Chico Center for Psychotherapy

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


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. 

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Chico Parenting Support: free parenting workshops

I wanted to share some information about upcoming parenting workshops.  I have been planning on starting a reflective parenting group but it is still in the works.  I would like to share the parenting workshops that are coming up, conducted by Lynn Haskell.  Lynn has been active in the community working with parents and young children for many years, and will be offering the free parenting workshops at Butte College.  The workshop 'NO DRAMA DISCIPLINE' is based on the book by Daniel Siegel, MD and Tina Payne Bryson, PhD. It is an interactive workshop that includes exercises and group participation.  The focus will be on parenting pre-school to school age children.

May 24    Week 1/4  Rethinking Discipline, your brain on discipline

May 31    Week 2/4  From tantrums to tranquility: Connection is the key

June 7    Week 3/4  1-2-3 Discipline: Redirecting for today, and for tomorrow

June 14 Week 4/4  Addressing Behavior: As simple as R-E-D-I-R-E-C-T

To sign up call Butte College Foster/Kinship Care Education at 530-897-6235 to sign up.



Respecting your teen's privacy in a technology filled world

As a therapist working with children, teens and their parents the issue of how to deal with a teen's privacy in this technology filled world comes up on a regular basis.  I recently came across an interesting study by Cranor, et al, about parents' and teens' perspectives on privacy. It was interesting that most of the parents interviewed thought it was important for their teens to have privacy, that it was an essential element in their growth towards becoming independent adults.  It was interesting to see that the researchers found that the parents in general transgressed this right when it came to monitoring their children's use of technology.  They did not act in accordance with their believe in the importance of privacy at all.  The reason for this was a lack of understanding by the parents on which role social media played in the role of their children's social life.  The fact that popular media focus on those new technologies from a 'worst-case scenario' point of view also contributed to this effect. The reporting might give parents the impression that Snapchat is use mostly  for sending sexually explicit messages, while it is only a small fraction of teens who use it that way. 

The negative effect of this is that teens feel that their space is being invaded, and they feel they are not trusted by their parents.  All this can lead to a negative spiral of growing misunderstanding between parents and teens.  

The study finds that it is important that parents get better educated about these technologies, on the other hand, they agree that parents have an important role of guidance to play.  They advocate for software that is less restrictive but tends to nudge the teens more in the right direction.  The current digital monitoring software is not in tune with the goals of parents.  Parents want to guide, but not necessarily block certain sites. 

Digital parenting software that would be more in tune with parents' objectives would detect actions that a parent might not approve of and take the opportunity to remind the teenager of the parent’s expectations and the teen’s responsibilities, yet not block the action.  In a field trial of privacy nudges for Facebook, Wang et al. found that visual reminders of a family member being able to view content was effective in encouraging privacy-protective behaviors The nudging approach to digital parenting software might alleviate parent-teen tensions because teens would still be free to make their own decisions, albeit with guidance and reminders.

To schedule an appointment call An at (530) 487-4245.

For the study, see: Cranor, Lorrie Faith, et al. "Parents' and Teens' Perspectives on Privacy In a Technology-Filled World." SOUPS. 2014.

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.' 


The adult in every adolescent

Several years ago psychologist Ronald Epstein argued in his book 'The case against adolescence' that teens are much more competent than adults think, and that their problems stem for the most part from the restrictions placed on them by parents, and society. It is their infantilization along with the fact that we gather them in places where they spend most of their time with peers, while having minimal interaction with adults that leaves their capacities unexploited, underused.

The prolonged childhood that can last until  the 'child' reaches the age of 26, makes the transition to adulthood for a lot of teens problematic. There is a hesitation to start, to make the leap, a postponement that seems to coincide with the vast world of possibilities that are open today, and that the adolescents will put to the test. Adolescences seems to be a procrastination. It seems that the vast world of possibilities can be translated as an endless postponement. 

Miller in a recent text (En direction de l'adolescence) refers to a point that resonates with Epstein's observation of teenage children spending most of their time with peers and not with adults: Where in earlier times the child, to acquire knowledge had to pass through the Other (the parents, teachers, adults)at this point they have the knowledge in the palm of their hand. They only have to click and ask, and the device will answer, circumventing the necessity to address the Other.  

However, things might be changing.  The talk is that the newest generation of teenagers, generation Z is much more independent than the Millenials, and are intending on cutting lose from their parents at a younger age.  The digital age in which they grow up seems to provide them also with a platform that transcends just easy access to information, without having to address the Other. It opens a way of connecting to the wide world, and it opens possibilities of enterpreneurship and inspires initiatives by these young people who are eager to bring their abilities to the world. 

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

Therapists and doctors: they can collaborate.

Working with children who have also physical disabilities, it can be very important for the therapist to work closely with the doctor. Catherine Mathelin gives in her book The Broken Piano some interesting case studies relating to successful and not so successful collaborations between therapists and doctors.

She relates the story of Alexandre, a ten year old boy, physically disabled due to brain damage caused by brief respiratory failure during birth. Although he was a brillant student, his body could not follow suit. Mathelin describes her as a virtuoso whose only available instrument was a broken piano.

After his annual appointment with the chief neurologist the previous year, Alexandre had shut himself in his room, and had become quite oppositional. He did not want to go to school, and just wanted to be left alone. When Mathelin saw him he was oppositional and depressed, complaining about the injustice done to him. He felt caught between revolt and despair.

Talking about the consult with the neurologist he said that he was 'fed up with doctors.' He said that he 'tried to see the doctor's eyes, but it was hard, because he was not looking at me.' His eyes were on the 'chart.'

Every year Alexandre was brought before a specialist who did not look at him. Mathelin suggested to his parents to bring him to a pediatrician whom she respected, in addition to the visits with the neurologists. This pediatrician saw him alone, graphed his progress in a large notebook, explained all his interventions, and encouraged him to keep track of his development and growth. Alexandre was supposed to take care of the notebook and to bring it to every appointment. Unlike the chart, this notebook belonged to him. 

'For Alexandre, going to the pediatrician meant that his body now belonged to himself, just like the precious notebook.' He would speak to the pediatrician about the sessions with Mathelin and with Mathelin about the physician. 'For certain children with physical ailments, collaboration between their doctor and therapist is essential,provided that the roles are clearly defined and not interchangeable, and that the confidentiality of thesessions and respoect for the child are always in the foreground.'

Which child needs therapy?

When parents come to consult for a child, it can take some time to determine who is suffering, who wants help: the parents or the child. And sometimes when they consult for a child, it is not always for the child that is suffering most.

This shows in this summary of a chapter from the book by Catherine Matelin: 'Lacanian psychotherapy with children: The broken Piano.'

The parents of Aurore and Christine came to see CM with their two daughters. Aurore was beautiful, tall, blonde, smiling a fairy-tale princess who resembled her name. She was 7 years old. Christine, age 5, was dark and quite small, she seemed shy and more retiring. When CM asked the parents which girl had the appointment they seemed amused: 'Christine, of course.' 

CM asked the parents, once in the consulting room why they were so surprised, when she asked who had the appointment. The parents responded they thought she would have noticed right away: Aurore is self-assured, joyful. She feels good about herself. People are always worried about Christine. Christine is small, reserved. Yes, she has friends, does well in school, she likes to work. But she is very quite. Aurore is always talking, center stage. She seems overwhelmed by her older sister. 

When CM talked to Christine, she seemed not to be suffering. She was talking perfectly well, expressing that she does not always likes to talk so much, and prefers to read her books. play the piano... The parents seemed to be on the lookout for symptoms, but CM could not see what their concern was. Christine did not seem to want help, and CM invited the parents to come back and talk as it seemed that they wanted help. Perhaps it was not Christine, but something else that was on their mind.

In the meantime in the waiting room Aurore had torn out a piece of paper from the notebook in her schoolbag and drawn a picture. When she saw CM come in she rushed over to CM and gave her the drawing. Something in the urgency of the little girl made her feel that she had to listen to her. It was the sort of picture all 7-year-old girls draw: flowers, a sun, a beautiful princess with a carefully decorated gown full of sparkling jewels, gray clouds, a blue sky. 

Among the sprinkling of flowers were a few small red mushrooms that attracted CM's attention, and she asked her about them:

CM: Oh, that kind of odd, so many mushrooms...

Aurore: Yes, the are poisonous, you know, deadly mushrooms.

And the gray clouds up there?

Aurore (smiling): Yes, those are toxic fumes that kill people when it rains. 

CM: And these hills on which you planted the flowers?

Aurore: (still smiling) These are the lairs of the living dead. They come at night to cut people's throats and suck their blood; sometimes they smother them.

CM: And the princess? Is she in danger?

Aurore: The princess is the one who orders the other ones to kill. So she is afraid that they will come and take revenge.

The parents looked stunned: 'Aurore, how can a nice girl like you say such horrible things?' 

CM noticed that Aurore had written on the other side of the paper S.O.S.

The parents were correct in feeling that they needed a consultation, only they didn't know for whom they had come. It is often found that a family's demand on behalf of one child actually concerns another.  The guilt that was devouring A and her parents could be spoken of only through their 'victim,' who was bearing up quite well. It is not always the preferred child in a family who is in the better position. 


Collaborative Divorce

As a therapist I see first hand the devastating effect that a conflicted divorce can have on children. I was very happy to hear about the presence of a Collaborative Divorce team in Chico. The Chico CAMFT Chapter invited attorney Melissa Atteberry and therapist Courtney Calkins to talk about the Collaborative Divorce process. As a child therapist who works a lot with children of divorced parents learning more about this possibility in the North State is very exciting. The consequences of litigeous divorce proceedings for children can be devastating.  

Collaborative practice offers an opportunity to do things differently and better. And the exciting thing is that it is not just a process that fits couples that are still on friendly terms, as one might think. Collaborative practice can escpecially help very conflicted situations. 

The practice offers the divorcing couple a team of skilled and compassionate professionals. The team members - attorney, coach, financial neutral, child specialist - each experts in their own field help navigate the multitude of issues that are at stake in the divorce.

There are three principles to this approach:  1. Both parties pledge to resolve the issues without going to court. The partners make the decisions themselves, not the judge. 2. Open exchange of information, no secrecy, through face to face meetings with the whole collaborative team.  3. A solution that addresses both partners' interestes and concerns and that is designed to protect the interest of the children.  

The beauty of this approach is that although divorce ends a marriage, it does not need to end ties or relationships. This is especially important when there are children involved. 

Although it might seem that due to the involvement of a whole team the cost might be high, it appears that this type of divorce by reducing conflict ends up saving people a lot of money. The parnters can control the pace of the process, and do not have to fit within the 'court' schedule.

For more information look for the Sacramento Collaborative Practice Group.

An Bulkens    |    Licensed Marriage and Family Therapist    |   MFC 52746

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