Which Came First? Thinking or Feeling

Gabrielle Gruber, M.S.W., Clinical Social Worker, Roger E. Lauer, Ph.D., Director, Center for Neuropsychology and Learning, Ann Arbor, MI (http://www.CNandL.com)

What causes learning problems? This question is sometimes viewed as a chicken and egg debate. Recent research has begun to identify the areas of the brain that are involved with learning problems; however, children experiencing learning difficulties are still labeled as unmotivated, lacking effort or lazy. In our practice, we also see children with anxiety and depression who struggle with school, but they do not have learning disabilities. Sometimes we, as professionals, are able to see a pattern of which came first by taking a thorough history during our evaluation. Other times, we cannot tell. In the latter situation, this may be due to co-occurring conditions since studies have shown that 20 % of individuals diagnosed with a learning disability also are depressed or anxious. In this article, we try to identify the emotional vulnerabilities of children with learning disabilities, explain the link between thinking and feeling, and discuss how to help.

Self-Esteem and Learning Disability

Children with learning disabilities are vulnerable to low self-esteem. The following are some potential contributors:
 A history of academic difficulties despite a child’s best efforts to succeed.
 Social comparisons (e.g., comparing their performance to that of their peers).
 Fear of disappointing important adults in their lives such as parents and teachers. Children, by nature, are eager to please.
 Schools that wait too long to identify learning problems or are slow in providing an evaluation or needed resources, unnecessarily prolonging a child’s perception that he is a failure.
 A lack of understanding as to why the child is struggling among teachers, administrators, parents, and other adults in the child’s life. With the best intentions, they may try to push the child to try harder. When the child continues to struggle, this can further exacerbate the child’s damaged self-esteem.
These experiences of failure without a framework to understand the difficulties can lead to emotional concerns such as anxiety and/or depression. With appropriate resources and support, and as children achieve more success at school, they may develop a more positive view of themselves. Other times, however, further intervention such as individual or group psychotherapy may be needed to help children improve their self-esteem.

The Link Between Thoughts, Feelings, and Behavior

Thoughts, feelings, and behavior are all connected. Thoughts influence feelings, which in turn affect behavior. A “dysfunctional cycle” can develop wherein excessively negative, self-critical, and negatively biased thoughts can lead to angry, depressed, or anxious feelings, ultimately leading to avoidance, giving up, or inappropriate behavior (Stallard, 2002).
 Comorbidity is common: It is very common for children with a learning disability to experience mood disturbances because of the social and academic difficulties they have encountered. These mood disturbances can further impede learning. Consider the following examples:
o Anxiety: a child who has struggled in the past can develop negative expectations about her ability to perform on an upcoming exam, leading to physiological arousal (i.e., her internal alarms signal danger), which can lead to “freezing up”, or on the other end of the spectrum, impulsively answering exam questions.
o Depression: an outgrowth of painful failures at school. A depressed child exhibits distorted thinking: e.g., exaggerating the difficulty of the task, underestimating one’s abilities, thinking globally about one’s intelligence and self-worth (“I’m dumb,” or “I’ll never be good at anything”). These thoughts can lead to feelings of shame, worthlessness, and fatalism about the future and can create barriers to success.

How to Help Children with Emotional Difficulties

Professional help
 A neuropsychological evaluation can help on a number of fronts:
o It can clarify the diagnostic picture so that parents and professionals can gain a more solid understanding of the type and scope of the learning disruption and the best ways to address it (e.g., accommodations and services at school, tutoring, performance coaching, etc.)
o Boosting a child’s self esteem by identifying strengths and gifts, along with any particular learning style, to maximize performance and “set the child up” for success.
o Empower parents with knowledge, information, and a clear picture of how to work at home and school to carry out any intervention plan.
o Lastly, an evaluation can determine whether a child also struggles with emotional issues that are the root cause of the problem or secondary to a long-standing learning struggle.
 Psychotherapy can play an important role in helping a child succeed at school, relationships, and life.
o Therapy can address the linkages between thinking, feeling, and behaving, and help the child replace the dysfunctional cycle with a functional cycle: more positive thoughts, acknowledgements of success, and a balanced self-image which recognizes strengths; these thoughts can lead to relaxed, pleasant, happy feelings, and to appropriate behaviors in which the child confronts challenges (Stallard, 2002).
o Therapy can also help normalize a child’s low self-esteem and feelings of shame about a learning disability, and help her to understand that it’s not her fault and that they are not alone.
o Therapy can also teach children a “vocabulary” for their feelings so they can talk about what is bothering them rather than act on it.

How Parents Can Help Their Children
 Educate yourself about the learning struggles of your child.
 Listen to your children’s worries, and offer empathy before suggesting solutions.
 Trying to help your child with homework can often be stressful for parents and children alike. Find opportunities to have fun with your child everyday. This will let him know that he is loved; showing him that you see him as fun, thoughtful, smart, artistic, etc. will help him view himself in a more positive light.
 Advocate for your child at schools and other institutions to help professionals who work with your child understand the nature of the problem, appreciate your child’s strengths, and ensure that appropriate support systems are employed.


Reference
Stallard, P. (2002). Think Good – Feel Good. A cognitive behaviour therapy workbook for children and young people. John Wiley and Sons: West Sussex, England.