THE STEP-BY-STEP DEVELOPMENT OF ANXIETY-HYPERACTIVITY
The seed of SIH is sown when parents stop talking openly/directly with each other (or important outsiders) in key areas that pertain to their child. They may be talking freely about family budget, vacations and other interests, but around one or more aspects of their child’s life – eating habits, bedtime, clothes, haircut-style, school, sports (issues will vary from one family to the next) – they have essentially given up. Here is an almost pure anxiety case in its incipient stages:
C3: Michelle, 6, was brought to clinic by her adoptive mother because of nighttime wandering about the house. Observation in her mother's presence revealed her to be silent and apprehensively inhibited. Her posture at times was almost cringing, pulse rate rapid, pupils dilated. She was obviously an anxious little girl. Alone in the playroom, however, she became alert, fairly relaxed and talked easily. Probing brought out that Michelle was most anxious immediately upon returning home from school, especially on days when bringing home her school work. At school she was a model student, but reference to this later evoked an unusual response from her mother, who became notably irritated: "How can these teachers give a star for work riddled with mistakes? Teachers nowadays are altogether too soft. I prefer achievement over virtue." It was apparent that her philosophy was that awards should be reserved for actual accomplishment, whereas the teacher was encouraging effort. Mother had never conveyed her sentiments openly and directly to the teacher, but her upset feelings and adverse comments about ‘modern education’ regularly got through to Michelle.
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THE STEP-BY-STEP DEVELOPMENT OF ANXIETY-HYPERACTIVITY
Michelle's position was that of an unknowing potential transmitter of covertly held antagonistic ideas between her mother and teacher. With each piece of work she carried home, Michelle was effectively conveying the teacher’s philosophy, which was in disharmony with that of her mother. This resulted in unpleasant things being said about the teacher. Michelle never conveyed these negative feelings back, so in a sense she was a unidirectional relayer, a not uncommon state in the early phase of generation of an SF:RS. The outcome for Michelle was moderately intense situational anxiety.
Treatment consisted of a fairly simple compromise. Because of the mother's rigidly held bias or theme interference (it stemmed from values acquired while herself in school, reinforced by an indifferent, passive husband), a meeting on the issue of educational philosophy between teacher and mother was deemed inadvisable. It might have turned into an unpleasant diatribe, unnecessarily alienating a teacher whose objective cooperation would be needed. Instead, it was diplomatically arranged that the teacher give gold stars for accomplishment and silver stars for effort. This pleased mother and a three-month follow-up indicated that Michelle's acute anxiety, which had abruptly abated after the planning interview (!), had not returned. At this point, marital counseling for her adoptive parents began.
The ‘split field’ communication block usually happens slowly over time. Before the split field comes between them, parents openly argue about things crucial to their child. Maybe father considers eight o’clock to be the right bedtime, but mother insists the child drag off upstairs on its own when tired. Or, mother feels their child should judge for itself how much food to eat, while father insists that every last scrap be cleaned up. Possibly mother extols the virtues of doing well in school, but father downplays this, or even sneers at the idea. Maybe they actually agree on one or two points. But, overall they disagree and cannot agree to disagree. They simmer with topical anger. Many a child in such an environment manipulates the situation and sides with one or the other parent in order to get what it wants. Sometimes one parent will openly recruit a child to his/her side. The child will then show anger and may direct it at the vilified parent. The parent cut out of the circuit gets yet more irritated at the other parent and will see their child as two-faced. This sub-phase of ‘taking-sides’ (or pseudocoalitions) may be short-lived or go on for years. If nothing else, such a youngster will certainly grow up to be an accomplished manipulator.
Up to this point the situation is the simple ordinary problem of a child caught in the middle. The critical essence of the SF:RS goes several steps further. First, gradually, almost imperceptibly, the parents become tired of disputing each other and their direct communication literally shuts down. But next, and here is the crux of the matter, they don’t shut up. They begin to carp and argue surreptitiouslythrough the medium of their child. It goes something like this:
1. A father is irritated at having to make last minute school lunches. Out of his wife’s hearing, he makes a pejorative comment to their child, “Your mother may have done okay in school, but she knows nothing about running a house.”
2. The child takes this in and later, perhaps when forbidden to stay up late, relays an edited version on to mother, “Dad says you’re smart, but sure act brainless around here.” It may not be that blunt, but mother instantly reacts.
3. “Is that so? Well let me just tell you about your father!”
And out come the criticisms. So it goes, back and forth, on and on, over time as shown in the first diagram. Children are normally excluded from hearing such parental differences. The child who is not, has a good chance of becoming a relayer of their mutually adverse messages across the parental split field. Children, who are dependent little beings, simply cannot handle this sort of perverse power reversal with equanimity. (In popular psychological terminology children internally experience cognitive dissonance.) Nor can they extricate themselves from it on their own. In the final step they become truly trapped. Should an astute child have the temerity to point out parental differences or complain about being swept up in them, a subtle metamessage (mm in diagram) is sent out by one or both parents—sealing the untenable nature of the SF:RS and firmly closing its trap-door on all three.
Key point: A metamessage, defined, is a message about the main message, that is, a modifier on a higher abstract level of communication. It is usually nonverbal. In the SF:RS it subtly denies any parental conflict (“This is not happening.”) and carries a covert threat of punishment if not heeded (“Don’t ever mention it, or else.”). Heeded, it betrays the child’s sense of reality, amounting to a quandary that locks—binds—all three into a conspiracy of silence about what is really going on.
This sinister metamessage is the final assault that seals the child’s fate. Any child (any adult for that matter!) caught up as a relayer of antagonistic messages between subversively warring authorities becomes progressively upset. The ‘upset’ assumes a specific form—anxiety with associated mild restlessness—akin to what was once called ‘free floating’ anxiety. (It was called such because nobodyreally knew strategies where it came from. Now we do!) Early on in the natural history of the SF:RS, intense, short episodes of relaying result in bouts of acute pure anxiety. As the system gets fully ingrained the child develops persistent, chronic restless anxiety.
If the parents later separate or get a divorce the drama rarely ends, for a perfect setup is then created for perpetuating this perverse triangle and the child’s anxiety continues to wax and wane. For children of divorce, and there are lots of those in our society, increasingly so, every visitation with one of the separated parents is an occasion for probing the child about the other parent’s doings. If the child responds, the parent may make some demeaning remark. Thus, the child continues relaying messages back and forth between them. The child is literally used by the alienated parents to irritate, reconcile, or spy on each other! Every separated parent intuitively knows better. But they only rarely do better. And their child’s mysterious anxiety comes and goes and eventually becomes persistent.
ANXIETY AS A UNITARY SYNDROME: Freud’s famous Oedipal complex is simply an internal, or mind, representation of an SF:RS (or RPB).iii It is ‘vague’ in the sense that it lacks concrete representation in the here and now. For decades the anxious child, from the classical monadic one-person perspective of psychiatry and psychology, has been characterized by three symptom-sign clusters: iv
1. There are emotional signals expressed, including apprehensiveness in strange situations, undue fears, nightmares and sleeplessness.
2. Next, are exaggerated autonomic nervous system signs – dilated pupils, mild tremor, sweaty palms, stomach ‘butterflies,’ even diarrhea or worse.
3. Lastly, there is conforming, inhibited, dutiful, approval-seeking behaviour.
The discerning reader will observe that these standard diagnostic criteria do not include hyperactivity! It was long thought that hyperactive behavior and anxiety were mutually exclusive. But, as Jenkins put it in 1969, overactive children “usually do not appear anxious except as their hyperactivity may at times be interpreted as evidence of anxiety.”v
FROM ANXIETY TO HYPERACTIVITY:
In 1972 I reported that “younger patients caught in the relayer position (of the SF:RS) display either apprehensively cowed behavior or hyperactivity.”vi Furthermore, I observed that the hyperactivity aspect climbs, “increasingly so, when (the child is) trapped in more than one split field.” Now we know with certitude – anxiety and hyperactivity are linked.
A frequency-plot shows the relationship. A single SF:RS induces mild through severe anxiety. Its incidence climbs under a normal distribution curve, reaching a peak at two split fields. After three SF’s, it rapidly drops off, tapering asymptotically towards zero as the MSF-generated hyperactivity rises in a straight line. The intersection-point of curve and line is a singularity-cusp at three SFs. The gray area represents coextensive anxiety-hyperactivity, 90/143 cases, recorded in my child-psychiatric medical practice. At graph’s right a reciprocal relationship between hyperactivity and anxiety also emerges.
As hyperactivity level increases, the overt signs and symptoms of anxiety diminish to the extent that the end result is pure hyperactivity. Notably, the child may appear emotionally calm, but be wildly, almost constantly, active. So, SIH is a ‘behavioral equivalent’ of inner anxiety.vii
Split fields may involve relatives outside the nuclear family or go well beyond the extended family altogether, with other significant adults. Thus, one or both parents may be at covert odds with grandparents—or the school. If parents fail to visit the school to discuss progress a teacher never really knows how they feel or what they think. Nevertheless, messages get subtly passed back and forth: A slurring comment about lack of parental involvement perhaps is written on the report card. When the parents read it they may slur right back—mumbling or grumbling to the child about the teacher. Whether parental comments actually get back to the teacher or not, the child is essentially again in the thick of it. So we have another split field (parent-teacher) for the relayer child to maneuver. A child on probation or in foster care can be enmeshed in several, even multiple, split fields and may present with marked hyperactivity.
The SIH-drama is unique in other ways. Noxious sequences in perverse triangles do not spontaneously heal as does injured tissue—the processes simply chase around in never-ending cybernetic circles. Unlike neuro-ADHD, SIH is not unitary; the child alone is neither the proper focus of assessment nor the correct locus of treatment: the child’s family and social environment are. To conclude this formulation of the biphasic SF:RS-MSF complex, it is moot to point out that anyone growing up constantly exposed to this mechanism may later spread it far afield and definitely down to his/her own family—and children. It is passed through the generations, socially ‘inherited’ as it were. As an interesting case-in-point, consider SIH in its fullblown ‘maturity’ in a strategically-placed adult:
C4: A nurse (secunded to a public health school clinic) displayed symptoms of chronic anxiety at work. She was jumpy, too eager to please, had constantly damp palms and sweat stains under her axillae, a strained voice pitch and tended to stutter. She seemed regularly involved at the edge of little squabbles. To her supervisor she brought bits of gossipy information about her colleagues, but always in a ‘helpful’ way. Before long on the job, she began to miss too many days with minor ailments. An administrator called her on the carpet and wanted to fire her because she was a “hopeless neurotic." Enquiry of a previous hometown employer indicated that her family was composed of a "bunch of neurotics" also. On the positive side she was energetic, original, and, when present, genuinely devoted to work.
She was raised in an environment bearing all the earmarks of a split social field between her mother and father. Throughout her developmental years she had learned to become an adept relayer between them. Now she could be described as a chronic, compulsive relayer who attempted to recreate rifts wherever she went. She was most successful, being a well-trained expert in the field of triangular architecture. At work she exercised an uncanny sense in recognizing subtle differences between essentially friendly co-employees, and she craftily played these up behind the scenes. Her reward: a bit of limelight and the establishment of, to her, a familiar system of interpersonal relationships. The one psychological drawback for her was the continued high level of chronic anxious restlessness she suffered. Getting caught and almost dismissed was her narrowly missed punishment. (Do you know someone like this on your job?)
Treatment consisted of a forthright, hard-nosed but kindly, discussion. She responded with an Aha! reaction of flooding insight. She agreed to stop searching out covert differences between colleagues and the transmision of their conflictual messages. Her resolve was reinforced by a period of work probation under the attentive eye of an enlightened supervisor, who, if she slipped back into the old pattern, arranged for a get-together between the parties. Results were dramatic. Her productivity at work increased, her natural creativity gained fuller expression, her basically empathic nature soon came to the fore, and she emerged as one of the best-liked work group members. Incidentally, as a side effect, her marital relations, which had been strained, improved concurrently with the virtual disappearance of her jittery anxiety.
