Sunday, June 29, 2008

Trouble, part four: Hypothetically Speaking

Last summer, when Ben’s troubles were at their all-time peak, he would exhibit a curious form of imagination.

When he became at all upset or frustrated, he would unleash a stream of imagined acts of aggression and destruction. He would say things like:

“I want to scratch [my classmate].”
“I want to hurt and scratch and push [my classmate].”
“I want to push Dora and Boots and they will fall down and they will have a big, big, big owie and they will be so sad.”
“I want to hurt ALL the children. I want to break ALL the children. I want to scratch EVERYBODY.”

We never quite knew how to respond to these statements except to acknowledge them and allow him to feel heard. I would try several different responses to see if anything helped him calm down:

“Wow, you sound like you’re pretty frustrated.”

“It’s okay to talk about hurting, but it’s not okay to hurt people.”

“I won’t let you hurt anyone. I’ll keep you and your friends safe.”

“Thanks for letting me know that you’re feeling mad.

None of these responses ever seemed to have an impact. He wasn’t in listening mode. His voice was anxious and panicked and tearful. Finally, I just started doing what all good friends do when someone needs to vent. I simply held him and said,

“I know, buddy. I know.”

This phase passed eventually and we only heard him say these things occasionally after that.

But recently, Ben discovered the linguistic tools for talking about cause and effect and that’s introduced some new, baffling verbal behavior.

It all started when we made up a game I call, “What will happen if?”

This involves playing with three juggling balls while Ben asks a series of questions:

“What will happen if the balls go in a puddle?”

“They’ll get wet,” I’ll reply.

“What will happen if the balls go in the oven?”

“They’ll get really hot.”

“What will happen if the balls go in the snow?”

“They’ll get really cold.”

The scenarios become progressively more silly, and there is much giggling.

When Ben behavioral episodes started to increase recently, we’ve seen him transposing this idea of “what will happen if…” to stressful situations. Now the last summer’s litany of “I want” has turned into “What will happen if…?”

When he starts to feel anxious, frustrated or angry, he starts to ask questions like:

“What will happen if I pull [my classmate’s] hair?”
“What will happen if I bit [my cousin’s] hand?”
“What will happen if I break the whole house?”
“What will happen if I break all the planets?”

These are generally unrelated to the frustration at hand.

No matter how I answer, he seems like he’s looking for me to say something different, something specific.

So, like with the “I wants” I just try different approaches. For example, if the question is, “What will happen if I bite [my cousin’s] hand?”

I’ve tried realistic:

He’ll get hurt really bad and he’ll be really sad. Uncle and Auntie will give him a band-aid.

I’ve tried dire and scary:

He’ll have to go to the hospital.

I’ve tried acknowledgement:

You sound like you’re really mad.

I’ve tried stern:

“I won’t let you hurt your cousin. Hurting is not okay.”

I’ve tried Socratic:

“What do you think will happen if you bite [your cousin]?”


None of these approaches seems to have any effect. He simply keeps asking and asking and asking, as if he’s not getting the answer he wants.

And occasionally, after he’s been doing this for several minutes and seems to be a bit more calm, I try humor:

“His hand will be down in your tummy and his hand might tickle your tummy and you would laugh so hard that milk would come out of your nose.”

If applied at the right moment, this works. He starts to laugh, and this gives him a safe way out of being stuck. Sometimes it works.

But sometimes, we're just in too deep.

We had a particularly difficult episode recently, one where Ben’s hypothetical imaginings seemed to fuel actual aggression toward both of us. It took a long time and plenty of tears (from everybody) to return to a state of normalcy.

Afterwards, Chris wondered aloud if when he’s asking “what will happen if…?” if he’s searching for a limit, if he’s trying to find the boundary he cannot cross. Our responses to his questions are designed to acknowledge his feelings and help provide explanations, but perhaps we just end up conveying a confusing and squishy world of no real consequences.

We decided that we’re going to try a single, consistent party line in response to any question involving the result of misbehavior – whether realistic or ridiculous, whether imminent or hypothetical:

“We will take away your shows.”

And we have decided that we will stick to this plan of limiting videos as a consequence of real – not imagined – misbehavior.

We haven’t had to do it yet, but now I find myself wondering, “What will happen if Mommy takes away Ben’s shows?”

I guess we’ll find out sooner or later.

4 comments:

jaki said...

Oh wow! This is a hard one for you to deal with. I admire the way you both search and search for just the right thing to say for it to 'work' for Ben! He's so lucky to have you as parents!!

Jordan said...

That's a really good thought, that he's searching for the boundaries. Sounds like a very plausible possibility and I hope it works.

One other response I've seen work for a psychologist in response to "What if I hurt ___" was, "You would feel really, really sad."

KAL said...

"None of these approaches seems to have any effect. He simply keeps asking and asking and asking, as if he’s not getting the answer he wants."

You know, Sam does a lot of this too. Not as specific as the "what if" game, but he gets stuck sometimes on asking the same question over and over. I wrote about it once (http://autismtwins.blogspot.com/2008/05/perseveration.html) and got some amazing advice on how we might deal with it. I don't know the answer, but I do know it's frustrating to not know what's really being asked.

Good luck with the new response!

goodfountain said...

Chee's language is not to the point where she has had those kind of conversations with me. I think I'm nervously anticipating it now though.

However, if it's any consolation, she has never been upset when I took her shows away. She just found something else to do.

I hope it works for Ben better than for Chee. Perhaps just the threat of it will.

By the way, I gave you an "Award" today. I hope you don't mind. :)