The 3 Primary Brain Systems

3 Primary Brain Systems

C.A. Childress, Psy.D. (2011)

Parenting involves three primary brain systems,

1) the Authority System

2) the Social Dialogue System

3) the Psychological Connection System 

We will discuss each of these systems individually and more fully in separate blog entries, but I’ll review each system briefly here.

The Authority System

Dominance-submission

Metaphor: the gorilla troop

The Authority System is essentially a set of dominance-submission networks, and the metaphor is the gorilla troop.  In the presence of a “dominance cue” (the big gorilla pounds his chest) we can induce submissive behavior in another person through the application or threatened application of punishment (the big gorilla bops the younger gorilla on the head).

The Authority System is an external control system, and it is ALWAYS an external control system (we don’t magically “internalize” the control – “self-control” actually originates from different motivating systems than the dominance-submission networks of the Authority System).  The Authority System only activates in the presence of the dominance cue.  When the dominance cue is removed, the person’s actions become motivated by factors other than the Authority System.

The Authority System uses discipline strategies to achieve obedience.

The Authority System uses punishment to induce submissive behavior.  By definition, punishment always involves inflicting suffering on another person.  There are always negative side-effects from inflicting suffering on another person.

The Authority System plays an important role relative to a specific Relationship System, called the Attachment System.  The communication of calm-and-confident parental authority is important in conveying a sense of security for children.  The absence of parental communication of calm-and-confident authority can lead to a disruption of the Attachment System creating insecurity and anxiety for the child (this will be discussed more fully when we talk about the 2 Relationship Systems).

The behaviorist approach relies almost exclusively on activating the dominance-submission networks of the Authority System.  Since we build what we use, if we use the dominance-submission networks to achieve children’s obedience during the school-age years, we have strengthened and built this system for when they reach adolescence.  If you’re the big gorilla, I need to do what you want.  However, if I’m the big gorilla, you need to do what I say.  Over-reliance on using the dominance-submission networks of the Authority System during earlier childhood can result in a stormy period of adolescence as parents and adolescents fight for dominance. 

Behaviorism focuses extensively on the dominance-submission networks and it tends to interpret all parent-child interactions from this frame of reference.  This is primarily because rats don’t have the more complex communication and relationship networks that humans do, so a model of social relationship based on rat behavior will, of necessity, focus almost exclusively on dominance-submission networks.

The Social Dialogue System

Metaphor: an orchestra

In a orchestra, each person is playing a different instrument and a different part of the overall composition, yet everyone is functioning together to create an integrated and harmonious social activity.

This is an important brain system.  It is the system that “controls” (actually a more appropriate word is "modulates") our functioning 90%-95% of the time.  It involves 1) reading social cues, 2) interpreting what the social cues mean, 3) emitting social cues (communicating to others what we’re going to do) and 4) coming up with a socially organized plan for how to fit our activity into that of the social group.

In our daily lives, we don’t go around asking ourselves “am I going to get in trouble for doing this?... am I going to get in trouble for doing this?”  The dominance-submission networks don’t typically control our day-to-day activities.  Instead, we take in the meaning of the social situation and fit our actions into the social group’s activity in a harmonious and coordinated way.

The Social Dialogue System uses guidance strategies to achieve cooperation.

The Social Dialogue System involves both communication and relationship systems.  Whereas the dominance-submission networks of the authority system are highly resilient and resistant to significant disruption, the nuanced complexity of the Social Dialogue System is easily disrupted by a variety of factors, often from overwhelming-disruptive emotions.

Since we build what we use and the dominance-submission networks are typically not the problem, we will want to tread lightly in using these networks (however, the Authority System, and the calm-and-confident communication of parental authority remains important relative to Attachment Security).  The problem typically lays in disruptions to the Social Dialogue System, so we will tend to want to use this social communication system more that the dominance-submission networks of the Authority System. 

This is one of the significant problems with the behaviorist approach.  Focusing almost exclusively on the dominance-submission networks of the Authority System in an effort to suppress symptoms (i.e., obtain “compliance”) targets the wrong brain networks for use-dependent growth.  While we can suppress behaviors through the external control aspects of the dominance-submission networks, we can do so only as long as we maintain the dominance cue of our presence. Furthermore, by using the dominance-submission networks we are not building the more important social cooperation and communication networks of the Social Dialogue System, and it is disruptions to these social cooperation networks that is the cause of the “problem behavior" (metaphor for the "problem behavior": the child doesn’t hear the music of the orchestra and so is simply playing his or her own music without an awareness of the broader social context, or the child doesn’t know how to play his or her instrument, or the child has trouble staying in tune or rhythm with the music of the social group).

While communicating calm-and-confident parental authority is important to a well-functioning Attachment System, most of our interventions will be focusing on using (building) the coordinated and harmonious functioning of the Social Dialogue System.  Our goal is more than achieving an obedient child.  Our goal is to achieve a cooperative child.

The Psychological Connection System

Example: watching a movie in the theater and feeling what the actors feel.

The Psychological Connection System (technically called “intersubjectivity” in the scientific literature, although Ed Tronick at Harvard refers to it as a “dyadic state of consciousness” – I love that phrase for this system) originates from a set of brain cells called “mirror neurons.”  There is a wonderful little video by the PBS show Nova on mirror neurons at http://www.pbs.org/wgbh/nova/body/mirror-neurons.html

Technically, our brains enter a resonant synchrony with the brain states of other people (we enter the same "phase-state organization"), but this level of understanding for this system is only necessary for those of us who do psychotherapy.  Parents simply need to appreciate that the system exists and how it functions.

This is such an important system that I will be “unpacking it” in several blog entries.  For one thing, it is at the core of understanding protest behavior, and understanding protest behavior is at the core of understanding how to respond to the child’s dysregulated-disorganized emotions and behavior (i.e., “problem behavior” - notice I always put the term "problem behavior" in quotes.  Ultimately, we will be replacing the phrase "problem behavior" with "protest behavior" but I haven't explained protest behavior yet.  In the meantime, however, you may want to practice extracting the phrase "problem behavior" from your thinking and replacing it with "protest behavior").

Our brains possess the capacity to feel what others feel “as-if” we were feeling these emotions and experiences ourselves.  When we go into a movie theater, the lights are turned off and our sense-of-self recedes into the background, leaving our Psychological Connection System up on the surface of experience.  We then feel what the actors experience in the movies “as-if” we where having the same feelings and experiences ourselves. This is the Psychological Connection System.

The Psychological Connection System is one of the two important Relationship Systems, the other being the Attachment System.  When the Psychological Connection System is functioning well, the feeling is a warm-and-wonderful feeling of belonging, of being part of the group.  When the Psychological Connection System becomes disrupted the feeling is one of psychological loneliness and alienation, which is an extremely painful emotional experience for humans.

Now here is an interesting feature… what happens in the movie theater when the movie becomes too scary?...  We look away.  We break connection.

Because of this Psychological Connection System, children feel what their parents feel (i.e., they enter the same resonant brain state).  What happens when their parents are too angry, too sad, too stressed, too anxious, and it become too painful for the child to maintain a psychological connection with the parent?  The child breaks psychological connection.  If this break in psychological connection occurs too often and becomes too chronic, then the child develops an inner sense of psychological loneliness and alienation, which is an extremely painful experience.

With regard to emotions; anger always breaks psychological connection; the positive emotion of happy always promotes psychological connection.

Based on this feature of emotions alone, one recommendation I would offer to parents is to decrease the amount and intensity of anger in the home and increase the amount of relaxed pleasure, joy, laughter, and happiness.  If there are barriers to increasing the amount of relaxed happiness, joy, and laughter in the home then it would probably be fruitful to problem solve how to reduce and eliminate these barriers.

A second recommendation I would offer based simply on the presence of the Psychological Connection System in the brain is that it would benefit children’s emotional and psychological development for parents to be a calm, relaxed, pleasant psychological state a majority of the time.  This means that, as parents, we need to look into our own stress reduction and psychological-emotional health, because whatever we’re experiencing is being psychologically imported directly into our children.

We will discuss the Authority, Social Dialogue, and Psychological Connection Systems at greater depth in future posts (and video seminars as they become available).  

Brain Development: We Build What We Use

Brain Development: We Build What We Use

C.A. Childress, Psy.D. (2011)

The brain develops based on the principle of “we build what we use.”  That’s all you need to know for this part, but I’ll continue just for those who want more background.

This is called “use-dependent” or “experience-dependent” neuro-development.  A major figure in neuro-developmental research, Donald Hebb, coined the phrase “neurons that fire together, wire together” to describe the use-dependent development of the brain. 

This “build what we use” process (i.e., use-dependent development of neural systems) is also called “canalization” of brain networks – drawn from the word “canal” like a channel.  Think of a dirt hillside during a rain.  The first raindrop can go any direction down the hill, but when it does it takes a little dirt with it.  Subsequent raindrops can also take a variety of paths down the hill, but they tend to take the paths, the channels, the canals, that are being formed as each raindrop takes a little more dirt away with it.  Slowly, deeper channels, or canals, develop on the hillside.  Brain networks work the same way (“canalization”).   We build what we use.

Every time we use a brain cell or an associated set of brain cells (i.e., such as a larger network or system), structural and chemical changes take place within the used brain cells (a process called “long-term potentiation”) that make the used network pathways more sensitive to activating. 

Pathways are also made stronger through use as the used brain cells (called neurons) grow more connections along the used pathway (this growth process in connections is called “synaptogenesis;” – synapses are the connection points between brain cells and genesis refers to growth – synaptogenesis; the growth of synapses).

Neural pathways also gradually becomes more efficient as a result of the cell’s stimulation through the increased growth rate of a fatty covering, called myelin, along the parts of the brain cells (called axons) that transmit the signal down the cell.  

When we use a brain network or a brain system it becomes stronger, more sensitive to activation, and faster and more efficient.  We build what we use.

This is the first key conceptual shift.  Within a behaviorist paradigm, punishment and reward are used as social control mechanisms to coerce the child to emit the desired outward behavior (called “compliance” in the research literature).  Within a developmentally supportive parenting paradigm, the issue is to “scaffold” or support the use-dependent growth of the desired brain systems and networks that are responsible for healthy emotional-social-psychological development.  Our goal is to achieve more than merely an obedient child.  The goal is to achieve a cooperative child; a child who is self-motivated; a child who is pleasant to be around; a child who is actively and easily communicative; a child who is kind and compassionate yet who can also be appropriately self-assertive; a child who possesses a moral-ethical core and who is motivated by factors such as what’s right and wrong; and a child who is happy, who laughs easily and often, and who grows into a mature, responsible, and successful adult. 

None of these goals are relevant to modifying the behavior of a lab rat.  Our goal is to raise an emotionally, socially, and psychologically healthy child who will grow into a mature and responsible adult, with a good job, and who has a secure, supportive, and affection-filled family.

Our goal is more than merely obtaining an obedient child; our goal is to achieve a cooperative child.  And we now know enough about the neuro-development of brain systems during childhood to be able to achieve this goal of a cooperative, self-motivated, mature, and successful child.  It’s not about behavior.  It’s about communication and relationship features.

We build what we use.  We want to “scaffold” the use-dependent development of the brain networks that will result in a cooperative, happy, and successful child. So the next question becomes, what networks do we want to use?  What are the brain networks responsible for achieving a happy and cooperative child versus an angry, sad, defiant, anxious, un-motivated, rude, hyperactive, intrusive, impulsive, argumentative, uncooperative, disobedient, disrespectful child? 

I’ll tell you, but I first need to explain how the brain works.  I need to explain the 2 Relationship Systems, the nature and functioning of protest behavior, the role of our motivating intentions, and the nature and functioning of the emotional system relative to communication and relationship systems.  Each piece will make sense, and you’ll find each piece of value.  And when its all put together, everything will make complete sense and you’ll understand exactly what to do.

So lets begin,

There are three fundamental brain systems involved with parenting, 1) the Authority System, 2) the Social Dialogue System and 3) the Psychological Connection System...

Shifting Paradigms: The Behaviorist Context - Part II

Shifting Paradigms: The Behaviorist Context Part II

C.A. Childress, Psy.D. (2011)

I am a trained behavioral psychologist.  From the very beginning of my studies at UCLA in the mid-1970s, I was steeped in Learning Theory and the behaviorist model.  I may be one of the few clinical psychologists who was actually trained in behavior therapy by first starting with teaching a rat to press a lever in a Skinner box (in a course called Learning Lab) as a way of teaching us the very basic and foundational principles of Learning Theory on which behavior therapy is based.  I know Learning Theory and the behaviorist paradigm intimately.  And it’s wrong.

I love science.  My wife will take a book from the New York Times bestsellers list to read at the beach, I take a copy of Scientific American.  Back in the early-70s, when I started my training in psychology, the science was with Learning Theory and behaviorism.  But it has shifted.  Attachment theory emerged in the late 1960s, and then research on early childhood psychology and brain neuro-development really took off by the mid-1980s.  And since 2000, the scientific research on brain neuro-development has been profound. 

Science has moved on, but the behaviorist paradigm continues today essentially unchanged from its origins with lab rats in the 1940s and 50s.  I love science, and I’ve followed the science into the neuro-developmental areas in which it has shifted.

I practiced from a behaviorist perspective for many years.  I even used behaviorist principles in raising my son, Jack, at least initially until I switched to a developmentally supportive paradigm because that’s where the science moved (and my switch from a behaviorist parent to a developmentally supportive parent proved to be much, much more beneficial for both Jack and I).

Again, I will have more to say about behaviorism in my video seminars, but suffice to say at this point is that the entire paradigm of behaviorism is fundamentally wrong and leads to seriously flawed misconceptions when it is applied to child development.  Behaviorism represents an inappropriate application of an animal-based model to child development. I am of the firm professional opinion that child psychotherapy needs to be based in the scientifically derived evidence on child development, particularly the neuro-development of the brain during childhood, not in an animal-based model for altering the behavior of animals in the laboratory. 

I’m not saying Learning Theory is wrong.  It’s just very limited, and it shouldn’t be used as a basis for child psychotherapy.  Using Learning Theory as a basis for a model of child psychotherapy represents an inappropriate application of an animal-based model for use with human children.  Child psychotherapy should be professionally based in the scientific evidence regarding child development and the neuro-development of the brain during childhood – not on modifying the behavior of lab rats.  Human children are not lab rats.  Human children are immensely and significantly different from lab rats.  And the behaviorist model leads to erroneous interpretations, misperceptions, and seriously flawed treatment recommendations.

Lab rats have a very small brain that takes only a matter of weeks to fully mature, human children have a very large and complex brain that requires YEARS of socially mediated development in order to mature.  That’s a major difference. 

But even more importantly, lab rats don’t have language.  Human children have language.  Language development is of immense and central importance to understanding both child development and brain functioning.  Language has led to significant and major development of brain systems that simply have no counterpart in other animal species.  Even social species, such as dogs, have only very rudimentary relationship and communication systems compared to those possessed by the human brain.  The acquisition of language during childhood requires that the central features of human brain development during childhood involve interpersonal communication and relationship features, not simply overt behavior control techniques.  A failure to understand and appreciate the fundamentally communicative and relationship basis of human parent-child interaction will lead to seriously flawed misconceptions of what is occurring, resulting in seriously flawed, counterproductive, and potentially even harmful “treatment” recommendations. 

And finally, another major and important difference between a human child and a lab rat is that we don’t care if we get an emotionally and psychologically healthy lab rat, we do care if we get an emotionally and psychologically healthy child.  There are professional moral and ethical issues involving behaviorist “therapy” with children that I find highly disturbing from a professional standpoint, but I will discuss these professional concerns elsewhere.  But let me simply state here that NONE of the research on behaviorist child “therapy” techniques has used as outcome measures the healthy emotional and psychological development of the child.  All of the research on behaviorist child “therapy” techniques has simply used behavioral compliance variants as outcome measures.

Can we induce submissive behavior in children through the application of punishment.  Absolutely yes.  I will stipulate all of the behaviorist research evidence showing we can induce submissive behavior in children through the application of sufficient punishment.  But that does not necessarily lead to an emotionally and psychologically healthy child.

So what should we know that will help put us on the right track to achieving an emotionally and psychologically healthy child?

First, the brain does not develop based on the principles of reinforcement and punishment. 

Forget reinforcement and punishment as constructs to use with children (we will return to a variant of punishment, and its appropriate use, when we discuss the Authority System, but for now simply purge these constructs from your brain). 

Second, there is NO SUCH THING as negative attention.  Children DO NOT “misbehave” because they want to be yelled at and punished (we will return to this issue when we discuss “protest behavior”). 

Clear your mind of all things behavioral, we’re about to enter a different conceptual world; the world of relationships and communication; the world of co-constructed meaning and the development of self; the world of human brain development during childhood. 

Don’t worry, it will all make total sense.  Each piece will make sense in turn, and when it’s all put together, the whole thing will make total sense.  Ultimately, it will seem self-evident and natural. 

All you’ll need is to have the words and constructs to recognize what’s happening, then once you see what’s actually taking place you’ll know exactly what to do to achieve the cooperative, happy, and successful child you want.  You’ll be happier, your child will be happier, and (…yes this is true) the world will be a better place.

So here we go…

Shifting Paradigms: The Behaviorist Context - Part I

Shifting Paradigms: The Behaviorist Context Part I

C.A. Childress, Psy.D. (2011)

Before entering into a discussion of developmentally supportive parenting and psychotherapy, I want to set the context of where we are currently with regard to parenting recommendations and psychotherapy.  The current theoretical paradigm governing our approach to parenting and child therapy is “behaviorism,” an approach that developed its formal organization in the 1940s and 50s.  Before we shift into an entirely different paradigm involving the neuro-development of brain systems, I’d like to first review the origin and the failures of the current behaviorist paradigm relative to parenting and child therapy.

Everything in psychotherapy begins with Sigmund Freud.  Back in the 1930s and 40s, Freud’s psychoanalytic theories, and variants of them, represented the dominant paradigm governing psychotherapy.  But in the 1950s and 60s, a backlash against Freudian/psychoanalytic theory developed, particularly within universities in the United States, which held that the psychoanalytic paradigm was “unscientific” because its basic tenets could not be subjected to experimental proof by the scientific method. Since the tenets of psychoanalytic theories could not be objectively observed and measured (e.g., one could not directly observe and measure an Oedipal complex), there was no way to scientifically prove or disprove their theories.  A movement arose within professional psychology to base psychotherapy within the scientific method, and many theorists and practitioners turned to the emerging psychological science of the 1940s and 50s regarding the modification of behavior with lab animals (primarily lab rats using an apparatus called a “Skinner box,” named after its developer, B.F. Skinner).

These “scientifically based” theorists combined the laboratory findings of Ivan Pavlov who studied the paired association of stimuli (i.e., the sound of a bell with food presentation to dogs; called Classical Conditioning) with the findings from modifying the behavior of lab rats in a Skinner Box (called Operant Conditioning; because the lab animal actively “operated” on the environment as opposed to Pavlov’s dogs who were more passive recipients of the association experience – and since Pavlov’s work (1930s) came before Skinner’s (1940s) Pavlov became “Classical”). Later, in the 1960s, a third set of research findings (Albert Bandura) having to do with observing a role model was added to the mix, and together this set of experimental findings was labeled “Learning Theory” because it was believed that this set of research findings explained how animals, including humans, learned.

The principles of Learning Theory proposed that behavior was the end-product, the result, of the organism’s learning history.  Change the learning history and you will change the behavior.  The principles of operant conditioning held a central role within Learning theory, and were essentially that; 1) behavior that is reinforced (rewarded) will increase (the studies primarily used food as the reinforcer with lab animals), 2) behavior that is punished will decrease (the studies primarily used electric shock as the punishment with lab animals), and 3) removing the reinforcement from a behavior will also decrease that behavior (called “extinction”).  The details of this process were extensively studied and are much more elaborate that the brief synopsis I provide here (involving concepts such as shaping, fading, stimulus control, cue discrimination and cue generalization, differential reinforcement schedules, behavior chains, etc.), but the reinforcement-punishment-extinction triad is the primary core of the operant conditioning model.

During the 1960s and 70s a movement arose within psychology to apply Learning Theory principles, called behaviorism, to child “behavior problems.”  In order to base child theapy within the scientific method, theoretical constructs were restricted to observable behavior only.  Motivations, needs, meaning, were all excluded because these constructs could not be observed and measured.  According to the behaviorists, the psychoanalytic paradigm of Freud and his colleagues had moved away from a foundation in the scientific method by trying to address the person’s inner experience, which could not be formally studied by the experimental method.  Behaviorism was steadfastly certain that it would not make the same mistake, so only observable behavior was an acceptable construct for theory and study.

Since its emergence in the 1960s, behaviorism has achieved a dominant hold on the field of professional psychotherapy, and behaviorism is far and away the dominant paradigm currently governing child psychotherapy.  Within the field of professional psychology, euphemisms for the behaviorist paradigm include “evidenced-based practice” and “empirically validated practice” and there is a considerable push within the professional establishment to have funding agencies limit reimbursement to ONLY behaviorist interventions. Such restrictions will have the effect of essentially eliminating all other non-behaviorist therapeutic approaches by cutting off the funding for these non-behaviorist approaches – although those advocating this restriction don’t explicitly use the term “behaviorist” but instead use the euphemisms of “evidence-based” and “empirically validated.” 

(note: the "evidence" that they talk about as "evidenced-based" is essentially that we can induce submissive behavior in children through the application of punishment... some "evidence."  Seems pretty self-evident, and we know that simply punishing children for "misbehavior" has not solved the problem.)

This effort at restricting child psychotherapy approaches to only behaviorist approaches becomes highly problematic once we understand how the brain grows and develops during childhood. Once we understand the inter-relationship of the brain systems involved in healthy child development, we come to realize that the recommendations of the behaviorist paradigm are actually the entirely wrong thing to do, and in many cases will actually make the situation worse from a neuro-developmental perspective.  Furthermore, there are very problematic moral and professional ethical concerns related to the use of behaviorist interventions.  But we’ll get to those later… 

(note: by the way, I’m a trained behavior therapist, although I no longer practice from a behaviorist model having now come to understand the neuro-development of the brain in childhood.  In fact, for me, knowing what I know about brain development and child development, I would personally consider it unethical and unprofessional practice for me to prescribe a behaviorist treatment plan for one of my child clients – with the possible exception of a child with severe autism (although I’d still likely go with a “DIR floortime” variant) or a child with significant mental retardation).

Back to the story… One of the first challenges facing the behaviorist child therapy model was to identify the reinforcer that was maintaining the child’s “behavior problem.”  Since child behavior problems occurred frequently despite punishment efforts designed to decrease the frequency of the “problem behavior,” there must be some positive consequence to the child’s “behavior problem” that is serving to reinforce the continued occurrence of the “problem behavior,” even when that behavior is subjected to punishment.

The answer to this “reinforcement of problem behavior” question emerged through the observation of the parent-child interaction process.  It was noted that when children display “behavior problems” they typically receive increased parental attention, while when they behave “appropriately” they receive no such parental attention, and they may actually be ignored by the parent who will engage in various non-child related tasks.  Since everyone knows that children love parental attention, this parental attention must be so reinforcing for children that they will continue to present the “problem behavior” because they have “learned” (remember Learning Theory) through the reinforcement provided by "negative parental attention" that presenting the problem behavior is a  way to receive parental attention.  Even when the parental attention involves anger and punishment, the reinforcing power of parental attention overwhelms the negatives of the interaction, and the term “negative attention” was born. 

According to behaviorist theory, children will present behavior problems in order to receive negative attention from their parents.

Therefore, one of the first goals of behaviorist child psychotherapy was to remove the proposed reinforcer of negative parental attention from a child’s “misbehavior” (i.e., place the “behavior problem” on extinction), so a procedure was developed called “time out from reinforcement” (which was later shortened to simply “time out”) that did just that.  Specific procedures and instructions were developed for parents (and were extensively studied in the laboratory) instructing parents to place their children in a “time out chair” and walk away whenever the child “misbehaved.”  The standard instructions for time out are for parents not to talk or dialogue with the child, but to do everything possible to remove their parental attention from the child’s “misbehavior” in order to eliminate the reinforcing effect of “negative attention” in maintaining the child’s “negative behavior.”  I will have more to say about all of this in my video seminars where I take behaviorism to task.  But let me just say here that there is no such thing as negative attention.  

Negative attention as a reinforcer is a myth and it has NO scientific validity. It is wrong, wrong, wrong.

But to return to the story… since the child is supposedly “acting out” to get parental attention, even if this is “negative attention,” then a second goal of the behaviorist model is to provide the child with positive reinforcement for “positive behavior.”  This typically involves recommendations to parents that they provide the child with praise (i.e., positive attention) for “good behavior.” This procedure of giving positive attention to "positive behavior" is sometimes referred to as “catch them being good” – a “clever” variant of what parents typically do which is “catch them being bad.”  

It is interesting to note that the research evidence on parental praise as a reinforcer has found that praise has NO measurable effect on the child’s behavior (cf., Roberts, Hatzenbuehler, & Bean 1981; Roberts, 1985).  Yet, despite the absence of research support for positive parental attention as a reinforcer, behaviorists continue to propose that parental praise is a reinforcer (it is also interesting to note that when a theory predicts a particular outcome, such as behaviorism predicting that parental praise is a reinforcer which, when delivered contingently to a desired child behavior, should increase the frequency of that behavior, and this prediction is contradicted by the actual research evidence, this is generally called “disconfirming evidence” for the theoretical model – meaning that the theoretical model is wrong – if your theory predicts xyz and xyz doesn’t occur, that means your theory is wrong.  Because that’s a basic tenet of the scientific method, I find it even more intriguing that behaviorism arose as a “scientifically based” alternative to the unscientific nature of psychoanalysis, but when the scientific method produces “disconfirming evidence” for the validity of the behaviorist model, behaviorists simply ignore the disconfirming scientific evidence and continue doing what they do and continue advocating for an inaccurate model.  It makes me smile and shake my head in disbelief).

Behaviorists sometimes also use star charts and point systems (called “token economies”) to reinforce “positive behavior,” although token economies are notoriously difficult to construct and maintain with children, and any competent behavior therapist will realize that using extrinsic reinforcers to establish a behavior requires that a typically time consuming and involved “fading” procedure will ultimately need to be constructed and employed otherwise “extinction” processes will occur when the delivery of the active reinforcer is eventually stopped.  The logical and theoretical inconsistencies within behaviorism are myriad and widespread, but there’s simply a tacit conspiracy of silence within professional psychology not to openly talk about them (la-la-la, I’m not listening, everything makes total sense, la-la-la, it’s scientific, I have research evidence, no, no no, I’m not listening, la-la-la). 

Its time professional psychologists begin to talk about the glaring inconsistencies and inaccuracies within the behaviorist paradigm, because behaviorism is a fundamentally flawed theoretical paradigm for use with children.  There is solid scientific evidence emerging from brain neuro-developmental research to suggest that the recommendations derived from the behaviorist paradigm are counter-productive and may actually be harmful (and I am actually being kind by adding the qualifier “may” to the phase “be harmful,” since I am of the personal and professional opinion that behaviorist approaches to child “therapy” are harmful to children and are ethically very problematic – I will discuss my ethical concerns elsewhere).

End of Part I

References:

Roberts, M.W., Hatzenbuehler, L.C., and Bean, A.W. (1981). The effects of differential attention and time out on child noncompliance. Behavior Therapy, 12, 93-99

Roberts, M.W. (1985). Praising child compliance: Reinforcement or Ritual. Journal of Abnormal Child Psychology, 13(4), 611-629

Introduction & ADHD Diagnosis

Introduction to the Blog & the Diagnosis of ADHD

C.A. Childress, Psy.D. (2011)

Since filming videos for e-how.com regarding Attention Deficit Hyperactivity Disorder and other parenting issues, I’ve been receiving a number of e-mails requesting my consultation with child behavior and parenting issues.  While restrictions within professional standards-of-practice prevent me from offering specific advice in response to these e-mail requests, from time-to-time I’ve responded with general information on parenting and child development issues that may be helpful.

Many of the parents contacting me are presenting similar sorts of problems and questions, and I thought it might be more broadly helpful if I would begin to develop a blog, offering my responses more generally into the Internet community so that more parents might possibly find some help from my general parenting and child development responses.

In addition, I’m currently in consultation with some colleagues about filming and offering online a set of free parenting seminars regarding these issues as well.  So these video parenting seminars may begin to become available soon.

During these first set of blogs, I plan to establish the basic principles of developmentally supportive parenting (and psychotherapy) as well as a common vocabulary that we can use in discussing the issues related to problematic child behavior and problematic parent-child relationships.  Developmentally supportive parenting is based in the scientific research on child development, and particularly regarding the neuro-development of brain systems during childhood.  The principles and concepts are relatively straightforward and they make complete sense to all the parents I’ve worked with once I’ve explained them, but developmentally supportive parenting (and psychotherapy) is a different approach to understanding and addressing child behavior problems and problematic parent-child relationships than has typically been advocated by “behaviorists.” So, at least initially, it is important to develop a common understanding, language, and frame of reference regarding the nature and origin of child behavioral and relationship issues.

Over the years, I’ve conducted many parent and teacher seminars and I've taught the principles of developmentally supportive psychotherapy to graduate psychology students.  In my private practice I typically discuss with parents the basic principles of brain development and the impact of integrated and non-integrated functioning of certain brain systems on children’s behavioral, emotional, and relationship functioning.  The graduate students, parents, and teachers that I’ve taught have consistently expressed to me that developmentally supportive parenting (and psychotherapy) makes complete sense and becomes self-evident once it’s explained. 

They come to understand the origins of “problem behavior” (re-conceptualized as “protest behavior”) and they develop an understanding for exactly how to respond to children’s protest behavior in a way that is supportive of their children’s developmental growth and progress.  They come to understand the origins of explosive-emotional tantrums and how to respond to these emotional tantrums in a way that is supportive of their children’s healthy developmental progress.  And, what’s more, they understand the neuro-developmental brain systems origins of the symptoms of “attention problems” (actually these attention symptoms also involve motivational issues), hyperactivity, and “impulse control” problems that form the core symptoms for a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD), and they understand exactly what to do in response to these behavioral symptoms in order to support children’s return to normal developmental progress.

Let me say that again, just to be clear.  Once we understand the neuro-developmental systems origins (i.e., the cause) of the attention, hyperactive, and impulse control symptoms that are typically associated with a diagnosis of ADHD, we can respond in ways that address the underlying neuro-developmental systems (i.e., we can treat the cause of the symptoms) and actually eliminate the cause, and so eliminate the symptoms.  

Does this mean that we can cure ADHD?  Yes, for the most part (depending on the specific cause, but usually).  I would offer only one qualification; that once the cause of the ADHD symptoms is understood from a neuro-developmental systems perspective I would propose that the actual diagnosis of ADHD disappears.  Knowing what I know about brain system functioning and the neuro-development of the brain in childhood, it is my professional view as a clinical psychologist treating ADHD that there is no such thing as ADHD.   Attention Deficit Hyperactivity Disorder represents a set of symptoms.  The more relevant feature is the underlying cause of these symptoms.

I’ll specifically address this diagnosis issue more fully in my video seminars, once they’re produced, but let me simply state here that in my view a diagnosis is more than simply putting the word “disorder” at the end of a set of symptoms.  If you have an infection that causes a fever and you go to see your medical doctor, your physician does not diagnose you with a “fever disorder.”  If you go to your medical doctor with a symptom of pain, your physician does not diagnose you with a “pain disorder.”  In my view, a diagnosis involves using the information derived from the symptoms to identify the cause of the symptoms. 

And, in fact, if you went to your medical physician because you had a symptom of pain and your physician diagnosed a “pain disorder” and prescribed a pain suppressant, rather than using features of the pain symptom to diagnose, and so treat, your heart attack, or your appendicitis, or a muscle tear, this would typically represent medical malpractice and be a cause for legal action against the physician.  However, currently, with regard to professional psychology, we can simply put the word “disorder” after the child’s symptoms of difficulty focusing and sustaining attention (i.e., attention deficit) and difficulty modulating arousal activation, limiting behavioral activity, and organizing behavioral focus (i.e., hyperactivity) and so claim a “diagnosis” of Attention Deficit Hyperactivity Disorder, without ever identifying and treating the underlying cause. 

Attention problems (and motivational symptoms), disrupted behavioral organization (i.e., hyperactivity), and “impulse control” problems (understanding the origins of “impulsive” symptoms requires an understanding of the functioning of the Relationship Systems and, to some degree, the role and function of protest behavior) all represent symptoms.  Simply putting the word “disorder” after the symptoms of “attention deficit” and “hyperactivity” is nothing more than “diagnosing” a fever as a “fever disorder,” or pain as a “pain disorder.”  In my view, this does not represent a diagnosis.   A diagnosis involves using the information available from the symptoms to identify the underlying cause, and to understand the cause of these symptoms of ADHD requires both an understanding of principles of brain neuro-development during childhood and an understanding of the integrated functioning, and dysfunctioning, of various brain systems relative to child development.

With medical issues, the underlying cause of a disorder or disease process often lay in disruptions to the healthy normal-range functioning of the involved physical systems, such as the respiratory system, cardiovascular system, muscular systems, etc.  In some cases the disorder or disease process may be caused by the invasion of outside pathogens, such as bacteria or viruses.  Similarly, with regard to the behavioral and emotional symptoms that are the realm of professional psychology and psychotherapy, the underlying cause of these symptoms lay in the disrupted functioning of the underlying brain systems that control and modulate the functioning of emotional-behavioral-social activity, or in some cases from “outside pathogens” involving problematic caregiving responses.  Just as a physician needs to understand the functioning of the body’s physical systems, and the effects of various bacteria and viruses on the body’s functioning, a professionally competent clinical psychologist needs to understand the functioning of the developmental brain systems governing emotional-behavioral-social activity and the effects of various caregiver-child communication and relationship features on the functioning of these systems.

In my view as a clinical psychologist who specializes in treating “Attention Deficit Hyperactivity Disorder,” ADHD as a “disorder” does not exist.  Instead, what exists are disruptions to particular underlying emotional-relationship and social communication brain systems that result in a symptom pattern of decreased capacity to focus and sustain attention, an inhibition of task-oriented/goal-directed motivation systems, hypersensitivity to emotional distress and a consequent pain-aversive motivational press, difficulty modulating behavioral arousal, and a difficulty in developing socially organized behavioral activity.  And, from a neuro-developmental systems perspective, this constellation of symptoms makes total sense relative to the disruption and non-integrated functioning of particular brain-relationship systems.  Treating the cause of the attention deficit, hyperactivity, and impulsive behavior symptoms has the potential for resolving the problem at a neurological level and thereby eliminating the symptom set.

Behavior is a symptom, the brain is the cause.

I plan to expand on this discussion over the course of my blog entries and in possible future video seminars on developmentally supportive parenting (and psychotherapy), thereby opening more complex dialogue regarding the origin and resolution of children’s behavioral-emotional problems and parent-child relationship problems. 

Welcome, and I hope you find the information helpful.