Date added: 17/02/21

This short article aims to provide some food (not necessarily a carrot!) for thought on this interesting and complex subject. It is of such importance and continually challenging. It is one of those subjects that is helpful to regularly reflect on, however many years we may have been working on it. 

Pain-Based Behaviour 
Traumatized children’s difficult behaviour is often referred to as ‘acting out’.  The term acting out implies the question - what is being acted out? Anglin (2002) uses the term ‘pain-based behaviour’ to describe ‘acting out’ behaviour and the internalizing processes such as depression which are often the result of triggering this internalised pain.  This helps to shift our focus towards the meaning beneath the behaviour. 

The work involved with traumatized children can be extremely challenging. It may resonate with our history in a way that can lead to powerful feelings and at times overwhelming emotions.  Therefore, there must be a high level of training and support available to those carrying out this skilled and sensitive work.  

Core elements of a helpful response to the child’s behaviour are,
•    believing and validating the child’s experience
•    tolerating the child’s affect 
•    managing our own emotions

Punishment and Rewards 
Traumatized children are often used to being punished and for reasons they cannot understand.  Many times they will have been punished and treated harshly, in an arbitrary fashion based on the mood of the adult rather than on the child’s behaviour. For children who are traumatized and who have hyper-aroused stress response systems, punishments are often likely to make matters worse.  By increasing stress levels and re-enforcing a negative view of the world as a hostile and unforgiving place.  We need to model qualities that challenge the child’s negative view of the world, or, as John Bowlby (1969, 1973) described, the child’s internal working model. Perry and Szalavitz (2010, p.243) point out,

Punishment can’t create or model those qualities.  Although we do need to set limits, if we want our children to behave well, we have to treat them well.  A child raised with love wants to make those around him happy because he sees his happiness makes them happy too; he doesn’t simply comply to avoid punishment.

The ‘carrot and stick’ approach does not tend to work with young people who have suffered complex childhood trauma (Perry and Szalavitz, 2010).  Just as punishment is ineffective so is a system based on rewards. Both are an attempt to manipulate the child into being compliant and behaving ‘well’. The key issue here is manipulation. There is a risk of further reinforcing the child’s defences and lack of concern for others by putting the focus on either gaining a reward or avoiding the pain of punishment. A child whose development has been disrupted by trauma and feels little concern towards others will be helped better by first of all feeling the care and love of others. Then through the development of a meaningful relationship, the child begins to care about not hurting a valued ‘other’. Donald Winnicott (1963) referred to this as the ‘development of the capacity of concern’. It is one of the fundamental developmental achievements. 

Commission for Children and Young People (2012, p.12) argue that behaviourist approaches that rely on systems of reward and punishment tend to be ineffectual,  

Behaviourist techniques may achieve a degree of change in children’s behaviours but without engaging with the underlying emotional content of the behaviour, these changes will not ultimately correspond to transformations in the child’s internal working models or assist them to achieve psychological healing (Forbes and Post, 2007). Forbes and Post (2007) maintain that these techniques inadvertently convey to children that the feelings behind their behaviour are not valid or intelligible.

Perry and Szalavitz, (2006, p.244) make a similar point, 

Traumatized children tend to have overactive responses and, as we’ve seen, these can make them aggressive, impulsive, and needy.  These children are difficult, they are easy to upset and hard to calm, they may overreact to the slightest novelty or change and they often don’t know how to think before they act.  Before they can make any kind of lasting change at all in their behavior, they need to feel safe and loved.  Unfortunately, however, many of the treatment programs and other interventions aimed at them get it backwards: they take a punitive approach and hope to lure children into good behavior by restoring love and safety only if the children first start acting “better.”  While such approaches may temporarily threaten children into doing what adults want, they can’t provide the long-term, internal motivation that will ultimately help them control themselves better and become more loving towards others.

As children mature, they need greater space to be autonomous and to make their own choices.  Children are most motivated by feeling they are doing something because they want to do it, rather than because they are being manipulated into doing it.  Alfie Kohn (1993) in his aptly titled book, ‘Punished by Rewards: The Trouble with Gold Stars, Incentive Plans, A's, Praise, and Other Bribes’, has referred to numerous studies where systems of punishment and reward, or even just reward have reduced motivation and performance.  For example, children given a sweet as a reward for doing well in a test did worse in the next test compared to those who weren’t given a sweet. The mere suggestion that the child has an extrinsic motive other than the intrinsic value in the subject can reduce their interest. Summarizing the key meassage of his book Kohn (1994) says,

"We can never meet our long-term goals by doing things to students, only by working with them. Rewards, like punishments, are ways of doing things to people. And to that extent they can never help them to take responsibility for their own behavior, to develop a sense of themselves as caring people, to work as creatively as they can or become excited learners for the rest of their lives. Rewards, like punishments, actively undermine those goals."

This doesn’t mean that adults should not be clear and firm about their expectations of the child’s behaviour, but within that, the child needs space to work things out for herself.  Caregivers and other adults who are warm and provide clear and consistent expectations for children’s behaviour also encourage early conscience development (Eisenberg and Murphy, 1995; Kochanska, 1991, 1993, 1995).  Pro-social role modelling plays a crucial role in showing the child morally responsible behaviour. 

As said, it is helpful to have clear expectations about what behaviour is acceptable and what is not.  When a child crosses a line, we can help them think about it and find ways in which things could be put right.  Making reparation for something hurtful or damaging that they have done, provides them with the vital developmental experience of contributing and making it right (Dockar-Drysdale, 1953, Winnicott, 1963).

Many traumatized children believe that the mistakes they make, or their negative behaviour has catastrophic and long-lasting consequences.  They have learnt this through experience. A small misdemeanour may have resulted in a severely punitive or abusive response from a caregiver.   In some cases, difficult behaviour may have been followed by a major change such as being taken into care. The child often believes he or she is ‘bad’ and responsible for whatever happens.  

The capacity to make reparation rather than be punished also requires that the child has a degree of empathy and concern for others.  For children who are so emotionally underdeveloped, it may take considerable time before they can do this.  To show concern and care for others, first, they need to experience being cared for.  We can also encourage the development of empathy by discussing with the child, his behaviour and how it might make others feel.  Perry and Szalavitz (2010, p.313) suggest, 

To encourage empathy, discipline by reasoning, perspective taking, consistency of appropriate consequences, and above all, love.

They continue (p.314), 

If you teach children to behave by using reason, they are likelier to be reasonable.

Dockar-Drysdale (1953, p.7) argued in her paper, ‘Some Aspects of Damage and Restitution’, that a punitive approach may even damage the child’s potential to develop a capacity of concern towards others,  

I suggest that punishment not only anticipates but hampers and probably blocks the natural process of restitution, thereby preventing the further process by which the child may direct into constructive channels the hostile feelings which have led to guilt and the need for making restitution.  

Traumatized children are familiar with being punished, humiliated, and hurt.  Punishing such a child is likely to trigger his memory of these experiences, causing him to feel angry and resentful towards whoever is punishing him. The skilled worker needs to adopt a non-judgemental approach. This is more focused on working with pro-social behaviour modification, rather than blaming the person.  This has been called, “challenging the behaviour, not the person” (Barton, Gonzalez and Tomlinson, 2011). It is more helpful to give the message that it is the behaviour that we find unacceptable rather than the person.   

Consequences of Behaviour – Positive and Negative
However, children must be helped to understand that there can be positive and negative consequences of their behaviour.  We need to help them understand the positive consequences of their behaviour, as much, if not more than the negative consequences.  This is because these children know only too well that they can do hurtful and destructive things, but they often have no idea that they can do things which give pleasure and make others feel good.  They often feel that they are insignificant to others and the only way they can have an impact and be of any significance is by being challenging.  As Perry (2016) has said, we need to help children feel the intrinsic value in relationships. 

Reward and punishment systems often undermine the idea that a child may be interested in what another thinks or feels about him or her. The key to healthy growth is not based on fear or material gain, but on developing a sense of care and concern towards others within meaningful relationships.   Referring to the kind of points systems, sometimes used to induce children to change their behaviour, Perry (2016) argued that ironically, they often miss the point. This is especially so in work with children and young people who are not emotionally regulated. Instead, he claimed that,

"Positive human interactions are the most positive reward we can experience."

Natural Consequences
Sometimes we do need to help a child understand something about the negative consequences of their behaviour and to do something if possible, to put it right. The more natural or ‘logical’ the consequence is to the behaviour the more likely it is to make sense to the child.  For example, if the child has damaged something in the home, helping to fix it is more relevant than having to go to bed early.  Helping to fix something that has been broken can be understood as a natural consequence. However, Kohn (1995) warns us how easy it is for the use of consequences to slide into a disguised form of punishment,

A number of people seem to think if we call it "consequences" or insert the modifier "logical," then it's okay. "Logical consequences" is an example of what I call "punishment lite," a kinder, gentler way of doing things to children instead of working with them.

However, used helpfully, consequences rather than punishment can be seen as a form of discipline, showing and teaching children how to behave, by providing a climate of mutual respect, where problems are seen as opportunities for learning and growth.  Children are supported to learn from their mistakes through natural and logical consequences. Self-discipline is more likely to grow out of this. Redshaw et al. (2012, p.44) outline the differences between discipline and punishment,

Qualities of Discipline
•    To teach
•    A climate of mutual respect
•    Problems are opportunities
•    Preventative planning - a proactive focus on preventing problems
•    Natural/logical consequences, discussed with children
•    Reasons for standards
•    Demands responsibility
•    Teaches caring values, control by inner values
•    Adults as coaches and mentors

According to Laursen (2003), one of the primary goals of discipline is to: 

… provide a safe and consistent environment where children can learn reasonable rules, limits, and consequences, as well as the reasons for them... 

Qualities of Punishment
•    To inflict pain, penalise, cause loss, suffering, to treat in a harsh manner
•    Must respect those in power
•    Problems require punishment
•    Reactive response
•    Arbitrary consequences
•    Do it because I said so
•    Demands obedience
•    Teaches rule compliance
•    Adults as rulers
•    Controlled by external enforcement

The Need to Manage Ourselves
In work with traumatized children (as in parenting) there can sometimes be a sense of being at a loss of what to do. When this is mixed with strong emotions, such as anger, anxiety, and fear, there can be a reaction to do something and feel in control. For many reasons, including our own childhood experiences, we may feel justified in punishing the child. We may feel that we have to do something to create a positive change. The concept of punishment and reward can be seductive in these moments. Taking a punitive action may provide some relief to the adult, and give an impression of making a difference, however short-lived. 

Therefore, as well as considering the child-centred matters discussed in this article, we also need to ensure there are ways for the adults involved to process their feelings, to feel supported, and to be able to take a step back.  As in the children’s histories, the most punitive and unhelpful responses are likely to occur when adults are at the ‘end of their tether’.  

Anglin, J. (2002) Pain, Normality, and the Struggle for Congruence: Reinterpreting Residential Care for Children and Youth, New York: The Haworth Press Inc.

Barton, S., Gonzalez, R. and Tomlinson, P. (2011) Therapeutic Residential Care for Children and Young People: An Attachment and Trauma-informed Model for Practice, Jessica Kingsley Publishers

Bowlby, J. (1969) Attachment, Attachment and Loss Series. vol. 1. Harmonsworth: Penguin

Bowlby, J. (1973) Attachment and Loss, Volume 2: Separation, New York: Basic Books

Commission for Children and Young People and Child Guardian (2012) Views of Young People in Residential Care Survey - Responding to Trauma and Attachment Needs in Residential Care: What Young People’s Perceptions Tell us About how Well we’re Doing, Brisbane, Queensland

Dockar-Drysdale, B. (1953) Some Aspects of Damage and Restitution, in Dockar-Drysdale. B., Therapy and Consultation in Child Care (1993), London: Free Association Books

Eisenberg, N., and Murphy, B. (1995) Parenting and children’s moral development, 227-257 in Bornstein, M. H. (ed.) Handbook of Parenting, Volume 4: Applied and practical parenting, Mahwah, NJ: Erlbaum

Forbes, H. and Post, B. B. (2007) Parenting Beyond Consequences, Logic, and Control: A Love-based Approach to Helping Attachment Challenged Children with Severe Behaviours: Volume 1, Orlando, FL: Beyond Consequences Institute. Retrieved 10 January, 2012, from http://www.beyond-consequences.com

Kohn, A. (1993) Punished by Rewards: The Trouble with Gold Stars, Incentive Plans, A's, Praise, and Other Bribes, Boston: Houghton Mifflin

Kohn, A. (1994) The Case Against Rewards and Praise: A Conversation with Alfie Kohn by Sara-Ellen Amster, in, Harvard Education Letter, Volume 10, Number 2, March/April 1994, Harvard Graduate School of Education, 

Kohn, A. (1995) Punished by Rewards? A Conversation with Alfie Kohn, by Ron Brandt, in, Educational Leadership, Volume 53 Number 1 September 1995, 

Kochanska, G. (1991) Socialization and Temperament in the Development of Guilt and Conscience, in Child Development 62:1379-1392.

Kochanska, G. (1993) Toward a Synthesis of Parental Socialization and Child Temperament in Early Development of Conscience, in Child Development 64:325-347

Kochanska, G. (1995) Children’s Temperament, Mothers’ Discipline, and Security of Attachment: Multiple Pathways to Emerging Internalization, in Child Development 66:597-615

Laursen, E. (2003) Principle-centred Discipline, in Reclaiming Children and Youth 12(2): 78-82

Perry, B.D. and Szalavitz, M. (2006) The Boy who was Raised as a Dog: And Other Stories from a Child Psychiatrist’s Notebook, New York: Basic Books

Perry, B.D. and Szalavitz, M. (2010) Born for Love: Why Empathy is Essential and Endangered, New York: HarperCollins

Perry, B. (2016) Child Trauma and Neglect, Conference, Tralee, Ireland, 30th September

Redshaw, S. et al. (2012) The Therapeutic Residential Care Program: Practice Paper, Mercy Family Services: Queensland, Australia

Winnicott, D.W. (1963) The Development of the Capacity for Concern, in, The Maturational Processes and the Facilitating Environment, London and New York:  Karnac Books (1990)


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