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Subject:

Re: 'Conduct disorder'... Bollocks

From:

Robbie Coull <[log in to unmask]>

Reply-To:

GP-UK <[log in to unmask]>

Date:

Wed, 14 Jan 2004 16:20:21 +0000

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (61 lines)

> child (brat?) has just been diagnosed as having 'conduct disorder' by
> child psychs referred by the families SW (hopelssly chaotic single-parent
> household with mum from birth quite unable to or willing to exert any
> disciplin on any thing). Specific psych problems ruled out eg ADHD, autism
> etc.

Diagnosis is clearly P3D - 'Parental Discipline Deficit Disorder'

(not sure of the Read code.....)

> Are these pseudo-diagnoses not only wrong but are socially defined, but are
> counterproductive?

Yes, we are colluding with patients who are unwilling to accept the true
cause of their problems.  This helps no-one (except perhaps the
professionals, who can avoid a confrontation with the parent).

I tend to demonstrate how discipline works - coming from a family of
teachers, I have learnt the lost art of 'The Voice'.  This is a deep voice
projection technique similar to stage acting, but combined with disciplinary
behaviour.

Physical violence is only necessary on rare occasions when the child is
being violent or threatening - distract parent then aim for above the hair
line, or pressure on 'pain points' such as the olecranon, so any bruising
does not show up.  Alternatively, for older children, produce a white needle
on a 50 ml syringe and point out that doctors are the only people allowed to
legally inflict pain on people.
(note: above comments are tongue in cheek - before I get a letter from
social services!)

Anyway, as Brat 1 and Brat 2 are trashing my room and Mum is sitting in
'lump mode' I use The Voice - result, two delightful children sitting at my
feet listening to me quietly talking to them (success rate 85%)

One mum, to give her her due, did ask the practice manager if she could
'take me home' to look after her kids, but most get upset at this
demonstration as it shows that it is them that are at fault, not the
children.


Other technique that a child psychologist taught me is the 'Running
Commentary' - you simply describe every action of the child in a monotone if
they misbehave:

'Now you are picking up the bin, and now you are hitting your sister with
it, and now your sister is crying, and now you are taking books off the
shelf.....'.  After about 3 minutes of this the child (and anyone else in
earshot) will just sit and stare into space quietly.  Only question is
whether you can survive 3 minutes with the child to get it to work (success
rate 70%).


If neither of those work, then I reach for the Cattle Prod....

--
Robbie Coull
email: [log in to unmask]             website: http://www.coull.net

https://www.locum123.com contact locum doctors by SMS and email

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