Impulsivity, Consequences and the Brain

The issue of consequences with regard to children and adolescents who manifest aberrant impulsive behaviors is often raised by many who attend my seminars. Statements such as: "There are consequences to their actions", "These kids need to be held accountable for their actions", and "They just don't seem to care what happens to them" abound. Such statements are often followed by questions like: "What about consequences?", "Aren't they responsible for what they do?", "Are you (i.e. me) suggesting that they shouldn't be held accountable for their actions?".
  
Such comments and questions really defy the logic inherent in them. Those kinds of comments and questions are generally raised by those who, unwittingly and perhaps unconsciously, believe that impulsive behavior is premeditated, purposeful and manipulative, mostly because they think that the kids are trying to get their own way. The implication is that these kids know exactly what they are doing. I beg to differ. Allow me to explain.
  
Impulsive behavior is just that, impulsive. And, while that may seem sarcastic, the implications are subtle. It means that such actions/behaviors are not generated by what many think they are. They are not premeditated, purposeful or manipulative. It's not that they don't know about consequences, it's that these kids have difficulty in RESPONDING to them. These types of kids have their cart before the horse; the tail is wagging their dog. These are the kids who act first and think about it later which also means they reflect on potential consequences AFTER they exhibit their behavior. If they had the innate, brain based ability to reflect on the consequences before they acted, then perhaps occurrences of rude, obnoxious and disruptive behavior would be minimized. Such is not the case. To demonstrate the incongruity of thoughts and actions of those who are not impulsive and who attempt to understand and help those who are, I offer the following scenario.
  
Take, if you will, the example of a teenager who has just done something impulsive, like say something totally out of turn and out of context. Or, they did something more rash like throw something at a sibling. Now, imagine yourself asking things like: "Why did you do (or say) that?" "Where did that come from?" "What were you thinking?" Now, to further the exasperation, the kid looks at you and says, "I don't know." In response to that you then say, incredulously, "What do you mean you don't know?!" "You're the one who did it!" "Of course you know, now tell me what made you do that." And so, the kid, not knowing what else to say, goes on to concoct something that s/he hopes will satisfy and resolve the authority figure's total confusion and amazement about the impulsivity they just observed. After the concoction is delivered, the next thing said is, "You're lying." In total frustration the kid is sent to their room in order to calm down and to think about what they've done and "lied" about. They are directed to come back with an apology and a truthful explanation after they get themselves back together. Pheww... boy what a mess.
  
I present this scenario to the seminar audience in a light hearted fashion and refer to the above questions (i.e. the "what were you thinking" ones) as "The Three Silly Questions About Impulsivity." While these are the kinds of questions and logic that totally miss the point, impulsive situations/behaviors are quite serious and those dealing with them not only need to understand the basic nature of impulsivity, they also need assistance in order to help these misunderstood, confusing and disruptive kids.
  
The simple truth here is that such behaviors are not "reasonable and logical," at least not by the usual dictates about reason and logic. Impulsivity, by it's very nature, is random, chaotic, nonsensical and illogical. And, that's just the point. I have what I call The Basic Truths About Impulsivity. The first is that what makes sense about it is that it doesn't make any sense at all. The second is that what's logical about it is that it's totally illogical. Heck, if it made sense and was logical, it wouldn't be impulsive! That is, if it made sense and was logical in the normal scheme of things. For most, when trying to figure something out, like why something happened, some sort of strategic, logical rationale is invoked, usually based on some sort of cause and effect, the old scientific principle. Impulsivity defies that sort of reason and logic. Impulsivity is fractal geometry for the mind. It makes perfect sense once one suspends one's usual mind set about reason and logic in order to realize that impulsivity has, in a sense, its own reason and logic, namely its random chaoticness.
  
I maintain that once people realize the basic nature of impulsivity that they will cease asking such silly questions as they will already know the answers. For those of you who do not know them by now, here they are. The kid has no idea why they did what they did. They, like you, have no idea where it came from. And, they were not thinking before they did it, meaning their cognitive system/process was not on top of the situation. So, when they tell you they "don't know," they are telling you the truth. When they make up a story to satisfy your inquiry, they are not lying. They too are scrambling to come up with some reasonable, logical explanation. And, they are trying to get you off their back. It's amazing to me how some people, trained clinicians and educators among them, seem to think that lying is now a feature/symptom of, for example, ADHD.
  
The brain, for the sake of this discussion, has two basic systems that operate, preferably in synch with each other. When they do not function in tandem, glitches, such as impulsive emotional/behavioral episodes, result.
  
The oldest part of the brain is known as the limbic system. Also referred to as the reptilian brain, it is the emotional/personality system of the brain. Imbedded within the limbic system which is deep within the brain, is an almond sized and shaped organ called the amygdala. This little organ, fully mature and ready to go at birth, is the seat of the primal, instinctual survival energy of the organism. Think of the amygdala and the limbic system as sort of always simmering, always ready to respond in a flight or fight manner to a perceived threat to the organism in order to insure its basic survival.
  
The other, younger brain system is the cerebral cortex, the commonly thought of gray matter of the brain. Made up of four different lobes (frontal, temporal, parietal and occipital), one of each housed in each of two hemispheres, this is the cognitive system of the brain, the one responsible for the higher order level of thinking, reasoning and logic that separates us form other species on the planet. A primary function of the cerebral cortex, this cognitive system, is to mediate (referee if you will), the energy that emanates from the limbic system. It is, as has been noted, the guardian angel of our emotions.
  
If all goes according to design, these two systems operate in tandem to provide the person with an efficient and effectively running cognitive/emotional system that is balanced and healthy. if there is a glitch in any single system or in their inter-workings, problems emerge. For instance, if the frontal lobes, the seat of executive functions such as planning, organizing, sequencing, task completion, etc. are not fully engaged, not up to speed and operational, the result is executive dysfunction (aka executive deficits), the core features of ADHD and other cognitively inflexible conditions.
  
What happens here is that the frontal lobes are not up to speed with the rest of the cerebral cortex which in turn compromises the overall integrity of the cognitive system. Since the cognitive system cannot adequately perform its mediation role with the limbic system, limbic system energy has "an opening" through which its energy can "escape and manifest," resulting in impulsive behaviors and emotional outbursts. In bi-polar disorder, for example, it appears that the amygdala is way too overactive for the cerebral cortex to handle. Add to that some glitches in neuro-chemical transmission and frontal lobe/cerebral cortex inefficiency and one begins to get a sense of the complexity of such a condition.
  
Many children and adolescents with conditions such as Tourette Syndrome, ADHD, OCD and Bi-Polar Disorder are faced with the above outlined scenarios and the resultant impulsivity. Not only does each condition pose specific challenges but the interplay among them (i.e co-morbidity) further compounds their plight.
  
What these types of kids are often told is: "Take a deep breath and count to 10." "Stop and think (preferably ahead of time!) and consider the consequences before you say or do anything." All of this sounds good until you realize that they can't quite seem to be able to pull off any of that. Now the frustration mounts. Soon parents and kids or teachers and kids are engaged in a confrontation, the proverbial power struggle. The authority is insisting that the kid respond in certain ways, namely to behave. The kid is basically doing what their brain is making them do. The assumption is that the kid is consciously/cognitively in charge and they just need to behave. All they need is a little discipline, right? All they need, in essence, is to just do it. Ahh, if it were only that easy.
  
If an impulsive person had the ability to come up to the edge of the chasm, look down, reflect on their situation and in so doing, think "Hmm, I don't think I want to go there" and then take a few steps back, take a few deep breaths and count to 10, they would NOT be impulsive in the first place. That is an apt description of someone whose brain systems are working well in tandem. These people have the ability to respond appropriately fo the situation. They are responsive as opposed to those who are impulsive, namely those who do not have the ability to respond as needed or desired.
  
Commanding and demanding that impulsive kids stop being impulsive is not only ludicrous, it's counterproductive. It also denies and defies the true reality of their predicament. They are challenged by cognitive and emotional systems that are not harmonious. It is not an excuse to avoid attending to one's condition. It is, quite simply however, not their fault. The necessary brain functions to do what is asked and often demanded of them are not intact. They need our help to assist them in acquiring the skills needed to improve their condition, to do the best with what they have, just like the rest of you.
  
In the future, when you encounter an impulsive individual, perhaps now you will realize what they are up against. They do not choose to be that way. They are not that way on purpose. They struggle to be like everyone else, to be normal. They are, put succinctly, wired that way. Count your blessings.
  

Garry L. Earles, LICSW & Bridging The Chasm 2008

All material on this website ©2009 by Bridging the Chasm and Garry L. Earles, L.I.C.S.W.