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. 

What if my child does not want therapy?

Therapy to be effective has to be a voluntary activity, something a person engages in because he wants to. Of course, nobody really 'wants' therapy. Maybe, on one level we might want change, but on another level change can be difficult, and the known, even if painful, can be comforting in so far as it is the known.

Sometimes people come to therapy because their spouse thinks they need it, and in the case of children it is often the parents who think the kid needs help. The spouse, or the parents might be right in thinking there is something troubling their loved ones.  However, when the child or spouse don't want to come in for themselves but rather to please someone else, or because they are forced to, therapy becomes impossible.

If I tell this to parents that consult me for a child who seems to be resisting coming to therapy, they sometimes hang up, and say their child does not have a choice. This is an unfortunate response, as I like to tell them a second part. 

Whenever a child, teenager, or an adult is not sure whether they want to engage in therapy for themselves, I invite them, if they feel comfortable with me after the first session, to commit to 6 sessions, and to make the decision whether they want to continue after those 6 sessions. It is not because a person says that he does not want therapy, that he does not want therapy! It could just mean: I do not want to comply with what you want for me. In those 6 sessions a space can be created where the person can come to the decision that therapy is something that could benefit him, or is something that she can want for herself, in her own name. 

I have also had a parent stop bringing a young child, because the child said she did not want to come to therapy. However, this child was engaged in the process and making progress. However, going to therapy is difficult and can produce anxiety. It is very typical not to want to go to a session, but that does not mean that the child does not want therapy.

It is important not to take these expressions at face value. The time and the space need to be taken to explore them. Therapy cannot be forced upon someone, but it is possible to offer people space where they can come to their own decision whether they want it or not.

Chico Therapist starts new Parenting Group: Parenting Salon

Chico based therapist, An Bulkens will be starting a new, small and intimate group for parents of young children. It will be a 'parenting salon.' We will be reflecting in a small and intimate group of max. 6 parents on specific situations that we encounter with our children, and that puzzle us, might leave us feel a bit perplexed.  

The focus of the group will not be to 'teach' on how to parent.  Parenting is a creative job, and there are many different ways to parent. But to help you explore new ways of approaching situations where you might feel stuck. This group will foster your capacity to reflect on your child, and the specific interactions between you and your child.  It is precisely this capacity that is important in creating a strong connection with your child. Our starting point will be the very concrete situations that you encounter with your child. We will explore these situation in detail, from multiple points of view, with the goal of allowing a new perspective to arise. This will offer you a new perspective on how to engage with your child in difficult moments.

The group will meet on an ongoing basis, with a commitment of a month (4 sessions). Each month, if there is an opening a new member can become part of the group. Fee per session: $40. 

The group will be lead by Chico based psychotherapist An Bulkens, LMFT. An has a background in developmental psychology and psychoanalysis, and works with parents and young children. 

How to talk with your young child about sex (2)

In my therapeutic work with children and in consultations with parents the issue of sexuality and how to talk about it often comes up. I recently saw a youtube video where young children were giving 'the talk' about where babies come from. The environment was a quite sterile and gray environment with the parents sitting quite awkwardly at a table with their child, to whom they were going to deliver 'the talk.'

Rather than planning on having the talk at one specific moment, it might be a better idea to start talking to children as soon as they have explicit or implicit questions. When you are giving a 2 year old a bath, and he points at his penis, name the part by its actual name. The same for the girl.  Typically around age 3, when they discover sexual difference, children start to have more questions. Sometimes they pose them explicitly: They make a comment on the difference between boys and girls, or they volunteer an idea on how they think babies are made.  Or the question is implicit: Suddenly they start to make a lot of 'butt jokes,' or 'fart jokes.' Valuable opportunities are missed when those questions are not responded to, or when the 'inappropriate behavior' is punished without the underlying question being heard.  

These are all great opportunities to explore the child's thoughts about the subject more, and to give them simple information, in a matter of fact way, in the line of the truth. These kind of conversations will need to be repeated as the child grows up, as the child tends to 'forget' those things. It is important to take the child's questions at face value, and to not get embarrassed about it. Simplicity and a matter of fact approach are key in responding to the child.  If not they might feel there is something wrong about the topic, something that cannot be spoken about.

Here are some examples mentioned at the website of the Mayo Clinic: 

• How do babies get inside a mommy's tummy? You might say, "A mom and a dad make a baby by holding each other in a special way."
• How are babies born? For some kids, it might be enough to say, "Doctors and nurses help babies who are ready to be born." If your child wants more details, you might say, "Usually a mom pushes the baby out of her vagina."
• Why doesn't everyone have a penis? Try a simple explanation, such as, "Boys and girls bodies are made differently."
• Why do you have hair down there? Simplicity often works here, too. You might say, "Our bodies change as we get older." If your child wants more details, add, "Boys grow hair near their penises, and girls grow hair near their vagina's."

It is these kinds of little conversations, where the questions of the child are heard, and then responded to without embarrassment, giggling...

Sometimes, if you feel too embarrassed to answer certain questions, it does not hurt to be open to your child about that. You can tell them that you have to think about how to answer that question. 

Sometimes a therapist can also help you out how to explore these important topics with your child.

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

There are no 'Bad parents'

When parents contact me for therapy or treatment for a child, it is often with a sense of guilt, or feeling inadequate. They might even fear that they will be considered being a 'bad parent.' One of the first things that I want parents to know when they come consult me, ask me for help with their child, is that there is no such thing as a 'bad parent.' Not for me as the therapist, not for the child they are concerned about. The flurry of books that teach you how to parent might give the impression of there being a 'norm' a 'standard.' However, as I have said in other places, each family, each child, each parent is unique. There is no standardized way to parent. 

The proof of this is that even when parents do everything 'according to the book,' or 'according to best practices,' there can still be impasses, surprises, unexpected struggles and challenges. The reason for this is that raising a child is not only about limits, behaviors, consequences.  There is a wealth of relational, and emotional threads, some visible, some known, but some hidden that might go back to very early times in the child's history and in the parents' history. Sometimes those threads get into incomprehensible tangles. No parenting book, no well meaning advice can help here. This is where the value of psychotherapy can come in. A good psychotherapist is not into labeling, is not going to tell you what a 'good' parent would do, but can help you untangle the threads in which a family can get caught.

You can reach me at (530) 321-2970

How to respond to your young child's 'inappropriate' behaviors.

In the course of a therapy we often bump into family secrets or painful situations that are not spoken about. The taboo on talking about difficult subjects is something that I also notice in some preschools and nursery schools protocols. When a child picks up a stick and starts 'shooting,' he or she is often met with a 'no, this is not allowed,' but no elaboration, no further communication.  The 'no' to picking up a stick and shooting can be puzzling to a child. Why do I see adults shooting on tv and video games  all the time, but am I not even allowed to pick up a stick and pretend to do the same thing?  It is very puzzling, and without 'conversation' it just does not make sense.  It is not uncommon that the child keeps repeating the action of shooting, implicitly questioning the adult, in an attempt to make sense of the adult's logic. A more constructive way would be to help the child find different ways to express his power, his strength, his ability to practice his 'aim.' Rather than forbidding it, the child can be congratulated for his strength and power, while at the same time being guided to a more complex way of expressing his aggression

When a 4 year old child made a phallic sculpture out of play dough and put it in his pants, he was reprimanded. But no further conversation was offered. Often those behaviors are implicit questions about sexual difference. Responding by congratulating the child on observing the difference between boys and girls, a conversation can be started, which would be more enriching and helpful for the child than a pure no. 

What we communicate with these rejecting 'no's'  to the child is that we are not comfortable talking about violence and sexuality. How difficult it is indeed to talk about the simple, basic things of life. However, in my experience being able to talk about these basic things of life is one of the most important gifts we can give to our children. 

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

What is not talked about, tends to repeat itself.

In my practice I encounter at times parents who do not want to talk about certain aspects of the past: the painful history of an absent father, the fact that the child was abused at an early age... I often get the question: Why talk about these painful things when the child does not even remember them, or even asks about them? As if talking about them will increase the pain, will unnecessarily open old wounds that do not need to be opened anymore.  Talking about it might be very hard and difficult for the parent, but can be a crucial step in helping the child, and in preventing the past to repeat itself.

In my work with adult clients I see how not addressing the truth about a biological parent, or about a painful family event can have very detrimental, long term effect. Over and over again I see, that what is not spoken about, what is taboo tends to repeat itself in family histories. I think of the family where 4 generations of women have been raped, and where the teenage daughter is putting herself in situations that might be devastating. It is not until this family history and the pain that goes with it is put into words that something new can happen, and history does not have to repeat itself. 

New downtown chico therapist office

Starting December 1st I will be in a new office at 344 Flume street, Chico, CA 95928. It is on the corner of East 4th Street and Flume - not too far from the big hands sculpture. 

 

Looking forward to welcome you there!

(530) 321-2970

What to say when your child asks: 'Is Santa real?'according to dolto

I am continuing with my little series on Francoise Dolto. This time an excerpt from 'Lorsque l'enfant paraît.' Volume 1, pg 94-96. A rendition of the radio program she used to have in the 70's. People would call in with their questions on child rearing.

Dolto responds to a question about Santa. Will children not be very disappointed when they find out that the parents lied to them about the existence of Santa? Her answer:

'I think that this is posing the wrong question. Children need a lot of poetry, and adults too, since they themselves keep wishing each other a merry Christmas, right? What is a real thing? By the way, a lot of money is made due to Santa: is that not real? When one makes a lot of money, then it seems to be a real thing, right? But, I think that this listener worries that the child believes in Santa as in a lie, and that talking to his child about Santa is lying,' But a myth, is poetry and has its own truth. Of course, this does not have to go on too long, and don't tell that Santa won't bring presents if the child does not listen to the parents...

When the parens 'add on' to this belief and seem to take it too seriously, then the child herself won't be able to tell them anymore: 'You know, my friends tell me Santa does not exist.' At that moment you explain her the difference between a myth and a living person, who is born, has parents, a nationality, who has grown, will die, and who lives like all human beings in a house on earth, and not in the sky. (French Santa seems to live in the Sky - Note by An)

I want to let you know that this listener is strongly opposed to Santa's, especially the ones walking around in the streets.

Maybe he feels rightly so that those dressed up people depoetize the real Santa, the one in which he believed, and the one one did not ran into during the whole month of December. It bothers him. Or maybe he is a person who does not have much poetry left inside. In any case, I don't know whether you still believe in Santa, but I still do. I can tell you a story - as everyone knows I am the mother of the singer Carlos - when Jean (that is his real name) was in Kindergarten, he asked me one day: 'How come there are so many Santa's? There are blue ones ... purple ones, red ones!' We were walking down the streets and they were everywhere. I told him: 'You know, that Santa there, I know him, it's Mr So and So.' It was one of the salespeople at the toy store or the bakery, who had dressed up as Santa. 'You see, he has dressed up as Santa, and that other one too. He is a salesman dressed up as Santa.' He asked me: 'But what about the real one?' - 'The real one is inside of us, we carry him in our hearts. It is like a big gnome that we imagine. When we are little we like to imagine that gnomes and giants exist. You know that gnomes do not exist. Neither do giants from fairy tales. Santa. he was not born. He does not have a mother or a father. He is not alive. He is only alive on Christmas in the hearts of all those who want to surprise and celebrate little children. And all the grown ups regret not being little kids anymore. That is why they like telling kids: 'That is Santa.' When one is little, one does not make the difference between real living things, and things that you can find only inside, in your heart.'

He listened to all that and told me: 'So, then the next day, he does not take off in his sleigh, with his reindeer? He does not fly through the sky?' - 'No, as he is in our heart. - 'So, when I hang my stocking, he will not give me anything?' -  'Who won't give you anything?' - 'There won't be anyting in my stocking?' - 'But yes.' - 'But who put it there?' I smile. 'You and daddy will put something in it?' - 'But of course. - 'Then, can I be Santa too?' - 'Of course you can be Santa.' We will hang our stockings, your dad, me and Mary. You will put things in it. You will know that you are Santa for others. And I will say: Thank you, Santa; it is you who will be thanked, but I will act as if I do not know. For your dad, I will not tell him that it was you, that will be a surprise.' He was delighted, happy and he told me on our return: 'It is now that I know that he does not really exist, that Santa is really good.' 

The child's imagination and poetry is not gullibility, nor childishness, but intelligence in a different dimension. '

From: Francoise Dolto, Lorsque l'Enfant parait.

To contact An, call: (530) 321-2970.

Dealing as a parent with sibling rivalry 2

In my therapy practice the issue of sibling rivalry is a recurrent theme. Here are some thoughts about the issue by Francoise Dolto was a very popular French psychoanalyst. She had a radio show in the 70's. Her understanding of the world of children is still very relevant today. This is a continuation of last week's post.

The interviewer mentions a 4 year old boy biting a little baby quite viciously, and asks Dolto whether that is quite common. She replies:

'Relatively common yes, it is especially important that the parent stays calm and present (see the post on reflective vs reactive parenting). Especially, don't yell at the older child. He feels already pretty bad about what he did. Instead, take him aside and tell him: 'See how strong you are. But your little brother or sister is very weak, very small, just like you when you were little. Now he knows that he (or she) has a strong brother and he will have confidence in you. But, you know it is not him that you have to bite. There is no point. You cannot eat him.' Because little children when they find something that they think is good, they taste it, eat it. They are not that far removed from cannibalism. Especially as they might see the little baby breastfeed. For them a baby that sucks on his mother is a cannibal. They don't understand anything of this strange world. Biting will pass when the parent perceives it not just as a mean reaction, but more as an anxious reaction.'

But when the jealousy  continues, does it not become serious? What to do in those cases?

It becomes serious when the parents are anxious. Secondly, when the child suffers a lot from feeling abandonned. This does not mean that he really is abandonned, but maybe he is not getting the right help. And how to help a jealous child that is suffering? The father can do it best. The father, the mother's sister, an aunt, a grandmother...If it is a boy, it should be a man who helps him. For example, on Sunday his father might tell him: 'Come, we men...' And they leave the mother and the baby:  'She only thinks of her baby.' It is important that the dad says little thinks like that: 'You are big, you come with me.' It is as if he is promoting the older one to help him deal with the jealousy reactions like wetting the bed again, just wanting to eat baby food, whining or not wanting to walk anymore. What is all this? It is an identity problem: a child seeks to imitate the ones that he admires, and he admires what the mother and father admire. So, when it looks like one is admiring a baby, you can't manage anymore: it is important to support the older child in his development. It is important to have him spend time with his peers, not always keep him close to the mother and the baby."

From Francoise Dolto: 'Lorsque l'enfant parait.'pg. 23

To schedule an appointment call (530) 321-2970

Dealing as a parent with sibling rivalry

In my therapy practice the issue of sibling rivalry is a recurrent theme. Francoise Dolto was a very popular French psychoanalyst with her own radio show in the 70's. A lot of what she said is very sound advice even in our time. It is a pity that she has not been translated, or has been barely translated into English.

I will be posting some excerpt of her radioprogram, related to topics that come up in my practice and that have relevance for parents today.

"About the birth of a new sibling. The older child might say: 'But why? I don't want it.' 'But that baby is not for you.' However, in many families, parents announce: 'A little brother or sister for you.' The child then immediately expects to have a friend of his own age, as he knows other children who have brothers and sisters. So he thinks 'that will be immediately.' 'But you know that you were born a very small baby.' You show him photos: 'See what you were like when you were little. That is how the baby will be born.' And if  the child decides: 'If it is a boy, I don't want it,' or, 'If it is a girl, I don't want it,' you might answer: 'But, you know, it is absolutely not necessary that you love your little brother or sister. He will have parents just like you have parents.' The child that is told that he does not have to love his sibling, will love him or her the most, as it is very natural. When he says that he does not love hiis sibling, it is only to say something silly, to oppose his parent, to push her buttons."

(Lorsque l'enfant parait, pg 22)

How to talk to your child about important events.

As a therapist I might have a certain bias towards talking. Based on my experience I know how important talking, conversations can be to help a person move through traumatic events.  And I know how important it is for adults to talk to children, even very young children about changes. A move, an upcoming absence of a parent, a death of a relative... Life events that can ruffle up our lives but that we often do not talk about with our young children. ''But she won't understand.  She is too young.' This is a typical adult response when he or she does not think about talking  to the child about those major life event. I would respond: 'Exactly. It is because she does not 'understand' (in 'adult' categories)  that it is of the greatest importance that the child is addressed, spoken to about these major events. Not necessarily in 'logical' terms. If not addressed the message that the child might be getting is that he is just an 'object' that can be 'moved' like a car (in the case of a move,) someone that is not affected by the sudden absence of a family member (travel for work/ death). It is as if he gets the message that he does not have an inner life. These implicit messages can be quite detrimental for the child's growth. It can also affect the relationship with the parent, the sense of connectedness.  It might lead to acting out,behavioral issues that might be quite incomprehensible for the parent, and might spiral out of control to frustration of both parent and child.

This is important for even very young children. I am reminded of a child who moved as a 6 week infant into a new home. After this move the child seemed 'depressed.' Indeed, this young child went through an experience of loss. The newborn child who is just starting to attach to his caregivers, attaches to the caregivers in the sensory context of the environment.  Dolto pointed out that for the baby the mother and the father are a mother and a father in this particular house, environment. When the family moves,  the baby 'loses' the mother and the father from the old house, and needs to addresed about this.  If this is not addressed the symptoms the baby might be showing might even imitate, or appear as symptoms of autism.

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

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.

A therapist about the treatment of a child

Helene Bonnaud is a child analyst and therapist who practices in Paris. The following case study is a close rendering of a case from her book ‘The Child’s Unconscious’ (L’inconscient de l’enfant.’) I am summarizing it here as it can give a sense a better sense of psychoanalytically oriented therapeutic work with children.

Sarah

Sarah just turned three. She does not move, does not speak, does not play. At the moment of the consultation she has been in treatment with an occupational therapist, and has received diagnoses of infantile psychosis and autism.

During her first encounter with Sarah, Helene Bonnaud remarks that although Sarah does not look at her (a symptom often understood as indicative of autism), she seems to ‘avoid’ her gaze (indicating she is aware of the gaze). Sarah seems also very present and attentive to what the father and the analyst are talking about. Based on this initial presentation, Helen Bonnaud thinks that the diagnosis of autism is not warranted.

Sarah is the youngest of 3. The oldest sibling, a boy, died at a very young age, which was a great loss for the parents. The second child, a girl, anxiously anticipated after the loss of their first child is doing very well. When Sarah was born, the parents were less worried. She was a quite child, posing no problems. She ate well, slept well. The only complaint the parents might have had was that she did whine and moan quite a bit. At the moment of the first meeting the father is still in shock after an incident that happened the week before: Sarah had fallen out of bed and had broken her petrous bone. This incident had reactivated the anxiety connected with the loss of the first child. She was hospitalized for 3 days and recovered well. In the hospital the nurses were impressed with the fact that Sarah had been so ‘courageous.’ Unlike a typical child her age: she did not cry, did not complain a word.

At the time the parents come to consult for Sarah they are going through a divorce. The mother is planning on moving back to her native town in the south of France where she already spends part of the week. She leaves Paris on Sunday night and returns a couple days later on Tuesday night. On Wednesday morning she accompanies Sarah to her appointment with Helene Bonnaud. ‘Going to see Ms. Bonnaud’ takes on the function of a desire for the mother, and this is crucial. At the level of needs/requests there is a certain level of reciprocity (I ask, you give). However, it is essential that beyond this level of ‘needs that want to be met’, another dimension shines through: the dimension of what the other ‘desires.’ It is because the mother has been able to formulate a demand that is not just that Sarah eats well, becomes potty trained, sleeps well, looks cute, but a demand that we call desire, that the analytic work has been able to allow for Sarah to encounter this desire of the other.  

After several months Sarah is not mute anymore and starts talking to Helene Bonnaud, who is surprised that one day she calls her ‘Madame Bonnaud-lyste.’ Every week Helen Bonnaud gives Sarah an appointment card which she puts with pride in her pocket. She is very proud of this as her mother has also a card of ‘Madame Bonnaud-lyste.’

So, for Sarah the moment when her mother returns home, is in syncwith the rhythm of her weekly sessions. The appointment card, with the name of her analyst, lends itself to a little game: it becomes a train ticket for Marseille, the city of her mother. And it is very entertaining for Sarah to discover all the things one can do with it… She leaves, returns, she puts Helene Bonnaud in charge of selling the tickets, and slowly assigns her the role of the mother who buys the tickets to leave. By way of this play she starts to symbolize the absence and presence of the mother. This is an essential operation for the child, as it gives meaning to the absence and as it allows to situate this loss or separation in a back and forth movement: the object will return after she leaves.

After 10 months of therapeutic work Sarah is transformed. She speaks well and learns easily. She is lively, and determined which surprises her environment. Although at times she can still be withdrawn and a bit sad, or ill at ease.

When she moves to Marseilles, she understands that leaving is taking the train and that there is always a back and forth. She knows that her mother returns, that her father comes and goes, that traveling is like the analysis, one puts one’s name on a ticket and that means ‘see you tomorrow.’

The treatment of Sarah concerned the want for a presence and absence. The weekly sessions, combined with the coming and going of the mother allowed to symbolize something that had not been symbolized. In fact the birth of Sarah had reactualized the mother’s loss of her first baby, a boy. Unconsciously she felt guilty to not have been able to replace the lost boy. To be able to give another boy to her husband would have reduced the mourning for their first child.  Sarah’s wants were left unanswered, and she became a child that did not manifest itself. This absence of a demand in the child was a response to the mother’s sadness, which took form as a failed love. It was impossible for the mother to invest the girl, as her tainted desire left her in sadness.

On top of this, because of the separation with her husband she felt abandoned as object of desire and she only saw her life as characterized by loss and abandonment. Sarah literally ‘filled’ this loss.

There are two types of want: the want for an object – a need, and the want for love, which is not a wanting of a specific object but a wanting for ‘nothing,’ a wanting for being addressed by the other. Why call this ‘nothing?’ It names what cannot be given, what cannot respond with a ‘filler-object’ to the want of the child. It is of the utmost importance for the child that there is ‘room’ for this ‘nothing’ in the way that one responds to a child’s wants. When the mother responds to each and every cry by giving to eat, or to drink, she establishes a response that excludes ‘lack’ and which can have as a consequence that the child cannot tolerate frustration.

Hélène Bonnaud: ‘L’Inconscient de l’Enfant. Du symptôme au désir de savoir.’ Navarin. Le Champ Freudien, 2013.

Parenting from your 'own space.'

In my clinical practice as a therapist I often see parents struggle with 'where to draw the line' with their child.  The tendency to 'give the child what he wants,' 'to give in' typically ends in a type of interaction that is 'reactive.' Because, typically after 'giving' your child what he or she 'wants' (ok, 5 more minutes, ok 5 more, 2 more....) we reach a limit where we can't take it anymore and then typically respond in a 'reactive' way by blowing up, yelling... Feelings of resentment grow as all this giving is not met with gratitude. And your child might be confused that you suddenly withdraw your love, after having given him all these extra tokens of 'love' by 'giving in.'  When these types of interactions become the typical way of interacting, the parent might feel that his or her space is 'shrinking' and the child's is 'growing' beyond their control. Something is out of balance, and neither child not parent are happy about it.

Underlying this dynamic that is confusing to both child and parent, there is often the parent's sentiment to not know where to draw the line, how to set a limit. 'What is reasonable?' There are indeed no standard rules that can be applied: each family, child, parent is different. A parent might want to distance himself from his own, more 'authoritarian,' or 'hands off' role model:  How do you draw a line without being authoritarian? There might be an implicit insecurity: Is the parent still entitled to her own space,' to a world where the child is not the ruler? The child has often become the parent's ideal: He should not lack anything, should not be 'deprived.' 

Typically, when the parent becomes clearer on claiming his or her own, separate space from the child, it becomes more natural to have the child respect that space. And the nice thing about it is that the child will feel more respected in his own space, allowing for better connection between parent and child.  

The importance of 'mentalizing' in parenting.

I recently attended a conference in Napa for therapists and early childhood workers of all ilks with the internationally known psychoanalyst and researcher Peter Fonagy. The topic of the conference was the concept of 'Mentalization,' or the abilty to 'keep the child's mind in mind.' This is the ability to take the child's thoughts, desires, intentions ... (his or her mental states) in mind, while engaging with the child. This abiltity allows for a 'reflective' stance, rather than a 'reactive' stance towards the child's behavior. The 'mentalizing' parent knows that underlying the behavior of the child are certain thoughts, motivations...

Especially the parents' ability to 'mentalize' with their young children between the ages of 6 to 18 months is crucial for helping the child develop a healthy and secure attachment, and to help prevent later psychological disorder. This is an important finding with a lot of practical implications for early childhood workers and parents alike, that was known for more than 75 years by psychoanalysts, but is currently robustly confirmed by contemporary research. It goes against the harmful assumption that 6 months to 18 months old children's thoughts, intentions... should not be taking into account as they are 'too young to understand,' or as they do not even have them. 

A parent who is able to keep the infant's mind in mind, and to see the child's mind as separate from his or her own will be in a better position to help regulate the child, and to help nurture the child into a secure relation towards the world and the broader social environment. 

Fonagy gave an example of the different reactions of two mothers to an 'unhappy' or 'fussy' child. One mother, who sees her unhappy child, still feels happy herself to see the child, and is able to sooth the child by mirroring to her child, talking to it. This mother experiences her child's mind as separate from hers, and she is able to help the child regulate. She does not feel threatened by her child negative feelings. The other mother, responds to her child's unhappiness with sadness. She might experience it as if the child does not like her, as if she is not a good mother, as a rejection. She gets 'caught up' in the child's emotions, and the child sees the sadness in the mother, and is not able to use the mother to regulate his own negative feelings, to 'make sense' of it. This can lead to a cycle or decreased mentalization, with as effect that the relationship between child and parent 'sours' and that the 'connection' is undermined.

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

How to respond to the demanding child.

In my therapeutic practice and consultation with parents the topic of how to handle ongoing 'requests' is a recurrent theme.  Incessant demands from our kids can drive us parents crazy. The more we seem to give the child, the more the child seems to be asking for, demanding. The demands of the child never stop. This can be very frustrating for the parent as the parent feels that the things he gives the child with so much love, are not really appreciated and valued. It can go so far that the parent himself feels not valued, appreciated, 'used' by the child. 

This unfortunate situation has something to do with a profound misunderstanding between adult and child. The parent becomes exhausted by the demands of the child, because he or she takes the demand at face value. He or she thinks that the child 'really wants' the object he demands.  Then why is he or she not satisfied when I give what he asks for... However, what we ask for is not necessarily what we want. 

I think of the mother of a teenage girl who came to me exhausted and hurt by the demands of her daughter. She had sacrificed so much for her daughter, had given so many things to her  that she could not really afford, and still the daughter was not satisfied. In the treatment the girl was able to tell the mother that she actually wanted her mother to say no, when she asked for yet another new gadget. A 5 year old girl who was doted on by one of her parents told me: 'When it is given to you, you don't want it anymore.' Often, the asked for object, once received, turns to waste and we need a new thing 'to want.' What our children 'really want' from us is to be supported in this dimension of 'wanting.' More than 'being given' things they want, they want to be supported in developing  'their own desires.' 

This is why a child can be much more satisfied with a 'conversation' about a desired object, than with being given the object. The conversation 'sustains' his or her desire, humanizes it. It allows for the gratification to be postponed, In the course of the conversation the child will feel 'recognized,' 'valued.' And the connection with the parent deepens, to great satisfaction of both. 

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