Harmful Praise

Most people thrive on praise.  Praise leads to the repetition of the behaviour that garnered the praise in the first place; this behaviour could be good manners in a toddler, a teen independently tidying her room,  or landing a large client at work.  Irrespective of age, praise makes people feel that what they have done was worth the effort.  How, then, can praise be harmful?

Firstly, the manner in which praise is given may be damaging in the sense that it makes the person receiving the praise feel uncomfortable.  Not everyone enjoys being in the limelight – often referred to as introverts – public praise will likely cause these individuals embarrassment resulting in the behaviour not being repeated.  This is not to say that an opposite behaviour will then be followed: considering the large client example above, the person embarrassed by public praise, such as mention during a department meeting, will not stop garnering clients, but may not reach for the prestigious ones or would rather assist someone else in getting these.  For these introverts, getting the job done is more important than outward praise.  However, as all people do like a pat on the back, sending an Email of praise would be far better received and would likely encourage the go-getter attitude.

The second instance of harmful praise applies mostly to children: using praise to motivate.  Parents and teachers want their children to achieve and be polite, and praise them for attaining these goals.  Who needs more praise than the little tyke who is struggling, right?  It depends.  When children struggle with something, they know they are not good at it and receiving continual praise of little milestones in the efforts to motivate results in the praiser losing credibility and often the child’s self-esteem is lowered. 

Please note continual praise of little milestones can be harmful.  If the umpteenth attempt to tie shoelaces has been unsuccessful, praising that the right shoe went on the right foot doesn’t cut it as this was already legitimately praised when that portion of the task was mastered.  Rather than looking for areas to praise (which can be difficult), be honest with children and praise their efforts over the outcome.   

Continual praise may also result in praise becoming addictive where a child requires praise to do anything, including everyday chores. As with any ‘addiction’ a pat on the back will eventually not be enough; this is when praise turns into bribery and tangible things are required over the voiced praise.

Apart from loosing credibility, continual unreserved praise can result in an inflated self image which runs the risk of being seriously hurt when moving into an environment that offers praise less quickly.  Teaching someone to link their self worth to the amount of praise they receive results in low self esteem.

In order for praise to have the desired effect of repeating behaviours:

• Be mindful of the personality and determine whether public or personal praise would be better received.  
• Ensure the degree and time of praise are relevant to the effort put in the task, not necessarily the outcome, to remain credible and appear genuine.  
• To avoid creating a ‘praise addict’ vocalise praise rather than provide items.

Above all, praise from others should not replace your own commendation of your hard work.

Confrontation

Nobody enjoys confrontation.  There may be people for whom not addressing a problem is more uncomfortable than the confrontation itself, but no one looks forward to it.  Despite this, it is something we of all ages must do on a regular basis, and make no mistake the child confronting a sibling and the employee confronting a boss are equally as difficult for the individual involved. 

There are two important aspects to this topic: planning and defining.

Planning

Here is an example of a personal situation where I failed to plan.  We have had very noisy, party happy neighbours for the past two years.  On one night these neighbours were particularly loud and I ventured outside to confront them, sans planning.  My request for them to keep the noise down was met with anything but understanding.  While the confrontation was over in mere seconds, nothing was resolved.

Had I planned my argument I would not have chosen this particular time (2am); the venue (the street); the circumstances (a drunken party) or my frame of mind (sleep deprived).  Admittedly, we cannot guarantee the perfect scenario but planning will at least reduce the possible negative outcomes.  Had I planned my confrontation I would have chosen a more suitable afternoon time (not the morning as this group tend to rise later) and invited them to my home where I feel more confident and relaxed (and could practice my line of reasoning in the actual space).  There is no assurance my request for quiet after midnight will be met, however, I will have been pro-active about a problem I have and would not have received a drunken retort.

Defining

I have used many synonyms for “confrontation” above, some appear aggressive and others less so. 

The way you define this term for yourself will contribute to how confidently you approach your issue.  If you define it as someone wronging you, you are likely to be more antagonistic.  If you define it as a misunderstanding, you are likely to be more composed.  By no means should a misunderstanding have any less weight than an outright wrong.

If it went wrong the first time

Once a topic has been poorly confronted it is very difficult to revisit it later as the confrontee will have a bitter or trivial memory of the first attempt.  A bitter recollection immediately places them on the defensive, while trivialising the event puts them in a position to dismiss the topic before your argument can be brought forward.  This is not to say if the initial encounter went abjectly the whole topic should be discarded; rather state out right that your first attempt did not come across well and you’d like to revisit the matter.

In short

Defining the problem in a way that fits with your values and practicing what you want to say can make all the difference in how successfully your confrontation goes and ultimately the likelihood of a favourable resolution.

ADHD and Autism

The intention in writing this article was to develop a concise understanding of the relationship between Autistic Spectrum Disorders (ASD) and ADD/ADHD; the road was far from short and generated its fair share of questions on the way.  Nevertheless, I succeeded, albeit momentarily, to adjust the circles to some semblance of a straight line. 

The first of my circles, oddly enough, began right at the beginning: do ASD and ADD occur together in a significant number of cases?  The answer is both no and yes.  According to the Diagnostic and Statistical Manual IV (DSM-IV), the tool used by members of mental health professions to diagnose disorders, a diagnosis of ADD can only be made once Autism has been ruled out; the two cannot co-occur.  Yet the same professionals who use this diagnostic tool have seen with their own eyes a single child who ticks all the boxes of both ASD and ADD.  To appease the DSM and allow for a comprehensive treatment plan ASD can be said to co-occur with features of ADD including inattention, impulsivity and hyperactivity (as a side note I tried to rephrase this since inattention, impulsivity and hyperactivity define ADD and ADHD, but to avoid another circle I accepted it in all its humour). 

After avoiding that circle, I stepped straight into another one: the development of a comprehensive treatment plan.  For some, a change in diet and various therapies, such as OT and Behavioural Therapy, can have the desired effect on a child with ADD to concentrate more effectively for longer periods of time.  For others, medication is the answer and for others still a mixture of everything is required.   For a child diagnosed with ASD with features of ADD, where non-medication therapies are not quite enough, the question of whether or not to introduce medication arises, followed immediately by which one: stimulant or non-stimulant? 

Stimulants, such as Ritalin, which are widely used to treat inattention and hyperactivity as a result of ADD and ADHD, often have the side effect of increasing anxiety.  For children with ASD anxiety is already, very often, part of the package; an increase is not welcome to say the least.  Furthermore, research has shown that those with Autism respond at a lower rate than those with ADD alone.  Side effects of non-stimulants such as Strattera can include mood swings and suicidal thoughts.  Mood swings are another symptom where an increase is unwanted.  Should the individual already be self-injurious, the addition of suicidal thoughts could be disastrous.  Having shared these terrifying thoughts, there are those on the Autistic Spectrum who have benefited greatly from stimulant and non-stimulant medications.  Some parents have reported an increase in language and calmer behaviour. 

This medication circle was never suitably uncurled in my mind beyond the fact that every child is different.  And so came the temporary straightening of my circular adventure; no eureka moment of how to completely separate or entwine ASD and ADD, nor a treatment option that worked for at least 99% of individuals with a primary diagnosis of ASD or ADD with features of the other.  After my momentary frustration I decided to take solace in the fact that I confirmed something we all know:  despite a diagnosis, each child comes with a unique set of traits and needs to be treated accordingly; and that path unfortunately is rarely straight.

Published in Living ADDventure Issue 3 Oct 09

About

Thoughts of a Registered Counsellor is a blog on topics that regularly come up in my practice.  These topics range from school readiness, to subject choice to career counselling, and all the general difficulties that come with each life phase.