Intellectual disability is a developmental deficiency in which intellectual function is lower than average. This deficiency creates a significant delay in development, which includes difficulty in acquiring learning skills, communication skills, and the skills required for everyday activities. There is no doubt that emotional development is also affected by these difficulties.
For years, people with intellectual disabilities have been seen as unsuited for psychological treatment because of their lack of profundity and introspection, which are necessary for the therapeutic process. Intellectual disabilities is seen as an organic deficiency that cannot be changed, and therefore no real attempt has been made to understand the emotional dynamic of these children and adults, and observe the developmental, psychological, and social aspect of their experience. Very little is written in the professional literature about the emotional world of the person with intellectual disabilities, and the possibility of emotional therapy for children and adults with cognitive impairment.
In recent decades there has been a certain change with regard to therapeutic work with patients with intellectual disabilities, and various psychological characteristics typifying their experience and inner world have been highlighted. Among these characteristics are, for example, difficulties in early childhood related to problems with the ability to communicate emotionally with their parents, the formation of an experience of insecurity and anxiety, and difficulty in developing the capacity for play and symbolic thinking. All these affect the ability to achieve separation from parents, delay growth and independence, and make it difficult to cope with various life situations.
Another significant difficulty in the emotional development of the child with intellectual disabilities is the difficulty in developing a sense of self – the sense that the child has of himself as having intentions and desires that belong to him and come from him, and of being a single organic entity that has continuity. The feelings of efficacy, self-esteem, and self-confidence are built onto this sense of self. Because the child with intellectual developmental disabilities lacks this initial “equipment”, these feelings develop slowly and imperfectly. In emotional terms, a person with intellectual disabilities is forced to cope with an environment that changes too quickly for him, without having effective tools for coping with this reality. These hard-to-handle situations are liable to become painful and overwhelming, and sometimes the person will try to protect himself from the pain by exacerbating his confusion, lack of comprehension, and absence of thinking, and as a result will behave in an even more regressive manner.
Today we know that emotional therapy, even for children and adults with limited cognitive capacity, can make it possible for them to give space to and acknowledgement of their pain, and help them express difficult emotions of anger and frustration. It is also possible to help the patient recognize these different feelings, and help him to accept himself as he is.
The daycare centers at Beit Issie Shapiro are attended by toddlers and children who have been diagnosed as having intellectual developmental disabilities. From my experience with these toddlers, it is of the greatest importance to provide emotional therapy even at this early stage. This therapy gives the toddlers a special opportunity to develop their sense of self and their ability to communicate. It is noticeable that support for the development of these feelings helps them with their organization and their availability for new learning, and with establishing an experience of significance and intention.
Children and adults with intellectual disabilities usually have a good ability to make and enjoy connections, and emotional therapy, based on a long-term therapeutic connection, has a real potential to help and promote these patients.