IN A RECENT consultation with the parents of an 18-year-old girl whose behavior was characterized by impulsivity, angry outbursts against her family and society, and an increasing difficulty in maintaining even minimal social relationships, the parents loudly pointed out that ten years previously their child had been diagnosed as brain damaged. They resented the implication that we were now talking of her problem as having an emotional base. Although they had not been reassured by the earlier diagnosis, at least it had been tangible and useful in understanding the erraticism of her behavior. It did not, however, modify the parent's antagonism toward the behavior of the child which had gradually increased over the years.
The immediate presenting problem concerned the child's running away from home and massive resistance to any sort of disciplinary activity. Earlier parental perplexity had changed to a state of almost pure helplessness. The child's behavior under