by:  Julie Beem

iStock_000005984201XSmallThe world is enamored with behavior plans for anyone whose behaviors are “out of line” with society. But do they work? I can’t speak for children with other disabilities, but children who have been traumatized and have attachment challenges just do not respond to traditional behavior modification plans. And frankly, I don’t think I would either.

What if I had a behavioral plan? After all, I have behaviors that really need changing. Let’s take two – I don’t exercise nearly enough and I drink too much coffee. So, what could my family do to get me to exercise more? Well a behavior plan would be structured to encourage one behavior (exercise) and extinguish the other (coffee drinking). They’d have to figure out what would motivate me to exercise and what would either motivate me to stop drinking coffee or punish me (deter me) if I did.

What would motivate me to exercise remains to be seen. Chocolate is a huge motivator for me, so starting with M&Ms might be a simple reinforcer, but pretty contradictory to the benefits of exercise. And the thing about this is that while I might start exercising for one or two candies, by the end of the week I’d be negotiating for the whole bag. And on rainy days, or days when my muscles were sore, I’d search the house for where that bag of candy was hidden instead of heading out to exercise to earn a few.

Now my family might try praise to get me to exercise. And because I have a healthy attachment to them; it might work – at least better than other reinforcers – for a while. I love them and know they have my best interest at heart. And I want them to be proud of me and I want to please them – we are attached. But I also know, because I hate exercise, it’s hard for me and I get very little joy out of it (where are those endorphins everyone talks about???). So the tricky part is that too much praise or disingenuous praise or pushing too hard causes a different reaction in me – it pings at my shame. My feeling brain says “maybe you’re not ‘good enough’ for your family the way you are.” And their praise becomes an instant de-motivator, because I start to feel ashamed of who I am and how I haven’t exercised for years. If my shame and negative emotions get too big, then I’ll just stop exercising (and search the house for those remaining M&Ms!)

So what about the coffee drinking? Well one type of behavior plan might reward me for reducing my coffee drinking, which would mean that we’d need to determine what rewards work for me (back to those M&Ms). Another might actually punish me or consequence me in such a way as to deter my coffee drinking. Maybe mixing the coffee with something that makes it taste bad, for example or fining me money? The problem with coffee is that in addition to liking it, I am addicted to the caffeine. In this way, it resembles a bit more the stress hormones our children have in their brains – the cortisol wash that feels “normal” to them. So when our children look addicted to chaos – they are. Even if I’m agreed to the behavior contract and see the need to reduce my caffeine intake, I have to be very highly motivated to follow the plan to get through the headaches and irritability that will happen when I don’t get the caffeine. Now, I’m an adult with fairly strong willpower, and this is still very hard. Imagine being a traumatized child whose behaviors are directly related to their overwhelming fears and survival beliefs – a child who hasn’t had a healthy attachment and is actually fearful of their relationship with you.

Imagine how much harder it will be to follow through on the behavior plan when you’ve got all these big feelings and no one to share them with.

So, what do we do when the person doesn’t comply with the plan? Usually we increase the consequences. Back to my coffee drinking. A huge deterrent would be to fine me money for drinking coffee and keep increasing the fines. While this might make me stop drinking coffee in front of you, it is also highly likely to make me start sneaking my coffee consumption, and even look for ways to get it (stealing perhaps) without you knowing. And, by the way, I would be very aggravated with you – yes, downright angry!So much for building our relationship.

My guess is that if you set up a behavior plan for me to change my exercising and coffee intake, you would eventually give up. My desire to not change these behaviors is significant enough that until it was important enough to me internally to change, I could outlast all the candy and praise you could bring or all the punishments you could levy. You would decide that it just wasn’t worth the effort you were putting into the plan and that my behaviors aren’t socially outside of the norms.

So, what if my behaviors were social outside of the norms and needed changing? What could possibly work if behavior modification isn’t the right strategy for traumatized children? Let’s talk about that in the next blog.