Friday, October 15, 2010

ADHD Parenting: Flexibility

I was recently sitting in a team meeting with the members of our clinic team. We were having a discussion which was partially about patients, but also partially about parenting techniques which we use as parents ourselves.

It was a very interesting discussion…

You see, I was talking about the difficulty that a set of parents were having with their ADHD and ODD teen. He would push the parents to the limits of their comfort zone. He would take any issue to the extreme – and in so doing, push either mom or dad’s buttons to the extreme.

And then the parents would either argue with each other and cave in on their expectations, or just cave in on their expectations.

Let’s be clear – I’m going to refer to a ‘theoretical’ set of parents – and pull some general types of situations that I hear about from different families to illustrate the points for this article.

In my experience, most parents have a ‘bottom line’ that they don’t want crossed. They feel that if that line is crossed, that they have failed.

The issue is that sometimes, mom and dad have different bottom lines.

And even though parents don’t say out loud what their bottom lines are, their teens know them. And they push the buttons right to the ‘bottom line’ whenever they need to get something, and it doesn’t seem to be going their way.

Although I’m speaking about a theoretical example of a 2 parent family – teens can do this just as well with a single parent as well. They just push it to the extreme on the ‘touchiest’ issue that their parent has.

And it shouldn’t surprise you that your teen knows your biggest buttons. Let’s be realistic. Kids know them before they are 10 years old. Probably before they are 6 years old – or even 4 years old. Kids observe their parents well – and they try lots of behavior to see the responses their parents will give. And then they hone in on the areas that give the biggest responses. Bingo – they know your hot button. No PhD necessary…  Just time, practice, and daily wearing you down…

Back to our theoretical parents.

Let’s say that mom has a ‘bottom line’ that there can’t be any aggression in the home. And dad has a ‘bottom line’ that the parents need to provide a roof over their kid’s heads, or they have failed as parents.

So, let’s look at a theoretical situation where a teenage boy with ADHD and ODD wants to do something, and he feels that the parents are coming down too hard on him. Let’s say he wants to play ‘World of Warcraft’ and he doesn’t think it matters that he’s been on it for 11 hours today, he wants to keep playing. When mom and dad try to take the computer cord or to shut off the internet to get him to go outside, or to eat a meal – he starts to fight, and ‘goes for the throat’.

In my experience, most kids and teens with ADHD aren’t completely consciously aware of their parent’s buttons. But they certainly are unconsciously aware. And they go for it.

To make sure he will be able to get to play more time on the computer here’s a strategy he could use.

First – he gets angry, and ‘in dad’s face’. He starts yelling, and threatening. He pushes his chest out and takes a threatening posture. Dad’s anger and male ‘macho’ starts to kick in when he gets so angry about how he’s being disrespected. So, he raises his voice, and ‘puffs out’ his chest. All the while, mom is watching this and she starts to get very concerned that her son and husband are about to get into a physical fight.

Remember – mom considers the worst thing that can happen to be a physical fight in her home. So, she starts to freak out – and she jumps in to stop this ‘testosterone challenge’ from continuing.

Now, dad gets angry at mom for stepping in and undermining him. Mom feels that although this is a problem, it’s far better than letting her son and husband progress to the extent that it’s even remotely possible that they could get into a fight.

At this stage of the situation, the teenager has now split mom and dad, and he’s close to ‘winning’. He probably doesn’t feel that he’s close to winning, in fact he probably feels angry and charged up, because he was getting close to wanting to fight his dad.

Now that mom and dad are starting to fight, the teen now goes for the ‘final blow’. He has already pushed mom’s biggest button, so now he goes for dad.

He says something like: ‘I don’t have to deal with this bullsh**! If I leave and go to my Jim’s, his parents aren’t nearly as crazy as you two!’ Now this will push some of dad’s buttons.

But if he said: ‘ I’d rather live at the Salvation Army shelter than deal with this crap!’ This would really get dad going. Remember – dad considers it the ultimate failure if his kids aren’t being sheltered in his own home.

So even if mom thinks that her son could get a ‘dose of reality’ if he moved out for a while (like the shelter staff wouldn’t let him sit on a computer for 11 hours, and serve him food in his room), dad wouldn’t tolerate it.

Now, mom’s buttons are pushed, dad’s buttons are pushed, and now it is relatively easy for the teen to continue on with the behavior that he or she wanted to do in the first place.

The fallout of this – everyone is upset. The parents feel that they can’t do anything to stop their teen’s behavior. The teen is angry. Mom and dad and angry with one another, and they are arguing about what could have worked if the other parent hadn’t screwed it up. The parents feel that they need to call the doctor or the therapist because their child’s disorders (ADHD and ODD) are out of control and the medication needs adjusting…

Coming back to the meeting I was having with my treatment team at my clinic, I was talking about strategies to help these theoretical parents come onto the same page and strategies they could use to improve the situation.

The ‘solution’ to this type of situation really involves the parents doing a lot of personal and relationship work.

The parents need to change or eliminate their ‘buttons’ so that they can’t be pushed to the limit by their teen. The parents need to get on the same page, so that they can’t be ‘divided and conquered’. And the parents need to be more flexible.

Flexibility is the key.

Let’s summarize it this way: ‘she/he who is more flexible, wins’.

What I mean by this is – if your child or teen has more ways to upset you and push your buttons than you have to handle it, then he or she wins.

If you have more ways to handle the situation than they have to mess it up – then you win. And if they try to push a button – and you laugh, don’t fall for it -and go on to push their buttons, then you win.

And this is where the discussion was going with the other therapists in my team meeting. Through the course of the discussion, the team members who are also parents of teens shared some of the strategies they use.

A male therapist said that his teens have informed him that he needs to keep his shirt on when they are out in public because he’s ‘hideous’. So, when he’s out with his teens, and they are getting demanding and unreasonable – he informs them calmly that if they continue on with that issue, he will take off his shirt in 30 seconds. This new strategy has worked every time.

A female therapist explained that when her teen was having issues with getting home on time – she said that she would drive to the party and come in to get her daughter – and make sure to say hi to all of the teens and ask them about what they had been doing that night. Her daughter started coming home on time (rather than ‘die’ at how embarrassing her mother would be).

These examples are not meant to be examples of the best solutions to parenting your ADHD and/or ODD child. What they are examples of is parents who have decided that they are going to be flexible, creative, and do what it takes to show their kids that they are the parents, and they have the upper hand. When they do this successfully, they maintain some semblance of control.

When their teen pushes their buttons to the extreme, and the teen gains control, the parents have lost their ability to parent.

Think about flexibility. How can you be more flexible than your child or teen.

And if the example described above rings true to your experience, take some time to talk to your doctor or therapist about specific approaches you can take to increase your flexibility and increase your sense of control with your ADD/ADHD, ODD or just difficult child or teen.

Please share your thoughts or experiences below.

Best,

Dr. Kenny

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