Friday Counseling Issues: Learning Disabilities

Visual Processing Disorder:   This is a problem not with vision, in terms of being nearsighted or farsighted, but instead  it concerns how information taken in through the eyes is processed in the brain. Here is a website that will help explain the problem:

http://www.ldonline.org/article/6390?theme=print

In simple terms,  the person simply can’t make sense of what he sees in what we consider normal terms.  For instance, spatial problems would be those in which it is difficult to perceive the positions of objects in a given space, or in relation to other objects. You may notice, for instance, a child reaching for a toy and missing it  over and over again.  It is normal in the beginning, but if it persists and does not improve, there could be a visual processing disorder.

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Other problems will develop.  Math and reading are both based on symbols or figures that a child needs to learn to identify and use correctly.  Also, a child with visual processing disorder may be one who is told he is clumsy, or needs to be more careful. He bumps into things, trips on the steps with regularity, puts his cup or class on the edge when he thinks he has set it far enough back that it won’t spill.

This is not an area of expertise for me. I have taught kids with several of the other learning disabilities we’ve discussed, but not this one.  From what I’m reading online, there are interventions that can be helpful.  One of them has to do with what we call “figure-ground,” something I learned about  in working with kids who had ADD.  The “ground” is the paper  on which the “figures” are written.  I learned to write tests that had lots of white space instead of crowding the page with too much  type. Matching sections were done in sets of five rather than ten or more, which can be terribly difficult for kids with a variety of learning disabilities.  And I did not hand-write my tests.  Students learn to read the printed word, not the written word. Not all teachers have the same handwriting, and some have  a hand that is difficult to read.  Typing, especially in  a size larger than  10 or even 12, is easier on the eyes.

Because I designed my tests for the kids who had difficulty, all my students grew to appreciate my uncluttered, easy-to-read tests.  Clutter is a real problem for kids with visual perception difficulties. A neat and orderly locker, desk, or book bag is very helpful for these kids. It’s a skill that should be taught and learned early on.

Next week I’m going to finish this series with a post about autism.  Again, I’m no expert in that subject, but because it is becoming so common I’d like to address it. The best news is that there IS help, and there is hope.

 

Friday Counseling Issues: Learning Disabilities

CAPD: Central Auditory Processing Disorder, sometimes also just Auditory Processing Disorder,  is a condition that affects a child’s ability to process what he hears in the same way other kids do because his ears and brain don’t fully coordinate. Something interferes with the way the brain recognizes and interprets sounds, especially speech.

Some kids with this problem are very sensitive to loud noises They will, when very young, cry if there is nearby thunder.  Fireworks?  No, no, no.  Not fun for a child who has CAPD.

It’s very easy to confuse CAPD with ADD or ADHD. (You know, I truly dislike writing in acronyms!)  Some of the symptoms are the same. The thing to watch for is whether or not the child mixes up sounds even if they are clearly pronounced.  Now, don’t get all flustered. All kids mix up sounds when they are first learning to talk. It’s hard for them to distinguish S from F, for instance, or B from D.  Often, they come up with some pretty cute, funny, or embarrassing mistakes. But as time passes, these mistakes go away. A child with CAPD?  The mistakes remain.

Background noise is a problem.  Big crowds, noisy kids in a cafeteria at school, loud music in a restaurant, can all make it very difficult for someone with CAPD to hear clearly. Feeling stupid, they learn to pretend they’ve heard and to just nod or smile rather than trying to answer.

Only 5% or so of kids actually have CAPD.  There is help.  Here is a good website if you think your child–or maybe your spouse or other relative–may have this disorder. Sometimes, just understanding it goes a long way toward living with it.

http://kidshealth.org/en/parents/central-auditory.html

Friday Counseling Issues: Learning Disabilities

Dyspraxia  is  a learning disability that most of us have never  heard of before.

Living with Dyspraxia ~ | DyspraxicFantastic.com

Dyspraxic people can  have language problems, and sometimes some difficulty with thought and perception. Dyspraxia, is not a matter of low intelligence, although it can cause learning problems in children.

Developmental dyspraxia is an immaturity in understanding and performing multi-layerd movement. For instance, a dyspraxic child will not do well at learning to play the piano. There are too many things he must process all at once, and he simply can’t.

A person with dyspraxia has trouble planning what to do, and how to do it. He is overwhelmed by complex problems of physical movement, including speech and handwriting.

The National Institute of Neurological Disorders and Stroke2 (NINDS) describes people with dyspraxia as being “out of sync” with their environment.

Studies have shown that about 10% of people have some degree of dyspraxia, while approximately 2% have it severely. Boys have it more often than girls . And dyspraxia often comes packaged with ADHD.

Daniel Radcliffe, better known to the ancient ones among us as Harry Potter, has dyspraxia. You can read what he has to say about it here.

Early symptoms of dyspraxia can include slowness in learning to sit up, crawl, stand up,  walk, speak, and potty-train. All of these actions require multiple movements, and a dyspraxic  needs more time and maybe some hands-on help to get it figured out.

The list of difficulties grows as a child gets older. Shoe laces, buttons, zippers, buckes, snaps–they’re all problematic in varying degrees.  Getting dress?  Shirts are backward, buttons all messed up, pants unzipped, shoes on the wrong feet and untied. He’s not deliberately messy.  He think he did a great job of dressing himself.

There is so much involved in dyspraxia.  You can read about it in detail on the link I gave you about Daniel Radcliffe.

Treatments range from physical therapy to occupational and speech therapy. Some kids have trouble learning not to stuff their mouths, and then they can’t swallow. They don’t make the connection between an over-full mouth and swallowing. They have to be taught to take smaller bites, chew, swallow, repeat.

Other therapies include Active Play and even Equine Therapy, which is being used quite successfully for many difficulties in children and teens. There’s something about the horse-human connection that gives a child confidence that he is not just stupid, clumsy, careless, and all the other unpleasant names we tend to label our children with.

This is a fascinating field, and I’m getting lost in reading about it. It goes beyond simply having trouble learning this or that task. It is a bewildered child not understanding why he can’t do the things all the other kids do.

It hurts my heart.

 

 

 

Friday Counseling Issues: Learning Disabilities

Dyscalculia.  This is going to be a short one today, because dyscalculia shows so many similarities to the dyslexia we covered last week.

This one I know about on a very personal level.  I’ve struggled as long as I can remember with simple calculations because I tend to put the numbers in backwards, or to do the wrong calculation with the right numbers.  Like, eight minus four is 24.  Seriously. 

dyscal

I wore holes in my homework papers with all the erasing I did. I understood the processes perfectly, but getting my problems right was a daily torture.  I did finally discover that talking to myself as I worked was helpful.  If I said the numbers and the process out loud, it seemed to make a big difference. 

I loved algebra and geometry.  It wasn’t all numbers.

Here’s a symptom list that you may find helpful:  

http://www.aboutdyscalculia.org/symptoms.html

So did I ever ask for help?  Good grief, no!  I was an “A” student.  My problem made me feel so stupid!  I’d never heard of learning disabilities back then, and I doubt any of my teachers had, either.  I even managed to test out of 8th grade math and go right to Algebra I in eighth grade, which was such an immense relief to me that I thought I’d won the lottery.  Algebra, I could do.  It was fun.  There were letters AND numbers, which cut my misery in half.

My problem was relatively minor compared to a lot of kids who ended up in tears during most math lessons.  But I will always remember how much I struggled, and how embarrassed I was when I had to go to the board to solve a problem, dreading that moment when the teacher would intervene with a puzzled look at me because I was “one of the smart ones.”

There is help. Lots of help online.  Search “dyscalculia help” and you will find lots of good information.

You know, the memories are flooding in right now.  Learning my nines in the multiplication tables was torture. I hated long division. Timed tests were also torture. And I’ll always remember the time I put the check number in the  amount column in the checkbook, and the amount in the check number column. Yeah, that was lots of fun to figure out.  When I finally realized what the problem was, I wanted to punch holes in walls.

Terry thought it was funny, which made me want to punch holes in HIM 🙂

Friday Counseling Issues: The Personality Disorders

Today, we’re looking at Dependent Personality Disorder. Keeping in mind that in this cluster of disorders, all the disorders are based on fear/anxiety, what seems irrational to a person who does not struggle with any of them is completely rational to those who do. As a therapist, I’ve had to sort of rewire my own brain in order to empathize and have compassion with dependent people, because the truth is that this disorder irritates the fire out of me.  I am so NOT dependent that it’s very hard for me to understand how anyone can function  when they so desperately need the help/approval of others.

Years ago, I was given the leadership position of a ministry in my church.  I took “leader” to mean that I was to make decisions and implement them. It wasn’t long before I discovered that I was wrong. What was expected of me was to put any ideas or decisions that needed to be made across the desk of my pastor, and HE would tell me what to do. This created a problem between us until I realized that most people in leadership ministries expected the pastor to do their thinking for them.  I couldn’t understand that. It all ended well because the pastor was a wise man, and I was willing to meet him more than halfway. I share this because I want you to understand how  difficult it is for me to truly understand dependent people.  It’s just not the way I roll.

The core feature of the Dependent Personality Disorder* is a strong need to be taken care of by other people. This need to be taken care of, and the associated fear of losing the support of others, often leads people with Dependent Personality Disorder to behave in a “clingy” manner; to submit to the desires of other people. In order to avoid conflict, they may have great difficulty standing up for themselves. The intense fear of losing a relationship makes them vulnerable to manipulation and abuse. They find it difficult to express disagreement or make independent decisions, and are challenged to begin a task when nobody is available to assist them. Being alone is extremely hard for them. When someone with Dependent Personality Disorder finds that a relationship they depend on has ended, they will immediately seek another source of support.

https://www.mentalhelp.net/articles/dsm-5-the-ten-personality-disorders-cluster-c/

The person with Dependent Personality Disorder (DPD) will hear, throughout the course of his life, that is is “needy,”  “clingy,” and “can’t stand on his own two feet”  His need for the approval and support of someone else is overwhelming, and when he loses that support he flounders around until he finds someone else who will fill the role for him. He really can’t stand to be alone. He will follow someone all over the house, keeping up a conversation of little or no interest to the other person, just to keep contact.  His need for obvious approval is unrelenting, and it wears out the other people in his life.

This is the high school girl who asks her best friend every single day, “Do I look okay?  Makeup?  Hair?  Outfit?  How about my shoes? How do I look from the back? Is this color good for me?”  She will then gather up her books from her locker and stick like a woodtick to her friend’s side as they walk to their first class.  If they don’t share the same class, she will say, “Okay, see you after class.  Can we meet at my locker?  Will you sit with me at lunch?  I’ll miss you!”

Her confidence and ability to function depends on her knowledge that her friend will always be available to her, no matter what.

In order to get a diagnosis of DPD, these traits have to be inflexible. All of us, especially during our teen years, tend to have a best friend that we rely on for support.  DPD goes way beyond the normal teen behavior. These traits cause functional impairment, and visible anxiety in the person who has them.  The traits create a problem in functioning well in normal society, and in interpersonal relationships.  Most important, the person who has DPD is miserably unhappy with her own behaviors, but is unable to break the pattern.

Treatment is in learning to confront anxiety; to tell oneself the truth; and to develop a set of personal goals that involve learning to become less dependent on others. As with all personality disorders, it’s not easy.  Good talk therapy with a patient, understanding counselor is important. The counselor needs to know how to draw the boundary so that the client doesn’t become dependent on her.  It’s a fine line to walk, and takes some experience  and compassion.

Friday Counseling Issues: Cluster C, Fearful/Anxious

Cluster C personality disorders are characterized by anxious, fearful thinking or behavior. They include avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.

avoidant personality disorder

Avoidant Personality Disorder can easily become a self-fulfilling prophecy.  The person who has this disorder has probably always felt inadequate, socially shy, and is certain that everyone sees him as a loser.  He’s always picked last when kids are choosing up sides to play a game. It seems as if no one even sees him or notices when he quietly backs away and leaves. People forget his name, or just refer to him as “that round-headed kid.”

We’ve all fallen in love with Charlie Brown.  He mirrors how we feel about our own perceived inadequacies, and we can identify with him easily—unless we’re narcissistic 🙂

The biggest problem here is with the person’s own perception of himself.  Our perceptions become our realities, and it’s no different for the Charlie Browns out there.  Here’s a good comprehensive list of symptoms:

  • Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
  • Is unwilling to get involved with people unless certain of being liked
  • Shows restraint within intimate relationships because of the fear of being shamed or ridiculed
  • Is preoccupied with being criticized or rejected in social situations
  • Is inhibited in new interpersonal situations because of feelings of inadequacy
  • Views themself as socially inept, personally unappealing, or inferior to others
  • Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing

What we believe to be the truth motivates our emotions, words, and behaviors. The more convinced we become that no one likes/wants/appreciates us, the more likely it is that we will behave in such a way that avoids people altogether.We become so self-effacing that we are actually self-erasing.

Treatment can include good talk therapy with a counselor who understand that this is more than just being a little bit shy.  Sometimes an anti-anxiety medication is helpful in the early stages of counseling because it helps the person be more objective about his situation.

I have found that it is very helpful to talk with a client who has this diorder about his own worth and value to the God Who created  him.  Changing his beliefs about himself will start him on the road to understanding how God sees him, and will help him to realize that part of his problem is not so much  a lack of self-esteem as it is a conviction that other people don’t esteem him appropriately.

Friday Counseling Issues: The Personality Disorders

“He/she  is such a narcissist!”

Such a statement has become quite common, and applied like a coat of varnish over anyone who seems even a tiny bit more self-involved than we like.  It’s usually a major overstatement of the situation, but like lots of other psychological terms, it is applied freely  when it really doesn’t apply at all.  We need to be careful with our words.  Words mean things, and contrary to the old “sticks and stone” jingle, they DO hurt.  They hurt, and they remain in the human psyche for a very long time.

The legend from which we derive the name for this disorder is, briefly, that a very handsome  young god named Narcissus saw his reflection for the first time in a pool of water.  He fell in love with himself at first sight, and eventually fell into the water and drowned.  Narcissus flowers sprang up  in the place where he died.

The moral of the story is that being totally consume with oneself leads to nothing good.

The person who has true Narcissistic Personality Disorder goes way beyond being just a little vain. These people truly believe that they a special, set aside for some glorious destiny in which the whole world will acknowledge their unique qualities, and they will finally receive the glory and honor they deserve.

Their envy of others  goes way beyond reason, and in some cases can lead  them to commit crimes against the object of their jealousy.  They are capable of murder, believing they have done the world a favor.  Of course, as with any other disorder, there is a huge degree of difference among narcissists.  Not all of them are sociopaths!

They often present an arrogant, haughty attitude because they alone understand how wonderful they are.  The rest of the world needs to catch up.  They can be quite charming, lulling another person into believing that they are truly interested.  Their only real interest, however, is in self-promotion.  They take praise and adulation as their due.

They are often innately dishonest,  exxagerating their accomplishments in order to achieve whatever status they desire. They are certainly capable of abuse, although most of the time it is not visible.  They are master manipulators,  seeming to know exactly where to put the knife of sarcasm, belittlement, and criticism  to do the most harm.  When they are confronted with their nasty behavior, they will raise their eyebrows in shock and claim that you simply must have misunderstood them.

They are never wrong. Ever. They don’t apologize for anything unless doing so will further their cause.  You can’t win an argument with a narcissist.  You can’t reason with an unreasonable person.

There is no specific treatment.  Talk therapy can help IF the person acknowledges he actually has a problem.

Friday Counseling Issues: The Personality Disorders

Histrionic Personality Disorder.  The name seems to cover it, but there are some nuances that separate this one from Borderline, which it closely resembles.

 

It wasn’t hard at all to find images that describe Histrionic Personality Disorder (HPD).  The disorder is fascinating, but it wears you out–whether you have it, or you’re close to someone who does.

It takes a lot of energy to keep up the kind of drama that characterizes HPD.  The person who has it is demanding, needy, and convinced that the things that happen to her have never happened to anyone else, and that the whole world is fascinated by her experiences. She loves to talk about herself, and takes or makes every opportunity to do so. She rarely sees the distaste or the boredom in the eyes of her captive audience, because she is consumed with her performance and has very little awareness of other people.

You go ahead and try to have a normal conversation with  a person who has HPD.  Good luck. Your first sentence will likely prompt him to go off on one of his own stories, totally taking the stage and derailing what you were trying to say.  Everything is about him, all the time.

Here’s a good list of diagnostic symptoms, taken from psychcentral.com :

  • Is uncomfortable in situations in which he or she is not the center of attention
  • Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior
  • Displays rapidly shifting and shallow expression of emotions
  • Consistently uses physical appearance to draw attentionto themself (my sharp-eyed son caught this egregious grammatical error.  Himself, not “themself.”  Oy.)
  • Has a style of speech that is excessively impressionistic and lacking in detail
  • Shows self-dramatization, theatricality, and exaggerated expression of emotion
  • Is highly suggestible, i.e., easily influenced by others or circumstances
  • Considers relationships to be more intimate than they actually are

HPD cannot be cured, but as with all personality disorders, it can be mitigated with good therapy.  Sometimes, medication can be helpful in calming the extreme attention-seeking and impulsive behaviors.

As with all the personality disorders, a biblical approach is often the most effective therapy.  When a person truly comes to Christ, it changes him.

 

 

Friday Counseling Issues: The Personality Disorders

Borderline Personality Disorder (BPD) is fascinating to the clinician, but a pure misery for the one who has it and those who love the one who has it.

Borderline personality disorder (BPD) is a serious mental illness that causes unstable moods, behavior, and relationships. It usually begins during adolescence or early adulthood.

Most people who have BPD suffer from:

  • Problems regulating their emotions and thoughts
  • Impulsive and sometimes reckless behavior
  • Unstable relationships

Incidence

  • BPD affects 5.9% of adults (about 14 million Americans) at some time in their life

  • BPD affects 50% more people than Alzheimer’s disease and nearly as many as schizophrenia and bipolar combined (2.25%).

  • BPD affects 20% of patients admitted to psychiatric hospitals

  • BPD affects 10% of people in outpatient mental health treatment

  • (taken from  http://www.borderlinepersonalitydisorder.com/what-is-bpd/bpd-overview/)

The gold-standard treatment for DBT has become Dialectic Behavior Therapy, which is an offshoot of Cognitive Behavioral Therapy.  Therapists who work with BPD usually study DBT in order to be most effective (please forgive the acronyms.  I don’t usually resort to them, but all these psychobabble labels are a real pain to type out all the time!)

My personal experience with BPD is limited.  I’ve had a couple of clients who had it, and after two or three sessions I sent them both to a specialist in the disorder.  Group therapy is very important and helpful, because  it gives the client the opportunity to interact with people in a controlled atmosphere while they learn skills that will help them function normally.

If you or someone you love has BPD, you know that there’s a lot of drama.  It can wear you out and shut you down. Borderlines crave close relationships, yet they continually destroy those relationships with their endless demands for complete closeness. They often feel that others dislike them, are keeping secrets from them,  or have abandoned them. Romantic relationship often go sour because the Borderline person is so possessive and jealous of the object of her affection.

While BPD can’t be permanently cured, it CAN be treated and kept in check with good therapy and family support. The person’s need for constant reassurance is wearying for the family. Boundaries are important in a relationship, lines that cannot be crossed without serious consequences.

There’s lots of good information out there in cyberspace.  As I’ve scanned through many different articles, I’ve found almost everything to be accurate. Of course, I use trustworthy sources like  the National Insititue for Mental Health (NIMH) when I go looking for information.  Check your sources carefully.  Not everyone who writes about these things has the training, authority, and experience to do so.

Friday Counsling Issues: The Personality Disorders

Today we’ll take a look at  Cluster B (Dramatic, erratic) personality disorders, which include Antisocial, Borderline, Histrionic, and Narcissistic personality disorders. In fact, I think we’lll just talk about the first one. We’ll see how it goes 🙂

It’s very important to understand  that this is a serious maladaptive pattern of behavior.  It is NOT typical of someone who just prefers to be alone.  We are far to quick to slap labels on people who walk a little different path than we do.

Someone who has Antisocial Personality Disorder may disguise it well, depending on basic temperament, but typically this person really doesn’t care too much how he is perceived. Lying is his primary MO, and he feels no remorse whatsoever in lying.  If he is confronted, he will either charm his way out of it or he will shrug and walk away.  His philosophy is that other people exist to  help him get what he wants; to take care of him, and to make no demands on him whatsoever.  He cannot truly love.

As a matter of fact, this person could easily be considered sociopathic. There is just no concern at all about the effects of his behavior.  He was probably a very difficult child, angry and maybe violent. This is a young person who will not hesitate to physically attack a parent or a sibling, and he can be a bully with his peers if he is strong enough to pull it off.  He has very little fear.

Some refer to this disorder as The Cold and Callous Man.  Not that all people with Antisocial PD are men, but it does seem that there are more men than women who fall into this category.

Treatment is difficult. There is no permanent cure, although if the person can be reached with the gospel, there can be a huge improvement. If the person will agree to treatment, there are several approaches that can be tried.  You can go here for a comprehensive article about treatment for ASPD.  Sadly, the person most often refuses treatment, blaming everyone else but never himself for the situations his behavior creates.

Next week: The very interesting Borderline Personality Disorder.