A mother's quandary

The last insight, wisdom tidbit, fact, reveal – whatever we shall call it – that I named for the mother of a teenage client is the first one that some other therapists would, I suspect, have offered. Her son, whom I hadn't seen in three months, had only attended four sessions total. The last one included his mother. The boy and I quietly ganged up on her: Please tell your husband, the stepfather, to stop shaming, ridiculing, criticizing him. Recently, the mother returned, alone, to give me the backstory of her son's problems that included depression, depressive personality (where he preferred feeling miserable to feeling positive) and suicidal thoughts. Three years earlier, he had pushed a sexual behavior at a non-rape level, that may or may not have been consented to by the other person, that may have led to legal involvement but didn't. He was kicked out of school, went to a different school, was assaulted by another "behavioral" student, sent to a third school where his reputation followed him. He got a job but was harassed there, and quit. Many stresses, and they came home to an environment that was shaming since he was a toddler.

He was not motivated to get to school on time, or to do his homework, or to do his chores. We're all familiar with the term "old school." That means: It doesn't matter how you feel or how serious your problems are: You must toil and toe the line. Mother described the punishments levied to motivate him: remove his electronic devices and social media access. I said that may not be great at two levels: Punishment, in general, will make a child feel worse, and these are punishments one might administer to a 13- or 15-year-old, not to a young person about to turn 18.

I cited Thomas Gordon's concept of 'who owns the problem?', which could also be called 'who owns the child?' If a little boy's friend dumps him, it's his problem, not the parent's. Help him get his feelings out, respect and validate his feelings, help him brainstorm through Active Listening, but don't drive over to the other child's house and strategize with the mother about how to resuscitate the friendship. The principle that says 'the parent doesn't own the child' is a very difficult one for many parents to grasp. This is easily seen in another of Dr. Gordon's examples: A teenager is ditching important classes, a potential crisis that would activate the proprietary instincts of most parents. But should the parent force him to go by threat, have him monitored, stand over him as he does his homework, make him think? The child owns himself. See what his grievance, his pain is, which might go back years. Care about him more than the grade.

My client's mother had a solid rebuttal: She would get in trouble – Child Protective Services – if her son didn't go to school. A powerful argument as long as you leave out the "care" factor. Her old school mind also explained the removal of the boy's television from his room.

I recommended Gordon's book, with a "warning" that it may be hard to take, this notion that the child should be respected as much as the parent.

As the session ended and we were about to exit the office, something occurred to me by sheer, stupid luck: Stupid, that I had almost missed it in the fervor of psychoeducation and the mother's polemical intransigence. I said: "What it comes down to, the essence of everything, is that your son needs to feel loved." She paused for a fraction of a second then said: "Yes, he does. I wish I knew how to make him feel loved."

Best and worst clients

Maybe it's a peculiar way that clients are supposed to be reactive in therapy. It's not just mutually interactive – a conversation of surface and deep thoughts and feelings. It's not just where the client receives information and has an adult-plane emotional reaction to it, though an adult-plane understanding of the insight may trigger deeper understandings and feelings. It's not just the client's inner dwelling, his awareness of his problems and feelings, that is expressed in sometimes-long narratives and a few tears. None of these behaviors will shake anything loose at the core of his disturbance, of his self. The adult cannot heal the child.

Our worst clients will be those who remain on their adult plateau and who believe that's who they are. Many clients, then, are our worst. I believe this is mostly a factor of the modern psychology culture with its "here-and-now," happiness, mindfulness, everybody-knows-their-psychiatric-name conceit. Back in Freud's day, the rallying cry was "id." Serious men in suits and high positions (who were probably raping their daughters) lay on the couch and free-associated about their bizarre fantasies and sexual fixations. They descended to their symbolic and literal bowels and their dormant, itching psychoses. But shallow is deep today; feeling is commodity today, as Cole Porter might have sung.*

Our best clients are those who collapse in memory and tears and who, in that place, join with us in their worst, give us their pain. Bruno Bettelheim, who blamed "refrigerator mothers" for their children's autism, knew this: "I speak here of the child's private world. . . . Each of us is implying in his way that one cannot help another in his ascent from hell unless one has first joined him there."

I have a few good clients.

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* https://www.youtube.com/watch?v=r7NJ9ylAhos

Should I suggest that she get numb?

"Sixteen-year-old girl remains in a steady-state of disconsolateness, silent, glazed-eyed and bereft looking for much of the hour. This sometimes ruins to silent heavy tears. 'Carly' spoke more quietly than a whisper, said that she's been 'telling myself things that aren't true.' Initially not interested in disclosing what these things are, she later said: 'I tell myself that no one cares about me.' She knows her star-crossed girlfriend Runa cares about her, and can't deny that I care about her. But she believes (not merely 'feels') that neither her mother nor her father cares about her. Carly said that she skipped dinner and no one inquired after her. I talked with her about the challenges of making friends under the shadow of depression and fatalistic assumption. She acknowledged that at school she may wear an 'I want to be left alone' look. After all, she doesn't want to be there and might project an off-putting air to potential friends.

Challenge of the day, this young person. I have twice invited her mother to have a parent-only session. Her response to the first request was "busy," not even "maybe." Her response to the second request was silence. I've seen her father once in my office, once in the waiting area. This is one flaccid walking coma. He does nothing to challenge his wife's solipsistic childishness and meanness. "Perfunctory attention" should be his middle name. I believe my client: Her parents really don't care about her.

Her kind of negativity redoubles itself, though she comes back week after week and must sense my effort to mitigate her doom feeling. I wonder if a young female counselor would be a better interactor with her. Girl talk, collages, maybe a more delicate and discreet way of approaching her parents. I am delicate and discreet, benign and gracious, practically courtly, when it's a matter of keeping the child in therapy, not directly angering the parents. In the 1990s when I worked in rural Logan, Ohio, I might walk downtown (five buildings, maybe) with my teen clients to the book-snack store. The ambience of walking, caring, getting air had power and strength. In Pickerington, Ohio, the teens and I could walk in a miniature meadow -- a couple trees and a gentle grassy hill. These ways get us out of the box of therapy. Where I am now, we could only do the parking lot circuit of a medical park. So we are stuck on a chair and a sofa feeling and questioning the worst feelings.

Nine years ago when I started the blog, I would have ended this piece with a pessimistic or optimistic statement. Now, there's no reason to.