Life in Basket C

Dr. L was our first psychiatrist.  He seemed surprised that the dog lady had referred us to him  He didn't have room in his practice, not really, but was willing to evaluate Max and give us an opinion.  We'd later learn that if you find a child psychiatrist who has room in his practice, he probably sucks.  Better to see someone without room, and then beg for their mercy.
My husband and I both went to that first appointment, I think.  Dr. L. asked lots of the same questions that the dog lady had asked.  He was thoughtful, tall, good-looking.  A nice Jewish psychiatrist who would meet with Max 3 times, and then meet with us again to discuss...something.  I'm not sure I ever knew what to expect.  I always felt that I had to be on my best behavior.  Proper mommy outfit.  Not too much makeup, but not too casual.  I had to look like I cared, but not too much.  Always hard to tell who they're looking at, the psychiatrists.
He met Max 3 times.  The third time ended prematurely, Max ran out, giggling hysterically, crashing through the office, down the hall.  I could barely get him into the car, into the car-seat.  It was a common site for problems, the car.  By problems, I mean...problems.  Like taking off his shoes and throwing them at me on the highway.  Like taking off his seatbelt, climbing out of his car seat, and grabbing me from behind while we were speeding across the Tappan Zee Bridge.  I'd be desperately trying to control him with my right arm while I drove with my left, screaming, crying.  Sometime later a preschool teacher asked where Max learned the word "fuck".  I told her he learned it on the Tappan Zee Bridge.
But back to Dr. L.  He would turn out to be ALWAYS correct.  Never wrong.  Everything he ever said turned out to be truer than we could have imagined.  Not always right away, but eventually.  And there were things he said that no one else ever told us, and that we still say to one another to this day.  The first one he said when he met with us after those three meetings with Max: "Don't talk to other parents," he said.  And he was right.  We didn't realize how different we were.  We'd been dropped into a cold pan of water, and then the water was brought to a boil, so we didn't even know how bad it was.  If we'd been dropped into the boiling water, we would have screamed for our lives.
Dr. L. said Max had a "mood disorder", and we started down a long medication road right there.  He gave us an abbreviated version of a lecture he gives to medical students at Yale.  I still have my notes from that meeting, and sometimes I even still refer to them, but mostly I've memorized the whole damn thing.  We started with a tiny dose of stimulant medication, "just in case" this was "just a really bad case of ADHD".  I didn't know that I was supposed to be hoping it was just ADHD.  It wasn't.
The next medication was Abilify, an atypical anti-psychotic medication you can see advertised during the 5 AM news.  The lonely woman walking in the forest, and then it turns sunny.  That's Abilify.  In tiny doses, it helped right away.  For 3 weeks, life was incredible.  Max was manageable, and did what I asked.  He stayed calmer, and could process requests.  There was no violence, and I imagined that life would be normal.  But then it stopped working, and Dr. L. sighed, "I've seen this happen".  But none of the drug reps knew anything about this possibility.  It was devastating.
Dr. L. suggested that we read The Explosive Child, a book by Dr. Ross Greene, who's at Massachusetts General Hospital.  The book isn't about diagnosis, but about managing kids "like Max," who are exceptionally angry, and whose families have to run around in circles to manage them.  Using a method called "collaborative problem solving", the book was radical, suggesting that we can choose to stop fighting about all sorts of things, placing many of those things into "Basket C," where we realize that we can't invest time in them.  Truly important things are "Basket A".  Basket A was about safety...the rare things about which we just have to impose our will against our child for everyone's good.  Basket B was supposed to be a place where we started genuine negotiating with your child, in an effort to teach them skills, to help them catch up where they were developmentally lost.  What resulted was what Dave called "life in basket C".  Max couldn't negotiate anything.  He got stuck on an idea, and was totally unable to give it up.  He would decide that he needed something....a matchbox car, a certain kind of waffles, and demand that we immediately go to the store to buy it.  He could focus on something for days.  If we bought it, it didn't help, he just moved on to something else.  And if we didn't buy it?  He would talk about it incessantly, sometimes raging through the house, throwing every solid object he touched: toys, crayons, chairs.  Wooden toys became forbidden in our house, as the walls became more and more distressed with the evidence of our child's rages.
Then Max began going to a summer program called Prospects, allegedly for kids like him.  Dave and I constantly called it "Promises", after the celebrity drug rehab in Malibu.  Mostly it was really poor kids who suffered from tremendous under-parenting, as well as their psychiatric disorders.  I had to sign a contract that I would participate in therapy, and that I'd go to a parent group.  I thought it might be helpful. That's when we still had hope, when I thought that I could do what these experts told me, and things would get better.  But the experts had already turned on me.
Prospects used a behaviorist model: kids got points and could use them to buy things in the store.  No one told me that a behaviorist model is the OPPOSITE of Ross Greene's baskets.  Mostly, I think the professionals we came in contact with underestimated how closely we were listening to them.  Far from the "non-compliant parents" they were used to, I took it all to heart, hopefully implementing everything.  Eventually, the psychologist in charge at Prospects, Dr E, told me that using collaborative problem solving was the opposite of Prospects. Oh.  So, I don't know what I'm doing, and I don't know what you're doing, and why does my kid act like this?
Prospects introduced Max to all sorts of clinical lingo that he still uses: he calls other children  "peers" and he might describe a child having an outburst as "testing limits". It sounds ridiculous when Max says it, and worse when a clinician is impressed by Max's use of these idiotic words.  Prospects also had bizarre lingo unique to their program.  When a child starts to act out of line, the staff members would say "That's a prompt".  I think it was supposed to mean that the staff was prompting the child to improve his behavior, but I"m honestly not sure.  Max knew that getting a prompt was bad, but he could never really understand why he had gotten one.
Slowly, Max moved up their level system...he made it to level two, Hooray!  Then he'd throw a marker, or a chair, and be down on "restriction," meaning he couldn't go to the Prospects store and spend his points.  Secondarily, that meant two hours rages at home where he angrily tore the room apart when I denied him any points.  Points became a new focus of his rage, and his rage only seemed to get bigger as he grew.  By July, Dr L and Dr E started discussing something new: psychiatric hospitalization.

I'm Going to Help You

That's what the first psychologist kept saying.  She resembled a troll; less than five feet tall, I surprisingly found myself looking down to talk to her.  She almost never wore shoes, only slippers in her home-office, tucked under the side of a large yellow Dutch colonial on a private road in New Canaan. There were images of Golden Retrievers everywhere.  Her therapy dogs were always Goldens, she told me  It seemed sweet, and almost normal, the therapy dog thing.  It made it seem like taking a five year old to a psychologist was a normal thing that normal people did.  But it wasn't.  And despite the New York-accented nasally "I'm going to help you", I knew it wasn't normal.
She hadn't met Max yet, not when she first said it.  We had told her everything we thought we knew.  He was impossible to discipline, despite all efforts with setting limits, sticker charts, cajoling.  The child was miserable, and he was taking us along with him.  He never understood the consequences of his actions, so much so that we doubted that any consequence made sense at all.  He had tantrums that would last an hour, but they weren't about anything.  Things would be OK, everyone walking on eggshells through our lives, when suddenly the bomb that was Max would go off.  He would thrash on the floor so violently that I had to move furniture out of the way to keep him safe, as if he were having a seizure.  Our family was functioning in crisis mode, but the crisis never ended.
We put our hope in the psychologists oddly small hands.  We endured weeks of testing, piles of forms to fill out; we meticulously described eating habits, sleeping habits, family history of everything from depression to learning disabilities.  She spent hours with him, astonished over his lack of desire to be toilet-trained. 
She tested his empathy, his I.Q., his understanding of reality, and a wide variety of aspects of his learning.  He had tremendous difficulty with spatial relations, which seemed to excite her.  The Aspergers Syndrome Diagnostic Scale (ASDS) indicated Aspergers was "Highly Likely".  Of course, we didn't know that the ASDS mattered until years later.  Literally. Years. Later.
When she told us the results of the testing, she leaned forward as she spoke, desperate to share her findings with us.  She diagnosed Max with "Non Verbal Learning Disorder", in which she was an expert.  We were lucky, really, because she was going to help us!  Many people do not accept that NLD exists as a unique diagnosis, but our troll doctor did.  And she just kept smiling, and looking delighted that Max had "NLD", even as she said it was just the worst thing to have because these kids just have no social skills, high rates of depression and anxiety, but, she did assure us, and put in bold in her report "NLD is NOT an autism spectrum disorder".  And she just kept saying that she was going to help us.  But she didn't.
She sent us home with vague advice and a bibliography.  Amazon made loads off Max's "NLD", and still makes annoying NLD book recommendations when we log on.  Months later, things were still beyond miserable, getting worse all the time, so she referred us to our first pediatric psychiatrist.

Radical Jewish Parenting- an introduction to some ideas

What if you never offered your kid an incentive or a punishment? What if every time you wanted your child to do something, you had a conversation about it?  What might happen? The "parenting experts" claim it would be chaos.  Kids would have no boundaries, which we're told that they need.  Kids wouldn't know right from wrong, and they'd never make the correct choice.
Judaism has this concept, or pair of concepts, really.  We believe that a person has a yetzer tov (a good inclination) and a yetzer hara (an evil inclination).  All people have both, and therefore we are all prone to the pressures in the world which might make us choose good or evil.  The Rabbis taught that we must find a way to fulfill our evil inclination, but that it should be channeled.  The common example of this is that a violent man should become a butcher, which would help him to fulfill his yetzer hara without doing harm.  A person who desires fame above all else should be encouraged to donate money to his community; the recognition he receives for his donations might fulfill his urge for fame while doing good.
I assert that we can appeal either to the yetzer hara or the yetzer tov, and that we should be appealing to the yetzer tov whenever possible.  When soliciting money for a cause, the primary method should be pointing out the good in the world such a donation would create.  Secondary to that should be the free tote bag.
When we teach our children, we might appeal to their yetzer tov by pointing out the good in what we are asking them to do.  I'd like Henry, my 6 year old, to pick up his Legos because it makes it easier for everyone to walk through the room when the toys are clear.  I'd like him to help a friend because it's the right thing to do, and makes us all feel good when we can help one another.  He does not receive starts on a chart or a sticker for these acts, because that would be appealing to his yetzer hara.  Furthermore, if I threaten him that I will take away the Legos, I am again activating the yetzer hara, by inviting him to fight with me.
I discussed this concept with a very nice Modern Orthodox rabbi recently, who felt that external rewards are the only way to get children "in the habit" of doing good acts.  He had mentioned, in the course of our conversation, that he is a baal teshuvah, so I had to ask why he ever started putting on tefillin.  Did someone offer him a prize?  He pointed up, and said "that's where I get my reward".  Having proven my point, he continued to insist that children need external rewards, such a small slips of paper signed by a rabbi, to encourage them to help a friend.
This very kind, thoughtful rabbi, having spent years in Jewish education, told me that he'd never heard these ideas, and they were quite radical to him.  Thus, radical Jewish parenting.
What do you think? What works for you with your kids? How nervous does it make you to take the whole reward/consequence system out of the picture?