The student came into the office for our first session. Having already seen his educational records and talked with school personnel, I knew he was intellectually gifted, but wasn't doing any work in school or at home, and that he was on a cocktail of psychotropic medications for his diagnoses of ADHD, TS, OCD, Bipolar Disorder, and Asperger's Disorder.
He looked curious and attentive and ready to laugh. After the initial pleasantries, I asked him to tell me about himself. He slumped slightly in his chair, and his expression became somber. "I have a lot of problems," he said.
He then went on to list all his diagnoses for me and all the medications he was on at the time. He was starting to tell me the diagnostic criteria for his most recent diagnosis and the side effects of his newest medication when I interrupted him softly and said, "I asked you to tell me about yourself. You've given me a string of labels, but that still doesn't tell me who you are. So let's start again, and tell me about yourself. What do you like to do? Who is this young man sitting across from me?"
One of the things I struggle with on a daily basis in my professional work and in writing articles is how to label these.... things. Diagnoses are part of the mental health profession, but the view is primarily a medical/psychiatric one that is often based not on evidence of any biological or disease process, but on behaviors. But does whether we call something a "disorder," a "disability," or (just) "different" make a difference to how we approach the child and how the child views himself? I believe it does, as I am seeing too many children and teenagers who feel "broken" because the weight of all of their diagnoses is more than their young shoulders can bear. Having been told that they have a (medical or psychiatric) problem and/or that their behavior isn't their fault because there's something wrong in their brain, how are they to feel about themselves, and how will they relate to their peers?
In many respects, this web site is much more negative than I would like to see it, because I have focused on the problems children and teens may face (or will probably face), without spending enough time addressing what might be the positive consequences of having these "disorders." While many people are already aware of the reported association between Bipolar Disorder and creativity, less attention has been paid in the literature to other conditions, and yet anyone who spends time working with students with regulatory "disorders" usually recognizes that there are often some positive aspects to dysregulation. Sadly, we spend so much time trying to change the child or "fix" the child's "symptoms" and not enough time helping the child or teen appreciate the positive aspects of their "disorder" or "disability."
Sometimes on this site you will see me use the word "disorder" and sometimes you may see me use the word "condition." The truth is that I actually prefer to just talk about these children in terms of their minds working somewhat differently than the "average" or "normal" child. When most of us think of "disorder," we think of something that needs to be treated (the medical model). But just because a child is different in how their mind works, it doesn't mean they need treatment. In many cases, all they will need is our understanding and respect for the fact that their mind does work differently, that they may learn differently, that they may have more variability in their behavior, and that they may have different ways of expressing what they have learned. Surely we should be able to accommodate differences, right?
So that day, as I sat in the office with that student who had made his "disabilities" the central focus of his young life, I started talking to him about "different kinds of minds" and how by working together, he might come to understand how his unique mind works so that he could accomplish more of what he wanted to accomplish. And I told him that my goal was not to "fix" him because he wasn't broken.
He left the office smiling.