I always find it hard when I meet someone for the first time - particularly a child or a young person - who wastes no time in telling me what they think is “wrong with them”. Maybe it is “anger issues”; or perhaps attention deficit hyperactivity disorder (ADHD); many have “got anxiety”; others are convinced that they must be “on the spectrum”, just because they feel different.
Now there is even a condition called oppositional defiant disorder (ODD), which can be diagnosed when argumentative or defiant behaviour persists for more than six months. There is apparently a “normal” range of frequency and severity of such behaviour, which if exceeded, tips the young person into the realms of a formal diagnosis.
It is very easy in one sense to look at the behaviour of any child or young person and - particularly if it is extreme, erratic or disturbing - decide that it “isn’t normal”. There must be something wrong with them, surely? Schools and parents can breathe a small sigh of relief. Now we understand; now something can be done; there may even be a pill to pop.
What, though, if it is the circumstances and environment which are not normal - and the individual’s response is actually very normal, in the face of the extreme turmoil, alienation or adversity they face? Not to react to their environment and circumstances, in the way that they do, would in fact be abnormal.
In March 2018, writing in the BACP’s magazine Therapy Today, school counsellor Michelle Higgins coined a new term - “crap life disorder”. With increasing pressure to succeed at school, within ever tighter parameters; with the siren call of social media to be better, brighter and more beautiful; with financial struggles at home; with family fracture and upheaval; with the rise and rise of identity politics, calling us to join one tribe and aggressively reject all others; with violence in homes and in the street outside; with widespread substance abuse; with the sexualisation of everyday exchanges and the effects of extreme pornography; with a drip feed of disaster stories from around the world 24/7 - is it any surprise that quite a few of us, of all ages, struggle to cope?
We know that good, strong, supportive relationships provide some insulation against the effects of adversity. “Relationships are not the icing on the cake - they are the cake” (Dr Dan Siegel, UCLA). They can buffer us from life's storms. How does that work, though, when young people currently feel more lonely and isolated than any other age group*, or those around them are distracted and fighting their own demons? The visceral anger of the teenage boy who has been rejected by his dad becomes more understandable; as does the acute anxiety of the young girl who feels life in the big, wide world is just too hard and complicated to face, so she retreats to the safety of her bedroom for weeks on end.
There is nothing “wrong” with these individuals. Each one is unique and amazing in their own way, with their own gifts to offer us and their own story to tell us - if only we can listen. It is what has happened to them which is driving their behaviour, and which needs to be unpicked. People can start to look at themselves and their situation in an entirely different light, if they can see that their response is entirely natural and understandable in the circumstances; and if they feel that someone is on their side. They can then work on new and different ways of managing their situation, experiences and feelings.
This is where counselling can help. A skilled professional offers warmth and relationship; provides a different perspective; and a safe place to look at what can otherwise seem too painful, scary or impossible to explore. Sometimes, sadly, the counsellor may be the only responsive and reliable person with whom that individual has regular and meaningful one-to-one contact.
Feeling normal has huge therapeutic benefit. While labels might describe the contents, they don't unwrap the parcel. Labels may elicit extra support and relief that we “know what's wrong”; but they can also be counter-productive, convincing the person that their “deficiencies” define and limit them. Labels describe symptoms and mark the individual, without fully exploring the underlying issues. Seeing the person in the context of their suffering, and the impact of environmental and social factors on their wellbeing, would help us all - families, schools, communities and society as a whole - to start to address much the wider issues which should concern us all, and which these diagnoses can mask.
* Nationwide survey carried out for BBC Radio 4's All in the Mind, in collaboration with the Wellcome Collection, 2018.
For more information on the effects of childhood trauma and environment on brain development, please look at the work of the Harvard Center on the Developing Child: www.developingchild.harvard.edu
For more information on challenging diagnostic labels, please look at the work of A Disorder for Everyone (AD4E) at: www.adisorderforeveryone.com