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Dr John B
Dr John B, Psychologist
Category: Mental Health
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Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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At age16, our good kid, Jacob, began risky behavior like car

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Our son Jacob is a paradox.  In high school, he maintained a perfect grade point average and was known as a good kid, until the middle of high school and especially during his senior year.  He was even chosen as one of the class speakers for graduation, because of academic achievement.


 


Around age 16, when he had access to a car, he began risky and adventurous behavior like "ding-dong ditch" and car chases, which involved contact with the police.  This behavior culminated in streaking (naked) across the football field at a home football game.  As you can imagine, this resulted in a week long school suspension, expulsion from National Honor Society, and other legal and financial consequences for himself and us, his parents.  His younger siblings also paid the price at school, for being the siblings of the "Pulaski Streaker."


 


Currently he is 19 years old and is a student at UW-Madison.  Right before starting college last summer, he started smoking pot and it has made his behavior stranger.  He's getting good grades, so far, but socially, he is completely withdrawn and shut down and has not made new friends.  He's a loner and only hangs around a few pot smokers.


 


From an academic standpoint, he appears to be successful, but socially and emotionally, he's not doing well.  He says he's been depressed since he was little, and he's also been cutting himself.  Starting in middle school, he's withdrawn more and more from making friends.  He participated in sports, but didn't get close to anyone.  For the past few years, he has withdrawn from family members also.  His issues seem to stem from anger.  He holds everything in, then gets angry and tries to express himself, gets frustrated, and he has even punched holes in the walls in our house.


 


We've tried counseling, but he's not willing to go and fully participate.  We'd like to get to the underlying causes and help our son.  We've contacted the PNP center, but they have not been able to work with us yet.


 


Dr. Phil, can you help us or give us any suggestions for treatment in our area?  We're willing to do whatever it takes to help our son.


           
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr John B replied 2 years ago.

Hi,

Sorry to hear of the situation. Can you please clarify what you mean by PNP? Also, do you know if Jacob has experienced any major traumas? What kind of counseling did he receive?

Customer: replied 2 years ago.
PNP is Dr. Phil's The Lawlis Peavey PsychoNeuroPlasticity (PNP) Center.

Yes, as his mother, it seems like something like a trauma would have triggered the beginnings of this in middle school, but he denies anything of the kind. His psychologist couldn't find any indications of one.


After streaking, he went to a psychologist for a few visits.
Expert:  Dr John B replied 2 years ago.

Hi Annette,

I should point out here that this service is not provided by Dr Phil or his organization. We are a separate organization that is recommended for use by Dr Phil's website.

I queried possible trauma as self-cutting is frequently seen in teenagers who have experienced an events that disrupts the development of secure attachment styles. Attachment can disrupted by death of loved one, parental separation or divorce or any other event to interrupts developing secure relationships with love ones.

Is there any history of mental health problems in the family?

Customer: replied 2 years ago.
There seems to be depression and substance abuse in some of Jake's cousins and uncles. Not in the immediate family
Expert:  Dr John B replied 2 years ago.

I note that you mention social withdrawal since mid teens how would you describe his interpersonal skills in general? Within the extended family for example.

Customer: replied 2 years ago.
He hasn't had a relationship with his siblings for years. Hes the oldest of three. He answers us his parents in one word answers and only when asked a question. He only talks to us when he wants something. He didnt make any friends in college
Expert:  Dr John B replied 2 years ago.
How was his social functioning when he was younger? Before reaching his teens or even in his very early teens? This may seem like an unusual question but has he ever appeared to understand other people in more than a purely practical fashion? What's his sense of humor like? Does he appear to understand more subtle aspects of social interaction?
Customer: replied 2 years ago.
he did have 2 best friends in grade school, but drifted from them in middle school. Since then, I'd agree that he only understands people in a practical manner. He like sarcastic-type humor, family guy, tosh.o. No, he doesn't understand subtle social interactions.
Expert:  Dr John B replied 2 years ago.

I'm going to presume here that at some point you had a 'something is not quite right here' moment.....what age was he when you first started thinking there may be an issue?

I apologize for all the questions but I need to work my way through this information

Customer: replied 2 years ago.
I'd guess around age 12, he stopped talking conversationally. When I spoke with him about it, he said he didn't like his voice-puberty. My husband feels that around age 12, he avoided doing things with him, like bike rides.
Expert:  Dr John B replied 2 years ago.

Ok, thanks for all the extra information.

Obviously I have no way of diagnosing Jacob but here is what am thinking based upon your description so far:

With the absence of a strong family history of psychotic illness I would want to assess whether

1) Jacob may be experiencing difficulties associated with some form of developmental disorder like Asperger's syndrome. I would query this possibility as it sounds as though he has been having some form of difficulty for many years, it's pervasive and it seems to be primarily impacting his social functioning.

2) Jacob has in fact experienced something traumatic that has disrupted the development of secure bonding and attachment but is not willing or able to acknowledge it.

My suspicion would be number 1 as disrupted formation of attachment doesn't usually impact upon a person's understanding of subtle social situations (just the formation of stable relationships). While self-harming is more commonly associated with trauma I am aware that some individuals with Asperger's develop self-cutting behaviors due to intense frustration and anger around their difficulty understanding the people around them.

Again, I can't stress strongly enough that there is no way for me to know whether either of these possibilities is likely. I make these suggestions based on a theoretical consideration of the description you have provided. There may be important information I am unaware of that would make these suggestions unlikely.

I am interested to know what your reaction is to these suggestions. In my experience a parents 'gut feeling' can often be highly accurate.

Customer: replied 2 years ago.
my gut feeling is something in brain development like a mild form of Asperger's. I also see similar situations with his cousins.

Is this something he will outgrow when his brain fully develops? Should we seek treatment for him? What type of doctor can help us?
Expert:  Dr John B replied 2 years ago.

Asperger's is not something that you 'outgrow' as such but it is certainly something that can be helped immensely by the right assistance. You can think of something like Asperger's as just a different way of being. The way a person with Asperger's understands other people and how they best go about learning about complex social interaction is different to the way most people go about the same process.

For example, literal interpretation is much more predominant and a person with Asperger's is often served well when 1) they learn that not everyone else is being literal all the time and 2) those around them realize that non-literal information may be completely misunderstood by the person with Asperger's. This is a small and simplistic example and the point I am trying to illustrate is that people with Asperger's often benefit greatly when their own differences are acknowledged and accommodated. As another small example of this approach: I worked withe a teenage girl with Asperger's who was continually in trouble at school for yelling out and disrupting her classes. What we realized was that she didn't pick up on the cues we use to know when another person is talking directly to us or talking to a wider group of people. The result being that she continually thought anybody who spoke out with volume (i.e. the teacher) was speaking directly to her! We arranged to have simple card placed on her desk that reminded that the teacher may be speaking to the whole class. She still sometimes got confused but it greatly reduced th incidence of her yelling back at that teacher.

You certainly should seek assistance an the first step is to get him properly assessed. How likely is he to willingly participate in an assessment?

Customer: replied 2 years ago.
he's willing to be assessed, he's leery of "shrinks" but is interested in finding solutions. What type of doctor does theses assessments?
Expert:  Dr John B replied 2 years ago.

An assessment for developmental disorders is usually conducted by a Clinical Psychologist with specialty in the area. You can contact the American Psychology
Association (APA) for assistance with locating a Psychologist; take a look at
the APA locator service here. You can use this to find Psychologists in your area and there is a phone number you can contact if you want a referral arranged for you. Also,
take a look at an article published by the APA here. It's an interview with a senior Psychologist and covers some of the things you should consider when you looking for a Psychologist.

Developmental difficulties like Asperger's Syndrome are actually reasonably common and I'd be highly surprised if there wasn't assessment services readily available in his area. The APA will certainly be able to direct you (or him) to someone local who conducts these kind of assessments on a regular basis.

If you have further questions about this I'm more than happy to answer them here.

Customer: replied 2 years ago.
Thank you so much!
Expert:  Dr John B replied 2 years ago.
You are more than welcome Annette. If you have further questions or would like me to clarify or elaborate on any part o my answer please let me know. If not....I wish you the best of luck!
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
Dr John B and 2 other Mental Health Specialists are ready to help you
Expert:  Dr John B replied 2 years ago.
Hi Annette,

I hope you have been able to find some assesment services for your son. If I can be of further assistance or if you ever have other questions in the future please don't hesitate to contact me directly.

Regards,

John

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