A New Group and Its Mission: Learning Disabilities and the Psychology of the Self

The International Forum on Learning Disabilities (IFoLD) is a recently formed group of clinicians interested in learning disabilities (LD) who attend the international self psychology conference. The group, started by Joseph Palombo of Chicago, is enriched by a diverse membership. It includes Amy Eldridge, also from Chicago, Susanna Federici-Nebbiosi and Marco Bernabei from Italy, Eva Rass from Germany, and Faye Mishna and Margaret Amerongen from Canada. The group has presented several pre-conference workshops and original papers at International Conferences during the past several years. The aim of this group is to inform psychoanalytic therapists about the potentially complex and far-reaching impact of learning disabilities on the lives of their patients (including child and adult patients who have LD and those whose family members have LD). The group is committed to articulating the ways in which self psychology theory can be helpful in understanding and addressing the impact of LD. Presentations and networking at conferences have yielded a gradually growing list of colleagues who share the group’s interest.

IfoLD recently identified its mission in the following statement:

• The International Forum on Learning Disabilities (IFoLD) is an organization devoted to furthering an understanding of the impact of learning disabilities on the development of children, adolescents and adults. It recognizes that this impact may be complex and multifaceted. Learning disabilities may profoundly affect an individual’s sense of self, relationships with others, and social, academic, professional and everyday functioning.
• IFoLD is dedicated to the dissemination of knowledge about the difficulties faced by individuals with learning disabilities and their families, and about the treatment interventions used to alleviate these difficulties. These interventions are guided by an effort to understand the subjective experience of the individuals involved, drawing on information about the complex interplay of cognitive, emotional, behavioural, familial, and environmental factors.

At the most recent conference in San Diego, IFoLD members conducted a pre-conference workshop. It featured some of the problems faced by children with LD and their families as well as self psychologically-informed therapeutic interventions.

It is vital for therapists to recognize that a sizeable number of people have LD. According to Statistics Canada 100,400 children aged 5-14 have LD, second only to asthma as the leading chronic condition limiting children’s activity. Although a significant number of individuals with LD function well, approximately 40% of students with LD develop psychosocial problems. Throughout the lifespan, individuals with LD are prone to experience empathic failures and unmet selfobject needs. Some of the stresses confronting children with LD and their families are outlined here.

The LD may mean that a child’s selfobject needs for experiencing a sense of competence, belonging, admiration, and support are frequently not met both inside and outside of the family. Rather, experiences of frustration, stigma, isolation, and shame may be all too common.

Families in which a child has an LD may engage in escalating vicious cycles of interaction. Children’s problems may overly tax the parents’ empathic capacities, which may interfere with the child’s development and attachment to the parents. The child then may not meet the parents’ needs for affirmation of their effectiveness and for attachment.   The parents may consequently be less able to support the children, who then function even more poorly. Parents’own self deficits may further complicate the picture.

Behaviour management and helping the child master developmental tasks and social competence are among other challenges that may confront families in which a child has an LD. While many such children develop well, they are more at risk of having behaviour problems than their peers without LD. Specific cognitive impairments (e.g., acquisition of language, labeling feelings, perceiving the nonverbal communication and intentions of others, problem-solving and other executive functions) may hinder the development of age-appropriate self-regulation and social judgment. Problems with impulsive behaviour, emotional outbursts, and non-compliance are also reported in the literature. Lacking social competence and being stigmatized because of their academic weaknesses, children with LD often have difficulty making friends and are more prone to be bullied than their peers without LD. These experiences thus compromise the children’s opportunities to obtain selfobject experiences outside the family.

Families may have difficulty determining behavioural expectations and limit-setting suitable to the specific needs of the child with LD. The family must find the delicate balance between, on the one hand, providing the greater support and guidance dictated by the LD, and on the other hand, promoting age-appropriate independence and initiative. Children may need their parents to recognize that they may require more help with particular tasks. They may need more preparation, more coaching, and to have less demanded of them than other children. However, parenting styles that are overly controlling or protective can evoke conflict with the child or can erode the child’s competence. The added complication of the LD may intensify the parent-teen clashes that are common in adolescence.

The greater stress suffered by parents of the child or teen with LD may exacerbate already existing conflicts between parents. Parents who might otherwise have coped adequately can be pushed over the edge by the LD-related problems. Feeling uncertain and inadequate, parents may blame each other and feel insufficiently supported by each other.

Effective therapeutic work dictates that therapists acquire knowledge about LD and the multifaceted impact that it can have on the lives of children and parents. Helping family members to better meet each other’s selfobject needs means that the therapist’s empathic attunement must include how the LD may be affecting experience.

To illustrate: the child needs the therapist to understand that a learning disability may impair his or her verbal communication or contribute to misunderstanding another’s intentions. Misunderstanding and feeling misunderstood, the child may act in ways that others find offensive. Further, many behaviour problems in children with LD are due to anxiety and shame surrounding any activity in their area of weakness. Defiance and irritability may mask uncertainty, even panic. Unruly behaviour may be the logical outcome to the conviction, “It is better to be bad than stupid.”

The parents analogously require empathy from the therapist that is attuned to their particular struggles. The therapist must appreciate that parents may feel exhausted by the child’s special needs and apprehensive about the child’s future. Parents may feel that they and their children are misunderstood and criticized by those who are uninformed about LD. Significantly, parents may feel blamed for their child’s problems.

IFoLD members will continue to exchange ideas with colleagues about these important matters. In future presentations, the group plans to address issues related to the impact of LD on adults and to discuss considerations for psychotherapy with adults who have an LD or suspected LD.

References

Cosden, M. (2001). Risk and resilience for substance abuse among adolescents and adults with LD. Journal of Learning Disabilities, 34(4), 352-358.

Lewandowski, L.J., & Barlow, J.R. (2000). Social cognition and verbal learning disabilities. Journal of Psychotherapy in Independent Practice, Special Issue: Social Competence and Developmental Disorders, 4, 35-47.

Statistics Canada (2002, December 3). A profile of disability in Canada 2001. Retrieved

March 26, 2003 from http://www.statcan.ca/english/freepub/89-577-XIE/index.htm.