Oppositional Defiant Disorder: Label or Diagnosis?

Recently, difficult children have been given a “fashionable” diagnosis – oppositional defiant disorder. Psychotherapist Erina White argues that this is nothing more than a modern-day “horror story”, which is convenient to explain any problematic behavior. This diagnosis scares many parents and makes them give up.

As psychotherapist Erina White notes, in recent years, more and more parents are worried that their child suffers from oppositional defiant disorder (ODD). The American Psychiatric Association defines ODD as anger, irritability, stubbornness, vindictiveness, and defiance.

Typically, parents will admit that a teacher or family doctor stated that their child may have ODD, and when they read the description on the Internet, they found that some of the symptoms do match. They are confused and anxious, and this is quite understandable.

The OIA label, affixed by “well-wishers”, makes mothers and fathers think that their child is dangerously ill, and they themselves are useless parents. In addition, such a preliminary diagnosis makes it difficult to understand where the aggression came from and how to eliminate behavioral problems. It is bad for everyone: both parents and children. Meanwhile, OVR is nothing more than a common “horror story” that can be overcome.

First of all, it is necessary to get rid of the “shameful” stigma. Did someone say your child has ODD? It’s OK. Let them say anything and even be considered experts, this does not mean that the child is bad. “In twenty years of practice, I have never met bad children,” says White. “In fact, most of them act aggressively or defiantly from time to time. And everything is fine with you, you are normal parents. Everything will be fine – both for you and for the child.

The second step is to understand what exactly is bothering you. What happens – at school or at home? Perhaps the child refuses to obey adults or is at enmity with classmates. Of course, this behavior is frustrating, and you don’t want to indulge it, but it’s fixable.

The third and perhaps most important step is to answer the “why?” question. Why is the child behaving this way? Significant reasons are found in almost all children.

By the time a child becomes a teenager, people who had every chance to help him become afraid of him.

Parents who think about situations and events that may have triggered the warning behavior are more likely to discover something important. For example, to understand that the child becomes especially unbearable when the school day is clearly not set. Maybe some bully bothered him more than usual. Or he feels unhappy because other children read better than him. At school, he diligently kept a straight face, but as soon as he returned home and found himself among his relatives, in a safe environment, all the difficult emotions splashed out. In essence, the child is experiencing severe anxiety, but does not yet know how to cope with it.

There are reasons caused not so much by the child’s personal experiences as by what is happening around. Maybe mom and dad are getting divorced. Or your beloved grandfather fell ill. Or a military father and he was recently sent to another country. These are really serious problems.

If the difficulties are related to one of the parents, they may feel guilty or become defensive. “I always remind people that at any given moment we are doing our best. Even if the problem cannot be solved instantly, identifying it already means removing the glued label, stop looking for signs of pathology and start correcting children’s behavior, ”the psychotherapist emphasizes.

The fourth and final step is to return to symptoms that are treatable. You can help your child cope with aggression by teaching him to understand his own emotions. Then move on to work on self-control and gradually develop mental and bodily awareness. To do this, there are special video games, playing which children learn to speed up and slow down their heartbeat. In this way, they understand what happens to the body when violent emotions take over, and learn to automatically calm down. Whatever strategy you choose, the key to success is creativity, a friendly and sympathetic attitude towards the child and your perseverance.

Problematic behavior is easiest to attribute to OVR. It is depressing that this diagnosis can ruin a child’s life. OVR first. Then antisocial behavior. By the time the child becomes a teenager, the people who had every chance to help him become afraid of him. As a result, these children are given the most severe course of treatment: in a correctional institution.

Extreme, you say? Alas, this happens all too often. All practitioners, educators and doctors should expand their horizons and, in addition to the child’s bad behavior, see the environment in which he lives. A holistic approach will bring much more benefits: children, parents and the whole society.


About the Author: Erina White is a clinical psychologist at Boston Children’s Hospital, an internist, and a Master of Public Health.

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