Parenting: Prescribing the Symptom

Rebecca was struggling with 3 year old Kevin's screaming. Whenever someone didn't do what he wanted, he screamed and screamed, hoping to get his way. Rebecca had tried many different things to get Kevin to stop screaming, such as time outs, telling him to use his words, walking away and ignoring him, taking away toys and taking away events, such as a birthday party. A couple of times she had lost it and screamed back at him. Nothing was working to get Kevin to stop screaming. Even though screaming didn't work for him to get his way, he kept doing it.

As Rebecca and I discussed it in a phone session, it became apparent to me that Kevin and Rebecca were stuck in a power struggle, with Rebecca trying to get Kevin to stop screaming and Kevin doing everything he could to resist being controlled. We needed another tactic.

"Rebecca, the next time Kevin screams, do what I call 'prescribing the symptom.' This means that you say to Kevin something like, "Kevin, maybe you are not screaming loud enough. Maybe if you scream louder, you will get what you want." You need to say it in a light tone of voice, with no anger. Almost matter-of-factly."

The next time Kevin screamed, Rebecca did exactly that.

"Kevin looked at me like 'are you kidding me?' and screamed louder. So I told him that it must not be loud enough, so he screamed louder. When I told him it still wasn't loud enough, he looked at me like I was nuts and stopped screaming. He hasn't screamed like that since!"

So what happened here? What happened is that Kevin was screaming to not be controlled by Rebecca, as well as hoping to get his way. When she actually told him to scream, the only way he could not be controlled by her was to stop screaming! Her prescribing the symptom also pointed out to him the absurdity of screaming to get his way.

Prescribing the symptom can work for many behaviors:

"Maybe if you whine even more, you will get what you want."

"I don't think your temper tantrum is quite doing it. Maybe if you kick harder and cry louder, you will get what you want. I'm sure you can do better than this."

"You know, that's a pretty good pout. But it's not quite good enough. Maybe if you pout even more you can get what you want."

"You are putting up a pretty good argument. Maybe if you argue longer and louder, you will get what you want."

You need to be sure that you do this right away, before you feel angry or frustrated. You need to be able to keep it light. It is important for your child to see you calm rather than flustered. Sometimes kids act out just to feel the sense of control over their parents' behavior when their parents get angry and flustered. It can give children a sense of power to upset people so much bigger than them.

Fortunately or unfortunately, prescribing the symptom can work with adults too - adults who are acting like kids and going into resistance. Many people automatically resist as soon as they think someone is trying to control them and prescribing the symptom can work wonders with these resistant people.

It might even work with your self. If you find yourself reaching for the box of cookies when you have vowed to lose weight, telling yourself that maybe eating the whole box will make you feel better and solve whatever problem or feelings you are trying to avoid with the cookies might just stop you in your tracks, as it did with Kevin!