Challenging Behaviour & Dry Cleaning Fluid
Two short stories before I get to the main thrust of this post.
There was a fabulous old Victoria Wood sketch which was presented as a mock documentary of one of those old 1960s kitchen sink dramas. The action took place in a dry cleaning shop and the central character was probably a precursor for the character Wood played in Dinner Ladies. The big scene in the documentary sees the main character throw a bottle against the wall and she says – “I am sick to death of the smell of dry cleaning fluid”. The bottle smashes and she storms out of the shop. The next scene is of the actors sitting in a rehearsal room, discussing the character’s motivation for her speech:
“I think when she says she’s sick of the smell of dry cleaning fluid, she’s really saying she’s had enough of living in a back to back in Cleethorpes with a good for nothing husband”.
“I think she’s really saying that she cannot take any more of oppressive Conservative politics”.
The tag line of course is, Wood says – “Just a suggestion…… perhaps, she’s just saying that she’s had enough of the smell of dry cleaning fluid”.
This afternoon I saw a client at work that I’ve been seeing for just over a year. About a month ago, his 18 month wait for NHS counselling ended and he decided to take up their offer of 6 sessions and see what happened. Yesterday he had his second session with them. Obviously, I’m not going to break his confidentiality but this is a man who is doing some fascinating research of his family history. It is an honour to be in the same room as this man as he comes alive when he talks about his latest discoveries. At the second session of CBT, he’d been talking about what he gets out of this research and the therapist suddenly said to him – “You’re very keen to talk about that. I’d like to talk about the things you’re not talking about”. And that was the end of his NHS CBT experience. He said “Fuck you” and left.
I’ve been having lots of Twitter conversations about challenging behaviour. I loathe that title. There’s a whole industry built up around it now, so there must be a vested interest in labelling our guys “challenging behaviour”. I’m in the camp that firmly believes that when Steven’s behaviour becomes difficult, it is about anxiety, fear, pain or anger. It is definitely a communication. And I also believe that if the person is displaying “challenging behaviour”, the problem is with you – you must be doing something wrong. The person is not being understood and communicating in a desperate way to be understood. The longer the behaviour continues, the more of a cock up you’re making in understanding him.
I know this goes against the grain for most behaviourists. I’ve written before that when Steven was in the positive behaviour unit, he had a signature tune to greet the manager on his arrival – Queen’s “I Want To Break Free”. He frequently said to anyone prepared to listen – “I want to go home” or “I want to live in the Uxbridge house” or “I want to go and see Dad”. Reading through the unit’s records whist preparing for court, it was amazing seeing what lengths they went to, to interpret these statements – every time sailing straight past the most obvious message – I WANT TO GO HOME. It was dismissed as an example of echolalia. It was read as Steven not wanting to conform to the house rules. There were a couple of times where it was recorded: “we have to bear in mind, that Steven often says the complete opposite of what he is meaning”!!!! That seems pretty desperate to me – on their part. But then, the industry has to be fed, it needs lab rats. It needs self justification.
Imagine you are the autistic man like Steven. You have spent ages trying to form the sentence to communicate how you’re feeling about something. You are in an anxious state and are looking for reassurance. Eventually, you blurt out the best way you can but are immediately dismissed by the person you have chosen to trust with your anxiety.
You might lash out. And out comes the ABC charts, the SMART recording forms. And the agenda for the next team meeting is set. And someone goes off to write their case study for module two of their positive behaviour course.
From → Social Care