Laura Burns Understanding and supporting challenging behaviour

Laura Burns
Understanding and supporting challenging behaviour.

A definition of Challenging behaviour according to Eric Emerson 1995 “culturally abnormal behaviour(s) of such an intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit use of, or result in person being denied access to, ordinary community facilities “(pg4)
My understanding of this definition of challenging behaviour is when someone takes risks or put others at risk, this could be through aggressive behaviour where the person lashes out at family, friends or care staff and has regular tantrums, sometimes they can become withdrawn and isolate themselves. This can also affect their daily routines and their quality of life.

This behaviour can be due to not getting appropriate support or attention when in distress this can be frequent due to a learning disability and can be intensive due to frustration as sometimes the person doesn’t understand why they are behaving this way. Communication can be a barrier as they sometimes find it difficult to express or say how they are feeling or what support they need. These behaviours can also come from young children who may be going through different stages in life, they may not have appropriate support whether it be at home or in school.

Persons with mental health issues can also display challenging behaviours due to alcoholism or drug addictions. These behaviours may occur due to a person’s thought process, frustration and distorted realities when an addict is going through withdrawals and is desperate for next fix.

It is culturally normal for a toddler to have a tantrum, but for an adult this is abnormal and can be challenging by putting themselves or others at risk, an adult with a learning disability this can be the norm as a person with a learning disability function at a different mental capacity.

As we grow older our strengths increase, when an adult with a learning disability who finds it hard to control feelings and outburst, this can put themselves and others at risk .it can also affect others around them i.e., at home or in a care setting. it can also affect every day aspects of life, like going to day centres, classes or normal chores like shopping. challenging behaviours can sometimes limit a person’s everyday living.

There are a range of different challenging behaviours. I will give 4 examples.

Inappropriate Sexual behaviours can be challenging, where a person can be in a state of undress in public or masturbation, where a person could use items sexually which also can cause harm.

Aggressive behaviour can be threatening, verbal abuse, screaming, hitting, scratching and throwing objects at others.

Self-harm is a challenging behaviour where a person can refuse medication, food or support. Cutting, scratching, head banging. Drug taking, and excessive drinking can also be a form of self-harm.
Non-person directed challenging behaviour can be a person damaging their or others property, intentionally break items phone and computers. destruction of clothes and incontinence i.e. bed wetting and soiling clothes. can also be part of challenging behaviour.
Sigmund Freud, according to Freud the mind is made up of three parts the i.d, ego and super ego, which work together and create complex human behaviour.

The id is made of two types of the biological instincts which Freud called Eros and Thanatos.

Eros or life instinct is the survival part, it helps with everyday things which help us survive like breathing eating and sex(freud1925). this instinct is called the libido. the Id is the part of the personality which pursues pleasure and gratification.

Thantos or death instinct, is seen as the destructive part present in all human being(freud1920), when it is directed at others it is conveyed as aggressive and violent. Freud believed the Eros is stronger than Thantos this allowing people to survive than self-destruct.

The ego develops from the id during infancy, the egos aim is to satisfy the demands of the id in a manner socially acceptable. the ego is the part that is aware of reality and is in contact with the outside world.

The super ego develops during early childhood, it is responsible for ensuring honest standards are followed, the super ego operates on honest values and encourages us to behave in responsible and acceptable manner .it is the conscience that instils guilt when we indulge in dishonest or immoral behaviour.

In order to deal with conflict and problems in life, Freud stated that the ego employs a range of defense mechanisms.  Defense mechanisms operate at an unconscious level and help ward off unpleasant feelings (i.e., anxiety) or make good things feel better for the individual. Someone who displays challenging behaviours may use Freuds defence mechanisms as a coping strategy.

Regression is a defence mechanism where a person’s behaviours can become more childish, I have worked with a service user who regresses back to childish behaviours due to being refused money as he may have spent his weekly allowance. his social worker budgets his money and when he is refused he can also redirect threatening behaviour towards staff. this defence mechanism is displacement, when someone redirects threatening or aggressive behaviour on to someone.

Abraham Maslow. according to humanist psychologist Abraham Maslow, our actions are motivated to achieve certain needs.

Maslow first introduced a concept of a hierarchy of needs in his 1943 paper “A theory of human motivation” and his subsequent book motivation and personality. this hierarchy suggests that people are motivated to fulfil basic needs before moving on to another, more advanced need.

Maslow believed that people had a natural desire to be self-actualized, that is to be all thy can be. but to meet these goals, other basic needs must be met. the needs for food, love, safety and self-esteem.
Maslow’s hierarchy is often display as a pyramid the lowest levels are made up of basic needs food, water, sleep and shelter, once these are met a person can move which is safety and security .as people move up the pyramid needs become more psychological and social. further up the pyramid is the need for love intimacy and friend ship these are important. then there is the need for personal esteem and feeling of accomplishment take precedence.

Like carl rogers, Maslow emphasised the importance of self-actualisation, which is a process of growing and developing as a person to achieve individual potential. most people will move up the pyramid but some may not, this can be due to a person who puts their safety at risk, it can also be a person who cannot form a healthy relationship whether it be friendship or intimacy. a person with a learning disability may find this difficult due to the lack of understanding about relationships they might get a friendship mixed up with a relationship, become frustrated due to very little contact or even too much contact, so this would stop a person from moving on to the next level.

Our environment can also prevent growth and development.
When someone has challenging behaviours, there is Internal and external factors to consider, internal factors can be how they see themselves, how they are feeling, are they being listened to or given appropriate support. Feeling of being left out , someone might be getting more support than others and a person might think no one wants to support them but this may be down to support plans and care packages .sometimes a person can display challenging behaviours as they don’t feel worthy of anything good in their life’s, something tragic might have happened to them in the past and they blame themselves for it so can go on punishing themselves for it. They could be on medication and experiencing side effects or weight gain, so a person may act out because of this. drug or alcohol dependency can also affect a person internally if a person has no drink or drugs there is several challenging behaviours that may be displayed. these factors need to be considered when supporting a person.

External factors can be how others see a person or what they may think about them, some people may worry about how they are seen to the outside world, there environment ,who is around them where they live, friends and family can have an impact on a person with challenging behaviours ,they may be a good influence on them or a bad .how a person is living and conditions they are living in can be an external factor , sometimes how others behave round a person can have an effect as a person might see how they are behaving is the norm and do also whether positive or negative . A person may fell they are not being included and don’t have a say in any support plans or their thoughts aren’t being considered can also make a person act in a challenging way.

My conclusion is that there is a lot of factors that need to be considered when supporting a person with challenging behaviours, whether it internal or external. when a person is showing challenging behaviours, this may be a persons way of communication or having control over a situation or a person. there is always a reason to why they are behaving in a challenging way, the theorists I have applied have helped me to understand challenging behaviours.

Ref; Emerson ,1995, cited in Emerson, e (2001,2nd edition); challenging behaviour; analysis and intervention in learning disabilities, Cambridge university press. accessed 25.09.18