I started working with an 8-year-old Diego* and his family to address some of his more difficult behaviors, including his anger, defiance and aggression towards others. He frequently yelled at his parents and could become physical with the kids at school. When I started working with him in his home, one minute we would be playing basketball and laughing, and then the next minute Diego would be throwing gravel in his sibling’s face after she accidentally bumped into him. As a result, my time with him often felt like I was walking around a minefield. While challenging, Diego could also be a very funny and sweet kid. It soon became apparent to me that Diego had a very sensitive nature, and his gut reaction was always to fight back.
Play is an essential part of how we implement behavioral interventions at FCNI, and I made no exception with Diego. As an energetic child, Diego needed frequent stimulation and physical activity. Playing sports together was a natural way for us to build a relationship, and also gave Diego an opportunity to expend some of his energy so that he could regulate his mood. As time passed, I began incorporating new elements to grow Diego’s skills. We always took time to collaboratively discuss the rules for play, as well as consequences, in order to build communication skills and help him learn better self-control. It turns out, Diego was actually very compliant when he was allowed to participate in the rule-making process, and he would often hold himself accountable. Additionally, we began combining basketball or soccer with the “Red Light, Green Light” technique to help Diego’s develop his ability to “stop and think” while highly stimulated before reacting. Diego’s mother and siblings played along too so they could learn skills alongside Diego and better support him in using them throughout the week.
When it got dark in the evenings, our play moved inside. We would usually take turns choosing games with siblings so that Diego could learn to wait and be okay with not always being in control of the situation. We played “Emotions Charades” to practice identifying feelings and matching them with situations that cause them so that Diego could find better ways to express himself. The most popular games with Diego and his family were definitely fast-paced card games like “Spoons.” Not only did it make us all laugh, but it was a great way for Diego to practice controlling his responses. We set ground rules for how we should treat each other if we wanted to be allowed to play. This was very difficult for Diego in the beginning, as he often couldn’t help but shriek and tease others when he won, or cry and lose control when he lost. At the same time, his family members realized that some of their playful interactions of teasing each other were actually triggering Diego’s reactive responses, and so they practiced different ways of joking and helping him learn to determine what jokes are appropriate and not hurtful.
When Diego did lose his cool, which was often, we practiced coping skills to help him self-regulate. I made him a poster with his favorite character and a list of five techniques to help him calm down in heated moments. Diego was so excited about his poster and was able to teach others about coping skills a week after it was first introduced.
"Taking space" in his room to cool down was a game-changing skill for Diego once he learned to use it well. It removed excess stimulation so he could slow down his overactive nervous system and process his feelings. After only a few minutes, Diego was able to tell me what he had been feeling when he had acted out and why. We practiced assertive communication skills such as using "I-statements" to help him communicate these feelings to his family in a healthy way, such as “I was upset that I couldn’t choose the movie.”
All this work, and more, went on for months and it still seemed like we were getting nowhere. Diego continued to blow up over what seemed like minor things. I often came home from work tired and frustrated, wondering if I was missing something. I wondered if Diego would ever internalize the things I was telling him, or have the self-control to implement them. Then one day, we were on a walk with his siblings. Diego tripped slightly over a crack in the sidewalk. No big deal, right? However, one of his siblings chuckled at his mishap, and I saw thunder clouds form immediately in Diego’s eyes; he hated being laughed at. My whole body tensed to intervene, but before I knew it, Diego unclenched his fists and said calmly, “It makes me angry when you laugh at me.” My jaw dropped. Is this the same child? He’s ACTUALLY been listening to me this whole time?! Even when his sibling did not respond, Diego moved on from the incident without further issues. It was one of the proudest moments of my career.
Of course, growth is not linear. The following months with Diego were filled with more difficult days, more skill practicing, as well as some small victories. However, after that day, I was filled with new hope because I knew that Diego understood how and when to use the skills we had been practicing. I saw his desire to do things differently, even when it takes effort. I felt more sure that someday he would be able to communicate and manage his feelings without me there. And sure enough, we’ve long since closed services for Diego and his family as they were no longer deemed needed.
When I think back on the hope that Diego gave me that day, I realize that it wasn’t just hope for him. I saw an 8-year-old boy with brain chemistry that’s set to be “out of control” recognize his emotions, restrain his negative response, and replace it with a positive response all within the span of two seconds. If he can do it, maybe anyone, even grown-ups, can too. Maybe instead of immediately blocking anyone who offends them on social media, we can stop, listen, and respond with respect. Maybe our families, friends, communities, and leaders can actually sit down and have a real conversation with each other. Maybe voices can be heard, relationships repaired, and problems can be solved. I am so blessed to be a small part of this change for Diego and his family, and I look forward to experiencing the world that Diego and others like him are working to build.
*Names and details have been changed to protect client confidentiality