Sue Terrell dissertation

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The Experience of Youth Identified as Having a Behavioral Disorder

A Dissertation Submitted to the Faculty of the Institute for Clinical Social Work in Partial Fulfillment For the Degree of Doctor of Philosophy

By Sue Terrell

Chicago, Illinois Spring, 2014

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Copyright © 2014 by Sue Terrell All rights reserved

Abstract

This qualitative study explores the subjective experiences of thirteen youth identified by their school systems as having a behavior disorder. The study examines how these youth view and understand their lives, their selves, and their relationships with others through unstructured, in-depth interviews. Grounded theory was used to analyze data and findings were interpreted from a self psychology perspective. Three basic patterns of underlying psychodynamics became evident in the participants involved in this study. The youth displayed either primary or secondary disorders of the self depending on their selfobject experiences. Youth with secondary disorders of the self experienced adequate selfobjects which led to a cohesive sense of self accompanied by the view of liking themselves and seeing others in a flexible, nuanced manner. Their disorder became manifest when they did not have access to adjunctive functions that supplemented core deficits. Youth with primary disorders of the self consisted of youth who did not experience adequate selfobjects. One group displayed a fragmented sense of self with intense object hunger. The other group displayed a faulty sense of self that fragmented when their selfobject needs weren’t being met. When this occurred, they perceived others negatively. This study suggests further research in the area of theoretical understanding of the developing child with inadequate selfobject functions as well as research regarding policy implications for schools treating youth with an educational disability of Emotional Disability.

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I lean to you, numb as a fossil. Tell me I’m here.

--Sylvia Plath, The Collected Poems

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Acknowledgements

I wish to express my gratitude to Joan DiLeonardi, PhD, my dissertation chair, for many hours of stimulating and fruitful discussion and for her steadfast assurance that this would get completed; to Joe Palombo, MA, encourager and supporter extraordinaire, for his wise mentoring and excellent ability to make sense of my sometimes cluttered thinking; to Pat Seeghers, PhD, for her ability to listen with a finely-tuned clinical ear not only to what the children in the study were saying, but to what I was trying to formulate and articulate in my writing; and to Denise Duval Tsioles, PhD and Erika Schmidt, MA, my readers, for their thoughtful comments and questions.

I also wish to thank the faculty at ICSW whose paths I have had the good fortune to cross, whether through class or clinical consultation. I owe a great debt to all of you in fostering and furthering my clinical skills.

I thank my family: to my father, for giving me a sense of curiosity and wonder of the world; to my mother, for giving me the tenacity to see things through; to Jenny, Ellie, and Luke, for being the best cheerleaders a mother could ever wish for; and to Tom, my partner through life, for always being there for me, thank you so much.

Finally, I thank the youth who were willing to share of themselves with me. I hope this study does their stories justice.

SRT

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Table of Contents

Page Abstract.............................................................................................................................iii Acknowledgements............................................................................................................v Chapter I. Introduction………………………………........………………………………1 Purpose of the Study Significance of the Study for Clinical Social Work Statement of the Problem Questions Explored II. Literature Review……………...........……………………………………..…5 Introduction Normal Development in Early Adolescence Pathology in Early Adolescence III. Methodology…………………………...........……………..……………….33 Theoretical and Conceptual Framework of the Study Research Design and Strategy Data Management and Analysis

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Table of Contents—Continued

IV. Results………………………….......…….…………………………….……44 Introduction to the Results Description of the Sample Commonalities The School-Focused Group The Home-Focused Group The Globally-Focused Group Summary V. Discussion and Conclusions………………................…………………….118 Limitations of the Study Theoretical Discussion Summary of Theoretical Considerations Conclusion Clinical Implications Implications for Future Research Policy Implications Appendices A. Recruitment Flyer and Letter……………...…….....................……….……167 B. Consent Forms…………….....……………………………….........…….....170 C. Sample Interview Questions..........................................................................176 References…………….………………………………………...…........………178

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1

Chapter I

Introduction

Purpose of the Study The purpose of this study is to further the knowledge of the experience of children identified as having a behavioral disorder by the school system. Fonagy’s research (1996) indicates that the treatment of children with disruptive disorders has a low success rate.

He states that children with these disorders are likely to be difficult to engage in a reflective process. They are often impulsive and reactive to situations.

Developmentally, pre- and early adolescence is a time of change when, historically, children are viewed as beginning to form their own self-identities (Erikson, 1959). If a child has an external identity of being labeled as behavioral disordered, the question arises as to if and how this affects the developmental process of adolescence.

Students identified in the school system as having a behavioral disorder experience frequent behavioral failures in the school setting. This study explores how the children understand these failures, what it feels like to them, and how the school’s interventions impact them. This study explores how these children interpret their lives. It also explores whether the students sense they are “different” from their peers, and if so, if this matters to them and how they account for this difference.

2 Significance of the Study for Clinical Social Work Children with behavioral disorders are often puzzling and difficult to treat (Willock, 1990). They require intensive therapy if they are to change. At the same time, they are often difficult to engage in a reflective process. Kutash, Duchnowski, & Lynn (2006, p. vii) reported outcomes for children who have emotional disturbance continue to be the poorest of all disability groups in the school setting. They state the field “can be characterized as being fragmented and underdeveloped and confused by conflicting terminology and professional perspectives.” These children are at great risk for lifelong mental health issues.

Statistics from The Center for Mental Health in Schools (2008) indicated that in 1996, 11.5 % of nine through seventeen years old in the USA were labeled with a behavioral disorder (Oppositional Defiant Disorder, Conduct Disorder, ADHD). Lane et al. (2005) assessed the behavioral progress of students labeled as EBD (Emotional Behavioral Disorder) that were receiving specialized school services in a large metropolitan area over the course of one academic year and found there was no significant progress in either the behavioral or social domains. Montague, Enders, & Castro (2005) followed students identified in kindergarten as being at risk for behavioral disorders through high school and found that young students with behavioral problems continue to display problems into adolescence, placing them at serious risk for school failure and dropping out.

Several researchers (Rones & Hoagwood, 2000; Franklin & Gerlach, 2006; Kauffman, Mock, & Simpson, 2007) indicate between 5% and 9% of children can be classified as seriously emotionally disturbed and are served in multiple, separate systems

3 Â that often provide uncoordinated and redundant services. Kauffman, Mock, & Simpson (2007) portray the field of special education, where the most serious of children with emotional disorders are served, as a failed system. They state these children are often underserved for the following reasons: there is the stigma of being labeled; there are problems in the definition of mental illness or emotional disorders in children; there are problems in identifying children with mental or emotional disorders; and there is a lack of money and services available.

Although there is a plethora of research investigating behavioral symptoms and interventions for children in school settings with an Emotional Disability, there is no research that gives voice to the students and how they experience this identity and/or their struggles. This current study may aid therapists in understanding how their young clients identified as behaviorally disordered through the educational system perceive and make meaning of these experiences. In so doing, it may help shape their practices to better treat this population. The study points to further research possibilities by identifying gaps in the current knowledge of children who struggle with behaviors that are seen as disruptive in the school setting. The understandings gained may be shared with the wider community of adults who are involved with the lives of these individuals in order to serve them better.

Statement of the Problem This research studied the experiences of middle and high school children identified as having a behavioral disorder through the educational system as narrated by the youth.

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4 The following questions were addressed: • How do middle and high school students identified as having a behavioral disorder view their lives?

• How do they understand being placed in an alternative school setting?

• What is their sense of self amidst the implicit and explicit messages they receive that they are “failures” according to school norms of conformative behavior?

• Do they sense they are “different” from their peers, and if so, how do they account for it • And how do they experience the use of the interventions used by the schools in the attempt to monitor and change their behaviors?

Questions Explored The main question asked was: What is the experience of middle and high school students identified as having a behavior disorder through the educational system?

Ancillary questions asked were: Does the identification and labeling of a child with a behavioral disorder affect the self-understanding and/or self-cohesion of the child and, if so, how? How do school practices for working with these children enhance or detract from their sense of self-esteem and/or self-function?

5 Chapter II

Literature Review

Introduction In order to understand pathology, it is helpful to first understand the concepts of normality. Offer (1991), after conducting a ten-year study of adolescent males considered to have “normal” mental health, concluded there is a wide range of normality when describing adolescents. He noted his findings were strikingly similar to the few other longitudinal studies on normal adolescent population (Symonds & Jensen, 1961; Kagen & Moss, 1962; Cox, 1970; Block, 1971; Holmstrom, 1972; and Vaillant, 1977). The adolescents in these studies exhibited various psychological manifestations and utilization of different defenses, while still remaining under the umbrella of “normality.”

Similarly, psychodynamic theories view normality as wide-ranging when speaking of development in early adolescence. However, each theory has its view of what constitutes the major task(s) of adolescence. These are discussed in the following review.

6 Normal Development in Early Adolescence

Ego psychology.

Different theorists see the major task of adolescence in different ways. Ego psychologists, beginning with Anna Freud (1958), view adolescence as a time when there is an upsurge of the libidinal drives and therefore the major task of adolescence is the internal adjustment between the id and the ego. Blos (1967) elaborated on this view, calling adolescence the second individuation process and emphasizing not only the drive functions and ego activities, but also the shifting relationships with internal objects and the adolescents’ use of the social environment to meet their needs. Erikson (1959) added an additional dimension when he pointed to the significance of the environment by developing a model of “psychosocial” stages. Erikson saw the major task of adolescence as the formation of an identity. He tried to intertwine his ego psychological perspective with a more classical analytic framework by demonstrating how the psychosocial stages are dependent on the psychosexual stages of development in determining the mental health or pathology of an individual.

Object relations.

Object relations theorists essentially reverse the foreground and background of what is important to the ego psychologists. Object relations and their internalized representations are seen as the primary context for development. People are objectseeking rather than instinct-gratifying. Melanie Klein (1958), one of the originators of the concept of object relations, proposed the idea that there is a division between the good

7 and bad object, between love and hate, that takes place in infancy. This division, or splitting, is one of the initial defenses and precedes repression. The more the ego can integrate its destructive impulses and synthesize the different aspects of its objects, the richer it becomes. The concept of splitting drew the focus to the adolescent’s affect states rather than their drive states.

Kernberg (2006) provides a bridge between ego psychology and Kleinien theory by stating the task in adolescence is not only the integration of the self in an ego identity but also an integration with significant others. Winnicott (1965) emphasized the idea that the goal of maturity is towards interdependence, not independence. He spoke of the concept of the True and False Self. A child develops a True Self when the good-enough mother provides an adequate holding and facilitating environment. The mother regularly and routinely meets the omnipotence of the infant and makes some sense of it to the infant. The child is then free to be spontaneous and has an authentic sense of self. Only the True Self can be creative and only the True Self can feel real.

Self psychology.

Self psychology theorists view the healthy self as developing from the presence of others who provide certain experiences that foster the formation of this healthy self.

Wolfe (1982), coming from a self psychology stance, proposes the transformation of the self as the major task of the adolescent phase of development. The new insights the adolescent attains by way of the sudden increase in cognition along with its selfobject milieu, more than pressure from maturing sexual capacities, forces the self into a restructuring of itself—the so-called adolescent process. Adolescents can no longer hide

8  from themselves the inevitable discrepancy between who they had imagined their parents to be and who they really are. This leads to deidealization of parental selfobjects that results in an increased vulnerability of the self. To strengthen this, the adolescent uses peers as selfobject functions. The self’s goals are not autonomy and independence, but cohesiveness in its striving for integration into a reciprocally responsive matrix of selfobject relationships.

Palombo (1988) more fully elaborates a theory of adolescent development from a self psychological stance. He integrates self psychology with cognitive theory and developmental psychology. He posits that adolescence is a phase in its own right and does not represent a recapitulation to earlier developmental phases. Adolescents have specific developmental needs that require particular responses from their caretakers. The parents, as selfobject functions, are still necessary for the adolescent to successfully negotiate this stage, but the selfobject functions of the parents have to change in order to meet the needs of the developing adolescent. How the adolescent interprets and uses selfobject functions to negotiate this phase of development determines how successfully a nuclear self is formed. The culmination of this phase is the consolidation of the nuclear self. This nuclear self is the core set of meanings the person has attained through which life goals are defined and pursued.

Relational and other theories.

The relational theorists (Sullivan in Palombo, 2009; Altman et al, 2002) introduce the concept of a two-person model for the theory of development. Although other theories recognize the importance of the environment, especially the primary objects, to

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9 varying degrees, relational theory is the first theory to espouse that the interpersonal relationship with the actual person is the pivotal factor in healthy development.

Relational theory also de-emphasizes a heavy importance on the early childhood years, holding the view that every interaction with a variety of different people throughout the lifespan can have a significant psychological effect on the individual.

Attachment theorists (Allen & Land, 1999; Fonagy & Target, 2002) postulate that attachment rather than libidinal energy is what bonds people. Early attachment relationships are important in the development of the child as these relationships help foster the interpretation of emotionally meaningful experiences and the mastery of selfregulation. In adolescence, there is a transfer of attachment needs from the parents to peers.

Tyson (2005) uses the principles of nonlinear dynamic systems to explain development in children. She states it is the interaction among elements of various systems and with the environment that impacts development. Healthy development results from the primary caretakers 1) fostering a sense of safety and secure attachment; 2) responding in a timely manner to a child’s affective signals; 3) establishing reciprocal emotional dialogues in which verbalizing and reflecting on feelings and mental states is central; 4) creating “play space;” and 5) setting limits and providing a consistent, predictable structure.

Overview of theories.

In overviewing the theories, there is a common thread of the parental figure continuing to hold a prominent position in the life of the adolescent. Their primary role is

10 viewed differently depending on the theoretical bent. There is a gradation of the significance of the actual parents and their influence on the intrapsychic life of the adolescent ranging from being of upmost importance with less importance being given to earlier introjects, as can be seen in the relational theoretical view, to the influence of the introjected parent as being of prime importance and the role of the actual parent not significantly being addressed, as can be seen from an ego psychological view. Other theoretical views are in between these two extremes, giving more importance to the real versus the introjected parent, depending on the theory.

For instance, Erikson (1959), though coming from an ego psychological frame of reference, also emphasizes the role the parent must provide in giving an “average expectable environment” appropriate for the adolescent stage in order for the adolescent to successfully master this stage in life. Winnicott (1965), from an object relational view, speaks of the need of the actual parent helping the adolescent deal with the instinct tensions and patterns that were first laid down in early childhood. Wolfe (1982) and Palombo (1988), from a self psychological viewpoint, state that even though there is a deidealization of parental selfobjects by the adolescent during this period, the parents still need to provide necessary support in order for the adolescent to successfully navigate this phase of life, albeit in a different form than previously. Apter (1990) makes a strong argument for seeing adolescence as a time of individuation, but not separation. Instead, she proposes a reformulation of connectedness with primary objects.

Some theorists (Allen and Land, 1999) do not see adolescence as a separate phase but as a transitional phase from one stage to the next, or a re-working of old representations. Other theorists (Erikson, 1959; Blos, 1967; Palombo, 1988; Sullivan, in

11 Â Palombo, 2009) see adolescence as a separate phase with its own unique tasks. Ego psychology and object relations theorists (A. Freud, 1958; Erikson, 1959; Klein & Riviere, 1964) see pathology as normality during adolescence. These theorists expect the adolescent to be in turmoil and view a smooth course with no emotional upheaval most probably pathological. Other theorists (Offer, 1991; Hauser and Smith, 1991; Apter, 1990) do not see this as the case. They report that the time of adolescence can be emotionally labile or emotionally calm and still be considered normal.

Different theorists have different perspectives on the inherent changes in adolescents that spur the advent of this time period. Many theorists (A. Freud, 1958; Klein & Riv, 1964; Blos, 1967) see psychosexual changes as being the catalyst for growth. Others (Erikson, 1959; Sullivan, in Palombo, 2009; Winnicott, 1965; Kernberg, 2006; Wolfe, 1982; Palombo, 1988) emphasize the psychosocial aspects as central to the tasks of this time period. In addition, these theorists, with the exception of Erikson, also emphasize the interpersonal. Still other theorists (Hauser and Smith, 1991; Allen and Land, 1999) suggest that advances in cognition from concrete to formal operational can play as large of a role in the adolescent crisis as do pubertal changes.

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12 Pathology in Early Adolescence “Behavioral disorder”-- also called Emotional/Behavioral Disorder, Severe Emotional Disorder, or Emotional Disability—is a term commonly used in the educational system to identify children whose behaviors are so disruptive that they impede their own educational processes (National Dissemination Center for Children with Disabilities, 2010). It is not a psychodynamic term. As such, there may be a variety of underlying pathologies that lead to these manifest symptoms.

This was noted by A. Freud (1970) when she said it is not possible to know a child’s psychopathology from the manifest symptoms, citing school failures and failures in social adaptation as two such examples. Failures in social adaptation may be due to adverse environmental circumstances, defects in the ego functions and the defense organization due to developmental arrests or neurotic regressions, the result of economic alterations in the balance between the id and ego, the result of defects in the superego, or as the result of faulty ego ideals, due to deviant parental models for identification. Causes of social failure are extremely varied, ranging from purely environmental to the nearpsychotic.

The following review will attempt to cover the theoretical perspectives of the major psychodynamic orientations regarding the etiology of pathology in the adolescent that frequently result in acting-out, disruptive behaviors. As such, it will not focus on a diagnostic category per se, but will instead explore what each particular theory perceives as the underlying causes of pathology and how these might then manifest in disruptive behaviors.

13 Ego psychological view.

A. Freud (1965) assumed the emotional disorders of childhood generally are the result of the arrest or distortion of one or more emotional, social, or cognitive developmental lines. These deviations create difficulties for the child, and he or she might find maladaptive solutions in order to cope. The “immaturity and weakness” of the child’s ego results in a lower threshold for frustration tolerance and increases acting out due to the relative inability for the child to use verbalizations in emotional situations.

Pathology in adolescence results from the inability of the ego to master the tensions and pressures arising from the drive derivatives in a healthy manner (A. Freud, 1958).

If the adolescent does not have a fairly intact ego, the normal adolescent ego regression that occurs during this time period results in the engulfment of the regressed ego in its early abnormal condition. The adolescent is not be able to handle the limited ego regression, as this can occur only within a relatively intact ego. If firm selfdelineation has not been achieved, the individual is at risk of falling into a borderline state (Erikson, 1959).

In 1982, Palombo (in Palombo, 1983) compiled a consensus definition from the literature of the borderline child from an ego psychological perspective. He stated: First, a variety of symptoms are commonly associated with children identified as borderline; these include: neurotic-like behaviors, impulsivity with affective constriction and involvement in fantasy, chronic diffuse anxiety, grandiosity and low self-esteem, and poor social and peer relationships. The second component is the developmental profile of the child. This includes, in the area of drive development: no manifestations of libidinal phase dominance, precarious self

14 boundaries, grandiosity, body image problems, and poor self control. In the area of ego development: the primary autonomous ego manifests areas of dysfunction, such as deficient perception, distractibility, disturbances in thinking, faulty barriers between conscious and preconscious thinking, speech disturbances, and disturbances in motility. Secondary ego functions are also defective with faulty drive regulatory capacities, pleasure principle level functioning, low frustration tolerance, defenses of projection, denial, displacement, introjection and regression; splitting is also noted, and defenses are usually ineffectual; object relations are disturbed with self-cathexis being predominant; the superego’s development is incomplete, manifesting impaired capacity for the internalization of controls and dependence on outer objects for restraints.

Bornstein (2006) stated the psychodynamic constructs of ego strength, defense style, and mental representations of self and other people are the determining factors in understanding personality pathology. Reality testing and impulse control are key factors in assessing ego strength. Low ego strength is correlated with adolescent delinquency and antisocial behaviors. Negative early experiences lead to a less mature defense style characterized by coping strategies that entail greater distortion of internal and external events. Qualitative and structural dimensions of an individual’s object representations help determine interpersonal and psychological adjustment throughout life. The person who has internalized introjects that are primitive and affectively negative is at risk for increased pathology.

Solnit (1987), using the concept of developmental lines in observing children who exhibit disruptive behaviors, stated play in children who are severely deprived, or whose

15 Â behavior has found instant short-cuts to tension discharge, is not elaborated and tends to represent a narrow or small repertoire in terms of links to fantasies. The play often fails to achieve the elaboration and structure that is characteristic of a progressive development indicating these children lack the structures necessary for a normal, healthy developmental line.

Gilmore (2000) states the observable phenomena of ADHD can best be understood as reflections of disturbances in basic ego functions. She states the poor modulation of stimuli, the inability to regulate affect, and the intrusion of drive derivatives that disrupts coherent narrative in the story are the internal correlates of the behavioral syndrome of restlessness, distractibility, and impulsivity. She believes the inconsistency and variability of the integrative, organizational, and synthetic functions of the ego are the problem, rather than a defect or deficit. There is generally some form of disturbance in object relations. Narcissistic fragility and the need to be in control are common features. The ADHD individual has difficulty in the modulation of attention.

They are most attentive to things that are impersonal but highly absorbing and entertaining and least attentive to things that are hard for them, boring, or highly interpersonal. The symptom of impulsivity demonstrates the dysregulation and affect intolerance that underlies it and reflects the ongoing failure of internalization of the capacity to wait. The symptom of hyperactivity is a reflection of the dysregulation of tension discharge (Gilmore, 2000).

In summary, ego psychologists focus on the dysfunctions of ego structures when discussing childhood pathologies that include symptomatology of acting-out behavior.

The ego, whether due to immaturity or weakness (A. Freud, 1958; Bornstein, 2006), lack

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16 of structure (Solnit, 1987), or inconsistency and variability of its functions (Gilmore, 2000), is incapable of meeting the demands of the drive derivatives in a healthy manner.

Instead, the response of the individual is to act on the impulses to which the ego is incapable of managing.

Object relations view.

Kernberg (2006) assumed that identity diffusion characterizes all severe personality disorders. Identity diffusion is the result of temperamental predisposition integrated with developmental and psychosocial etiological factors. The temperamental predisposition of a negative domain of early experience is the result of the combination of a genetic disposition to affect activation resulting in an excessive development of aggressive affect and a genetic disposition involved in cognitive control, particularly the areas determining the capacity for “effortful control,” that result in affective dyscontrol and generalized impulsivity.

The mother-infant relationship is another determining factor of the predominance of the negative domain of affective experience. The mother needs to be able to register the infant’s negative affect state while at the same time showing the infant she can empathize with it without sharing it. If she cannot do this, the infant will experience a predominance of negative affect (Kernberg, 2006).

Developmental etiological factors include a disorganized attachment in the mother-infant pair as well as the possibility of neuropsychological developmental disorders. Specifically, these would be Attention Deficit Hyperactivity Disorder and

17 nonverbal learning disability syndrome. These disorders might play in the development of some personality disorders (Kernberg et al, 2000).

Psychosocial etiological factors include exposure to physical or sexual trauma, abandonment, or chronic family chaos. These factors predispose an individual to abnormal fixation at the early stage of development that predate the integration of normal identity. A split persists between idealized and persecutory internalized experiences under the dominance of corresponding negative and positive peak affect states.

Clinically, this is represented by identity diffusion, with a lack of integration of the concept of the self and lack of integration of the concepts of significant others (Kernberg, 2006).

Identity diffusion explains the dominant characteristics of borderline personality organization. Borderline personality organization reflects the subjective and behavioral consequences of identity diffusion and presents secondary defensive operations and symptoms that maintain it. Identity diffusion implies internal working models that reflect disorganized/disoriented representation of the self and others. These are derived from the splitting mechanisms that fragment the representatives of self and others in terms of polar opposite affect dispositions (Kernberg, 2006).

The lack of integration of the self leads to an inability to integrate one’s past and present into a capacity to direct future behavior. There is a decrease in the capacity to form a stable commitment to professional goals, personal interests, work and social functions, and intimate relationships. The lack of integration of the concept of significant others leads to an inability to realistically assess others and choose partners harmonious with the individual’s actual expectations (Kernberg, 2006).

18 The lack of integration of self and others also interferes with the internalization of value systems, leading to an exaggerated quality of the idealization of positive values and the ego ideal and to a persecutory quality of the internalized, prohibitive aspects of the primitive superego. This leads to a predominance of splitting mechanisms of the superego functions, with excessive projection of internalized prohibitions and an excessive, idealized demand for perfection that further interferes with the integration of a normal superego (Kernberg, 2006).

Willock (1990) posited that many of the characteristic behaviors of children with a behavior disorder represent developmental arrests and distortions at various stages on the “peek-a-boo” developmental line. Each step on this line connotes an increased level in confidence of the child that, despite separation, the primary object is still there and reunions will occur. Each new step expresses and thus contributes to the growth of basic trust.

The action of running away, displayed by many behavior disordered children, might actually be an attempt to “hold on” to the other’s attention in a very controlling manner and force the adult to play “chase me,” a game at the lower end of this developmental continuum. The absence of fun and humor characterizes the developmentally distorted versions of these games enacted by conduct-disordered children. An almost nonexistent capacity for sublimation characterizes these children.

The developmental line of interactive play is underdeveloped and conflicted in children with disruptive disorders (Willock, 1990).

The disruptively disordered child has an extremely sensitive core of narcissistic vulnerability that is masked by aggressive denial, externalization, projection and related

19 primitive defensive processes. The child feels driven to devise strategies to force caretakers to become involved with him because he feels unlovable. These severely disturbed children have psychologically treatable, developmental arrests and distortions in the realm of object relations, self-structure and ego development (Willock, 1990).

Mahler (1971) asserted “confident expectation” and its opposite, “basic mistrust,” contribute and relate to later attitudes in life, even though drive and defense mechanisms greatly influence and maybe even change these patterns. Through the rapprochement process, the sense of identity, the self representation as distinct from the object representation, begin to consolidate. The less gradually the intrapsychic separationindividuation process takes place, and the less the ego gains ascendancy, the greater the extent to which the object remains a bad introject intrapsychically. In an effort to eject the bad introject, the aggressive drive comes into play and the self representation identifies with the bad introject. If this happens during rapprochement, aggression might be unleashed and do away with the good object and, along with it, the good self representation.

In incipient infantile neurosis, conflict is indicated by coercive behaviors directed at the mother, designed to force her to act as the child’s omnipotent extension. This alternates with signs of desperate clinging. The clinical outcome of these rapprochement crises are determined by the development toward libidinal object constancy; the quantity and quality of later disappointments; possible shock trauma; the degree of castration anxiety; the fate of the Oedipus complex; and the developmental crises of adolescence— all of which function within the context of the individual’s constitutional endowment (Mahler, 1971).

20 Â Egan and Kernberg (1984) stated pathological narcissism reflects a libidinal investment in a pathological self-structure. A pathological grandiose self emerges as a defense against intense preoedipal and oedipal conflicts over love and aggression from pathological object relations. Ideal object, ideal self, and acceptable self-representation are fused, and unacceptable self- and object images are dissociated. Superego precursors are not integrated with aggressive components, and the external object is devalued.

The pathological defense mechanisms manifest as excessive self-absorption, intense ambitiousness, grandiose fantasies, feelings of inferiority, and overdependence on external admiration and acclaim. These children have major deficiencies in their capacities to love and be concerned about others. They lack the capacity for empathic understanding of others, and show chronic, intense entitlement and selfishness (Egan & Kernberg, 1984).

Narcissistic pathology does not reside in regression to an infantile position or in untamed infantile narcissism. Instead, narcissistic pathology actually reflects a pathological formation of the self used for defensive purposes. Family dynamics may contribute to this if--instead of being a consistent authority that both confronts and disciplines the child and enables the moderation of ego-ideal precursors, facilitates individuation, and supports the integration of positive and negative aspects of self and objects--there is no appropriate limit-setting and the child does not define boundaries between fantasy and action and is not helped to subordinate his infantile omnipotence to the reality principle (Egan & Kernberg, 1984).

Beren (1992) discussed the profile of narcissistic children. She states the narcissistic child’s sense of self is usually less developed, more vulnerable, and more

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21 dependent on outside approval. These children are easily injured and respond to perceived slights with a great deal of anger. The narcissistic child’s self and object constancy and self-other representations are not as fully developed. Beren believed the roots of narcissistic disorder lay in the early relationship with the mother and in particular in the inherent contradictions in the anal rapprochement phase as described by Mahler. It is during this stage that the parents have to be emotionally present for the child while at the same time setting limits and maintaining empathy for the child’s struggles. The parents of narcissistic children usually have a great deal of difficulty doing this. Instead, they either turn away from their children at important times or are there but are not emotionally present.

Beren (1992) enumerated a number of characteristics that might alert the therapist to the possibility of a narcissistic disorder. These are: 1. A disturbance in regulation of self-esteem 2. A compelling need for the self-object; 3. A lack of self-awareness that leads to a lack of empathy; and 4. Precocious ego development that can be observed in the extreme unevenness of development.

In summary, object relationalists view pathology as stemming from distortions in early object relations. Kernberg (2006) stated identity diffusion characterizes all severe personality disorders. Identity diffusion is a result of lack of integration of concept of self and others. Beren (1992) stated self and object constancy and self-other representations are not fully developed. Willock(1990) posited there are developmental arrests and distortions of object constancy and basic trust. Mahler (1971) stated the object remains a

22  bad introject intrapsychically. Egan & Kernberg (1984) stated narcissistic pathology reflects a pathological formation of the self used for defensive purposes. The child’s infantile omnipotence is not subordinated to the reality principle.

Self psychology view.

Self psychology posits there are a number of factors that can hamper the sense of cohesion in adolescence. These include the biological changes of puberty, the presence of neurocognitive deficits, the emergence of affective disorders or panic disorders, the presence of attention deficit disorders, or the onset of a thought disorder leading to a possible psychotic break. A destabilization of the sense of cohesion does not automatically mean there will be fragmentation. The adolescent could respond by seeking a higher, more symbolic level of integration (Palombo, 1988).

Wolfe (1982) stated the individual that does not experience itself as a self is not a cohesive self but is merely a fragmented existence. Impairment of a self-sustaining psychological environment thus leads to some loss of self. He stated psychological man cannot exist in a psychological vacuum but only in a psychological environment that makes the emergence and maintenance of the self possible.

The borderline condition is a structural deficit in the sense of the self. It is not due to a conflict between the drives and the ego. Instead, there is an innate absence of the ability to maintain cohesion. The lack of cohesion produces an undercurrent of chronic, overpowering anxiety. This absence of self cohesion might be contributed to by the lack of other significant functions such as self-regulation, self-soothing, and self-control.

Individuals with borderline condition might indiscriminately seek out selfobjects and

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23 cling to them in intense mergers, rely on a set of defenses as protections against disintegration, or rely on selfobject functions such as substances or affects that become transitional objects clung to with desperation (Palombo, 1983). Individuals with borderline conditions have good reality testing, but their judgment is poor. They often have low self-esteem that is due to their perception of their own sense of inadequacy.

The borderline child, regardless of the etiology of the condition, experiences life in a chaotic fashion. There is “a sense of internal disruption that interferes with the capacities for self-regulation, which leads to the perception of the world as a chaotic, overwhelming and ungratifying place in which to live” (Palombo, 1983, p. 330). These children suffer from the lack of adequate selfobject functions that would permit them to cope effectively with the stresses of life. The onset of a borderline disorder can be due to three possibilities: 1.

The child is born with neurocognitive deficits that are severe enough to constitute serious interferences with the integration of the child’s experiences;

2.

The child suffers a psychotic break with a subsequent reintegration that has a “stable instability;”

3.

Some life trauma or a series of stressors has a corrosive effect on the personality, destabilizing the sense of self (Palombo, 1983).

Palombo and Feigon (1984) explored whether there might be a relationship between childhood borderline disorder and deficits in a child’s neurocognitive make-up.

They stated that from a clinical perspective, the experiences of some children with learning disabilities might be identical to the experiences of children labeled borderline.

24 Developmentally, children with learning disabilities might have an impairment in the ability to comprehend, integrate, and process their environments. Their worlds might appear puzzling and unpredictable. Physical space itself might be perceived differently than for the child without a learning disability. These children might attempt to adapt to their environments in a way that seem bizarre to others. Areas of impairment became more clear to observers as the child advances developmentally from the sensory motor phase to the preoperational phase.

These children may experience caretakers differently than the more intact child experiences them. They may not experience the caretakers as empathic, but instead as critical and bent on frustrating rather than helping them. The children may attempt to manipulate the parents in such a way as to get their needs met. The caretakers may experience this as exploitive, attention-seeking and destructive. The child is simply trying to cope (Palombo & Feigon, 1984).

Viewing this from a self psychology standpoint, the primary issue is a structural deficit in an important part of the self, not an internal conflict. The deficit contributes to the child’s inability to maintain a sense of cohesion. Thus, the child lives with a constant undercurrent of anxiety. He experiences the world as a chaotic place. This internal chaos becomes expressed through behavior. At best, the child experiences low self-esteem. At worst, the child’s personality becomes fragmented and manifests itself as borderline since, for the borderline child, the central problem is the absence of cohesion in the sense of self, with the issue of self-esteem being secondary (Palombo & Feigon, 1984).

In summary, the view of self psychology is that there is a structural deficit of the self, not an internal conflict, that leads to pathology. There is an absence of cohesion in

25 the sense of self. This is due to an absence of adequate selfobject functions that would permit the child to cope adequately with life stressors.

Relational theory view.

Relational theorists have three interrelated assumptions about psychopathology.

These are that complex human behavior, including psychopathology, is always the result of the interaction of the child’s constitutional endowment and his environment; psychopathology is usually not distinct from normal development but exists on a continuum, or as a variation, of it; and lastly, what is defined as psychopathology depends to some extent on the cultural and personal values and outlook of the observer (Altman et al, 2002).

These theorists also have three broad ways of understanding psychological difficulties: the patterns of attachment and relatedness; the patterns of subjective experience; and self-regulation. Disturbed patterns of relatedness are caused by insecure patterns of attachment; problems with identification and confusion; problems with interpersonal negotiation; or disturbed patterns of achievement. Patterns of subjective experience involve the phenomenon of dissociation. Dissociation is universal, occurring along a continuum from the mildest level of normal development where it is used to integrate various aspects of the self, to a pathological extreme of being unaware of oneself at all. Disturbances of self-regulation include disturbances in regulating one’s inner experience, behavior, or both (Altman et al, 2002).

26 Attachment theory view.

Recent studies show a link between the adolescent’s attachment organization and psychosocial functioning. Two insecure attachment strategies, the preoccupied and the dismissing strategies, have been implicated in problems of psychosocial functioning.

Internalizing problem behaviors tend to be used more with preoccupied strategies and externalizing problem behaviors with dismissing strategies, although the opposite could also be true (Allen & Land, 1999).

Fonagy & Target (1996) stated that children with disruptive behavioral disorders have deficits in their ego mechanisms. As these ego processes are necessary to establish a theory of mind, these children also have deficits in their theory of mind, or mentalization.

Early relationships with primary caregivers are important because “the mental mechanism that moderates the expression of individual genotypes is intrinsically linked to the quality of the early relationship with the primary caregiver” (p. 307).

The function of attachment is to bring complex mental life into being from a complex and adaptable behavioral system. Early experience does not determine the nature of self-other representations. Rather, it might jeopardize the very existence of a structure to represent object relationships, the processing skills required to deal with interpersonal interaction, and the extent to which this interpretative mechanism could function under stress and process emotionally charged information. What is lost in a dysfunctional mother-infant dyad is not the bond, but the opportunity to generate a higher order regulatory mechanism for appraisal and reorganization of mental contents (Fonagy & Target, 2002).

27 Â The developmental course, the unfolding ego capacities, and emerging conflict interact continuously and shape the evolution of mental structure from the very beginning. Research indicates that at least some children with ADHD develop their symptoms from intrusive and overstimulating care. Insecure attachment is consistently associated with externalizing disorders when in the context of environments of high social risk (Gilmore, 2000).

Violence and aggression can be understood to be a recourse to action in the absence of the capacity to reflect on interpersonal experience. Aggression can be seen as the use of destructiveness to protect a vulnerable self-structure, and violence as an attack on ideas and feelings felt to be intolerable, either in others or in one’s own mind (Fonagy & Target, 1996).

Thus, attachment theorists look towards a faulty mother-infant dyad as the cause of the inability of the ego to form appropriate intrapsychic structures which then leads to dysregulation in affect, self-control, and other behavioral disorders. This theory emphasizes the very formation of ego structures is dependent on the adequate attachment of the infant-mother dyad. Without this attachment, the mechanism to even represent object relations might not be put in place.

Integrated theories.

Greenspan (1988) hypothesized that disturbances of affect regulation might emerge from a different constitutional maturational pattern and set of early experiences.

He stated decoding the meaning of affect might come more from the auditory pathway whereas decoding affect intensity might be more of a visual-spatial pathway task. He

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28 hypothesized affective regulation disorders emerge from visual-spatial processing difficulties coupled with a lack of empathy and limit-setting.

Pine (1980) described three areas of psychopathology that commonly first become evident during school years as children fail to adapt to the tasks that are demanded of them in a school setting. These are borderline disturbances, behavior disturbances, and disturbances of learning. Children with borderline disturbances have central developmental failures or aberrations in ego development and object relationship. These children fail to achieve the signal function of anxiety. Unpleasant affect readily escalates to panic instead of triggering reliably available defenses. The children also experience early failures in the process of separation and individuation. They quickly lose their sense of self as they merge into an undifferentiated self-other duo. Their personality organization varies with changes in their affect level and object attachment. These children become identifiable in the school-age period because normally there would be some degree of stability of character and socialization in the child. The “peculiarities” of the child with a borderline disorder generally violates that expectation. Core failures in the development of ego functions and object relations conceptually unite this group.

The second group of disturbances, the disturbances of learning, occur along three developmental lines. The first is the availability of basic learning tools. The second is the harnessing of potential interferences with the learning process that can disrupt attention and the ability to take in information, such as impulsive behavior or too intense affect.

The third is the achievement and maintenance of secondary autonomy drives and their attendant fantasies Functionally, these all have major implications for school success.

They often have an impact on self-esteem. These children and their parents have to be

29 helped to understand the reality of the deficit, including understanding of its specificity, i.e., that the child is not totally “damaged.” Though “secondary” in a causal sense, they can be of major impact for the child’s functioning (Pine, 1980).

The third group of disturbances is the behavior disorders. Pine (1980) states there is not much diagnostic significance for this category. The term “behavior disturbance” is reserved for those disturbed behaviors that have an antisocial or at least interpersonally disruptive component. They are troublesome or dangerous in some way. There are three reasons behavior is a characteristic area of disturbance in the school-age child: 1.

The school makes a great demand for motor restraint;

2.

The school-age child is at the early end of the continuum from steady

movement to less steady movement, and 3.

The school-age child has motor capacities for strength and independent

action that make his behavior a potential source of concern for others when it goes awry.

Pine states there is much diagnostic confusion in the area of behavior disorders.

He states (1980, p. 196), “Much of our labeling of behavior disorders comes from external, social criteria, even though we know very little about the ‘disordered behavior’ without an understanding of its interior features.” He then describes five phenomena that fit the external description of behavior disorder. These are: 1. An “outburst” in which a child who is normally reasonably self-controlled reaches his limit. The child is deprived/frustrated, insulted/humiliated, or provoked/injured to the point where he lashes out.

30 2. An impulse that has ready access to action with little or no delay, and little or no cognitive or defensive working over of the impulse as a mediating process.

Shapiro (in Pine, 1980) says this is a defect in planning, a defect in the capacity to envision consequences of action, and he reserves the term impulse disorder for just this phenomenon. Pine (1980) proposes the term “behavioral disorder” should be reserved for those who have the constellation of minimal control, minimal cognitive mediation of impulse, and ready access of impulse to motor pathways.

3. Neurotic character disorders that culminate in disturbances in the behavioral realm. The action of the child expresses a fantasy in compromise (disguised) form.

4. An area of ego disturbance where considerable cognitive work is going on between an impulse and the expression of outrage.

5. Some behaviors reflect socialized behavior within a particular family or group subculture rather than intrapsychic maldevelopment.

Pine (1980, p. 200) suggests the term behavior disorder be used for “those instances of failure of delay between impulse and action, those absences of cognitive working over, which are characteristic of a particular child, are repeated, predictable modes of reaction to an array of impulses and an array of settings.” He states the ability to delay impulses results from: 1. The infant experiencing sufficient gratification and relief following upon need that he begins to trust that relief will come again;

31 2. Developing “basic trust” such that the infant can scan his environment and learn where need satisfaction/tension relief will come from; and 3. the internalization of parental standards and the formation of the superego, with its accompanying affect of guilt that tends to accentuate control processes.

Conversely, lack of delay of impulse is the result of: 1. Insufficient attachment to, or empathy for, others; 2. Insufficient cognitive elaboration of possibility, of alternatives, of plans and; 3. Failures in conscience development.

Barish (2006) believed the core pathogenic process in childhood is the development of a demoralized or defiant sense of self. Thus, at the core of most child psychopathology (giving due consideration to undeniable biological influences) is an emotional injury that has not been repaired. The immediate effect of any emotional injury is complex. The child first suffers a painful affect. There is also an intensification of the child’s instinctive self-protective responses—withdrawal or retaliation, or both. Finally, the child’s response is accompanied by a restriction in his or her expression of affect.

How well children repair injuries determines their psychological health or vulnerability to emotional illness. How children respond to injuries becomes the defining aspects of their characters.

Psychopathology in childhood is primarily the result of a failure of the normal reparative processes. Instead of healing there is a spreading of rage, shame, or sadness in the psyche and failing or maladaptive efforts at self-repair. The manifest symptoms of

32 Â child psychopathology reflect some phase of the injurious pathogenic process. The core pathogenic process proceeds along a pathway of demoralization (withdrawal), characterized by affects of sadness, shame, and futility or a pathway of defiance (retaliation), characterized by anger and grievance. The pathogenic impact of an injurious or traumatic event in the life of the child depends on the capacity of the child and his or her supportive environment to effect some repair and prevent the spread of painful affects and fantasies (Barish, 2006).

Tyson (2005) stated children with disruptive behaviors have a deficient sense of agency. They have not experienced sufficient reciprocal affective dialogue within a secure attachment or emotional interactions with consistent rules and expectations to develop their own emotions and intentions in a healthy manner. They also have not developed an ability to use their emotions as a warning system. They have little capacity for delay, self-control, or self-regulation. The children do not have an ability to integrate their mental states. Instead, they develop disturbed object relations and an impoverished, disorganized sense of self with an underdeveloped superego. They construct maladaptive emotional procedures that predispose them to peremptory impulsive reactions to emotional stimuli (Tyson, 2005).

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33

Chapter III

Methodology

Theoretical and Conceptual Framework of the Study The premise of this study starts with a relativist ontological view. That is, “realities exist in the form of multiple mental constructions, socially and experientially based, local and specific, dependent for their form and content on the persons who hold them (Guba, 1990, p. 27). From this flows an epistemological stance of subjectivism. The investigator and volunteer together create the findings through the process of their interactions. The methodology used was both hermeneutic and dialectic. The constructivist process as outlined by Charmaz (2006) was used to elicit, refine, and interpret individual constructions. These were then compared and contrasted dialectically to generate constructions on which there was substantial consensus (Guba, 1990).

The constructivist grounded theory approach as envisioned by Charmaz (2006) allowed for this research to be grounded in data from the field and encompass “diverse local worlds, multiple realities, and the complexities of particular worlds, views, and actions (Creswell, 2007, p. 65). The emphasis of the research lay more within the views and beliefs of the individuals than on the methods of the research. The investigator’s personal experiences of having lived and worked in diverse cultures ranging far and wide ethnically, racially, geographically, situationally, and socioeconmically, aided in allowing

34 for interpretations to encompass a wide scope of possibilities. The ability of the investigator to make a connection with the volunteers directly impacted the material gathered for the research. When the volunteers felt the investigator could be entrusted with their feelings and that they would be understood, they were more likely to share more troubling feelings. This role of empathy is exactly the premise upon which Kohut (1971, 1978) shaped his theory of self psychology and upon which this research is heavily based.

The theory of self psychology posits that a firm, cohesive self results from optimal interactions between children and their selfobjects. “Selfobjects” is the term coined by Kohut to describe the functions performed by a person that provide “a selfevoking and self-sustaining experience to the potential and to the emerged self” (Kohut & Wolf, 1978, p. 2). Selfobjects are objects that are experienced as part of the self. There are three kinds of selfobjects. The first type, the mirroring selfobject, responds to and confirms the child’s innate sense of vigor, greatness, and perfection. This selfobject is responsive to the child and admires the child for who the child is. The second type, the idealized parent image, is a selfobject who the child can look up to and with whom the child can merge as an image of calmness, infallibility and omnipotence. This selfobject possesses the qualities the subject lacks. The third selfobject, the alter ego, provides the child with the experience of a common bond with others that unite human beings together and results in the feeling of kinship with others. Selfobject functions are required for an individual to be whole. The child internalizes these selfobject functions.

The firm, healthy self has three major constituents: two poles on a continuum and an intermediate tension-arc. The pole at one end of the continuum precipitates from

35 mirroring experiences and becomes the locus of the need to be confirmed. Ambitions and the basic strivings for power and success emanate from this pole. The second pole at the other end of the continuum is derived from idealizing experiences. It contains the basic idealized goals and values. An intermediate area of basic talents and skills are activated by a tension-arc that establishes itself between these two poles of ambitions and ideals (Kohut & Wolf, 1978). Kohut contends that the therapist acts as a selfobject for the client and it is through the use of empathy and introspection that healing occurs.

Kohut does not see sexuality as the central motivator of behavior. Rather, the motivators are the maintenance of the self’s cohesion and self-expression, which are experienced as self-esteem. The success and failure of sexual desires have important meaning for the self and influence its cohesion as well as its self-esteem. During the oedipal phase, if the child’s parents appropriately respond to the child’s awareness of sexual differences and love for the opposite gender parent, the child’s self esteem will remain intact. However, if there are failures in selfobject functioning, such as overstimulation, aggressiveness, or criticism, there may be a loss of self cohesion and self esteem. This can lead to pathology such as aggression (Wolfe, 1982).

The borderline condition is due to a structural deficit in the sense of the self, not to a conflict between the drives and the id. There is an innate absence of the ability to maintain cohesion. This, then, leads to lack of other significant functions such as selfregulation, self-soothing, and self-control (Palombo, 1983).

36 Research Design and Strategy This research is a qualitative study using a grounded theory approach. Qualitative research is well suited to the task of giving voice to those who have not been represented (Creswell, 2007). Grounded theory is a good design to use when a theory is not available to explain a process (Charmaz, 2006). The voices of behaviorally disordered students have not been previously documented. There has not been a study that explores the intrapsychic meaning and/or inter-relational impact this disorder has on children or young adolescents. This research attempts to build on previous psychodynamic research and theories in understanding the intrapsychic lives for this cohort. It looks for patterns and explores new concepts that have not been looked at before or have received scant attention when considering children with behavioral disorders. It attempts to generate a theory through interrelating categories of information, such as the individual meaning of the disorder to the children, the impact of the educational setting, the impact of school interventions, and the implication of the students’ significant relationships in understanding and making meaning of their lives.

Operational definitions of major concepts.

For the purposes of this study, students with a behavioral disorder are defined as students who have been identified as having an “Emotional Disability” through their school system and as defined by the Individuals with Disabilities Education Act (2004) as follows: Emotional disturbance means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely

37 Â affects a child's educational performance: 1. An inability to learn that cannot be explained by intellectual, sensory, or health factors.

2. An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

3. Inappropriate types of behavior or feelings under normal circumstances.

4. A general pervasive mood of unhappiness or depression.

5. A tendency to develop physical symptoms or fears associated with personal or school problems.

Emotional disturbance includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined they have an emotional disturbance.

Middle and high school students are defined as students in fifth through 12th grades.

Statement of assumptions.

This research assumes the following: 1. The experience of living with a behavioral disorder has psychological, social, and emotional consequences.

2. Middle and high school children with a behavioral disorder are capable of conveying meaning through story-telling, relating past experiences, and reflection.

3. An interview format is appropriate for attaining the information necessary to conduct this research.

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38 Data Management and Analysis As this population was a vulnerable population and difficult to reach, the research protocol was designed in a way to maximize the potential for volunteers to enroll. Hence, there was only one interview conducted, thinking that the requirement of two interviews might discourage potential participants. Data were collected using one unstructured, faceto-face interview that lasted approximately sixty minutes. The shortest interview was twenty minutes. The longest interview was eighty minutes. Most interviews were one hour in length. Part of grounded theory for Charmaz (2006) is “member checking,” i.e. making sure the investigator understands correctly what the volunteer is attempting to convey. Since there was only one interview, the investigator incorporated member checking into the single interview by re-stating what she thought the participant had said and asking if this was correct. The investigator also re-asked the same question in a different form and at a later point in the interview to try to make sure she understood what the participant was trying to convey.

The interviews were recorded and then transcribed. Most of the parents wished to voice their own concerns and observations to the investigator. These conversations were not recorded, but were noted and summarized shortly after each interview by the investigator. Field notes that included observations of nonverbal communication, the milieu, and impressions of the investigator were written by the researcher shortly after each interview was conducted.

39 The sample.

The scope of the study is limited to the experiences of thirteen middle and high school students who are, or have previously been, placed in an alternative school setting due to disruptive behaviors in the general education classroom. The students have an IEP for an Emotional Disability. The experiences were ascertained by way of interviews in which the students narrated their thoughts and experiences to the investigator.

The setting was a private setting chosen by the participants. Six of the students were interviewed in their homes. Two students were interviewed in the back yard of a relative’s or friend’s home. Two of the students were interviewed in the investigator’s office. One student was interviewed in a private room at a local library. Two students were interviewed via Skype. The population consisted of middle and high school students identified as having a behavioral disorder through the school system they attended.

The sampling came from volunteer students who were recruited through flyers posted on public bulletin boards, at social service agencies, and at mental health agencies; through notices sent through therapist listservs, through informational websites for parents of children with behavior issues, and through support and advocacy groups for children with emotional and mental health issues; and through postings on Facebook.

The source and nature of data was the students’ verbal accounts, parents’ comments, and observations made by the investigator. Data were obtained through interviews with students; speaking with parents who spontaneously and voluntarily shared information with the investigator they felt was pertinent to the study and that they wished the investigator to know; and through field observations made by the investigator.

40 Â Data analysis.

Analysis was performed as described by Charmaz (2006). As soon as possible after each interview, the recording was transcribed, and the data was selected, sorted, and separated. Each segment of the data was taken apart, named, and sorted into preliminary groupings. The codes remained close to the data, showing actions, and indicating processes. The codes were provisional, comparative, and grounded in data. The coding was done line-by-line or incident-by-incident.

Data were compared to data to develop focused coding. The decision was made as to which initial codes made the most analytic sense to categorize data incisively and completely. The most significant and/or frequent codes were used to sift through the large amounts of data. Data were compared to the focused codes to refine the codes and develop categories. Theoretical coding was considered as a way to specify possible relationships between categories developed in the focused coding.

Memo-writing was utilized to analyze ideas about codes. Thoughts were written down, comparisons and connections were made, and questions were crystallized. The memos delineated directions to pursue. Each memo was dated and titled. The category being treated was defined and thoughts were made as to the direction the category and data might lead.

The gathering of data were stopped once there were no more avenues the investigator had the power to explore in seeking volunteers. This occurred after a year of attempts to recruit volunteers. This population is extremely vulnerable. Therefore, there are many protections and safe guards in place in an attempt to prevent exploitation of

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41 these youth. As such, they were a difficult population to find and reach. It is estimated parents of thousands of potential volunteers were reached through recruiting efforts.

Eventually, the original parameter of using middle school students was expanded to the addition of high school volunteers to increase the pool of potential participants, as several mothers contacted the investigator about the possibility of their high school student participating. In the end, most volunteers came from individuals who distantly knew of the investigator from a third-party personal or organizational connection. The third-party vouched for the investigator’s integrity to the individual who then vouched for the investigator’s integrity to the potential volunteer. Saturation was reached in some, but not all, categories, due to the difficulties in finding volunteers.

Next, data were theoretically sorted, diagramed, and integrated. Memos were sorted to create and refine theoretical links. Diagrams and mapping of categories were used to conceptualize broader themes. The memos were integrated by ordering for process or as necessary to make relationships intelligible. Theories were generated using a constructivist approach with an interpretive stance.

Protecting the rights and confidentiality of the participants.

The rights of all volunteers in this research were protected. The investigator explained the purpose of the research and what was being asked of the volunteers should they wish to participate. The research was explained first to the parents in the student’s presence and then again alone to the students in language that was age appropriate. The participants and their parents were verbally informed that they had the choice to participate or not participate in the research. The volunteers were told they could stop the

42 Â interview at any time and they did not have to answer any questions they did not want to answer. The students and their parents were given the opportunity to ask any questions they had prior to signing consent forms. The investigator obtained informed consent from all parents of participating students and informed assent from all students.

One student asked if he could stop the interview after twenty minutes of engaging in the interview process and still receive his monetary award. The interview was stopped at that point and the youth received his gift card. Another student appeared so highly defended during the interview process that the investigator asked her if she wished to stop the interview, assuring her she would still receive her gift card and her mother would be told the interview was satisfactorily completed. The student said she wished to continue.

All volunteers and their parents were informed both verbally and as part of the written consent that should the volunteer experience emotional distress due to the interview process, the investigator would provide them with the name of a local therapist who would debrief the interview with them. No one availed themselves of this offer. In fact, a number of the students expressed disappointment that there was only one interview as they enjoyed being able to talk about themselves and their experiences.

The researcher obtained two signed copies of a properly executed assent or consent document from each participant and each parent (see Appendix). A copy of assent was provided to the volunteer and a copy of consent was given to the parent. The investigator retained the other copy of each form.

In order to maintain confidentiality of data, only the researcher and dissertation committee members had access to raw data. The data, once transcribed, were kept on a password protected computer and file. Data identifying the participants were not made

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43 Â available to anyone other than the principal investigator. Pseudonyms for all participants and any persons named during the interview process were used during the transcription and throughout the rest of the data analysis. Consent forms were kept in a separate file.

All raw data will be destroyed after five years of completion of the dissertation.

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44

Chapter IV

Results

Introduction to Findings This research captures and explores the experiences of thirteen youth between the ages of ten and sixteen identified in the school setting as having an Emotional Disability.

It explores how the students understand this identity, what it feels like to them, and how it impacts them. It investigates how students handle the messages that they are failing in controlling their behaviors according to school norms. It examines whether the students sense they are “different” from their peers, and if so, if this matters to them and how they account for this difference. It looks at how the children view themselves and others. This study explores how these youth interpret their lives.

The thirteen youth in this study have an Individualized Education Plan (IEP) for Behavior Disorder (BD), Emotional Disability (ED), or Emotional-Behavioral Disorder (EBD). These categories are all labels for basically the same entity. The nomenclature has changed through the years, as discussed previously in this study. Currently, the term “Emotional Disability” has been designated as the official terminology and is defined as: (includes schizophrenia but does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance) means a condition exhibiting one or more of the following characteristics over a

45 long period of time and to a marked degree that adversely affects a child's educational performance: •

An inability to learn that cannot be explained by intellectual, sensory, or health factors;

•

An inability to build or maintain satisfactory interpersonal relationships with peers and teachers;

•

Inappropriate types of behavior or feelings under normal circumstances;

•

A general pervasive mood of unhappiness or depression; or

•

A tendency to develop physical symptoms or fears associated with personal or school problems (Illinois State Board of Education).

The term “Emotional Disability,” or ED, will be used throughout this study to designate the special education category in which the children in this study have been placed. All of the youth in the research are aware that their schools consider them to have this disability and that they receive specialized services because of this.

Description of the Sample Thirteen youth between the ages of ten and sixteen participated in this study.

There were five females and eight males. Nine of the participants were Caucasian and four were African American. The socioeconomic class ranged from upper middle class to poor. Six participants lived in a Chicago suburb, two lived in Chicago, one lived in southern Indiana, two lived in Alabama and one lived in Georgia. One youth was homeless, three lived in subsidized housing, five lived in a single family home, four lived in an apartment, and one youth lived in a foster home.

46 Six participants lived in a family with both parents, four participants lived with an extended family member, two youth lived with a single mother, and one youth lived with a foster mother. All the children but one in the study lived with other children in their homes.

Five of the youth had an Emotional Disability as their sole disability under the educational categories. The other eight, in addition to their emotional disability, had various disabilities, including Other Health Impaired (OHI) and Learning Disability (LD). Included in the OHI category were students with ADHD, Sensory Integration Disorder, Nonverbal Learning Disorder, and Generalized Anxiety Disorder.

Six of the participants were recruited through a Facebook post soliciting volunteers. From the original post, friends of friends re-posted the request. A number of clergy seeing the post informed members of their congregation about the opportunity to volunteer and several people responded. Three of the participants were recruited via flyers posted at the social service agency they attend. One participant was recruited via a flyer posted at their local library. One participant was recruited by an extended family member who was a therapist and saw the post on a therapists’ listserv. The last two participants were not sure where they heard or saw of the opportunity to volunteer. It is most likely they saw a recruitment flyer through their local mental health agency.

Commonalities Common to the thirteen participants is their form of responding to aversive stimuli in the school setting by having “blow-ups,” a term often used by participants to describe their behaviors. Currently, nine of the participants display this disruptive

47 behavior during the school day when they are stressed beyond other means of coping.

One participant displays disruptive behavior that involves physical movement and verbalizations but does not escalate to “blow-ups” and angry interactions. The three remaining students report they used to have disruptive behaviors frequently, to the point of violence, but now they have no or limited access to their feelings, so don’t act out, but instead withdraw.

The twelve students who have disruptive behaviors that escalate to angry actions (or used to have these behaviors) state they are aware when their behaviors become increasingly disruptive. They know before they resort to action that they are going to “blow.” The general consensus is they have this knowledge a few minutes before they resort to action. However, there is a step prior to their blow-ups. The youth report a feeling of frustration or anger towards an incident or experience that is occurring, or recently occurred, prior to getting to the point of “blowing-up.”

They do not have failure to achieve signal anxiety per se. There is a prodromal period that the youth recognize. In telling their stories, they can often identify and verbalize what initially frustrates or angers them, be it an immediate external event or an intrapsychic wound that gets activated.

Even if the youth can’t identify a particular event or thought, they are aware of a frustrated or angry feeling. However, once they reach a certain point, if either they are not able to do what they instinctively feel they need to do to calm themselves, or there is no one attuned to their needs to facilitate a decrease in the intensity of the situation, they have a “blow-up” or “fit,” which manifests itself in physical or verbal acting-out.

48 The youth resort to action when they feel trapped. They begin to feel overwhelming anxiety and also feel there are no other recourses: they aren’t allowed to leave the room to regroup and there is no one in the room attuned to their needs. At some point, the thought crosses their minds that they are “going to blow” and they don’t care.

Post-episode, the youth are troubled by their actions to varying degrees. Some of the youth focus on these behaviors, whereas others don’t. Each one admits to acting-out behaviors and knows this is why they have the label of ED. This, however, is not necessarily the problem that is uppermost in their minds. Shortly into each interview, all the youth stated in one form or another that they “have a problem.” The scope of the problems falls into three main groupings. The School-Focused Group identifies their problem as disruptive behaviors that are only problematic in the school setting. The Home-Focused Group identifies their problem as not living with their birth mother and focuses their attention on their home lives. The Globally-Focused Group identifies several problems: external environmental hardships, having a change in their primary caretaker, not getting enough attention from their mothers, and having difficulty controlling their anger. They view their problems as being both at home and in school.

One of the phenomena observed interwoven throughout the interviews is the deflection by the youth of painful subject matter. This is accomplished through ignoring a question asked, changing the subject, or giving false information. It can be safely said that this is ubiquitous not only among youth with a classification of “Emotional Disability,” but among all children and youth in general. Nevertheless, the extremes to which some of the children in the study take this measure, along with the extreme

49 negative disapproval and consequences that children might receive in a school setting for this behavior, makes it worthwhile to investigate in depth.

All the children at some point in their interviews change the topic at hand. This happens most often when the subject matter approaches seemingly emotionally-laden material. Many of the children also misrepresent facts as something different than what they are. For instance, a number of the youth state that they have always been in a general education classroom rather than in a separate special education classroom, as is actually the case. Half of the youth state they never have behavioral problems in school, although their placement in an alternative school setting is due to acting-out behaviors in school.

The distortions move from these simple instances of “saving face” with the investigator to more aggrandized fictions, such as the declaration of being able to kick a soccer ball so far and so high as to soar over a lake that is a half-mile away or that the principal’s husband is actually the interviewee’s father, to the outrageous lie that the individual can fly, soaring over water with ease, at which case the individual is leaving reality completely behind and fantasying. These differences will be discussed under the separate groupings below.

School-Focused Group Source of the problem.

There are four youth in the School-Focused Group ranging in age from ten to sixteen. There is one female and three males. In addition to being identified as having an Emotional Disability, these youth also currently have--or been treated in the past for-other disorders, including ADHD (four students), Non-Verbal Learning Disorder (one

50 person), Learning Disability (one student), Generalized Anxiety Disorder (one pupil), Executive Function Disorder (one youth), Bipolar Disorder (one person) and Sensory Integration Disorder (one student). All of the children take medication to address their emotional and/or neurological difficulties.

Two of these students are in self-contained classrooms. One student has been in a therapeutic day school for five years and is just transitioning back to her neighborhood school this year with a full-time aide. The final student in this grouping goes to his neighborhood school for three hours a day and sits in the office with a one-on-one aide.

He then comes home and is home-schooled for the rest of the day. This is a result of his mother pulling him out of the therapeutic boarding school that the school system had placed him in earlier this year. This student had originally been diagnosed with being on the autism spectrum by his school. After several years with this diagnosis, the school district changed his disability to Emotionally-Behaviorally Disturbed, which is how it stands today.

These students identify their problem as having difficulty in the academic setting that leads to frustration and subsequently acting-out behaviors. The difficulties range from something about their physical self that is giving them trouble (“My body gets out of control;” “I have a messed-up brain”), to having schoolwork that is too difficult, to having other students making fun of them. These problems exist squarely within the school setting. None of them identify their problems as impacting them outside of school.

Each of these youth remembers the optimism with which they started school. One student says, “It [school] started out well. It was a good first day.” Slowly, school

51 devolved from a place to eagerly learn and grow to a place of worry and frustration. All the students can pinpoint a moment in school when their problems began. Kenny says, In second grade, that’s when I would start like, oh, this is so hard, then I’d be frustrated with my work. Then kids would bug me and then I’d push and the kids, I don’t know, I’d just get into fights.”

Three of the students point to the frustration they felt over trying to do difficult academic work as the catalyst for behaving in ways that were unacceptable to their schools. The fourth student points to her body “being out of control” as the cause of her difficulties. All four youth present a defined problem that is discrete from the essence of who they are and troubles them mainly in the school setting.

Annie says her “body starts getting out of control.” She separates her out-ofcontrol body from the rest of her self. It is her body, not herself, that gives her trouble.

She is unable to sit still in school and is a distraction to others. Because of this, she has spent most of her school years in a therapeutic day school. She has a strong desire to overcome her problem and be able to be in a general education classroom without any supports or help.

Hank states his problem is a “messed-up brain.” He says he learns differently than other kids. He states, “It’s hard having brain issues because you can’t learn properly.” He relates part of his problem is that when he gets frustrated, it’s hard for him to “get the frustration out” and he ends up becoming angry and acting out of control. He, too, separates his problem from the rest of himself. Now sixteen and a sophomore in high school, he is in a self-contained classroom and feels content remaining there.

52 Kenny says his problem is his frustration with difficult schoolwork and peers making fun of him. He is in eighth grade in a self-contained classroom and can clearly track his misbehaviors from year to year, starting back in second grade. At that time, his frustration led to outbursts and tears. Other children started making fun of him, which led to him instigating fights. Kenny’s problem is not as separate from his core self as the first two youth, because he feels personally attacked when other students make fun of him.

The last student in this category, Mike, vacillates between saying he has a problem due to frustration over difficult schoolwork to saying he really doesn’t have a problem, but rather ineffectual or unfair teachers have created a problem. He says, “The teachers really wouldn’t do anything [about problems that arose in class] . . . They [the teachers] didn’t do it the right way . . . One time, I was kicking my feet. The teacher just walked up. He knew I was kicking my feet, so he made it like I kicked him. And he just restrained me . . . They were pretty unfair about stuff.” He says, “[I get angry at] work that I think is going to be hard. But, then when I cool down and I actually try it, I see that it’s not so hard.” He has had a tumultuous school career with his parents and the school district having much disagreement regarding appropriate educational services for him.

Mike’s desire is similar to Annie’s and Kenny’s in that he wants to be back in a general education classroom without needing any supports or assistance.

How to cope.

This group of students spends the most time thinking about, and trying to improve, their acting-out behaviors at school. All four have the goal of getting back into the general education classroom full-time, although one of the students does not mind

53 being in his current self-contained classroom. For the other three youth, the longing and desire to return to the general education classroom is palpable as they talk about school.

One student says, “I’ll be pretty much in all normal classes next year . . . It feels good.”

Another youth remarks, “I don’t like the BIP (Behavior Intervention Program) class . . . I like the regular ed class.” They minimize the differences between themselves and other students in the general education classroom. If they focus on any difference, it is the difference in the ability to learn, not a difference in how they handle their emotions compared to other students, which they deem the “normal” students. They do not bring up their acting-out behaviors until the topic is introduced into the conversation by the investigator. When they speak of these behaviors, there is often a feeling of shame accompanied with their stories. Hank states, “I got kicked out of school after that, but I don’t want to talk about the part before I got kicked out of school because . . . I don’t feel good about it.” Kenny muses, “So this was really bad: I punched him and stuff.” Later he states, “I don’t like talking about stuff that makes me angry.”

Three of these students identify that being angry leads to “blow-ups.” They identify various sources for their anger. They point to frustration in trying to understand schoolwork and being made fun of by peers as two major sources of anger. One youth explains, “I was trying to do something and the teacher made me mad so I tried to, like, it just came out that, I kinda blew up on a teacher.” Another student says, “I started having blow-ups with other kids or with work or with teachers and that kind of kept, not escalating, but kept going.” A third youth states: I actually remember in second grade, I threw a cone at this girl because she was making fun of me because I got a buzz cut or something and she was making fun

54 of me for it, so I was about to throw a cone at her, but the teacher stopped me. I was pretty blown up. I was literally just about to throw the cone and the gym teacher at recess came by and grabbed me. And then the teacher stopped me and I remember being so angry the whole day.

He remembers being angry the whole day. Yet, as he further reports, he sits at his desk the rest of the day, participating in classroom activities with no further disruptive behaviors. This seems to be a child that is able to show great restraint and control.

The fourth student cannot identify any emotions, but states her body gets “out of control.” She doesn’t remember difficult times or getting angry in school. She says, “I don’t know what’s on my mind when my body gets out of control. I think it’s just harder to focus on what I’m doing.”

Besides frustration with academia, Hank also gets angry when he is scared, when he feels he is getting blamed for something that is an accident, when people say he “has to” do something that he doesn’t want to do, when he is getting yelled at by the teacher for not doing his homework, when he is trying hard to do something and it is not “good enough” for the teacher, or when someone “pushes his buttons.” Once he starts to get angry, Hank describes a period of time when “I feel like I’m tensing up. I get tensed up and then I feel aggravated. And this builds up on top of each other and then the adrenalin comes up.” He says he then “blows up” and everything goes into a “big, raging mess. It’s kind of a volcano. I get tense, and I get frustrated, and I check out when people say I have to do this and that and that and then I get, like, then I got kicked out of school.”

55 Kenny states, I know maybe three minutes before I get angry that I’m going to blow. It’s not like I can’t control it. I can definitely control it. Sometimes I just feel I need to blow up. I definitely know [when I’m getting ready to blow up]. I get this shaking feeling like in my chest, like rrrr, like I’m a ticking time bomb or something like that.

Mike says he feels angry when he thinks something is going to be hard or when he has to do something he doesn’t want to do. He also feels he gets punished for “innocent” actions and kids blame things on him and the teacher believes the other students. He says he throws “pencils, crayons. I’ve thrown a desk on the ground.” He has a difficult time thinking about the process of becoming angry. He initially says he doesn’t know how he feels before he gets angry, but then he says he feels “a lot of different ways.” When asked what some of those ways are, he does not answer but changes the subject.

When they do become angry, a common request from these youth is to “give them some space.” These individuals do not like to be approached or talked to when they are angry. One interviewee says, “Give us some space and wait for us to talk. Don’t try to force us to tell you what’s wrong.” Another student says, I would say, if a student’s really kind of frustrated and really edgy and about to blow up, or start crying or something like that, I would say let him do whatever he needs to do and then give him, like, three, five minutes just to do what he needs to do, come back and then if he needs to do it again, go ahead, just let the student do what he needs to do.

56 Use of action.

Two of the students in this group readily embrace the school interventions and supports that are provided them. Whether it is a weighted vest, a behavior chart, or a oneon-one aide, they accept and utilize the intervention. They know what is available to them and talk about how they use these tools to help maintain control in school. Neither of these students likes using the behavior charts, but they reluctantly say it helps remind them how to behave. Nevertheless, one of these students explains how he manipulates using the charts: “I would mainly choose a number goal that I thought I could make that day. But, I think I usually chose a lower number so I would be sure to make my goal.”

The other student has developed her own strategies to fit into the flow of the general education day without being noticed. She tries to walk into class unnoticed and looks to see “what they’re doing so I don’t disturb the class.”

These two students also use teachers to help them maintain control of their behavior. Says one student, “My teachers are really good at noticing when I, like, they’ll see my movements and physical features. I’ll make this expression on my face, and I’ll be really tight. I’ll be like that and they’ll notice.” In addition, these students regularly use a therapist and/or the school social worker to help them cope.

Kenny and Mike do not elicit help from counselors or therapists. In fact, Kenny says the therapist is not helpful at all. “They [therapists] want to get this information out of me, and I just don’t like it.” Mike thinks therapists are ineffectual in helping. These students also scorn school interventions. As Kenny puts it, “That stuff is just stupid. I mean, squeeze a ball and then you’ll forget a kid called you a fat ass or count to ten because then that teacher never yelled at you.” He says he would “just write down

57 anything” on his behavior chart to be done with it. Mike maintains he enjoys being in the intervention room because it is “entertaining.” He says it is “not helpful” for him to be in this room, though it is amusing to watch the other students fighting and getting into trouble. He says the behavior charts are ineffective and the therapeutic boarding school he recently attended just made things worse for him.

All of the students advocate taking breaks, either when they get restless or as an escape when they think they are about ready to “blow up.” Being allowed to walk out of the classroom and into the hallway for a few minutes is seen by all as an effective method for helping them keep control of their emotions as well as “save face” in front of their peers.

Use of thoughts.

The children employ various thinking strategies to help them cope. Two of the students focus on the goal of getting back into a general education setting. “My goal at the end was to go back to the [general education] school like a full day.” This student tries to just focus on her work and not dwell on the fact that she is in a special education setting. One student accepts his “differentness.” He says he recognizes it’s hard for him to learn because he has “different ways to learn.” These two students accept they need the assistance of interventions or others in order to be successful. This is not always an easy thing for them to do. One student said several times she has to tell herself that it is OK to need to use these interventions and to not try to get rid of them too soon.

Several of the students try to minimize the differences between themselves and the other general education students. For example, one states,

58 Like we mainly did the same things . . . I think sometimes it maybe is [hard paying attention], if, like, the first snow happened I think in science class, and so it was a big distraction to everybody.

One student says the fear of being sent to an alternative school helps him keep his behavior in check. He states: Well, I was thinking about the bad things, like being expelled or being sent to the other school. Like, the things that could happen to me when you’re at school and you’re getting frustrated, if you blow up or something. Thinking about that stuff made me be like, OK, I’ll just stop being mad, cause I really don’t want to be sent to an alternative school or get expelled or suspended for a long time.

Other coping measures.

All four of these students at times avoid answering potentially emotionally difficult questions by changing the subject. For instance, one student was asked to talk more about first grade. This was the grade he was transferred to an alternative school. He responded, “My teacher is not at the school anymore. I think she retired or, like, moved. I don’t remember. It was either one.” Another student was asked what was going on right before he got angry and he responded, “Wait, Mom, come here! How does this go away [something on his computer]?” Another student stated, “I didn’t enjoy [seeing the therapist]. It’s not that I didn’t want to go. It’s just I didn’t enjoy talking about that stuff.

But, anyway, can I talk about sixth grade?”

The youth also deny, or have difficulty remembering, a number of facts known to be true as told by the primary caretaker and/or through written records. Students said they

59 couldn’t remember difficult times at school or they couldn’t remember why they got suspended or expelled. One student said, “I’ve been going to it [general education neighborhood school] since kindergarten.” This student has been attending a therapeutic day school for the past 5 years. This same student, talking about one of his friends, said, “He’s been in my class all the years except for first.” His friend is at, and always has been at, the neighborhood school. Another student, when asked, “Did you ever get in trouble at school?” responded, “For, like, wait. From, like, kindergarten? No, not really.” One student, in an apparent Freudian slip stated, “I would, like, go out into the other classes, too. That’s pretty much where I would spend my whole day. It wasn’t even like I was in the regular ed. I mean, it wasn’t like I was in the special ed.”

Two of the students admit to lying as a way to escape punishment or to avoid doing unwanted tasks. One student admits to lying to remain out of trouble. He says: I’m not a good liar. I mean, I don’t like to, but when I do lie I’ll try to do my best.

But, half the time I don’t lie, a lot. It depends on what it is. Like, my parents are like, ‘How was your day?’ It’ll be not too good, and I’ll be like, ‘It was fine.’ Or with my teachers, ‘Did something happen at home that affects you at school?’

Then I’ll be like, ‘No, nothing happened,’ when something had happened. Stuff when people are asking questions and you really don’t want to tell them. Then I’ll lie.

The other student says he has lied about having his homework completed, but has discovered this only leads to more trouble, so he doesn’t do that anymore. One of the students initially tells the investigator he has accomplished a feat that upon further questioning by the investigator he admits he has actually never done.

60 Relationship to mother.

There are strong ties between the School-Focused Group and their mothers. This is evidenced in several ways. The most striking way is the physical presence of these mothers during the interviews. It is explained to the mothers and youth that the interviews need to be conducted in a place where privacy can be assured. All the mothers and youth agree, yet these mothers have the interviews conducted in areas that are not private. Three of the interviews are conducted in dining rooms that are open without the ability to shut a door to make the room private. The mothers assure they will stay away from the room during the interview and they will keep others in the house away, also. All three of these mothers busy themselves in the kitchen, the room adjacent to the dining room, during the first part of the interview. The fourth interview is conducted over Skype. This youth appears to be in a common room in the house. The mother can be heard passing back and forth during the interview.

Each of these mothers comes in at some point during the interview. Two of the mothers ask, “Do you want me to answer that one?” for a question just asked of the interviewee: Mom: You want me to answer?

Student: Yeah. Would they [the school] send me work [when suspended]?

Mom: No. You would just have days off. It was kind of stupid. I mean, it was like a treat for him. He got to hang out with me all day. Right, Kenny?

Student: Yeah, yeah, I actually didn’t mind it that much [having an out-of-school suspension].

61 This interchange is of note not only for the fact that the mother intervenes to help her son out with the question, but also in her answer, reminding her son of his bond to her: “It was like a treat for him. He got to hang out with me all day.”

The students look towards their mothers for the answer or for help. One of the students is asked, “So, right before you get mad, does your body feel different, or are you thinking something, or, what’s going on?” In reply, the student says, “Wait, Mom, come here!” and asks his mother a computer question. The question is too anxiety provoking for him, so he not only changes the subject, he calls on his mother to come by him. He needs her physical presence.

In another interview, the tone shifts from a superficial level to a deeper, more reflective one as a student shares some difficult material. He says in response to how other peers treat him, “Some people make fun of me. Some people, like, try to come up and insult me. Some people walk away, think I’m weird, you know.” There is a feeling of pain and sadness in the room. Just at this point, the youth’s mother walks into the room and asks if the investigator would like a cup of tea, breaking the intense feeling in the room and returning it to a more polite, superficial level.

These mothers keep vigilance over their children. They need to know that the interview is not going to emotionally harm their child in some way, so they hover nearby to appraise the situation. All four stop this behavior part way through the interview and go to other areas of the house, out of hearing of the interview. Once they are confident their child will not be harmed, they are able to return to their daily activities.

A more subtle way the relationship is demonstrated is in the fact that the students in this group do not talk about, or reflect on, their relationships with their mothers. Rather

62 than this indicating that their mothers do not play an important role in their lives, it reflects the opposite. They do not need to talk about their mothers because she is firmly in their minds. At different points in the interviews they reference their mothers, or adopt their mother’s perspective as their own. Annie, while talking about what it was like when she found out she was being transferred out of her school to a therapeutic day school, talked about being able to buy a new backpack for the school. She says, I was wondering who my teacher would be and I also got a new backpack. Pink is my favorite color, and my sister had the same one, but it was pink. Pink is my favorite color and my mom thought if I had a purple one it would remind me of my sister, and so, I had my sister’s favorite color, which was purple.

One can almost hear the love and concern that this mother has for her child who must transition to a new school during the middle of the year after not being able to succeed in her neighborhood school. Her sister already has the color backpack that she herself wants. Her mother resolves this problem by suggesting the color purple, her sister’s favorite color. The mother wraps this child in memories of her family to take with her when she goes to school. In talking about going to the therapeutic day school, this child says, “I was kind of looking forward to it, because I knew if I was going to a new class it wouldn’t be for a reason that was bad, I knew it would be for a reason that was good for me. And so, I was looking forward to it.” Here again, the mother’s voice can be heard through the child’s reasoning.

The mothers’ voices can be heard in the students’ comments. One student, reflecting on something he had done, says his mother thought it was “stupid.” Another student says, “I didn’t know until my parents told me,” about the school considering

63 transferring him to an alternative school. He reflects later while talking about seeing the school social worker, “Like, my mom knows this, I don’t like talking about stuff that makes me angry.” One of the youth reasons why people say hurtful things to him. He states, “They’re trying to get attention from people. Like, maybe their parents are not giving them enough attention or they’re doing it, for just the fun of it. But they’re actually bringing themselves lower.” His mother’s reasoning can be heard in his own response.

Later, while talking about a medical procedure he has to have that frightens him, this youth states, “My mom wants to give me, she thinks I should be knocked out.”

Relationship with others.

The youth in this grouping are emotionally connected with their immediate families. They all have siblings they live with and talk about them sporadically in the interview. They muse about what it’s like to be in their position in the family, whether it’s oldest, youngest, or in the middle. They talk about sibling squabbles, but also talk fondly about their siblings. One youth explains, Sometimes my brother is pretty crazy. My sister is not that crazy. They do a lot of the same things together. I want to play with my oldest brother, but he thinks he’s big and cool. If I was the oldest, I wouldn’t.

Mention of their fathers is largely absent in this grouping, although they all live with, or see, their biological father on a regular basis. When the youth mention their fathers, it is generally to say what kind of work it is they do. Hank identifies with being able to work with his hands like his dad does. Kenny talks about his family’s life “before he was a twinkle in his father’s eye.”

64 Friends in this grouping take on different significance depending on the participant. Annie can identify one friend who she calls her “best friend,” but sees infrequently. They do not go to the same school. When asked if she hopes for anyone in particular to be in her class when she starts school this year she says “no” and then states, “I’m open to meeting new friends.” When asked who she hopes to see during the school day, she responds she doesn’t really care. She says she never really made friends with the other kids in special education and that mainly her friends were at the neighborhood school, although she never sees them.

Hank has one good friend. He says, “Me and my friend go a long way back. He has kinda like what I have. Some of it’s similar, but some of it’s different.” He describes how he and his friend “mess around” in school and enjoy each other’s company.

When asked if he has friends, Kenny says, There’s this group of kids who really like me. They think I’m nice and funny and stuff. They’re like the jockey-type kids, and, um, they just think I’m funny so I guess I’m acquainted with most of them . . . I’m friends with this other kid, well, more like an acquaintance, but, like, we talk and I like talk to him and stuff, cause he’s like friendly and stuff.”

He then muses about the one person he identifies as his friend: I know this one kid who’s in his own planet kind of like, and I’m friends with him, because he doesn’t really have any friends and I don’t really, either, so I’m just like, yeah, I guess I’ll be friends with him . . . he told me, “Oh, I have Asperger’s, I have ADD, I have ADHD” and stuff like that and at first I was talking to myself, like in my mind, Kenny, why do you want to be friends with

65 this kid? This kid is on his own little planet or island or whatever, so whenever he argues with someone he says, ‘I don’t care’ and just stops there, or he’ll say the most random things or he’ll always be like making a joke out of things. I guess he can’t help it maybe and then I just think that and then I’ll be fine. But, yeah, I’m friends with him. Overall, he’s a nice kid, so, and he likes playing video games like I do, so.

Mike says he knows all of the students that are in his grade and he is friends with most of them. He reports peers never say anything that hurt his feelings. On the contrary, he appears to be popular and a leader among his peers. He thinks his friends would describe him as “totally awesome.” He has one particular friend he does things with outside of school. This student is also in a behavioral program. They do a lot of risky activities together.

Two of the students say that peers make fun of them frequently. They both take a philosophical attitude towards this. One student relates his peers taunt him: “They say, ‘Hey, look, there’s a retarded person!’ And then I just walk by and ignore them, just pretend they’re not there, just keep walking to class. . . It’s just, they’re trying to get attention from people.”

The other student states: Other people would probably, like, some people would describe me as, ‘Oh, this kid’s so funny. . . And then some kids would be like, ‘Oh, that kid’s such a jerk.

No one likes him.’ And then, some kids would be like, ‘Oh, that kid’s awesome.

He’s really nice and stuff.’ Some kids would be like, you know, ‘I just don’t like

66 him. He’s just not right,’ . . . You know, some people just have different points of view.

Interaction with investigator.

The School-Focused Group viewed the interview as something their mothers wanted them to do and something they didn’t mind doing since they received a $20 gift card at the end of the interview. They were polite to the interviewer and sincere in trying to answer the questions they were asked. Once the interview was underway, they became engaged in the conversation and wanted the interviewer to know their view of things: how they felt about the decisions that had been made about their schooling; how they feel about their behaviors; why they react the way they do, their likes and dislikes. They enthusiastically shared stories about their lives.

The mothers in this group wanted their children to participate in the research because they wanted their children’s stories told. All of them felt their children have survived against difficult odds. The mothers state they often felt they had to push hard and be a strong advocate in order for their children to receive the supports and interventions necessary for them to receive an adequate education. They all say the schooling process has not been easy for their children. They have been frustrated many times and hope that by their children giving voice to their experiences, perhaps others can hear and learn from them and make the road a little easier for others.

67 View of self and others.

The youth in the School-Focused Group generally view themselves in a positive light. They describe themselves as having positive attributes. “I would say I’m adventurous, I like to explore new things, sometimes I’m picky about stuff, I’m a pretty go-with-the-flow. I’m social. I’m anti-shy—I’m not shy.” “I’m awesome. I’m strong, good at fishing, good at lacrosse, and funny.” Another volunteer feels good about himself and likes things how they are now.

They each can point to things they are proud they have accomplished. Some of their descriptions include: “I actually was proud of myself because I made an accomplishment and I was able to cope to go back to my neighborhood school for all day.” “My strength is being really good, really coordinated in the arms.” “It feels good that this year I’ve improved so much.”

They think that others think well of them: •

“Teachers would describe me as a really, really nice kid. They care a lot about me.”

•

“Teachers would say I’m smart, intelligent.”

•

“I think the teachers were really proud that I was trying my best.”

•

“Friends say I’m funny, cool, beast. Beast means like, awesome, totally awesome.”

•

“My mom and dad would say I’m smart, I can behave, I know how to do stuff if I try.”

They are also able to take a rather sophisticated perspective on others’ view of them that don’t view them so well:

68 You know, some people just have different points of view. People I’ve gotten in fights with in the past or had arguments, or people that just plain old don’t like me have different opinions than people who are like, “Oh, this kid!”--the jockey type fellows who think I’m funny, who like me and stuff.

Another volunteer, when asked how he feels when other kids insult him says: I go by an old saying, “Don’t judge a book by the cover.” Some people judge the people on the outside, they don’t judge people on the inside. Let’s say for instance you’re friends with an overweight person and another guy makes fun of that person that you’re friends with, but he’s only seeing the outside. But, when people get to know the person they get to know them better so they don’t have to make fun of them. If you don’t know the person, don’t judge them. Just try to get to know them.

One of the volunteers, when reflecting on peers says, The regular kids? [laughs] They sort of interact, but they don’t like interacting with people with brain problems. They like to interact with people like their own.

I don’t know why that is. They just like to interact with their own kind. I like to interact with both because I like to meet new people. I’m not really a shy kid very much.

The students at times are able to separate their school placement from the essence of who they are. One student says, “I never really thought about it that much [being at a therapeutic day school]. I think it was just, like part of the routine of the day.” Another

69 student accepts that he is in a self-contained classroom and says he feels comfortable there.

At other times, these youth struggle with thinking they might be “different” or thought of as being different by others. One participant doesn’t like his class being any different than the general education classes and wishes they were the same. This group’s interviews are scattered with comments such as: • “This way I was the same.”

• “I’m in, well, it is a regular class, it’s just for a little more extra help, and like, they call it Special Ed, I really don’t like that name. It sounds like I have Down Syndrome, or something like that, or I don’t like it, but anyway.”

• “We, um, in each class we try to review what the kids in the normal, or not, like, in the other class, in the higher range classes are doing.”

• “Kids at school think of anger management as they’ll get so mad that they’ll beat you up right away, or something like that. They’ll get angrier quicker than others. I don’t like to think it like that.”

• “In first grade I was just a normal kid and fine.”

• “Half-day I was like a normal kindergartener.”

• “I don’t like it because I just feel like they’re making kids feel bad because they’re putting them in a lower class and then there’s a kid who got into a really high class and I’m still in the lower class, or something like that.

So, I mean, I guess it’s unfair is what I’m trying to say.”

70 Two of the students identify “their class” as the general education class in their neighborhood school, of which they are not a part. Another student says, “It feels good that I’ve improved, but they’re still keeping me in the special ed classes for the rest of the year.”

Sometimes the students differentiate themselves from other special education students by talking about “them” and making the point that they do not need as much help, or they are able to go out into the regular education classes more. One student remarks, “And I was in the room and I was just sitting on the floor with my friend, and we were kind of laughing [at the other kids].” This student says he didn’t have problems like the other kids at the alternative school, so his mother removed him from the school.

At other times, they recognize their reactions are different from the school norm.

Kenny states, “My problems are a little, tiny bit different than other kids. Kids don’t get as angry as I do. Or something like that, I guess . . . I just think of, like, there’s kids obviously with worse problems than me.” Hank says, “[My emotions] are a lot different [than regular kids] because other people can deal with their emotions, but some people like me can’t deal with their emotions as well as people, like regular people can.”

They can also be generous towards others. Hank says: Maybe they have issues, they can’t speak, or they can’t learn. My mom knows a friend, we know a friend, she has two boys who have a genetic disorder. They can’t speak or anything. Their only way of talking is by poking you. That’s the only way they know how to communicate. And they’re very nice people if you get to know them. They like to pull on my hair [laughs]. Yeah.

71 Home-Focused Group

Source of problem.

There are four individuals in the Home-Focused Group, ranging in age from fourteen to sixteen. In contrast to the School-Focused Group, the Home-Focused Group students see their problem as originating early in life, before school even began. None of them live with their biological mother and they all state this is their problem: their biological mother is not in their lives. Now between the ages of fourteen and sixteen, these four youth talk a lot about their early years. Three of the youth have never lived with their birth mothers, while the fourth lived with her mother until being removed from her care at five years of age. This youth has been in the foster care system since then. The other three youth live with biological relatives. Two have been with the same relative since birth or shortly thereafter. The other youth has bounced around from home to home for much of his life. He has been living with his current relative for a little over a year. As one volunteer put it while talking about his biological mother, “That’s the only problem I’ve been having in my life.” The others echo this sentiment. They are consumed with thoughts of their mothers, while rarely, if ever, seeing them. As one participant explains, “I’m OK having ADHD and everything . . . it’s just my mom gave me away in a bar when I was ten days old.”

Similar to the School-Focused Group, these students are also being treated for other disorders including ADHD (two students), Bipolar Disorder (one person), Depression (one student), and Learning Disability (one individual). These four participants are on medication as well for various emotional or behavioral reasons.

72 These four participants are aware that their behaviors do not conform to school standards. Two of these youth have spent at least several years in a therapeutic day school. The other two were in self-contained classrooms for at least one year. All four receive some type of special education services for inappropriate school behavior. All have been in multiple schools, whether due to moving or due to being transferred within the school system from one school to another, mirroring some of the inconsistency in their home lives. Despite this, school, and their behavior at school, is not a major concern for any of them. As one student puts it, “School’s kinda like a hangin’ thing in the back of my head.” They recognize there are problems at school, but there are much larger problems on which they are focused. Another student says, “I love school, half to death.

If I could live at school, I would, because that’s the only place I can actually get away.”

Contrary to the school being the source of her problems, for this youth, school is viewed as a sanctuary, a place to get away from her troubles. One participant says, “School’s not bad. The school is really cool . . . I have no problems at school, whatsoever.” The schools may have problems with having these young people as their students, but as far as the students are concerned, they do not have problems with the schools.

These four participants worry about their “mental problems.” One student states, “I know it’s [the problem] all pretty much in my head.” Another says, “I think I have psychological problems because I got a really bad anger, temper, whatever.” Still a third acknowledges, “Stuff that really shouldn’t bother me, bothers me.” The fourth participant states,

73 I have, like, five disorders. I don’t really know half of them. It’s just, it’s kind of hard, but, like, visiting my mom, that’s not a disorder, because I can actually visit her, but like, [big sigh], it’s a lot to handle.

How to cope.

In contrast to the School-Focused Group, the children in the Home-Focused Group do not spend a lot of time worrying about their acting-out behaviors at school.

Since they do not see this as their primary problem, these behaviors are not the focus of how to cope with their situation. They readily acknowledge that when they get angry they respond by “throwing fits” or resorting to violent behavior. They observe their own behaviors, but speak about them seemingly without caring how this may be impacting their school lives. One participant observes, “So, like, if you misbehave at school, then they’ll send you to a different school immediately. It’s kind of hard, but, ehh, I can deal with it.” Another student states: I had my little behavioral issues at the first school I went to. I don’t know. I had my behavioral issues up until I left my grade school. . . It was just like screaming, yelling, and then later on, there’s just slight acts of just violence, throwing books and stuff . . . . So I went to the next school, but I got kicked out of there because, you know, I wasn’t very, you know, I still had the behavioral issues and I used to act up.

Another participant reflects, “Surprisingly, I don’t really fight a lot in school.

Kids with anger management, you’d almost have to think that, even though they have the

74 medicine in them, if kids start doing something, you’d almost have to think that they get mad very easily, but, I would say, I don’t really.”

Instead, the focus is on their behaviors at home and how their behaviors are the result of not having their mothers in their lives. One youth states, I actually did almost hurt a kid once, but that was it. But, the only reason why I almost hurt him was because, like, I don’t really wanta—I don’t know if I should talk about my life story, but, I don’t say it too many times, but the thing is, um, the person I call now is Mom, basically, she’s actually my grandma.

Another student says, It’s hard [being transferred to an alternative school] because I tried my best to try and, like, try and not to do certain things and I ended up doing the wrong thing instead of the right thing and I—[big breath]—I’ve been in foster care for at least, since I was five-and-a-half years old.

One youth contemplates, I get in trouble a little bit more, but I usually hold my anger in when I’m at school and when I get at home, I usually let all my anger out. . . . And it’s like I have all these outbursts and everything at home, I mean, I put probably five holes in the wall because of my anger.

Another participant remarks, “I said I was here [Outward Bound] because I need to know the concept of getting along because I was yelling at my mom a lot at that point in time.”

The youth inevitably link their acting-out behaviors to thoughts of their mothers or their homes. This is exemplified by one participant who states,

75 Sometimes [I throw fits], not much. Like, only if somebody tells me “No, absolutely you cannot do that.” Then I’ll go, “You cannot make me. I am not your child and you are not my mom, so just back away.” [laughs] And then I usually throw a book or something around [giggles heartily].

Use of action.

This group is more vague about their acting-out behaviors. They generally do not describe what they do during incidents of “blowing up” or “throwing fits.” Instead, they talk about what others do to them during these times. Barbara states, “They’re nice people [school staff] and everything, it’s just if you don’t be good and you don’t behave, like, you throw fits and everything, they’ll put you in lock-down.” All four of these children say that others have had to physically restrain them from acting-out behaviors.

Two students get put in a “lock-box” frequently, a small, padded room with no windows or furniture in it for children to be in until they physically calm down. Carl says his older brother has physically restrained him on a number of occasions to keep him from hurting himself.

In a moment of reflection, one interviewee states: Really, when I’m in these fits, I don’t really mean what I say, but whatever I say just comes out and I don’t really control what I say. . . . When I get into these fits, I actually do think I can’t handle these fits anymore. I mean, the more I get older, the more worse they’re going to be . . . I’m at a young stage, and I’m like, kicking holes in walls and everything. . . but, like, if I do damage to the wall [now], when

76 I get older I can actually have the ability to kill somebody. I’m not saying I will, but . . .

This individual is troubled about his outbursts. He takes the time to consider his actions and think about how they may manifest in the future. This moment is rare in this group. The more general response is similar to Frank’s remarks. He states, “Well, it will be like, I get in trouble, but OK, I did it, it’s over now. I’ll just take whatever’s coming.”

As a whole, this group is less concerned about their acting-out and more concerned about making a connection with somebody, anybody, somewhere. This is demonstrated even when talking about times of uncontrolled behavior. One volunteer explains in great detail what people do to her when she has to be restrained. She is excited while she is talking and demonstrates how staff hold her and pin her down. Even if it is a “negative” connection, it is a connection nonetheless. As she thinks about being transferred to yet another therapeutic school as well as having just arrived at a new foster home she says, Because, wherever I go, that right there is where I’m staying. Like, wherever I go for a little while, that’s where I’m hoping to stay for like, maybe a month or so, ‘cause I don’t really want to go bop, bop, bop, bop.

In the impermanence of her life, one month is a long time, and she dare not hope for more.

Another student admits, “I kinda disconnected myself to my family . . . I don’t associate myself with many people.” And yet, he follows this by saying, “I don’t like being alone” and goes on to describe the great lengths to which he goes so he does not find himself alone anywhere.

77 These four youth have less of a repertoire of things they use to cope with their feelings. None of the youth talk about school interventions or think that they are effective or necessary when asked about them. They consider themselves to be above needing behavior charts. One student remarks: And then they’d always have these charts in the back where we always got stars if we helped the teacher and I mean, really, or if we do good, I mean I literally had a lot of stars because I was usually asking the teacher, “Do you need help with anything? Do you need this? Do you need that? But, I wasn’t intending on getting any stars for it. Usually I just like to help teachers, because usually I’m bored a lot in class when I get done with my work, so I ask them if they need me to carry anything or do this or do that, or help her organize stuff, or, do that and they usually say, sure, you can have this, and so it’s like, I always like to keep myself entertained a lot.

Another student says, “I didn’t really care [about the behavioral chart].” Two of the students say they don’t need school interventions. One student says the school doesn’t have anything that can help him, so he has to help himself.

A distinction of this group from the other groups is their talk of the pursuit of high adventure, dangerous, or illicit activities. One volunteer talks about a game that he and his friends made up that involves a lot of physical beating. Another talks about racing cars at high speeds. Another talks about flipping over in a four-wheeler. One speaks about shooting ducks with a BB gun to scare them but then accidentally killing them.

Another speaks of smoking a lot of marijuana. Rather than these activities being the

78 result of impulsivity without thinking, it seems that they are an effort to keep at bay thoughts that are so troubling and painful to the point of being intolerable.

Use of thoughts.

This group of students rarely thinks about, or cares about, ways to succeed in school. They aren’t preoccupied with thinking about their acting-out behaviors. One participant says, “I honestly don’t know what was going through my head [when having a blow-up].” Another participant says he is just “trying to have fun,” and instead gets in trouble.

Though they don’t spend much time contemplating their school lives, they spend a lot of time thinking about their birth mothers. Again and again, their thoughts veer off to their mothers while talking about their current difficulties. One student talks about the difficulty of being transferred to yet another [therapeutic day] school, but ends up saying, “Yeah. I journal and I scrapbook and stuff, because my mom’s in the last stage of kidney failure.” Another student says, “The only reason why I usually get mad at people is because they talk about my mom and they usually say stuff about her and it gets me mad.” Another participant, while talking about some recent trouble he got into, says, “My mom puts it this way, and I know how it is for her and everything, well, actually my adopted mom, but, I call her mom.” He is talking about the woman that adopted him shortly after his birth, yet the thought of his birth mother intrudes into a conversation that is ostensibly about a recent behavioral infraction on his part. The other two students say they get angry when others make fun of their mothers. They both tell stories of fighting other students who make derogatory comments about their mothers.

79 All four of the students view teachers in a positive light. They view them as helpful and trying their best to help the students. Frank states, “I mean, they [teachers] try and they try and they try. I never did nothing.” Another participant says, “So there was always one teacher that could always set me aside and she could help with me, like, separately, just help with me.” The students are more emotionally detached from their school behaviors, yet they are able to observe that others are trying to help them, even if their efforts are not very successful.

Other coping measures.

As in the School-Focused Group, these students also make use of avoidance and denial during the interview to cope with painful emotions. They change the subject when the talk gets too close to uncomfortable topics. They deny having feelings about difficult events. In fact, two of the students in this group say they don’t know how they feel about almost anything. One participant explains, That’s just how I’ve known my life to be. I just don’t feel—I’m never angry, ever.

It’s like I burnt myself out or something . . . At points I know I should be angry, but, not during it, no. I’m just, like, indifferent. I don’t know what to say. I don’t know what’s going on. I don’t know if there’s, like, I know it’s happened, I don’t know how I feel about it.

Another volunteer says, I don’t let it bother me. I guess that’s kind of how I survive. It’s how, I don’t feel it. I don’t let it bother me. . . . I haven’t gotten mad in a long time. But, right now, I just start to lay down.

80 As he talks about being on probation for getting in trouble with the police he states, “It’s just like, I never had a home, I got in trouble a lot so, I still say I don’t care.

But, I just try not to let it, you know.”

A participant muses, “Sometimes I don’t take “no” very good. It hurts me and then I won’t do it again. I won’t even bother next time.” He doesn’t ask for what he wants for fear that he will receive “no” for an answer. He has given up on trying to get his needs met. At other times, the students convince themselves that they don’t mind, and they actually at times enjoy, the consequences they receive. One student says, “Ehh, it’s kind of fun [in the lock box], but still.”

One interviewee copes frequently through the use of fantasy. After talking for some time about how she was removed from her mother’s care, she says she would like to live at the school with her mother and then she talks about being able to fly. She says, “It’s really, really fun whenever you get to go and dive off the diving board and then you fly, especially if you have bird wings. I’ve actually done it before. Yeah, and it was actually kind of fun [giggles].” She also talks about her father. “My birth dad is a truck driver and he explores everywhere that you’d imagine, like all the 50 states and everything. He goes to Hawaii sometimes to deliver a load.”

Relationship to mother.

In contrast to the students in the School-Focused Group, all of whom live with their mothers, none of the students in the Home-Focused Group live with their mothers.

The early histories of these children are known mainly through their eyes, but it appears that three of the birth mothers were only marginally, if at all, involved in their children’s

81 lives for the first years of their lives. For two of the children, their grandmothers became their primary caretakers. For one child, this grandmother remains his primary caretaker.

For the other child, the grandmother moved away when he was three or four years old, leaving him in the care of another extended family member.

The remaining two children have had a variety of caretakers. One child was removed from her birth mother’s care when she was five-years-old and has been in the foster care system since that time. She has lived with multiple foster care families. The last youngster has lived with a number of different members of his extended family throughout his life.

None of these children have regular contact with their birth mothers. They all see their birth mothers occasionally. Woven throughout these children’s interviews are longings for actual relationships with their birth mothers. Barbara talks extensively about her mother throughout the interview. She has fantasies of helping her mother. She says, “I’m planning on protecting her for the rest of her life, whether it costs me my whole entire life, my job, or anything.” She talks at length about her mother’s poor health and how she, Barbara, is going to help her mother. She fantasizes about how she will help her mother with the $20 gift card that she will receive at the conclusion of the interview.

What I’m going to do with that gift card is go and buy her [mother] some stuff, like, vitamins and stuff like that where she can actually take it and it can actually make her feel better and then give her a lot of energy and stuff.

And later in the interview, “Still, that 20 dollars, I’m planning on buying me a little bit of something, like, maybe 5 or 10 dollars and then go and spend all of the rest on her [mother].” Still later, “I’m planning on buying her a credit card or

82 something. I don’t know why, but, something that’d be in my name and I could go and help her, like buy, like, gum to quit smoking and stuff.” She then states: Because my mom has protected me for the past 14, 15 years. Oops, 14, 13 years.

I’m going to protect my mom because my dad, he didn’t really protect my mom.

My aunt, she claimed that she was going to go and protect my mom, which she is buying my mom drugs and alcohol and she didn’t even go and buy her what she needed. She didn’t buy her no multivitamin when she was pregnant with me, she didn’t do anything.

Barbara is 14-years-old. Her slip at the beginning of this quote of her mother protecting her for the past 15 years fits in with her thoughts at the end of the quote where she is stating no one was making sure she was being taken care of even while she was in utero. The reason this student is currently being transferred to an alternative school at the time of her interview is because she took what she thought was a pain pill that another student gave her at school. It turned out this pill was actually a prenatal vitamin.

Carl, in talking about a fight he was involved in with another student, interrupts himself and says, I don’t know if I should talk about my life story, but . . . my biological mom didn’t really want me, cause when I was a baby she always gave me away to people, didn’t really watch me, gave me away in the bar and everything, to people when she’d always go up there . . . that’s the only problem I’ve been having in my life.

Carl has been living with his grandmother most of his life. She adopted him and he calls her mom. He says,

83 But my mom puts it this way, and I know how it is for her and everything, well, actually my adopted mom, but, I call her mom . . . I don’t say it too many times, but the thing is, um, the person I call now is Mom, basically, she’s actually my grandma, she adopted me because my biological mom didn’t really want me.

George talks several times about his mother during the interview. He says he has never lived with her and then says, “I don’t know [how I feel about that]. I mean, I, I, I’ve never lived differently.” He remarks a few times that “it’s not easy for me to get to her” even though she doesn’t live far from him. He says it’s “just inconvenient to get to her” and he does not see her much. He concludes by saying, “She just had another kid.”

His primary caretaker is an extended family member. He says “I have a solid relationship with her. It’s not as good as it could be because I’ve been out of school and now I’ve been away from home for awhile, but I have a pretty decent relationship with her. Yeah, I have no complaints.” However, he says he is rarely home and spends most of his time at other people’s houses. When George talks about his primary caretaker, he talks about her as an equal. He says, “We [he and his primary caretaker] never really got me tested for it [ADHD].”

Frank says his mom left and “did her own thing” early in his life. He lived with his step-dad, who was his primary caretaker, during those years. He states: I miss my step-dad. As much as I hated him. He was so mean. Cause, like, every little thing that I did wrong, I was hit. But, then I tried to learn. I realized I had to spend time with him. . . . As much as I hated him, I still love him. I mean, like, I guess he just wanted me to do good and grow up and, not get in trouble and stuff.

84 He wanted me to come out, like, a good kid. He wanted me to be a good kid. I always wanted a family of my own growing up.

He says he has seen his mother only a few times. He then states, “I don’t let it bother me. I guess that’s kind of how I survive. It’s how, I don’t feel it. I don’t let it bother me.”

Two of the students in this Home-Focused Group are protective of their mothers and defend their actions. The student who was removed from her mother due to neglect and abuse blames the Department of Family Services for this, saying her mother hit her “accidentally” and she was very angry being taken from her mother. The other individual says: I don’t blame her [his mother] for not wanting me because I actually, she was probably 20. I’m not saying that’s a good age, but in the position she was with all this drinking and everything, when she was pregnant with me, I just really think she was at that young adult stage where she wasn’t ready to have a kid because she was in that drinking stage and everything and I don’t really think she was ready for me.

Relationships with others.

The youth in the Home-Focused Group come from large, complicated family systems, with many half- and step-siblings, cousins, and adult figures. Three of the youth live with an adult from their extended family. They show respect for this adult, yet make it clear that she isn’t their mother. The one youth says if he could change one thing in his life, it’s that he wouldn’t have run away from his step-father’s in the first place. “It’s not

85 that I don’t like it that I be here [with his relative], I love it here, I love being here with everybody.” However, he talks about missing his younger sister and half-brothers (who live with his step-dad). By running away from his step-father, he also left the individuals that were his “real” family.

Frank says he has a number of friends. He has one friend he identifies as his “best friend.” He says, “We’re always together and stuff.” He says: [My friends] call to do stuff a lot. I just never ask to do it. I guess, sometimes I don’t take “no” very good. It hurts me and then I won’t do it again. I won’t even bother next time. And then I get sad that I didn’t go, but, I mean, the main thing is, they’re like, at least try, man. And, I say, I will, right after school. But, then, I don’t usually ask. I don’t want to get yelled at, “Next time, clean your room.”

Frank notes that he acts differently around his friends than when he is at home.

“At school I’m totally different than when I’m at home. I’ve always been like that. I’ve always been really, like, excited, playing around while I’m at school. I think it’s just because I’m around my friends.”

Carl calls the relative he lives with “mom.” He reports, “She actually cut my umbilical cord. She gave me my first bath and she held me because my mom just said, no, she didn’t want to hold me.” He sees his mother now and he states, When I’m alone with her [biological mother] she says that she has done all this and she was at the court cases and everything else and like, I’m in the middle, it’s like between my [relative]—well, mom—and J [birth mother]. It’s like a tug-ofwar because I don’t know who to believe.

86 He calls his cousins, who he lives with, his brothers. He states, “We [brothers] have our ups and downs, but we get along very well generally. We get in trouble together, basically.” This individual credits his older half-brother with saving his life multiple times, both from him committing suicide and from near-fatal accidents.

Carl recounts going on Outward Bound and becoming close to the others on the trip. He remarks, Well, I was actually surprised [they accepted me] because I thought they were going to think I was kinda weird. . . . My people who, at the beginning of the trip were just complete strangers, by the end of the trip didn’t care that I had problems. I mean, we all just got along. They accepted me. They didn’t care if I had problems or not.

Carl states, Sometimes [I become friends with the wrong people] because, I’m friends with a guy, I’m OK with him, but me and him always goof around a lot and we usually get yelled at by the teacher in the class. But, I’m still friends with him, I don’t really care.

Barbara, the youth in the foster care system, has virtually no connection with any of her family, except for occasional supervised visits with her mother. She talks about her biological father saying, “It hurt when he left. He’s hard to deal with. He only thinks about himself. He is very, very selfish. Even though he has 10 kids. Me, I’m the ninth one.”

87 Barbara says of the many teachers she has come in contact with, “They’re nice people and everything.” She indiscriminately makes friends with everyone and anyone.

She considers anyone that she meets to be her friend. She says: It’s just, you don’t get to make as many friends if you move a lot, but, like, I’ve gotten so many friends. Right now I have two friends at the one school, two friends at the second school, and then, 10 or 15 friends at middle school. And then, my ex, and my other boyfriend, my boyfriend goes to middle school and two or three of my exes go to the school I’m going to be going to. So I may just break up with the one boy and go out with the other boy.

She observes that her friends often get her in trouble. She talks about her latest incident where she was expelled from school saying “It was a big, big, big mistake and I’m not friends with that person anymore.”

The last individual in this grouping has a large, extended family that he has access to when he chooses, but he generally does not see his family. He states, “I kinda disconnected myself to my family. I’m never home. I don’t like being home.” He stays at his neighbors a lot and says of them, “We’re really a tight-knit kind of, like, I’m part of the family. They love me.” This individual has a best friend. He says: We were just instant friends and then we started to realize how similar we were and how much we understood each other. I constantly need to be talking to this kid. We’re really therapeutic to each other. I swear . . . we’re almost the same person. It’s really kind of weird. . . . He’s like my best friend in the entire universe and we’re pretty sure we were meant to be each other’s soul mates. We’re that close. We understand each other completely.

88 Interaction with investigator.

The interviews had great meaning for the students in the Home-Focused Group.

As part of the consent process, all the youth were informed that if they agreed to participate in the research, their participation would consist of one interview approximately one hour in length. They all agreed to this and verbalized their understanding. Yet, two of the youth in this group wanted to know when their next interview would be and expressed disappointment when reminded there was only one interview. One youth, responding to the fact that her actual name wouldn’t appear in the written report says, “I’d like you to, to where they knew [laughs]. You could put, “Special resident.” Another youth asked if he could be sent a copy of the transcript of his interview. After the interview was over, the youth remained physically close to the investigator while she was there rather than go off with the other youth who were present.

Another participant, who learned of the research through a mutual family friend, asked at one point in the interview, “Do you remember when that [an incident when he was two-years-old] happened to me? I don’t know if you remember that.” One week after the interview of another participant, the investigator needed to call his primary caretaker regarding some unfinished business. She reported that “all of a sudden” the research participant was studying, doing his homework, and not getting into trouble. “I don’t understand it,” she said. “Nothing has changed. Nothing has happened since you interviewed him.”

The youth in the Home-Focused Group formed a strong alliance with the investigator almost from the beginning of the interview. One of the participants,

89 betraying her initial anxiety, said to the investigator at the start of the interview, “You’re so much prettier than I thought you would be!” She then went on to form a strong, positive attachment, telling the interviewer she had eyes like her sister, asking the interviewer if she had ever had a baby, telling the interviewer she “might want to go with her” when she needed to use the restroom. She stated, “You know how my wrist is small and stuff compared to her [her mother’s],” as if the interviewer knew all about her and her mother. Later, this same student declared, I could sculpt you right now, and it, like I could do your hair, and everything, just perfectly the way it is. And I could like make a shirt in clay just like yours, and I could make the earrings like that, and dangle off, and it would be clay.

View of self and others.

Students in the Home-Focused Group do not like themselves. One says, “I don’t like me.” Another responds, when asked to describe himself, “I don’t know. Awful.”

Another participant says, “The more I get older, the more I get worse.” Yet another student says, “I try my best, but I still end up doing wrong.”

They are not preoccupied with how others view them. It is striking that in these interviews, only one participant compares himself with his peers and this is done briefly.

He states, “Basically, in my perspective there’s three different categories, one is like the regular, then there’s like me, but then there’s the other kids that really do have more worse of the attention deficit, they have to be in the wheel chair and everything.” They don’t think about whether or not they may be different than others. As one participant states, “Maybe some people think I have mental problems. I don’t know. I don’t care.”

90 As painful as it is for School-Focused Group students to be segregated from their peers, this is not an issue of major concern for the youth in the Home-Focused Group.

They recognize they are in special education. None of them like getting moved to different classrooms, but it does not occupy their minds. They have other concerns.

Unique to this group is the extent to which they tell stories about themselves that are stories of escaping dangerous situations, participating in high-risk activities, stories of excelling way beyond their peers, or stories that are told as actually happening but leave behind reality for fantasy. Some examples of these comments are: •

“I woke up and I was still in the same position [in the canoe] and I was happy for that. The only problem is, I woke up and there was a poisonous snake right next to me.”

•

“I was like, man, if we don’t keep on paddling, that sucker’s [an alligator] going to probably come out and grab one of our canoes in half. I know that for a fact.

So, I just didn’t want to run into a big one. I didn’t mind a little one, but, I mean, I asked the instructor numerous times if I could grab a little one but they always said, ‘no.’”

•

“I was riding it [the motor bike], and I’ve done it numerous times before, but it doesn’t mean something bad’s not going to happen, but I realize I didn’t hit the brakes sooner and slow down, but I always hit the gravel patch. I just always like to slide, and I was going just a little bit too fast and I hit the concrete and I kind of flew off. I got up laughing.”

•

“We [he and his friends] know how to sword fight and we have really high pain tolerance. We would take down branches and take them to the face. Cause we

91 were weird. We invented the most brutal game in the history of brutal games invented by twelve-year-olds.”

•

“They had to go put me in lock box and they always put a tranquilizer right here and push it, like this, and the needle was about that long [indicates six inches], and then, the thing where the medicine is, about that long [another six inches], and the pushy thing, whenever they stick it right there, wherever your birthmark is, they’d stick it right there, and they went and pushed it into my stomach and I screamed twice whenever they pulled it out and pulled it in.”

•

“Clay and play dough put together like, if I want color, different colors, I would put flour, butter, eggs, and, I make my own stuff sometimes. Like I’m trying to learn how to make the stuff, like from scratch, like the ingredients and everything.

Normally I make pizza dough stuff and I mix it in with all kinds of special colors.”

Similarly, their hopes for the future are less reality-based than the other two

groups. One plans to go to a top university in the country even though he is currently almost failing out of school. Another says he wants to work with alligators or be a freestyle motor cross rider, such as an individual of fame who he knows jumped across the Grand Canyon. The other hope is to have a family, to be with a parent they are not with currently.

92 Globally-Focused Group

Source of problem.

The Globally-Focused Group consists of five individuals ranging in age from twelve to fifteen. This group of students speak equally about problems occurring inside as well as outside of school. Inside school, they wrestle with frustration over school work that is too difficult, being singled out as “different” due to receiving special education services, and not getting along with teachers or other students. Outside of school, this group struggles with family financial hardships, parents paying scant attention to them, and/or removal from their mothers and placed in relatives’ care. Two of these students live with their biological mothers, one lives with both biological parents and two live with extended family. The two living with extended family were removed from their mothers’ homes by the Department for Children and Family Services.

One student is in a therapeutic day school, one is in a self-contained room, and the remaining three receive special education services both within a general education classroom and a Learning Resource Room, a room to service students with IEPs staffed by special education teachers. One of the students is on medication for ADHD. The remaining four receive no medication. Three of the students also receive IEP services for a Learning Disability in addition to their Emotional Disability.

All five of these students live in households of financially low income. One student is currently homeless. She and her mother are temporarily staying at a friend’s home. Three students live in subsidized housing. During the interviews, it seemed that two of the volunteers were participating in the study to receive the $20 gift card not just

93 as a thank you for their participation, but as a way to supplement the family income. The mothers of these two students told me over the phone prior to the interview that their child would like the gift card for a local superstore without first consulting their child, as the other participants’ guardians did. (All of the other participants in the study chose gift cards to toy, game or sports stores.) The children assured me when I initially arrived to speak with them that they were voluntarily participating and no one was forcing them to do so. Despite this, 20 minutes into the interview, one of these participants said to me, “What about the $20?” The child indicated he didn’t want to talk anymore and wanted his money. The interview ended at this point and the volunteer was given his gift card.

These five students talked intermittently about difficulties at home as well as difficulties at school. They had concerns in both places. Four of the five students talked of life being better before they moved to their current residence: three when they lived with their original primary caretakers, and one when she lived in an apartment with her mother before they had to move in with friends. These external factors in their environment and the losses of important figures in their lives, which will be discussed further under the section about Relationships, impact how they currently perceive their problems. One student says, “It was better where I used to live [with mom] rather than here with my relative. I didn’t get in trouble then.”

One youth declares he has bad behavior at home and at school. He says he learned this from watching his parents fight at home and watching one of his friends have outbursts at school. Another participant says he worries that he will get in trouble both at home and at school. He gets into arguments and fights at school because other kids are mean to him. At home, his mother doesn’t pay attention to him.

94 Another student states, “If you don’t pay attention in class, they yell at us, they kick us out of class, that’ll be four demerits. And I be like, ‘Oh my god.’ So, I’m just trying to get these four years [of high school] over with.” She currently lives with a relative, who is worried the youth will be expelled from school. Once she finishes high school, this participant plans on going back home to live with her mother. A fourth youth says she misses her mother, but she doesn’t want to end up being like her mother. Life is very different in the city with her relative and she often feels scared. Many times, she is too tired to do her homework.

The last individual in this category is distressed about being in a self-contained classroom. She states, “I don’t belong in that classroom [self-contained room]. ‘Cause some slow kids are in there. And they kind of embarrass me. I’m not like them.”

Currently in eighth grade, she is new to her school this year. She says she has been in a lot of different schools in her life. She is thinking she may only be in this school for a short while. She is hoping her mother will find an apartment where they can live so they don’t have to live with their friends anymore.

How to cope.

The youth in the Globally-Focused Group talk about problems both at home and school. There is a more fluid feel to their musings. What troubles them at school can also be troubling at home and vice-versa.

Larry states: That feels kind of good and kind of bad [using a behavioral chart]. The good reason because the teachers actually know that you’re doing good, you’re safe,

95 and you’re respectful. The bad thing is that it shouldn’t really, they shouldn’t really be doing that. They should just have, like, a safe and respectful on it. But, responsible, the teachers should just know if it’s a one or a zero. It’s just not very nice to kids that forget their homework every day. It’s not really fair to them because they want to reach circle and make their mother and father or whoever they live with, proud of them.

Another youth states: Like, my grandma’s so scared that I might get kicked out of that school, cause one of these days I’m going to yell at them, cause some of the teachers I don’t like in that school, cause they always give me demerits for little things. Like, if I even breathe hard, I think she’s going to give me a demerit.

These youth think about their school misbehaviors, but their thoughts are also occupied with issues at home: wanting to go back to live with their biological mother; trying to get mother’s attention at home; and worrying about economic hardships. They attempt to cope in a variety of ways.

Use of action.

All of these youth except for one admit to frequently arguing, getting angry, and fighting. The fifth person says she gets angry often, but withdraws and doesn’t speak to anyone when she is angry. Three of these youth are focused on behavioral intervention strategies at school. They have behavioral charts and use them to a degree, even if somewhat reluctantly. Evan is knowledgeable about his behavior chart and tries to get a sticker each day. He identifies taking time-outs as a beneficial strategy for him to use

96 when he gets upset. Iris is on a demerit system at her school. She does not like it and thinks the teachers are unfair in giving her demerits. She says, “I got kicked out for crumpling up paper and, um, what else did I do? For sneezing. I sneezed and they thought I was just pretending, but I sneezed because I had a little scream in my sneeze.”

As a whole, this group uses people to help them control their emotions more than things, such as charts or assistive devices. This group likes going to the school social worker or therapist to help them. Three of them are also able to use a favorite teacher to help them calm down when they are angry. One student says, And then, my teacher just, my teacher knows why we do it, cause, cause, we had an IEP meeting not too long ago. She said I do my work and she knows that, if I, she could tell by my face if I don’t get the work cause I be like, what? I don’t understand this.

Another student has befriended almost every staff person in the school, from the custodian to the principal, and utilizes their support as needed. They also use their friends to help them calm down when their anger starts to escalate out of control. One interviewee says, Like my hands, sometimes they’ll turn red [when I’m angry]. My hands turn red and they’ll shake. Or my nose, my friend’s like, “Girl, your nose turning red.”

And I’m like, I’m getting angry cause the teacher say something to me and my friend trying to rub my back. It helps, a little bit. And like, she’ll hold my hand and go like this and massage my hand.”

97 Use of thoughts.

These youth think some about their acting-out behaviors at school. They do not like being in an alternative academic setting, so try to behave so that they can be mainstreamed into the general education classroom. The thought of being expelled helps one participant to control her behavior. “I don’t [get into fights] cause if you do, you get kicked out. You get 10 days suspension and expelled.”

These youth tend to minimize their actions, saying they get punished for innocent actions and accidents. In beautiful detail, one youth explains a recent incident and her thoughts and feelings during it: And, like the other day, no, it was yesterday, we had picture day and I was wearing my bow and my teacher told me to take out my bow and I was like, no, because I measured before I left the house and it’s not over 2 inches [the maximum length the dress code allows], so I walked away. So, she gonna come up to me and I felt my body in a hot. And my friend was talking to me and she said, “Calm down.” And I was like, “If you don’t leave me alone. Please, leave me alone.” The teacher came up to me and she was tapping me on the shoulder, and I was like, “Can you get away from me? For real.” And she’s like, “Don’t you ever talk to me like that. That’s a demerit.” And I’m like, “I don’t care. Like, I’m not taking out my bow.” And she took the ruler and she was, just, like trying to measure my head and I was moving, I was, like this move, just move around, and I went to class and then the dean of discipline came and got me out of gym class, talking about, “You have to take that bow out or you’re gonna go to detention.” I told him, “I’m not taking my bow out,” and he was like, “OK, you go to the

98 principal.” So, he took me to Ms F [the principal]. And me and Ms F is like, really close, umm, yeah, and she’s like, “Ms J, can you please take your bow out for me?” So, I took it out for her. I was, like, “Here.” And she was like, um, she measured it, and she was like, “It’s 2 and a half inches.” I was like, “What you mean? I just measured it before I left the house.” She was like, “Did you wear your glasses?” I said, “No.” And, she like, “OK, well, I’m going to keep it until the end of the day.” And then Ms S came and messed with me the whole day about it. Like, she be picking, like picking at me and stuff. That’s my advisor. I don’t like her. I can’t stand her.

The retelling of the incident by this student is salient for a number of reasons. She tells of a day that starts out special: she is going to get her picture taken and she dresses up for it, including a nice, big bow in her hair. Her teacher immediately confronts her on the wearing of her bow, saying it breaks the school dress code, and orders her to remove it. The girl really wants to wear the bow for her picture, so she doesn’t comply. Rather, she walks away. The teacher persists and the incident escalates. The student feels her “body in a hot.” Her friend tries to calm her down, but she rebuffs her. The teacher persists, this time physically touching her by a tap on her shoulder. The student walks away and goes to her next class. She is next confronted by the school disciplinarian. She stands her ground: she is not going to remove her bow. At last, she is ordered to the principal’s office, and this is where the story takes a change.

The girl says, “Me and Ms F [the principal] is, like, really close.” In other words, the girl feels respected by the principal and she in turn respects the principal. The principal politely asks her to remove her bow, saying “please.” The girl complies and the

99 bow is discovered, indeed, to be out of compliance with the dress code. Things could have taken a turn for the worse here, if the principal had decided to come down hard on the girl. Instead, she asks, “Were you wearing your glasses [when she measured the bow]?” She maintains respect for the girl and gives her a graceful way to exit the situation. The girl replies, “no,” and the principal politely says she will need to keep the bow for the rest of the day. The girl accepts this and returns to class. Unfortunately, she reports that for the rest of the day, her advisor “messed with me the whole day about it.”

She concludes by saying she “can’t stand” her advisor. In other words, her advisor is showing her no respect, and in return, the student gives the advisor no respect.

To the casual onlooker, it may appear that this girl was breaking the school rules and being rude and disrespectful to the school staff about it. The girl was breaking the school rules, but most likely it was done not out of malice or ill-intent, but that she wanted to look pretty for picture day. She comes from a low-income household and this may be the only bow she owns. However, once confronted in a manner that at the least showed little empathy for the girl’s attempt at looking pretty and at the most, much disrespect, the girl becomes angry and the situation turns confrontational. It takes someone who maintains a respectful stance while at the same time holding to the rules to resolve the situation in a peaceful manner.

Feeling respected is a theme interwoven throughout these children’s stories. One student states, Cause my teacher thinks I tell lies and, our mom, cause in the beginning of the year I believe the parents and the teachers have a little phone talk and then, our mom must have told her that I lie. And so, she really doesn’t believe me. And

100 sometimes I even tell the truth, and our mom doesn’t believe me! I told the truth a lot at home.

This Globally-Focused Group also thinks about concerns at home. One student says she “just takes it” when talking about how she copes with hardships that have happened in her life, such as being homeless, her older brother being in jail and her uncle recently dying. Three of the youth think a lot about the days when they were younger and under the care of a different primary caretaker. They all have narratives about these days and share them with the interviewer in a wistful, nostalgic manner. All three say they wish they still lived where they used to, under the care of the person who used to care for them.

Other coping measures.

As the other two groups, this group utilizes avoidance and denial during the interview when a topic becomes too emotionally charged. They change the subject when something is too painful to talk about. They deny they have feelings about difficult events. One participant says, “For me, I don’t really have my feelings hurt.” They deny needing any extra help. One participant explains, “Going with her [special ed teacher] doesn’t really help me.”

Relationship to mother.

Three of the students in the Globally-Focused Group live with their mothers (one of these students lives with both his mother and father). The other two students live with

101 their extended family after having been removed from their mothers’ care by the Department for Children and Family Services.

The three students who live with their mothers talk about trying to get their attention. Danielle says her favorite person is her mom. When she gets angry she says, “I just don’t talk to anybody, but my mom.” However, she explains, “Most of the time, she be’s at work” and so can’t talk to her. This student is protective of her mother. Her wishes are her mother’s wishes. She talks about the hardships her mother is experiencing and says, “She just takes it. There’s nothing she can do about it.” Mirroring her mother, Danielle states, “I’m pretty much used to it” when commenting on how she copes with family hardships and tragedies.

Another student says he is angry at his parents most of the time for not listening to him. He says he has not been able to see the therapist for several months because his mother has not signed the permission slip in order for this to happen. The third student explains how he tries to get his mother’s attention. He says, She [his mother] would usually say, “What do you want, what the “f***” you want?” She would usually say that, and that would make me sad and sometimes it would make me mad. I would be right next to her, trying to get her attention, and then whenever I actually do get her attention, she usually says that and then I get sad.”

This student remarks his mother “doesn’t believe me or stick up for me.”

Larry lived next door to his grandmother for the first 8 years of his life. She was his primary caretaker as his mother was quite depressed during these years. His grandmother died of cancer and the mother and children moved out of state. Larry, now

102 11 years old, still thinks often of his grandmother. He invokes her memory whenever he has a nightmare or goes through troubling times.

The other two students in this grouping live with extended family. Both talk about their mothers. They are loyal to their relatives, but still long for their mothers. They have personal narratives and memories of being with their mothers when younger. One participant says, My mom had to carry me a lot [at age two when I hurt my toe]. I enjoyed it!

When she carried me. I didn’t have to walk. Mom, she’s cool. She’s like me. I’m like a little her—I never get lonely. Every time I look in a mirror, I see her.”

Another participant states, We be having fun [when living with mom], my mama let me do anything we want. I talk to her [mother]. Like, usually, when she didn’t used to call, like, you know how people call you every day? Well, now she calling more and stuff. Well, they [her brother and mom] live right down the street from each other, so they see each other. I think that’s better for him, so he don’t have to travel no bus to go see her. I never go see her. Um, I don’t know what else.”

Relationship with others.

This group displays mixed degrees of relationships with others. The two individuals who have come under the care of extended family show respect for them, but there is not a sense of emotional closeness to them. They chafe at the new limitations put on their previous freedoms, and voice difficulty in adjusting to new surroundings. One participant states,

103 Umm, I love where I used to live, so, you know, it’s a lot different here. It’s more noisy here. There’s a lot of traffic. And where I used to live it’s much more quieter and we have more room and it’s nicer and bigger and there’s more stuff to do. Here, we have a lot of rules. And mom, we didn’t really have that much rules.

Another interviewee says of her new surroundings, “Because, these kids look extra big. Like, I’m short, like in the class and everybody’s tall and like a giant and stuff.

Whoo! When I first went to the school I was scared.” She continues, I was in my relative’s car, I was looking at how they split up, like black people on the west side and white people on this side, nice houses, and um Mexicans on the different side. Yeah, I just noticed that.

The three youth who have come under the care of a different primary caretaker in recent years have extremely strong connections to their siblings, with whom they live.

Two of these students have older siblings, who they look to for protection. The other youth is the oldest sibling. She takes on the role of protecting her younger siblings. Iris states, “I’m proud of being the best big sister. Whatever my brothers or sisters need, I give it to them.” Larry has a strong bond with his older brother. He says, “So then I ask [my brother] why did you punch me and he says, ‘Well no matter what I do, if I call you any names or do anything bad to you, I’m still going to love you, no matter what.’”

Jessica identifies strongly with her older sister. She talks about her sister possibly failing school this year, which would put the two in the same grade the following year. Jessica states, “It would be so cool. Cause people think we be twins. And we’re not.” She talks about her older sister being brave and protecting her. She hopes to have the same teachers that her sister had.

104 Danielle’s sole close relationship is to her mother. She states rather nonchalantly that her dad and her relations on her dad’s side, “don’t really care about me or anything.”

She never sees her father or hears from him. She also has no close friends as she has just moved to a new area. She says she misses her friends from her old school, but does not keep in contact with them.

Evan lives with both of his parents. He says he is angry at them. They do not appear emotionally attuned to him, but are rather focused on the day to day activity of economically surviving. He, in turn, seems to not bother with what his parents are telling him. His father yelled at him several times during the interview process, but Evan gave no indication that he heard what his father said. Evan talks about having friends in a vague sort of way. He doesn’t see or talk to his friends outside of school. His associations inside school seem to be loose in that they happen more by who he is in proximity with rather than having a true friend set.

Iris has a strong girlfriend group. She states, “Me and my friends, we have our own little clique. We always together. You never see us divided up.” She feels safe and protected by this group. She says, “I always stand in the middle of the group. Like, we can be at, like a big circle, and I be right there in the middle. My teacher asks me why I’m always in the middle of my friends and I’m like, cause I’m the baby.” She says, “I love my friends. They like family, They’re like my brothers and sisters.”

Jessica has some peers that she calls friends, but what is significant with her is that she has forged relationships with almost every adult in the school. She reports talking with them often. “Cause mostly I know everybody around the school. Ms M, she’s our

105 counselor, I think. And Ms H, that’s our principal and some teacher, I know the lunch ladies, the janitor. We have a whole conversation.”

Larry has difficulty maintaining friendships. He states, “Kids bully me.

Sometimes they exclude me from games, they call me names, they usually would stay away from me.” He says, “I like some kids, some specific kids, and I really hate one kid.

She always be’s mean to me.”

Interaction with investigator.

Two of the students in the Globally-Focused Group used the interview as a way to make money to support the household income. As per protocol, the research was explained to these interviewees and they were asked in private whether or not they wished to participate. Both said they did, but both had a difficult time in answering questions, saying they didn’t know the answer, they didn’t remember, or changing the topic more frequently than any other participants. One of these participants indicated about fifteen to twenty minutes into the interview that he wished it would end, so it was stopped at that time. The other interviewee was asked twice during the process if she wished to stop the interview, as she stated, “I don’t know” in response to many queries.

Both times she wished to proceed with the interview. For these two students, the interview was a means to help the family meet their daily needs.

The remaining three participants in this group developed a moderate attachment to the investigator. One of the interviewees said she liked to talk and did not want the interview to end. She cast around in her mind some additional things to say when the interview seemed to be at an end. Another participant said she “knew right away” that the

106 investigator had a “good vibe.” She stated, “I won’t walk away from you [the investigator]. I knew that right when you started talking to me.” The third participant shared troubling feelings and recent events that had occurred in his life, asking why people responded in the way they did, taking the investigator into his confidence in an intimate manner.

View of self and others.

The individuals in the Globally-Focused Group, like those in the School-Focused Group, generally have a positive view of themselves. Says one, “I’m the nice person. I’m fun to be around.” Another states, “I’m loud, giggly, and I like to have fun.” Yet another participant says, “I’m happy, fun to play with, smart, not mean.” Danielle is the one exception to this group. Her one defining characteristic is that she gets mad easily.

Otherwise, she does not know what makes her different from any other girl in 8th grade.

These participants also acknowledge troubling aspects. One participant says he goes back and forth between the general education school and the special education school because “The behavior. It’s bad.” Another says, “I think I’m bipolar. I get angry a lot.” Another volunteer says, “I can be very malicious.”

They are able to point to something of which they are proud. One says, “Umm, what have I done? I’m proud to have a good voice.” Another says, “This year my report card is all better. I only have one D and one F.” A female states, “Some of the boys in school scared of me, cause I’m in shape, I can do more push-ups than them. And sit-ups.

And more burpees. Everything what they did, I did.” They also exaggerate their abilities.

Says one boy, “I can kick so high that the ball can go over the lake and not even go in the

107 water!” Another states, “Teachers would say I always participate in class, always raise my hand. Every question. Even the question before it come out they mouth. I have my hand up. Like this.”

Although these students think that some people think well of them, (“Teachers would say I’m loud and giggly and like to have fun;” “Everybody say that me and my sister be comedians”), they also express more dislike for others as well as thinking others dislike them more than either of the other two groups. Says one participant, “Ms S came and messed with me the whole day about it. Like, she be picking, like picking at me and stuff. That’s my advisor. I don’t like her. I can’t stand her.” One of the participants, talking about her classmates, says, “These kids get on my nerves!” Another interviewee says, “Some of the teachers I don’t like in that school.” Another states that other kids are mean to him and he is “always bullied.” One volunteer states, “I don’t pay attention to ig’nant people” when talking about her classmates. A volunteer observes, “My brother don’t usually like me.” One student thinks that his mother and teachers don’t think well of him. He also doesn’t think his older brother protects him the way he thinks he should.

The youth in this category do not want to be thought of differently than their peers. One volunteer states, I just don’t talk to my [special ed] classmates. I don’t want to be thought of as one of them. I just don’t want to be in there [the self-contained room]. ‘Cause some slow kids are in there. And they kind of embarrass me. I’m not like that. I’m not slow.

Another youth says,

108 I just sit back [if I don’t understand the work], yeah, I understand this, yeah.

Cause some these ign’ant kids, they say, “Girl, girl, stop raising your hand. Girl, you know you don’t understand.” I be like, “What you talkin’ bout?” These kids be real uhh!

Another volunteer states, “She [special ed teacher] comes and gets me because she, I don’t know why! All we do is vocab!” Later he says, “It doesn’t really feel that pleasant [going with the special ed teacher].”

Summary The participants in this research project were all youth under the Special Education Category of Emotional Disability as determined by their school district. They receive a varying amount of special education services addressing their inappropriate school behaviors. These range from being in a therapeutic day school full-time to receiving specialized services removed from the general education classroom but within a general education school. These youth know they have been determined by their schools to have an “Emotional Disability” and they know they receive special education services for this.

The students were asked to describe their experiences of having an Individualized Education Plan for Emotional Disability in their schools. They were asked to talk about what school was like for them, why they thought they had an IEP, how they felt about receiving special education services, and anything else they wished to share. What followed were responses that were thoughtful, reflective, and showed a great deal of struggling on the part of the youth in trying to cope with what they perceived their

109 individual problem to be. Sometimes they avoided answering specific questions or denied certain issues existed, but for the most part the participants were engaged in the interview process and sincere in trying to get their thoughts and feelings known. As the data was sorted, the results fell into three main groupings of the participants regarding their responses and how they viewed their experiences. These results are shared within each sub-grouping under the general topics of: “I have a problem”; How to cope with the problem; Relationship with others; and View of self and others.

“I have a problem.”

Early in each interview, all the participants stated, in one form or another, that they had a problem. Their answers fall into three main groupings. The first group, designated as the School-Focused Group, identify their problem as disruptive behaviors that are only problematic in the school setting. They view their difficulty as a problem of their behavior, separate from who they are as an individual. The individuals in the second group, designated as the Home-Focused Group, identify their problem as not living with their birth mothers. They know their behaviors do not conform to acceptable school standards, but this is not of major concern to them. Instead, they are consumed by thoughts of their birth mothers. Much of their emotional energy is spent in either trying to make sense of why they are not living with their birth mothers or in warding off painful feelings about their situation. The third group, called the Globally-Focused Group, is concerned with issues both inside and outside of school. They know they have an emotional disability according to their schools, but have a harder time accepting this categorization. These individuals see their problems as being singled out as being

110 “different” in their schools, having a difficult time controlling their behaviors in school, and having difficulties at home, ranging from economic hardship that occupies their thoughts, to having a change in their primary caretaker in recent years, to their mother not paying enough attention to them.

How to cope.

In discussing the major problems in their lives, the interviewees also discuss at length the ways in which they try coping with these problems. The one coping measure used by all, either currently or in the past, is the use of acting-out behaviors. Several of the children call these “blow-ups” or “fits.” It is these behaviors that led to them receiving a designation of Emotional Disability in the school setting. The youth are well aware of the behaviors they engage in that meet the disapproval of others. For some students, these behaviors are of grave concern and they are trying hard to stop them.

Other interviewees know their behavior gets out of control, but it doesn’t occupy much of their emotional energy in worrying about them.

Of the three groups, the youth in the School-Focused Group are the most concerned about their acting-out behaviors. They point to frustration in trying to understand and do school work as a major source of anger that then leads to “blow-ups.”

One student explains her body just “gets out of control.” Generally, the students recognize when their behaviors are going to become disruptive shortly before it happens.

They all state one of the most helpful things adults can do is give them “space” at this time and to not try to talk to them in the moment. The students also advocate giving them breaks as needed. Two of these students utilize external supports provided to them by

111 their schools, whether in the form of behavior charts, assistive devices, or other sensory tools, to try to conform their behaviors to acceptable school standards. They accept the help of others, including teachers, school social workers, and their parents. The other two students in this grouping do not like the school interventions provided, nor do they like talking to the school social worker or other adults about their outbursts.

Two of the students in this group try to focus on the goal of getting back into a general education classroom as a means to motivate them to have “proper” behavior.

They have also come to accept the idea that they need external support in order to succeed in the school environment. Several of the School-Focused students attempt to minimize the differences between themselves and general education students. Most of the youth express some shame for their acting-out behaviors. During the interview, all the students used avoidance techniques and denial to cope with topics that they did not wish to discuss.

In contrast to the School-Focused Group, the youth in the Home-Focused Group do not spend much time focusing on their acting-out behaviors at school. Instead, the focus is on their behaviors at home and how these behaviors, in their minds, are the result of not having their mothers in their lives. School for these youth is more often than not viewed as a safe place to go. When speaking of their acting-out behaviors, these youth inevitably link them to thoughts of their mothers. The group is more vague about their actual acting-out behaviors and instead they talk about how others respond to them during these times. They have all been physically restrained a number of times and share these stories in a manner that emphasizes the physical connection made during the incidents. The youth talk about being disconnected from their families and others, yet

112 also talk about how important it is for them to have a connection with others. These youth have less of a repertoire of things they use to cope with their feelings. None of them think that school interventions are effective. Unique to this group is the sharing of stories of high adventure, risky activities, and/or the use of illicit drugs.

This group spends little time thinking about their school lives but a lot of time thinking about their birth mothers. When talking about their current difficulties, the talk continuously veers off to their birth mothers. All four of these students view their teachers in a positive light ant think they try hard to help them. As in the School-Focused Group, these students also use avoidance and denial during the interview to escape from talking about subjects they do not want to explore. Two of the students deny having feelings about difficult events. In fact, they say they don’t know how they feel about almost anything. They say they are numb from their feelings and explain this is the way they can cope with their situation and problems. One of the participants frequently uses fantasy as a way to cope.

The youth in the Globally-Focused Group talk about problems at both home and school. They think about their acting-out behaviors at school, but they also worry about issues at home, from wanting to go back to live with their biological mother, to trying to get their mother’s attention, to worrying about their family’s economic hardships. Four of the youth in this School-Focused Group admit to frequently arguing, getting angry, and fighting. The fifth student says she gets angry often, but withdraws and doesn’t speak to anyone. Several of the youth in this group use the behavioral strategies offered at school.

However, as a whole, they tend to use people to help them control their emotions more than things. The youth in this Globally-Focused Group want to be mainstreamed into a

113 general education classroom so use this thought as a motivator for appropriate behavior.

They tend to minimize their actions, saying they get punished for innocent actions and accidents. One student frequently lies to stay out of trouble. The School-Focused Group also thinks about concerns at home. One student says she just “takes it” when explaining how she copes with all her hardships. Some of the participants deny having their feelings getting hurt. They often deny needing any extra help from others. The three youth that were under the care of a different primary caretaker in their younger years have developed personal narratives of these times and invoke these memories often. As with the other two groups, this group utilizes avoidance and denial during the interview when a topic becomes too emotionally charged.

Relationships with others.

The youth have varying amounts and degrees of intensities in relationships with others. The three groups show marked differences in their relationship patterns. The first group, the School-Focused Group, have strong, positive relationships with their mothers.

This is evidenced by their mothers’ presence in the interview process, both physically by the mother remaining nearby in a protective vigilance during the early part of the interviews, to the youth all referencing their mothers at various points in the interview, including when they adopt her perspective as their own. The mothers’ voices can be heard in the students’ comments. Their love and concern is evidenced in the explanations the students offer as to why some situations are so difficult.

These youth appear to also be emotionally connected with the other members of their immediate family. They talk about their siblings, sharing some of their conflicts, but

114 also acknowledging their fondness for them. They do not speak much about their fathers, other than to say what kind of work they do or to mention a characteristic they have in common.

Friends in this grouping take on different significance levels depending on the participant. However, they are generally relegated to less significance in the youths’ lives. Two of the participants appear to not have any close, emotionally intimate friends.

The other two have friends with which they share things in common.

The interaction with the investigator of the study was uniform in this group. They participated in the study because their mothers wanted them to and because they wanted the $20 gift card that they would receive for participating. They were polite during the interview, engaged in the conversation and freely shared their views of their experiences.

In contrast to the students in the School-Focused Group, all of who live with their mothers, none of the youth in the Home-Focused Group live with their mothers. They all see their birth mothers occasionally. Woven throughout these interviews are the children’s longings for actual relationships with their birth mothers. Some fantasize about forging a relationship with their mother in the future, when they are older. They show respect for their current primary caretakers, some of whom have taken care of them almost since birth, but there is not the strong emotional bond evidenced by the youth in the School-Focused Group towards their mothers.

The youth in this group show a mixed degree of closeness in their relationships to other family and friends. The interviewee currently in the foster care system has no connection with any of her family or with any friends. She attempts to establish a close connection with the investigator throughout the interview. The other three youth in this

115 category have formed some connection with at least one other person. One youth has a very strong emotional bond with a friend, who he calls his “soul mate.” The other two youth have moderate emotional connections with either friends or extended family. These three youth also attempt to form a more intimate connection with the investigator.

The youth in the Globally-Focused Group show varying degrees of relationships to their mothers. Two of these youth were removed from their mothers’ care and currently live with extended family members. They show respect for their caregivers, but still long for their mothers. They share personal narratives and memories of being with their mothers when they were younger. The other three students who live with their mothers talk about trying to get her attention. Whether due to external hardship, the mother’s internal stress, or both, these mothers are unable to give the youth the amount of attention for which the youth crave. The youths’ thoughts are occupied with trying to get the attention of their mothers.

The youth in this Globally-Focused Group also display mixed degrees of relationships with others. The three youth who are under the care of a different primary caretaker in recent years have extremely close emotional connections to their siblings, with whom they live. If they are younger, they look to their older sibling for protection. If they are older, they serve as the protector for the younger sibling. One of the youth who lives with his parents and siblings shows a moderate degree of conflict in his relationships with his family members. The other youth has no relationships with anyone other than her mother.

Two of the students in the Globally-Focused Group use the interview as a means to supplement their family income. They are not invested in the interview or become

116 engaged with the investigator. The remaining three participants in this group form a moderate connection to the investigator. They state they enjoy the interview process, like talking, verbalize “approval” of the investigator, and seek the advice of the investigator during the interview.

View of self and others.

The individuals within each group are fairly unified within their groups regarding their view of themselves and of others. The three groups as a whole are markedly different from one another in their views. The youth in the School-Focused Group generally view themselves in a positive light. They think they have positive attributes and despite the fact that they have the most neurological deficits of the three groups, they like themselves the most of the three groups. They also view others in a positive light. They recognize that others don’t always think well of them, but they are able to tolerate this and have formed fairly perceptive reasons for why this may be so. At the same time, these youth struggle with the thought that they might be “different” than their peers.

The youth in the Home-Focused Group do not like themselves. It is striking in this group that they do not consider how others might perceive them. They do not think about this. Conversely, they have a positive view of others. They like other people, despite the fact that others may not treat them well. Unique to this group is the extent to which they tell stories about themselves full of high risk and adventure.

The youth in the Globally-Focused Group generally have a positive view of themselves. They cite positive attributes for themselves. They also acknowledge parts of themselves that are troubling. Although these youth think that some people think well of

117 Â them, they also express more dislike for others as well as thinking others dislike them more than either of the other two groups. The youth in this category do not want to be thought of differently than their peers.

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Chapter V

Discussion and Conclusions

Limitations of the Study There are a number of limitations to this research study. First, the small sample size of thirteen participants precludes the generalizability of the study. Although there was a broad socioeconomic range of students, a good mix of urban versus suburban versus rural domiciles, a fair representation of males and females, and an age range covering early to mid adolescence, there were not enough individuals in any one demographic to allow for more than the ability to say that the experience was true to that particular youth. Minorities were underrepresented in this study by a ratio of about two to one, so their voices may have been less heard overall. There were two students in the same school district. The rest of the students came from different school districts scattered across the Midwest and the South. As such, the students were possibly subject to different protocols for school interventions for their Emotional Disability. Although a broad range of students was captured, this study may not cover the scope of experiences of middle and high school children identified as having a behavioral disorder.

Second, the study depends on the subjective recall and opinions of children that may vary from day to day depending on their emotional state at the moment and therefore

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119 may not accurately reflect their life experiences. The interviews themselves were a dynamic process that may have shaped how the students responded to questions.

Third, the self-selection of participants may skew the results of the study as those attracted to undertake the research might have been of a particular individual mindset regarding their experiences whereas those who weren’t interested in participating in the research might have been of a different mindset about their life experiences. By and large, an adult in the child’s life had to initially bring the study to the attention of the child. Therefore, if there was no adult in the child’s life who thought volunteering for the research study was a worthy enterprise, the child would not know of the opportunity to participate.

Theoretical Discussion This dissertation is a study about youth who have been identified in the educational system as having an “Emotional Disability.” “Emotional Disability” is one of the designated disabilities subsumed under the Individuals with Disabilities Education Act (IDEA). This is a law “ensuring services to children with disabilities throughout the nation. IDEA governs how states and public agencies provide early intervention, special education and related services to . . . children and youth with disabilities (IDEA, 2004).”

“Emotional Disability” as defined by IDEA has been previously cited in the results section of this report.

IDEA has rules and regulations regarding the identification of youth with disabilities. This includes directives to “use a variety of assessment tools and strategies to gather relevant functional, developmental, and academic information about the child,

120 including information provided by the parent, that may assist in determining whether the child is a child with a disability (IDEA, 2004, 300.304).” A team of special education personnel, generally including, but not limited to, a school psychologist (not necessarily a clinical psychologist), school social worker, and special education teacher, are used to evaluate each child.

After the evaluation is complete, and if a child is determined to have a disability, the child has the right to a “free appropriate public education.” In order to ensure an appropriate education, an Individualized Education Plan, or IEP, is developed for each child. This plan is individualized for each child and is developed to enable the child to function in the educational system with the necessary supports and help in order for the child to be successful (IDEA, 2004).

The assessments for the evaluation of an Emotional Disability are conducted from an educational, behavioral viewpoint with conclusions reached derived from the behavioral manifestations of the child. Likewise, the Individualized Education Plan (IEP) that is developed following the evaluation is formed through a behavioral lens. The child’s behaviors are documented, measured and charted with goals and objectives for improvements in behaviors being a major part of the IEP. (IDEA, 2004). Thus, there is the potential for there to be a wide variation of underlying emotional difficulties with which these youth are contending. There is also the potential for the IEP to never address the root causes of the individual’s difficulties.

From a psychodynamic perspective, the label of “Emotional Disability” (formerly known as “Behavior Disordered”) is arbitrary and does not necessarily identify the underlying problem. Pine (1980) attempts to address this very issue when he delineates

121 phenomena that satisfy the external definition of behavior disorder into a variety of different etiologies. He demonstrates there are a number of underlying causes that may manifest as inappropriate or acting-out behaviors. He proposes the term “Behavior Disorder” should be reserved for “those instances of failure of delay between impulse and action, those absences of cognitive working over, which are characteristic of a particular child, [and] are repeated, predictable modes of reaction to an array of impulses and an array of settings (Pine, 1980, p. 200).”

The significance of these findings is that by all ostensible accounts, these youth, designated by the school system as having an Emotional Disability (or Behavior Disorder), would be presumed to be the individuals to fit the description that Pine states he reserves for the label of “Behavior Disordered.” In other words, these youth should have little impulse control and little reflective capacity. Their manifest behaviors seem to suggest this. However, even within the limits of one interview, it is not difficult to see that the profile of many of the youth fit in better with one of the other disorders that Pine (1980) delineates. He describes at least four other internal phenomena that may be termed as behavior disorders from an external view. These are: 1. An “outburst” in which a child who is normally reasonably self-controlled reaches his limit. The child is deprived/frustrated, insulted/humiliated, or provoked/injured to the point where he lashes out; 2. Neurotic character disorders that culminate in disturbances in the behavioral realm. The action of the child expresses a fantasy in compromise (disguised) form;

122 3. An area of ego disturbance where considerable cognitive work is going on between an impulse and the expression of outrage; and 4. Behaviors that reflect socialized behavior within a particular family or group subculture rather than intrapsychic maldevelopment.

Besides these conditions, Pine (1980) describes two other major characteristic disorders that may lead to similarly appearing external behaviors. These are a disturbance of learning and a borderline disturbance.

Shapiro (in Pine, 1980) says an impulse disorder is a defect in planning, a defect in the capacity to envision consequences of action. These youth are well aware of what the consequences of their actions will be. They state this goes through their minds as they begin to “blow-up,” but at the time they don’t care about the consequences. Many also don’t care about the consequences after the fact. As one youth states, “OK, I did it, it’s over now. I’ll just take whatever’s coming.”

Though it may be difficult for the youth to engage in a reflective process about a specific incident, these youth are reflective. They did a good deal of reflecting about themselves and their lives during the interview. They can be surprisingly self-aware.

However, be it due to shame, guilt, or the stirring up of noxious feelings, they acknowledge they do not like to reflect on past incidents of acting-out and report they resist when social workers, therapists, or teachers try to engage them in a process of “thinking through” their unacceptable behaviors. This implies that Cognitive-Behavioral Therapy may not only not help these individuals, but may exacerbate the circumstances if the youth become further labeled as “stubborn” or “resistant” to treatment.

123 There is a capacity for reflection that is defended against. There is ideation that accompanies the behavior, usually in the form of feeling personally disrespected or that disrespect is being cast upon their mother. This fits in with Pine’s (1980) description of individuals where cognitive work occurs between the impulse and the expression of rage.

There is tremendous pressure put on these youth to conform to a system they are ill-equipped to function in adequately. A number of the youth describe how they feel they are at “the end of their rope” with trying to cope with the school’s demands before they have a “blow-up.” This fits with Pine’s (1980) description of children who have an “outburst” because they have reached their limit of frustration.

This research goes beyond the individual symptoms in an attempt to identify underlying dynamics. It supports Pine’s (1980) explanation that manifest behaviors are multiply determined. It explains how other children who have similar profiles to the youth in this study may not manifest the behaviors that lead to a special education categorization of “Emotionally Disabled.” There can be many different causes and associated damage that lead to similar behaviors.

The youth in this study share similar acting-out behaviors and come under the umbrella of “Emotional Disability.” However, due to different constitutional endowments, environments, and significant primary relationships there are marked differences in the way the 13 participating youth view themselves, others, and the worlds in which they live. These ways of experiencing fall into three separate, noticeably distinct, groupings with unique psychodynamics, sense of self, and sense of others. This section will explore the theoretical implications of these three different groupings from the theoretical standpoint of self psychology.

124 Self psychology.

Self psychology is a theory that studies the psychological structure called the self, its subjective manifestations, and its vicissitudes (Wolf, 1988, p. 11). The self is: the psychological structure that undergirds the totality of a person’s experiences, both conscious and unconscious. It represents the subjective dimension of the person’s psychic organization. The cohesive self is enduring and stable. It represents a sense of intactness, wholeness, and vitality. Once firmly established, it embodies the person’s values and world view (Palombo, 2001, p. 25).

In order for the self to develop, it must have the presence of others who provide certain types of experiences that evoke the emergence and maintenance of the self. These are called selfobject experiences. Firm, cohesive selves result from optimal interactions between selves and their selfobjects. The selfobject needs of the self include, 1. Acknowledgement and affirmation by a primary caretaker called mirroring needs; 2. A caretaker that possesses qualities to be admired and who offers a sense of protection, security, and safety, called idealizing needs; and 3. A feeling of essential likeness, or sharing, called twinship needs (Fosshage, 1995, p. 240).

Psychological structure formation, called transmuting internalization, results in the nuclear self of the child. Transmuting internalization cannot occur unless the child’s mirroring and idealizing needs have been adequately met. It takes place in consequence of the minor, nontraumatic selfobject failures in response to mirroring and idealizing

125 needs of the child. These failures lead to the gradual replacement of the selfobjects and their functions by a self and its functions (Kohut & Wolf, 1978).

Parental expectations exert a considerable influence on the baby’s developing self. The self arises thus as “the result of the interplay between the newborn’s innate equipment and the selective responses of the selfobjects through which certain potentialities are encouraged in their development while others remain unencouraged or are even actively discouraged” (Kohut & Wolf, 1978 p. 417).

A strong self has the ability to tolerate the vicissitudes of life. There may be wide swings of self-esteem in response to events with a variety of accompanying emotions, but the sense of self remains intact. If the self is not so firmly established, secondary disturbances of the self may ensue during times of stress. These will be reactions of a structurally undamaged self that has the ability to return to equilibrium. Also included in the secondary disturbances are reactions of the self to physical illness or to incapacities of a structural neurosis (Kohut & Wolf, 1978).

1. Primary disturbances of the self, on the other hand, occur because of consistently faulty selfobject relationships during the formative years. These disturbances can be divided into four subgroups: psychoses where there is serious, permanent damage to the self; 2. Borderline states where the nuclear self is damaged but the manifestations of the central defect are covered by complex defenses; 3. Narcissistic behavior disorders where individuals display symptoms of perverse, delinquent or addictive behavior, but the underlying disorder is only temporary and with support of increasing insight may be able to be relinquished; and

126 4. Narcissistic personality disorders where break-up or distortion of the self are also only temporary but where the symptoms--hypochondria, depression, hypersensitivity to slights, lack of zest—concern primarily the psychological state of the individual rather than his actions (Kohut &Wolf, 1978, p. 416).

The youth in this study appear to display a variety of disorders of the self, both primary and secondary. The participants in the school-focused group appear to display secondary disorders of the self, whereas individuals in the home-focused and globallyfocused group appear to display primary disorders of the self, generally the narcissistic behavior disorders and the narcissistic personality disorders. At least one participant appears to be at the borderline level of functioning. Psychodynamically speaking, treatment for these youth calls for different responses, depending on the underlying etiology.

Ubiquitous to all, these youth experience narcissistic injury and a lack of selfobject functions (at least in a needed moment) that ultimately leads to a lack of cohesiveness. From a self psychology viewpoint, the youths’ symptomatologies are due to threats to self-cohesion. They experience narcissistic rage that keeps them cohesive as they are able to organize around the rage. Kohut talks about the self existing in varying degrees of coherence, from cohesion to fragmentation; in varying degrees of vitality, from vigor to enfeeblement; and in varying degrees of functional harmony, from order to chaos. The youth in this study show these varying degrees of the self. Kohut states, “Faulty interaction between the child and his selfobjects result in a damaged self—either a diffusely damaged self or a self that is seriously damaged in one or other of its

127 constituents (Kohut & Wolf, 1978).” The theoretical implications are discussed below under the three subgroups into which the youth fall.

School-focused group.

The youth in this group have the most severe neuropsychological deficits and/or learning disorders of the three groups. They are different than other youth in the educational system diagnosed with a Learning Disability or youth who receive special education services under the category of Other Health Impaired (OHI) in that even though they have a disability that fits under one of these categories, their acting-out behaviors overshadow their other disabilities and they become categorized with an Emotional Disability.

In the minds of these individuals, their “problem” is their inability to control their inappropriate behaviors during the school day. These behaviors manifest themselves in different ways. Three of the four children talk about having difficulty sitting still according to school norms. They have difficulty in controlling their actions. One individual says he likes to touch things and has to be reminded often to keep his hands to himself. Another individual says her “body gets out of control” and she moves around a lot, distracting others. The difficulty in sitting still was displayed in the interviews with two of the youth who fidgeted and moved almost non-stop during the interview. They shook their legs, they played with small objects, and they squirmed. One student delineated his activities at the end of the interview. He said he had been doodling with his gel pen, covering an entire piece of paper with his doodles; he was playing with the

128 drawer at the desk, running a cord in and out through the drawer handles; and finally, he played with his socks saying “they keep, like, messing up and I keep fixing them.”

These youth start their academic careers battling innate predispositions for a high level of motoric activity due to their neurological make-up in a school atmosphere that demands them to sit still. One of the students begins school with an undiagnosed learning disability that hampers his ability to be successful in an academic setting. In addition, this student is overweight, putting him at risk for being outside the norm of acceptability in physical looks by his peers. Thus, the children in this group begin their formal education with compromised abilities to be successful according to the measures of success in a school environment.

Not surprisingly, the youth do not succeed in their endeavors to perform satisfactorily in their school settings. For some, this becomes apparent almost as soon as they start school. For others, school begins smoothly enough, but there is a sense early on that all is not quite right. Initially, these failures are described as the inability to sit still, the inability to perform adequately in academic work, or the inability to fit in with their peer group. After these initial failures, subsequent failures occur in the form of “blowups” due to frustration in trying to succeed in the initial areas of failure. Viewing this from a self psychology standpoint, the primary issue is a structural deficit in an important part of the self, not an internal conflict. Viewing this from a developmental/structuralist view, the primary issue is a disturbance of learning. The behavior of the youth is a secondary response to the frustration and/or shame of trying to cope with a disturbance of learning. The behavior is not a primary disturbance.

129 Defense mechanisms.

All of the youth avoid potentially painful topics during the interview by changing the subject, engaging in denial, or disavowing of a truthful statement. By using these mechanisms, the youth are protecting themselves against narcissistic injury of their selves. When they change the subject, they don’t need to address areas of their lives that bring them shame or embarrassment. When they engage in denial, they are able to ignore a potential internal source of anxiety. When they make false statements, they are able to defend against a reality that is painful to acknowledge. In addition, some of the youth talk about intentionally lying at school or home. This type of lying—to avoid punishment for an action or to avoid doing an unpleasant task—is different than the defense mechanisms listed above. However, behaviorally they may appear to be similar.

It is generally accepted that lying is a ubiquitous human phenomenon. All children lie at some point in their lives (Freud, 1913; A. Freud, 1965; Piaget, 1932; Kohut, 1971; Winnicott, 1971). Piaget states, The tendency to lie is a natural tendency, so spontaneous and universal that we take it as an essential part of the child’s egocentric thought. In the child, therefore, the problem of lies is the clash of the egocentric attitude with the moral constraint of the adult (Piaget, 1932, p. 135).

Theorists distinguish three types of lying: 1. Innocent lying, which is the work of primary process thinking in the young child that militates against truthfulness in the adult sense of the word;

130 Â 2. Delinquent lying, or lies of convenience, which children use to gain material advantage, to escape from criticism or punishment, or as wished for aggrandizement; and 3. Fantasy lying, or pseudologia phantastica, which children use to cope with intolerable realities by regressing to infantile forms of wishful thinking.

Sometimes the etiology of the lie consists of a combination of all three forms (A. Freud, 1965, Dithrich, 1991, Diamant, 1997).

The type of lying that the youth discuss with the investigator and the type of false statements that the youth make while being interviewed have a tangible qualitative difference. The former type of lying was done with forethought. The youth were consciously trying to escape from unpleasant duties or unpleasant consequences. The untrue statements that the youth make when telling the investigator that they have always been in a general education classroom and/or have never had behavioral difficulties at school do not seem to be conscious lies. There is no sense of deliberately trying to fool someone. Rather, it is painful internally to admit and think about their inappropriate behaviors and the consequences they have endured because of their behaviors. Later in the same interview when they talk about being in a special education classroom or describe their acting-out behaviors in school, there is no indication that they previously denied or misrepresented these facts.

These false statements are not lies to avoid a consequence or criticism. They lie in the realm of wishful thinking, closer to the young child’s primary thinking. Even though the students know these things to be true: that they are disruptive in class, get in trouble often, and receive specialized services for their inappropriate behaviors, they would

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131 rather pretend that it is not true. It is a defense to protect against a present-day reality that the youth want to deny. The feeling of shame is connected with being in a special education classroom and being identified as not being able to control one’s emotions. The lies could be an attempt to consolidate identity in the secondary separation individuation of adolescence as Wilkinson and Hugh (in Halpert, 2000) note in their clinical examples.

Several of the children in the school-focused group talk about delinquent lying.

They say they “don’t like to lie,” but resort to it when they feel there is no alternative.

They are referring to lies that will let them escape from unwanted work or that they hope will keep them out of perceived trouble if the truth is known. The children spend some time in explaining to me their justifications for participating in this type of lying as well as emphasizing that they are careful to make sure they can “get away” with the lie, knowing that the consequences for being caught in a lie will only make matters much worse than the initial problem.

Diamant (1997) states there is a theory of mind that is a prerequisite for mature lying. In mature lying, the liar aims to create an impression in somebody else’s mind that differs from reality. There is the capacity to differentiate one individual’s state of mind from another individual’s. When the youth explain their reasonings behind their lying, they are displaying a theory of mind. They are aware that their mind is different from the person’s mind that they are trying to convince of the lie. The youth appear to use delinquent lying when they are taxed beyond their means of trying to accomplish something for school (e.g., lying about completing their homework as it is a difficult and time-consuming process that often yields poor results).

132 Relationship to mother.

These children share in common mothers that are attuned to their needs, are protective of them, and act in a pro-active manner for them. All four of the mothers state they have spent much time in advocating for their children within the school system.

These mothers have been functioning, and continue to function, as important selfobjects for their children. They are able to provide selfobjects that meet the youths’ emotional needs and allow them to function at a higher level than might otherwise be possible. The mothers are vigilant and attuned to their children. They also provide adjunctive functions in order for their children to succeed. Adjunctive functions are “part of the supports the child needs in order to survive” (Palombo, 2001, p. 28). They are similar to selfobject functions in that they act to complement the sense of self, but they differ in that they are an adjunct to the child’s cognitive and physical capacities. They are needed for the child to operate adequately in the world, but they do not necessarily provide a selfobject function, i.e. they do not address the individual’s emotional needs (Palombo, 2001).

At school, these complementary functions are largely missing. The children are not able to succeed without their selfobjects or adjunctive support. This can be seen with the youth in this study. Two of the children accept the interventions their schools have to offer them in the form of separate classrooms, behavior charts, sensory tools, and extra support personnel. These children are compliant with the school’s system of supports.

These supports can be considered adjunctive functions. One of the students is quite articulate about her feelings of these adjunctive functions. She does not like them, but knows she needs them in order to succeed in school. Her repeated advice to other students “like her” is to “accept what you need. Don’t try to take it away too soon.” The

133 “it” are the adjunctive functions that help her manage the demands put on her in the school setting.

The other two children resist the school’s interventions. They don’t think the interventions help, they think they’re “stupid,” and/or they think the teachers are ineffective in implementing the plan. Perhaps the adjunctive functions offered these students are not the supports they need in order to be successful. Or, having to rely on adjunctive functions in a public manner that other children are able to observe may damage their self-esteem and thus their sense of self. So, they prefer to “go it alone” in an effort to preserve their cohesion. Another variable may be that in addition to serving as adjunctive functions, the support personnel with the first two students may be meeting selfobject needs, thus promoting the acceptance of the adjunctive functions as they are tied to the selfobject, whereas the support personnel with the second two students do not act as selfobjects and thus there is no emotional impetus to accept the adjunctive functions.

In terms of self psychology, the underlying causes for these children’s behaviors are biologically determined deficits that they are able to compensate for with the help of their selfobjects. These youth have experienced people in their lives who provide selfobject functions that allow them to operate at a higher level than their innate predispositions might dictate. As Wolfe (1988, p.55) states, “To maintain its cohesion, its vigor, and its balance, the healthy self needs to be embedded in a milieu that is experienced as constantly supplying a self-sustaining selfobject ambience.” Emergence of self requires more than innate experience. It also requires others to help in the maintenance of the self. At home, these youth experienced this self-sustaining selfobject

134 ambience. It was only when going off to school and confronting demands that they were incapable of meeting, combined with having inadequate selfobjects and/or adjuncts in the classroom to aid in meeting those demands, that their selves experienced fragmentation.

Thus, they do not experience failures until they are in a daily environment where this selfobject function is not provided.

Palombo states, “Children’s subjective experiences are filtered through their neuropsychological deficits and the context in which they are raised. The deficits restrict, modify, or impose constraints on the child’s experiences, while the caregivers influence the child’s interpretations” (2001, p. 5). He further states that there are three types of complementary functions essential for the development of a sense of cohesion: selfobject functions, adjunctive functions and compensatory functions. The caregivers for the youth in the School-Focused Group provide both selfobject and adjunctive functions.

The last type of complementary functioning mentioned by Palombo (2001) is compensation. This is any measure children devise themselves to achieve their desired goals without the use of another person or tool. For instance, one of the students stated he thought about the negative consequences that would happen to him if he engaged in disruptive behaviors and this helped him control his actions. He stated he didn’t like that strategy but, “It’s the only thing I had.” This strategy, of thinking about negative consequences that will ensue if a particular action is taken, as well as the strategy of focusing on the goal of getting back into the general education classroom, was a strategy that all four of the children in this group mentioned utilizing. It is a compensatory function leading to the developmental skill of self-regulation. Self-regulation is “the manner in which the process called the “self” comes to regulate its own processes

135 (Siegel, 1999, p. 156).” “Effortful control” is the ability to inhibit a response one is all set to perform (Shonkoff & Phillips (Eds.), 2011, p. 116). Prior to school, the children, by using selfobject functions and adjunctive functions, were able to regulate their emotions to an acceptable household standard. It was clear that the children had not developed sufficient self-regulatory skills for school at the advent of their formal education. The compensatory measures developed by the children are cognitive means of attempting self-regulation.

View of self.

Despite the differences in how they respond to their school’s interventions, these children, by and large, have a firm, cohesive sense of self. The four youth are acutely aware of their failures. They share narratives of early experiences in school where they fail to conform to school standards. The commonality with these children is that none of them perceived there were any problems until the start of school. Their narratives of failure begin when they enter school. Up to that point, they view their lives and themselves as successful. It is the strain of conforming to a specific environment in which they have skill deficits that causes their “problems” to begin.

The youth in the School-Focused Group generally view themselves in a positive light. They think they have positive attributes and they like themselves. Because they have experienced adequate selfobjects, the youth have developed a cohesive sense of self.

At the same time, these youth struggle with the thought that they might be “different” than their peers. They express shame and humiliation with their acting-out behaviors and with being singled out for having special needs that their peers do not have. They feel

136 they are “different” and at this point are coming to terms with what this means and how they feel about it. As they enter into the period of adolescence even further, the twinship selfobject function will become more crucial in determining the sense of cohesion that these youth experience.

View of others.

These individuals tend to view others in a positive light. They recognize that others don’t always think well of them, but they are able to tolerate this and have formed fairly perceptive reasons for why this may be so. Because they have a cohesive sense of self, they are able to have a flexible and nuanced view of the world and others. They can tolerate imperfections in others. They can also tolerate rejection by others of themselves because they are secure in their primary relationships.

None of the individuals in the school-focused group have strong relationships with their peers. This may speak to future issues, as the twinship selfobject function is necessary for healthy development. Children need to experience a common bond with others. They need to feel that they belong, that they have a kinship with others (Fosshage, 1995). The youth in this group can identify at least one person they call “friend,” but they all struggle with being accepted by their peers. Up to this point, their mothers have provided the acceptance that they have needed for emotional cohesion, but as they enter more deeply into the adolescent tasks of separation and individuation, the lack of friendships may play a crucial role in the continuance of their emotional development.

Finally, Kohut (1971, p. 9) demonstrates there is a continuum of development and regression in the realm of the omnipotent object, i.e., the primary caretaker, that

137 influences how others are treated. He states in normalcy, there is a mature form of admiration for others and there is the ability for enthusiasm. The school-focused group demonstrates this when they agree to the interview process to please their mothers and to attain the monetary gift awarded them for participating in the interview. During the interview, the investigator was treated politely, as a separate entity with whom business was to be conducted. They engaged with the investigator and were absorbed in telling their stories. The emotional connection was both one of helping out the investigator in her study as well as wanting someone else to understand their story and view of life.

There was never a sense of attempt at merger with the investigator.

Home-focused group.

The youth in this group do not have other educational disabilities besides Emotional Disability, unlike most of the youth in the other two groups. The common thread with the youth in this group is that none of them live with their biological mother and they all identify this as their “only problem.” Of the three groups, these youth have exhibited the most extreme acting-out behaviors in the school setting, yet in their minds, this behavior is hardly worthy of attention. They are focused on their mothers. They think about her, they yearn for her, and they come up with reasons in their minds for why they are not with her. One of the youth has had the same primary caretaker since being an infant. This caretaker is herself physically handicapped. The other three have experienced at least several primary caretakers at different points in their lives.

138 These youth have not experienced a selfobject that has been able to provide them with the necessary selfobject functions to achieve a cohesive self. Kohut and Wolf state (1978, p. 416): It is in the matrix of a particular selfobject environment that, via a specific process of psychological structure formation called transmuting internalization, the nuclear self of the child will crystallize . . . we can say, 1. that it cannot occur without a previous stage in which the child’s mirroring and idealizing needs had been sufficiently responded to; 2. that it takes place in consequence of the minor, non-traumatic failures in the responses of the mirroring and the idealized selfobjects; and 3. that these failures lead to the gradual replacement of the selfobjects and their functions by a self and its functions.

These youth have not had someone who has met their mirroring and idealizing selfobject needs. They fit the profiles described by Kohut and Wolf (1978) as the understimulated and/or the overburdened self. The understimulated self is a chronic condition of the self that arises from prolonged lack of stimulating responsiveness from selfobjects. These individuals lack vitality. They experience themselves as boring and apathetic and experience others the same way. They will use any available stimuli to create a pseudo-excitement in order to ward off the painful feeling of deadness that tends to overtake them. Three of the youth in this group struggle with being motivated to do anything. They talk about having no feelings or feelings of great despair. Two of the youth describe themselves as being “numb” of any feelings. They talk about the feeling of wanting to give up, yet at the same time hope for something different. All of the youth

139 in this group describe daredevil activities in which they engage, whether in fantasy or in reality. One individual uses illicit drugs on a daily basis to numb his intolerable feelings of anxiety and despair.

The overburdened self is a self that has not been provided with the opportunity to merge with the calmness of an omnipotent selfobject. This self suffers the trauma of unshared emotionality. The individual will have the absence of a self-soothing capacity that protects the normal individual from being traumatized by the spreading of his emotions, especially by the spreading of anxiety. Their world is a dangerous world (Kohut & Wolf, 1978). The four youth in this grouping all shared stories of dangerous situations they have been in and survived. One individual has made several suicide attempts. One youth cannot tolerate being alone.

Wolf (1988, p. 39) states, “The person whose self regresses from a state of cohesion to one of partial or total loss of structure experiences this as a loss of selfesteem, or as a feeling of emptiness or depression or worthlessness, or anxiety. This change in the structured state of the self has been termed fragmentation.” The youth in this category express feelings of depression, emptiness, and anxiety. Sometimes they engage in autoplastic attempts to restore selfobject functioning (depression, lack of zest, and hypersensitivity) and sometimes they engage in alloplastic attempts with behavioral acting-out activities.

Defense mechanisms.

The youth in this group, as in the other two groups, avoid painful subjects by changing the topic, denying facts, and making false statements. One notable difference

140 between this group and the other two groups is that they do not talk about engaging in delinquent lies to the investigator. Rather, they are quite frank about their misdeeds and openly share at least some of their delinquent behaviors. Also, these youth don’t deny their alternative educational placement, their acting-out behaviors, or that they are receiving interventions for an emotional disability. They do not seem to be bothered by these facts. The students minimize the impact of their acting-out behaviors, but do not deny them.

While they don’t appear to be highly defended against their school behaviors and their academic histories, they use significant defense mechanisms regarding their birth mothers. They protect her image at all costs. They change the subject when the topic of their birth mother comes up, they speak highly of her, or they give defensive explanations as to why she cannot mother them.

In talking about themselves, three of the youth engage in aggrandizing statements and one youth engages in fantasy lying. The youth that make aggrandizing statements in their interviews talk about performing feats that border on the impossible to do. When they make these statements, they are in the midst of telling the investigator their accomplishments and things they have been successful with in life. The “feats” they do are better than all the other children can do. The aggrandizements seem to be a way to shore up a faltering sense of self-esteem or worthiness. The unbearable thought and narcissistic injury of being rejected or abandoned by their mother perhaps because they are not good enough is defended against by stories of how they are not only “good enough,” but excel in life.

141 The interview of the youth that engaged in fantasy lying was replete with fanciful tales. Prior to the interview, the caretaker of this youth stated to the investigator, with obvious irritation and disapproval, that the youth “lies all the time.” She said she could never tell when the youth was telling the truth or not. She said this as a warning to the investigator, implying that the youth would perhaps be telling the investigator lies. The possible consequences in terms of relationships to others and/or disciplinary measures imposed by the school for using a defense that involves denial or fantasying may be deleterious for a child who is already experiencing a fragile sense of self.

During the interview, this youth told the investigator she could fly. She described in detail how she has flown, and how she has soared out over the ocean. This conversation came directly after the student asked when the investigator was returning and the investigator reminded the student this was the only interview that would be conducted. This, in turn, happened directly after the youth talked about not being able to see her mother (she was in foster care) and having dreams of her mother and father dying.

For this child, reality is a harsh and unpleasant place to be. She has been in many foster homes in her short life. At the time of her interview, she had just been expelled from one school and was going to be placed in yet another therapeutic day school the next day. Her fantasy played the defensive role of allowing her to escape her intolerable fate of being tossed around from one person to the next and from one place to the next, of not being in anyone else’s mind. It allowed her to feel above the need for connection and instead give her the feeling of being self-sufficient. She not only escaped in her fantasy, she soared. She flew high above her problems and the world that rejected her. In a final touch, as she talked she stood spread eagle, her arms spread wide with her hands in fists

142 except for her middle fingers, which stood straight out, as if pointing to the world and saying, “This is what I think of you!”

A brief review of the literature explains in greater detail the psychodynamic processes at work with this interviewee. Kohut (1971, pp. 109-112) states “faking of reality” in narcissistic individuals is not lying in the classical sense but is rather the phenomenon of “pseudologia fantastica.” The individuals are convinced of the truthfulness of their faked reality. They are not, in the moment, aware of telling lies.

Diamant (1997) agrees with this view, saying that when a person is not able to distinguish between his internal state of mind and the object’s state of mind, he is also unable to perform mature lying, i.e. to lie to manipulate the other person’s mind. The individual may affirm the ‘not-real’ while not knowing the real. Thus, the person appears to be lying. However, the inner truth does not exist within their mind and can exist only as part of the interaction with the other person. Lying is an ongoing interpersonal process by which inner truth is negotiated.

Halpert (2000, p. 672) states, “A lie always denies some aspect of psychic reality and substitutes some less threatening mental construct.” He distinguishes between focusing on the meanings of lying versus the psychic structures and mechanisms involved in lying. He proposes both cognitive abilities and the psychic apparatus have to develop to the point that the self can be distinguished from the object and a superego prototype must be present before the means and motivations for lying are in place. This early superego—in which threats of the loss of mother and/or her love are seen as punishments for transgressions—has to exist for there to be a motivation for lying.

143 Deutsch & Roazen (1982) and Fenichel (in Ditrhrich, 1991) also speak of pseudologia phantastica—the fantasy lie. They maintain pseudology is a taking of psychological truth and turning it into external reality. The pseudology, as a self-creation, is free of anxiety. It plays a defensive role in denying unpleasant realities and replacing them with better ones. The imaginary world is more exciting, and preferred, to the harsh reality. Deutsch & Roazen (1982) believe the individual is relieved of the obligations of real life and withdraws into a fantasy world. Fenichel (in Ditrhrich, 1991) proposes the individual has the hope that if someone else can believe that untrue things are true, than it is also possible that true things, the memory of which threatens the individual, are untrue.

Relationship to mother.

The youth fantasize about taking care of their mothers. They defend their mothers, explaining why she can’t be taking care of them. In this way, intrapsychically, they can keep the hope alive that their mother is the all-nurturing, omnipotent, omnipresent person they fantasize about. They convince themselves that it is external circumstances that prevent their mother from being with them, otherwise for sure she would be right there with them. They defend against the thought of their mother not wanting them by saying they are unlikeable. This serves to protect them from the too terrible reality that perhaps their mother rejects them because she is unfit to mother or because she does not want to have a child. Intrapsychically, it is easier to accept that they are the cause of failure for the relationship. In this manner, they attempt to create and preserve an idealizing imago selfobject.

144 In reality, the birth mothers of the youth in this group have not been able to act as selfobjects and thus provide the children with needed selfobject functions. Three of the children had mothers who were never involved in their care. Two of these children had multiple caretakers for the early years of their lives. The third child had the same caretaker since infancy, but this caretaker is physically handicapped and unable to do much of the physical care. The fourth child was removed from her mother’s care at the age of five due to child neglect.

The youth never had a selfobject they could use to meet their emotional needs so they could develop a healthy, core sense of self. They all speak well of the person who is currently their primary caretaker, but there is not the sense of a close, emotional connection. It appears the current caretakers do not act in the role of selfobjects. These youth are bereft of the most essential, basic relationship they need to emotionally survive.

As Wolf (1988, p. 70) states, “A chronically faulty selfobject environment, rather than single traumatic events, causes the developmental failures that leave the child vulnerable.”

View of self.

The youth in this group demonstrate a less cohesive sense of self. They don’t like themselves. Two of them can acknowledge positive aspects about themselves, but they all struggle with perceived negative aspects of themselves. Fosshage (1995, p. 240) states, “Faulty selfobject relationships entail insufficient developmentally required selfobject availability and responsiveness, which disrupts the development and maintenance of a positive sense of self. Without sufficient affirmation a child, for example, cannot develop

145 a positive image of self.” These youth did not have selfobjects available to provide them with the mirroring needs necessary to acknowledge and affirm them as individuals. The youth did not have an adequate self-selfobject matrix for healthy development to occur.

The youth think others try hard to help them, although they are convinced no one is able to help them successfully. In other words, they perceive themselves as beyond help from adults who should be able to help them. They recognize the effort others put in towards helping them, and think kindly of them for this, but think their efforts are futile in effecting change. Kohut (1978, p. 417) states, “The essence of the healthy matrix for the growing self of the child is a mature, cohesive parental self that is in tune with the changing needs of the child.” The youth have not experienced a selfobject attuned to their needs. Kohut (1978) speaks of the mirror-hungry person, saying these individuals are convinced they will not find an echo of understanding empathy. Intrapsychically, the youth in this group are convinced they are unlovable and unworthy of love.

View of others.

These youth have a loss of connection to a significant adult. Their minds are preoccupied with creating this connection. This can be seen in the way they relate to adults. They try to make a connection with anyone via almost any means, including being physically restrained in school.

During the interview process, these youth attempted to incorporate the investigator into their lives, and hence, themselves. They made references to past experiences in their lives as if the investigator carried memories of these experiences in her head. There was an emotional hunger felt by the investigator during the interviews

146 emanating from the participants. The participants did not want to let go of the investigator when the interviews ended, following her to the car and asking when she would come back again. There was an intensity to these interviews that was not felt in the other two groups of interviews. In Narcissistic Behavior Disorders, there is a compelling need for merger with the powerful object: the stage of the idealized parent imago (Kohut, 1971).

Kohut (1971, p. 45) states if the child suffers traumatic loss or disappointment of the idealized object, optimal internalization does not take place. The child does not acquire the needed internal structure and the child’s personality will be dependent on certain objects in what seems to be “an intense form of object hunger.” This is due to the fact that these individuals are searching for “a substitute for the missing segments of the psychic structure.”

Two of the youth also display this object hunger in their relationships with peers.

One youth latches onto anyone, declaring everyone is her friend and all the boys she knows are her boyfriends. The other youth has made a strong bond with a peer who he calls his “soulmate.” He identifies so strongly with this individual that he states he thinks they are “almost the same person.” This seems like the twinship selfobject function, which in part it is. However, these youth are also attempting to get their previously unmet mirroring and idealizing needs from an earlier developmental phase met through their peers.

At the same time, these youth think well of others. They are compelled to like everyone in a desperate search for someone to act as their selfobject: someone who will mirror them and act as the idealized parent imago. They dare not dislike anyone for fear

147  that what little selfobject functions they glean from others will be totally lost and they will fragment completely. In the same manner, they perceive others to like them and think well of them, even when they impose harsh consequences on them. Again, they dare not risk the possibility that another would dislike them as this would be too great of a narcissistic injury. By liking everyone and by supposing that everyone likes them, or defending against these thoughts completely by saying they don’t care what others think about them, these individuals can maintain some sense of cohesion.

Globally-focused group.

The youth in this group have a broad smattering of issues, both environmentally and constitutionally, with which to contend. All five participants live in poverty. Two of the individuals have experienced sexual abuse. Three of the participants have had a change in their primary caretaker in recent years. One participant lives in a family that engages in violent behavior. Three of the individuals have a Learning Disability. One individual is diagnosed with ADHD. This group worries about issues both at home and school. At home, they are focused on both practical and emotional needs. Practically, they worry they will not get their basic physical needs met. This environmental poverty may also interfere with their ability to get their idealizing needs met if they are unable to see their primary caretaker as being able to offer a sense of protection, security, and safety. Emotionally, they are not getting their intrapsychic needs met as evidenced by all five of these students longing for more maternal attention.

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148 At school, these youth worry about being “different.” They also worry about how their school behaviors will impact their relationships at home. This group rejects the adjunctive support offered to them. They resist interventions put in place by the school and they resent that these interventions single them out as “different.” Their selfobject need for twinship overshadows the need for adjunctive functions to succeed in the classroom.

Defense mechanisms.

Two of the youth in this group were heavily defended against revealing their thoughts and feelings throughout the interview process. Their answers to most questions were short and answered in as concrete of a manner as possible. They evaded any potential exploration into their emotional lives. One youth did make a self-aggrandizing statement when talking about what he liked to do, saying he had extraordinary physical prowess. This was a way he could try to shore up a faltering self-esteem.

The other three youth utilized denial, avoidance of topics by changing the subject, distorting the facts, and fantasying. Denial and distortion of facts was used most often when talking about school. They admitted there were problems at school and they have inappropriate behaviors, but they denied that they cause the problems. This group projects the source of their school problems onto their teachers and peers, blaming them for treating them unfairly and getting them into trouble. They justify their misbehaviors as defending themselves against injustice.

Avoidance of topics is used most often when speaking about the emotional availability of their mothers. They talk about their mothers, but change the subject when

149 starting to reflect on the lack of emotional closeness. Some of the youth use distortion of facts when speaking about their current relationships with their mothers and fathers, presenting the relationships to the investigator as real, external relationships when these do not in fact exist according to the primary caretaker.

One of the students uses fantasying as a defense. For instance, she tells others that the husband of the principal at her school is actually her biological father. This student was removed from her mother’s home due to neglect and sexual abuse and moved out of state to live with another primary caretaker several years ago. Her father has never been involved in her life. Dithrich (1991) states fantasy lying protects the individual from intrusion and impingement of painful reality. While it may appear as though creativity is at play, the person’s experience is fundamentally schizoid and dissociative. Selfreflection and interpretation of subjective experience are limited or absent. Fantasying rather than imagination is utilized.

Another student talks about lying as a way to get his needs met, whether to avoid doing his homework or to stay out of trouble. He acknowledges lying frequently, although he excuses this behavior and justifies why he does it. These are delinquent lies (A. Freud, 1969) rather than the defense of denial. This individual displays a theory of mind, as he is aware he is trying to create an impression in someone else’s mind that differs from reality (Diamant, 1997). Though the lies are delinquent, they also serve the function of trying to maintain a relationship with the adults in his life. He links getting his schoolwork done with being accepted as a person by his mother and teachers. He lies to avoid consequences, but he also lies in the attempt to get his selfobject mirroring needs met. This leads to intrapsychic difficulties, as he imagines that his mother and teacher

150 talk about his lying and that they don’t trust him because of this. He is highly indignant that they don’t trust him.

Dithrich (1991) states all lies rely upon denial, whether utilized against internal or external sources of anxiety. He states, “The lie functions intrapsychically by offering protection from painful affects and phantasies associated with failing to meet internal standards. Lies by definition are intentional, (p. 657).” There are both internal and external sources of anxiety for this youth resulting in his lying. Externally, he will meet the disapproval of his mother and teachers if his work is not completed. He also feels shamed in front of his peers. Internally, the lying is a way for this child to justify the nonattention of his mother: he doesn’t deserve to receive her emotional warmth and closeness as he is bad by not doing his work and then lying about it.

Relationship to mother.

The relationship to their mother is complex for the youth in the globally-focused group. Two of the youth experienced change in their primary caretaker within the past few years due to maternal neglect. One of these children was also sexually abused. These youth now reside with relatives. Another youth, though living with his depressed mother, was being primarily cared for by his grandmother until her death several years ago. He continues to mourn her loss. All of the youth report mothers who are unable to give them attention or be attuned to their emotional selves.

The youth that live with their mothers expend a moderate amount of energy trying to get her attention to meet their emotional needs, and when they are not met, in explaining to themselves why their mother is not emotionally available. Intrapsychically,

151 Â their selfobject mirroring needs have not been met. They have not experienced selfobjects that sufficiently admire them and give them acceptance and confirmation.

The poverty in which these youth live is an external force that could potentially drain a mother of her available emotional resources for her children. However, even within these constraints, it appears the times when the mother has the potential to be emotionally available to her children there is more misattunement and rejecting of emotional need than successful meeting of these needs. Intrapsychically, this is an intolerable state of affairs, so this is defended by the youth in explanations as to why uncontrollable, external forces make it impossible for their mother to provide this need.

The other two children, though having caretakers that are looking after their needs and are emotionally available, still long to be with their biological mothers. At this point, they are not utilizing their primary caretakers as selfobjects. They are using them as adjunctive support to get their external needs met. Intrapsychically, they currently remain bereft of a needed selfobject, although they do carry an internalized memory of their mother meeting at least some of those needs in the past.

A strength of all the youth is that in their self-narratives, they have stories and memories of their primary objects fulfilling at least some of their emotional needs. They tell of grandparents that took home videos of their early milestones and childhood antics.

They share memories of eating meals together with caring adults and having fun with extended family. At one point in their lives, these children experienced selfobjects that performed selfobject functions to at least a minimal degree. Because of this, the formation of a nuclear cohesive self was begun.

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152 These students, as much as they intrapsychically defend against the thought of a mother not meeting their emotional needs, can be in touch with some of the “negative” feelings about their mothers and are able to show some tolerance for the ambiguity of a mother who is not always the ideal parent. This is possible as a nascent core self was formed, possibly through adult relationships other than their mothers or maybe as a conglomeration of several significant, important adults. In any event, these youth are able to tolerate some of the imperfections of their mothers.

View of self.

In general, this group likes themselves. They are able to articulate qualities they like about themselves. They are able to give distinguishing qualities about themselves differentiating them from others. When not feeling threatened, they maintain cohesion.

One of the features of this group is their narrative of their earlier lives when they perceived life to be better. They talk of caretakers who cared for them and nurtured them.

It appears that in their formative years, these youth experienced selfobject functions that were able to meet some of their intrapsychic needs.

Nevertheless, they feel threatened easily at which time they begin to fragment.

For instance, the categorization of these youth as having an Emotional Disturbance threatens their self-esteem. They respond by being angry or hostile towards the interventions given to them by the teachers in their schools. Their mirroring needs and idealizing needs have not been sufficiently met for them to withstand what they perceive as a slight on their character.

153 View of others.

The youth in this group have strong likes and dislikes of others. They tend towards all-or-none thinking. They think others often don’t like them. Their relationships tend to be conflictual. They think individuals think less of them because of “bad” parts of themselves. This can be explained intrapsychically by examining the precariousness of their sense of self. When they feel respected, they respect others. They are receiving adequate mirroring functions to remain cohesive. They, in turn, can use the other individual to also meet their idealizing parent imago needs. When they feel slighted, or disrespected, their sense of self feels threatened, and they begin to fragment. At this point, they turn to rage as an organizing entity to retain cohesion.

These youth have the ability to develop relationships with others to help meet their selfobject needs. All of them see either their school social worker or an outside therapist (sometimes both). None of them object to seeing these individuals.

Significantly, two of these youth report strong connections to their therapists. One youth has forged a relationship with almost every adult that crosses her path as a way to get her needs met. These include the schools’ support staff such as custodians and secretaries.

Three of the youth in this group have extremely strong sibling relationships. The siblings care for one another, look after one another, and protect one another. They and their siblings have formed their own family matrix. The siblings attempt to provide selfobject functions for one another. The oldest siblings act in the capacity of an idealizing parent imago. The younger siblings look up to the oldest siblings and depend on them for protection and to help get not only their physical needs but also their

154 emotional needs met. The younger siblings, in turn, admire the older siblings and help meet some of the eldest’s mirroring needs, albeit in a nonconventional fashion.

One of the youth has strong bonds with a friend group. This parallels normal adolescent development in that in typical adolescent growth, the parental selfobjects are deidealized and adolescents turn to peers to fulfill selfobject functions. The self’s goals are not autonomy and independence, but cohesiveness in striving for integration into a reciprocally responsive matrix of selfobject relationships (Wolf, 1988). The difference from normal adolescent development with these youth is that prior selfobject needs have not been met before entering adolescence. Thus, they are trying to get earlier developmental needs met through their friends and/or siblings.

The globally-focused group is in between the home-focused group and the schoolfocused group regarding the use of the interview. Two students use the interview to make money to support the family income. It is an external use, not an intrapsychic use. They end the relationship at this point. They endure the interview rather than become engaged in it. They remain defended throughout the interview process. The other three participants in this group develop a moderate attachment to the investigator. They express the desire that they don’t want the interview to end and that they like talking. There is not the sense of attempt at merger as there is with the home-focused group. Instead, they ask advice of the investigator, wanting to take her ideas and use them for themselves.

155 Summary of Theoretical Considerations This dissertation is a study about youth who have been identified in the educational system as having an “Emotional Disability.” From a psychodynamic perspective, the label of “Emotional Disability” (formerly known as “Behavior Disordered”) is arbitrary and does not necessarily identify the underlying problem. This research goes beyond the individual symptoms in an attempt to identify the underlying dynamics.

The youth in this study fell into three separate, noticeably distinct, groupings with unique psychodynamics, sense of self, and sense of others. These groupings are designated the School-focused group, the Home-focused group and the Globally-focused group. They are examined using the theory of self psychology. Ubiquitous to all, these youth experience narcissistic injury and a lack of selfobject function (at least temporarily) that leads to a lack of cohesiveness. The youths’ symptomatologies are due to threats to self-cohesion.

The youth display a variety of disorders of the self, both primary and secondary.

The participants in the school-focused group display secondary disorders of the self whereas individuals in the home-focused and globally-focused group display primary disorders of the self, generally the narcissistic behavior disorders and the narcissistic personality disorders.

156 School-focused group.

The youth in this group have the most severe neuropsychological deficits and/or learning disorders of the three groups, yet they show the most cohesiveness of the three groupings. Their primary issue is a structural deficit, not a conflict or lack of adequate selfobject functions during their early developmental years.

These youth feel shame in being identified as not being able to control their emotions and needing specialized educational services. They utilize denial as a way to avoid this painful reality and to protect their sense of self. Some of the children also talk about purposefully lying. They do this most often when they are taxed beyond their means of trying to accomplish a school demand, such as completing an assignment. In the moment, the lie seems like an easier way to deal with the frustration of the task at hand rather than in attempting to do the task and encountering even greater frustration.

These youth have a close relationship to their mothers. Their mothers are attuned to their needs, are protective of them, and act in a pro-active manner for them. They are important selfobjects for their children. They meet the youths’ emotional needs and allow them to function at a higher level than might otherwise be possible. They also provide important adjunctive functions for their children.

The underlying causes for these children’s behaviors are biologically determined deficits that they are able to compensate for with the help of their selfobjects. At home, they experience a self-sustaining selfobject ambience. It is only when in school and being confronted with demands they are incapable of meeting, combined with having inadequate selfobjects and/or adjuncts in the classroom to aid in meeting those demands, that their selves experience fragmentation.

157 Â These children generally exhibit a cohesive self. They view themselves in a positive light. They like themselves. At the same time, they struggle with the thought they might be different than their peers. Currently, their mothers provide the acceptance they need for emotional cohesion. Because their mirroring needs are met, they are able to view others in a positive light. They have a flexible and nuanced view of the world and others. They can tolerate imperfection in others. They relate to others as having separate subjectivities. They can also tolerate rejection by others of themselves because they are secure in their primary relationships.

As they delve deeper into the task of adolescence, the twinship selfobject function will become more crucial in determining the sense of cohesion that these youth experience. Currently, the individuals in this group struggle with being accepted by peers.

The success of the next phase of separation and individuation may depend on the ability of these youth to find others to meet their twinship selfobject needs.

Home-focused group.

The youth in this group do not have other educational disabilities in addition to Emotional Disability. They exhibit extreme acting-out behaviors in the school-setting, yet in their minds, this behavior is hardly worthy of attention. They are focused on their mothers.

These youth have not experienced a selfobject that has been able to provide them with the necessary selfobject functions to achieve a cohesive self. They have not had a connection to a significant adult. Thus, they have not acquired the necessary internal structure to develop the self and their personalities are dependent on certain objects in an

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158 intense form of object hunger. Their minds are preoccupied with creating a connection and they attempt to forge it in any way they can. This fits in with the profile of a narcissistic behavior disorder, where there is a compelling need for merger with the powerful object, the idealized parent imago (Kohut, 1971).

These individuals don’t like themselves. They perceive themselves to be beyond help from adults who should be able to help them. They appreciate their efforts, but are convinced their efforts will be futile in effecting change. Intrapsychically, the youth in this group are convinced they are unlovable and unworthy of love. In a role reversal, and as a way to try to get their emotional needs met, these youth fantasize about taking care of their mothers. They defend their mothers and explain away the fact that she isn’t taking care of them. Intrapsychically, they keep the hope alive that their mother is the idealizing parent imago they fantasize about.

These youth, besides engaging in acting-out behaviors, also make use of denial to defend against narcissistic injury. These injuries are most acute and happen most frequently in relation to the thought of their birth mothers. Three of the youth engage in aggrandizing statements and one youth engages in fantasy lying. The aggrandizements are ways to shore up a faltering sense of self-esteem or unworthiness. The fantasy lying is a way for the youth to protect herself from the unbearable truth and harshness of the reality of not having a selfobject in her life to care for her or meet her needs.

These youth think well of others. They are compelled to like everyone in a desperate search for someone to be their selfobject. They dare not dislike anyone for fear that what little selfobject functions they glean from others will be lost and they will fragment completely. They also perceive others to like them and think well of them. They

159 dare not risk the possibility that another would dislike them as this would be too great of a narcissistic injury. In this way, they can maintain some sense of cohesion.

In addition to adults, two of the youth display object hunger in relation to their peers. This seems like a twinship selfobject function, which in part it is. However, these youth are also attempting to get their previously unmet developmental needs met through their peers.

Globally-focused group.

The youth in this group have both environmental and constitutional issues with which to contend. Accordingly, they espouse multiple problems. At home they are focused on both practical and emotional needs. They worry about getting basic physical needs met. This may also interfere with getting their idealizing needs met if they are unable to see their primary caretaker as the idealizing parent imago who provides security, protection, and safety. Emotionally, all of these individuals long for more maternal attention.

At school, these youth worry about being “different.” They also worry about how their school infractions will impact their relationships at home. This group rejects the adjunctive supports offered them at school as it makes them look different. Their selfobject need for twinship overshadows the need for adjunctive functions to succeed in the classroom.

In addition to acting-out, the youth in this group make frequent use of denial and projection to defend against narcissistic injury. They admit they have behavioral problems at school, but project the source of their problems onto their teachers and peers,

160 Â blaming them for treating them unfairly and getting them into trouble. They avoid the topic of the lack of emotional availability of their mothers. One of the youth uses fantasying as a defense against the painful truth of her father abandoning her and her mother being forced to give her up due to neglect. Another student talks about lying as a way to get his needs met. He lies to avoid consequences, but he also lies in the attempt to get his selfobject mirroring needs met.

The relationship to their mother is complex for the youth in this group. They all report mothers who are unable to give them the attention they need or who are attuned to their emotional selves. A strength of these youth is they have self-narratives filled with memories of times when their selfobject needs were being met. These children have experienced selfobjects that performed selfobject functions to at least a minimal degree, allowing the beginning of the formation of a cohesive, nuclear self. These youth are able to show some tolerance for the ambiguity of a mother who is not always the ideal parent because a nascent core self was formed.

This group, in general, likes themselves. When they are not feeling threatened, they maintain cohesion. When they are threatened, which can happen fairly easily, they start to fragment. Their mirroring needs and idealizing needs have not been sufficiently met for them to withstand what they perceive as slights of their character.

The individuals in this group have strong likes and dislikes of others. They exhibit all-or-none thinking. They think others often don’t like them. Their relationships are often conflictual. This is explained intrapsychically by examining the precariousness of their sense of self. When they feel respected, they respect others. They are receiving

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161 Â adequate mirroring functions to remain cohesive. When their self feels threatened, they begin to fragment.

These youth have the ability to develop relationships with others to help meet their selfobject needs. They make use of teachers, therapists, friends, and other adults in their lives. Significant to this group is the prominent role with which their siblings play in their lives. They and their siblings have formed a family matrix where they each act to meet the selfobject needs of the others.

Conclusion The youth in this study are chronologically at the ages of pre-adolescence to adolescence. The purpose of this study was to learn about the experiences of these youth to better understand their lives and how being identified by the school system as having a behavioral disorder with its subsequent interventions affects their emerging sense of self during the time period when conventionally children are facing the psychological tasks of adolescence. It was discovered that in general, the emotional focus of these youth is on meeting earlier developmental needs and they have not begun to address the psychological tasks of adolescence. These youth are focused heavily on their primary selfobject relationships.

There are three basic patterns of underlying psychodynamics evident in the participants involved in this study, dividing them into three fairly distinctive groups. The underlying psychodynamic in the first group of participants, the School-focused group, is related to having a learning disorder. These children have mothers who provide adequate selfobject functions. They also provide their children with needed adjunctive functions to

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162 navigate their worlds. Because of this, they don’t experience undue difficulties until they start school where those adjunctive functions are no longer available. The children become frustrated and problem behaviors ensue. The behaviors are secondary to the learning disorder.

The underlying psychodynamic in the second group of participants, the Homefocused group, centers around these children’s lack of connection to a significant adult.

They have not had someone to provide them with adequate selfobject functions. They have a primary disorder of the self. Their behaviors are the result of unconscious needs to protect their fantasized all-good mother and to make a connection with someone who will provide them with selfobject functions.

The underlying psychodynamic in the third group of participants, the Globallyfocused group, stems from a mixture of faulty selfobjects, learning disorders, and an impoverished external environment. This group has selfobjects that are able to provide some of their needed selfobject functions. They have developed a nascent core self, but it has been damaged due to impingements of the environment, their unmet need for adjunctive functions due to their learning disorders, and their only partially met need for emotionally available selfobjects. Their behaviors reflect this in that when their needs are met, they present a cohesive self and they are able to function adequately.

Since the School-focused group has experienced adequate selfobjects in their lives, they have developed a firm sense of self. They like themselves and are flexible in their approach to others, understanding that not everyone will like them. They are able to tolerate the narcissistic injury of disapproval. They approach other relationships with an open mind and are able to engage with others in an appropriate manner.

163 The Home-focused group has been deprived of adequate selfobjects in their lives.

Subsequently, their sense of self is severely damaged. They do not like themselves.

Intrapsychically, the only way they can maintain an idealizing parent imago is if they view themselves as damaged to the point of being unlovable. In their relationships with others, they imagine everyone trying to like them. It is not the others’ fault that they are unlovable. They are able to recognize the effort that others put in to try to help them.

These youth are so object hungry that they like everyone in an attempt to merge with someone to get their selfobject needs fulfilled.

Because the Globally-focused group has had their selfobject needs met inadequately, they also suffer from a primary disorder of the self. In general, this group likes themselves, but they describe their actions and behaviors as “bad.” When their mirroring needs are being met, they maintain a cohesive sense of self. During these times, they see the other person as the all-good, idealized parent imago. When their mirroring needs are not being met, they begin to fragment and perceive the other as intentionally depriving them of their selfobject needs. Intrapsychically, they have not had adequate transmuting internalization to withstand minor empathic failures.

Clinical Implications There are three major clinical implications to consider as a result of this research.

The first implication is the decision to identify a child with the disability of “Emotional Disability” in the educational system. This implies that there is an entity (the emotions) that is impaired in a child. In conceptualizing the emotions as a particular and discrete unit, the child’s emotions are reduced to a simplistic component of the youth with the

164 implication that they can be considered apart from other aspects of the child. This research demonstrates the complexity of human emotions and how redacting them to manifest behaviors misses important underlying psychodynamics. Clinicians need to be mindful of this when a child is referred to them from the school setting to be treated for “Emotional Disability.”

The second implication is that some of the techniques used in the school setting for treating children with Emotional Disability are not helpful from a psychodynamic perspective and may in fact be adverse to the child’s overall well-being. Children are well aware of the fact that their acting-out behaviors are inappropriate. They may or may not have the ability to use the interventions that are typically offered them in an educational setting to help them through their behaviors. If they are unable to make use of the proffered interventions, their sense of shame and despair may increase and may make them feel even more hopeless in meeting school expectations. Clinicians need to consider the psychodynamic ramifications for the child of the school interventions. This issue may need to be addressed by clinicians to the parent and school personnel.

The third implication is that the differentiation between the three groups of the youth in this research illustrates there are clinical indications as far as the kind of interventions to be used. Making a proper differential diagnosis will steer the clinician in the right direction as far as what is needed for an effective treatment. The clinician should also be mindful that part of the treatment process may be to direct the parents/teachers to the use of adjunctives from other sources.

165 Implications for Further Research One of the findings of this research was the differing view of self and others between the two groups with primary disorders of the self. In particular, the pairings of not-liking-self with liking-others in the home-focused group and liking-self with extremelikes/dislikes-of-others in the globally-focused group was notable. It would be interesting to further explore these psychodynamics to understand more fully the intrapsychic etiologies of these pairings.

Another finding of this research was the use by some of the participants of their siblings to try to fulfill their selfobject and adjunctive needs. The mind knows what it needs in order to develop and mature. When there are no reliable selfobjects to be found in the conventional manner, unconventional ways may be tried. Some of the siblings formed a strong family matrix with each other. It would be interesting to explore the use of siblings from a psychodynamic viewpoint to see the effects these close sibships have on the individuals’ sense of self.

Corollary research would be to examine the psychodynamics of how adolescents-when the selfobject need for twinship is particularly strong--navigate using peers to meet their twinship needs when their earlier selfobject needs have been inadequately met. In particular, it would be interesting to note if they also attempt to use their peers for their mirroring and idealizing needs, and if so, the psychodynamic ramifications of this.

A further area of research would be to examine the kinds of adjunctive functions that sustain children and enable them to perform at an optimal level of functioning. This should include remedial services needed at school as well as healthy adjunctive functions the parents can utilize at home.

166 Â Lastly, it was apparent that several of the youth were able to make use of visual keepsakes or recordings of their younger selves as a way to develop their own selfnarrative. This, in turn, seemed to help them develop and maintain their sense of self when externally much of their lives did not remain the same. It would be worth exploring the underlying psychodynamics of this process to further understand how children can incorporate and make use of these external objects to increase internal stability.

Policy Implications There are several implications for shaping future policy for treatment of youth with an Emotional Disability. These are: 1. Teacher education of psychodynamic child development. This should include normal childhood development from a psychodynamic view along with a beginning understanding of the defenses children might use to protect their sense of self. This would include children’s use of denial, making of false statements, and fantasy lying. This would then hopefully lead to the formation of a student disciplinary code that would reflect such understanding.

2. The ability to offer students psychodynamic treatment within the school setting through clinically trained child mental health therapists.

3. Development and use of effective adjunctive supports for children in the school setting.

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167

Appendix A Recruitment Flyer Recruitment Letter

168

VOLUNTEERS NEEDED! Let your child’s voice be heard!

Your student’s perspective is very important in helping us understand his/her experience more fully!

STUDENTS needed for a one-hour interview

***RECEIVE A $20 GIFT CARD*** Each student that participates will receive a $20 thank-you gift card to a store of his or her choice

Qualifications for the study: • The student must be a middle or high school student • The student must have an IEP for emotional disability (ED) What will happen during the interview?

Students will talk about themselves, their interests, and their lives as students For more information contact: Email: susan.r.terrell@gmail.com Cell phone: 773-396-6750 Sue Terrell, RN, LCSW, PhD Candidate, Institute for Clinical Social Work This research is part of a dissertation entitled “The experience of youth identified as having a behavioral disorder.”

169 Susan R Terrell, RN, LCSW 773-396-6750 susan.r.terrell@gmail.com

Dear Parent(s)/Guardian(s) and Students, I am looking for students in sixth through eighth grades to participate in a study about the experience of children who have been identified as having a behavioral disorder in the school setting. To qualify for the study, children must be in 6th, 7th, or 8th grade and have been removed from the general education classroom and placed in an alternative educational setting due to their disruptive behaviors. These may be special education students with an IEP for “Emotional Disability” or they may be students placed in a Regional Safe School. The purpose of the research is to describe this situation through the eyes of the students. Very few studies have focused on how the students view their experiences. By taking part in this research, your child’s voice will be heard. Your child could be very helpful by talking to me for an hour that will be scheduled at a convenient time and location. Complete confidentiality will be maintained at all times, protecting your child’s identity in all data and reports. He or she will receive a $20 gift card to a store of his/her choice as a thank you for the time involved.

I am a licensed clinical social worker with experience working as a school social worker in a kindergarten through eighth grade school setting. I am also enrolled in a doctoral program at the Institute for Clinical Social Work in Chicago. I am conducting this research for my doctoral dissertation at the Institute for Clinical Social Work (312 9354232). My proposed research has been reviewed and approved by the Institutional Review Board.

I hope you will take this opportunity to call me at 773-396-6750 or email me at susan.r.terrell@gmail.com to learn more about the study. You will not be obligated in any way. This will be my only attempt to contact you since I have been given no identifying information about you or your child. Feel free to pass this letter on to anyone who may be interested in participating in this study.

Your child’s perspective is so important to help us understand these students’ experiences more fully. Thank you for your interest.

Sincerely, Sue Terrell, RN, LCSW PhD Candidate

170

Appendix B Consent Forms

171 INSTITUTE FOR CLINICAL SOCIAL WORK Child or Adolescent Consent for Participation in Research Dear _______________________________________, Student Name

I am inviting you to participate in a research study. This form explains all about the study and what you will do if you decide to participate in it. I will read this form out loud to you as you follow along and read the complete form silently to yourself. Please ask any questions that you have now or at any time during this process.

By signing this consent form below, you are agreeing to take part in a research study called The Experience of Middle School Students Identified as Having a Behavioral Disorder. Sue Terrell will do the study. She is a student getting a doctoral degree in clinical social work, which is a degree that will help her to help people with their feelings. Her school is called the Institute for Clinical Social Work and is located at 401 South State Street, Chicago, IL 60605, (312) 935-4232. Her teacher is Joan DiLeonardi, Ph.D. Dr. DiLeonardi will make sure Sue does everything right in her research work.

Purpose of the Research or “Why is this being done?”

This is a research study to learn about what it’s like to be a middle school student identified as having a behavioral disorder through the educational system and be placed in a different school setting than in your regular neighborhood school. It is hoped that this study will help others better understand what it is like for kids to have these experiences and how they understand this in their own lives. One of the best ways to find this out is by asking the students themselves. That way they can say exactly what it is like and the adults can have a better understanding of them. You are being interviewed for research purposes. This is not a therapy session.

Procedures Used in the Study or “What do I have to do?”

If you agree to participate in this study, you will: • Have one interview with Sue, the researcher, for approximately one hour at a time and place you both agree on.

• Agree that the interview will be recorded on a digital voice recorder in order to make sure Sue has a complete and accurate record of everything that is said.

• Be able to choose a $20 gift card from a store of your choice as a thank you for being in the study.

• Have the chance to ask for a summary of the study results.

Your parents will do the following: • Sign a Consent Form.

Benefits or “What’s in it for me?”

You will receive a $20 gift card from a store of your choice.

Cost or “Do I have to pay anything?”

172 It does not cost anything to be in this study. You will be donating about one hour of your time.

Possible Risks/Side Effects or “Can anything bad happen to me if I do this?”

It is possible that in talking about your experiences, you might have some uncomfortable feelings. If this happens, Sue will offer to stop the interview and take the time to talk with you about these feelings. However, this is not a therapy session. If you feel confused or uncomfortable after the interview has ended, Sue will give your parents the name of a therapist who would be willing to talk further with you to debrief the interview. You have the right to stop the interview or your participation in the study at any time. You don’t have to answer any question you don’t want to answer. If you decide to stop the interview, or not answer a question, no questions will be asked and no one will try to talk you into continuing. Your thoughts and feelings are respected and listened to at all times.

Even if you want to participate in this study, your parents might not want you to do so.

They have the right to not let you be in the study.

Privacy/Confidentiality or “Will people know what I say?”

This research study is being done as part of the doctoral dissertation by Sue Terrell. A dissertation is a large, written, report Sue has to hand in before she can graduate. It becomes a permanent, public record. Sue will make sure everything you say to her during your interviews are kept private and confidential. Sue will not tell anybody, including your parents, what you have said. Your identity will be disguised and protected in any written work. You might be quoted in the study, but no one will know it is you that said it, because your name or anything else that might identify you will not be included with the quotes. All recorded interviews will be erased after a written record is typed. The typed records will be kept locked in Sue’s private files, along with anything else she writes during the interviews. All of these records will be destroyed within five years after Sue completes her dissertation.

Subject Assurances or “Our pledge to you.”

By signing this consent form, you agree to take part in this study. By signing this form, you are not giving up any rights or releasing ICSW (Sue’s school) from responsibility for carelessness.

You may stop being in the study at any time without penalty or loss of benefits. Your parents also have the right to stop your participation in the study at any time. You or your parents’ relationship with Sue Terrell (the researcher) or staff of the ICSW will not be affected in any way, now or in the future, if you refuse to take part or if you begin the study and then stop.

173 Â If you have any questions about the research methods, you can contact Sue Terrell at 773396-6750 or Joan DiLeonardi at 312-935-4232. If you have any questions about your rights for being a part of this study, you may call Daniel Rosenfeld M.A., Chair of the Institutional Review Board, ICSW, 401 South State Street, Suite 822, Chicago, IL 60605, (312) 935-4232.

Signatures I have read this consent form and I agree to take part in this study as it is explained in this consent form. _____________________________ Signature of Participant

_____________ Date

I certify that I have explained the research to ____________________________(Participant) and participant has explained back in his/her words understanding of the study procedures and this consent form. He/she has agreed to participate freely. I agree to answer any additional questions when they arise during the research or afterward. __________________________________ Signature of Researcher

_____________

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174 Parental Permission for Participation in Research Study INSTITUTE FOR CLINICAL SOCIAL WORK Title of Study: The Experience of Middle School Students Identified as Having a Behavioral Disorder What is the purpose of this research?

I am asking your child to be in a research study because we are trying to learn more about middle school children with behavioral disorders in the school setting. For the purposes of this study, middle school students with behavioral disorders are defined as students in 6th, 7th, or 8th grade who have been removed from the general education classroom and placed in an alternative educational setting due to their disruptive behaviors. These may be special education students with an IEP for “Emotional Disability” or they may be students placed in a Regional Safe School. Your child is invited to participate in this study because she or he meets these criteria. This study is being conducted by Sue Terrell at the Institute for Clinical Social Work. If you have questions now, or at any time, please feel free to ask me.

How much time will this take?

This study will take about one hour of your child’s time.

What will my child be asked to do if I allow him/her to participate in this study?

If you allow your child to be in this study, he or she will be interviewed for approximately one hour. These interviews will be audio taped.

What are the risks involved in participating in this study?

Being in this study involves the risk that your child may have some uncomfortable or confusing feelings during the interview. For example, your child may feel uncomfortable about answering certain questions. If this happens, I will offer to stop the interview and take the time to talk about these feelings. Your child or I have the right to stop the interview at any time.

If your child feels confused or uncomfortable after the interview has ended, I will give you the name of a therapist who would be willing to talk to your child to process these feelings. You would incur no charge for this session. It would be paid for by the researcher.

What are the benefits of my child’s participation in this study?

Your child will receive a $20 gift card to a store of their choice for participating in this study.

175 Can I decide not to allow my child to participate? If so, are there other options?

Yes, you can choose not to allow your child to participate. Even if you allow your child to be in the study now, you can change your mind later, and your child can leave the study. There will be no negative consequences if you decide not to allow your child to participate or change your mind later. Also, even if you give your permission, your child may decide not to be in this study.

How will my child’s privacy be protected?

The records of this study will be kept private. The dissertation is a permanent record and some data will be included in it. However, in any report we might publish, we will not include any information that will identify your child. Research records will be stored securely, and only researchers will have access to the records.

Whom can I contact for more information?

If you have questions about this study, please contact Sue Terrell at 773-396-6750. If you have questions about your child’s rights as a research subject, you may contact: Daniel Rosenfeld, Chair of Institutional Review Board; ICSW; 401 South State Street, Suite 822; Chicago, IL 60601; (312) 935-4232.

You will be given a copy of this information to keep for your records.

Statement of Consent: I have read the above information. I have all my questions answered. I permit my child to be in this study.

Child’s Name: _______________________________

Grade in School: ____________

Parent/Guardian Signature:_______________________________ Date: _____________

176

Appendix C Sample Interview Questions

177 Sample Interview Questions The following are questions that may or may not be used during the interview.

The interview will be open-ended and begin with general opening-conversation remarks. The participant will then be invited to talk about his/her experiences.

1. Tell me about yourself. What’s one of your favorite things to do? What don’t you like to do?

2. Tell me about the school you’re at now. How long have you been there? Tell me about this experience.

3. You know that the school you’re at is for kids who had a hard time at their old schools in behaving the way the teachers/the school wanted them to behave. Tell me your thoughts on that. Could anything have been done differently for you there that would have made it better?

4. What did/do your parents have to say about all of this? Tell me your thoughts on this. Has it changed anything for you at home? With your friends?

5. If you had to describe yourself to someone else, what would you say? What’s one of your best qualities? The thing you need to work on the most? Do any of your experiences affect how you think about yourself, your life, or other people?

6. If you could tell the person that makes decisions about kids in schools like yours about what’s best for the students, what advice would you give?

7. If you could change one thing, what would it be?

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