I once had the parents of a teenage girl come to me very concerned that she had been drawing on her arm. I was slightly perplexed by their reaction. Kids draw on themselves all the time. They proceeded to show me pictures of some intricate artistic work on her arm. I have to say, I was impressed. They, however, were concerned that it was a form of self-injury. Knowing the teen, I knew it was not.
The incident reminded me of when I found a somewhat disturbing drawing my then 6-year-old son had left on his floor. It depicted several gravestones. I immediately grew concerned. Was he afraid of death? Was he depressed? I asked him about the drawing. It turned out that his picture was inspired by a graveyard scene on Scooby Doo that morning. Phew. No need for alarms.
In DBT, we often talk about balancing the opposing tendenciesof “normalizing pathological” and “pathologizing normal.” In other words, sometimes we look at completely common and appropriate behaviors as signs of a problem. On the other hand, we often turn a blind eye to problems by writing them off as “normal.” A willingness to consider each of these possibilities can assist us in maintaining a balance.
In the case of my son’s drawing and the teen girl’s body artistry, anxious parents (yes, me too) pathologized normal behavior. In both of these scenarios, it was possible that there were signs of a problem. It was just as possible that there was no need for concern.
I always suggest to clients that we approach these types of behavior with curiosity rather than assumptions and judgements. Ask questions and consider the healthy and less-healthy explanations of the behavior. For example, “tell me about the drawing on your arm,” or “what made you decide to draw on your arm?” The answer may be “I was bored in geometry,” or “I saw the drawing on the cover of a book.” It may also be “drawing distracts me from anxious thoughts and allows me to focus.”
If the behavior is a non-harmful way of coping with strong feelings, talk about the feelings driving the need to “cope.” There are so many possibilities that we miss out on if we don’t approach gently and ask questions.
I also caution people for using the word “normal” to assess healthiness of a behavior. It is not normal to have an above average IQ, but it certainly isn’t problematic. In contrast, binge drinking in college is “normal,” but still risky behavior. Perhaps a better question to ask is whether the behavior or characteristic is causing distress. Neither the arm artistry, or graveyard picture were causing anyone distress.
My son is fairly introverted. Every year in elementary school, I would receive feedback from teachers that they were concerned by his recess behavior. He typically sat alone and read a book. I truly appreciated their concern over this non-normative recess behavior. At the same time, my son was very happy to spend that time re-charging on his own and was not feeling socially isolated. Hours of being surrounded by people at school is a bit overwhelming for an introvert!
As parents, many of us spend a lot of time worrying about the “normalcy” of choices our children make. We also dismiss a lot of distressing choices based on their “normalcy.” Moreover, a lot of this worry and dismissal is based on a lack of asking more questions. Instead of deciding on your own what is cause for concern and what is not, first engage in a conversation about it with your kids.
Take this approach with yourself as well. Instead of asking yourself whether your behavior is “normal,” ask yourself if it is causing distress for you, or someone else.
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