Positive Behavior Supports

Mike Mayer: Well, you know, all behavior communicates something. If you come in to a lecture that I'm doing and you fall asleep, you're communicating something. It may not be my understanding of your behavior may not be an accurate interpretation of it. I may be looking at it and go how disrespectful, how rude that you would fall asleep in my lecture. Or I could look at it and go, that is one really tired guy. I wonder if he worked the 11 to 7 shift last night and got ordered to come to this training today. And he's come to the training, but sitting down and listening to some guy talk all day long is not going to work for him. He's not going to learn anything. So I can take that behavior and I can translate it one… you know, a variety of different ways. And those are just two examples.

And I think that one of the things that happens with behavior is we start ascribing to that behavior what we think it means on the basis of, if we were to do that behavior, what would it mean. If I was to sit in, in a lecture and I was to fall asleep, would I be meaning to tell the person I was bored? No, because if I was really that bored, I would probably just get up and leave. If I fall asleep, it means I wanted to stay, I wanted to hear, but I'm having a hard time with it. But that could be very different than the person sitting next to me. So behavior, all behavior, communicates, but it doesn't necessarily mean that it's communicating accurately. So part of what we have to do is figure out if our translation of that behavior makes sense.

I've had so many experiences with people who have had significantly complex behavioral challenges that have tried to explain to us with their behavior what they were trying to accomplish. And I'll just use a quick example of a guy by the name of Jeff that I worked with out in California. Jeff desperately wanted to be paid attention to. Jeff needed attention. Jeff also had a severe seizure disorder which scared staff because they would take him out into public and he'd without notice would fly forward and bang his head on the sidewalk or on the floor in the grocery store or whatever. But he wanted to be out, he wanted to be seen, he wanted to be part of his world, and he wanted to be known. I mean, that was a need for him. But they became so scared about him getting hurt, that they wanted to keep him where everything in his world was foam rubber so that if he fell forward he would bounce and not crack his head open.

Now then he started intentionally hitting himself. And that was a new behavior, that he would start hitting himself. I asked the staff, "Why do you think he's hitting himself?" "Oh, he's frustrated "or "He's angry" or whatever. And I said, "You know what? I think it's his way of getting us to pay attention to him after the seizure." I think because what's happened is that he has a seizure, we put him on the couch or we put him in his bed and let him sleep after the seizure and recover from his seizure, but that just means he's alone longer and it's going to be that much longer until he goes out into the public again because everybody's afraid he's going to have the next seizure.

And I said, if he's hitting himself and he's screaming in pain, people come in to see him and they talk to him and they try to calm him down and they stroke his arm and they spend time being physically with him. I said, "I think what we need to be figuring out how to do, is how to do those things with him and for him before he hits himself, not after he hits himself."

To just use that as an example of hitting yourself could mean a lot of different things. In this case, it just seemed to me that this is what it could mean. And if turned out, I was right. But what it meant to Jeff as our side, some people would say that Jeff didn't even understand our language. He may not. But he understood tone of voice. He understood physical presence. He understood caring. He understood that we were there for him and with him, not just to do stuff to him. And that made all the difference in the world to Jeff. And he calmed down.

Now one of the interesting side effects of all that increased what we call non-contingent attention, meaning paying attention to him for no reason other than Jeff needs to have attention, instead of saying, "Oh, that's bad, he's doing these things for attention," which I hear all the time. There's nothing wrong with wanting attention.

We all want attention. We want it from different people in different ways at different times for different reasons. It's not wrong to want attention, but it is not good to have to hit yourself in order to get it.

All this additional non-contingent attention, the interesting thing was, is that Jeff's seizure rate declined. So now the question became, we wondered how much of his seizure activity was related to a frustration of saying, "I want something that I can't get." So that's an example.

But the bottom line is that I think it's important for us to understand that when somebody's doing something, there's usually a reason for it, and not just to minimize it or to blow it off. And to pay attention the same way we would to anyone else's words. What are they doing and does it mean something I should be responding to?

Compassion and empathy are fundamental elements of being able to do this work the right way. Without compassion and without empathy—and empathy is not the same thing as sympathy. Compassion's not the same thing as sympathy. It's not about feeling bad for somebody. It's about caring—that's compassion—caring about how somebody else is feeling. And the empathy is, I'm trying to understand what it means to you.

Without compassion, without empathy, you are not going to be able to do this job well, because then you're just trying to treat lab rats. And these are people, they're not lab rats. You know, the, the cold distant scientist doesn't need to care how they feel. We do.