"Defusing the explosive child" and "A child's first funeral"

Readers respond to the war between the psychologist and the pediatrician. Plus: Angry readers say, "Kill the gerbil!"

Published July 20, 2001 8:25PM (EDT)

Read "Defusing the explosive child" by Lawrence H. Diller, M.D.

Dr. Greene sounds like a quack. When did children start raising themselves? I have four children, and they do not tell us what they are going to do or accept. We do. We are the adults; they are the children. Children need limits and boundaries; they need to be told, No, you can't have that. If I (or my wife) had behaved in this manner, I'd be in a body cast. We have certainly screwed up this world when we let children make their own decisions and parents pick battles that are important for a little peace and quiet now. Setting limits early on is the best gift you can give to your children so they will be adults who understand that you don't always get what you want and sometimes life just sucks. Medicating children seems to be a poor way to be a parent.

-- Kevin McCreavy

As a teacher, I am sickened to see one more book come out that gives parents an excuse to allow their children's bad behavior. The sad fact is that little Johnny's "oppositional defiance disorder" or "bipolar disorder" or "ADHD" won't matter a whit when he curses a police officer or threatens others in authority. Parents do their children no favors with these permissive methods and teach the children to intrude on the rights of others. I have had meetings with students and their parents who use this jargon to excuse stealing, low grades, traffic violations, drug use, etc. Why does our society wonder that three out of five teachers quit within five years?

-- Dorrie Fletcher

As the parent of a teenager diagnosed as bipolar, I have experience with an explosive child. The advice to "not sweat the small stuff" is completely wrong: It is by consistently addressing the small stuff of everyday living that the staff of the program where my daughter resides has brought about a dramatic change for the better. The challenge of the explosive child, I believe, is that he both requires and rejects externally imposed structure. It is hard to cope with this conflict, for both the child and the parents, and the difficulty is compounded by the lack of support from society in general. The approach at North Crossing involves a combination of medications, family therapy, peer group norms and consistent focus on living up to expectations. The result has been close to miraculous.

-- Justin Fisher

As an advocate for children with mental illnesses, and the mother of two such children, I was horrified to read Dillard's review of "The Explosive Child," as well as his comments about medication.

Brain research has revealed more in the last decade than in all of preceding history. The discoveries, fueled by improved scanning, epidemiological and DNA research, show that childhood-onset mental illnesses are physical malfunctions of the brain more severe and debilitating than in their adult counterparts. ADHD and bipolar disorder are more heritable than juvenile-onset diabetes. Nongenetic triggers include perinatal complications, prematurity, toxins or viruses during pregnancy. Parenting practices do not cause these illnesses.

We have new hope for these children with the advent of more effective, more targeted medications and counseling therapies. Without up-to-date medical management, we condemn these children to high risk for delinquency, teen pregnancy, substance abuse, suicide and runaways.

I urge readers to study the science behind the new treatments. Medication is no picnic. The medications have worrisome, irritating and painful side effects and cost a lot of money. However, they correct the faulty imbalance of neurotransmitters, making it possible for these kids to lead nearly normal lives, and to develop socially, morally and academically. This is cause for celebration.

-- Diane Weaver

First, what prompted Dr. Diller to pen this biased and inflammatory review of a book that has been out there for a couple of years already; and second, why did Salon decide to publish it? By now many readers probably know that Diller has successfully latched on to the anti-child medication, improve your parenting, back to basic discipline reactionary movement with several books and an incessant stream of repetitive articles. Perhaps his sales have been sluggish lately? Certainly there must be literate psychiatrists out there to review such a book who have more relevant clinical experience and less of a hardened viewpoint than Diller's. Coming on the heels of similarly irrational ranting in Amy Benfer's article on Bruce Levine's condemnation of psychiatric medications, I see a trend in what Salon chooses to publish. Why can't Salon readers be exposed to a more diverse array of experts on psychiatric disorders and their treatment?

Diller's attempts to undermine Greene's strategies only anecdotally and with his "professional" disbelief are Reagan-esque. Greene's ideas are not theoretical but based on years of experience with real children and their families. Nowhere in the review does Diller actually state any objective reason why he finds Greene's strategies to be ineffective with some extreme children. In fact, the criticism of the book appears to be in spite of the success of Greene's approach.

Without any proof he slanders Greene's practice -- indeed, all of modern child psychiatric research -- for overdiagnosing certain disorders, unapologetically quoting unnamed "critics" as a source. What Diller seems to miss entirely is that "The Explosive Child" is indeed meant only for that small minority of difficult children who make the lives of their teachers and family a living hell. Certainly such families deserve a book or two. The portrayal of this book as part of a general degradation in parental discipline is another misrepresentation useful for Diller in tarring this book and a long list of others with the same, tired old brush of "the now waning self-esteem movement." Diller once again reveals his strong bias with unsubstantiated fear-mongering, promising society at large will suffer vague "pernicious effects" of "already-lax parenting."

One of the more subtle unstated and unsubstantiated assumptions in Diller's review is that the "appearance of a child" at his practice and at Greene's is somehow equivalent -- that they treat a similar client base, and that therefore Diller's experience can be considered by the reader to be equivalent to Greene's. Given the rather overexposed nature of Diller's opinionated writings, many parents with difficult children probably already know to avoid his practice. Likewise, those familiar with the success of Greene's methods might be selectively attracted to his practice. Diller's anecdotal success with improving parenting of some of his clients is laudable, but no more and no less valid than Greene's. Both can be true, but rarely, I am convinced, in the same child or family.

Diller's outrageous polemic reaches crescendo, however, only when he attempts to refute and preempt future research showing benefit to Greene's approach, and indeed gleefully predicts its appearance, considering it evidence of an entire field run amok. I hope the discerning reader will find this anti-intellectual and offensive enough to remove any credibility Diller might otherwise be granted as an objective medical expert.

You might think from Diller's review that "The Explosive Child" is a book about medicating your child. This is another misrepresentation perpetrated in the name of bashing the book; the book certainly advocates and explains careful diagnosis and use of some medications, but saves its bulk for explaining how and why the "basket" approach might work. In case Diller or any other readers wonder, it is in fact true that many parents do find success with calmly enduring (not promoting or praising) a verbalized obscenity or two in the name of promoting peaceful home life and modeling of a proportionate response to what are just words and not deeds. Such a response does do more good for many of us than a strict, unyielding and punitive disciplinary approach. Why is this surprising?

And yes, I am someone who has endured a decade of faulty, institutionalized, cookie-cutter parenting advice from every level of professional, only to find that an approach including medication and much of Greene's strategy was remarkably successful and has saved our family from the abyss. Most of these unsuccessful professionals didn't have much to say after their advice didn't work. Don't disregard treatment of mood disorders in children until you have looked deeply into the eyes of a destructive, violent and struggling child and seen the face of the illness, only to have this image replaced with a courageous, appropriate, high-achieving, courteous and loving individual a few months after proper treatment. That's all I need to be convinced.

-- Brian Heltsley

Read "A child's first funeral" by Triste Longcore.

There is a time to indulge your child's desires to make her own decisions and there is a time to take your child by the hand and say, "I am making this decision, and we are going to do things my way. You may not understand now why I'm doing what I'm doing, but you will understand when you are older."

Letting a helpless creature suffer a lingering, obviously painful death for three days because a young girl cannot let go is appalling and cruel. What a brutal indulgence of one's child!

-- Beverley Brackett

What the hell is this supposed to be about? What kind of an adult would allow an animal to suffer for three days just so her kid can enjoy the rituals of death? A pet is a responsibility, not a toy -- even if it is "just a gerbil."

-- Christine Lehman

By Salon Staff

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