class diagnosis in a nutshell | a small idea from Raising Adults

I’ve long been dismayed at lists of danger signs parents should watch out for in their children—lists that include things like:

• New, different friends  
• Changes in eating or sleeping patterns
• Fatigue
• Weight gain or loss
• Lower achievement in school
• Changes in dress style
• Changes in musical taste
• Belligerence
• Spending large amounts of time alone behind closed doors

Sorry, but with the exception of radical weight gains and losses, or precipitous drops in achievement, these changes are so common among adolescents as to be normal. Can such things signal the first step down a slippery slope to drug abuse or dropping out? Perhaps. But they can also indicate the sudden discovery of snow boarding or basketball or country music.

Look, I’m as concerned about the country music problem as the next guy, but I’m not gonna panic if my kid comes home wearing a retro Hank Williams T-shirt. There could be a perfectly innocent explanation. Like, “The dog ate my Flaming Lips shirt.” I’ll be danged if I’m gonna start World War III over a stupid T-shirt, no matter how stupid the shirt is. And for the record, some of my best friends are dedicated country music fans. [i]

Of course I’m sad when parents miss clear signs of trouble. That means there’s been a disconnect and that’s never ever good news. I have friends who wish to God they’d paid attention to the storm clouds gathering in a child’s life. But I know other parents who drove their children into the night by obsessing over a list of warning signs that was supposed to put them on notice but really just put them on edge. I’ve seen a fifteen year old boy hospitalized and medicated because he consistently failed to keep his room clean and had a short temper (not violent, just short). I’ve seen kids put on powerful drugs because they had trouble paying attention at school. I’ve seen adolescent girls praised endlessly for how good they looked until it became clear they were “cheating.” Next thing they knew they were hospitalized for eating disorders—which they in fact had and to which their families and friends and the whole freaking culture contributed by congratulating them every time they lost an ounce and criticizing them for anything less than the appearance of perfection. 

Somehow the hospital was supposed to sort through all that before the insurance ran out. Their moms couldn’t even get the stink of vomit out of those girls’ bedroom closets before the insurance ran out. 

Treating kids in psychiatric hospitals was quite the thing out in the suburbs for a while. Some of the therapies attempted to blend behavior modification (a re-socialization process based on deprivation and reward) with the 12-Step program (a peer-based process of identifying, admitting and surrendering out-of-control behaviors to a higher power). An unlikely combination since the two are virtually antithetical. A hospitalized kid, learning to beat the behavior modification system, found it easy to get friends to meet him at open 12-Step meetings held in the hospital’s Community Room. He got points from the hospital staff for going to the meeting and drugs from friends who infiltrated from outside. Sounds like a win/win to me.

Wait, there’s more. I’ve known kids hospitalized for eating disorders, family violence and overtly suicidal behavior who accomplished much more than simply scoring drugs in a treatment facility. In a matter of days, they learned to beat the treatment system by gaming the simple scheme of rewards and punishments. Some gained early release not because they were better but because they were better than the system and figured out how to say what their keepers needed to hear in order to sign the release papers. I knew a couple of kids who managed to extend their hospital time by relapsing at the right moment. Anything to keep from having to go home. I give them high marks for ingenuity and problem solving. 

Do you remember Abraham Maslow’s Hierarchy of Needs? Maslow said people work from the bottom up, taking care of basic needs like safety, food and shelter, before getting around to loving and being loved or self-actualization. It really doesn’t matter what you think about that because what I want to say has nothing to do with the hierarchy of needs. But it does have to do with Maslow, who also said somewhere:

I suppose it is tempting, if the only tool you have is a hammer, 

to treat everything as if it were a nail. [ii]

And that, in a nutshell, is Class Diagnosis. 

— from Raising Adults

[i]  Actually—for the record—this is not true . . . as far as i know.

[ii] Abraham Maslow, Psychology of Science, p 12