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« Population Control: Target Africa | Main | Whites in Africa or white Africans? »

March 02, 2006

Ozodi Osuji Weekly Series on Psychology 2006, #11 of 52: Children's Mental Health Issues

by Ozodi Thomas Osuji, Ph.D. (Seatle, Washington) --- Some time ago, I visited a Nigerian in a different state from the one that I live at. This man and his wife are rich; I mean rich. They are probably millionaires? They have several houses in the city they live at and have at least six luxurious cars. They live in a six bedroom mansion. By all accounts this couple has made it, they have arrived.

The couple has four children ranging from four to twelve years. They brought their mother from Nigeria to take care of their children while they are out making money. They left house before seven in the morning and seldom came back before nine in the evening.
What is the problem with this picture, you ask? Don’t you like the smell of money? Are you jealous or something? Get out of here.
The problem is the couple’s children. The three of them at a nearby elementary school were all in special education classes, that is, classes for children judged mentally deficient.
Here is the picture. In the morning, the children walked to the school, only a few blocks from their house. School is over at 3PM and they walked home. Grandma was there and stayed with them. They watched TV and did whatever they could to entertain themselves. Grandma does not speak English (she speaks Pidgin English) so the kids really could not relate to her and generally amused themselves the best way they know how. Essentially, there is no one around to help them do their homework. By the time their parents are back from their work the children are in bed. The parents are generally out of the house in the morning before the children get up from bed so it is up to grandma to get them up and get them ready for school.
When I stayed with this very generous couple, I had nothing to do in the evenings, so I decided to help the children with their homework. We would sit by the humongous kitchen table and do their arithmetic, English, science and social science assignments.
On weekends, I took the children to the gym and had them swim; I played basketball with them; I worked out with weights; we played table tennis and tennis. In fact, the oldest boy began running with me (I run every other morning, five miles, at last). On the whole the children had an adult play with them, a new experience for them. Their parents are busy working hard to have the time to go do fun things with them. As you can imagine, the children developed strong attachment to me. The bonding was so strong that some wanted to go home with me. Nigerians, generally, do not play with their children. Some of them think that they are too important to go play soccer with their children. This is very unfortunate, for there is nothing more joyous than playing with ones children. I used to run with my son, Obi, and no wonder he runs for his university.
One day, I walked the children to their school and out of curiosity decided to talk to their teachers. I talked to all three teachers, primarily to find out why the children were judged special education material…they seemed to me like normal, averagely intelligent children and I expected them to be in regular classes. After talking to the teachers, I went to talk to the school psychologist. I asked her why the children were placed in classes for the mentally challenged, whether she tested them and found them deficient. She told me that she received information from teachers that the children were not doing well in school and requested permission from their parents to test them but that they refused. Since they were nevertheless not doing well she sent them to special education classes. I told her that I thought that the children were normal average kids and that with special effort that they would return to regular classes.
In the couple of weeks that I stayed with this fine couple, I taught the children the basics of arithmetic’s: addition, subtraction, division, multiplication, fractions, decimals, ratios etc. In fact, I began teaching the twelve year old algebra, geometry and trigonometry. I brought them up to snuff with the basics of English grammar, science and social science. Before I left town, I went back to the school and insisted that the children be returned to regular classes; one was.
My encounter with these children got me thinking about the plight of Nigerian children.
Nigerian children, like children everywhere in the world, have psychological issues but seldom do their parents have an inkling of what is going on with them. Many Nigerian parents just assume that their children are okay and that that is all there is to it. Poor fellows.
Nigerian children, like children everywhere, suffer from the whole array of psychological problems found in children. In this essay, I will briefly review the major psychological issues found in children. My goal is for parents to be aware of them and observe their children to see if they show signs of them and if so take them to mental health professionals who are equipped to handle such problems.
What is my qualification regarding children’s mental health? Long ago, I was a licensed therapist and worked as children’s therapist, then supervised a bunch of children’s therapists in a children’s psychiatric hospital. I have done just about every job there is to do in the mental health field. At any rate, it is up to you to listen or not. My self assigned task is to share information with you; what you do with it is your issue, not mine.
The American Psychiatric Association’s Diagnostic and Statistical Manual is divided into to several sections: one section is devoted to children’s mental health issues, another to organic mental disorder issues, a third is devoted to drug and alcohol issues and another section is devoted to adult functional, as opposed to organic, mental health issues. If you are interested in today’s subject, please peruse the relevant section of the DSM. You can also write to me and request a list of books on Developmental Psychology, that is, children’s psychology.


There are many psychological issues first encountered in childhood. I cannot possibly cover all of them. What I will do is briefly define the major ones that you are likely to encounter. They are separation anxiety, oppositional defiant disorder, conduct disorder, attention deficit hyperactivity disorder, autism, reactive attachment disorder, Asperger’s disorder, Down ’s syndrome, mental retardation etc.
Separation anxiety is seen in children during their first days of school. The child’s mother takes him or her to school and he does not want to be left at school and cries and wants to go home with the mother. He does not want to be left at school to be with strangers. I can speak from personal experience here, for I had terrible separation anxiety. At age five, my mother took me to school and I would not let her go. I simply clung to her legs and did not want to let her go. I cried my little heart out. Go she had to go and after a few weeks of this scenario I got somewhat adjusted to the school environment.
What is going on here is that the child has anxiety issues. Anxiety is exaggerated fear. All people have felt fear and therefore know what anxiety is. Anxiety is feeling of fear in a situation that should not arouse fear in people. In fear the individual’s heart pounds fast, he breathes fast, his nervous system works rapidly, he experiences a powerful urge to run (flight or fight response). These physiological responses are mediated by neurotransmitters. I am not going to get into the science of anxiety disorder, let me just say that neuroscience has shown that anxious children are born that way and inherited quick danger alerting system in their bodies.
(If you are interested in this research, please see Jerome Kegan’s efforts at Harvard University; also see Isaac Marks writing on anxiety.)
The anxious child feels fearful when there is no threat to his life and experiences an urge to run, hence he clings to his mother’s legs for protection. This problem is generalized: such children tend to be anxious across board. In fact, they tend to develop social anxiety (sociophobia) and or avoidant personality (fear of others rejection and avoiding people to avoid rejection). Some such children may develop obsessesive compulsive disorder and any of the anxiety related personality disorders.
Some children tend to have opposition defiance disorder, ODD. Where this problem exists, you can see it in nine year old children. Such children do not want any adult to tell them what to do. They resent their parents and teachers telling them what to do. They are constantly in power struggle with adults, resenting being told what to do. While resenting adult authority they gladly conform to their peer groups demands on them. Indeed, they may even accept leadership from the leader of their cohort.
If not handled properly, ODD children tend to drop out of school and go do their own things. As adults, they tend to be oppositional to authority figures and do not listen to their bosses and tend to be fired by bosses or simply quit their jobs because they do not want to be pushed around “by the freaking, god damned son of a bitch of a boss”.
These children simply do not want any one to tell them what to do with their “freaking lives”.
I have written extensively on this subject and do not plan to repeat myself here. Why some children do not want adults to tell them what to do has always intrigued me, since I am somewhat of a rebel myself. This resentment of adult authority is probably rooted in the child’s desire for autonomy and separation from the whole, God and man.
Some children have conduct disorder. In addition to not listening to adults, as ODD children do, they engage in anti social behaviors; they steal, tell lies and beat up other children etc. If not helped, such children tend to progress to adult antisocial personality disordered persons.
By elementary school age, you can already make out children with conduct disorder; they usually start smoking early, drink alcohol early, and do drugs early. (Visualize the twelve year old boy in your secondary school who tells lies, smokes cigarettes, drinks alcohol, gets into fights with other boys, and generally does not bother with other people’s well being.)
Conduct disordered children tend to be self centered and do not care for other people and do not feel guilty or remorseful for their hurtful behaviors. These children are heading towards criminal behavior and eventually to jail, their adult home. Their encounter with the law generally starts around age fourteen when they are arrested for law breaking and sent to juvenile detention centers. Thereafter, it is in and out of correctional facilities until they are burned out in their forties.
Some children have attention deficit hyperactivity disorder, ADHD. These children are hyper active and cannot sit still for twenty minutes without fidgeting. Their minds tend to wander all over the place and they are unable to concentrate on their class work. They are every teacher’s nightmare; they are disruptive of the class process.
These days’ teachers generally refer them to school psychologists who test them and refer them to physicians for medications. The various psychoactive stimulants (Ritalin, Adderol etc) seem to have paradoxical effect on these children: calm them down. That which stimulates adults calms them down. Coffee also calms them down. This problem is very pervasive in American schools and no one quite understands why the sudden increase in ADHD.
There are all kinds of speculations as to what causes ADHD and its milder form ADD. Some attribute causal factors to dysfunctions in the brain; others see it as a result of ingesting too much sugar, yet others see it as a product of the break down of parental authority in society. (These days if you raised your voice at your children and or punished them corporally you could be arrested and jailed for child abuse.)
Suffice it to say that we do not yet know what caused this problem. At any rate, in this essay, I am not interested in a causal analysis; I am just pointing out some childhood issues that you may want to know about.
Some children have autism. Here the child looks normal but does not care to socialize with other children. He keeps to himself and occasionally self stimulates (strikes his head on the wall etc).
Some children have a milder form of autism called reactive attachment disorder or Asperger’s disease. They do not know how to get alone with their peers and just want to be left alone. They develop poor social skills as result.
I have written extensively on this disorder. I think that it has to do with not loving and caring for children. If a child is not loved and is emotionally abandoned he tends to learn to build a psychological wall around himself and not want anything to do with other people. As it were, he says: if you relate to people, they will hurt and or abandon you, so don’t even bother relating to them; keep to yourself.
Children who were raised in orphanages and or placed in numerous foster homes where they were either abused or ignored tend to develop reactive attachment disorder.
Since many Nigerians really do not pay attention to their children their children tend to feel emotionally abandoned and develop some forms of reactive attachment disorder.
Some children have Downs’ syndrome. These children inherited serious Chromosomal deficits which are generally severe enough to make them less educable; they tend to think concretely, not the abstract thinking required for education. In the past this disorder used to be called Mongolism, for such children look oriental even if they are born in Africa. Women over age 35 are more likely to have children with Downs’s syndrome than younger women.
Some children have mental retardation. Every parent has the illusion that his or her child is a genius but the fact is that children have different levels of intelligence.
IQ testing breaks down as follows: IQ under 70 is mental retardation. IQ 85-115 is average intelligence. IQ of 118-128 is above average intelligence. IQ over 132 is superior.
Generally, about 2% of the population has mental retardation, 2% has superior intelligence, 90% has normal intelligence and about 6% has above average intelligence.
The most used IQ test instruments are WAIS for adults, WISC and Stanford Binnet for children.
If a child tests out below 70, he is generally unable to learn in regular classrooms and cannot really graduate from elementary school. It takes average intelligence to do school work and certainly to complete secondary school.
If you want to know how smart you are, hence how smart your children are, take IQ tests. But you pretty much already know your intelligence level. If you were mostly a C student, you are average. If you were mostly a B student you are above average. If you consistently were an A student you are gifted. Of course, it all depends on the type of school that you attended, for an A in a yucky school is a C in an outstanding school.
For our present purposes, some children have mental retardation and are usually sent to special education classes until they turn eighteen and are seldom able to read or write beyond the first few grade levels.
High intelligence is not correlated with success in adult life; what it is correlated with is ability to do well at school.
If your child has high IQ you had better send him to a school for the mentally gifted if you do not want him to be bored by the drivel taught at public schools. Every school district in the USA has a school for exceptional children. These children tend to learn quickly and tend to feel bored and may get into mischief unless you give them more difficult tasks to perform. They thrive on solving difficult intellectual problems.

Most children, like most adults, are normal, psychologically and mentally. That is to say that at least 90% of the children at a typical school are normal children and do not give teachers a hard time. Schools are geared towards the normal-average child. As in adult life, some children are not normal.
The seriously intelligent child, the child prodigy, is not a normal child; in fact, he finds other children too silly to play with. As a matter of fact, he finds most adults too idiotic to worth his time. I had such a child in my Sunday school class at my church. He was only ten years old and knew more physics, chemistry and biology than university students. He graduated from Harvard before his peers entered university.
Then there is the reality of the mentally deficient; there are the children with anxiety issues; and finally there are children with conduct issues.
This is the real world. The real world exists in Nigeria, as it exists every where else. Nigerians tend to think that just because they do not think about these psychological issues that they do not exist.
Nigerians are human beings and suffer from the whole array of psychological problems human beings are prone to. If you randomly select one hundred Nigerians, you will see that two of them are psychotic, six of them have personality disorders, two of them are mentally gifted, two of them are mentally retarded and ninety of them are average and normal. This is reality. It is as simple as that. You can wish all you want to, facts are facts.
If you are trained in psychology and you relate to people you can see the whole array of mental health issues in the people before you. There is nothing you can do about it for such is life, cest la vie. You cannot make a dull chap brilliant just by wishing for it. Nor can you make a normal person a neurotic by wishing for it.
Most people are the way they are because of a combination of inherited biological constitution and social experiences. You cannot change them. All that you can do is work with them as they are, without illusions that you can change them. You are not God and cannot change people. However, if these problems are found in children there is a lot that we can do to help them before they become rigid and inflexible in their dysfunctionality.

My recommendation is for you to observe your children. The chances are that they are pretty much normal and do normally at school and society. But if you see some of the problems that I briefly mentioned above, please take the child to mental health professionals for help. Put away your pride and go get your children help. If you have the resources, it might be useful to have your children tested for intelligence and personality. These tests are very expensive and will probably set you back a thousand dollars.
Nigerian children have the issues children all over the world have and there is no use pretending that they are different. They are not.
In American schools Nigerian children are increasingly relegated to special education classes. Get involved with your children’s education, help them do their homework; that way you will prevent your children from being sent to classes for dumb kids.
Many white persons assume that just being black makes one unintelligent, thus if your child shows the least sign of not following what the teacher is doing, it is off he goes to Special Ed. His issue may not be intelligence but poor language skills, poor culture skills etc. As a matter of fact, if your child is brainy and was tested and scored very high the chances are that the white psychologist may doubt it. I remember taking the IQ test and the white psychologist not believing that an African can be smart and had several others test me, all with similar results.
Please pay attention to your children’s education. The world out there makes wrong assumptions about Africans and it is up to us to correct those assumptions.


COUNSELING

If your child has any of the identified issues mentioned above get him into therapy. Whereas I am not proposing to do therapy here, I will briefly mention some of the therapeutic modalities available for children. They are individual, family, group and play therapy, and these days, medications or, as it is also called, pharmacotherapy.
Therapists make the assumption that a child is a member of a family. He is intricately connected into the web of family: father, mother and siblings. This family triangle (triangulation) is the child’s world.
The family is a system where member’s behaviors affect other members. What one member does is reacted to by other members and adjusted to and that reaction sets in motion responses from other members. The child cannot be outside his family system and wily nily must adjust to it. His personality is, in fact, largely influenced by his manner of adjusting to his family system. Personality is shaped by biological factors, the family climate and peer relationships. The family web is crucial in forming the child’s future patterns of behaving in the larger society.
Most children have normal families and adapt to them. Some families are abnormal…dysfunctional families. Children exposed to dysfunctional families form dysfunctional patterns of relationships.
Consider a family where the father is an alcoholic. The mother probably copes by playing the role of the enabler, making excuses for his behavior. She learns to tell lies for him. When he is too drunk to be able to go to work she calls his work place and tells them lies, such as say that he is sick. By and large, she does things that prevent him from taking the consequences of his problematic behavior, such as get fired from his job.
The alcoholic father creates a whole lot of problems for all members of the family and the children adjust to the dysfunctional home individually. In this pathological family, one child may play the role of the hero, another rescuer, another scapegoat, another rebel and yet another mascot etc.
The hero intervenes and does what the emotionally absent father is supposed to do and essentially becomes the man of the house. The rescuer does what helps every person in the hurting family. The scapegoat does things to get into trouble with the law and society. The mascot or family clown tries to become a comedian so as to reduce the tension he sees in the family.
Each child develops a pattern of behavior and takes it to the larger world. The clown tries to make his classmates and later all people happy, the rescuer devotes his life to helping other people (as I am doing here), the hero saves every body around him, the scapegoat or family rebel is always getting into trouble so that other people would rescue him, or talk about his issues. The scapegoat, in time, get into so much trouble that eventually he brings the family to the attention of authorities who then require them to be in therapy. The identified patient actually helps all members of the family to receive the help they desperately need.
The salient point is that people develop behavior patterns in their families, patterns of behavior that they take to other arenas in their lives and act them out there.
To help a child, therapists, therefore, want to do family therapy with him. They invite the entire family to sessions, usually for an hour or more a week. They observe the family’s interaction patterns, family dynamics, and note dysfunctional pasterns, if any, and try to intervene and get everybody to behave differently.
Consider a very common family pattern in Nigeria: husbands as terrorists. Many Nigerian husbands are psychological terrorists; they use fear to intimidate their wives and children to obey them. As a result, they produce members who are essentially fearful persons, persons who are afraid to use their God given minds to think for themselves. Children who come from family milieu where they were not encouraged to think tend not to be creative, whereas children who were encouraged to think and their opinions were respected tend to think and contribute to social discourse in a meaningful manner.
We have some psychological terrorists on Naijapolitics; they try to intimidate folks to think as they want them to think and if you dare think freely they go on a campaign of intimidation. I have in mind two Igbo engineers on the forum; both are terrorists and need serious psychotherapy. One has to dismiss them as psychologically stunted and warped fellows and delete their silly posts, all efforts to intimate folks into conforming to their half baked positions on social issues.
For our present purposes, some families terrorize their children and make them fearful persons. Family therapy enables them to learn to love and respect each other.
No therapist can work with a child without doing some family therapy, for the child is an intricate member of a family system and is affected by members of the family. You cannot heal him and have him go back and adjust to a dysfunctional family. You have to heal the entire family if you want to heal the child.
Therapists do individual sessions with children. They use whatever methodology they have to try to deal with the child’s issues. Question: how would you help a child with oppositional defiant disorder? How about if I gave you an assignment to read three books on that subject? Do so.
Your child may not be listening to you and you may be in constant power struggle with him. Each of you digs in your heel, trying to win and the other to loose. You see yourself as right and your child as wrong; he does the same. So who is going to win this battle of wills?
Find out a better way to handle your child’s need for autonomy and share power with him while still guiding him, setting boundaries and limits for him. There are many good books on how to raise children. I can think of the one I used to use called 1-2-3 Magic (it is also in videos). It teaches parents how to ask for time-outs and discipline their children without resorting to physical violence.
(All adolescents go through a rebellious phase where they do not like to listen to their parents. This is a natural development and is not the same thing as opposition defiance. Each adolescent must reject his parents and their values so as to go out there and find out who he is and define himself. You must therefore distinguish between normal teenage rebellions from ODD. The ODD teenager will stay out all night long if you ask him to come home at a certain time, will quit going to school if you insist on him doing so etc. The ODD child is a rebel without a course.)

Each therapist gravitates to particular methodology in his psychotherapy. There are tons of psychotherapies out there. I used to practice Adlerian and Cognitive Behavior Therapy.
Alfred Adler teaches that children feel inferior and want to feel superior and that most of their acting out behavior is rooted in their efforts to seem powerful; as Adler sees it, children want to have control and mastery over their world. He teaches parents how to handle this power issue in children.
Cognitive behavior therapists like Albert Ellis and Aaron Beck teach how to use reasoning to correct folks distorted thinking patterns. Change cognitions and change behavior and teach new patterns of thinking and behaving.
As the Roman philosopher, Epictetus said: it is not what is happening out there that makes you anxious, sad, or angry but how you interpret and respond to it. You can interpret stimuli differently and respond to them differently.
Suppose a white racist calls you put down names. You can respond to him with anger or with compassion. He is a stimulus but the type of response you exhibit is up to you. For example, the two Nigerian bullies on naija politics are so out of control that instead of being angry at them one can learn to pity them. They do not need to make you angry. You can choose how you respond to them.

You can teach children how to think in a rational manner and behavior in socially appropriate manners.

Many therapists employ group therapy in working with children. Here a number of kids are in a group and process their issues within the group. Group therapy is useful for it teaches interpersonal skills. We are social animals and must live together; groups help us learn how to get along with other members of our society. In group sessions, problems are solved through every members input. Members not only receive feedback from other members but learn that their problems are not unique to them, that other people have similar problems. This makes them feel not alone in the world.
Consider the anxious child. He is afraid of other people. He is afraid of speaking up in the group. He often experiences stage freight in classrooms particularly when teachers call upon him to come to the front of the classroom and speak, such as answer questions. He feels that if he spoke up that other people would think that he is no good, is unintelligent and as a result reject him. He does not want to be rejected by other people, so he keeps quiet in the group, classroom etc.
One can use group’s sessions to teach the shy, socially avoidant child to overcome his timidity and become assertive rather than passive or aggressive. He can learn that he can speak up in groups and that even if he is rejected by a few members that it is not the end of the world. He can be taught assertiveness skills.
In assertiveness one says ones bit and protects ones rights without putting other people down, without disrespecting other people. In aggressive communication one disrespects other people in pursuit of ones rights. In passive communication style one allows other people to walk all over one; one is a door mat. Obviously the aggressive person does not get what he wants for he alienates people and they oppose him; the passive person is ignored by other people. It is the assertive person who mostly gets what he wants out of life

Very young children are mostly treated with play therapy. Children learn mostly through playing, so the therapist can play with the child and through doing so help to identify his issues, solve them and teach him new social skills. There are many good books on play therapy, browse through some of them.

These days’ psychiatrists are increasingly resorting to using medications in treating children. I know six year old children who are already on anti depressants such as Paxil, Zoloft and Prozac. I know ten year old children who are on the various neuroleptic medications, such as Risperdal, Seraquel, Geodom, Zyprexa etc. I know six year old children already on Lithium, Tegretol and Depakote. I know children on psychostimulants.
Obviously, sometimes medications are called for but to subject six year old children to these psychotropic medications, medications with serious side effects? I will let you decide that one for your child. All that I can say is that if I had a child who had, say, ADHD, I would use behavior management to deal with his issues rather than medications.
(The psychological issues that your children have probably run in your family and you ought to know how to solve them through observing your family tradition. For example, if you are shy and anxious the chances are that one of your parents is shy and anxious. Indeed, if you have a certain type of personality the chances are that other members of your family have it. Family genes and culture determines similar behaviors in members. If you have successfully learned how to cope with your own issues the chances are that you can help your children cope with their issues.)
I am not in the business of giving medical advice. I am only trying to explain the various psychological problems found in children. If you see these problems in your children, it is up to you and your doctor what you do about them. What you should not do is ignore them and think that they would go away. They do not go away and need to be dealt with.
You see what is going on in Nigeria. Parents see their children developing conduct disorder and ignore it. The children grow up to become antisocial personalities and go into politics and transform their office into avenue from which they rob the country down. If we are going to change Nigeria we have to start by paying attention to our children, making sure that they are taught prosocial behaviors and that they internalize appropriate social norms. The climate of every behavior goes that exists in Nigeria is obviously not sustainable. Civilization cannot exist in the chaotic, anarchic milieu that is contemporary Nigeria.
Civilization, as Sigmund pointed out in Civilization and its Discontents, requires repressing Id instincts (sex, aggression) in children and sublimating them to prosocial behaviors. The price of civilization is suppressing our putative anti social proclivities.
If you give free rein to all desires and wishes then you live in a jungle. The jungle is not the best place to live, for as Thomas Hobbes (Leviathan) reminds us, in it the strong eat the weak and consequently life is perpetually nasty, brutish and short. We need to discipline the little savages called children, and make them respect the laws of society.

CONCLUSION

My goal in this essay is to point out the psychological issues seen in children. I am not aiming at showing how to heal them. If the reader believes that his children have some of these issues, he should take them to mental health professionals (psychiatrists, psychologists and clinical social workers) for help. Do me a favor, will you, do not ignore your children’s issues for they do not go away, they get worse. If you need evidence, look at Nigeria and see what ignoring children’s needs have done? If we want a better tomorrow, we must take good care of our children today.

Ozod@africainstituteseattle.org

Posted by Administrator at March 2, 2006 10:18 AM

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