therapist work with parents

As a child therapist one of the delights of my work is to be able to work with parents.  Sometimes, I work mostly with the child, and meet with the parents once every month or every other month. Sometimes, I work mostly with the parent, and meet the child only on occasion.  And sometimes I never even meet the child, I just meet with the parents.  

This all depends on the specifics of the situation, and of who wants help. Is the child suffering, and wants he or she help, or is it more the parents who need the help? To find the right modality or way to work might take a couple meetings.  But the multiplicity of also indicates that there are different ways of bringing change about.  Not all the players need to be necessarily involved.  However, the work will go much faster if there is a willingness of the parents to also be engaged when the child is brought to therapy.  It is not a prerequisite, but it is helpful, and allows for change in both parent and child, enhancing the therapeutic outcome. 

Sometimes there is an initial reluctance for parents to come talk, as they have the hope that the therapist will 'fix' their child.  Or they feel that by talking about themselves in connection to their child they implicitly acknowledge that they might somehow be implicated in their child's problems. 

One of the delights for me of working with the parents is to see how their  perception of the child's problems changes. Initially they come in focused on the problem behaviors, and on how to remove those behaviors.  However, as the work continues they start to see the behavior not just as a problem that needs to be suppressed but as a language of their child, as an attempt of their child to express something of their very being that they want to see recognized.

I think of the mother who was concerned about her son hitting and kicking her. She would consistently draw the line, and give him a consequence. However, the behavior did not subside, and the anger of the boy seemed to increase.  As I was listening to the mother I noticed that she was doubting the way that she was intervening with her son, she felt that the way she was drawing the line also implied her 'ignoring' him.  As we thought about it together it appeared that the mother was encouraging her son's behavior implicitly as she was not really listening to what was going on in the son, beyond his behavior.  She 'ignored' where his frustration was coming from. Not being listened to, being ignored made the son feel powerless, and encouraged his 'acting out' of hitting.  The mother came to the realization that there is a balance to be maintained between drawing the line, which she was naturally good at, and allowing room, recognizing where her son is coming from, creating a space for him.

Parental Guilt

Child therapists often deal in their work with parents with the parents' feeling of guilt. Parents might feel that they have made mistakes in the early years of child rearing. They feel that the opportunities are missed and that it is now 'too late.'  It is true that a child's character is formed by the age of 6, and that this character is shaped by the type of relationships this child has had.  But this does not mean, if these early relationships were difficult that the child will necessarily suffer or be 'damaged.' 

The important thing is not to try to compensate for what did not happen in the past now.  What has happened, has happened. It would be much more important for the parent to talk to the child about it. The parent could tell the child that she realizes that she might have maybe done too much for the child, and not have left enough room for the child to make her own mistakes.  She can say to the child that she wanted to give the child everything she did not have as a child, and was maybe too 'giving,' and maybe smothering.  That she realizes that her child will have to find her own way, separate from her, that she cannot keep holding her hand. That part of her wished maybe that she could keep holding her hand, but that she also feels how important it is that her child can go her own way, and how proud she is of that as a mom, and that she can trust that the child can go her own way.

Or in the other direction: it would not make sense to starting to feed a 9 year old the bottle because the parent realizes that he was maybe not feeding the baby enough bottles when he was a baby. Although there are certain kinds of therapy that focus on compensating for what is missed, on closer investigation it is much more the symbolic dimension, the ability to symbolically work through the early trauma which is the healing factor.

In this context I also think of the young mother of a 15 month old child, who is prone to arguments with her spouse.  Although she tries to change this, the urge to argue is sometimes so big that she cannot resist.  After she got in a big argument in the presence of her son with her spouse she apologized to her son, and talked to him on how she was working on this issue.  She was surprised how attentively her son was listening to her as she was talking to him 'heart to heart.' Admitting our mistakes to our children in a genuine way, talking to them truthfully, in an open way, is a powerful tool that can mitigate possibly traumatizing experiences.

If you want to talk to a therapist,  call An at (530) 321-2970

My Child is lying!

As a child therapist I often have parents express their concern about their young child lying.  This 'lying' can take on many forms, and there is nothing that we can say 'in general' about lying, We have to look at very concrete examples to explore why the child might be lying.

However, when the child is still quite young, what parents perceive as lies are often just fantasies, myths, inventions. There is no point in treating these fantasies as lies and in reprimanding the child for them.  These are poetic inventions originating from the child's imaginary. Children, just like adults need this poetic dimension in life: As we have so little power, are so limited in our human lives, we like to imagine ourselves capable of realizing what we cannot do or have.  Those fantasies have the same status as an adult reading a novel, or watching a TV show: they are not true, but they are important in our lives. Reprimanding a child for these kinds of fantasies would be the same as reprimanding someone to read a novel, because why would you read something that is not 'real.' 

It could also be that the child tells a lie to contradict or get a rise out of the parent. Maybe the child has never had the ability to contradict the parent in play, in a 'pretend mode?' Better to treat these lies with a sense of humor. The child might be tricking the parent, enjoying the power of not complying with the parent, having his own little secret the parent does not know about...In any case, it is always important to explore why the child thinks lying is so fun.  It is crucial to try to understand where the child is coming from, rather than get upset and angry with her, as this is counterproductive. This is especially the case if the child tells a lie to get out of trouble.

Children often lie when they feel guilty.  Forcing the child to admit that he or she did the wrong thing, for example by saying: 'You won't get in trouble if you admit it,' misses the point.  If a child did something harmful or hurt another child the goal would be for him or her to be able to take responsibility for this act. Rather than forcing the child to admit the truth, you will move him more towards being able to take responsibility, according to Dolto, by talking to him like this: 'These are your hands, and your feet, but it was not you who wanted to hit the child; I know that sometimes the hands and the feet do things, that the head does not want them to do.' You are more likely to move the child towards taking responsibility like that. 

When a child is not able to take responsibility for his act that is fine. This cannot be forced, better to talk, and dialogue about it. In this case Dolto mentions the following possible interaction:

Parent: 'I see that you are too ashamed to admit. You are right, but please, don't do this again.'

Child: 'But I did not do it!'

Parent: 'I believe you. What is done is done. Let's not talk about it anymore, but know that even if you did it, I love you and I trust you: and if you did not do it, please excuse me for having suspected you.' 

I agree with Dolto that this is a better solution than creating a big drama.

To schedule an appointment with An call: (530) 321-2970

How long will my child need therapy?

In my practice I often get the question how much therapy it will take for a child to get better. The unsatisfying answer to it is that 'it depends.' 

A very young child that is brought in when he or she has not been struggling for a long time can improve quite quickly within a time span of 6 to 8 sessions.  A child that is in the later years of elementary school, junior high or high school and has been struggling for quite a while might take a longer time. In those cases it might be unrealistic to expect that a couple sessions of 'talking' will bring about the hoped for change.

Sometimes, there are dramatic improvements after the first couple sessions. This might cause optimism in parents and they might feel like they can end the treatment right there and then. However, too much, too soon, might be something to be suspicious of. It is likely that the child is feeling somewhat anxious about the treatment and is trying his best to be 'good.' It is important to have the time to explore this, and to not cut the treatment short too soon.

Children (and adults) can start to change quite quickly and typically after about 6 months of consistent therapy you will see some substantial change. Unfortunately, a lot of parents want to stop the treatment as soon as the symptoms that bother them disappear.  However, to the work of therapy there is an internal logic, and it is important to complete this work. Rather than having the parents decide when to stop the work, it is important to take the child's wish into account.  If the child is not ready, the work should ideally be continued.  

Just as the child should be the one ending the treatment, he should also be the one that wants to enter it. It might take several sessions to explore whether the child wants to come talk for him or herself. If not, it could be helpful for the parent to talk in the presence of the child or even without the child being present. Therapy cannot be forced.  

To schedule an appointment you can reach me at (530) 321-2970

Reflective vs reactive parenting

​This is an older but still interesting post on 'reflective' parenting from Psychology Today.  Reflective parenting helps parents to 'reflect' on the intentions, thoughts, desires, goals... that are motivating their children's behavior. A parenting approach that takes this reflective stance, rather than reacting to the behavior without considering what might be behind it, is proven to improve the parent-child relationship: it leads to an increased sense of connectedness between the parent and the child, and helps the child regulate his or her emotions and behaviors better.  In this approach it is not crucial that you come up with the right reason underlying your child's behavior. As the mind of another person, and also of your own child, will always remain to some extent opaque, this approach implies that it is not crucial to find the the exact right motivation of your child's behavior.  More important is to have the reflective, wondering stance towards your child's thoughts and intentions.