Hidden messages in the alphabet song: MeN nO Pee

One of the reasons I love working as a psychotherapist with young children is their unique and fascinating relation with language. Their relation to language differs very much from the one that we have as adults. We are often caught up in the meaning of language, and don't have as much of an ear for the equivocation that is inherent to every use of language. As children are entering language with 'fresh ears' they experience language more at a concrete level and might hear messages that we as adults have become 'deaf' to. 

I recently had another nice example of this in my practice. A little boy who had had some difficulty entering language, was proudly writing down the alphabet.  He got stuck at the M. He sang the alphabet song, to help him remind what would come after the M, and although he was singing it correctly he could not figure out that next was N. Unsure, he wrote O, deleting the N - avoiding the word NO I thought. As he was singing it, and he seemed utterly puzzled, and I repeated what he said, I started to notice what he was hearing: Men No Pee. This boy, who had been very puzzled by his mother thinking he would be born as a girl, and who had also felt there was a certain prohibition of expressing aggressive, typical boy like behaviors seemed to hear in this alphabet song, the message that he could not be a boy, that men could not do what distinguishes them from girls (boys can pee standing up, girls sitting down).  

As we caught this message that he was hearing, and which expressed something about how he felt about himself, we were able to talk and laugh about it. I, as a girl, was able to deflate this message from what he heard as a prohibition of his 'boyhood.' 

Sometimes it is in being attentive to these very subtle things that we can get a peek into the mind of a child, and the ability to address it.

To schedule an appointment with An call (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

Psychotherapy or counseling effective for treatment of schizophrenia new study finds.

Psychotherapy or counseling for the treatment of psychosis and schizophrenia has been frowned upon in the mainstream.  No point in talking with or listening to schizophrenics! The recommended treatment option consists typically of heavy use of antipsychotic drugs. These drugs can cause severe side effects such as weight gain, or debilitating tremors. 

However, the results of a new long term study might finally be a game changer.  The study found that schizophrenic patients who received more one-on-one talk therapy, in combination with family support and smaller doses of antipsychotic drugs showed greater recovery over the first two years of treatment than the patients who received the standard drug-centered care. 

First episode psychosis happens typically to young people in their late teens, or early 20s. The study found that the sooner people start treatment after their first break, the better the outcome. The study was based in part on successful programs in Australia, Scandinavia and elsewhere that have improved people's lives for decades. It is the first implementation in the real world in the US.  

The study involved over 400 patients and more than 30 community clinics in 21 states. All randomly selected. The patients were randomly assigned to the combined treatment or to treatment as usual. Over the two years that the patients were followed both groups showed steady improvement, but by the end those who were in the combined program had more symptom relief. They were functioning better. The progress they had made was more noticeable to friends and family.

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