Monday, October 27, 2008

On blaming the parents

It's been well over a year since I last posted - this blog got lost in the shuffle of daily life, trying to find a steady job (which I could have, except I'm picky enough to want something I actually enjoy, so I'm still temping), working temp jobs to pay rent, having a social life, having a relationship, finding a house, keeping the one we're still stuck in somewhat decent, not killing housemates for not helping with that last one... I got prodded in a comment to say that I'm actually doing something useful here though, so I'll try and get going again.

As of a few months, I've been doing temp work at a closed mental health facility for 12 to 18-year-olds. It's a fairly new concept in the Netherlands. Up until less than a year ago, you either managed to cope in a somewhat open setting, where you had some freedom to come and go as you pleased, or you went to juvenile prison. Now our juvenile prisons aren't even technically considered prisons, as, unlike in the US, they do focus on rehabilitation, so they do offer some basic amount of treatment - but you're still putting children who are particularly vulnerable in with what you know to be a bad crowd, which is problematic. And there is the message it sends to the kids in question, when you put them in prison for having mental health issues.

One of the things I've been in charge of are the file screenings for new applicants. As a closed setting is a matter of last resort - after all, you don't want to lock children, or anyone, up unless you've tried all other options - these children usually have impressive files by the time they get to us. One thing these files often get me thinking about is parenting. There are a lot of children in our house who have very clearly been dealt a very lousy hand when it comes to parenting, and whose problems clearly stem from problems with parenting. I'm very seriously considering trying to go work for the Dutch equivalent of the Child Protective Services since I've started screening these files, since it makes painfully obvious the effects abuse has on children.

The thing is, when you're blaming parents for their childrens' problems - as the above might imply - you venture into tricky territory. There's a history in psychology of blaming the parents for anything that might be wrong with their children. Autism, for example, used to be explained by claiming a child's mother wasn't sufficiently affectionate towards her child. This has since been found to be nonsense, but before that was determined, it caused a good bit of damage; making parents responsible for their children's disability in that way is a huge burden to place on a parent who already has been dealt a hard hand in dealing with that disability.

I am, in fact, firmly in the camp of Good Enough Parenting; you're never going to be a perfect parent, and you don't have to be to raise a child. Children have a pretty good tolerance for "Mommy's trying to juggle 6 things at once and is short on time now" or bumping their head while you're not looking etc etc. You're highly unlikely to cause autism or ADHD through your parenting style, and as long as you're reasonably committed to being a good parent and making an effort, you probably won't cause any kind of serious behavioral problems.

So what is the difference between what I am saying, and blaming parents for autism?

Basically, you are talking about two fundamentally different types of problems: reactive behavioral problems, and psychiatric problems. The latter refers to concrete disorders, which no one is really to blame for. ADHD, autism, depression, schizophrenia all come forward as results of a complex interplay of genetics and environment where upbringing is going to be a comparatively minor factor. It is, in large part, the luck of the draw that determines whether you, or your child ends up with one of those. Reactive behavioral problems are different; reactive behavioral problems are basically healthy children responding to a crazy world. These are children who are raised in an environment where they were never taught healthy ways of dealing with the world. They have mostly been abused or ignored, or may have encountered traumatic experiences. They have been taught unhealthy ways to view the world, and you'll often find that, if you take on their world view for a moment, their actions make perfect sense. Reactive problems are the kinds of problems I'm thinking of when I want to join CPS.

The thing is, when you're talking about reactive problems, you are talking about extremes of behavior. You might have noticed that I qualified my statement about good enough parenting with "as long as you're reasonably committed to being a good parent and making an effort". Children with reactive behavioral problems are generally the children of parents who are either unwilling or unable to commit to being a good parent (or, in some cases, the children who are unlucky enough to run into the wrong crowd at the wrong time. Reactive problems come into being as a response to the environment, and while we often end up talking about parents when we talk about childrens' environments, they are far from the only influence on their children).

Also, this doesn't mean you don't have any influence as a parent when your child does have a psychiatric disorder. I know a young boy who I strongly suspect of having a minor degree of ADHD. If you give him space, he can be a nightmare; pushes rules to breaking point, permanently tries out how far he can go, restless... I also know that boy as a really nice kid. The difference? Structure. If you create a clear framework for him, and enforce it in recognizable ways, that gives him ways to channel his energy in ways that make him most charming and loveable. Children with autism can similarly benefit from a parent willing to work with their limits and possibilities. But there needs to be a recognition that this puts demands on parents that go beyond those of parenting a 'healthy' child. When a parent is unable to meet these extra demands, that doesn't mean that they're a bad parent, or that they're causing the problems. It means their plate is overfilled.

So where does that leave us? Probably with a point I've made in an earlier post already; at the end of the day, it's not one thing or the other, biology or upbringing, that determines the outcome for a child. But if you have a child that has been biologically unlucky, it's going to take a lot of extra effort to get an outcome where they can cope with life effectively, and if you have a child that's been biologically lucky, you're going to have to make an effort to create a problem in their development. There are, however, no clear lines in this.

Of course, that leaves you with one final question: now what? Even if it's quite clear that parents are somehow to blame, then what? Once children are done with closed treatment, they are going to have to deal with their parents again. Every child needs their parents, even if they might have to find a new place for them in their lives, one which is less, or differently, involved. There's no point in blame; it misses the point. All there is is putting your every effort into finding a way for everyone to interact in the best way they can.