Why Some Kids Won't Talk
Sam Goldstein, Ph.D.
This is a SamGoldstein.com Monthly Article - January, 2003
Copyright © 2003 Dr. Sam Goldstein - All Rights Reserved
I don’t know if other mental health professionals have observed this phenomena, but increasingly coming into my office are parents of a small group of children who may or may not have ADHD, but certainly suffer from a very low emotional threshold, a hair-trigger temper, a high intensity of reaction, a rigid, inflexible pattern of thinking, and an inability to easily recover once they become upset. Dr. Ross Greene has referred to these children as explosive. Some research groups have questioned whether these children experience a form of childhood mania, or perhaps the early emerging signs of an Intermittent Explosive Disorder. Others have suggested that these children simply represent the extreme manifestation of ADHD. Regardless of the label we apply or the hypothetical lens through which we choose to view these children, they are extremely frustrating and difficult to parent some of the time. In between their outbursts, I have found that most of these children, though difficult, are not completely unmanageable. Some of these children, I have found, experience outbursts on a daily basis, while others may only experience a few outbursts each week. In this month’s article, I will reflect on my experience with this group of children, and offer a hypothesis to explain why these children resist talking about their problems.
In addition to being offered medication, parent training, and, if needed, school and social intervention, parents of children with this pattern of difficulty are often advised to place their children in counseling. Regardless of the counselor or therapist’s theoretical orientation, the basis of counseling requires communication between child and therapist. Though some schools of therapy believe that non-verbal communication as a primary modality in therapy can be beneficial for children, there is scant research evidence to support this belief. In fact, the basis of proven psychotherapy for conditions such as anxiety, depression, or, for that matter, anger management, is a cognitive behavioral model. Clients provide information about themselves, their thoughts, feelings, and behaviors. The therapist offers alternative ways of considering these phenomena, ultimately guiding the client to think differently and thereby become capable of feeling and behaving differently.
Thus, in the best of all worlds, this group of difficult children should respond to and be benefitted by cognitive behavioral therapy as an adjunct to the other treatment modalities they receive. Yet, time and time again, I have been told by parents of these kids that the previous therapists for their children eventually gave up, indicating that they couldn’t work with the child because the child wouldn’t talk to them about his or her problems. I must admit, I encountered the very same challenge when I first began working with this population. I expected that if I was kind, patient, and a good listener, this group of children would tell me how they felt, why they lost control and why they had so much difficulty recovering control when they became upset over often minor irrelevant experiences, thereby allowing us to then get on with the business of helping them change. But they wouldn’t talk! Despite my patience and a variety of strategies, the majority of this group of children appeared incapable of talking about their thoughts and feelings when they were or had been upset. Eventually, however, I have gleaned enough information to understand why these children don’t talk in therapy.
This group of children never knows when they are going to become upset. They never know what might upset them. Because they are rigid and inflexible, it could be something as simple as their favorite shirt being in the wash, or a sibling changing the television channel. When they become upset, they never know how upset they are going to become, or how long it’s going to last. They possess few, if any, strategies to recover, and thus find themselves prisoners in an agitated state of mind that only intensifies as parents fruitlessly, and often desperately, search for a means of calming and controlling the child. So here is what happens. When they are upset, these children are so agitated and upset, they are beyond talking. However, when they are not upset, their lack of confidence in their self-control, their inability to predict what will make them upset, leads to an interesting coping strategy. As one of the kids told me, “I never know when I’m going to get upset or what will upset me. I never know how long I’m going to be upset. So, when I’m feeling good, I don’t want to talk about feeling bad because maybe even that will make me feel bad.”
I’ve come to understand and respect this coping strategy and mindset. It has allowed me to strengthen my reservoir of patience. I have also discovered a number of strategies that seem to work. We don’t talk about being upset, we talk about being in control. We don’t discuss what happened to the child in the past, but rather, what is going to happen in the future. For some children, a hypothetical discussion of the future is a lot easier than a factual discussion of the past.
