Everyday Responses to Demanding Children

Posted on June 11, 2016 by Robert

Sometimes it helps to practice therapeutic responses day to day. I.e., therapy does not have to be confined to office sessions. I have been recalling the following interaction, and thought others might benefit from reading about it.

Some time ago we lived for a few years in Canada, a lovely country back then where most of the population lives near the southern border with the U.S. (Now an ugly country even under Trudeau, tearing up its soil muskeg and its aboriginal treaties to produce trainloads and pipelines full of tar sands Bakkun crude — the worst of the fossil fuels — further damaging a climate already on life support.)

One of our neighbor boys, about age seven back then, was the youngest of three siblings. While usually fun and within normal limits, he could sometimes be unusually ‘demanding’ — in need of attention. One day he snuck up on me while I was mowing with our electric lawn mower. Jabbing me in the sides from behind, he seemed intent on experiencing my reactive startle.

“Ow! Don’t do that,” I said with minimal eye contact. (Eye contact can be very rewarding to misbehavior.)

— “Did I scare you!?” he demanded, moving closer to watch my face. But he had not acknowledged my directive. No biscuit.

“Don’t do that!” I repeated with no pleasure in voice or face. I call this non-juicy limit-setting. I recommend it for serious teaching around serious disrespect. Simultaneously I give zero response to the offender’s agenda. He had a turn steering the bus and he blew it.

— “But did I scare you!?” This ‘broken record’ technique of repeating a demand was invented by kids, because it works. Except with me.

I called up my sharp-voiced inner alpha dog. Alpha dogging has a limited place breaking up disrespectful agendas. It uses a short ‘broken record’ with just a little shame, served with a no-fun facial expression. (And keep this very short.)

“Don’t do that. Do you understand?!”

— “Yes.” His tone submissive, we were done.

Time to change the subject. “Did you guys have lunch yet?” And so we moved on. Lesson delivered, learned, and behavior stopped.

Well, almost stopped. A few months later I was working in my garden when he appeared with a plucked flower. He grinned to himself and tried to tickle my face with it, forcing adult attention.

“Hold on, Pardner. You need to ask before you touch other people’s faces.”

— “Can I touch your face with this flower?”

“No, but thanks for asking.”

Whereupon he tried to do it anyway, eager for any attention from a safe adult. Probably having a bad day with his older sibs.

I could have gone back to alpha dog again but his behavior was not dangerous, as when I was power mowing. So I did a field impression of Empathic Therapist. (Convincing because it is real.)

Big voice, moving closer with eye contact: “Wow, you didn’t listen to me! That is so helpful, because it tells us that somebody didn’t listen to you when you wanted them to stop! We’ve got to figure out who!! Who didn’t listen to you?!!”

With unexpected vulnerability he answered sadly, “My brother.” “And my mom.” “And sometimes my dad…”

Maybe that was accurate, maybe exaggerated, maybe imagined (probably not). What mattered was that he was finally focusing inside and sharing his inner life (thoughts and feelings) at that moment. So I responded with acceptance and empathy, allowing us to feel like friends instead of opponents.

Me: “I’m sorry. Not feeling listened to can be really hard.”

(Not a good time for defensive put-downs such as, “How do you YOU like it, huh?! Now you know how it feels, right?!!!”)

After a pause, he chatted about something else, and we had our usual good visit.

Recommendation: practice looking under the surface so that when kids do annoying things we are ready to focus on inner thoughts and feelings. I.e. “What’s going on inside?”

“How Should I Handle this Paradox?”

Posted on May 20, 2016 by Robert

Question from a colleague in upstate New York —

I encountered an odd dilemma. I have a private practice in New York, and it is close enough that sometimes, not always, I bike to the office, instead of drive.

Last week I had a light morning schedule, just one family at 0930. It is a family with a history of shame and blame, based in their intergenerational transmission of many struggles and disappointments. Now the father brings his young adult son, and things are going well. They are on their way to new-found resolution and stability.

On that particular morning I arrived at 0900 (checked the time) and parked my bicycle in back of the office building. The waiting room was already open for other offices, so I opened my office, turned on the lights, read my mail, penned some thoughts for today’s session and waited.

Unlike some, this family usually arrives a few minutes early, so at 0925 I stepped into the waiting room to greet them when they arrived. But for whatever reason, they no-showed, and at 0945 I closed up my office and headed off on the next part of my morning. (When clients no-show, I usually wait a few hours to contact them without the pressure of immediacy.)

A half hour later I received an email from the father asking me to call the son about today. He wrote that they had arrived on time at 0930, and the son had gone in and reported back that the office was locked and dark. If an email can have a tone of voice, this one would have been accusatory.

I called the son and he said that they had not seen my car so they assumed I had not arrived. He added that his father had looked in and reported that the office was locked and dark. (In the interests of time, I did not point out the discrepancy in their stories.) I apologized for any confusion and rebooked for next time.

When do you recommend I confront these folks about their discrepant stories? When should I try to get to the bottom of the truth?

Thoughts from Vermont —

Thanks for a good question – New Yorkers have a knack for them!

You could certainly take the inquisitive or direct confrontational route – many therapists would. My suspicion is that focusing on their obvious discrepancy is premature. Here’s are a few possible reasons….

(Assuming that there were no simple explanations such as daylight saving time, or broken digital clocks.)

1
You report that “they are on their way to new-found resolution and stability.” With many families with long traditions of conflict, starting to change things for the better will trigger unconscious pushback – the system is trying to maintain equilibrium, as they say. Trying to make that the next focus of therapy may be premature to repairing the relationships and co-regulating whatever affect comes up about their memories. THEN you might be in a position to discuss actual events without defenses, if it still seems relevant. Relationship connection first.

2
In families such as you describe – steeped in blame and shame — any crisis will require finger-pointing and assigning some failure and/or negative motives to others, if only to avoid being on the hot seat oneself. The goal of each member becomes, ‘it wasn’t MY fault’. Suggesting that you are the one who must be lying or mistaken helps expose the family’s dilemma like an x-ray. No need to waste this vulnerable moment trying to rush everyone into cognitive realities. They are ripe for empathy for their fears of vulnerability to each other. Spend your opportunity wisely.


3
Having made what sounds like lovely progress on the surface, you may be being tested before being allowed in to a deeper level of worries and fears of this family. To pass this test, you must show them a different way to handle the shame/blame cycle – and you have to do it under the spotlight of a crisis. ‘How can you maintain you were there when we say you weren’t?’ Can we get you to argue with us about our clumsy different stories? (As we do all the time…)
Or will you continue to deliver empathy for our accusatory defenses, continue to value our stuckness as an honor to work with, and avoid our surface invitation to divert your care for us into a search for ‘the facts’?

My guess is that ‘the facts’ – or anything else — can be discussed after re-affirming your deep empathy for this family and their need for safety and co-regulation of their big feelings.

Here are the priorities in order: 1) a sense of safety for the family, 2) help regulating their traditional big feelings, 3) then, lastly, if you get there, reflecting with empathy on the cognitive meanings of this situation, after no one is any longer fearful (as you are not) of being in the crosshairs of family blame. After all, sometimes all things are true at once.

All the best from Vermont —

“May I Get a Copy of the Refrigerator List?”

Posted on May 17, 2016 by Robert

This request arrives by email after every presentation when I run out of handouts. The most desired handout is the Refrigerator List.

It is called the Refrigerator List ever since some of the first foster parents to receive a copy — while attending my talk in Indiana — told me later they stuck it up on their frig for quick reference. It helped them in the heat of the moment when they struggled to maintain understanding and empathy for newly arrived foster children.

The Refrigerator List suggests that acting out behaviors are a coded language — the best the child can do to communicate given the insecurity of their inner thoughts and feelings. Sometimes the child is simply testing the waters — as children need to do to find out for themselves where the rule are. But an emotionally struggling child is often saying as best they can, “This is what I was given, and this is the safest way I learned to ask for help — to just dump it on you and hope you can figure me out…..please? PLEASE?! Nobody has gotten it yet, and I’m going crazy trying to regulate my awful thoughts and feelings. Here, have some….show me how to manage them!”

And next thing you know you are feeling frustrated, resentful, even furious and despairing. But it didn’t come from you. You weren’t feeling those feelings before. They came from the child as a desperate gift to you, in hopes of getting help they have been asking for since their development was left behind.

And the catch is — their horrible paradox — they have to reject, refuse and hide from whatever direct help you offer, until you have been tested to the bone for about three months longer than you can possibly stand it. Hang on to your sense of humor, your supports, and your capacity to consult for outside help!!

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The Refrigerator List

Suggestions for decoding behaviors — possible explanations

by Robert Spottswood, M.A., LCMHC Norwich, Vermont

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Violence, picking fights



— (Chronic fear of being deserted. Feeling abandoned usually triggers rage in humans and primates.) The surest way to prevent desertion is to keep you mad and angry at me for fighting.
— Please stop me! I’m begging to feel contained and safe!
— I need closeness but I do not deserve it; hitting is the safest way to be close, while disguising both my need and shame.
— My endless fear, sadness and loneliness only gets a moment of relief when I put it into other people and then laugh at them for feeling it for me. That temporarily numbs my own anguish — when I can laugh at seeing others feel my pain for me, outside of me.




Bizarre goofiness, endless pestering, whining



— I have to be in your thoughts all the time or I’m afraid I’ll disappear! (I feel empty inside; don’t yet know who I am.) Are you thinking of me now? How about now? Now? Still? What about now?….
— I didn’t have much for role models, so I provoke other people to react so I can observe them and try to learn.
— I’m so under-socialized, this is the best I can do. I’m so used to being called ‘weird’ it feels normal.
— Closeness, intimacy — terrifies me. This behavior keeps people annoyed and at a safe distance. Not hard at all.




‘Hiding’ behaviors: (sneaking, tricking, lying, stealing, hoarding, cheating, shoplifting,……….all very annoying!)
— I know I’ll be kicked out of this home, so I have to practice hiding and sneaking for when I must survive on my own.
— I don’t deserve to have my needs met. You don’t realize that yet, but I realize it. Nobody will give me anything I need after they realize how bad I am. Sneaking will be my only way to survive.
— Depending on adults is like volunteering for a concentration camp; not possible, not on radar, can’t happen ever again!
— Since I am a shameful being, but you think I’m good, I’ll try to preserve our doomed relationship as long as possible. I will sneak around and lie to protect you from the horrible reality of who I am; because you are so nice.
— Lying is my way of trying to tell you about my past; it’s what I had to learn in order to get along in my old life. Can you talk to me about that, or are you just too freaked out by lying to help me integrate my past nightmare life?

Oppositional defiance



— I need to feel safe by maintaining control. So whenever you suggest something, I immediately say NO, to create some safe space to think it over. Then maybe I can say Yes. This is me coping. And it starts over every time. Sorry. Help!
— Saying ‘I’m not coming!’ and then screaming ‘Don’t leave me!!’ recreates an early conflict drama, over and over. I’m trying to work it out, and need help, but can’t accept help. (If that doesn’t make sense, welcome to my world.) All my shame about this I must project onto you: you’re wrong, you’re mean, you’re stupid; I have to make my failure be about you. (It hurts too much that it’s really about me.)




Letting adults down, disappointing them



— Positive adults make no sense to me. All I can do is humor them until I run away or fight again, and watch their fragile dreams for me crumble over and over. Are they stupid?
— The horrors I lived through (including neglect) are not even in the middle class vocabulary of conceivable experiences, so what do I do with these nice people? Let them think their big thoughts and make their big plans for me, until I have to act out my real shame, letting them down over and over. Sorry, nice people.
— Get over your disappointment and stop caring about me. I did.




Avoiding



— You’re moving too fast. First I need emotional safety. Second I need you to co-regulate my huge emotions. Lastly I might talk about all your great ideas….. But make me feel safe first.
— Getting involved with closeness or even with conversation means getting vulnerable. Can’t happen ever again, thanks to my past.
— I never learned normal conversation, so I feel stupid when you talk to me. Just leave me alone so I don’t feel stupid.





Blowing up when told No; zero frustration tolerance; big rages when limits are set



— I’m stuck back in the Toddler’s Dilemma, back when kids normally come to accept that grown-ups who love us can also say No, and may set limits. I never was helped to resolve that back then, and I’m still trying to intimidate and terrify people into always saying Yes. I need help learning this lesson late, sorry. Please help. (But remember that I have to reject your help. Good luck, and don’t give up!)

— Too much choice, freedom, and independence! And too soon! I can’t handle it, but I can’t refuse it either – just like if you let me drive the car. I’m stuck! Please step up to the plate, take charge, and don’t let me intimidate you out of it, because I’m really stuck. Did I mention that I’m stuck? Need more Momma! Need more Papa!

— Though I can’t ask for help, I need help – it is scary to be aging with only infant skills to handle frustration. So please be confident, be in charge, figure me out, and set loving yet firm limits I can struggle against without being shamed; early and often until I am done with that struggle and can move on. I don’t need screen time, electronics, or stuff. I need parents and I need them to be in charge. I’m just a kid trying to figure out complicated stuff. (This is so frustrating….)

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Reflections on shame and rage in the office

Posted on April 6, 2015 by Robert

I feel badly that I cannot ever publicly credit some of the more rageful children for showing us so painfully how shame works. From their hard work we can see how past shame can explode into the present, greatly confusing everybody who expects to live happily ever after in real time. For me it is like being handed an x-ray of how the child’s early experiences of neglect or abuse were stored as shame, back when they were very small and unable to integrate their nightmare experiences.

In the safety of the therapy session things usually begin calmly. Hiding the shame works.

After a bit I may allude to the child’s history, at which point the shame begins to rise to the surface. Early signs of dysregulation include avoiding, distracting, interrupting and changing the subject.

Finally, when I reflect on how hard this appears for her, the shame may sense that its cover is blown. We may see a sudden switch from mild dysregulation to a rage by someone trying to be the worst person in the world — which is how shame feels. Shame tells the child that the only hope for relief is to try to make people to whom she feels vulnerable — usually family members — feel the shame for her. Swearing and spitting, hitting and hurting, she tries to give away some of the terror and disgust of her shame — tries to put it into others. (Strangers and those farther away pose much less threat of seeing under her surface defense.)

Parents often say something like, “He just changes all of a sudden, like a switch turning on with no warning!” (Similar to complaints from sweethearts of controlling adults.)

What helps in the heat of the moment? Two observations have helped some caretakers.

1 — It’s not about you. Shame rages are more like a time machine showing us a film about her past maltreatment from others; a film about surviving betrayal and ambush, despair and abandonment, but ‘surviving’ only physically — the child’s emotional despair required a huge IOU of shame be stored deep inside.

2 — She is stuck in a desperate paradox: she needs help with shame, AND shame cannot accept help. (Wow!)

Those observations can help us adults mentally step out of the situation long enough to get our bearings enough to help. We can put on our emotional oxygen mask and go back down to sit with her, trapped as she is in her septic tank of shame. There we can share the survival supplies we brought — which are common relationship gifts. They must be rejected at first, as the paradox cycles through, but that is okay because the power of relationship increases with its ashes.

What does that look like?

Beginning with acceptance, curiosity and empathy for where she is stuck, I try to model a counter-intuitive response for the parent to take home with them. For instance if the child is name-calling, I might reflect based on knowing that name-calling, like most projecting, is rooted in her fears about herself. “Somebody used to call you a ‘fucker’ — was it your first parent who called you names? You seem afraid that you might be ‘stupid’, and that is always such a big worry!”

If that fails — because shame hates empathy — I may shift to singing. Anything with a rhythm, because it is the rhythm which struggling children hear. “When I, waza sailor, upon, the high seas, Singin’ Oh, row, blow the man down,….”

But if that makes it worse I may shift to reflecting on my experience of her and articulating our relationship in this moment. “You’re doing your best to let me know how awful it feels inside. Thank you for helping me understand how hard it was when you were so little! You’re doing the best you can to help me be a better helper…such a big heart!….etc.”

And perhaps around again.

During a recent session the raging child (age six) told his adoptive father, “I’m going to run away from you!” (Shame’s deepest desire.) The father quickly responded with the hard steel of logical reality — “I won’t let you!” But I jumped in with a story before father could continue down that emotional dead end.

“Oh my gosh, you would start walking all the way home [80 miles] and your dad would drive back and tell your mom, ‘I had to come home without Seymour because he decided to walk home.’ And your mom would SCREAM with panic and make your dad come back with her in the car to look for you!”

Using the rhythm of slow repetition, I would continue. “First they thought they saw you…….but when they got close, it was just a baby deer.

“Then they thought they saw you…….but when they got close, it was just a mailbox on a post.

“Then they thought they saw you……and it was YOU! And your mother started crying and crying, she was so glad to see her son, and so happy to find him when she thought he was lost, she just cried for joy!”

At that point the boy was quiet. He could see that my eyes were welling up as I described his mother’s love for him. (Of course I was imagining the scenario with my own children, so I could better tell the story.)

And when it was time to go, he wanted to stay. We had connected through his shame-rage.

DOUBLE-BIND — when families are stuck in paradox

Posted on July 20, 2014 by Robert

Sometimes a parent will bring in a child – natal, adopted, foster, etc. — who functions well enough in school and in public, but who has recurrent rages toward the parent at home. Rages only at home, and only at this parent.

The parent is typically a very nice and kind parent – undeserving of any violent treatment (assuming anyone anywhere is deserving of violent treatment.) So the parent is mystified. “What’s going on? She needs help!”

A case example walked into my office in Ontario soon after I finished graduate school. A single father complained about his nine year-old daughter. “Sometimes she is fine, but suddenly she’ll be frustrated or upset by some little thing, and she starts attacking me or trying to break something precious to me! I feel so helpless. Why does she do that!?”

Does she say anything? I asked.

“Mostly just screaming. Sometimes she’ll say odd things like, “I don’t deserve to be in this family!” or “You hate me!” or “I hate you!” or “You don’t love me!” What should I do!?

This question, “What should I do!?” is a red flag for most psychodynamic therapists. We know so well that our goal is not to give advice but to help reflect, help with process. However “What should I do?!” is one of my professional weaknesses.

Too often I head off into advices:

Try to not reassure, but give Empathy for how she must be feeling….“I tried that.”

…and be in charge of yourself so there are not TWO dysregulated people in the room…

“I did that.”

….and remember that the more you want to get away from her, the more she needs you nearby….

“I remembered that.”

…..

Finally I heard myself rattling off ‘advice’ to an emotionally exhausted parent who needed my empathy for himself – my empathy for how he was feeling, my empathy for how hard he was trying, and my empathy for his own unresolved past traumas.

I apologized.

Beginning with the last item, this father’s own traumatic past left him determined to keep things positive for his own child. He dealt with his despair by disallowing any ambivalent feelings of his own such as resentment, until it burst and he would lash out verbally, after which he felt horrible.

Thus when he felt frustrated at his child’s blind, out-of-control behavior, he would bury his frustration so that it came out sideways – tearful pleadings with his daughter to “Tell me what’s wrong so I can help you!!” and “What is it you want!?”

And when she of course could not explain herself on a conscious level, but kept expressing her sense of shame and worthlessness preverbally and violently, he would eventually blow up in exasperation, desperately wanting to help.

This explosion would leave him burdened with shame and fear that he had wounded his child. However it sometimes had the paradoxical effect of calming his child. At last she could finally see in this repressed father some real feelings she could trust.

I now had a helpful map of their double-bind. In a double-bind, people are stuck in a dilemma: feeling bad if they act, and equally bad if they do nothing. Lose-lose, what do you choose?

Father could try to be direct about his own anger and resentment, but then would beat himself up for expressing negative feelings to a child, his suffering daughter no less. Or he could keep repressing his own resentments and continue to feel unable to connect to her in her own struggles.

The daughter was also in a double bind: When I get scared that I’m not lovable, my dad doesn’t get it and wants me to explain it and tell him what I need. But I have no idea how to articulate that stuff – I’m just a kid! — so my sense of being not good enough increases….(begin again)….

Finally, as the therapist, I also enter the double bind (though I am the one who can best reflect productively on the experience of being there.) Heck, I offered this father my best ideas and advice, yet was repeatedly dismissed with “I tried that.”

Rather than start arguing with father about whether or not he ‘tried that’ the proper way, my path forward is to recognize my privileged position. I am experiencing what the father AND his daughter experience – frustration, helplessness, hopelessness and the resentment at doing ones best and receiving no results, appreciation or recognition. If my ‘best’ was not good enough for father, perhaps I am not good enough.

When I can reflect on this, perhaps right away or later in clinical consultation, I feel honored to have been allowed to experience their stuck system for myself. I am grateful for an inside view of the emotional challenge which faces father: to find a way to tolerate standing with old intolerable feelings and reflecting from that place until it is safe for his daughter to recognize her own feelings in him, allowing her to sense (over time) that there is less need to maintain the fierce, defensive walls between them.

This is the therapeutic potential of allowing ourselves to sit inside any client’s paralyzing double-bind. Just not for too long.

WHEN MEETING THE SCHOOL BULLY….

Posted on July 3, 2014 by Robert

A 12 y.o. adoptee was brought in for bully behavior at school and at home. He was intimidating his new parents and classmates, and was recently charged with bringing a weapon to school — a sharpened stick which he could both use to threaten and technically argue that ‘it isn’t a weapon’. He loved to debate like a lawyer with anyone who would listen – but his strategy was to never give up because his goal was to always win.

The school psychologist had tried a shaming tough-guy approach. He called the boy “a creep!” This attempt to isolate by shame was gasoline on the flames of the child’s negative internal working model. (Since I’m so bad that even the helpers reject me, I’ll go for the gold – ‘success’ is now to be the worst kid ever.)

Because of a long early history of abject maltreatment, he had learned to recreate the “bad kid” response in the eyes of caretakers and other adults in charge. Using kids’ normal, unsound logic – which never gives up a point because they are really craving our attention and closeness – he would engage adults in endless arguments where he would always ‘prove’ the adult to be wrong, unfair, hypocritical, or otherwise unfit.

I think this re-creation in others of the intense feelings of rejection and inadequacy from his own early years displayed the bully’s signature brilliance of forcing others to feel his unresolved feelings for him.

When we were introduced, this boy saw me as simply the latest challenge for his undefeated debating skills. He looked me grimly in the eye.

“So. Do you believe in Creationism?”

Five possible responses were immediately on my plate. But he would have been familiar with only four of them.

A. “Uh…well, I….uh….haven’t really studied it…”

B. “What — now you want to argue religion?! What next!!”

C. “I’m asking the questions here, Buster!”

D. “Yes.” [or “No.”]

My fifth option was to go relational. I could reflect with complete acceptance, AND include my feelings of being at risk of losing a potential friend – a place he had been so many times:

E. [with feeling] “Wow, you want to know my personal beliefs! (Acceptance) Now I’m afraid of giving the wrong answer, because then you might not like me; I like you a lot, but I’m afraid you won’t like ME if I don’t answer right……What am I going to do?! [etc.]”

This was empathic mirroring of the child’s own unspoken fears from similar situations in the past. As we talked, I repeated this in various combinations and permutations, until to argue with me was to reject his own long-sought yearning to be accepted.

As Dan Hughes once pointed out with a smile, “It’s hard for any of us to reject for very long being totally accepted for who we are in this moment.”

Answers to High School Parents’ Questions

Posted on June 16, 2014 by Robert

1. “What Does It Mean to Listen?”

Parents who listen are paying attention to both the words and the feelings, because a parent’s role is a) to keep their young person in their thoughts (I love to learn about you and your life; I can’t learn enough), and b) to care enough to respond at any given moment with a brief mix of support and limit-setting. Parents then keep paying attention so they can respond in a timely way when the limits are tested. If this sounds hard, it is probably because we did not have it modeled enough when we were young people.

Tip: “It’s my job to keep you safe,” (i.e. like the dog) is less helpful than talking relationally. “I want so much to feel close to you.” Of course, you may expect snarly in return. But speaking relationally out loud is what counts.

Bigger tip: Reassuring (“It will be okay,”) is less helpful than giving Empathy (“That sounds hard; I’m sorry it’s hard,”) and Curiosity (“How did you find out? Huh. What did you do then?”).

Young people who listen are highly sensitive to three things: a) the word “but”, b) feeling judged, and c) lectures.

a) Try “and” instead of “but”. In most cases it works.

b) Judging others can sneak up on us, as in “constructive criticism”, arguing about who is right, and compliments! Compliments are judgments with a positive coating. Try starting compliments by asking, “May I give you a compliment?” It feels very respectful to be asked before being judged, either positively or negatively.

c) At about word three of a lecture, young people stop listening. We all do.

2. “What is respect?”

Respect is an attitude which reflects our perception of worthiness. To respect a person reflects my own respect for myself. If my history gave me enough positive images of myself as I was seen in the eyes of others (especially adult role models), I will have internalized a sense of self-respect; and I can give respect to others with little difficulty.

If I show a lack of respect (i.e., disrespectful behavior) that is often my hidden request for help. I may also have a rule that I don’t deserve any help, so while asking indirectly for help I will also reject attempts to help me. Welcome to my confusion. Please find a way to help. Your motives are good.

(Next blog: “What about setting limits and boundaries?” and “What are appropriate expectations?”)

Maintaining empathy for an aggressive, controlling child client.

Posted on June 3, 2014 by Robert

Increasing control is a common and logical response to rising anxiety. Yet sometimes reducing anxiety by increasing control can get out of hand, hurting relationships through pain and confusion. At a meta-social level, author Alan Johnson points out that men in a patriarchy find the fastest path to control is violence. (“Don’t make me hurt you…” “She threatened to take the kids, and I lost it….”)

Children can also project commands, threats, and other attempts to find safety through control. My first experience with such a child occurred early in my job at a Canadian mental health clinic.

A lovely but angry nine-year-old girl was brought in by her legal guardian. As usual, I asked the safe adult attachment figure – in this case the guardian — to stay in the room with us. [The four major benefits to this will be listed in a future essay.] And as usual, I accepted the child’s symptoms as clues to what she had been through. I knew from her history that she had grown up between divorced parents. She visited one parent who would avoid her strong feelings as much as possible (resembling the “dismissive” adult attachment style). And she lived with the other parent who treated her sometimes warmly and sometimes coldly, depending on her own mood (similar to a “preoccupied” adult attachment style.)

Consequently, the girl’s rude demands and commands in session were accepted as invaluable clues to her own attempts to make sense of her confusing history. The challenge for me was to respond with Acceptance, Curiosity and Empathy — versus either opposition or cooperation. (Note: it is best to avoid Playfulness with an upset child. It can sound a lot like sarcasm.)

With children like this girl, who bullies, my initial hypothesis (to be tested) is usually that she is trying to put her anger and frustration into others, where she can observe it outside herself – giving her a rare moment’s relief from experiencing those feelings within, 24/7. Peter Fonagy in the U.K. explains in a brilliant essay that the bullying person can experience brief relief from their own internalized shame and terror by forcing those feelings onto another person, whom they can then attack, drive away or even kill in an attempt to be rid of the feeling forever. (Note the routine daily news of murdered women in patriarchal societies.)

I did not have long to wait.

“Robert! Sit over in that chair!”

I let my jaw drop and outwardly reflected my experience of HER inner sadness and scaredness which she was trying to relieve by commanding ME. Matching her ‘vitality affect’ (Daniel Stern’s fine term), I used her commanding voice, but my words.

“You want me to change chairs! And if I do, you hope that you feel better! And I so want you to feel better!”

At first she registered only my failure to obey. “Go!! Sit there!!”

I continued to keep my voice loud, like hers, but my words empathic, like mine. “And if I don’t sit there, you’ll get more upset!! Oh dear!! I feel terrible!” I appeared visibly and audibly distressed — loud and vulnerable and without mocking sarcasm. I was reflecting from a stuck place, a spot she had experienced so many times in her short life.

“GO!! SIT THERE!!” The only response to non-compliance this girl had ever learned was her parent’s escalation.

Without mocking (practice this), I continued to mirror her affect (her outer expression of her inner feeling) and reflect on how it was affecting me as I cared about her. This ability to reflect is something she should have learned early in life, instead of being made to feel ashamed of her own feelings.

Me: “Now I am stuck!! I want you to be happy, because I like you, but if I don’t do what you want, I’m scared that I’ll disappoint you and then you won’t like ME!!!”

Being one-third my size, she did not try to push me, but she did try the other parent’s response: abandonment. Looking away she announced, “I’m ignoring you.”

I then shared my sadness at feeling ignored by her, whom I liked, and said in a hopeful, lonely voice that I hoped she would talk to me again soon! (This modeled for her how to articulate a complex relationship with feeling. I suspect she had never heard this before.)

She suddenly became vulnerable herself. “You’re scaring me, Robert!…..You know how come I’m afraid of you?”

Me: “How come you’re afraid of me?!” (Repeating her phrase tells her both that I’m listening, and avoids distracting from the huge window she is about to open onto her own thoughts and feelings.)

“Because,” she nearly spit in self-protective anger, “I WAS TREATED LIKE A LITTLE STUPID IDIOT MY WHOLE ENTIRE LIFE!!!”

I quickly reflected my feelings, while matching her vitality affect. “I AM SO SORRY TO HEAR THAT!!!” And I continued to share my own affective response to the thought of a child being treated like a ‘little stupid idiot’ her whole entire life. Almost wailing I said, “Oh! I am sad to think of you being treated that way!!”

Then, I introduced my curiosity: “What did you do?! How did you cope?” (Note: It sometimes requires a cool hand at the tiller to steer away from knee-jerk reassurances such as, “You’re NOT an idiot! How could anybody treat you like that!!?” But reassurance shuts down feelings, while I wanted to articulate her need for a way out – What shall I do? How shall I cope!?)

Now she deepened into her memory but still could not differentiate her inner life (remembering the past) from her outer life (being here now). She could not yet reflect from the safe emotional present, as most adults do. She was still emotionally in the past, stuck in the memories and trying to manage her old feelings by making others change (“instrumental” use of affect) instead of describing her feelings to deepen connection (“signal” use of affect).

Suddenly she glowered fiercely at me. “If you ever hit anybody in my family – I’ll shove that notepad down your throat!!”

That was low-hanging emotional fruit, for which I was extremely grateful. It is important to not waste it with the following abstractions: (‘How do you think that makes ME feel!?’) would demand of her a complex ability to feel empathy for others. (‘I can teach you to relax and let go of those old hurts.’) would go prematurely to cognitive solutions while she is stuck in a state of highly dysregulated emotion; I would be abandoning her in freefall with her scary feelings. Such a response would be congruent with van der Kolk’s theme of The Body Keeps the Score, emphasizing meditation and other pulse-slowing approaches to stored childhood trauma. Yet this path would be premature to where she was in this moment. I still had to establish safety, and co-regulation of her affect.

Accepting the low-hanging emotional fruit (“…I’ll shove that notepad down your throat”) I match her harsh vitality affect again: “(gasp!) Somebody shoved something down your throat!!”

Immediately she is able to reflect on the past, protected by the empathy I am giving her in the present.

“Instead of spanking me every time I was naughty I had to bite into the bar of soap and chew it and swallow it! And I didn’t get any water!”

She is tearing up. And as I imagine being her being made to eat soap, my own eyes fill, I bite my lip, and my mouth turns deeply down in empathy.

She looks at the ceiling. “And if you cry, Robert, I’ll burst out into tears!!!”

For the rest of our session we had trust. I had helped her feel understood beneath all her fierce threats, by responding only to the feelings under the behavior, and responding preverbally (voice, facial expression, mirroring affect) instead of with cognitive insight.

Co-regulated at last, this aggressive child was finally free to reflect on her life from a safe, outside perspective, something parents usually, unconsciously, provide to children from birth onward.

When therapists go prematurely cognitive – and how to return to emotional connection

Posted on May 28, 2014 by Robert

In my consultations to emotion-focused therapists, some common requests for help suggest areas in which many good counselors may struggle. A very normal pitfall is moving away from affect (how feelings are expressed) and prematurely into cognition (thoughts and ideas) before emotional safety is established. This is an easy slide because most outside conversations are cognitive: “How about those Red Sox last night – lost (or won) another one!” Clients may expect, and sometimes hope, that our focus will remain there. So easy for everyone to avoid big or complicated feelings.

When speaking to groups of therapists about this, I sometimes challenge them with the following list of blunt client statements which have been a source of struggle for consultees over the years. I ask the audience to try answering each of these statements without explaining, reassuring or arguing, and instead answer the question beneath the question, using empathy and acceptance.

“Am I the problem in this divorce?” [If I take the blame for everything, will it shortcut all this pain?]

(Counter-intuitive sample response: “How simple it would be to finally just have a yes/no answer for the complexity of a painful divorce! It must be so tempting to just take all the responsibility in hopes of putting an end to this slow process, which heals at about the speed of a dormant, wintering garden. Thank you for helping me understand how intolerably long and painful it feels.”)

“Are all your clients as difficult as I am?” [Am I going to drive you away?]

(Counter-intuitive sample: “Sounds like you’re scared that you will burn me out and then have to start over with someone else. It makes me wonder whether you have been judged harshly in the past and you remember feeling rejected and blamed.”)

“You’re not very good at your job.” [I expect you to reject me, as other people have, so I will reject you first to get it over with, because waiting to be rejected is a living nightmare.]

(“I’m sorry it feels like things are changing too slowly. Thanks for helping me understand how disappointing it can feel, and I would love the chance to do better at helping you.”)

“Hey, you didn’t answer my question!” [If I can’t fill the session hour with questions you have to answer, how will I be safe?]

(“It would feel so much easier and more familiar to have this be a question and answer process. Sometimes I wish we could do that too.”)

“I’m not talking to you. I have nothing to say.” [My life has too many risks already.]

(“That’s okay. You don’t have to talk or do anything else that feels risky right now. Thanks for letting me know. It is an honor just getting to meet you.”)

“Do you see my friend Rhonda? She says she’s your client too.” [I worry that I’m the only person who seeks professional help. It would reassure me to chat about someone we know in common.]

(“Everybody may feel a little lonely going for counseling. I wish I could help that easily. Talking in sessions has to be a little different than on the outside, and I apologize that it’s not as simple.”)

Behind the Rages of Disorganized Attachment Style

Posted on October 5, 2012 by Robert

Many caretakers begin the first session with heartbreaking tales of rage, rejection, betrayal and violence from the child in their care. “She said she wants to hurt the baby!” “She said she is stronger than any of us — and she’s five!” “He can’t be alone for two seconds without trying to destroy the upholstery.” Sometimes understanding the normal thoughts and feelings under those behaviors helps the adults to see things with less discouragement and personalization.

It is easy to forget how ego-centered children can arrive. Knowing nothing about the outside world, they assume that things happen because of them. Good things happen because I am good. Bad things happen because….I must be bad…

From there a child surrounded by neglect, chaos or other maltreatment may logically conclude that they are so bad no sane person would really like them, care for them or want them. Along comes a new caretaker, full of love but ignorant of the child’s ego-centered beliefs… Trouble.

For one thing, being hugged and loved by a new person can feel like that person just doesn’t know who I am. As someone put it, “It’s like having to rub noses with a stranger.” Sorry, nice person, but you don’t know how bad I am or you would not get half this close to me. Maybe I am smarter than you. (Always a scary thought for a child.)

Then if the child is given choices and independence normal for their chronological age, but premature for their emotional age level, they can feel overwhelmed with too much freedom for their thinly-formed social skills and regressed defenses. “What if I can intimidate these nice people?” may be a thought which both terrifies them and which they cannot let go of.

Finally, if they try something intimidating and the parent hesitates and appears to lose confidence, the child can feel compelled to recreate this drama over and over — both trying to resolve the problem of getting the parent to parent them, and exploring the first interpersonal theme over which they seem to have complete control. Their little fight-flight amygdalas (survival brain) are working overtime, triggered by more and more situations to go for control, because it makes the something predictable (intense conflict) happen over and over, on cue.

What helps caretakers is to realize the need of an out-of-control child for the parent to be in charge instead of be intimidated. This may bring up old issues for the adult, and that can become an early focus — how to remove old feelings of intimidation, of being bullied, for instance, in order to be the best parent this suffering, desperate child needs. As Dan Hughes points out, bullying children often have a constant fear of desertion. Acting violent can be their fastest route to forcing us to come to them, to think intensely about them, to feel strongly about them, to say their name and say it with real feeling…..

Inside the child is often an ongoing conversation something like this, “Are you thinking of me now? How about now? Are you looking at me? Don’t leave me! I can make you grab my arm, say my name, show me some feeling,…”

What can help is to find our confidence, move in, be close, say their name and show our deep feeling for them early and often — way, way, way before they become desperate for it.