As parents to a kid who had a brain tumor and all the other terrible consequences of the tumor, we have not felt comfortable disciplining him as we would a typical kid. Even when he engaged in what most would deem illicit behavior, we felt trapped by our doubts that corrective action would have any impact on his behaviors (stealing food or money for food, for example) since they appeared to be out of his control.
I am fairly sure that Sasha's behaviors, although maladaptive in most people's eyes, were probably adaptive in his eyes. After all, a hungry person will do whatever he needs to do to feed himself to keep himself alive. I believe he developed some habits as a result of his chronic hunger and the stringent lifestyle we created for him to try to control his excessive food seeking. The natural consequence of hunger+food policing=increased sneakiness, I'm sure.
Well, yesterday he was caught by his dad sneaking a package of graham crackers that he took from his afterschool care's snack table. We reminded him that he would be punished by having money taken out of his account. Instead of earning money for having a theft-free week, he would now have that same amount of money confiscated. As expected, he felt very sad. When I asked him why he was so sad, he said, "because I don't want you taking my money away." So, it appears that he was sad because he was caught and didn't want his money taken away, not because he did something wrong by stealing. That's ok- most kids would feel the same. Now that he likes to buy Magic cards for collection, this hurt him. Well, good. I reminded him that we discussed this as a motivation for him to not steal and that it was a reminder that while he doesn't like having someone take something from him, he should also think that others don't like having him take things from them. I asked him if he was thinking about consequences (this punishment) when he decided to take the graham crackers. He said "no." I dug in deeper and told him, "I hope that you will remember how badly you feel right now the next time you think about taking something that doesn't belong to you."
Aversive conditioning is supposed to make someone feel badly in order to make an association of the bad feeling with the undesirable behavior in order to decrease the undesirable behavior. I am confident that the oxytocin and naltrexone are improving his hunger and satiety issues (we received confirmation just yesterday at his school IEP meeting that he has significantly REDUCED- but not completely cured- his food seeking problems, yay). Now that the neuroendocrine problems are in better shape, it's time for some more psychological interventions! Let's see if my psychologist hat will serve my role as a mom here... I can only hope these punishments will be felt as painful enough by him to start undoing some of his bad habits from the days of HO monster.
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