Based on the DSM-5, developmental disorders include the so-called neurodevelopmental disorders, defined as conditions that have their onset is in the early phases of development and that are characterized by deficits in personal, social, school or work functioning. Deficits can range from specific limitations in learning abilities, to a global impairment in social and intellectual abilities: intellectual disability, communication disorders, autism spectrum disorders, ADHD, SLD, and movement disorders. Developmental disorders also include anxiety, eating, sleeping, continence, stereotypic movement disorders, and behavioral disorders such as oppositional defiant disorder, conduct disorders, and disruptive behavior disorders.
In my opinion, all these disorders lack definitive evidence of an organic etiology.
Research is still ongoing on their symptoms and diagnostic criteria, but certainty on their etiology is still scarce, and interventions in clinical practice to attempt the treatment of children with these disorders is mainly rehabilitative, or, as sometimes underlined, “habilitative” because is suggested that children never acquired the impaired ability.
Treatment with psychoactive drugs is frequent for several of these disorders, despite the repeated warnings on their potential consequences.
The most common intervention seems to be targeted to the children’s cognitive-behavioral aspects, while parents are mainly involved in the attempt of maximizing the child’s compliance to therapy. Parent training is a tailored program targeted at supporting and guiding parents in the management of children’s dysfunctional aspects and in their relationship with them. However, it is not aimed at dealing with the non-conscious dynamics of the family as a group.
While it is true that during the first year of life the emotional exchange between children and their caregivers deeply affects the future development of every human being, it is also crucial, during the early and middle childhood, to explore the possible risk factors for a healthy psychophysical development of children. In cases where a developmental disorder is already present, parents-involving should start as early as possible.
Rehabilitative literature and practice legitimately value as a positive outcome preventing the parents from feeling guilty for their children’s disorders, as guilt pertains to a religious point of view, while in science researching for the cause of a phenomenon is essential.
In the over 40 years of our experience, we obtained our first results when we were finally able to identify and manage, through a dynamic relational psychotherapeutic relationship (Massimo Fagioli’s Theory), the images and feeling that parents non-consciously act in their relationship with their children with such disorders.
For several parents, the deep interest and concern for their children’s wellbeing proved a crucial factor for compliance to the psychotherapy. In other words, we realized that these parents accept to face this difficult psychotherapeutic path because they strongly desire their children to be healthy and well. We therefore can plan a regular psychotherapeutic course with both parents separately, including setting, transference, and dream interpreting, or, more often, with only one of them.
Parents (or one of them), who are often disheartened by the scarce to absent results obtained through the most common treatment that they followed for years, easily overcome the pain of having to recognize their mistakes and are strengthened by the progressive positive responses from their children.
Our research aimed at identifying a causal relation between some aspects of the non-conscious reality of parents and their children’s symptoms.
We could not work on a large number of cases and with all of the above mentioned disorders, but the results of this research and practice seem to be definitely encouraging, as is reported in my recently published book “La parola ai bambini”.
References
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