Your Child - Your Divorce

When a new study comes out showing that Ritalin use doubles in children of divorce, it is easy to assume the very public perception that divorce is always bad for kids. But is it really that simple?

Below, Professor Lisa Strohschein asks the following question: ‘Is it possible that divorce acts as a stressful life event that creates adjustment problems for children, which might increase acting out behavior, leading to a prescription for Ritalin?’

Or as this blogger puts it so well:

People often use psychiatric diagnoses as if they’re explanations when really they’re nothing more than descriptions. The idea is that science will ‘fill in the gaps’ and explain how these differences occur.

The trouble is, the behaviour described by an ADHD diagnosis could occur because of genetic influences on brain development, because divorce is causing emotional distress, because the child is being bullied, or for any number of other reasons.

Ritalin is likely to help regardless of what is causing the child to be disturbed, because it helps the child focus by boosting attention.

The question is, should children be prescribed drugs because they are distressed by a divorce? There’s no definite answer in every case as each child and each situation is different.

But perhaps we should be concerned that children are likely being prescribed psychiatric drugs as a ‘quick fix’ for emotional distress and behaviour problems when research shows that parent training programmes are safe and effective.

Ritalin use doubles after divorce, study finds

By Scott Anderson Tue Jun 5, 9:47 AM ET

TORONTO (Reuters) - Children from broken marriages are twice as likely to be prescribed attention-deficit drugs as children whose parents stay together, a Canadian researcher said on Monday, and she said the reasons should be investigated.More than 6 percent of 633 children from divorced families were prescribed Ritalin, compared with 3.3 percent of children whose parents stayed together, University of Alberta professor Lisa Strohschein reported in the Canadian Medical Association Journal.

The study of more than 4,700 children started in 1994, while all the families were intact, Strohschein said. They followed the children’s progress to see what happened to their families and to see what drugs were prescribed.

“It shows clearly that divorce is a risk factor for kids to be prescribed Ritalin,” Strohschein said.

Other studies have shown that children of single parents are more likely to get prescribed drugs such as Ritalin. But is the problem caused by being born to a never-married mother, or some other factor?

“So the question was, ‘is it possible that divorce acts a stressful life event that creates adjustment problems for children, which might increase acting out behavior, leading to a prescription for Ritalin?”‘ Strohschein said in a statement.

“On the other hand, there is also the very public perception that divorce is always bad for kids and so when children of divorce come to the attention of the health-care system — possibly because parents anticipate their child must be going through adjustment problems — doctors may be more likely to diagnose a problem and prescribe Ritalin.”

Ritalin, known generically as methylphenidate, is a psychostimulant drug most commonly prescribed for the treatment of attention-deficit hyperactivity disorder in children.

There is a big debate in much of the developed world over whether it may be over-prescribed — given to children who do not really need it. In March, a University of California, Berkeley study found that the use of drugs to treat ADHD has more than tripled worldwide since 1993.

Strohschein said it is possible that some mental health problems pre-date the divorce, so “it is possible that these kids had these problems before, but are only being identified afterward.”

Her study was not designed to find out why the children were prescribed the drug.

“I might be finished with the survey, but I am not necessarily finished with the question,” she said in a telephone interview.

By Linda Freedman, PHD

Let’s take the case of Ellie. (all names, all ages, all identifyers are made up in this post).

She’s 9. Her parents divorced when she was 6 because they argued about everything and occasionally couldn’t control themselves, pushed and shoved too much. Her father grabbed her mother’s mother and bruised her badly in the final event that ended the marriage.

But Ellie thought all along (as I’ve said in other posts on parenting and divorce) that it was her fault that her parents divorced. Many of their arguments, and she heard SO many, centered around her. Drawing conclusions at that age isn’t as hard as you’d think.

Well, Mom and Grandmom moved far away, taking Ellie with them, which is not at all unusual. Dad had to work the legal system hard to get his little girl back in Chicago. He still only had visitation every other weekend. But at least Ellie was here, living with Mom and Grandmom, and oh, yes, and Mom’s significant other was never far away.

If you’re thinking family systems and are not automatically villifying Dad, assuming he’s a violent monster, then you might see that Grandmom played an inordinately large role in that marriage. In this case it was her advice about raising Ellie that conflicted with Dad’s, and Mom could not extricate herself from the conflict, couldn’t side with her boy.

There were other things going on, too. Usually divorce isn’t a consequence of just one variable, especially not the enmeshment variable, which seems so normal to people. Couples will more likely blame their relationship problems on outside relationships. Other significant others are usually a function of relationship/family problems, like . . . enmeshment.

Knowing that Grandmom played a large role in the marriage, you can assume that she also will play a large role in the couple’s post-divorce conflict. Divorce rarely ends the conflict, not without lots of smudging and dirt.

Should you bring Grandmom into the therapy?

She has an overly large presence in the narrative so certainly you want to see if and how Grandmom enmeshed Mom and how Ellie is also discouraged from developing into her own person. You can test that to a degree by finding out how well socialized Ellie is with other children, whether or not she does anything after school except homework and television.

But I’d bring Grandmom in just to confirm my guess and watch her in action, give her power to decide that Ellie needs more running room outside the family and how that should happen. Rather that fight a system, I work with it.

I’d try not to see her too often, though. She wouldn’t be one of my favorite persons and she’s not my patient. I’m not changing her or her world view and wouldn’t begin to try unless she really wants to work with me. I really don’t need her to get results, but she could, ultimately, really help the situation if she were amenable.

The judge ordered therapy in this case because Ella stuttered and was failing in Chicago, even though she did quite well in school prior to her move back into town.

I taught her some assertiveness, encouraged her to speak her feelings to her Mom, Grandmom, and Dad, more often, to make it a general habit.

See, and people wonder, why don’t you do much play therapy, Therapydoc? I feel guilty stealing, is why. Most kids need social skills training, not to play with a grown-up person, unless it’s their Mom or Dad. Truthfully, I will do play therapy when a kid isn’t verbal, but Ellie could talk and wanted to talk.

I coaxed her to ask her teacher for help. When the teacher said, Try it first on your own, she was to answer back and say, I already tried. I just don’t get it. Please help me. That worked, by the way. It made the teacher more aware of Ellie as a person, put her on the map.

How do I know? Systems therapists talk to teachers who are key players in a kid’s ecosystem. I don’t get it that other docs can’t spend ten minutes on the phone with teachers. You know who you are. Sorry if this is becoming a rant. Ignore me.

But don’t ignore this.

I titled this post Divorce or no divorce-your kid because I’m sure Ellie would have stuttered and had problems in school no matter her parents’ marital status.

Just being married is no lock on your kid’s sense of security and well-being. You have to be on top of that as parents. Security doesn’t come with the umbrella of “marriage” or even “committment”.

I bring this up here because one of the things Ellie told me in private was that her father didn’t call her very often. Dad SAID he’d call to help her with school work twice a week, but he forgot. And Mom didn’t have the skills to help her and very much left the job of teaching to the school. She also had a one-year old baby.

So when Ellie would be sitting at her desk and the teacher would pass back the homework and hers would have a big ZERO or a big fat F at the top, she would cry there silently, then force herself to smile and to try to socialize as if there was nothing wrong.

And at the end of the day, her Mom or Grandmom might ask, I really think they did, How was school? How were your grades? But Ellie wouldn’t share that experience with them.

After all, how easy is it to talk about failure at any age?

Then there’s Dad, forgetting to call. Yeah, I could have strangled him. He was the one bringing Ellie to therapy. He was the one with insurance, a house in the burbs, the better communicator.

So here’s the real universal parenting truth, Divorced or not divorced, your kid needs that emotional check up at the end of the day.

Like you, your kids need to hear questions like, Did the world give you a beating today? How are those kids in your class? Any mean ones? Anyone mean to you? How ’bout that teacher. Nice? They’re not all nice. Are you scared to ask for something if you need it, like a pencil?

If you act like you care, they’ll answer you honestly. That doesn’t necessarily mean you have to run right over and fix the problem. But you have to take your kid’s emotional temperature. Then you can go from there.

By the way. Start this while they’re young and you won’t seem like an alien to the kid during adolescence, all of a sudden going, Why in the world are you hanging around with THAT kid!

For kids, learning to talk about their lives, their day, is liberating and intimate. That’s why once they get into it, they want a PHONE. Academic (work) intimacy is key and it’s your job as a parent to foster the process, the skill of communicating events and feelings.

We don’t all do it naturally, you know, talk about ourselves.

About the Author:

Linda Freedman, LCSW, LMFT, PhD is in private practice in Chicago.  She blogs to rewire the way people think and is available to speak about almost about anything that affects mental health, relationships, and family life.  Read more at EveryoneNeedsTherapy: TheBlog

Divorced parents often have very different perspectives about what their children want or need.

A short time ago two parents in my court were debating whether their 5-year-old son should fly unescorted between Phoenix and Albuquerque for visitation. The mother said, “He hates to fly.” The father said, “He loves to fly.” I said, “Are you talking about the same little boy?”

When I asked the mother what made her think her son hated flying she said, “Because he told me so.” The father noted that’s how he too had got his information. The child had told his father that he loved flying.

A child telling each of his parents different things is a common occurrence in divorce cases. Sometimes children do this to manipulate their parents, but more often the child’s goal isn’t manipulation or deceit; the child’s goal is to make each of the parents happy.

Children are remarkably astute at figuring out what grownups want to hear, especially their parents. One way to make a parent happy is to tell each of them what they want to hear. Read the rest of this entry »