Consequences??

My daughter is very impulsive. She is diagnosed with Complex PTSD (attachment or relationship difficulties are one of the components of CPTSD, impaired cause-effect is another component of CPTSD for many). She does have some understanding of consequences but it's limited to the simple cause-effect relationships, and it can all go out of the window when she's in the moment anyway.I think impaired cause-effect thinking is a very common issue caused by past trauma - it's a sign that the brain isn't developing/hasn't developed how it should. To be honest, I have no idea exactly what has caused my DD to struggle in this area - it might be the effects of trauma, on the other hand it might be alcohol exposure in-utero, and of course she might be naturally impulsive as well.I know some children with attachment difficulties who definitely understand cause-effect and consequences...on the other hand I know some children like my DD who have attachment difficulties whose understanding of this is limited. Of course it's possible to understand consequences but be so impulsive that it doesn't occur to you until AFTER you've done something silly...I've not heard of this as any particular sign of attachment difficulties, just as a sign of trauma that caused the brain to not develop properly (which is also what has happened when a child has attachment problems). Impaired cause effect or strong impulsivity is a common issue among children with a number of dx's (attachment, CPTSD, ADHD, FASD etc)

I don't know if there is one right answer to this question! I will tell you my experience with a child who was (probably is, though is no longer in my care) RAD, PTSD but no known exposure issues (but who really knows, was an IA with a mostly unknown start in life). We instituted very consistent, appropriate for behavior (meaning as directly associated as possible) consequences from the word go at four yrs of age. By six for sure he knew well the consequence and understood it was coming. He, however, didn't care. He wasn't motivated by consequences I could implement, his motivations ran deeper: anger of authority figures at him and each other, manipulation of situations so he "controlled" them, and ultimately anything that gave him "control" over a situation. He was extremely calculating, not impulsive. Some of his behavior seemed impulsive to the untrained eye, but with time, one could clearly see that it was ALL very calculated. When he no longer achieved what he deemed adequate control in the home he simply escillated behavior to the point he was unsafe. There was NOTHING I could do that was either ethical or legal (ie not abusive) which changed his behavior (other than immediate line of sight and then he just turned to destroying his alarmed room at night) if he didn't consider himself in control. So in our case he most certainly understood consequence, he simply didn't care. His need to control his environment was too strong. And his behavior was, best I could tell, never accidental or impulsive, rather purely calculated and implemented to meet the end he intended to meet.

Thank you both for your responses. Carmen, my dd sounds like mostly like what you described. She has been through a lot of trauma and it truly does seem like her brain is not operating right, cause and effect seem to be missing. Have you tried any therapies that noticeably helped??

She's had therapy (art therapy, EMDR and talking sessions with the therapist). I can't say that the therapy has helped much, no. The goals of therapy were to deal with things like her flashbacks, memory processing, hypervigilance etc though. The symptoms you see in PTSD basically. She has made progress over the years with her cause-effect and her executive functioning skills but it's only been as a side effect of therapy and years of working on it at home. It's hard because she has a learning disability and also if (I'll never know) her issues with cause-effect/executive functioning are partly caused by alcohol in-utero, then I have to accept that there's a ceiling to how far she can progress. Still, that doesn't stop me from constantly working on it. Progress is really slow, over months and years, but it's there.

My daughter suffers with attachment issues, but she also has ADHD. She can be very impulsive....but it's hard to say if it is caused by the attachment stuff or ADHD...many of the symptoms overlap. My daughter knows the difference. If I ask her a question when I "catch" her doing something, she will avoid answering me because she knows she is guilty. Eventually, she will fess up. She can be very manipulative, and I can see the "wheels turning" all the time. I have to be one step ahead of her at all times.

Consequences alone didn't work for my DD. It's like saying Well, in order to stay alive, you must saw your own arm off.....You're gonna pick to live EVERY time, regardless of the negative impact to do so. The price is worth it.The thought process for RAD is very similar, it's a defense mechanism. The only real way to help them make better choices, is by helping them meet their needs in the least destructive way possible.Such as:Yes, you COULD cut your arm off....OR why don't we just move the pile of dirt trapping you....yes it is a little harder and may take a little longer, but in the end, isn't keeping your arm worth it?Eventually, HOPEFULLY the need they are trying to meet will change, lessen etc over time as they develop new skills. The urge, I'm afraid, may always remain but the tools to meet their needs can be constructive instead of DEstructive.