When the Lens Changes: Why Diagnosis Doesn’t Make Parenting Simple

One of the most common internal struggles I hear from parents adjusting to their child’s diagnosis is the tension between what they are gradually coming to understand about their child’s behaviour and difficulties, and the natural, intuitive and often rational interpretations that continue to drive their moment-to-moment parenting instincts and responses. This process often unfolds gradually and non-linearly over many years. A diagnosis can support a family’s understanding of a long-standing pattern of behaviour in their child, and often comes with a complex co-existence of emotions ranging from relief, understanding and hope to anxiety, uncertainty and grief (for a version of the future the family had grown attached to, not for the child themselves).

This increasing understanding often drives a parent into working towards providing more regulated, flexible and skilful responses to behaviours that once triggered confusion, frustration and fear. It also often leaves a parent feeling a disconnect between the dysregulated responses they provide when their child’s behaviour triggers those latter emotions, and their newfound understanding of what their child needs in these flashpoint moments. Take a common example discussed in my consultations:

Mia, a young girl recently diagnosed autistic, got in the car after school irritable and dysregulated; she was intentionally stirring her younger brother in the back seat, pushing his buttons until he snapped at her. Then, she ‘burst’, and all of her emotions started flowing out. Cathy, trying to focus on driving, feels overwhelmed and frustrated.

Prior to a diagnosis, many families struggle to understand why their child often acts this way immediately after school. The behaviour seems intentionally provocative, and counter to the values the parents are trying to instil in their kids for the future. In learning more about autism, Cathy has come to learn more about Mia’s difficulties navigating the significant social and sensory demands of her school environment, the cognitive fatigue she experiences in wearing the ‘social mask’ day-in and day-out, and the emotional outpouring she experiences as she gets in the car and is finally around people safe enough to take the mask off.

Cathy has intentionally tried to use her increased understanding to respond more flexibly when this happens. She’s made efforts to reduce the sensory inputs for Mia in the car, she’s spoken to her son about trying to cope with Mia’s afternoon moods, and she’s opted to give Mia space instead of going straight into questions about her day. She prepares herself to stay calm and focus on driving safely irrespective of what is happening in the back seat, knowing that her frustrated responses often only make the situation worse for everyone.

We all vary in our inherent capacity to tolerate strong emotions before they start to ‘drive’ our behavioural responses. Cathy is working on this in herself, both for herself and for her family, but sometimes that emotional threshold is reached. A parent in Cathy’s shoes will often come into consultations and say things like:

“I know she’s overwhelmed, but it still feels like she’s choosing to make everyone else miserable.”

“I understand it differently now, but in the moment it still feels like bad behaviour.”

“I know she needs calm from me, but sometimes I’m already at my limit.”

“It feels like all the understanding has to come from me.”

“I know there’s a reason for it, but it’s still exhausting to live with.”

A common feature of human cognition when strong emotions are triggered is that our thinking becomes less flexible, more black-and-white, and our assessment of a situation or circumstance becomes less nuanced or balanced. In the same way that a person having an argument with their partner might ruminate on thoughts of ‘they don’t love me anymore’, or a professional receiving negative feedback at work might conclude ‘I’m about to lose my job’, a parent confronted with their child engaging in dysregulated behaviour will often move into similarly catastrophising thought processes.

As for anyone learning to cope with a situation or circumstance that consistently pushes them into strong and challenging emotional states, the goal is not to learn to disregard these emotions, which communicate to us important information about what we’re confronted with. Instead, the goal is learning to sit with these emotions, understand what they’re telling us, and find ways to build more flexible perspectives when the emotional storm arrives. Where the person arguing with their partner might learn to see their fear of being unloved as their emotions communicating the importance of their relationship, and balance their black-and-white rumination with the more adaptive and flexible thought, ‘this conflict feels painful because the relationship matters to me, and one difficult argument does not mean the relationship is unsafe or unloved,’ the parent can learn to approach their child’s behaviour in the same way: ‘this behaviour feels overwhelming because I care about my child and our family, and my child can be struggling while the behaviour still needs support, boundaries and repair’.

If behaviour is the physical by-product of how we think and feel, the reframing of such a black-and-white way of thinking into a more dialectical one (meaning to hold two seemingly opposing truths at the same time, rather than reducing a situation to one side or the other) often allows a parent to respond in greater alignment with the broader understanding and context that has come through the process of learning about their child’s diagnosis. The capacity to intentionally form dialectical thoughts through increasingly overwhelming emotional states is a critical aspect of self-regulation, which, when practised over time and displayed by a parent, serves to model the flexible behaviour they seek to instil in their child who is struggling with their own emotions.

This concept of dialectical thinking is a particularly critical skill when considering the commonly reported dilemma of parents adjusting to their child’s diagnosis. On the one hand, the increased understanding of the underlying factors contributing to particular challenging behaviours that can come with a child’s diagnosis can draw a parent towards wanting to be more flexible, less reactive, more compassionate and less punitive in the moment. On the other hand, parents grapple this against their own experiences of being parented, where ‘bad’ behaviour necessitated consequences, and their desire to not reinforce such behaviour through lenient, weak, or permissive parenting. This inner conflict forms a common tension within the diagnosis adjustment period, and is particularly amplified when two parents vastly differ in how much they subscribe to either side of the debate.

At the core of dialectical thinking is the knowledge that two statements or beliefs that may seem opposite by nature can both hold important truths at the same time. Whilst compassionate and flexible parenting might seem inherently in opposition to consequences and negative reinforcement of behaviour, in reality, the truth that lies in both simultaneously will often be what reconciles this parenting dilemma and guide a parent towards the most skilful and values-aligned version of themselves.

I can understand why my child is struggling, and still hold boundaries that help them learn.

I can see my child’s behaviour as communication, and still respond in ways that teach responsibility and repair.

I can be compassionate towards my child’s difficulties, and still help them face the natural limits of the world around them.

I can lower demands when my child is overwhelmed, and still keep moving them gently towards growth, independence and resilience.

In reframing the thoughts that arise during challenging and tense moments into such dialectics, a parent can position themselves to respond with balance, recognising the value and truth on both sides of the coin. Not only do responses guided by these kinds of heuristics model self-regulation and psychological flexibility to the struggling child, whose difficulty across these areas often sits at the root of the behaviour being addressed, but it also often steers a family away from repeated crises and into stronger connection, collaboration and more effective boundaries.