One of the most challenging and important developmental tasks of adolescence is individuation. The separation of a teen’s identity from that of her parents is a necessary process that helps her move from the dependence of childhood toward the independence of adulthood. She might become more private, begin questioning old limits and rules or debate parental instructions. This transition, while normal, is new and therefore awkward territory both for the teen and her parents. Even mildly resistant behavior can feel like defiance to all involved, leading to parental frustration and adolescent resentment and guilt.
But as long as there is a sense of mutual negotiation and adaptation on the part of the teen and her parents during this process, some degree of conflict and even low-grade defiance is normal. Parents whose discomfort with this process reaches a high pitch, however, do well to consult with a family therapist. A therapist or psychologist can help parents identify strategies to accommodate their child’s need to individuate without abdicating their parental authority.
As teens enter the process of individuation, they may at times feel lost, confused, angry and guilty. They feel themselves changing from the inside out in ways—cognitive, emotional, and physical—that are out of their control. For some teens, this simply means that their adolescent angst, and possibly their level of defiance, is a bit exaggerated. This scary process, however, can also bring previously dormant issues to the surface, such as serotonin imbalances and depression, ADHD, past traumas, family conflict, or previously repressed resentments toward other family members.
When normal efforts at individuation are replaced by chronic defiance, a teenager may be suffering from oppositional defiant disorder (ODD). ODD is typically caused by some combination of familial, environmental, trauma-based, neurological and/or chemical factors. It sometimes co-occurs with or is misdiagnosed as ADHD, depression, or other emotional disorders. A teenager with ODD may be easily annoyed by others, intentionally provoke peers, exhibit chronic defiance or non-compliance toward adults, have a short temper, blame others for her own mistakes or be highly vindictive. To be diagnosable as ODD, several such behaviors must be present on a consistent basis for at least six months. If these behaviors are less predictable and more explosive and violent than is typical for an ODD diagnosis, an adolescent may be suffering from something called intermittent explosive disorder (IED).
When a young person exhibits the chronic defiance of ODD along with the destructiveness of IED, she may be suffering from a severe condition called conduct disorder. The defiance exhibited by an adolescent with conduct disorder may include chronic lying, frequent violent or destructive behavior, stealing, bullying, cruelty to people or animals, breaking serious rules or laws and/or blatant defiance of authority. Like any such disorder, conduct disorder fits into a continuum of severity, so sufferers vary greatly in terms of the number, severity and frequency of symptoms. Adolescents with conduct disorder are at a high risk for incarceration and of harm to themselves or others. Often these young people are not bothered by their behavior even though it is profoundly disruptive to those around them.
There are other disorders as well that are characterized by defiant behavior. If your teen is defiant to a point that seems beyond the norm, or even just beyond your comfort level, it’s critical to consult with a professional in order to determine whether a serious emotional or behavioral disorder is present. The right diagnosis, as with any illness, is the key to the right treatment.
Treating Defiance Disorders
While different defiant disorders, and different sufferers of the same disorders, may require different treatment, some themes run through all successful treatment plans. The best approach to treating defiant disorders is a multi-modal approach that hits the issue from a variety of complementary angles. For more serious forms of defiance, such as ODD or conduct disorder, a combination of pharmacological treatment, individual therapy, group therapy, parent training and family therapy is a good idea. Often, this kind of robust multi-modal treatment is most manageable in a residential treatment setting. Pharmacological treatments may include the use of stimulant medication to treat ADHD like symptoms and reduce impulsivity, or SSRIs to treat underlying depression. Though it is true for all adolescent treatment, it is especially critical with defiance-based disorders that parental involvement is critical. Parents who are simultaneously engaged in their child’s treatment, their own treatment and their family’s treatment greatly increase their chances for the healing and growth of their defiant teen.