Monday, 5 March 2012

Deficits in rule-governed behavior

The rush to medicalise new parts of the normal spectrum of human behaviour continues. Failure to defer to authority is now a treatable disorder:
Psychologist Russell Barkley, one of mainstream mental health’s leading authorities on ADHD, says that those afflicted with ADHD have deficits in what he calls “rule-governed behavior,” as they are less responsive to rules of established authorities and less sensitive to positive or negative consequences. ODD young people [i.e. those labelled with the sinister diagnosis of "oppositional defiant disorder"], according to mainstream mental health authorities, also have these so-called deficits in rule-governed behavior, and so it is extremely common for young people to have a “duel diagnosis” of AHDH and ODD...
In an earlier dark age, authoritarian monarchies partnered with authoritarian religious institutions. When the world exited from this dark age and entered the Enlightenment, there was a burst of energy. Much of this revitalization had to do with risking skepticism about authoritarian and corrupt institutions and regaining confidence in one’s own mind. We are now in another dark age, only the institutions have changed. Americans desperately need anti-authoritarians to question, challenge, and resist new illegitimate authorities and regain confidence in their own common sense.
From Why Anti-Authoritarians are Diagnosed as Mentally Ill by Bruce Levine (via).

Of course, kids need to defer to authority on occasion. Explanation and reasoned argument are better than 'because I say so', but when your five year old is about to inattentively run out into traffic, there's no time for reasoned argument - that can come later. Even in situations that aren't life threatening, there sometimes just isn't time to explain why it's necessary to be dressed in time to have breakfast and go to school, or why some piece of anti-social behaviour won't be tolerated.

Bad behaviour happens, and dealing with it is one of the challenges of parenthood. But it's also perfectly natural for children to be more interested in what they want to do than the boring stuff that parents want them to do. And, however inconvenient and annoying it might be for parents, it's also natural for children to try to assert their independence and push boundaries. As an adult you generally have experience, judgement and superior strength on your side, but this doesn't mean that you are infallible, or that a child who fails to obey your every command without question has a "disorder".

 The "disorder" label strikes me as lazy and actively harmful. Apply it to a child and it absolves parents of the need to think about the situation and to try out different strategies, or do some reality checks. Is this situation really serious enough to warrant time on the naughty step?  Is my failure to communicate to blame here? Am I the one being unreasonable? The respective answers may still be 'yes', 'no' and 'no', but the questions are still more valid than the automatic conclusion that it must be your child's fault on account of the kid's "disorder".

The dismissal of dissent as a form of mental disorder says more about the worrying normalisation of authoritarian ideology than it does about anything that might be going on in the minds of children. I'll believe in "oppositional defiant disorder" the day they start medicalising the sort of authority-friendly traits that help children to grow into servile, unquestioning, easily-managed servants of the powerful, such as an irritating over-enthusiasm for mindless group activities ("cheerleader disorder"), the unquestioning assumption that the most banal utterances of the rich and famous and every tedious detail of their lives must be of interest and importance to everybody else ("Hello! magazine disorder", or its middle-class equivalent "Sunday supplement disorder") and uncritical respect for authority ("toady syndrome").