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.


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!








We were walking together alongside the building when he veered away from me to climb the perimeter of an unused loading dock. He had done that before, on another walk, and appeared cheerfully confident of my discomfort as he placed one foot before the other on the concrete edge, tightrope-style. Dismissing my worries about his safety, he compared me to his granny, who was his guardian and whom he described as “your standard, everyday grandmother.”

Well, I didn’t correct him on that point; for a kid with his background, being able to take a caregiver for granted is a hard-won luxury. However, I can tell you, she was anything but ordinary. For one thing, she was actually his great-grandmother; her early life unfolded against a backdrop of WWII, yet she was still working full-time and ferrying kids to after-school activities when I started seeing them.

Before she obtained custody, she drove to Jason’s house each day—never knowing what she would find—to take him to school. Without her, he wouldn’t have gotten there, neglected among adults whose lives were given over to pills and needles. Now she was raising him. On a rainy afternoon, as she and I were chatting, I glanced down and noticed matching holes, big as silver dollars, worn into the top of each shoe; she laughed as she admitted she was too busy to try on new ones.

It’s thanks in no small part to her, I’m thinking, that Jason was able to hold his own in the world. His bravado on the loading dock notwithstanding, he had at least one quotidian fear that could send him into a panic. Perhaps that’s why it was tempting for him to show off a bit of fearlessness with me—it was probably empowering for him to scare me in that little way.

Someone had given him a pen that wrote in invisible ink. He brought it to show me once, and was writing secret hieroglyphs on the waiting room walls when I walked out to greet him. They would only be visible in purple light, he said. I think about that, and I think about his history, which he wasn’t inclined or equipped to discuss. Hopefully that exploration would happen one day. So much of our lives are written in invisible ink; it takes the right kind of light, shone in the right places, to reveal what is hidden in plain sight. At its best, counseling can shine a soft violet beam—which is, in fact, a careful reflection of a client’s own light.

Late November is meant, in my part of the world, to be a season of gratitude. This year I feel grateful on Jason’s behalf for the care I saw him receive—for the memory of his great-grandmother’s hand ruffling his red hair as she said, when I asked how his week had been, “He’s a good boy.” And I’m grateful for the invisible heart he drew on my hand. Despite innumerable washings since, it’s still there.


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!



“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.


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!


Fidget toys


“I’m making a machine,” Riley said, on our second visit. It was a sunny Tuesday noon hour, and his kindergarten teacher had presumably been glad enough to see him go, given his predilection for throwing furniture when distressed. His mom, fed up with what she perceived as the school’s maladroit interventions, was presumably equally glad to take him out of his classroom and bring him to me. Little did she know how inexpert I felt, with behaviors such as his.

So far I’d seen no physical outbursts from Riley—just an air of self-possession and a serious imagination, which he used to endow himself with every power convenient to his ends. Like his machine: my rectangular wooden fidget toy manipulated into a new configuration, which he pointed at me while declaring, from his mother’s lap, “I’m shrinking you!”

Instinctively, I drew my arms and legs tight to my chest, balancing back on my tailbone, and exclaimed in a pipsqueak voice, “Oh my goodness, what has happened to me? I’ve become so tiny that I’m almost disappearing! Whatever will I do?!

Seeming a little smug—not terribly surprised by his success—he rearranged the toy a second time. “I’ll make you bigger,” he promised slyly. “You’re a GIANT!” I flung my arms and legs out and sprawled all over my chair: “Oh no, this is even worse,” I boomed in my best basso profundo. I saw myself growing too big for the building, soon wearing the roof for a cap.

Growing even faster than me-as-giant was my sense of progress in our play; it, too, was exceeding reasonable bounds, although I didn’t know that at the time. I didn’t know that as weeks became months, my presence in the landscape of Riley’s world would require that I see and hear nothing of his actual life. It was like I was wearing a blindfold, and anytime I made as if to remove it, Riley’s hands would dart up to hold it in place and cover my ears as well. His imagination would come to seem to me as much defense as diversion. But defense against what?

One challenge in working with “conduct” kids is to maintain a therapeutic approach in the face of serious integration problems. How to help a kid fit into the systems around him? To function socially within the culture? I’m reminded of the Japanese proverb, “The nail that sticks out gets hammered down.” The word “socialization” sounds relatively benign, but that hammer tells some hard truths about how it can happen. And the philosophical questions and quandaries about who decides what counts as what—well, they appear endless.

Philosophy aside, though, teachers don’t care to be punched while doing their work, and who can blame them? Furthermore, other students have a right to safety in their school. A therapist can easily feel an urgent pressure, self-imposed or otherwise, to help “fix” things ASAP, and a premature sense of success with a child can lead to frustration and impatience further on down the line. Frustration and impatience are common, of course, and can be admitted in the company of sympathetic colleagues. But they have no place in therapy itself.

Q: Instead of using an apparently strong start to measure disappointment thereafter, can I learn to see it as a source for replenishment? A font of inspiration? A reason for hope?

“You better fix her,” Riley’s mom told him, with unintentional irony, as my sprawling reached its awkward limits. “If only you had a normalizer,” I lamented. Riley paused. “I do have a normalizer,” he said, notably setting down the rectangular toy and reaching for the round one. He spun it in his hands and then released me: “Now you’re normal,” he said.

The inventions didn’t end there, though. As his mom tried to fill me in about how things were going with him at home, he interrupted with another incarnation for me: “I’m going to zap you with my smartovator,” he said. “I’ll make you smart like me. I’ll make you think about things like me.”

Briefly but powerfully, I was transported to a cold walk home, late one December night, and a rare conversation with someone important to me. There were years of painful events and much distance between us, but he seemed to evoke a solution: if I could only be him for even a moment, I’d understand things and forgive him. How fervently I wished for such enlightenment! Needless to say, it didn’t come, although the very suggestion at least made it seem possible. We were adults, and might have used words to approach it, given sufficient time and mutual will.

Pulling myself back to the bright space of day, the four white walls around me decorated with children’s art, I found myself unable to enact my new part, even in play. I didn’t know how Riley thought—would that I did. He seemed to sense my limitation almost as fast as I did, and his rescue was, I thought, sensitive. A jumble of colors again, as he swirled the fidget toy: “Now you’re smart like you again.”

That would have to suffice.



In acknowledgment of the New Year, with its unknown challenges and joys, I would like to celebrate the intelligence and resilience of the eleven-year-old girl who was my first-ever client. Over the course of my internship at the elementary school I so loved, she and I would meet during her lunch hour, to sort through the pain in her heart. A natural storyteller, A. for a time needed a full lunch-and-recess on Monday just to talk through things, plus lunch period on Tuesday, when, having already expressed her last week’s store of thoughts, she was able to concentrate on learning and practicing skills. Although I had a set of mindfulness practices that I drew upon, I took my cues from her, and our work was a co-creation.

It was the best possible, richest beginning to this work for me, spending time with that bright girl whose life was shaken by the problems in her family; I left our meetings moved and brimming with hope for her tremendous capacity to recover and grow. Sitting under a picnic table in the fall, we had strikingly metaphysical conversations. Self-aware, she would say things like, “What happens now? I’m carrying so much. I’m carrying things for me, and for everyone else in my family.”

A veterinarian in the making, A. loved animals, but her heartbreak when one or another of the farm’s animals died was amplified by other losses she felt and continued to feel. We talked a lot about love and loss, what happens to love after deathdeath also symbolizing the other traumatic events of life. Like most of us, her model for dealing with pain was to escape or conquer it somehow. “I just don’t know what I have to do,” she said repeatedly during our second meeting.

Speaking slowly, I proposed that perhaps the “doing” might not be something that would happen on the outside. (Especially for a child, whose fate is largely in others’ hands, developing internal resources can make all the difference. Adults possess the advantage that developing within often leads to appropriate external changes as well; they are better positioned to bring “inside” and “outside” into accord.) “What if what you can do is something that happens on the inside?” It was a starting point at least, and a question that we worked on answering together.

Over time, A. practiced a number of skills with me and on her own. As part of our long and deliberate preparations for saying goodbye, toward the end of my time at the school, I asked A. to summarize her thoughts about each of her skills, how they worked and what made them count as such. As she spoke, I took notes, which I later typed up to put in a book that represented our year’s work. These are those notes, as they appear in her book, reproduced here with her and her father’s permission, granted on a last sunny day at the picnic table, in late spring.


(13 of) A’S SKILLS

1. Ranking your day on a scale of 1 (terrible) to 5 (great)

This is helpful in measuring the stress you have to lose and the happiness you have to gain.

 2. Body scan

This helps you identify which parts of you are most stressed, like taking your temperature: red = stress, blue = happiness. EA: I would add that when you know where your stress is in your body, you can work on releasing it, with stretching, deep breathing, massage, and other techniques.

3. Using your senses

This is helpful as a way of not focusing on bad things, but instead paying attention to what can soothe and comfort you. It helps you see what there is in nature that can help. EA: I love these thoughts. Using your senses is also a way to enjoy and appreciate just being alive.

4. Talking to your bad dreams

This relieves stress! You know your dreams aren’t going to hurt you because you’re talking to them. It makes you braver because you stood up to something that terrified you. It builds your confidence. EA: It was pretty wonderful how you took care of the bad dream about the bear.

5. Setting goals

This is really good to do. A lot of goals can help your future. It’s especially good to do when you’re stressed because it helps break things down into smaller parts that you can more easily manage. EA: You are an expert goal-setter, A.

6. Breathing deeply

It helps you just to concentrate on your breathing. After you take deep breaths, it’s easier to organize your thoughts. Breathing deeply makes you peaceful and satisfies you. EA: I really should have made this #1. I hope you’ll always remember the benefits of this!

7. Saying what’s true for you

Doing this helps keep things on topic. The person you’re talking to may see things differently. Saying what’s true for you can help you talk and solve problems; not saying the truth, on the other hand, can get you off track and might make things worse. EA: 100 percent, yes!

8. Mindful eating

Basically, this is a lot like breathing deeply. It helps you concentrate: on the texture, on the combination of flavors. You never know what flavor might come next. What it’s like to eat something can be different from person to person because they have different taste buds.

9. Imagining the invisible backpack

This helps you figure out what you’re struggling to get rid of, what stress you don’t need, what you can use or transform. It helps you balance your stress. Packing well helps keep you on your path. You can imagine you’re climbing a mountain. You need to pack your courage to go on; courage needs to be in your backpack to help you past the scary caves (nightmares) and pointy rocks (like losing an animal you love). When you get to the top of the mountain, that doesn’t necessarily mean that all your stress is gone, but you know you can control it.

10. Keeping a journal

Every time you write a word, a death-rock from the stress mountain is removed. It really helps, explaining yourself through paper. EA: Even if you don’t have time to write a lot, you can use a journal to write down your gratitudes (#13). It’s a nice way to begin and/or end a day.

11. Meditating

This lets you balance your stress with positive things. You rest your whole body. It’s a lot about focusing, same as with the deep breathing, where you just think of that one thing. EA: And as with most good habits, the benefits continue to grow and flower over time, like a beautiful tree.

12. Drawing the ecomap*

When you draw an ecomap, you show yourself. In your head, the picture isn’t so clear. Putting it on paper helps to show what could be causing (or helping) the stress, and where you can go when it’s happening. You go to the people or things that are higher (closer to you) on your map.

13. “The three gratitudes”

This helps you to remember what you’re thankful for and what makes your life special. When you know what’s important to you, you also know the things that can help you. Maybe not with a big emergency, but with your stress on a bad day. EA: See #10! I would also add that being someone who practices gratitude can indeed help in times of emergency.


*An ecomap can be defined and depicted in several ways, but is essentially a visual representation of the constellation of people, pets, hobbies, etc., that constitute our significant others, whether at a given moment in time or more enduringly.



The building that houses the outpatient clinic where I’m interning this year, seems to be under some sort of malevolent static-electricity spell. I was disconcerted, on my first day, to be sparking against every door handle, stapler, filing cabinet, and desk drawer I touched. Even the doorways are framed out in metal. Everywhere I went, that hazard followed.

I find such shocks intensely uncomfortable. A job of mine used to involve a component that exposed me to shocks regularly, and until someone kindly brought me a grounding wire, I became unhappier and more irritable each time it happened. Thereafter, standing in place, working the machine responsible for the static, I wore a bracelet with a strap that clipped to a bolt and spared me further pain and anticipatory stress.

There’s no such recourse, however, in an environment that involves walking about, and I quickly developed the habit of smacking things with the flat of my hand, to spread the charge, before handling them more precisely. Now I walk around the office thus, hitting door frames, tapping the photocopy machine—you get the idea.

It helps. It also fostered in me a habit so constant, in the 20+ hours I spend there per week, that it quickly generalized to other environments, such that I found myself smacking door frames and tapping handles every carpeted place I went. I realized this a few days in and was embarrassed by the quasi-OCD quality to my behavior. Was anybody watching? (Fortunately realization broke the habit.)

At the same time, an awe was woken in me for the power of aversion: the insidious way it has of becoming second nature and its ramifications for our assessment by others. I was aided in noticing this by the highly physical nature of the stimulus; but what about all those situations in which aversion is interpersonal and/or developmental? What about, for example, the child who resists certain people, locations, or activities? The child who balks, to the frustration of adults?

Perhaps this illustration can serve as a reminder that everything has an origin, even when we can’t retrace our steps to find it. Teaching mindfulness to children offers them a salutary awareness of their sensations and reactions that hopefully can at least help them express, to themselves and others, their challenges. If they can’t tell you where something began, and thus satisfy the demands of logic, they may at least be better able to say where they’re at.