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Comment by neilk | Hacker News Reader

I sometimes ask mental health professionals what the converse of Oppositional Defiant Disorder is. At what point do we recognize a disorder in a child who is unnaturally compliant and obedient? No answer so far.

I ask because I think I had this. When I was a young prodigy I had the mentality of a performing seal.

It's true that some people have difficulty controlling themselves, and they do need help. But the lack of symmetry says a lot about how diseases are identified; it is about institutional convenience.

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"Low self-esteem", sometimes colloquially called "people pleasing" or "being a doormat". A good therapist will recognize this and encourage the child to develop more of their own interests and assert themselves more.

Sure, sure. But would be ever prescribe prescription drugs for this? Everything you're describing is characterized as a personality trait, whereas the OP (who I hardly fully agree with) is claiming that anti-authoritarian sentiments are labeled a disease. Obviously, this makes a big difference in how these phenomena are treated.

  > Sure, sure. But would be ever prescribe prescription
  > drugs for this?

If there was a drug shown to improve self-esteem in children, it would likely become one of the most profitable drugs of all time.

  > Everything you're describing is characterized as a
  > personality trait, whereas the OP (who I hardly fully
  > agree with) is claiming that anti-authoritarian
  > sentiments are labeled a disease.

ADHD and ODD aren't diseases, they are disorders. When it comes to psychology/psychiatry, "disorder" is basically a word that means "personality trait that negatively interferes with everyday life".

> If there was a drug shown to improve self-esteem in children, it would likely become one of the most profitable drugs of all time.

It's called alcohol. It's wildly profitable.

When's the last time you give your child alcohol?

If you really cared about your teen with low self esteem, you would buy them a round at the bar.

Why don't you love them?

It depends on what state you're in... (provided you're going to a bar, and not just purchasing it and going home)

You could do it in Wisconsin, but not Illinois.

I think Tequila is what you are looking for. Here are the medical details: http://www.youtube.com/watch?v=EldQzTxSKMM

> If there was a drug shown to improve self-esteem in children, it would likely become one of the most profitable drugs of all time.

If the drug worked it wouldn't be very popular as children would start dropping out of school to join Y Combinator and the drug would be recalled for having horrible defects.

The baby boomers idea of self-esteem is disgusting.

> The baby boomers idea of self-esteem is disgusting.

It seems to be the same as yours: "If people had more self esteem they would want to be more like me"

The problem is that a child will not be brought to a therapist for following the rules; only a child who violates rules too frequently will ever see the inside of a psychiatrist's office. A child who always does what they are told will be rewarded, and will likely be rewarded further if their reaction to their rewards is, "What are my next set of instructions?"

This reminds me of a poem my favorite Math professor used to share, about a little boy who was always instructed exactly how to draw a picture of a flower: http://home.bresnan.net/~cabreras/theboy.htm

This "poem" is depressing.

Off topic: It's never made sense to me why people call things that don't rhyme "poems." As far as I'm concerned, this is an essay, not a poem.

It's a type of poetry called "free verse".

https://en.wikipedia.org/wiki/Free_verse

http://examples.yourdictionary.com/examples-of-free-verse-po...

Here is the classic story of a Real Programmer, written in free verse:

http://www.catb.org/jargon/html/story-of-mel.html

This story was originally written in prose, and it apparently got converted to free verse more or less by accident as it was bounced around mailing lists. Here's the prose version:

http://www.pbm.com//~lindahl/mel.html

HN discussion:

https://news.ycombinator.com/item?id=678999

  Another way to put it,
  I suppose you could say,
  is that the difference
  between prose and free verse
  is the number of lines.

Not the number, more like the form, but in general the difference between poetry and, uh, prose is something I do not quite understand.

  > Not the number,
  > more like the form,

  Now that's a great start!
  I wonder if the art is knowing when to go on until your breath runs out,
  and when to keep it
  short.

Free verse seems silly and pointless. So I wrote a trivial program to turn prose into free verse:

    import random

    def poem(text, p_break=0.5, seed=1234):
        rand = random.Random(seed)
        result = []
        for w in text.split():
            result.append(w)
            if rand.uniform(0.0, 1.0) < p_break:
                result.append('\n')
            else:
                result.append(' ')
        return "".join(result)

    print poem("This is a poem written by a program.  It is not really a poem because it does not rhyme, it is some weird thing called free verse, which is a poem that does not rhyme.", p_break=0.1)

Here's the output:

    This is a
    poem written by a program.
    It is not
    really a poem because it does not rhyme,
    it is some
    weird thing called free
    verse, which is a poem that does not rhyme.

http://en.wikipedia.org/wiki/Scansion#Elements

Most poems in the world don't rhyme. https://en.wikipedia.org/wiki/Rhyming#History This one uses a repeated structure instead of repeated sounds.

If how it sounds is as important when read out as the information content it's poetry. Even if you disregard free verse that isn't all poetry. The Norse skaldic tradition is amazing and they were much more into assonance than rhyme. Think rap but without a backing track.

http://www.okcupid.com/profile/Hibernian/journal?cf=profile Is this poetry?

Poetics aside, I have to agree with you about how the poem is a very sad story. My explorations in free verse elsewhere in the thread may be a way to cover up my tears.

My daughter is very bright, but when she was in grade school she'd sometimes have trouble with a homework problem because the textbook didn't explain a concept clearly.

So I'd tell her how I've always found it helpful to read multiple sources on a topic. If one of them doesn't click with the way I think, another one probably will. And just reading multiple references that explain things differently helps reinforce the concepts.

She wanted nothing to do with it! She only wanted to hear about the way "they" explained it - the textbook, the teacher, the school - the right way to do it. Nothing else.

I guess I wish she'd gotten a teacher like the one at the end of that story, early on.

That is depressing.

http://en.wikipedia.org/wiki/Metre_(poetry)

Does anyone know why the alternative version on that page has an unhappy ending and the original version has a happy ending?

(See the footnote at the bottom of this page: http://home.bresnan.net/~cabreras/theboy.htm)

Who wrote the alternate? Why would the author approve of one but not the other?

Both versions highlight the importance of a nurturing environment to the development of a child. However, the original version is about a child finally finding an environment in which his creativity can thrive; the alternative version is about a child's creativity being stifled during his early development to the point where it is unable to thrive even once he is in an environment that allows, and even encourages, it. Thus the alternative version also demonstrates the lasting damage that may result, and so is more effective at conveying the message of the poem.

Harry Chapin has a song called "Flowers Are Red" that is essentially a retelling of this poem.

I think that you are right in that there is probably a disorder in that particular case, but seeing the lack of symmetry in general to be an indication of a problem seems off. As far as I can tell we don't expect such a symmetry in the rest of medicine. I don't think there is an opposite of lung cancer.

lung necrosis?

Ha, fair enough.

I'd agree in general, but when it comes to biology, the health of an organism seems entirely rooted in moderation.

Cancer is when your cells replicate too quickly and out of control. What's the opposite? When your cells don't replicate enough. Radiation sickness is what that looks like.

Dehydration is a serious problem, but so is over-hydration.

Insufficient oxygen will kill you, as will too much.

Bacterial infection can be a serious problem, but eliminating all bacteria from the body will also kill it.

Overactive immune systems are just as bad as underperforming ones. And on and on.

They are classified as "dependent personality disorder" under the DSM IV, part of the anxiety group of Axis II disorders.

http://www.psychologytoday.com/conditions/dependent-personal... ?

In fairness, any abnormality defined by evasion of confrontation and dramatic episodes will inevitably attract less attention than the reverse, irrespective of institutional environnment.

  At what point do we recognize a disorder in a child
  who is unnaturally compliant and obedient?
  No answer so far.

I think this is a great question. And I am not surprised there is no answer.

Excessive obedience often means you had overly needy parents who couldn't tolerate you acting out. So, you take care of their needs by not causing problems. This probably isn't recognized in the DSM as a disorder, since on the surface it appears good for a structured, smoothly operating society, but one term that you will probably identify with if you search a little is "parentified child". There are quite a lot of books written about this.

https://en.wikipedia.org/wiki/Parentification

Pretty much, yes.

> But the lack of symmetry says a lot about how diseases are identified; it is about institutional convenience.

Is it?

I'd chalk it up to the fact that a unnaturally compliant child doesn't tend to cause the parents to seek out treatment, whereas a child who's kicking holes in walls and attacking their siblings does.

What about a child who is not violent, but who would rather spend their time reading advanced math textbooks, hacking, or otherwise learning? What about a child who will stand up to their teachers and say, "This is worthless homework, so I spent my time learning next year's material instead?"

The point of the article is that an awful lot of mental disorder diagnoses are being given to children who calmly reject certain authorities, or who demand that the legitimacy of an authority be demonstrated before they will submit to it. Psychiatrists are medicating people who question authority out of existence.

Do you have any evidence that kids calmly saying "I'd rather learn useful things" are getting widely diagnosed as ODD? Anecdotally, that's exactly what I did in the late 1990s with my biology teacher. No diagnosis.

I don't think many of the kids that are ADD/ADHD/ODD are old enough to be aware enough of what's going on. The system is in no way tailored to them. Instead of those running the system reflecting on it's shortcomings and trying to remedy them, they instead suppose that it's the children who are the problem, not them.

It would be hilarious if it wasn't so tragic.

Since we there is no exact definition of what a mentally healthy human being is, in the same way that those specifications would be available for a machine for example, the definitions of mental problems have obviously been developed mostly in other ways.

Conditions where a person causea problems for himself or his surroundings are then labeled as mental health problems. Naturally, the opposite conditions may be benign. The person may be overly obedient, or overly trusting (opposite of paranoia), irrationally peaceful (opposite of depression) and so on, and this may indeed be caused by the same mechanism that causes the opposite condition, but as it does not cause problems, it is not considered a disease.

> At what point do we recognize a disorder in a child who is unnaturally compliant and obedient?

Typically one of the important parts of diagnosis is "does it cause a problem for the patient?"

> it is about institutional convenience.

Misdiagnosis is a serious problem. But your comment is weird. Giving someone a diagnosis is not convenient. That person is now able to get medical treatment, maybe disability benefits, maybe time off work, etc. Once you diagnose someone you have a duty to try to provide treatment. It's far more convenient to say that people do not have a mental health problem and release them.

> At what point do we recognize a disorder in a child who is unnaturally compliant and obedient? No answer so far.

But if you give it a name people will start to recognize it and they will be harder to control!

Nice idea though, in theory.

http://en.wikipedia.org/wiki/Milgram_experiment

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