptoms that we equate with depression, anxiety, and bipolar manic states in adults are not always evident in children. What we usually see is the frustration. The irritability. The anger. The absolute rage.
Anger essentially is a scream of “I’m not OK, please help me.”
It’s also true that anger is developmentally a very normal part of adolescence. Parsing out what is normal and what may be the sign of an underlying problem is important. Because everybody gets mad sometimes. If we get so angry that it starts to interfere in our lives on a regular basis, it may be something that necessitates treatment.
But the mental health perspective on anger is maybe not what you would expect. Anger is the thing we learn to control. The underlying issue is what we actually treat.
Writing about my kids and their struggles is difficult. But what makes me a subject matter expert on children’s behavioral health? My PhD or my lived experience?
My friend Liza Long tells of her struggles with her son Michael, and how anger played such a large part of his behavioral health issues in her book, The Price of Silence. Her courage in doing so has inspired me to share my stories as well.
And like Michael, my own kids have made enormous progress in managing their anger and treating the underlying issue. My son’s was hurt. He was grieving the death of his father in a way that felt safe. My daughter had needs not met. She couldn’t manage the symptoms of her bipolar diagnosis within a large public high school. Instead of fighting about their anger, we started addressing the root of it.
Today my son has augmented his therapy with medication and neurofeedback. My daughter’s medications didn’t need adjustment once we found her a better educational setting. At Job Corp she can spend half her day in school and the other half hanging drywall or crawling around on a roof pulling up rotten shingles. Both of my kids are surrounded by people that care about them and their success.
And they let me share their stories so other families know in the face of all the tragedy we see on TV, there are other people getting the treatment and care that they need and achieving recovery. Step by step, we keep getting better.
Faith G. Harper, PhD, LPC-S is a mom. She is also a licensed professional counselor, board supervisor, and counselor educator. But her kids will tell you that none of those things hold a candle to her chocolate chip cookie recipe. She can be reached through her website.
Click here to view a video replay of Dr. Harper’s presentation at Claritycon2014, “The Impact of Bullying on Children’s Mental Health.” She co-presented with Adrian Warren, PhD, LPC-S.
Thank you Dr. Harper for sharing your insight. One in Five Minds appreciates our guest bloggers and recognizes the opinions and content shared here are exclusively theirs.