Sunday, September 23, 2007

Excuses

"I guess I can understand how his trauma history can be an excuse for his behavior yesterday" Sarah, a child care worker, said to me in training. "But today, he was feeling fine and I don’t see how his past is an excuse today."

The fact is that a child’s trauma history is never an excuse. It is always a reason. The child’s daily life, emotions, and thoughts are always affected by their past. The child’s biologically different, hyper-responsive nervous system does not change from day to day. His distrust of others is always present. His fear of being weak or vulnerable remains a part of his choices. His lack of emotion management skills, his sense that he is not worth while, that he is to blame for everything bad that happens, his inability to maintain a connection with others, stay present in every day life.

However, this does not mean that the child cannot change. He can begin to feel safe and to relax. He can slowly learn to trust a few people. Through experiences of success and approval from others, he can discover positive parts of himself. He can learn feeling management skills.

If a child had diabetes, we would not refer to his diabetes as an "excuse" for his reaction to sugary foods. We would not speak of his diabetes as an "excuse" to avoid eating certain foods. We would hope that the child would gradually increase in his competence in managing his diabetes, and would use the skills and technology available from others, and would lead a largely normal life. And, the diabetes would be always present as a reason for some actions and choices.

Even if a child had a broken leg, we would not call his broken leg an "excuse" to avoid a hike. If we were taking the child some where, we would make adaptations to promote the child’s success on the trip. We might bring a wheel chair for long distances. We would plan frequent stops to rest. We would teach him how to use crutches and bring them along with us. We would not be blaming the child for needing these adaptations.

At the same time, we would expect the child to get better. We might enroll him in physical therapy and encourage him to work hard at the exercises. We would gradually do less and less for him as he healed. His whole leg cast would be reduces to a smaller cast and then to a bandage. There would be a constant balance between understanding his pain and incapacity, and supporting his efforts to heal.

How we speak about kids can strongly influence how we feel about them and thus how we act towards them. When we speak of their trauma histories as an excuse, we imply that kids should have no responsibility and that what will help them is to simultaneously blame them for their incapacity and to have low expectations. This is, in fact, the opposite of what will help. If instead we understand the child’s trauma history as a reason, a fact, a condition they have been given, we will both not blame them, and we will have hope for their potential to heal and to achieve greatness.

1 comment:

Cat said...

Great point. With my diagnosis of MPD I've always kept in mind that I cannot and will not use it as an excuse to fail in life. I won't excuse my behavior based on the diagnosis, instead I will work harder to overcome the obstacles that I meet.

Just like one would do with a physical impairment, they'd keep going with gusto! Why not treat mental illness with the same excitement and goal setting?

Great post.