PSYCHOLOGICAL EVALUATION
PATIENT: Nathan Green
AGE: 9

PRESENTING PROBLEM: mother and father. They were concerned about their son's emotional outbursts, crying, temper tantrums and his sensitiveness of criticism.

EVALUATION: Nathan presented himself as an anxious, somewhat frightened child. He appeared nervous, high strung, somewhat compulsive and driven. His affect was appropriate and he was oriented in his environment. He appeared to be a healthy well-developed nine year old child. He currently is exhibiting the following symptoms: stomach pains, temper tantrums, crying, passive-aggressive behavior, stubborn behavior, difficulty following directions, and irresponsibility. He described home in the following manner. Dad is absent at work a great deal. He is sometimes angry at Nathan about school and encourages him to work at his tasks. Mom is described as loving and supportive but also quite anxious about the progress of his studies. He feels a great deal of pressure to study and has difficulty relaxing and playing at home. He prefers his grandmother's home where he can be a child.

He describes significant stress relating to school. He describes getting excellent grades in all subjects and appears content in them except for his social studies class. He feels that the teacher is mean to him. He describes incidents in which he is embarrassed and held up to ridicule from his classmates. This causes him a great loss of self-esteem and engenders significant hostility toward his teacher and especially toward himself. He describes feeling "no good" and "like a bum" when these incidents occur. He appears to be quite frightened of this teacher and is desperate to please her. It seems he has been unsuccessful in this task. He has indicated to me that when he does not perform adequately, he is singled out in the class, told to stand in the corner and if he shows feelings she says mockingly "poor boy, poor boy". At this point the children in class laugh. He said that the teacher holds his work up to the class and says "look everyone, Nathan missed these" in a ridiculing tone of voice. He wants desperately to please his parents and teachers and is filled with self-hatred and frustration that he cannot find favor with this teacher.

His parents reaction to this problem is to encourage him to study longer and harder. His father lectures him on his failure to perform and his mother cuts his play time short so he can study. While these reactions seem reasonable on the surface they only increase the problem. This child is in such a highly pressured environment that increasing any pressure or demands on him only decreases his performance. This appears to be the main problem in decreasing his performance in class. As his performance fails to live up to the teacher's standards, she applies more coercive and repressive measures to increase his motivation. But in fact, this only decreases his performance further. The same is true at home. As his parents place more demands on him for performance he becomes frightened, and extremely anxious. His concentration decreases as his anxiety level rises.

My evaluation indicates that his relationship with his social studies teacher is extremely counter-productive. Her behavior toward him is coercive, degrading, humiliating and extremely destructive. It would not be too strong to say that her behavior constitutes abuse. It is developing in Nathan, intense feelings of hostility, revenge and self-hatred. This child will most likely suffer long term psychological damage as a result of his relationship with this teacher. His parents can mitigate some of this damage by reducing the pressure on him at home. The responsibility for this problem cannot be placed on Nathan but must be placed squarely on this teacher's behavior toward him. As long as he feels responsible for the abusive behavior he receives, his self worth will suffer.

I recommend that he be removed from contact with this teacher on a permanent basis. The less contact he has with her, the better for him. I further recommend that his parents reduce the demands for performance that they have placed on him.

Please call if you have any questions or if you feel I can be of further help in this matter.

Yours,
George Smythe, Ph.D.
Licensed Clinical Psychologist