Pathways and Triggers Brought to Life 55please. Helen’s piano teacher observed that Helen tended
to become easily frustrated and often balked at trying
new pieces of music. Her second-grade teacher reported
that Helen had a tendency to grumble when new lessons
were introduced. Psychoeducational testing indicated
that while Helen was above-average in intelligence, her
expressive language skills were delayed. (If you’re think-
ing, based on the above information, that the language
and cognitive flexibility pathways might be coming into
play, you may be on to something!)
In one of their early meetings with Helen’s therapist,
her parents recounted one of her explosions during the
previous week.
“On Tuesday, Helen told me she’d like to have chili
for dinner the next night,” recalled her father. “So, on
Wednesday afternoon, I left work a little early and made
her the chili she had asked for. When she got home from
swimming late Wednesday afternoon, she seemed a little
tired; when I announced to her that I had made her the
chili she wanted, she grumbled, ‘I want macaroni and
cheese.’ This took me a little bit by surprise, since I
know she really loves chili. It was also a little irritating,
since I had put time into doing something nice for her.
So I told her she would have to eat the chili. But she
seemed unable to get macaroni and cheese out of her
head, and I continued to insist that she eat the chili for
dinner. The more I insisted, the more she fell apart.