Negativity

We work with a 26 year old woman who [has mental retardation]. She came to live in our program four months ago. She is very negative. She always talks about not feeling well or about something hurting. We do check to make sure she’s not really injured or sick but she never is. Unless she’s talking about something wrong with her body she hardly ever really says anything. When I walk into the home she’ll come up to me and say, “My stomach hurts” or “I have a temperature.”

Our behavior specialist is having us take data on how often she makes these statements, but honestly, it’s pretty much all the time. It seems obvious she says these things so we’ll give her attention, but we can’t always ignore her because what if she’s really sick this time? Do you have any suggestions for reducing this lady’s negative verbalizations?

You view this woman as very negative because her conversation consists primarily of statements about being in pain or not feeling well. Because you find this behavior unpleasant and tiresome, you see this as a problem that needs to be reduced. To that end you are collecting data to document the effects of a reductive strategy. You see this behavior as attention seeking, so this reductive strategy includes ignoring her when she talks like this.

I would like to encourage you to think about this woman, her behavior, and her life with you in another way.

This woman is still new to your home. She is not “seeking attention” so much as seeking connection and relationship. She is doing this the same way any of us would, by initiating conversation. Unfortunately, she has a limited range of things to talk about and ways to do so. You say that unless she is talking about something wrong with her body, she hardly ever really says anything. This is very telling. I think reporting pain or illness is simply how she tries to communicate with you, and what you are seeing is not “negativity,” but a limited repertoire of social speech. The good news is she wants to communicate, and relationship with you is important to her. There is nothing here to reduce.

Instead, it would be better to support her in expanding the range of things she talks with you about. You can probably best do this by helping her to explore her interests and getting her involved with activities she finds interesting and exciting. At least some of these activities should be things you can do with her to create shared experiences and help strengthen your relationship. As she develops interests and skills through these activities, initiate conversations with her about them, and help her learn to express herself. Then, not only will she want to talk with you about other things, she will know how. In time, those “other things” will naturally displace bodily complaints as topics of conversation.

Good luck. Thanks for shaking the Magic 8 Ball.