When Your Child's Exceptionality is Emotional: Looking Beyond Psychiatric Diagnosis

By Barbara Probst.

When people think of a twice-exceptional child, they usually think of someone who’s gifted and learning-disabled. The “second exceptionality” is typically an educational issue like dyslexia, or sometimes a physiological issue like sensory integration dysfunction. In other cases, however, a child’s second condition is said to be emotional, social, or behavioral. These are the children described as hard-to-manage, badly behaved, or just plain odd – despite, or perhaps because of, their high intelligence. They may even receive psychiatric diagnoses like Attention Deficit/Hyperactivity Disorder (AD/HD), Asperger Syndrome, or Bipolar Disorder. But do these difficulties merit psychiatric diagnoses? Are they disorders, or are they misunderstood and mismanaged aspects of giftedness? Perhaps your child does have a serious emotional disorder; if that’s so, then minimizing the problem may prevent him from receiving much-needed help. On the other hand, perhaps your child’s differentness has been pathologized – that is, turned into a disease; in that case, he may suffer unnecessary damage in the effort to fix what isn’t really broken. As a caring and concerned parent, how can you tell which it is? How can you distinguish difference from disorder, especially in gifted youngsters?

To explore that question, we’ll examine aspects of giftedness such as Dabrowski’s five overexcitabilities; explore how traits of temperament, as they manifest in gifted children, can lead to social and emotional difficulties; deconstruct some common diagnoses to see how difference is turned into disorder; and suggest strategies to reduce emotional overload and bring problems to a sub-threshold or manageable level.

Dabrowski’s Overexcitabilities

Kazimierz Dabrowski, a Polish psychologist and psychiatrist writing in the 1960s, developed a theory he believed could explain the intensity, sensitivity, and unusual behavior of gifted individuals. He identified five overexcitabilities – heightened responsiveness to specific kinds of stimuli – that he felt characterized gifted children and influenced their behavior. Though not widely known, his theory is worth examining because it can shed light on how giftedness interacts with, or is transformed into, disorder. These overexcitabilities follow.

1. Psychomotor. In Dabrowski’s model, this is more than just an abundance of large-muscle physical activity. A child might not race from room to room or jump on furniture, but express psychomotor excitability by rapid speech, nervous habits, restlessness, and difficulty quieting his mind in order to sleep. Like every excitability, this isn’t necessarily something negative; it can also be the source of a child’s boundless energy and stamina. Often, however, a gifted child with psychomotor overexcitability is mislabeled with AD/HD.

2. Sensual. Heightened sensitivity to sound, light, touch, texture, or smell can also be viewed in two ways: as a difficulty (the excessive sensitivity associated with Sensory Integration Dysfunction) or as the capacity for esthetic appreciation. In a supportive context, a child with sensual overexcitability may find a life of passion and artistic engagement. In an environment lacking sufficient stimulation or, conversely, with too much competing stimulation, the same child may become anxious, irritable, withdrawn, or even explosive. The mismatch between temperament and environment is the source of the difficulty – not an inherent defect in the child.

3. Emotional. Once again, this overexcitability can be easily misunderstood. The emotional instability of a child with intense highs and lows may be seen as evidence of immaturity, bad upbringing, or even a serious mood disorder – but it might be none of these. In particular, adults need to be very cautious before assuming that emotional swings represent a psychiatric condition like Bipolar Disorder. With emotional overexcitability, there’s a greater responsiveness to actual stimuli (including thoughts and memories); even if the responses seem excessive, they’re responses. With a condition like Bipolar Disorder, on the other hand, the emotional swings follow their own rhythm and aren’t always connected to objective events.

4. Imaginational. This overexcitability is characterized by vivid dreams, creativity, love of fantasy, and inventiveness. Here, too, traits that might seem indicative of AD/HD or even a delusional disorder (requiring treatment) can also be seen as talents (requiring expression). Gifted children who become lost in a fantasy world or insist on peculiar interpretations may become poets, artists, or inventors. If outlets for expression are denied, however, they may develop problems like anger or depression.

5. Intellectual. Dabrowski’s fifth category is the one most typically associated with giftedness – an insatiable appetite for questioning, discovery, finding answers, and solving puzzles. Such children can seem annoying or arrogant, and their stubborn individuality can be misperceived as defiance toward authority or indifference to social context. They may be caricatured as “little professors” or, if their intellectual drive is focused on a narrow or esoteric subject, labeled with Asperger Syndrome.

While Dabrowski’s theory of overexcitability hasn’t been subjected to rigorous study, it does present an intriguing approach and raises important questions about the origin of emotional disorders in gifted children. Identification of the specific overexcitability at the root of a child’s behavior can be a productive first step.

Traits of Temperament

Another useful framework for understanding the behavior of gifted children is temperament. Temperamental traits are found in everyone, of course, but can manifest in particular ways in gifted individuals. If these traits are misinterpreted (e.g., if a highly idealistic child is rebuked for being “critical”), two kinds of problems can result. First, the child may receive pejorative labels because adults assume that the behavior reflects an anti-social motive or even a pathological origin; and second, other problems like anger, withdrawal, or low self-worth can result. After all, who wouldn’t become upset in the face of chronic misunderstanding, frustration, criticism, and isolation?

Traits of temperament that may contribute to emotional or behavioral pro