Posted by Sarah Fitz-Claridge and David Deutsch on the TCS List on Sun, 5 Aug., 2001
1. How the problem arose: a TCS analysis
Posted by David Deutsch on the TCS List on Sun, 5 Aug., 2001 at 17:14:29 +0100
A TCS poster wrote:
Can someone give their thoughts on how to deal with a situation please? A child under 10yrs has been asked by medical workers to wear an eyepatch to make the brain use a lazy-eye. the medical opinion is that if the good eye is not patched for 1 hour a day then the lazy – eye will revert to having blurred vision. There is also medical opinion that the lazy eye can become fixed as blurred if the intervention is not carried out before the age of 10 yrs. The child understands the position but finds wearing the patch annoying.
Mother doesn't want to keep reminding the child but also is concerned that the child's sight may regress and be unable to improve in the future. The child wants to be able to see but doesn't want to wear the patch. At the moment mother and child agreed to not keep ‘going on about it’ but child keeps forgetting to wear the patch and when the day ends realises that it has not been worn. Mother feels stuck.
Mother has also read accounts on a lazyeye support email group of adults who were not forced to wear the patch when they were children and now feel resentful and annoyed at their parents for not insisting that they wear the patch. Mother read the emails to the child but feels that child felt that she was being coerced and mother feels that she was doing this also, mother felt that by hearing about the accounts of older people who have gone through the situation might have helped.
Mother really can't see how child can be happy wearing the eyepatch. Mother also can't see how she can help the child to wear the patch now for hopeful results in the future. Mother feels she is coercing the child as she knows that the child doesn't want to wear it. Mother feels that it is hard for child to plan for the future and hopes that she can help the child consider hir eyesight for the future.
Is there a way that mother can feel she has been TCS and helped child to have good vision in the future?
“The child understands the situation”. But “Mother feels that it's hard for the child to plan for the future.” This ‘planning for the future’ that the child is supposed to do involves biting the bullet and accepting being unhappy, right? That's what a more mature human being, one who did have this planning-for-the-future ability, would do. So, until he becomes fully human by developing a mature ability to make himself unhappy, what choice is there but to do it for him?
To me, the pivotal statement in this story is “Mother really can't see how child can be happy wearing the eyepatch”. If she can't see it, it shouldn't be all that surprising if he doesn't either. In reality, there are countless ways in which covering one eye for an hour a day in order to improve one's vision can be a perfectly acceptable thing, or even something that he looks forward to. The difference, and the distance, between reality and Mother's conception of it, is what is making this situation unpleasant.
Judging by the story, reading him those e-mails seems to have been a step in exactly the wrong direction. Those sad, reptilian people who wish their parents had forced them to wear the patch have, by definition, ceased to identify with their former selves. Their integrity has been fractured at some time between then and now. To ask the child to identify with those people is to ask him to fracture his own integrity right now: almost to deny his own existence. Why should he spoil his own life, now, in order to improve the vision of some future stranger who, by hypothesis, is as different from him, and cares as little about him, as those strangers do? He is a person, not a natural resource.
In subsequent messages a different, and incomparably worse, situation was portrayed.
To begin with the eye was covered with a type of sticking plaster for every waking hour. Child complied after the first day of crying.
Over the last year Child has cut down gradually from wearing the patch for all waking hours to just an hour a day or the equivelent.
This child was given no choice whatever. The child refused the patch, but was forced to wear it anyway. The patch therefore became an instrument of torture. The child cried, but nevertheless, the patch stayed on. All day. By the next day, the crying had stopped but the patch was still on. It stayed on for months, and the child is still not reconciled to it; the issue is a running sore.
The objective in this case should be the same as in the case above, and the same as what it should have been from the beginning: to help the child to solve the problem facing him – where ‘solve’ has the attribute that the child is not in distress or chronic conflict while he is doing whatever he has decided to do. This would probably have involved finding ways for the child to enjoy either wearing the patch or one of the other available forms of treatment.
What to do now? I have no idea. If the parents throw away the instrument of torture, apologise and promise him it will never touch him again, and even if he believes them ... the torture will still not end. He knows that his sight will probably deteriorate in the future as a result; and he knows his parents' state of mind in the present. Both these will cause him anguish if not resolved.
Quite possibly, despite being sore, browbeaten, confused and alienated, the child himself is still the most likely source of a solution. If he could somehow become aware of the fact that the situation in not inherently coercive ... but how could he? In a decent world there would be an internet support group, not for adults who wish they had been forced into treating this condition, but for children who are not forced but enjoy the treatment. But in this respect, we do not live in a decent world.
The problem-solving attitude and some ideas
Posted by Sarah Fitz-Claridge on the TCS List on Sun, 5 Aug., 2001, at 13:27:08 +0100
A TCS poster wrote:
Can someone give their thoughts on how to deal with a situation please ? A child under 10yrs has been asked by medical workers to wear an eyepatch to make the brain use a lazy-eye. The medical opinion is that if the good eye is not patched for 1 hour a day then the lazy – eye will revert to having blurred vision. There is also medical opinion that the lazy eye can become fixed as blurred if the intervention is not carried out before the age of 10 yrs. The child understands the position but finds wearing the patch annoying.
My heart goes out to this child – and his mother. His mother may find this painful to hear (sorry), but it seems to me that this is as clear an example as one could find of the fact that it is a terrible mistake to assume that any particular problem has no solution. It is vital to approach every problem with the idea that it is possible to solve it – that is to say, that it is possible to solve it in such a way that the parties prefer the outcome.
Had mother not been assuming that there was no possible preferable solution, I conjecture that this problem would have been easy to solve. It may still be easy to solve if mother can manage to change her pessimistic attitude, so don't lose heart yet, Mother!
Wearing an eye-patch simply isn't inherently coercive. I remember when I was a child that a boy in my class had to wear an eye patch. This boy's mother made him a black pirate-style eye patch, and he would come to school with pirate clothes, a toy stuffed parrot, a pretend peg leg (I think it was a cut down broom handle), and he had clearly been reading pirate stories or something, because he adopted pirate-style language and played pirates every break time. After a short while (the next day in fact), other children started coming to school with pirate gear, and several wore their own pirate-style eye patches, for fun, despite having perfect sight.
Perhaps this child doesn't like watching the marvellous Peter Pan cartoon I have seen on children's television from time to time, but there is bound to be something that would change wearing an eye patch from something unpleasant to something fun. Has this child thought of dressing up like a Borg drone? (I'd definitely go with the Borg drone myself. 7 of 9 is it!) The child could go for a standard Borg drone look, or a 7 of 9 look. Has this child thought of copying the rather beautiful Borg bit around 7 of 9's eye, and adapting it to cover his or her eye patch? You could make the patch black, and use aluminium or something to create a beautiful pattern. It could cover more than just the eye. It could look really stylish, and nobody would know it was an eye patch. Plenty of children love wearing fancy dress and masks and partial masks.
Which reminds me, when I was risking life and limb for freedom in Quebec City (see article on my web site if you are curious!) many many people were wearing black gas masks. I should think that might be a bit dramatic, but it would be very easy to hide an eye patch behind one of those gas masks, I can tell you. This child might enjoy dressing up as an alien or something, in one of those masks.
Or perhaps the child isn't at all into monsters and mayhem, and likes peace and beauty. Well in that case, how about dressing up in a very beautiful gown and head dress? I once wore Berber clothes for self-protection when travelling on my own in Morocco. It wouldn't be difficult to make a beautiful costume which covered one eye – or both with a veil, perhaps – which would be no end of fun to wear. The child could be taken to a fabric shop where he or she could choose lots of really beautiful fabric and sequins and glittery bits and pieces, and then spend hours creating different outfits or different ways of draping the fabric.
An hour a day is not very long for dressing up games!
How about trying to find other eye-patch-wearing children to get together with and play dressing up games with? Or if the child is too old for dressing up games, how about making a patch (or a cover for the patch) out of sequins, little mirrors, or some sort of beautiful fabric, which would just look stylish but not be a full fancy dress costume?
N.B. If this family doesn't know about the recent series of Voyager, they don't watch enough television.
If the child and parent try to think about this whole thing differently, I'm sure they will be able to solve the problem.
Best of luck!
3. Adopt the problem-solving spirit
Posted by David Deutsch on the TCS List on Sun, 5 Aug., 2001 at 18:58:33 +0100
The TCS poster wrote:
Right then- Considering that we obviously don't live in a decent world,
In this respect.
what should the mother do now? Should mother shut her face and leave the child to it?
Probably not.
Should mother read your email to the child?
Maybe. Probably not.
Should mother carry on feeling like she is a total shit because she has tortured her children in this way?
No.
Should mother turn back the clock to over a year ago and anticipate that this eye problem was going to develop and then deal with it in a different way?
No, that isn't possible.
What can mother do NOW for the best to be TCS ?
As I said, I'm afraid I don't know. I do know that there is something to be done for the best, and that it involves TCS.
What would you do David if you were the parent in this situation ? – I know you wouldn't have made the mistakes that have been made up to now in this situation,
Well, perhaps not those mistakes, because I happen to be well tuned-in to medical coercion and medical non-coercion. But everyone makes mistakes.
BUT – what can be done now to go forward in a TCS way ?
Mother never planned to be scewing up the child's life. Mother thought she was doing the best for the child's eyesight. Mother is not convinced that the patching intervention is right but is not medically qualified and was convinced by the eye experts she is concerned that she is playing with child's future eyesight if she now decides to follow some other alternative method.
Well, I see from the medical web sites there are other treatments, such as atropine, which some people prefer, though it may be less effective. There seems to be a little dispute about just how difficult/unlikely it would be to correct this problem in later life. But either way, the consensus seems to be that there is a serious risk to the quality of vision if this problem is not corrected before the age of 10 or so.
Mother is finding it VERY hard to become TCS. Mother doesn't want sympathy – she knows that she is carrying a load of baggage from her life thus far. She also is aware that she needs to do a lot to become even near to TCS. Mother is also aware that she is talking about mother more than she is talking about the child. WHAT SHOULD BE DONE TO REMEDY THE SITUATION NOW?
As I said, I don't know. Fortunately, SARAH DOES. See her inspiring message on this thread about the problem-solving attitude – and also her specific suggestions and those that others have posted. The idea is not necessarily to adopt them but to adopt the spirit of them, and then to find perhaps a variant that suits this particular child.
4. How to move forward from here
Posted by Sarah Fitz-Claridge on the TCS List on Sun, 5 Aug., 2001, at 14:23:17 +0100
The TCS poster wrote:
What can mother do NOW for the best to be TCS? Mother never planned to be scewing up the child's life.
Of course not!
Mother thought she was doing the best for the child's eyesight.
Thinking in terms of doing one's best for one's child is a mistake, in that it is not for the parent to make these decisions for the child. This should be a matter of the child's choices, not the parent's. Those choices should be informed by the information and arguments from the medical profession, and any other relevant information and arguments the parent has to offer. But informing a child is not the same as taking the decision out of his hands. Any kind of “doing one's best for the child” which is inconsistent with the child's wishes is making the mistake of treating (and seeing) the child as an object instead of a full person in his own right. That attitude, even a hint of that attitude, will cause problems and prevent parent and child solving problems.
Mother is not convinced that the patching intervention is right but is not medically qualified and was convinced by the eye experts she is concerned that she is playing with child's future eyesight if she now decides to follow some other alternative method.
I wonder if perhaps part of this problem may be that Mother suspects that the treatment advised is not even necessary? If the Mother thinks that, that might explain why she is finding it so difficult to think creatively about it. Just a wild speculation. And if the child is picking up these suspicions it may also be one reason why he is not wholehearted about rearranging his life around this theory.
Mother doesn't want sympathy – she knows that she is carrying a load of baggage from her life thus far.
We all are. There is no perfect TCS parent.
WHAT SHOULD BE DONE TO REMEDY THE SITUATION NOW?
This is the right question to ask. It is quite right to think about what to do NOW rather than wallowing in guilt about past mistakes.
Sometimes, to know what to do now, one has to understand something about where one went wrong in the past, hence my comment about the mistake of thinking of doing one's best for the child, and hence David's remarks in his rather dour first post in this thread. So the answer is – the two things to do are:
(1) for the parent to work on solving the immediate problem – see my other post for some ideas, and David's second post in this thread, and
(2) for the parent to try to work on how she sees and treats the child on a deeper level – to try to start thinking of the child as a person for whom she is a trusted advisor, rather than as a parent who should do things to or for the child for his own good. This (2) is what people mean when they refer to the “paradigm shift” of TCS.
I do hope this helps.
Comments
eye patch
Please visit our little three page website....showing how children as young as 3 months of age can tolerate patching and glasses, by the way. Although the ideas are targeted for the 0-3 population, with age-appropriate activities, the carryover can be successful. In my experience as an Early Intervention Vision Teacher, the eyepatch activities are very important...television is only minimally successful in strengthening the eye. Another method, perhaps easier, is to use prescription for Atropine, which a once a day eyedrop. It's proven to be just as effective as a bandage eyepatch.
Being a child of an eye
Being a child of an eye patch, I can say that Mother needs to buck up and do what is right for the healthy well being of the child. Had I not worn an eyepatch when I was a child, my vision would be far worse than it is now. Her whining and comiserating with her child does nothing of benefit for the child.
When I was a child, you did what you were told. Maybe Mother doesn't exert this kind of power in her household? Maybe she should.
Making eye patching fun
We solved this problem with our eight year old by chunking the sticky patches and buying a pirate style patch. Although hard to find in kids sizes we bought two from www.eyepatchstore.com and they have been great. Kids associate an eye patch with pirates and patching then becomes "pirate time" and fun.
eye patch
I completely understand what this mother is going through. I have a child now 6 years old that started patching at 2 years old and it was very hard. I made a DVD called "The Eye Patch Kids" to help encourage my son to want to wear the patch by making the puppets on the DVD have patches. It is a very highly entertaining and educational DVD to help children understand the need for patching while having fun during that time. The puppets encourage the child throughout the DVD to put on their eye patches to be like the puppets. I have received alot of positive feedback from it. My website is www.bjortandcompany.com if you are interested. It will get better eventually. After a while they usually can see better after patching so it becomes more routine. I told my son that if he had a scrape on his knee then we would put a bandaid on it to heal so since his eye has a boo boo the eye patch was just like a bandaid for his eye. Also, there are tons of different eye patches out there now so getting a few and letting your child pick out which one she/he wants to wear each day also gives them some control over the situation. I taught my son to color coordinate them with his outfits so they matched. Good luck and I hope it is a successful experience.
Kelly H.
www.bjortandcompany.com
patching
I would love to find a little one that my daughter could patch with. She is three and was born with a cateract in one eye. She had a contact in her left eye by 7 weeks old. Our patching is down to 1-3 hours daily, and I usually have to give her special activities the whole time. She does not like it and neither do I! I tried the patch on. It is NOT pleasant. But I know that one day it will be well worth it....
eye patch
Hi, I have a lazy eye (love the name!) and was not instructed to wear an eye patch. Had I worn one it is possible that the vision in that eye would have strengthened enough for the brain to accept it and for me to gain binocular vision. I'm sure that I would have disliked the patch. I teach skating to kids and adults and I've found that the adults typically won't wear a helmet but expect the kid to. Those parents who DO wear a helmet get better cooperation from the child. Maybe Mom should wear the patch along with her child as a together thing.
eye patch
Who's the adult here??? The mom needs to suck it up, get the kid to wear the eye patch and make it fun. Don't focus on the "agony" and pain. My daughter just started wearing an eye patch two weeks ago. She doesn't like it but we don't make a big deal out of it although she will have to wear it all day for six weeks.
Quit focusing on the pain... jeez... can the mom be anymore morbid and defeatist? It's for a few years a few hours a day. Make the kid wear it during TV time. That will shut down the whining fast. (If you want to watch TV, you have to wear your eye patch.) Heck before you know it the kid will look forward to the time he or she has to wear the eye patch.
It will simply become a part of life.
For my daughter, first thing in the morning she puts it on with her glasses- she can't do anything else until it's on... and when she gets home, she can't watch movies or play if the patch has been taken off. Sure when she first got it she cried... cried for two hours in fact. When she realized nothing was doing... she wasn't getting out of it, she settled down and we don't have any problems now.
There's simply no excuse - this mom is contributing to the blindness of her child because she won't step up to the plate and be the adult.
It's simple... as parents we must make difficult decisions. This is one of them. Let's face it, a child under 10 cannot (and doesn't need to really understand) the realities of life 20 years from now if they continue. It's your responsibility to step up to the plate and take charge.
pirates ahoy!
When I was 6 or 7 I was told by a doctor that I needed to wear a patch for my lazy eye. I had no problem with this idea--I thought it was awesome, because I'd just been on a trip to the Caribbean and been given a black eye patch from a man that (I believed) was a real pirate. I was excited to have an excuse to wear the patch to school, whose dress code would have normally forbidden it.
But the doctor insisted that my patch was unacceptable, because it let too much light in and because, in his opinion, it would draw too much negative attention from other children. My parents, normally sensible people, but becoming increasingly caught up in their own problems, did not take my side.
So instead I refused to wear a patch at all.
This incident is part of the reason why I have such bad vision today (another part being another instance of my parents being unwilling to listen to what, to me, felt like very valid complaints about my glasses). I believe it would have been better for my parents to support my chosen course of treatment than to allow me to have no treatment at all, OR to have forced me to follow the doctor's orders.
I believe most children are naturally accommodating and reasonable except when they have a reason not to be. Maybe there is something motivating the child in question not to want the eye patch that is not being addressed?
I remember, for example, that when I broke my collarbone at age 5, having to wear a sling made me miserable because it was boring and white--and so my mom made me a whole collection of different slings out of fabrics that I liked, and let me choose which one to wear each day. Then I didn't mind at all.
Perhaps the child in question just needs to be given different options on how the patch might be worn. Maybe a compromise can be made that may NOT be in full accordance with doctor's orders, but is a better option than forcing the child or having them refuse the treatment entirely. Or perhaps her problem is not with the patch itself, but something relating to it--such as fear of how the other children will treat her, or the fear of being unable to see with one eye. \
Play Specialist-eye patch training
Dear Kelly.....I am a Play Specilist on a children's Ward and often have referrals from our eye department to encourage them to war their patches..I use play to encourage this. We make pirates eye patches and colour etc. I have successfully used reward charts and a egg timer. children find the concept of time very difficult. So we keep the eye pach on till the timer goes off. We then get a sticker and when we get a agreed amount ther is a reward....We can then increase the time between rewards very easily.....
I am very interested to obtain your dvd to add to my programme to help with such a important part of the correction. Thank you
Julie x x
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