DON’TS AND DON’TS

 

A significant part of working with children involves working with family systems, and in community mental health, that often means contending with inter-generational trauma. I don’t think anything could have prepared me for the reality of that; I, under excellent supervision, expend a lot of mental energy trying to factor caregivers’ own personal issues into their choices with kids, adapting my message to what they can hear and take in at any given time. After all, if caregivers feel criticized, the likelihood of their support for therapy drops significantly, and change is unlikely to happen. Sometimes that means trading no change at all for painful slivers of increments. And sometimes, let me tell you, that trade becomes deeply sad and demoralizing. Like this month. Like this in-like-a-lion-and-the-lion-keeps-roaring March. I’m feeling spent by the effort of starting over every bloody session, and I just want to be mad and let it out. Indulge me?

If you are caring for a child who was born in withdrawal from drugs, abandoned, passed around, and abused in every possible way, and as a result lacks a sense of appropriateness and has a bottomless need for attention, please observe the following don’ts, in no particular order:

Don’t refuse to tuck her in because she hasn’t made her bed. Don’t deny her a birthday because you don’t like her behavior. Don’t send her to her room when she’s having a meltdown; don’t film her while she melts down further, desperate not to be rejected and alone. Don’t show the video to people and shame her. Don’t show the video to a therapist and expect sympathy for YOU, the person impassively holding your smartphone up while her struggle plays out. Don’t claim you’ve tried everything, because you haven’t if you haven’t rocked and cuddled her. Don’t expect her to act her age when that’s developmentally impossible. Don’t automatically take others’ word against hers, every time, not even teachers’; teachers see a lot, but not everything, and they aren’t always right. Don’t condemn her for craving electronics when you yourself bury your head in “Candy Crush” and other less important things when she’s trying to make eye contact with you. Don’t justify that by saying that she always wants attention. Don’t reject the games she likes to play with you. And speaking of games, don’t show mercy to other players but gloat (“Ha-ha!”) when you get her out, thinking you’re teaching her a lesson about fair play because, you say, that’s something she’s done. Don’t tell her it serves her right if she falls because she sat on a chair the wrong way. Don’t tell her she can’t have friends because she doesn’t know how to behave. Don’t tell her teachers, in front of her, that she’ll try to manipulate their sympathy. Don’t say, “We love you, but.” Don’t say you’re thinking you might not be able to keep her. Don’t say 100 no’s for every yes. Don’t miss every single chance to validate what she’s feeling, even when her therapist has explained quite clearly, with relatable examples, that validation isn’t agreement. Don’t take her to therapy, an hour a week, no matter for how many years, and expect the therapist to undo the damage of life in an unloving home. Don’t blame the therapist for failing, when the therapist is working hard to help the child feel like she matters. Don’t tell the child in your care that your life is shitty because you’re caring for her.

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Sympathetic readers might appreciate the haunting song “Nearly Midnight, Honolulu,” by Neko Case. Thank you, Neko Case, for your vision and your songs. // I’m deeply grateful for my readers, and in 2018, I’d love to reach more. If you enjoyed this piece, please consider sharing it with anyone you feel might like it, too, by linking to it in whatever way works for you. I typically post once a month, so no barrage.

Out of respect for client privacy, names here are always changed or omitted, and details may be altered in fact while relevant in spirit. Text and image copyrights held by me. To subscribe and receive future posts, please look to the upper right on your computer screen, or scroll to the bottom of the page on your mobile device. “The Numbers Game” (July 2017), now long delayed, will be continued in a future post, when I have more stamina for the topic. Thank you wholeheartedly for reading.

USE WORDS.

 

So I work with kids. I work with people who work with kids. In my free time, I read books about working with kids. I don’t, however, always drink the Kool-Aid. For example…

There are few phrases I find more inherently condescending than “Use your words.” This expression, all too common in English, is intended as a prompt to children to choose prosocial ways to communicate their wants and needs. At the best of times (which is by no means all the time) I think it’s meant to be empowering, a kind of “Go, you!” coaching. Even where the aim is worthy, though, the method makes me wince.

No caregiver enjoys tantrums. Kicking, flailing, screaming, wailing—that’s misery for all concerned, including children themselves. Just as newborns feel safer when swaddled, children are significantly happier when they’re regulated, i.e., in control of themselves.

In community mental health—where so many of the kiddos we see start their lives already burdened with trauma—tantrums can be even scarier, leading to assaults and destruction of property. One little boy I know, in the midst of a recent fit, climbed to the top of a fridge to grab the butcher knife kept there and threaten his family.

When children have facility with words, not only are they better able to make themselves understood by others, but they are also better equipped to make sense of events and form lasting memories. Thus the importance of reading to and with children, and talking over events both before they take place (in preparation) and after (to create narratives).

It has been demonstrated through studies that children from variously disadvantaged backgrounds typically hear far fewer words a day than their more secure counterparts—yet another way that inequality is perpetuated, making social strata more difficult for some to climb. Literacy programs seek to work against that pernicious trend.

“Use your words” is meant to work against the trend of tantrums, storms of tears, sullen silences. Does it? I haven’t seen the evidence. I know I have a contrary, independent streak and tend to want to kick over any traces that harness me to someone else’s direction or notion of labor; but from my perspective, the expression feels more like an impatient, insensitive dictum from on high than like a loving and truly attuned and listening encouragement.

Anything can be co-opted; but think of the ease with which grown people say “Use your words” to one another, with the explicit intent of being snide. If I were still a child, I wouldn’t have the words to say how I felt about hearing that from an adult, but I know it would make me feel as though the person speaking were asserting an unwelcome and invasive authority over me. How do you know what words are my words? What does it mean that you know, when I apparently don’t?

Another way to think about it is that in saying “Use your words,” the adult is often (and often unknowingly) simply outsourcing the hard work of relating, to the person least qualified to do it. “Use your words, as I wash my hands of this.” If words themselves are the point, why not just leave it at that? Would that not suffice as a reminder? “Use words” says much better, “Remember there’s a tool at your disposal.” Adding that possessive pronoun just raises questions about what the hell is meant, and who really owns what.

From a neuroscientific perspective, a child in a tantrum state or weeping fit needs first and foremost to calm down physiologically; the brain is not capable of cool reason and logic in a heated HPA cascade. And the way to calm a child is to love that child in ways the child can feel—to be patient; to touch if touch is welcome (or required for safety) and give near and supportive space if it is not; to offer sympathy for the strong emotions, via reflective statements. Not only does this demonstrate concern, but it models the exact behavior that’s desired: the positive use of words to communicate during a difficult time. When adults use their own words in prosocial ways, children are more likely to do the same.

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Two excellent resources on working effectively with children are The Whole-Brain Child by Dan Siegel and Tina Payne Bryson, and How to Talk So Little Kids Will Listen by Joanna Faber and Julie King. I can’t recommend them enough!

Now: I’m deeply grateful for my readers, and in 2018, I’d love to reach more! If you enjoyed this piece, please consider sharing it with anyone you feel might like it, too, by linking to it in whatever way works for you. I typically post once a month, so no barrage.

Out of respect for client privacy, names here are always changed or omitted, and details may be altered in fact while relevant in spirit. Text and image copyrights held by me. To subscribe and receive future posts, please look to the upper right on your computer screen, or scroll to the bottom of the page on your mobile device. “The Numbers Game” (July 2017), now long delayed, will be continued in a future post, when I have more stamina for the topic. Thank you wholeheartedly for reading!

 

 

 

 

 

META ON METTA

 

The end of any year brings seemingly innumerable invitations to make financial pledges. This is not one such! It is a contemplation, rather, on the merits of taking the whole process of New Year’s resolutions one step further, by creating or adopting a meaningful philosophical pledge, for the coming year and beyond—a pledge that, like metta meditation, moves you to consider your own life and the life of the world through the same lens—then post it somewhere prominent where you won’t fail to see it. A dashboard could work, for those idle moments in traffic. The back of a smart-phone case, as a tactile reminder on an abstract medium. A few valuable inches on your fridge.

I do my damnedest, in this writing, to maintain a positive approach to the subject at hand; I could opine all day long, but the virtual world is full of tirades already. I also try to be simple and straightforward; there’s an overabundance of glib commentary. With the conscious effort that my approach can require, I help reorient myself toward my own higher ideals—of which I not infrequently lose sight in my day-to-day interactions. I mostly write about my therapeutic work; but I’m no plaster saint, to use an old expression. As a child, I was asked to suppress my anger, and it’s still coming out now—mostly in the form of outrage over this and that aspect of culture, all the grievous injustices of which I’m aware, but also things that hit close to home and close to the bone, failures of friendship and emotional betrayals.

So: New Year’s resolutions are all well and good—my default is “Write more; swear less”—but I also need something bigger, deeper, stronger. Something to help me face the daily challenge of living, above and beyond a singular achievement, however important. My very first client, at my first internship, helped me to realize this. Whereas I had grown up in a broken-down neighborhood in a broken-down city, she lived a semi-rural life and loved her chickens with every fiber of her beautiful being—knew their personalities and followed events in the pecking order like a telenovela. Together we worked on validating her negative feelings, so that instead of being suppressed, they might transform themselves and empower her.

Through her, I came to be aware of the 4-H pledge: “I pledge my head to clearer thinking, my heart to greater loyalty, my hands to larger service, and my health to better living, for my club, my community, my country, and my world.” I saw her living out those values in continuing to love those who had hurt her, despite looking with clear eyes at their flaws, and rising above the chaos she’d known at home. The first four assertions have spoken to me ever since, like a nondenominational statement of grace. (I have mixed feelings about that string of possessive mys, and those feelings amplify as the picture gets bigger. Whose world? Our world.) An even simpler distillation of values, which for me is supremely grounding, is posted above my desk at work, a reminder to me and my clients: Be curious.

In 2018 and thereafter, I hope that ecosystems will be protected and valued as sacred, and that workers will be fairly paid and treated. I hope the humble honeybee, with its staggering commitment to fructifying the earth, will survive colony collapse. I hope that the rights of women, and various vulnerable populations, will be recognized and upheld. I hope that buzz words like “slow food” and “slow fashion” will build up to full-on movements, and that the doomed cultures of Agribusiness and Big Pharma will fall. Food doesn’t come from factories, and answers don’t come in pills. I hope that we collectively will have the resilience to develop the patience to labor on toward real answers—many of which can be found in traditions whose caretakers are indigenous peoples. And, of course, I hope children grow up feeling safe, loved, and respected. So many visions and wishes for our planet. I’ll be doing my part as best I can. I share these thoughts today, in this quiet corner of the internet—deliberately free from the commercial intrusions of ads—as an act of loving-kindness: I wish good things for me, and I wish them for you.

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Out of respect for client privacy, names here are always changed or omitted, and details may be altered in fact while relevant in spirit. Text and image copyrights held by me. If you enjoyed this piece, I hope you’ll consider sharing it. To subscribe and receive future posts, please look to the upper right on your computer screen, or scroll to the bottom of the page on your mobile device. “The Numbers Game” (July 2017), now long delayed, will be continued in a future post, when I have more stamina for the topic. Thank you for reading!

 

GORILLA! BANANA!

 

Frank was twelve, and living with grandparents for the reason now so common here: his parents got caught up in drugs and abandoned him. He had a roof over his head when I met him, but still lacked nurturing. One grandparent was an alcoholic whose next bender would crash the family car; the other was a chainsmoker forced to drag an oxygen tank with her everywhere she went. She dragged it into my office, where she proceeded to carp and nag and bicker Frank into oblivion. No wonder his posture had become a slow slink off the chair toward the floor.

Caregivers can be the unwitting designers of psychological stress tests, their children the unfortunate test subjects. Frank’s grandmother had a habit of saying “No” that was so deeply entrenched, I seriously heard her once contradict Frank on whether the sun was shining. The acts of defiance for which he was brought to counseling swiftly came to seem to me like logical expressions of resistance, little signs of patriotic loyalty to his own nascent self. Did they make life harder for her? I’m certain they did. I’m equally certain things weren’t, at bottom, his fault.

When Frank and I spent time alone together, the handful of times they came in, I made it my business to say yes as often as possible, to affirm his playful nature by playing back. Silliness came easily because I felt I could see it nourishing him; even though I believe in the value of play, it’s harder for me to be silly when I don’t feel connected to the deeper reward, just as it’s hard for me in my personal life to make small talk unless I know Big Talk is also an option.

Late one afternoon, Frank threw himself to the carpet. I remember it being dark outside, so we must have hit Daylight Savings, that cold plunge. I don’t why, but instead of telling me about his day, he began calling out the names of fruit: “Apple! Pineapple!” So I also lay down on the carpet, at the little distance my office allowed, and began repeating after him. When he came to “Banana!” he exclaimed it while “jumping” a little, as if popping from a cartoon peel. So I did that, too. He did it again. I did it again. Then, in the middle of trading off, I sat up slightly, beat my chest, and said, “Gorilla!” And the game became Gorilla! Banana!

Thrilled by the sweet, spontaneous fun of it all, I later described the scene to a coworker at my night job. “Sounds like a drinking game,” was his reply. Which sums up quite a lot about quite a lot, including why I write. I need a place to bring my enthusiasms and my earnestness. Everyone does.

Another evening, Frank was in a soberer mood. I invited him to color in a heart with a color for each emotion he was feeling and proportional to it. The heart he filled in was one of overwhelming sadness, with cracks in it, but with love at the center. He shared with me a new prognosis for his grandmother’s health. We discussed it, and he decided to show his heart to her when she came in. What do you think she did?

She told him he was lying—lying, about his heart—and ought to own up to the truth, that he was only sad about losing time on his videogames, a consequence imposed for some misbehavior. What good would counseling do, if he was only going to mislead his counselor? He and his sibling had both had services off and on, with various providers and the same essential refrain. I barely got a word in edgewise; she let me get as far as validating her perceptions as such, but then no further. She rejected utterly the notion of his love.

As they left the session and walked down the hall, I called after him softly. He turned. “Gorilla!” I whispered, and beat my chest. He brightened, and popped like a banana in reply. That was a couple years ago. I haven’t seen him since.

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Out of respect for client privacy, names here are always changed or omitted. Text and image copyrights held by me. If you enjoyed this piece, I hope you’ll consider sharing it. To subscribe and receive future posts, please look to the upper right on your computer screen, or scroll to the bottom of the page on your mobile device. ***I’d like to put in a plug for Playful Parenting, by Lawrence J. Cohen, an inspiring book and enjoyable read.*** “The Numbers Game” (July 2017) will be continued in a future post, when I have more stamina for the topic. Thank you for reading!

 

(UN)PLANNED OBSOLESCENCE

 

“Therapy is not meant to last forever,” I tell my kid clients during our first visit. After inviting them to express their feelings about being brought to counseling, I ask them to think about how they’ll know when the work of therapy is done. What will have changed for them?

In asking this, I hope to empower them and shape our work according to their priorities, not necessarily, or only, those of their caregivers. After all, change requires buy-in. Simultaneously, it is my way of planting a seed for one of therapy’s most important flowerings: the good goodbye.

Everyone can expect to experience loss over the fullness of a lifetime; but childhood, for the clients we see in community mental health, can already be replete with losses both clear and ambiguous. Parents especially seem to disappear, in the county where I currently work—into jail, substance use, other towns and states, other relationships and families, mental illness, accidents, suicide, and even death by homicide.

Such loss is complicated in untold ways, with impacts on identity and self-esteem, attachment, concentration, decision-making, moods, stress, coping style, and the immune system. A positive therapeutic relationship, while not “fixing” all that’s gone before, can be a corrective experience, providing safety, reliability, tolerance and adaptability, support and regard, healthy boundaries, respect, and (crucially) warmth. I would contend that when therapy “works,” that corrective quality is the main reason why.

Bringing closure to all the relating that’s come before, the good goodbye is one that is anticipated, planned for, and—though there’s room for sad feelings as well—celebrated together as an accomplishment. I like to provide client-specific “transitional objects,” small items that can carry forward the memory and meaning of our time together. I’ve given skeleton keys, worry stones, figurines, feathers, memory books, and (so far) one mixed CD, all accompanied by notes or letters of congratulations. One spunky little girl I see has already requested brownies, though the end is not yet in sight; for a teen with a love of savory sweets, I made rosemary shortbread.

Needless perhaps to say, all this preparation is as much for me as for the client. I, too, experience some attachment in my work with clients, to varying degrees, and the good goodbye helps me to find closure for work that has impacted me as well. (In The Body Keeps the Score, Bessel van der Kolk espouses the belief that clients can’t grow and change if they can’t see their impact on their worker; I’m hopeful that my clients can see theirs on me.)

The good goodbye is also a corrective experience for me for other losses, both personal and professional—those goodbyes that never resolve. When denied it—when, as happened late this spring, a favorite client simply drops off the map, our work together feels as open-ended and prone to fraying as an unfinished hem. Though coached by colleagues to trust and let go, it is hard not to comb over my memories of our last visit, for possible clues. Did an errant remark cause pain or offense that the client or caregiver wasn’t comfortable addressing?

It’s impossible to know. Some clients aren’t good about calling under any circumstances, let alone the momentous ones that announce the end. My lost client had made radical progress—was he just doing well enough that he felt he was done? Although I give all credit to him and his mom, did disappearing feel necessary to him, in order to own his gains? Or could it be that a lack of experience with healthy endings might have caused him and/or his mother to dread the emotions of closure? When people protect their emotions, it is often (and often unwittingly, though not always) at others’ expense.

In any case, I send my best wishes to him.

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Out of respect for client privacy, names here are always changed or omitted. Text and image copyrights held by me. If you enjoyed this piece, I hope you’ll consider sharing it. To subscribe and receive future posts, please look to the upper right on your computer screen, or scroll to the bottom of the page on your mobile device. “The Numbers Game” (July 2017) will be continued in a future post, when I have more stamina for the topic. Thank you for reading!

FIGURINES & HIGH-FIVES

 

 

Ten-year-old Gertie was beside herself one afternoon early this summer, because her sister was joining us as her guest. The last time had been a year prior; Amanda, two years older, had held herself with impeccable posture and poise on that occasion, allowing an ironic smile to play about her lips as Gertie, exclaiming, attempted to include her sister in her favorite activities. By asking arch and pointed questions, Amanda called attention to the immature nature of Gertie’s play and undermined her confidence as host.

This summer, however, Amanda was generous with her younger sister. She treated her kindly and played by her rules. Gertie delighted in her directive role and soon had us closing our eyes while she buried objects in my sand box for us to find. Feeling around in the cool soft spill of near-white particles, we uncovered shells and gems and fake fossils, cars and keys, dice and a dog dish, various animals, and little painted baby figurines: crawling baby, sleeping baby, baby with a blanket. Then it was Amanda’s turn to hide objects for us; and to help Gertie manage her impatience, her inclination to peek, I suggested that we leave the room and skip up and down in the long hall until we were summoned. That, she seemed to love. Skipping became part of every spell of waiting, sometimes with me, sometimes with Amanda.

Later in the summer, Gertie and I were out for a walk around the grounds—if such a term can be applied to a vast sea of asphalt with a shoreline of rough grass and scrubby trees—when I learned that she had never played Follow the Leader. Therein was a golden opportunity to offer her a healthy, sanctioned chance to take charge, since her interactions at school tended toward bullying behavior. Abused and shamed as a younger child by those she used to live with, she was hungry for acceptance and had a history of forcing herself upon her peers, neither respecting boundaries nor taking no for an answer. Notably, when given the role of leader, she offered me turns unprompted—a sign to me that it was, perhaps, serving as a corrective experience.

Follow the Leader followed us indoors and took up where skipping had left off, as a way of extending play beyond my small square office and into the hall. We walked in slow motion, and backward, and bawk-bawking like chickens. Gradually, inexorably, this turned into running laps.

For an “office-based therapist”—my term of self-introduction when we interview candidates for open positions, of which there are perpetually many; more on that another day—I run an awful lot of laps. And I feel, in doing so, a vertiginous awareness of what it used to be like to weigh almost nothing, my childhood body so light that I could nearly fly. I feel this as kids fly along beside me, colts beside a mare. I give it my all and sometimes even beat them to the far door or, back, to the wall where we land, smack, our hands planting hard.

Starting out, I don’t think Gertie was running for the pure joy of running; she was running to win, and with perfect competitive instinct, she forced me out of my own path, such that I would have had to physically push her to clear my way and run at full speed. I wasn’t going to do that, of course; I just trailed her, back and forth, wall to door to wall. When she announced she needed a break for water, I validated her awareness of that need. We’d stop for water, then start again.

And then something interesting happened. She said, “Go,” but let me take off on my own. Confused, I stopped. She directed me to run without her. So I did, back and forth. She sent me out alone again. This time, however, when I reached the door and turned, she started out from the wall and ran toward me, such that our paths would be crossing halfway. Instinctively, I reached for a high-five.

That became our new game: running separately, as if in a relay, and high-fiving each other in passing. For fun, I introduced variations: two-handed, to the side, down-low. Our palms met perfectly each time, a satisfying clap such as I have rarely known. As we passed my open office door, she must have had her eyes on the clock, for she started curtailing her circuit. Again, I was at first confused—was this a move to gain some advantage?—but she explained, “It’s almost time to go, so I’m shortening it.” So we ran shorter and shorter laps, clapping hands with increasing frequency, until at last we were circling each other, in a kind of do-si-do.

Gertie had gone through a prolonged angry phase over the course of the year, in which she proclaimed to hate her life and the world around her, especially her caregivers. There were exceptions, of course; but literally for months, she looked like she wanted violent revenge for every one of the many wrongs done her. She wore that look even while playing Follow the Leader. When we walked out to the lobby on the first day we ran laps, to rejoin her grandmother, she was wreathed in smiles.

I, too, felt wreathed—as if laurels had been woven and set upon my hair. Because again she had transformed her play, from competition to cooperation. And because I’d seen her face flushed and lit with its former, glorious light.

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“The Numbers Game” (July 2017) will be continued in a future post, when I have more stamina for the topic. Out of respect for client privacy, names here are always changed or omitted. Text and image copyrights held by me. If you enjoyed this piece, I hope you’ll consider sharing it. To subscribe and receive future posts, please look to the upper right on your computer screen, or scroll to the bottom of the page on your mobile device. Thank you for reading!