I was six the first time I saw a psychologist.
In the decade-and-a-half since then, most of the experience has been lost to faulty memory and even faultier record keeping, but I generally remember it going something like this:
I was having a miserable time in kindergarten. I wasn’t making any friends—on the contrary, a friend I had made in preschool had decided she wanted nothing to do with me—and I lived in constant terror of the looming specter that was the fire alarm.
The background of my mind was the site of a near constant calculation about when it might go off. It was a Catholic school, so we often went to masses as a class, and there never seemed to be a fire drill on those days. It also never seemed to go off when it rained or snowed, or during nap time, or while we were eating, so, at those times, I could breathe a sigh of relief. At every other moment though, I kept one eye trained on the hallway for the single flash of light that heralded the alarm’s blare. Unsurprisingly, this was a very stress-inducing way of living, and I exorcised my stress in a variety of “disruptive” ways.
The principal method of my exorcise was pulling out my hair, which my parents—and, presumably, the school—found unacceptable. The school counselor’s brilliant strategy was to give me a stress ball, which, to his credit, worked well for the few days. Soon, however, I went to my cubby to find it missing and threw myself into hysterics. I screamed and cried, pulled my hair, tore apart my school supplies, and to my recollection, banged my head against the wall (my mother contests that last bit, and I’m willing to chalk it up to conflation with another incident), only to find that I’d not actually lost it, but rather the teacher had taken it. I was furious for the rest of the day. The school told my parents they had to take me to a professional.
Being so young, I doubt I was told my diagnoses at the time, but over the years I’ve gathered a few tidbits of information about them.
1) I could not be definitively diagnosed with autism. I was six in 2011, so what is now known as autism spectrum disorder was split into autistic disorder, Rett’s disorder, childhood disintegrative disorder and Asperger’s syndrome, and I didn’t fit well enough into any of those to be diagnosed with them. I was “borderline autistic,” according to the psychologist, and “borderline autism” doesn’t count.
2) I may or may not have been diagnosed with generalized anxiety disorder. I remember being told I had anxiety extremely early in my life—and I must have been since anxiety has been listed on my medical history for years. But I don’t specifically recall when this happened or who I got the diagnosis from. My mother believes the diagnosis came later, and my father has seemingly no recollection either way, so it’s a toss-up.
3) I was potentially diagnosed with intermittent explosive disorder (IED). Of these tidbits, this is the most dubious. According to my father, the psychologist diagnosed both me and him with what he described as “some sort of disorder of frustration.”
By the time he told me this only a couple years ago, I was pretty familiar with the gambit of mental health disorders, and I had never heard of such a thing. I was interested, though, so I went looking.
Being in the United States in 2011, it’s most likely that my psychologist was consulting the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which lists nearly 300 mental illnesses, of which only three seemed to potentially fit the bill.
The first was conduct disorder (CD). It’s described as a “repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated.”
It was easy to rule this out. The damage I inflicted was always to myself and my own property, and though I was a prolific liar at school, they were always done to make me more well-liked (at one point, I stubbornly carried on with a story about how I had three super-cool older sisters no one had met before because they lived all over the country; in actuality, I am an only child, something I was tormented constantly by my peers about).
The next option was oppositional defiant disorder (ODD), characterized by “a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures.”
This, too, I was able to almost immediately rule out. I very rarely disobeyed my parents and generally complied with teachers; most adults found me very pleasant, and I certainly didn’t feel hostile towards them (except, perhaps, the teacher who took my stress ball).
This left intermittent explosive disorder (IED), characterized by “the occurrence of discrete episodes of failure to resist aggressive impulses that result in serious assaultive acts or destruction of property.”
This, more than any of the others, seemed like an accurate description of my behavior. When I showed it to my dad, he said it sounded like it could be the thing she said. Supremely unhelpful.
Nevertheless, I incorporated IED into my self-mythology. Even when I believed it had been written out of the more modern version of the DSM—it hadn’t been, it had just been moved to a new section of the book—I, more or less, understood myself as someone with an impulse-control issue. I still think of myself that way, and that knowledge has helped me manage my more destructive impulses, but I think the way that psychologist handled things was a bit fucked.
To put my cards on the table, I’m skeptical of a lot of practices in the field of psychology and psychiatrics. I am pretty anti-institutionalization, for example, and I think talk therapy is more or less a sham, and the “everyone should try therapy” sentiment is bogus (if nobody can live in a society without psychological care, then the society isn’t fit to be living in). I don’t think it’s my bias making me question the care I got, though.
Let’s say my mom is right about anxiety, and my dad is just misremembering, and the psychologist merely told my parents I’m bad with frustration. How would that not be completely unhelpful? Diagnoses are good because they help you find appropriate treatment for your condition. Vaguely gesturing towards kind-of-sort-of-autism and problems with frustration would not have helped my parents, two people completely unfamiliar with mental health care, help me.
By contrast, if the psychologist diagnosed me with anxiety and/or IED, she did not give me adequate coping strategies. I vividly remember being taught breathing exercises, doing them once and being laughed at, then never attempting them again. As for the IED, to this day I still pull my hair when stressed and rip up papers when I’m frustrated (through the years, I’ve also gathered a number of other destructive habits like biting my tongue and skin picking), and it makes sense considering I’ve never gotten treatment specifically for it. Clearly, it didn’t stick in my parents’ minds as something important if they were indeed told I had it, so they couldn’t have sought out someone specialized in it since, oh yeah, it’s a very understudied disorder.
On top of all of this, she was just plain wrong about the autism. When I went to a psychiatrist at 19, she told me that by every standard today, I am autistic. Autism is extremely underdiagnosed in females, so, while the different diagnostic metrics certainly played a part, I was probably not diagnosed simply because of gender bias.
It isn’t helpful to ruminate on should have, would have, could have, but I do wonder how having these diagnoses be more firmly defined might have changed my life. As I grew up, my problems only multiplied, as they tend to do. It’s not easy feeling like something is wrong but not knowing what. Would my childhood have been better if I had been able to put a name to it? Or better yet, if I had gotten support from the jump? No one can know.
What I do know, though, is that we should change the way we treat angry children.
Featured image courtesy of Wikimedia Commons.
