pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

Children’s Self Esteem

I met 13 year-old Shawn (not his real name) semi-conscious in the intensive care unit many years ago.

He had been dumped off on the front lawn of his foster home, stuporous, by some kids who sped away in their car.

There were some bruises and abrasions, but the hospital diagnosis was drug ingestion.

He laid thrashing against the leather straps which held his arms and legs secured to the corners of the high, narrow bed, which facilitated doctors and nurses to “work” on him.

He had tubes everywhere. A urine tube, one down his nose into his stomach, one for fluids into a vein of one arm, and another in the vein of the other arm threaded deep up into his heart. There was a tube into an artery, hooked up to pressure gauges; and we at one time had been thinking of drilling a hole in his skull for another pressure gauge.

He then began showing signs of arousing and the nurses had been speaking loudly to awaken him. The nurses called me when he came out of his coma. In the midst of his thrashing about, he began mumbling incoherently.

Before I left, I put my hand on his shoulder and said quietly next to his ear, “Shawn, you’re in the hospital. Things are OK. You’re a good boy.”

He immediately stopped fighting, and tears formed in his eyes.

Over the years I have become increasingly convinced of the power of the four words “you’re a good boy” or “you’re a good girl.” Not only for
reassurance but as a motivating force.

I later found that Shawn had been taken from his family because of abuse and had previously been tied in his bed for extended periods of time. Awakening from his coma he became panic stricken when he found himself again powerless against restraints.

Social workers will tell you that in large measure a child’s conduct is related to his “self-image,” or self esteem.

If you ask someone what self-image is, you probably will be told, “it’s how people feel about themselves.”

Thinking about it though, it’s not true. Self-image is what you think others think about you.

Most children start out thinking that they are “great stuff.” The younger ages are quite self-centered. Over the years, however, messages come through loud and clear.

Even basically good parents will occasionally drop into what I call the “Why-Can’t-You-Ever-How-Many-Times-Have-I-Told-You-When-Will-You-Ever-Learn” syndrome.

j0262971Someone told me once that they saw a four-year-old take a toy from the shelf of a busy supermarket.

The mother quickly retrieved the toy and put it back on the shelf as she exclaimed, “leave these alone. How many times do I have to tell you?” The child, only four, looked up at her puzzled and replied timidly, “seven.”

The mother was taken so off guard by such a concrete answer that she broke out laughing, and the situation was defused.

Obviously, the message she had intended to give the boy was not the message he received.

Self-concept is the term I use for how the individual feels about himself. And self-worth being the intrinsic value having nothing to do with how anyone “interprets” worth.

As a child’s self-concept diminishes, the quality and style of his behaviors also diminish!

So instead of gradually becoming less self-centered, the child suffering with poor self-concept seems to remain fairly selfish and demanding.

The quality of his actions may seem to lack direction and purpose, and the frequency of annoying behaviors increases unintentionally.

As the behaviors increase, so do the attempts at discipline. If the discipline style is demeaning of self-concept, then a further vicious cycle is entered with the discipline actually worsening the problem.

Only a very rare parent deliberately does things to destroy a child’s self-concept; yet it happens unconsciously all around us.

If your child’s behavior has some of the above mentioned qualities, you may be inadvertently giving the wrong kinds of messages.

Count the number of times that you say, “how many times have I told you,” “why can’t you ever,” “when will you ever learn,” or some such statement during a day. It may surprise you.

The problem is that even the best psychologist can only point out the problem and give general principles for parents to follow.

He cannot give specifics unless he lives with the child because there are too many individual variables to consider.

Parents, on the other hand, can get specific therapeutic ideas, but only if they sit down and quietly consider the problem and their options in an organized fashion.

The time I mentioned when my four words broke through Shawn’s shell and produced deep emotion would have been an ideal opportunity to linger and counsel with him.

However, because I was in a hurry, I made a mental note to talk with him at a later visit. I tried then, and have tried several times since, but he has never let either me or anyone else that deeply into “his world” again.

Perhaps some day he will.

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