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I’ve been reading a lot lately about the so-called “War on Obesity” and find myself wondering about both the terminology and the idea of waging war on what amounts to a difference between people, much like skin color, age, or gender. Now before you fly into righteous umbrage at my comparison of weight (which many people believe to be completely controllable, much like smoking) to factors that are completely out of one’s control, please listen to one fact: Weight is in between controllable and uncontrollable. I know, I know…I can hear the vitriol on both sides of this issue pour forth…sigh. However, research shows that body weight is as about much genetics and biochemistry as it is sensible eating and exercising.  Ok – one argument down – it’s not completely controllable, and it’s not completely uncontrollable – so let’s get on to the meat of this idea.

Given that whatever the cause we know that people who are overweight and obese suffer discrimination, I wonder if our “war on obesity” actually amounts to war on the obese. Study after study has documented that overweight men and especially overweight women experience discrimination in their jobs and in the rest of their lives (see http://www.usatoday.com/news/health/weightloss/2008-05-20-overweight-bias_N.htm and http://abcnews.go.com/Technology/BeautySecrets/story?id=4568813&page=1 for more information). We hear terms such as “fatty,” “pig,” “heifer,” or “fat cow” more often than many of us care to admit. We’re oinked at, barked at, and yelled at. We get rejected by dates, bosses, and family members because of our appearance. In this war on obesity, the obese are the casualties. My question is, does it have to be this way?

I get that obesity is not healthy, again no matter the cause. But if that’s true, why don’t we support the obese in their attempts to become healthy? Discriminating against people does not cause them to be more motivated to change; rather, it pushes people into resentment, anger and defensiveness, making them less likely to change. When you see someone who is overweight out walking, or exercising in any way, what stops you from saying, “Way to go! Awesome!” rather than “Fat Rear” or “Moo”? Why aren’t there more plus-size exercise clothes, exercise equipment, etc? If we truly want to fight obesity and help people get healthier, we need to STOP discriminating and start motivating.

Any psychologist can tell you that reinforcement (rewarding behavior you want to see increase) works way better than punishment – so why do we punish people and expect the behavior we want to see increase? It simply doesn’t work that way – punishment is designed to decrease a behavior. So guess what – when you discriminate against overweight/obese people, you’re NOT motivating them. In fact, you’re decreasing the likelihood that they’ll want to engage in change behaviors.

In this war on the obese, if we really want to see change, we’ll reward the behaviors we want to see – we’ll make accomodations to exercise equipment, we’ll make more comfortable, attractive workout clothes, and we’ll make access to health care services targeted to obesity more affordable and less stigmatizing. We’ll support people who are working on their weight AND we’ll recognize that people do come in different sizes – and that’s ok. We’ll support movements like Health At Every Size (http://haescommunity.org/). Most of all, we’ll accept that people who are obese having feelings, and have the same rights and privileges as every other person when it comes to access to jobs, employment assessments, and salaries/promotions – size simply is NOT an indicator of worth.

If anyone had told me 6 years ago that I’d still be changing diapers on a nearly 6-year old, I have to admit I would have been scared spitless and wondering what the hades I’d gotten myself into. And yet, here we are with Aidan in kindergarten and still wearing pull-ups because he either can’t or won’t use the toilet.

I remember when he was 3 and 4, people would say to me, “Don’t worry. He won’t go to school in diapers.” Well…again, here we are. Now, I’m just hoping he won’t go to high school in pullups.

The thing with Aidan is that, in terms of the autism, he’s pretty high functioning. He talks, expresses emotion, interacts socially (to some extent), and is generally a sweet little kid. Here’s where the other side, the ODD, comes in though. ODD is short for Oppositional Defiant Disorder, and it roughly boils down to where a child will say no and be oppositional simply for the sake of being oppostional. If you say the sky is blue, this child will say it’s purple with yellow polka-dots until he’s screaming bloody murder and insisting it’s purple with yellow polka-dots. This all occurs without me arguing with him. With some things, like the color of the sky, it’s really no big deal. But, with some things, it IS a big deal – like with potty training.

When I said “can’t or won’t” I was referring to the ODD. Aidan CAN use the potty to urinate, and generally does except when he’s in an ornery mood. Then, he’ll go in his pullup purposefully if I ask him to use the potty. Using the potty is a battle, no matter what I try, because of the autism-ODD combination.

Now let me explain that I have a Ph.D. in counseling psychology. I KNOW what to do, and we have a very behavioral household. There are rewards for trying, and better rewards for doing. For oppositional behavior, there are set consequences – losing privileges and time-outs along with losing whatever activity he was engaging in during the oppositional period. (Losing it for a time period, not permanently depending on what it is – I don’t want to punish my daughter for her brother’s behavior.) The long and short of it is that I know what to do – and it’s *still* frustrating.

ODD is a frustrating disorder to say the least. Sometimes he’ll just say no and/or refuse to do something for reasons I can’t begin to understand. Sometimes, it’s even for things he enjoys and wants to do. I don’t think even HE understands it sometimes. Stubborn is an understatement – this kid sometimes gets in his own way. Adding the autism into the mix complicates things because he has trouble relating to people anyway. I’ve been asked how much is ODD and how much is autism, and I honestly don’t know except to say I’ve seen both. ODD doesn’t account for his fascination with automatic doors, elevators, transformers (the ones on the power poles, not the toys), and lights or his language and physical delays. Autism doesn’t account for the oppositional behavior and the purposeful defiance that I see.

In the end, I think it burns us both out. I see him get so frustrated and upset and I WANT to help him. My love for this child, in spite of the ODD, is unending and I wish I could do more to help make things a little easier for him. And yet, I get burned out and frustrated. When I’ve changed the disgusting, feces-laden pullup for the 8th or 9th time in a day, there are times when I just want to scream. When I have to deal with “no” and “I won’t” and “You can’t tell me what to do” or him ignoring requests repeatedly, I want to run away. I get angry, frustrated and exhausted.

And yet, we muddle on. Although to some extent it’s a battle of wills, it’s also the story of a son who loves his mother and family and a mother who loves her son with all her heart. Will he get out of pullups? I sincerely hope so. I’m not going to say “by high school” or by anything anymore – my sense is that it just puts pressure on both of us. We already try to make potty training less a matter of control and more a matter of pride for him, and I work hard NOT to get into fights with him over it. The pressure of “by high school” or by anything is more on me – and I have to let go and let him do this on Aidan-time. I’m hoping the peer pressure of being in school will help and so far it seems to have had a positive effect

So where do I go from here? I keep loving this special child that tests my patience every day. I enjoy and appreciate the smiles and the happiness that I’m so lucky to have, given his autism. I love the hugs and imagination, and even the lights, elevators, escalators, and “button doors.” I see things I wouldn’t ordinarily pay attention to, like the color and shape of the transformers on the power poles and the shape of the lights and buttons in elevators.

And, I keep trying. And trying. And trying, and trying. I have faith that he can eventually do this, and that I will survive it. And I never, never, ever give up.

Reflections of Reflections…

Other Facets of the Mirror