Overnight visits for a toddler? Try age four.

Q.  What is your recommendation on the best interests of children age two re overnight visitation.

 

A.  My answer comes from asking in turn: What makes overnight visitation high-risk for duress in the primary caretaker and for anxiety in children younger than four.  You may perceive the answer in the question, as young children are highly attuned to the emotional state and availability of their primary caretaker.  The following scenes are very difficult to prevent because of the developmental reality of young children’s continuing dependence for emotional security on the primary caretaker:

 

— the primary caretaker is naturally nowhere to be found in their ex-partner’s home, and will never be in close proximity to the child when she gets anxious.

 

— the primary caretaker is generally giving their child up under duress; their duress is sensed by the child.  I.e., this duress is counter to the child’s developmental need to reference her primary caretaker for help with big feelings.  This makes forced overnights developmentally premature until age four when the child has sufficient conceptual capacity to rationalize and externalize the reason for the overnight absence of her primary caretaker.

 

— the child will try to perform well for both parents (in the interests of increased parental approval and attention) so learns to white-knuckle through her anxious moments – until she gets home and can more safely let out all the feelings.  The primary caretaker is then in a perfect set-up: her motives are suspect, yet she is the only one who can report how the premature overnights are manifesting in the child.  Meanwhile the other parent can usually, mostly, honestly say they observed “nothing wrong.”

 

— the other parent often wants to tell the child things such as, “This is your second home,” or “You have two homes.”  Children under age four cannot conceptualize the meaning of this; i.e., they cannot yet hold onto the idea that rules, routines and sleep patterns can operate just differently (versus punitively or catastrophically).  Yet the hosting parent sees no reason to not repeatedly push for increased time in order to make their own wishes manifest.  I.e., the developmental needs of the child are less real and imperative than the adult’s personal dream of how things should be.

 

— the noncustodial parent will normally ask How can I be a parent if I don’t have access?  What should the standard be?

 

My answer is that the standard should be limited to day-time visits only, until age four.

 

Thank you for your good question.

 

The Attachment System — thoughts over coffee

John Bowlby, “the father of attachment theory,” was a British psychiatrist and psychoanalyst who studied many British orphans after WWII.  He lost a great deal of face in his professional circles when he observed — counter to popular assumption — that “attachment” is not primarily about love.  He had to conclude that attachment was an infant survival mechanism.  The field has gradually come around to see what he meant.

Bowlby observed that most infants are born with an inherent set of skills — crying, waving, cooing, smiling, etc. — which are designed to attract and hold the attention of a caring adult.  The adult will hopefully organize both of them to provide the infant with nurture — the baby’s only hope of survival.

More recently Dan Hughes and Jon Baylin proposed that the infant’s attachment system actually triggers a complementary “caretaking system” in adults.  That is, when an infant cries, waves, coos and smiles, we adults are hardwired to respond — perhaps waving back while saying, “Hey cute baby!  Are you talking to ME?”  In this and many other ways a feedback loop is established which keeps infant and adult connected at an emotional level, long before babies understand language.

That caretaking system supports most adults to be ‘good enough’ parents to most children without having to think it through logically.  The hope for every child is that they experience enough safety and enough help with their overwhelming feelings that they gain trust and confidence in their adult caretaker — their ‘attachment figure’.  With such a “secure attachment” the child’s anxiety about survival is low.  They will rarely fear catastrophic abandonment, even in stressful situations.

When kids have a secure attachment, the cognitive-behavioral approaches to behavior and therapy tend to work more easily.  Phelan’s 1-2-3 Magic, for instance, can engage a child at the level of cognitive intellect, because that child is NOT distracted by and preoccupied with deep, unresolved anxiety about some unmet early need for connection to a safe caretaker.  Less secure children may try to force relationship reassurance first.  This is probably why the question of whether or not ‘the teacher likes me’ is a major variable in elementary school performance.

Seven illustrations at the following site attempt to show how early parenting can convey a sense of security and safety to an infant, using preverbal cues such as closeness, responsive facial and voice expressions, a kind and soothing tone, and eye contact.  I hope they are helpful.  (And I do intend to learn to ‘insert links’ before another decade passes.)

http://ddpnetwork.org/blog/parent-child-relationships/intersubjectivity-without-words-robert-spottswood/#jp-carousel-2484

 

Question: Why do child survivors want to watch horror films?

At the end of 2014 a pediatrician emailed an interesting question — Why do some child survivors like to watch scary films?

On Tue, Dec 30, 2014 at 9:44 AM, Dr. Mike wrote:

Dear Robert,

I would appreciate your brief insights on why it is that many kids who have experienced adverse events like to watch horror movies? I am trying to wrap my mind around this.

Thanks,
Mike

Hi Mike,

Great question. I have wondered the same thing, even about adults. Here are some thoughts:

It appears to me that horror movies consistently try to create a feeling of total abandonment – the more isolated and hopeless and painful and unfair, the better the horror movie, it seems.

If so, that would allow the trauma survivor of any age to:

— experience relative relief: ‘I had it bad, but not nearly so bad as that guy has it.
Whew!!’

— pretend that suffering is, well…..pretend. ‘It’s just a movie. It’s just acting. It’s not real!!’

— temporarily identify with the overwhelmingly destructive force (validates any remaining Stockholm syndrome).

— view others going through overwhelming pain, despair and abandonment, and laugh with anxious relief while they can briefly view those feelings from outside, in someone else. (Peter Fonagy articulates this dynamic in a U.K. lecture where he explains the psychology of attachment failure. He illustrates the lecture with the case of an adult client who had been convicted of a cruel murder.)

Other thoughts?

Thanks for a really good question!

Robert

Norwich, Vermont

Inner and Outer Worlds — Shifting Between Them

I recently presented in Ontario to a lovely audience of 100 colleagues at the Dyadic Developmental Psychotherapy International Conference.  I returned feeling very enriched with friendships, and pondering some of the realities of this work.

DSC03236

Using the mostly emotion-focused, relational model of DDP (Dyadic Developmental Psychotherapy), I pass frequently between the outer and inner worlds.  I can be having a frustrating day (here I am using middle class standards of frustration) such as when committee people don’t call back in a timely manner, the cell phone is ‘lost’ somewhere in the house, and I hear of a good friend’s early passing from an aneurysm.

But then I go into a session and I am under the surface, moving effortlessly through a family’s emotional life where we follow surface anger down, down to its roots in the ever-so-normal fear of another abandonment….or,

‘Talking for’ a clueless adopted child (i.e. no clue how to articulate his inner life)….talking for him to his rigid adoptive father.  Then answering by ‘talking for’ the father until they both recognize their vulnerable selves down underneath the surface of resentment and indifference.  Their sudden connection is tearful and at a deep enough level to finally count for them….or,

Consulting by phone or Skype with a distant therapist struggling to make sense of a number of surface behaviors – and we find a mother-lode when we consider each behavior to be a coded message underneath: ‘I’m afraid to get close, because I might get hurt again’ – ‘Should I abandon you before you abandon me?’ — ‘I care so much, and am so afraid what will happen if I show it’.

As Diana Fosha (author of The Transforming Power of Affect) brilliantly says of therapy work, “Affect is where the action is.”

Of course emotional safety is key for connecting with kids in the office.  As Dan Hughes points out on occasion, nearly everything kids do is an attempt to seek safety. 

For the counselor that means starting with Playfulness, Acceptance for all the child’s thoughts and feelings, Curiosity, and attention while requiring absolutely and positively nothing back from them.  Safe.  (They are used to professional adults expecting something back, something which that person ‘needs’ to hear.)

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Key for adult caretakers in sessions also seems to be emotional safety.  That means giving them the Empathy and appreciation they rarely hear for all their endless frustration and struggles.

I so wish I had learned to offer safety, back in undergraduate classes.  Safety — emotional safety — first.  But finding these lessons later, after almost accidentally hearing a DDP presentation at our state professional group’s 2001 annual meeting, is something for which I will always be grateful.

“Doorknob Therapy” and Idling Cars

This little thought struck me gently enough that I want to park it here on this blog.  It is not often we tie individual psychology to our need to save the earth.  Here is one example.

New counselors soon encounter a phenomenon which becomes familiar over the years.  A client will finish a decent therapy session, get ready to leave the room, put their hand on the doorknob and then say, “Oh, by the way….” and suddenly introduce some powerful new information which can change a lot of things.  But there is no time to process it — they are on their way out.

In the field this is commonly called “doorknob therapy”.  All the therapist can do is thank the client and make a note to reflect on this next visit.  It is too late for today.

I wondered why this happened until I watched the way car drivers will stop and talk to a friend through their rolled down car window – without turning off the car which may idle away, uselessly polluting for half an hour or more.

It struck me that these two behaviors share something in common: they provide safety to the speaker.

Why?  They surround the speaker with a context – the context of being about to escape.  When we are on the verge of leaving a situation, it feels safer to speak freely.  Think of that song about quitting a job, “Take This Job and Shove It, I Ain’t Workin’ Here No More.”  Pure freedom to finally say what the worker has wanted to say for a long time.  Because if I am leaving, you can’t do me any harm.

Not that my two examples are dangerous situations to begin with.  But unconsciously we do carry with us remnants of childhood when we were not certain what social situations were actually safe.  So at the moment of leaving a situation, all fear that the response by the other person might be unpleasant, unsatisfying, or simply unexpected, is lowered.  We can always say, “Well, I gotta’ be going now….”  Almost the definition of safety.

The doorknob in hand and the sound of the purring engine both tell us we can rush off at a moment’s notice, lowering our unconscious fear of being rejected, found unacceptable or threatened with abandonment.  We can speak with less inhibition and more courage.

Of course there is still just plain overconsuming pollution.  I am reminded of going to our town’s general store last summer.  Out front by the parking lot sits an old piano where anyone can stop and tickle the keys for awhile.  In front of the piano was parked a huge gas-guzzling SUV, idling away.  It had out-of-state plates, not uncommon in tourist-filled Vermont.  The ample-sized driver had one arm out the window and the other helping him inhale a mega-calorie Dove bar.

Being who I am, I went up and smilingly offered to play him a tune on the piano if he would turn off his engine (and stop polluting our town.)  He smiled back and laughed, snorting through his ice cream, “I don’t think so!”

Sigh.  At least he smiled.

Lawyer: “I don’t understand kids!”

A very good lawyer, who was a kind, single parent of two young children, once shared his anxiety that, “I don’t understand kids — I don’t know what they need.  I’m afraid I’ll make a mistake.”

Thoughtful, gentle……and serious.
I offered the following short version of children, recalled here as best I can:

Barring very unusual situations — like at the extreme ends of the relational spectrum — what most kids need, bottom line, are two things from at least one safe adult (preferably a caretaker, but not necessarily):

1) pay attention 

(“She thinks about me.”  “She remembers me.”  “She asks about me.”  “She keeps me in her thoughts!”)

2) care enough to be in charge 

(“She has boundaries she won’t let me cross.”  “She sets limits for me.”  “She corrects me.”  “She has rules I am expected to follow!”)

If the adult is safe and reasonably consistent, the affected child will likely be okay –- able to learn appropriate dependence as they grow.  (I.e., they feel safely contained by and connected to a safe, caring adult.)

Later, as adults themselves, they can transform that safe childhood experience of appropriate, vertical dependence on caretakers -– think caterpillar metamorphosis -– into a safe, mutual, horizontal, adult interdependence with a partner.

I.e., achieving dependence as a dependent child supports appropriate interdependence as an independent adult.  Conversely, it can be hard to manage adult interdependence if we failed to experience safe dependence in childhood.

Sexual boundaries make sense in this context.  Whereas the childhood dependent relationship with an adult makes overt sexual relations developmentally premature for the child and pathologically exploitative for the adult, the later, interdependent relationships of adults can accommodate overt and mutually enthusiastic sexual relations.

Sometimes adults show up for counseling with their own early, unresolved issues getting in the way of parenting the way they would like.  We may end up working with the parent or caretaker to resolve this, and it can take time.  It may require an extended, boundaried counseling relationship with a safe therapist who can stay empathic to the testing and stumbles which were never allowed or possible during childhood.

Because children slowly but progressively develop their independence and identities as people, infants will need more physical care, while older children will need more social and emotional care and attention to their increasingly complex inner thoughts, feelings and concerns. 

Finally, as adolescents, they re-introduce us adults to the exciting-frustrating integration of living in the home while working on peer and other outside relationships.  (Who am I really?  How do I fit in?  How do I get physically close outside my family in ways that feel safe and good?)

Sorry, is that more than you asked? I asked.

“Wow, no, that’s really helpful!” said the lawyer.  “Thanks!”

Welcome.

Answers to Parents’ Questions — part II

3. “What about setting limits and boundaries?”

Limits and boundaries mixed with sincere appreciation of the young person’s inner life (their thoughts and feelings) is something which young folks desperately need from adults.  Their early childhood experience of rules, boundaries and limits from adults who cared about them (and for them) is their best chance to internalize a sense of safety and security later in life. Rules mean structure, and structure is a form of attention.  (This is why children usually enjoy school.) Teens, of course, need to push, challenge, and test the rules all over again.  They can evade and avoid rules and even brag about it, but what counts ten years later is that adults never changed the rules or limits under pressure or threat.  “You returned an hour late.  I am not happy.  I expect better from you.  And the rule stays the same.”  Done.  Don’t apologize, and don’t explain twice. (Saying it twice is lecturing.)

Put another way, kids who grow up learning that ‘rules don’t apply to me’ stumble into adulthood without key skills in self-control and self-discipline.  They usually work out their impulses and emotional needs against police, mental health agencies, and other systems of authority for floundering adults.

4. “What are appropriate expectations?”

Appropriate expectations increase with age, and are best set slightly higher than a young person’s emotional age inside.  (A growth challenge.)  Does that make sense?

High-functioning child?

Try increasing choice, freedom and options. When they test and take advantage, you can apologize for moving too fast, and dial things back a notch. An adult’s job is to help young people grow at a pace appropriate to their emotional stage. And to do it without shaming.

Struggling young person?

Is the teen still denying, projecting, and hiding, as if much younger? Dial down the choices, freedom, and independence because they are crying for more structure, limits, and eyes-on supervision until they can catch up emotionally. And do this without shaming. Finally, the same young person may swing from one extreme to the other and back in a matter of days. Be prepared.

5. “What about suspending judgment?”

Openly judging actions, choices and events is important in a democratic society.  However, judging people is best done discretely because people need one anothers support and encouragement to stay connected in community and to grow through struggles.

Put another way, when I am struggling and making quite a mess of it (“It’s all your fault!!”) what is most helpful is to continue to see a better image of me in your eyes as you continue to relate to me and share your observations.  A judgment from you, on the other hand, can nail my sense of myself to my worst and hardest moments.

Answers to High School Parents’ Questions

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?”)

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

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 RS Toronto gesturesfollowing 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.”)

When Parents and Caretakers Struggle…

“We tried to explain to her…”

“I don’t know how many times I’ve told her…”

“If only she understood…”

Understanding the difficulties —

It can be very difficult for parents — newer, older, natal, foster or adoptive — to raise any child who has a troubled history.  Caretakers of all kinds come to the intake session with a range of frustrations.

It is important for counselors to acknowledge the adults’ own experience of inner and outer conflict about wanting to do a good job of parenting, while up against the inner life of a child who does not appear to behave in his/her own best interest.

In that respect, it helps to tend to the feelings in the room — the distress of the parents or other caretakers who have come to the intake.  Before trying to problem-solve, it pays to give empathy and acceptance to the caretaker adults who may feel unappreciated, unheard, and unsupported in their family.

It can really help when we are curious about all the thoughts and feelings which the adults may have wanted to express safely for quite awhile.  Underneath it all may be an unacknowledged grief — grief for the dream of how things would be or should have been by now.  Grieving their original dream can be where grown-ups need to start.