Verbs of the heart: understanding why we do things.

Half a dozen professionals sit around the table; they look wearily at one another. The head teacher asks, “Tell us about your work with Johnny.” We talk about our concerns; his behaviours begin to stack up. Johnny did this and then he did that.

The plan up to this point has been largely to keep adding professionals, a teaching assistant, a school counsellor, a mentor. (It reminds me of how I cook; I keep throwing ingredients into the pot hoping something good will come out in the end, but it rarely does). We have been here before and things keep getting worse. Each plan fails, and I sense that the agenda of the meeting is shifting. This is not about Johnny or finding a plan anymore. It is about building a consensus: he shouldn’t be in a mainstream school. It is as if collectively we have given up hope of change.

His behaviours are telling us something, but we need to think differently about the kind of support we are providing and how we are functioning as a group of professionals.

I am itching to ask a question: “If we don’t understand why Johnny is behaving that way, then isn’t it possible the things we think are helping could be making it worse? Johnny finds it difficult to feel securely attached to one adult, let alone to all these strangers who are trying to reach out to him.”

Finally, I get up the courage to ask, “Does anyone have an idea why he does that?”

His teacher replies, “I’m not a psychologist.”

I admit that at first I wasn’t sure why this teacher was unwilling to engage in this kind of reflective thinking about a young person’s behaviours and underlying intentions. Was it her response to being called upon to talk about something for which she was unprepared? Alternatively, was it driven by her concern of who would be left holding responsibility when none of the interventions were working. Such a fear might be a powerful (even if it is unstated) concern in many of our professionals’ meetings.

As educators, we may have put the task of understanding behaviour out of reach of some of those who are best placed to reach out to young people. The reality is that even training often falls short and expertise has its limits. I remember in my teacher training being taught how to carry out a Functional Behavioural Assessment and only later coming to realise for some young people almost anything could be an antecedent or trigger. The task of trying to connect so-called internal triggers to the consequences of their behaviour seemed both insurmountable and reductionist. Human beings and their complex behaviours cannot be adequately described in terms of the relationship between a stimulus and response.

As I reflected again on the school meeting, I could see the value of a more cautious approach. We should be prudent in how we understand other people’s intentions. We should be aware of our tendency to believe we understand another person too well. Psychologists observe that parents who are good at understanding their child’s mental states are also respectful of the opacity of other people’s minds. There is a form of intrusive mentalizing that can take place, where separateness of minds is not respected and adults may feel too strongly that they understand what a child is thinking and feeling1.

I remember interviewing a young person who was care experienced. He identified a time in his primary school, where in his own words, “things started to improve.”

“What was it that changed and helped things get better?” I asked.

“My teacher tried to understand me,” was his straightforward answer.

It helps children develop secure attachments when they experience someone who tries to sensitively understand. And, in turn, their own capacity to reflect on and to understand other people’s intentions grows.
This imaginative and reflective capacity is surely one of the most basic human traits. It is true we can’t see directly into someone else’s mind, but we can make an intelligent inquiry. The ability to understand interpersonal behaviour in terms of our own and others’ mental states—such as desires, beliefs, goals, and feelings—is fundamental to what it means to be human1. It makes sense that those who spend the most time with a young person probably have the most insight, but this sensitive work of taking a young person’s perspective may not be straightforward. Helping those adults closest to a young person sustain those connections may have to be clearly defined and supported by other adults. It works best when we help each other mentalize2.

AMBIT (Adaptive Mentalization-Based Integrative Treatment) is an example of a programme that has developed a team approach to mentalizing3. It recognises first that our capacity to reflect on a young person’s feelings and thoughts can be compromised by the fear and despair that comes when we connect to others and their pain. Similarly, it is realistic about the dynamics of a group of professionals with different goals who may doubt and misjudge one another. AMBIT uses a four-step process, called ‘thinking together’ that enables the key adult to be heard4. Their predicament (often some fear or worry) is empathised with and given clarity of meaning. The result is that the key adult is in a much better position to take up that curious, empathetic, and accepting stance.

Using the verbs of relationships

The structure of language itself may provide clues to understanding motives and intentions that otherwise are hard to identify. In the following questions, many of the verbs signify how a person relates to others; we can think of these as verbs of the heart. There is something mysterious and enigmatic about the heart when it refers to a person’s inner self or psychological centre. It is where thinking, feelings, and will connect. It is where we often want to communicate to and where we want to see change. When a person opens their heart to another person, we find the essence of human relationship. However, it can also be a dark place of self-deception and self-condemnation.

Rather than asking the following questions directly (adapted from David Powlison’s X-Ray Questions), keep them in mind as you observe and get to know a young person. Listen to how others experience a young person and compare your observations. We can use these kinds of questions to dissect the details of one particular incident or to help us think about patterns that characterise a young person’s life 5.

The answers can function as windows into another person’s unique worldview. For example, one of the ways a child who has suffered maltreatment may stand out is by her difficulty expressing reciprocity toward others. Rather than looking outwardly to others to love and care for her, she may feel driven to avoid or to control others.

Don’t be surprised if some of the answers to these questions are also counterintuitive, for example, the child may find the interest of an adult more of a threat than a comfort, and a young person may find safety in sabotaging a good experience or a promising relationship.

1. What does she love? What lights up her world? What gives her delight?

2. What does he desire, long for, wish? Do other people’s desires rule over him? Whom does he feel he must please? Whose opinion counts?

3. What feeling is she trying to avoid? Is there something she hates?

4. What does he hope for? Where does he bank his hopes? Have his hopes been dashed?

5. What does she fear? What does she fear losing? What does she feel threatened by?

6. Where does he find refuge, safety, comfort, or escape? When fearful, discouraged, and upset where does he turn? Who can make it safe or better?

7. What or whom does she trust? In whose presence does she find her sense of well-being? Whose promises does she trust?

8. What beliefs does he hold about life, himself, others? What are his specific beliefs about his present situation?

Keeping It Real by Redefining the Task

How a young person relates to others is probably the most significant factor in understanding why he or she does the things they do. We use others to help us find meaning, identity, and self-understanding. Thinking about what a young person’s behaviour is communicating allows an adult to approach that young person in a far more nuanced and sensitive way.

Instead of pushing more people into a young person’s life, the task of the professionals around the table can shift to helping one or two key adults to understand and relate to a young person who otherwise may find change very difficult. I have a proposal: What about redefining the task from how do we change this child’s behaviour to how do we understand them and how do we help them know we are trying to understand them?

References

1. Fonagy P, Allison E. What is mentalization? In Midgley N, Vrouva I. (eds.) Minding the child. Hove: Routledge; 2012. p.11-34.
2. Bevington D, Fuggle P, Fonagy P. Applying attachment theory to effective practice with hard-to-reach youth: the AMBIT approach. Attachment and Human Development. 2015; 17(2): 1-18.
3. Bevington D. Working as therapists and allied professions with hard to reach youth. Interview with European Society of Child and Adolescent Psychiatry. 2019. Available from:
https://www.escap.eu/care/teams-as-the-critical-agents-of-change-in-systems/
4. Anna Freud National Centre for Children and Families. Thinking Together. Available from: https://manuals.annafreud.org/ambit-static/thinking-together
5. Powlison D. X-ray questions: drawing out whys and wherefores of human behaviour. JBC. 1999’ 18(1): 2-9.

© 2021 David Woodier. Permission granted to reproduce for personal and educational use only. Copyright notice must remain intact.