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Please help me out with something!

I am 16 years old and I have been dating my boyfriend for well over a year now, he is also 16.

We occasionally get into arguments and fights about regular boyfriend-girlfriend type stuff or argue when we're having a bad day but sometimes he gets very upset and angry with me. He is never violent, but in the spur of the moment says things I know he doesn't mean. He always apologizes and makes it better. We've been doing quite good lately with not too many fights, and we're both extremely happy together but last night he confessed to me that he has Oppositional Defiant Disorder. I was absolutely shocked I just thought he had a bad temper but I don't know what to do about it.

I love him so much and there is no way I could live without him but he is very shy about it and I want to help him. Is there any way that by being an amazing friend while also being a supporting girlfriend can help his disorder?

I don't have a lot of information on it expect that it may result in other problems in the future which I worry about. I see a lot of exciting things for us in the future so I'm hoping that this will pass, or maybe not be very prominent? Is that possible?

He is very social, popular, and caring at school and has lots of friends. We have a perfect relationship except for the occasional fighting, and he is trying to get better but in the meantime what can I do to help him, and if his happiness continues is there a way to help ODD? He is always very polite when around my friends or my family, and even his friends would never assume he had ODD. His teachers love him and he is kind. He just occasionally gets into arguments with me.

Thank you so much for your time, its greatly appreciated.


ask dr-robert

Hello, Carmen--

Let me begin by observing that you seem a bit young to be so oriented on how things will be for you and your boyfriend in the future. It would be surprising—not unheard of, but surprising—if a couple who began dating when they were both fifteen really had that much of a future, but since it is possible, and since I understand that young love is a powerful force capable of producing high levels of illusion and wishful thinking, I will attempt to reply to your question in the same spirit in which your posed it.

I should explain to my other visitors that Oppositional Defiant Disorder (ODD)is a rather recent addition to the Diagnostic and Statistical Manual (DSM), which is a listing of the criteria some mental health professional use to diagnose and distinguish between various mental and emotional disorders. According to the DSM, ODD is "an ongoing pattern of disobedient, hostile, and defiant behavior toward authority figures" which supposedly goes beyond the bounds of normal childhood behavior. A person may be diagnosed with ODD if he or she manifests a pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present and occur more frequently than is typically observed in individuals of comparable age and developmental level:

1. often loses temper

2. often argues with adults

3. often actively defies or refuses to comply with adults' requests or rules

4. often deliberately annoys people

5. often blames others for his or her mistakes or misbehavior

6. is often touchy or easily annoyed by others

7. is often angry and resentful

8. is often spiteful or vindictive

and, "the disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning."

Now given what you have told me, I doubt that your boyfriend really has ODD. After all if your boyfriend is invariably polite when around your friends and family, if even his friends would never assume that he had a problem, if his teachers love him and if he is kind, I wonder why he or anyone else believes that he has Oppositional Defiant Disorder, which diagnosis requires manifesting at least four of the above negative behaviors more frequently than is typical, and being significantly impaired in day to day functioning. If everyone likes him so much, including teachers and parents, where is the impairment?

Further, Carmen, I am one of those psychologists who doubts that ODD really exists. Not that some children do not manifest problematic behaviors, but I am not at all sure that every case of such behavior should be considered a disorder. In other words, I find myself in opposition to the tendency of some psychologists to keep adding ever new types of disorder, like this one, to the DSM. Each time that book is revised it gets thicker and heavier with new disorders. And frankly I suspect that the tendency of some American psychologists and psychiatrists—particularly the ones who revise the DSM every few years--to to make any kind of human problem into a disorder has less to do with seeing things as they really are—making a useful diagnosis, that is, which will help in devising a suitable treatment—than it does in getting insurance companies to pay for therapy sessions which most will do only if a diagnosis of disorder can be found.

I am not alone in this. Allow me to quote from The Study Guide and Self-Examination Review in Psychiatry, By Benjamin J Sadock, Virginia A Sadock, and Ze'ev Levin:

Controversy has arisen as to whether a set of "voluntary"antisocial behaviors can be construed as a psychiatric disorder, or can be better accounted for as maladaptive responses to overly harsh or punitive parenting, or strategies that have survival value in chronically threatening environmental situations. (2007, p. 366)

To see a case of "ODD" in action, I recommend the 1985 film, The Breakfast Club, in which the character played by Emilio Estevez clearly meets most of the criteria for a diagnosis of this so-called disorder, but in which it is revealed that he has no disorder at all, but really has an abusive father who has forced him to rebel rather than be crushed.

This is an important point, you see, because once someone is diagnosed with a disorder, the next step is dosing him or her with some kind of psychiatric drug. In other words, a disorder implies a disease, and a disease implies needing medicine, so out comes the bottle of pills. This is why so many children--cruelly and unnecessarily, in my view, and without any choice in the matter--are being given daily doses of powerful mind altering chemicals when the problem may not a disorder of these children at all, but instead the problem may be inadequate parenting, inadequate schools, and unrealistic demands that all young people should conform to standardized expectations whether such expectations are reasonable for all children or not. For example, if a child cannot sit still for hours at a time in school does that mean the the child has a disorder (ADHD), or does it mean, perhaps, that some children naturally cannot sit still for hours at a time? I do not mean to say that such drugs are never necessary or never helpful, but I am morally certain that they are being used excessively, and to the detriment of many, if not most, of those kids who are taking them.

Carmen, my advice is as follows:

1. Show this letter to your boyfriend. I would like him to begin to doubt that diagnosis, and to doubt those who are responsible for hanging it on him.

2. Enjoy life, including having a boyfriend you like.

3. Stop worrying about the future, and do what you can today.

And you are most welcome.

Be well.

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