16. AssessTemperament & GoodnessFit - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
Consultant/Trainer/Author
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Born that Way, Temperamental Challenges in Relationships and Therapy
Chapter 16: ASSESSMENT USING TEMPERAMENT & GOODNESS OF FIT THEORY
by Ronald Mah





Charlie, Aliya, and Samuel, the family presented earlier is challenged by the difficult temperament of Charlie and the combination of traits among the family.  Charlie would be considered a difficult child in temperamental theory.  Charlie is very emotional and reacts provocatively with others, which often sets off a cycle of mutual agitation.  He often gets emotionally and behaviorally out of control.  "Because temperament refers to dimensions of reactivity and self-regulation, behavioral measures of child temperament have focused largely on emotionality.  Specific temperament concepts that have been widely measured in young children include negative affect/emotionality, difficultness, inhibition, and frustration (Bates & McFayden-Ketchum, 2000).  The concept of 'difficult' temperament is especially relevant to the goals of this study for several reasons.  First, children who exhibit enduring patterns of difficult behavior or negative affect (e.g., more irritable, angry, easily upset, noncompliant) may be less likely to regulate their emotions in appropriate ways and more likely to respond in inappropriate ways during peer interactions than are children who are temperamentally easy.  Consistent with this notion, Denham, McKinley, Couchoud and Holt (1990) found that preschoolers who displayed higher proportions of anger were rated as disliked by their peers more often than were children who displayed lower proportions of angry behavior.  Second, there is ample evidence that difficult/adverse temperamental factors are related to qualities of child behavior and interaction important for interpersonal relationships, and especially to child problem behaviors (see Anderson, Bohlin & Hagekull, 1999; Bates & McFayden-Ketchum, 2000; Rothbart & Bates, 1998)" (Szewczyk-Sokolowski and Bost, 2005, page 380).

A difficult temperament is a predictor of problem behaviors and interpersonal issues.  Research findings suggest that difficult temperament strongly influences lower or more restricted range of prosocial skills, aggression, and impulsivity.  Difficult temperament is linked to behavior adjustment problems.  In addition, temperament may predispose others to interact differently and to structure experiences to either increase positive or negative results (page 391).  Charlie, Samuel, and Aliya dynamically affect each other's reactions and evoke each other's responses with their temperaments.  Charlie is most obviously provocative with the two adults, but both parents also provoke Charlie and each other.  Examining each person's temperament and noting the key variations uncovers the influence of temperament on the family and the couple.  There are various temperamental theories each of which suggests traits and rankings to determine a person's temperamental profile.  Turecki uses Chess and Thomas' model. This model is useful to examine not just the temperamental profile of individuals but also the dynamics among them.  

There is an inherent subjective element when anyone including the therapist does a temperamental assessment.  The therapist should remember that it does not matter whether both or all participants (the individual, partners, or family members) rank the individuals exactly the same.  What is important is that everyone sees the relative rankings between individuals the same way.  For example, the first person ranks him or herself high in one trait, the second other person as medium, and a child medium-low.  There is not a problem if for example the second person ranks the first person medium, him or herself medium-low, and their child low.  Both see the first person has being the highest, the second person in the middle, and their child lowest in that trait.  Chess and Thomas' model avoids value judgments regarding either end of a bipolar trait.  High versus low does not imply that one or the other is better or worse.  High rankings are not necessarily "bad" and low rankings are not necessarily "good," nor vice versa- low rankings are not necessarily "bad" and high rankings are not necessarily "good."  In addition, medium rankings can be either positive or negative as well.  The value or functionality of the trait is determined relative to its interaction with other traits and the context for the individual.  Kagan's earlier discussion about the potential positive value of emotional reactivity is supportive of this perspective.  

Individuals will notice that sometimes they get along very easily with one of their colleagues or family members (Samuel and Charlie normally), but have trouble with another (Samuel and Aliya).  On the other hand, another person or his or her spouse has a hard time getting along with that first person was so easy, but gets along well with the one that was so troublesome!  Who matches up well with another including partners is actually predictable if one understands temperamental traits.  Or, how individuals aggravate each other becomes predictable as well.  Most people with two or more children, intuitively already know about temperamental differences.  They know that their children were born differently, with differences that are very resistant to being changed.  They were born that way!  In fact, many mothers were able to feel a difference in activity level when their babies prior to birth.  The therapist can expand this and use it to not only help understand individuals and relationships, but to improve and heal dynamics as well.  Temperamental differences may occur with or without cultural differences.  In addition, temperamental differences may be mistaken for cultural differences or vice versa.  Temperamental examination of Charlie, Aliya, and Samuel can produce important information that can be gained using the following chart.  Temperament should not be considered an exclusive or necessarily the primary tool for understanding the child, the adults, the couple, or the family.  However, as a dynamic element in diagnosis, it can be revealing for the therapist and a theoretical guide to therapy.



Charlie's profile would be very typical of what in DSM terminology would be diagnosed as ADHD.  In lay terminology, Charlie would be seen as hyperactive… or one wildly active child.  His combination of traits creates a classic difficult child profile.  Three high level traits that he shares with his step-father Samuel create the foundation for his challenges.  Charlie and Samuel both have

High Activity + High Approach + High Distractibility

These traits create a tremendous amount of stimulation for Charlie as they do for Samuel.  Since they both have high activity levels, they have a great tendency to experience and create a lot of stimulation through their actions.  Charlie and Samuel are well matched here for rambunctious wrestling matches, long hikes, and marathon games of tag.  They readily keep up with each other's high energy and activity.  One of the things that really pleased Aliya was how Charlie and Samuel were great play buddies early in Aliya and Samuel's relationship.  They could carry on all day and night.  Even then they showed a significant propensity to wear out Aliya who is lower in activity level.  She did not mind so much then, because she was so happy that they got along so well.  Now, she could deal a bit more quiet time and vegetating on the couch.  On the other hand, both Charlie and Samuel have trouble sitting still.  It's a good thing that Samuel's job as a contractor allows him to go from job site to job site and task to task on a regular basis.  

Charlie and Samuel also both have high approach, which causes them to gravitate immediately towards any new interesting stimuli.  This then often precipitates even more activity.  A more implicitly judgmental label could be high impulsivity.  It almost always looks like a great new adventure to the two of them, while stressing out Aliya who is much more conservative about trying out new things.  The two males are always leaping when Aliya is still looking.  She feels dragged into things that she not always ready for.  Even if it turns out well, it's stressful because she's much more comfortable taking her time and being cautious.  Not surprisingly this difference often leads to conflict between her and Charlie.  Worse than that, it gets between her and Charlie and his collaborator, Samuel who is supposed to be on her side!  The differences in how Aliya and Samuel experience Charlie's behavior often trigger significant couple's conflict.
In addition since all three of them are highly distractible, Charlie and Samuel will go after anything else that pops up that will draw their attention and energy.  Aliya on the other hand, will be distracted from a task at hand too, but not necessarily drawn to the new situation or activity.  She will then resent them distracting her with their leaping to the new situation and activity.  The high activity level, high approach, and high distractibility combine for both Charlie and Samuel to overwhelm Aliya at times, but also have further different consequences for Charlie and Samuel.  The difference is a consequence of interaction with other traits where Charlie and Samuel differ.  As a result of being attracted and drawn to high activity, Charlie experiences an extraordinary amount of stimulation.  Typical of children who are considered hyperactive, Charlie acts strongly upon and as a result is strongly influenced by the environment.  Adults, including Aliya often assume that a child like Charlie readily tolerates the noise, activity, and stimulation he creates.  Aliya is surprised when the therapist reveals that Charlie does not handle stimulation well because of his low sensory threshold.  Charlie's four trait temperamental profile is

High Activity + High Approach + High Distractibility
+ Low Sensory Threshold

Individuals with low sensory threshold can only tolerate a relatively small amount of sensory stimulation, while those with high sensory threshold tolerate what is overwhelming for others.  Aliya gets bothered by all the Charlie and Samuel caused stimulation.  That is not particularly surprising since she's usually complaining about their activity.  However, it may be surprising to people unfamiliar with temperamental theory that Aliya and Charlie share a low sensory threshold.  Although Charlie is very lively and activated by energy that his mother overtly complains about, he actually cannot tolerate it very well.  As a child, he is not sufficiently mature to self-aware of becoming agitated by his own activity.  In essence, he bothers himself!  Samuel on the other hand, who is so temperamentally similar to Charlie in many ways with six of nine traits identically rated, has the benefit of a high sensory threshold.  Despite being identical in the first three traits (high activity level, high approach, and high distractibility), Samuel's much higher sensory threshold compared to Charlie enables him to tolerate the high stimulation that Charlie cannot handle.  Practically, this means when Samuel and Charlie are being wild and crazy boys and having a super-energetic great time, their sensory thresholds are being affected differently.  Since Samuel takes on a lot of stimulation with capacity to spare, he can tolerate continuing in a good mood.  Simultaneously Charlie takes on the same amount of stimulation with no room to spare, and continues but with a degenerating mood.  They continue because they are both persistent, but as Charlie gets cranky and volatile, Samuel does not understand what is wrong with Charlie.  

Samuel is operating based on a common erroneous assumption.  Since it is ok for him, he assumes it is ok for Charlie.  He thinks it is not only ok for others but that it should be ok for others.  He understands and is somewhat better at intuiting that Aliya is temperamentally different.  She is resistant to and avoids getting into the high-energy play.  However, Charlie is so similar to him and has either initiated or quickly joined in the high-energy activity, Samuel doesn't get that Charlie can get overwhelmed.  As a result, Samuel gets angry at Charlie for not keeping it together.  "Why'd he start it in the first place if he gets all cranky in the end?" complains Samuel.  The answer is Charlie has high activity level, high approach, and high distractibility but not a high sensory threshold.  When Samuel gets frustrated about Charlie, he gets no sympathy from Aliya who was annoyed at both of them long before.  Different individuals may get agitated but experience it quite variably.  Highly emotion reactive individuals feel with greater sensitivity and depth.  Baby 19 in Kagan's study was reacted intensely to over-stimulation.  

On top of being over-stimulated, Charlie reacts to everything with great intensity.  His fifth temperamental trait is high intensity.

High Activity + High Approach + High Distractibility
+ Low Sensory Threshold + High Intensity

Charlie feels and experiences everything deeply.  When he's happy, he's overjoyed, ecstatic, and jubilant.  When Charlie and another person, Samuel or Aliya for example is having fun with him, it's great for everyone.  Peers and teachers love his passion, enthusiasm, and positive energy.  Samuel who is also a high intensity person is an exuberant play buddy when they are in sync.  Usually Charlie's positive intensity is manageable for Aliya.  However, when he's down, he's sad, distraught, and devastated.  When he's angry, he's furious, enraged, and nuclear.  Managing Charlie is difficult for anyone when he is in a negative mood because it is automatically an intensely negative mood often with matching intense negative behavior.  He's seldom a little upset.  Zero to sixty in seconds, he usually goes immediately to furious.  The volume of his feelings is stuck on high and no matter what emotional station he is tuned to, it will be intense.  His high intensity trait makes him a really fun guy when fun is happening, and a really miserable guy when things are not going his way.  Other people normally either really like him because he is so passionate, or really dislike him for the same reasons.  When high activity, high approach, and high distractibility overwhelm his low sensory threshold, he gets bothered.  Because of his high intensity, he gets bothered a lot!  And, since Aliya and Samuel also have high intensity, everyone in the family gets ballistic when bothered.

Since Charlie is bothered by all the stimulation, it would seem that he would know to just let it go.  Stop.  However Charlie's sixth temperamental trait is high persistence.  

High Activity + High Approach + High Distractibility
+ Low Sensory Threshold + High Intensity
+ High Persistence

Even though he gets overwhelmed and is deeply agitated, Charlie will continue with the same activity or behaviors that are agitating him… and others.  He is naturally persistent and has great difficulty letting go of his behavior.  Metaphorically, despite shooting himself in the foot with his behavior, Charlie cannot stop pulling the trigger.  "Stop it!  Just stop it, Charlie!"  If he were self-conscious enough, he would reply, "I would if I could, but I can't!"  Samuel in fact is highly persistent as well.  They are both significantly more persistent than Aliya.  It often works well for both of them.  For Charlie, being persistent is just what he does.  Often he gets his way by being relentless and wearing Aliya down.  Samuel sees himself as being tenacious and determined, but Aliya sees him and Charlie as stubborn.  Unfortunately, teachers and peers often think Charlie is stubborn too and a bit of a pain.  When any two of the three family members butt heads, the other antagonist accuses Charlie or Samuel of being stubborn.  High persistence has served Samuel very well in many ways.  It has helped him overcome some learning issues.  Persistence makes him an effective problem solver at his business.  It helped him win Aliya's hand.  

His persistence can wear down Aliya as well.  Aliya feels she has to give in to them all the time.  She gives in a lot, but does so with resentment.  A logical self-examination would suggest that Charlie not persist with behavior that is not effective and brings him grief.  However, such self-examination would be developmentally precocious for Charlie making it presumptuous of adults to expect him to have such insight.  If he were to not persist, his energy, emotional, psychological, or social needs would not be addressed.  As Samuel has found in his work, persistence can be a productive trait.  However, persistence can cause one to be relentless and grind others to the point of exasperation.  Samuel has a second temperamental trait that differs significantly from Charlie's profile.  In addition to having a higher sensory threshold for tolerating stimulation, Samuel also has high adaptability in contrast to Charlie's seventh temperament trait of low adaptability.  Aliya falls midway between the males with medium adaptability.  Charlie's low adaptability interacts profoundly with his other traits to create a challenging temperamental profile.  Charlie's eighth and ninth temperamental traits are high regularity and a positive mood.   Charlie is essentially defined by his rating on the first seven of the nine traits:

High Activity + High Approach + High Distractibility
+ Low Sensory Threshold + High Intensity
+ High Persistence + Low Adaptability
+ High Regularity + Positive Mood

The seven traits as rated give a typical temperamental profile of the hyperactive child.  The ADHD diagnosis strongly correlates with the temperamental profile of the difficult child.  Charlie's challenging temperament in Chess and Thomas' and Turecki's model would be mitigated if the child were highly adaptable.  Low adaptability is a core trait of the difficult temperament.  Charlie's other two traits of positive mood and high regularity are not as influential to his difficulties.  Being upbeat tends to be positive in the face of adversity or stress.  Samuel had a positive mood as well, which was another reason they do so well together when in sync.  Aliya however has a more pessimistic mood which Samuel's mood counter-balances in the couple's dynamic.  High regularity causes one to gravitate to situations and circumstances and eventually, jobs or careers with steady predictable routines.  Unscheduled or unexpected changes tend to disrupt high regularity individuals.  Low regularity individuals can often tolerate more regular routines, but also tolerate, enjoy, and even thrive in situations, circumstances, jobs, or careers with fluid schedules, changing routines, and unpredictable demands.  Charlie's high distractibility creates challenges to his comfort with high regularity.  Being distracted towards something attractive can simultaneously pull him from the stability of routine.  This creates paradoxically fun and stress simultaneously.  Charlie does better when the household or classroom routine was predictable even though he would eagerly jump at new experiences.  In general, young children do well when teachers and parents provide predictable stability of activity and environments.  On this trait, Aliya temperament was well matched for Charlie's needs.  Aliya has high regularity.  Her job as the administrative manager was routine and predictably dull which suited her just fine.  Parenting classes validated Aliya's high regularity tendencies to provide routine for Charlie.  Home by 5:30pm, dinner at 6pm, bath at 7:30pm, in bed at 8pm, up at 7am, and out the door at 7:45am every weekday worked for her and Charlie.  One of her issues with Samuel was his willingness… even eagerness (low regularity and high approach) to break routine and go off or drag them off to some adventure.

Samuel's temperamental profile is very similar to Charlie's profile with its potentially challenging traits along with two key differences.  Samuel shares the seven underlined trait ratings with Charlie.  

High Activity + High Approach + High Distractibility
+ High Sensory Threshold + High Intensity
+ High Persistence + High Adaptability
+ High Regularity + Positive Mood

They however differ on two key traits.  These two differences (not underlined): high instead of low sensory threshold and high instead of low adaptability allow him to be fairly successful.  Samuel's high sensory threshold allows him to tolerate the high stimulation that sets Charlie off.  And Samuel's high adaptability allows him to look for, find, and activate alternative solutions that his low adaptability step-child Charlie never sees.  Samuel's high adaptability has enabled him to get into and get out of numerous difficult situations all his life.  As a result, he is not risk-aversive like Aliya, but enjoys the thrill of the challenge.  This makes him more likely to be attracted to pushing the energy envelope and even creating mini-crises at home.  Adaptability ironically and Samuel's similar traits to Charlie make him almost as much a challenge for Aliya to live with as her child.  Aliya's temperamental profile could be Baby 19 as a grownup.  Despite other differences, Aliya shares similar ratings on certain key traits (the four traits underlined below) with Charlie.   These shared traits contribute to higher relative emotional reactivity for both of them.

Low Activity + Low Approach + High Distractibility
+ Low Sensory Threshold + High Intensity
+ Low Persistence + Medium Adaptability
+ High Regularity + Negative Mood

In particular, low sensory threshold causes both mother and child to be easily over-stimulated and high intensity causes both to be highly reactive.  However, Aliya's low persistence in contrast to Charlie's high persistence would cause her to be more likely to give up before finding success dealing with stressful situations.  Repeated failures as opposed to Charlie and especially, Samuel being more successful (including wearing Aliya and others down) would also accentuate her negative temperamental mood.  As a result, while Charlie can be fairly emotionally reactive, Aliya is more severely emotionally reactive than anyone else in the family.  She is more vulnerable to frustration temperamentally.  As noted earlier, other temperamental differences make her even more likely to be frustrated.  Her low activity level creates challenges for her to keep up since both her husband and child are much more active than her.  Low persistence would mean that highly persistent Samuel and Charlie almost always outlast her in conflicts.  Conflict between her and either of them occur when their high approach goes against her instinct to low approach.  Aliya's temperament is regularly activated by their behavior.  With temperamentally different family members, Aliya's overall temperament could otherwise make her relatively easy to live with.  For example, if Charlie were less active and persistent, there would be fewer battles between them.  If Samuel weren't so high approach and active, she would not be so stressed about being pulled into things she's reluctant to explore.  She wouldn't be restraining him as much either.  

Since everyone in the family has high distractibility, everyone is challenged to stay on task when there is family chaos.  Charlie and Aliya tend to get bothered first because of their low sensory threshold, while Samuel is bothered little or not at all because of his high sensory threshold.  In fact, Samuel by himself or with Charlie's participation may be creating all the stimulation in the first place.  When emotions run among the members of the family, it runs with the high intensity that they all share.  They are joyous together, deeply sad together, and adamant and enraged together, or at each other.  No pairing of members has lightweight fights.  Every argument tends to become a battle royale because of the heat that everyone brings.  Samuel and Charlie feel restrained by Aliya who is more cautious.  They also feels she's moody in contrast to their positive outlooks.  There are numerous other trait combinations that the therapist can examine to determine how this or another family interacts.  Shared traits may promote positive and negative compatibility for the same two people.  For example, two highly distractible people may delightedly wander and explore an interesting shopping district, and be the worst possible study partners continually drawing each other's attention from homework.  

The therapist should also look at differing ratings on the same trait.  Oppositional trait tendencies would likely lead to contrasting approaches to the same situation.  Two people sharing a trait rating that is different from a third person's trait rating are likely to align and engage in behaviors that naturally exclude the other person.  The therapist should also look for pairing of traits that predict behavior.  For example, high persistence and low adaptability together prompt repeated and fruitless attempts to resolve problems the same way over and over.  High approach and low adaptability together predict ease in initial transition with a later period of discomfort.  If one individual has both higher intensity and higher persistence than the other person, the first individual is probably going to win all the battles.  The first individual wins because he or she brings more heat to the battle (intensity) and more stick-to-itiveness (persistence).  The other person's lower intensity and lower persistence has little chance to endure the temperament traits onslaught.  He or she loses no matter the logic of the argument, and is likely to hold resentment against the first individual.  Accumulated wins can become a pyrrhic victory as accumulated resentment eventually results in catastrophic relationship retribution.  Temperamental evaluations can guide the therapist to logical interventions for specific traits rather than generalized interventions; and normalize, rather than pathologize behaviors and individuals.

ADDRESS:
433 Estudillo Ave., #305
San Leandro, CA 94577-4915
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
CONTACT INFORMATION:
office: (510) 582-5788
fax: (510) 889-6553
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