Chico Center for Psychotherapy

Psychotherapy and Counseling services for Children & Adults | Support for Parents

(530)321-2970

Chico therapist An Bulkens, LMFT is psychotherapist and counselor in Chico, California.  An Bulkens specializes in psychotherapy and counseling for young children  (toddlers, preschoolers, adolescents) and support for parents, with a special emphasis on  early childhood psychotherapy, and counseling  for preschoolers and Kindergarten aged child.  She also offers parenting skills support. She offers psychoanalytic psychotherapy for adults.  Her approach is grounded in  Lacanian Psychoanalysis. She was also trained as a clinical psychologist in Europe, Belgium.  Her education emphasized developmental psychology and psychoanalytic therapy. 

Filtering by Category: Child Psychotherapy

The Cost of Helicoptering and Snow-Ploughing your Child

Psychologists from the University of Mary Washington looked at how the parenting style of 'helicoptering' correlates with the self-determination and well-being of college students.  297 Undergraduates students (18-23) described their mother's typical parenting behaviors, as well as their autonomy and competence, their anxiety and depression, and how satisfied they were with life in general. 

The students who described their mothers as more helicoptering were  found to suffer more from anxiety and depression, and felt less autonomous.  They were also struggling more to get along with others. 

In two different studies it was found that young adults with helicopter parents have become addicted to affirmation, that they prefer the boost of self esteem over having sex, eating sweets and drinking. 

When children are praised for accomplishments, achievements they tend to read this not as the parents intend to.  They think: 'You love me for what I achieve, accomplish; this means you don't love me for who I am without my accomplishments.' They feel that they can only get love by earning it. 

Another problem is that this kind of parenting, where the parent is so over involved with the child, more than with the people of his own age class is detrimental for a more deeper reason. Why does the parent have to be so focused on the child? Why does the parent have to find satisfaction for her own life vicariously through the child.  The French Psychoanalyst Francoise Dolto pointed this out long time ago. In the introduction to Mannoni's 'The First Encounter with the Analyst' she mentions that the one crucial component in having a healthy development of the child is that the parents find the reason and meaning of their life in their spouse, or people of their own age, and not in their children.  This means that the thinking and worries about this child, that work done for this child and the love for this child never dominate the parents' emotional life. 

It is indeed the very opposite of helicopter parenting.  It is interesting that like Dolto would have predicted it is specifically this kind of parenting, which goes against the one fundamental environmental condition that Dolto mentions for healthy development that is found to be connected with an increase in mental health issues among young adults. 

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

How parents can help kids through their separation.

One motivation for a parent to bring a child to talk to a counselor or therapist is when the parents are going through a separation or a divorce.  Parents, aware of the conflict between them are often sensitive to the need of the child to have a neutral space to talk, to put things in perspective.  It is this neutral space from which to respond to their child’s implicit or explicit questions which has been lost.  The parents are at odds with each other, feel angry and hurt.  The child picks up on these emotions no matter how good the parents try to hide it, and parents are often at a loss of how to speak about their emotions to the child without attacking the other parent whom they feel so hurt by. 

An initial step would be for the parent to be aware of this underlying emotion, and to be able to name this emotion, acknowledge it.  This will allow the parent to recognize it toward the child in a more neutral tone, without the underlying, for the child confusing affect.  The child picks up on the underlying, diffuse anger that you are trying to hide, but if you can tell him as you are aware of your feelings you can say: ‘You know, I am very angry with your dad. We have a big disagreement, we are trying to work it out. I am sorry that I have been a bit short tempered, but our dad and I are working on it.’

Parents who are caught in a heated separation also tend to forget the good aspects about the ex, and the father of the child. And they might not realize that be painting this negative picture of the child’s other parent, they are at the same time painting a very negative picture of their child. Being able to acknowledge to your child your conflict, but also maintaining a space to talk about the positive aspects of the other parent will be an enormous support to the child.

Also being aware that you and the other parent share the same goal of nurturing secure children can be a common goal that allows you to connect, and transcend a space of hate and resentment.

 

Contact An to schedule an appointment at (530) 321-297

Learning about the world by creating your own world in art and play.

Before I started working as a psychotherapist, I worked with preschool age children in a small nursery school program that I had created.  I ran this little school l for about five years before opening my private practice.  One of the important things I was able to witness during my work with young children was the importance of play, and the typical high level of creativity, and natural creative exploration in young children.  You don’t have to teach a young child to play. You don’t have to teach them to be creative.  Children are naturally, deeply creative.

 

In a recent post, T. Goldstein states that 'any time a child does or learns something new they have to be creative in their own, small way. They have to come up with something original, which they’ve never done before, and something useful, which can be used to solve the problem they may be working on. Although this type of creativity may not be what we think of as being behind the great works of Picasso or Bach, the important connection between play and the arts cannot be overstated.'

It is easy for a young child to be creative before formal schooling, but it can be hard for children to keep that same sense of creative freedom once they’ve entered the classroom. Especially because of the current emphasis on curriculum standards.  This tends to lead to a certain rigidness of lessons and it deprives students of the best way of learning: through personal exploration and discovery.

This tendency has unfortunately entered early schooling as well.  Kindergarten is especially noted for moving away from child-directed activities and, 'disturbingly, towards high pressure teacher-led pedagogy.'  Goldstein mentions that 'engagement in the arts—which emphasizes personal ways of knowing, thinking about the self, and discovery—may be key to providing children with creative experiences.' 

In psychological and educational research on creativity, Goldstein states one often talks about different types of “Cs”: “Pro-C,” “Big C,” “Little-c,” and “mini-c.” “Pro-C” and “Big-C” are what we’re usually talking about when we use the word “creativity”—advances in the arts, engineering, or sciences with innovation and usefulness at the forefront. 

It is “Little-c” and “mini-c” that is critical to children’s growth, knowledge, and achievement. These can be thought of as the kinds of creativity children engage in when they’re discovering something new to them.  The process involved in this is foundational in later achievement and abilities.

How can we foster this capacity: One way is through engagement in pretend play and the arts. As children play they are creating a protected space for themselves to make mistakes and try out different emotions and social situations. Creating knowledge on your own is the best way to learn—children and adults alike will remember more, and know more deeply, material that they have taught to themselves over material explained to them. 

Sciences, math, and engineering do also require and engender creativity.  But at the elementary and middle school levels, much of the coursework in these topics is based on recreating knowledge that is already well established in those fields. 

The arts on the other hand demand creativity in the moment, constant trial and error, discovery, and mistakes. Goldstein mentions that 'in a detailed ethnographic analysis of high quality visual arts classes for adolescents, psychologists Lois Hetland, Ellen Winner, Kim Sheridan, and Shirley Veenema found that the key concepts being taught in arts classes—beyond learning how to hold a paintbrush or mold clay—were to stretch and explore thinking about materials and topics and to observe and reflect on how to engage in artistic work.'

It may be (and research is currently investigating this) that by learning these skills in an artistic way children will be better prepared for more traditional academic learning and creating their own knowledge. 

As parents we can make sure that our children can experience these kind of creativity engendering activities outside school life, which seem to be currently not feeding this need of children.

To schedule an appointment call An at Chico Center for Psychotherapy at (530) 321-2970

When your child claims the right to refuse treatment

As a therapist working with children and adolescents I am often confronted with a demand from parents to help their child.  It is typically not the child herself that picks up the phone and reaches out. Sometimes, when the parent calls the children themselves have asked their parents to talk to someone, but more often the parents call because they are concerned, and it is not sure whether the child wants to come in for himself or herself. And if they do, they might have quite different concerns. In cases where children do not want to come, or are hesitant I like them to commit to 6 sessions to give it a try, so that they can see whether it would work for them. Because, indeed, it is not because the child says he or she does not want to come, that she really does not want to come.  It could just mean that the child does not want to do what the parent thinks is best for the child. There is nothing wrong with that. Indeed, the child will have to see for herself whether she wants the therapy for herself. 

Parents often become confused when I put it that way, as they feel their child 'needs' the therapy, and it should not be left to them. My response is that therapy only works when a person can get engaged in it, and not when it is imposed by someone else. 

I came across an interesting article by R. Muller about a 17-year old girl 'who refused to undergo chemotherapy after being diagnosed with Hodgkin Lymphoma, a cancer of the lymphatic system.  The Connecticut Superior Court ruled that as a minor, Cassandra did not understand the severity of her condition. She was taken to Connecticut Children’s Medical Center in Hartford, where she was forced to undergo chemotherapy.'

In an essay that recently got published the girl states:

“I should have had the right to say no, but I didn’t. I was strapped to a bed by my wrists and ankles and sedated. I woke up in the recovery room with a port surgically placed in my chest. I was outraged and felt completely violated.”

As her mother did not comply with the court ruling, and did not bring C. to her appointments, she was removed from her mother and placed in foster care.  C. argued that she cared more about the quality of her life than the duration. Yet she was told that undergoing chemotherapy would increase her chance of survival by 85 percent. Without it, doctors said there would be a near certainty of death within two years. C. acknowledged this risk, but maintained that she had the right to make decisions about her own life and body.

The mother supported her daughter's decision: 

“She knows the long-term effects of having chemo, what it does to your organs, what it does to your body. She may not be able to have children after this because it affects everything in your body, it not only kills cancer, it kills everything in your body.”

There is some concern that C's opinion on medical treatment could have been influenced by her parents. This issue is especially important given the far greater chance of survival offered by treatment.

At this age the right to independent decision making at this age is an important factor. In her essay, Cassandra writes:

“I am a human—I should be able to decide if I do or don’t want chemotherapy, whether I live 17 years or 100 years should not be anyone’s choice but mine.”

And it is important that this desire for independence should be heard.  Does this mean that any demand has to be immediately satisfied, because it is the demand of the adolescent wanting to be independent? Of course not.  It is important to hear and and worked through. 

A refusal to see treatment, whether it is chemotherapy or psychotherapy does not necessarily have to be considered an obstacle to the treatment.  It is an important message that needs to be heard, and that can be worked on.  And it is an essential first step in having a successful psychotherapeutic treatment with an adolescent. 

C. was discharged from hospital last April, after completing treatment. Prior to being released, she wrote on Facebook: “I have less than 48 hours left in this hospital and I couldn’t be happier!”

She reported that she was grateful that she responded positively to the drugs and was predicted to survive cancer-free. But she also added:

“I stood up and fought for my rights, and I don’t regret it.' 

 

Co-parenting your child

Counselors  and therapists working with children and their parents are often confronted with the difficulties for a child of living in two households. It becomes increasingly difficult for the child when the parents do not, or barely communicate, and when miscommunication between parents build up. As I mentioned in the last post, a common effect of this is that parents perceive that the child is lying. However, this 'lying' is an effect of the parents not communicating, and the child wanting to protect both parents, and wanting to please each parent. This 'lying' can add to the conflict between the parents, who think that the other parent is instigating the child to lie, leading to an increase in alienation between the families, and complicating the position of the child. 

The practice of shared parenting has been recognized by the research community and by legal and mental health practitioners as the preferred parenting arrangement after divorce, and being optimal to child development. It is recognized that shared parenting is the most effective means for reducing high parental conflict. Of course this applies to situations where there is no substantiated family violence or child abuse. 

However, in my experience there is a lack in services to help families to support in their shared physical custody. It often is just 'shared' with respect to the 'time,' and the 'sharing' at other levels seems to be left to the child (hence the tendency to 'lie'). For this collaborative parenting to be successful, there needs to be an accessible number of family relationship centers that offer family mediation and other relevant support services outside of the court system. In this county it seems that mediation is immediately linked to the 'court.' There is a need for governments to help establish such networks.  To help parents create an environment for their child where 'shared' parenting is not just a 'time share.' Because when it is only a time share, without any further communication between the parents, the divide between the parents can get so big, that it is as if a wall is constructed within the child. The child lives in one world when living with one parent, and in another world when living with the other parent. It is as if the child is not allowed to have 'shared parents.' Each parent thinks he is the only parent for the child, and acts as if the other one is not there. The effects for the child can be devastating even when 'on paper' there is 'shared custody.'

To schedule an appointment call An Bulkens at (530) 321-2970

The 2 key components to handling your child's tantrum.

Parents of young children often consult a therapist or counselor because of acting out behavior, or the throwing of tantrums. A child's tantrum, especially if it occurs on a regular basis can cause a disrupt family life, and exhaust parents, leading to less patience of parents, more irritation, and hence more tantrums. 

There are two key points in addressing this kind of behavior that are often overlooked, and which are crucial in addressing your child's tantrum:

1. Stay calm:

Often when the child escalates, the parents escalates along with the child, not being able to contain the child. In those instances it is initially better to give yourself a 'time out' than immediately giving your child a time out. If you feel you are starting to escalate with your child, step to the side, take a few breaths, calm yourself down. The first important step to containing your child is to stay calm yourself. 

2. Reconnect:

Once the child is calmed down, the parents are mostly relieved that the storm is over,  and not much is said about the whole incident. However, as a parent you might want to reflect on the whole event. You might want to think about what triggered your child, what did he or she think, what did he or she feel. If you have some ideas about that, you can tell your child this in simple words, and you might have some ideas on how your child might be able to go about it in the future. 

So, while the child is escalating, you stay calm, do not try to reason with the child. You might want to use some soothing words, empathize with his strong emotions, without becoming overwhelmed by them. You can tolerate them, you are containing them for the child, who is not able to do this.

After the child is calmed down you can use words: not preaching, not lecturing. But reflecting words about what you think was going on for the child, and how the two of you might be go about it differently the next time. 

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

My child does not want therapy.

When parents first meet a counselor or therapist to talk about their child, they are often concerned that their child will not want therapy, or would not be willing to come in to talk. I typically do tell them that indeed for therapy to work it is important that the person engaged in it wants to come, is engaged in the process. This is the case for adults as well as for children. My first job as a therapist whether I am working with an adult or a child is to explore whether there is a demand for help. Sometimes the adult is sent by a concerned spouse, but is not suffering himself. Sometimes a child is brought in by concerned parents, but the child is not suffering himself. In those cases it might be better to work with the concerned spouses, or with the concerned parents.  It might take some time to explore whether the child wants to come.  

Just the child saying he or she does not want to come is of course not enough of a reason as the child does not know what he is refusing.  It will be important for the child to say this in the presence of the consulting room, after the experience.  Sometimes a child just tells his parents that he does not want to come, but actually engages in the process and tells the therapist session after session that he wants to come back.  If that is the case, it is something that needs to be explored. It is important that the decision to start or not start the treatment is something that is expressed in the treatment room, by the child himself, and not through a parent. 

Parents might be hesitant of their child wanting to come to treatment because they think of therapy as a way 'talking about feelings.' Although treatment can certainly include talking about feelings it is not only that, and it is much more in the work with children.  The child will typically come to the treatment with the idea that the therapist is a figure like a teacher or a doctor, a parent: an authority figure. It might take several sessions for the child to explore the possibilities and nature of the therapeutic space: a space where you can say whatever comes to your mind without getting in trouble, a space where you do not 'have' to do anything.

As an example of this I can mention a child that came in pouting, feeling he had been forced to come to see me. He did not want to come and talk to me. He had spent the whole session with his head on his arm, pretending he was sleeping, and eventually even falling asleep. He was refusing my presence. Or was he. At one point I peeked under his arm, met his gaze, waved at him, and he waved back and smiled. At the end of the session, in which I had been talking about what his parents told me about him, I told him I would like to see him again (even though he did not do anything!) He responded to my surprise that he wanted to meet me again the next week. A session were apparently little happens can be very important, and actually can mean a lot! 

To schedule an appointmet call An at (530) 321-2970

 

Language as traumatic for the child.

In the earlier blog I talked about trauma and psychotherapy with the child. When parents bring their child in they often think that their child’s suffering must be connected to a trauma, which is typically understood as ‘accidental.’ If trauma is  ‘accidental,’ it would imply that it can be avoided, and that there are some children who can escape it.  However, trauma is 'structural.' This means that also children who have not suffered an ‘accidental’ trauma can sometimes get stuck, and might at times benefit from psychotherapeutic work.

Indeed, one can say that entering into language for a child is puzzling, even traumatic. Language is at first completely incomprehensible to the child and full of equivocations. The words of adults are for the child full of impasses and ambiguities that cannot be resolved, and the affectif charge often adds anoteher puzzling dimension. The child's attempt to make sense of this, or to question the adult can be complex, puzzling, and lead to a cascade of mutual misunderstandings between parent and child.  Parents often think that communication is straightforward: a word is a word and means a thing, and they might gloss over the fundamental dimension of misunderstanding that is structural to human interaction. Often the implicit question goes unnoticed. In my work with children and parents it is crucial for me to explore what parts of language might be puzzling the child to the extent that it gets in the way of his or her development. And what might be the implicit questions that are connected with this piece of language which are not being heard. 

A little girl yells in a bout of frustration, angry at her mom: this is my house, leave my house, leave me alone.  These words shock and hurt the mother: They are the exact repetition of the words her father had used when the couple was going through a divorce but still living together in difficult circumstances. The mother’s affective response to these words was one of pain, sadness, feeling rejected by her daughter. She took the words literally as a real desire of the little girl really for her mother to leave her.  This lead to a response of the mother moving away from the child, leaving the child feeling abandoned, in despair, clinging to the leg of her mother, who became increasingly frustrated with the apparently illogical behavior of the child.

It is clear that those strong words the girl heard spoken by her father at age 2, 5 had a big impact. The threat of her mother being sent out of the house must have been a scary, but maybe even fascinating thought –leaving her alone with her daddy. In her anger with her mother, she expressed the same movement of rejection, she had seen her dad express to her mom. However, although she spoke those words, she was clinging to her mother’s leg, clearly not wanting her mother to go.  One could think that maybe the example of her dad being angry with her mom was the only model she had, and that was how she expressed her anger.  But there might be more at stake. We might see that expressing them in a moment of anger to her mother also implies an expression of puzzlement with those words. It might be a question regarding their parents’ relationship ending, and wondering about their fights, and about her place in this story.  Are the fights between her and the mother also going to end in her mother leaving her? Would her dad ever say such a thing to her, if he would get mad at her? When she yells this at her mom, could it mean: Dad was right to send you out of the house. I wish I could just be with him, and not have to bother with you. At dad’s house batteries never die…’

In my work with parents I hope that they can start to see that what their child says can have many layers to it, it is not one dimensional. When a relationship is stuck or a child is stuck, and the parent does not understand the child, or might be stuck in a limited understanding of the child, psychotherapeutic work can help start exploring a different approach that might open up the relationship between the parent and the child, or might help the child get unstuck.

In my work with the young child I help the child in the process of making sense of the enigmatic language of the adults that surround him or her, and I offer him a place where he can start to find his own place in the for him possibly confusing world of language. 

To schedule an appointment, call An at (530) 321-2970

Why does psychotherapy work with young children?

As a psychotherapist and analyst I can at times get a response of disbelief when I say that I work with children that are sometimes as young as 2 years old. Some of my colleagues work even with new borns, infants... The puzzlement seems to connect with a certain disbelief that 'talking' with such a young child could be helpful. And is there even need for help? Are children not resilient? Psychotherapy is  often, and rightfully understood as addressing some kind of 'trauma.' Are children that young already truly 'traumatized?' They can be, and even if there is no immediate trauma in the typical sense we are used to understand that word - a traumatic birth, a medical issue, there is the trauma that every human child is confronted with when he comes in the world: language. From the moment the child comes into the world he is immersed in a bath of language. The 'talking cure' can help even very young children for what can be truly traumatic for a child is exactly language. In spite of the best intentions of the people who speak them, words that surround the child can hurt and pain the child, can make it difficult for the child to speak, express himself.  It is this inability to put what hurts into words  that is the basis for appearing symptoms. Psychoanalysis and psychoanalytic therapy can  help deliver that what is said beyond the speakers intention, and what might be connected with the child's symptoms. Once this unspoken truth is delivered, the symptom can disappear. 

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

For Therapy to succeed...

For therapy with a child to succeed it is important that certain parameters are in place. The child needs to understand that the counseling session is confidential, that the therapy room is a place where her feels safe.  The child has to come out of his or her own desire to the counseling session, and not to please the parent or the therapist.  In case the parents are the ones that are suffering from the child, but the child is not suffereing from his symptoms, it would be more indicated to work with the parents.  It can take several sessions to establish this, and for the child to get a full understanding about the working of the therapy. 

But there are certain issues that if not put in place right from the beginning can already immediately predict the failing of therapy.  One common case is when a parent asks for therapy for a child, without telling the other parent with whom they share legal custod  about it. This becomes a very difficult circumstance to work under. The other parent will find out eventually, might become upset, and when the child feels that one of its parents are not in favor of it, the therapist's office stops being a safe place, and the work is jeopardized. As a therapist, for the sake of the child, I typically only work with the child when both parents are consenting to it.  Excluding one parent, would make it impossible for me to talk to this parent, who is equally important to the child as the other parent. Parents often do not fully realize this, as they are hurt by the other parent, and might not consider them a good husband or wife. This might be the case, but still each of the parents, no matter what their human flaws and limitations are need to be genuinely recognized and respected if the work with the child will be successful. 

This became again very clear to me through my work with a foster child. Unable to work with the parents, due to the state funding, as they were considered the 'perpetrators,' I was unable to build an alliance with the parents of the child, to connect with them. The inability to gain the trust of the parents of this child made it very difficult for this child to come to his counseling sessions. He did not experience it as a safe place, as he felt that his father was not in favor of it. 

Another typical situation that undermines the therapy work that can be done with the child is when the parents are engaged in a legal battle.  When the child feels that saying certain things might jeopardize the position of one of the parents, as there is no trust in confidentiality, the child then is torn between parents and therapy is not a safe place for her anymore. 

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

 

How long will my child need therapy?

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

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

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

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

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

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

Bruce Perry in Chico: Maybe lawyers know something Bruce Perry does not know

On May 8 Bruce Perry spoke about Childhood Trauma and the Brain in front of massive audience of about 1300 people during an event organized by Options for Recovery.  

Bruce Perry’s message is in essence a very hopeful and encouraging one for the treatment of traumatized children and adults. As the brain is a malleable, plastic organ, it can be changed and ‘healed’ by an intentional therapeutic practice that keeps in mind the findings of neurobiological research. Perry regrets that policy makers and current ‘evidence based practices’ are typically at odds with those findings. He advocates a treatment approach that mimics the development of the brain: ‘from the bottom up,’ with the more primitive parts of the brain developing first. The first brain structures to develop are the brainstem (regulating heart beat, respiration, stress response), and the cerebellum and diencepalhon (motor function control, hearing, vision, smell, taste and touch perception), followed by the limbic system (emotional and relational) and then the cortex (cognition, believes).  Traumatized children typically have disorganized lower brain functions, and a fortiori even more disorganized higher brain functions. It is crucial that therapy addressws the disorganization of the lower functions first, with interventions that are specifically tailored to regulating and strengthening the parts of the brain that are disorganized.  A typical Cognitive-Behavioral approach, which focuses on engaging the higher functions in modulating emotions and motor behaviors is ill informed from this perspective.

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An Bulkens    |    Licensed Marriage and Family Therapist    |   MFC 52746

Tel. (530) 321- 2970    |   186 E 12th ST,  Chico, CA 95928