The Conundrum of Childrens' Mental Health

Having a fifteen year old son who has never had a friend is heartbreaking. Actually I tell a lie. I am his (only) friend. But I also happen to be his mother.

I thought everyone has friends. Isn't it just part and parcel of life, whether you happen to be young or old, everyone has a friend. My son is kind and loving and funny – all ingredients that are necessary in friendships. Sadly, though the answer is no. He has never had a best friend, someone his age to hang out with. Ironically he tries so hard to make friends that ultimatley he alienates them. In his desperate effort to make a friend, he invades their space, they step back to breath and he feels rejected. This happens to him over and over again. I grew up to the mantra, “everyone is allowed to make a mistake once but no one should make a mistake twice.” He has been on a therapeutic journey for many years now. He has learnt to self advocate and to be resilient, patient, respectful, insightful and accountable. All vital life skills of course. But he still doesn't have any friends and he definitely repeats his mistakes. Not just once but many times.

Like many kids with special needs he has a high cognitive IQ but a low social and emotional IQ. But after a while even having a high cognitive IQ becomes a burden. Although he has excellent eye contact, unfortunately he wasn't born with the automatic social language piece that most of us are born with. If we see a certain look on someone's face we know to back off. If we see a smile that doesn't reach the eyes, we know it is not genuine. He doesn't know this language and so he has to second guess it. Inevitably, like guessing in a multiple choice math quiz, he often gets it wrong.

For most of us, reading social cues, is an innate, inbuilt skill that we learn when we are young, but for some children the harder they try the more mistakes they make. My son still doesn't really know how to interact socially with boys of his age. If he did know, he would already have done it. He doesn't seem to be able to link cause and effect. He really, really doesn't want to feel rejection by his peers. And when he does, that's when the real trouble begins. He blames his peers (so much easier than having to admit that it is him who is missing the social piece), he struggles with active listening and because this means just oh so much to him, he gets mad. Mad is the only emotion he knows that will always get him attention and hopefully with that attention someone will come and save him and help him get a friend. He will probably also seek revenge at this terribly unfair world he lives in. Because that seems fair to him.

Almost all children are born with the natural ability to pick up languages. Not just their mother tongue but the vital social and emotional language. However, my son wasn't born with this ability. So he has to learn it. And rather like if you or I had to learn Hindu, we would need to practice over and over and over again, every day, in order to accomplish any real progress.

Perhaps a more succinct way of describing his deficiencies is through the “Theory of Mind”. Theory of mind “is the ability to attribute mental states—beliefs, intents, desires, pretending, knowledge, etc.—to oneself and others and to understand that others have beliefs, desires, intentions, and perspectives that are different from one's own”. I have recently learnt that my son does not possess a theory of mind at all. As it turns out when my husband's sperm finally forged its way along my fallopian tube to meet up with my egg, the theory of mind wiring didn't happen. If only we knew who that electrician was. We would fire him for his shoddy work. Unfortunately this egg fertilization malarky is far from romantic. In fact because it turns out to be a complete lottery, our shoddy electrician will never be charged guilty. Instead I have a son who truly believes that everyone thinks in the same manner as he does. If he finds a joke funny then he believes everyone else does too. If anyone is to (oh shame on them) believe something different to him then he sees it as an immediate personal rejection. And a terribly unfair one at that.

Only now at the age of 15 is he slowly learning to hit “pause”. To take space and ask himself “what happened?” and then to evaluate everyone's feelings (not just his own). He needs to look for all the clues and then analyze them before he can come to an accurate conclusion. He needs to do this at every peer social interaction. Exhausting. So of course, as soon as his stress indicator increases, any ability to be logical or rational is already lost. It all happens just too fast. It really is one step forward and three steps backwards.

So what have I learnt as a parent (apart from never ending patience!)? Well firstly and fore-mostly I have learnt that I have a very complicated child who gets overwhelmed easily, misreads social cues and spirals into a limbic brain mode as soon as he feels rejected. I have learnt that when his (very short) fuse goes off, he shows every symptom of a child with ASD. I have learnt all about the limbic system; the hypothalamus, the hippocampus, the amygdala, the basal ganglia and the cingulate gyrus. Perhaps I should have just learnt Hindu. I have learnt not to communicate to my son how to feel, act or think or to criticize his feelings. I have learnt to embrace all of our collective emotions with a heart at peace. I have learnt to be flexible so that I can create way outs within our cul-de-sac. I have learnt that punishment does not work on a person with ASD symptoms. I have learnt not to enter or engage in power struggles or word battles, so as not to let him control my emotional content. It is our rules and our family culture that have the ultimate power.

It has taken us fifteen years to arrive where we are today and I feel that we back on the right track to maybe one day being a 'normally functioning family'. The sun is just, oh so slowly, peeping his glistening head over the horizon. Perhaps in another fifteen years time, my son will have a best friend.

Ultimately though I have learnt that the world of children's mental health is a complicated gambling game, one that like a bloodthirsty leach, will suck every ounce of your mind and spirit if you let it.

On the bright side though I have also learnt that living with challenge promotes progress and that accepting pain actually reduces suffering. Now pass me that gin and tonic.

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