Of praise and prozac

Since February, a story from New York magazine has been making the rounds on the Internet. Month after month, “How Not to Talk to Your Kids: The Inverse Power of Praise” still reliably tops the magazine’s online most-read list.

The gist: In the interest of buttressing our children’s self-esteem, well-meaning parents praise their intelligence at every turn. In the process, we unintentionally undermine their self-confidence; our darlings end up more fragile as a result, and more likely to underperform.

“I am smart, the kids’ reasoning goes; I don’t need to put out effort,” writes the article’s author, Po Bronson. “Expending effort becomes stigmatized — it’s public proof that you can’t cut it on your natural gifts.” What we should be praising are efforts, successful or not.

It’s a great story, but my first thought on reading it was, “Excellent — one more rule for how to parent properly.” Can we have become so preoccupied with perfecting our comments on a child’s activities that we actually fail to notice what they’re up to? How much joy has this sucked out of the family play date?

Yet I personally account for, oh, 17 percent of the hits keeping the story in circulation lo these six months later. I call it up from time to time — say, when one of my boys runs wailing from the room, too shattered by failing to complete something on the first try to try again. I get very upset when this happens: I perceive their self-esteem to be my personal responsibility, and the stakes as high. If I screw up, I imagine, I consign them to a life of depression and dysfunction.

I thought about Bronson’s story frequently while reading Lawrence Diller’s The Last Normal Child: Essays on the Intersection of Kids, Culture, and Psychiatric Drugs. A California behavioral-developmental pediatrician and bioethicist, Diller has been prescribing psychiatric drugs to children for 25 years. Along the way he’s become convinced that our anxiety about self-esteem has made us intolerant of kids who don’t behave or perform exactly the way we think they should, or the way we imagine others think they should. With the energetic assistance of the pharmaceutical industry and pressure from overcrowded schools, we now see syndromes or maladies to be treated with pills where earlier generations saw character traits that weren’t necessarily good or bad — they just were.

Some families do show up in his treatment room hoping he can prescribe something that will open the doors to an exclusive preschool or ensure a higher SAT score. But for most the quest isn’t so much to rise to the top as it is to keep from being sucked into an undertow of economic failure: We imagine that even the earliest bad grades can snowball into the wrong college or no college and a life on the bottom rung of the salary ladder.

American culture tells us — and this is a crucial point — that our child will sink or swim on the basis of their feelings of self-worth. Children get in trouble when they’re bored, squirrelly, defiant, too quiet, not working to their potential, and so on, and we worry they will develop a bad self-image. If a drug can improve a child’s focus or performance, we think, it’s worth a try if only to help them feel good about themselves.

It sounds so reasonable — unless you consider that we might medicate a child because of a trait that’s not so much bad as different. Maybe the child is a problem because her teacher has too many pupils to tend to. Or maybe — and this is not me, no, no, never — the rocket-fueled pace of a child’s need to know makes a parent feel inadequate. The corners we file off pharmaceutically trying to fit round pegs into square holes might be vital, essential parts of a budding personality.

“Ours is the only country in the world where the ‘symptoms’ of forgetfulness, dreaminess, and intelligence — in short, the characteristics of the absent-minded professor or child — would be considered signs of a mental disorder to be treated with a psychiatric drug,” Diller writes. “I, in my role as a specialist, do this all the time — medicate children with drugs like Ritalin, Adderall, and Prozac, much more frequently than I care to — even when I feel they have nothing seriously wrong with them.”

Or more precisely, nothing wrong with them that a better family situation, school, or childcare provider wouldn’t fix. Consider Diller’s patient “Ned,” a bright but failing boy whose family makes an appearance in Normal Child. Ned has a high IQ, a total lack of interest in his schoolwork, and parents more focused on the consequences of the undone homework than Ned’s entirely reasonable boredom with it.

“When I decide to medicate Ned,” Diller writes, “I know on some level that although I’m ‘helping’ him, I’ve relieved any pressure on the system to adjust to him or otherwise address the uncomfortable questions posed by his intelligent but underperforming personality.”

When the environment should change but won’t, we rush to bolster the self-esteem we are convinced our precious needs to navigate this sea of dysfunction. “In our worry over their self-images, we forget that some of our children’s best talents develop when they compensate for their weaknesses,” Diller writes. “We forget to appreciate our children’s diversity of talent and temperament and instead worry about their differences and how they feel about themselves.”

And you can bet that if we’re worried about their differences, they are obsessed with them. In response to these stresses, many boys become disruptive or aggressive, disproportionately earning a label like ADHD and a script for Ritalin. Girls, on the other hand, “try to please or become invisible,” making them excellent candidates for Prozac a few years after the boys are diagnosed.

A better prescription, Diller argues, is good discipline, something we paradoxically seem to think causes low self-esteem. But it’s impossible to expect effective, consistent discipline from adults who are stressed, overworked, depressed, terrified of having produced an imperfect child, or — the Big Kahuna — in a troubled marriage. Normal Child is peppered with tales of the doctor’s attempts to persuade grownups that in fact they are the ones who need professional intervention.

Do I buy all of this? Absolutely. A couple of years ago one of my sons flunked his first test. He’s smart and likeable and I gave him a response along the lines of, “Oh well, tests aren’t everything.” Far from reassuring him, this just made him cry harder. “You don’t get it,” he wailed. “Smart is all I have.”

I couldn’t talk him out of this — and why would I think I could, having committed every sin described in Bronson’s article? First I pounded him with praise for his smarts, and then I did an about-face. To a 7-year-old, this must have seemed more like betrayal than empathy.

It was hard to tell, for a moment, which one of us was more fragile. I share this counterproductive tendency to equate my kids’ self-esteem with their welfare and, by extension, a reflection of my love and devotion.

No wonder parents want a script guaranteed by the experts, something we can memorize. If we stick to it, we’re less likely to screw up. It’s understandable — Bronson went in search of just such a script — but I’ve come to believe something more happens when you give up the big, broad You Rule the World praise. To praise effort, you have to take the time to be aware of it, not just the activity but what it cost your child in terms of effort, pluck, and creativity.

Specific praise gets parents focused on their child, not the child they think they should have. And the child they have is doubtless more loveable, interesting, and worthy of that attention than that dull (and nonexistent) model kid. Imagine what kind of change is possible then.

Beth Hawkins is a Minneapolis writer.
Note: Dr. Diller has written two other books on kids and psychiatric medication, including one geared toward helping parents decide whether to medicate their child: Should I Medicate My Child? Sane Solutions for Troubled Kids with — and without — Medication.

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