The Designated Patient

Psychotherapists sometimes talk among themselves about the phenomenon of the “Designated Patient.” Parents will bring a child in for therapy, and before long the therapists realize that the entire family is dysfunctional, and the child’s problems are just a function of the larger family environment. But the other family members can deal with the situation only by conceiving of that particular child as the one with the mental health problem—the Designated Patient. “If that kid gets squared away, the family tells itself, everything will be great,” one therapist writes. “It’s that kid who has the problems, not us.”

It seems to me that education has become the Designated Patient in this country. Poverty, decreasing social mobility, the persistence of racial prejudice, the concentration of wealth and power in fewer and fewer hands—those aren’t problems we can face. But if we could just get those standardized test scores up . . .

In the classroom, the Designated Patient is the kid who can’t sit still and be compliant. Never mind what the classroom environment is like, or how realistic and age-appropriate the expectations are, or how unengaging the curriculum is, or how little recess or lunch time the kid gets. Something’s wrong with that kid, and the school’s job is to fix him.

At least in psychotherapy, the designation of one person as the “patient” sometimes succeeds in giving the rest of the family a face-saving way of getting the therapy they need. If only the same were true with education.

Related post here.
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