Conduct Disordered Children: Are They Simply Overindulged?

Last evening, I sat down at my computer to write an article on conduct disorder that I was going to submit to EzineArticles, an online article database to which I have been submitting articles. I had planned to be pretty straight-forward in my approach to writing about conduct disorder, providing basic information about symptoms, typical age at onset, incidence, etc.

Then, this morning, I received in the mail a promotional brochure from Cross Country Education announcing an August program in my area called “Overindulged Children and Conduct Disorder: Treating Overindulgent Families”. I got really excited, as only someone who is interested in this stuff can get. Unfortunately, when I looked at the date, I discovered that all four of the program’s local dates are around a time when I will be unable to attend. Damn!

Damn! And triple-Damn!

Suddenly, though, I moved beyond thinking about conduct disorder into the much more common world of overindulgence and its consequences. As I did a Google search on “overindulgence”, I found a treasure-trove of information.

One of the articles, from The Seattle Times, focused heavily on the book, “How Much is Enough?: Everything You Need to Know to Steer Clear of Overindulgence and Raise Likeable, Responsible and Respectful Children”. Connie Dawson, the book’s co-author, said that when she and her co-authors studied adults who were overindulged as children, they found three main ways that parents overindulge their children.

• They give too much.  
• They over-nurture. That doesn’t mean too much love. It refers to too much hovering or intrusion or deprivation of opportunities to grow and experience life, with all its joys and disappointments.)
• Too little structure. Children need guidance and limits and rules. They need boundaries and responsibilities.     

None of that was a surprise. But as I pondered this, I came across this quote:

“The children now love luxury; They have bad manners, contempt for authority; they show disrespect for elders and love chatter in place of exercise. Children are now tyrants, not the servants of their households. They no longer rise when elders enter the room. They contradict their parents, chatter before company, gobble up dainties at the table, cross their legs, and tyrannize their teachers.”

Well, that was attributed to Socrates, more than 2,350 years ago. And if you’ll just disregard the little mention of children no longer being “servants of their households”, it appears that many of the more annoying behaviors of our children have been going on for a long time.

But, as each new age arrives, the ways in which we can and do overindulge our children changes. These changes come as regularly as new technology, and, unfortunately, parents use overindulgence in privileges or things as a way to appease their children’s desire and need for structure and contact and love.

Maybe we should, at last, put overindulgence to good use by satisfying our children’s need for limits and commonsense. How far might that go toward preventing your child from developing a conduct disorder?

Dying for Attention: A psychiatric patient dies in hospital emergency room

The behavior of the staff of Brooklyn’s KIngs County Hospital didn’t surprise me. Oh,  like most, I immediately had many visceral reactions–most strongly among them disgust, frustration, shock–after watching the video that shows an unidentified woman falling out of a chair to the floor, struggling weakly, but being unable to get up, and finally dying, dying, while hospital staff–security guards, aides, nurses, and a doctor–ignored the woman’s distress for more than an hour.  

But I know that many–okay, I’ll say most–of the staff employed in psychiatric facilities routinely attribute all behavior to psychiatric/psychological reasons. In other words, doctors, nurses, mental health techs, et al, believe that anything a psych patient does is done solely to manipulate or to gain undeserved attention. Complaints offered up by patients are seen as attempts to gain some sort of unfair or undeserved privilege or sympathy or perk or even just the thrill of knowing that the patient has “put one over” on the staff.

And staff don’t like to think that they have been “had”, so they rationalize that the patient is faking any sort of distress. Readers who know the story of eleven-year-old Andrew McClain, a former patient of mine who died in a Connecticut while being restrained, already know how that kind of thinking turns out.

In a weak defense of mental health care staff, I will say that some psychiatric patients will pass gas, urinate, vomit, defecate, and do any other nasty thing they can think of to show their disrespect toward staff, and because staff know this, they often ignore the behavior. But anyone working in the medical field knows, or should know, that these bodily responses are signs of distress, of the sphincter muscles relaxing. Of death.

Unfortunately, for our still-unidentified Kings County Hospital patient–and her parents, uncles, aunts, grandparents, children, grandchildren, friends, acquaintances, and neighbors–Kings County Hospital staff never got close enough to the patient to determine whether or not her distress was real. And, so she died. Face down, alone, on the cold hard tile floor of an inhospitable, uncaring, unprofessional institution that she–or someone who cared about her–trusted.   

These Kings County Hospital employees should be held accountable for not properly caring for this woman. their patient. For those who hold licenses, such as the doctor and the nurses, consideration should be given to whether or not they should keep those licenses. 

And the rest of us–you included–should think about how we would tend to a woman who is lying, dying in front of us. Would you overly-pathologize her behavior because she is a known psychiatric patient or would you treat her as you would want a member of your family to be treated? As a valuable human who is now lost to us. Think about it.