Reflecting on... being old enough

Six-year-old Jessica talked about her hamster. ‘He looks funny and doesn’t want to play anymore.’ Jessica’s hamster had died but ‘because she’s too young to understand’ her parents substituted the much-loved pet with a replacement hamster and said nothing. Two adolescent brothers have diagnoses of schizophrenia. Their ten-year-old brother Miles has a worrying presentation which requires assessment. An offer of family therapy has been accepted but the boy’s parents don’t want Miles to attend ‘because he’s too young to understand about mental illness’. Eight-year-old Leon’s grandfather died. They’d had a close relationship before Leon went into care and became estranged from his family. Professionals decided that Leon was ‘too young to attend the funeral’.  Twelve-year-old Elsie believed she was becoming a monster. Evidence for this was hair on her ‘privates’ and blood in her knickers. Elsie’s father withheld consent for her to attend sex education classes throughout junior school ‘because she’s too young to know about that sort of thing’. 

Anecdotes like these make me incredulous at adults who deny children knowledge about their experienced realities. Not-knowing is an unbearable position so inevitably, ‘unknowns’ are filled with worry or fantasy; ‘my hamster is sick’; ‘my grandfather didn’t love me’; ‘I’m going mad like my brothers’; ‘I’m a monster; I’m bad’. Consequently, these negative beliefs manifest as ‘acting-out’ angry behaviours or ‘acting-in’ withdrawal and despair. Adults seek to medicalise children when all they are trying to do is make sense of their experiences. This is buck-passing and abusive.

Questions come to my mind about what is unknowable or unthinkable about and by whom. It isn’t usually the child, equipped with innate curiosity. I have engaged in many ‘facts of life’ conversations in children’s therapy sessions. Initially, I wondered if this was beyond my remit but I would argue not. Therapy is a safe space where children bring their worries, fears and fantasies to be thought about and made sense of. So I have explored ideas about death with a six-year-old, explained the characteristics of mental illness to a ten-year-old, described what might happen at a funeral to an eight-year-old, and discussed pubescent development with a twelve-year-old. And I have done so confidently and candidly. Children are never too young [whatever their age] to be treated with respect and protected from ignorance. They can manage information about life, sex, illness and death if an example of being able to manage is modelled for them. They are always old enough for that.    

 

First published in BACP Counselling Children & Young People, December 2013

Reflecting on... the language of the care system

Working with Looked After Children (LAC) has offered a valuable opportunity to explore the unconscious meanings contained within the language of the care system. An emerging acronym for children in care is ‘ChiC’. For me, this redefinition has uneasy undertones of cute, fluffy fledglings needing a home. Is this how we’re supposed to think of children in public care? Is it supposed to make them more care-able-about? More foster-able, perhaps?

Children are described as ‘taken’ into care which has connotations of an impulsive, unannounced act. Regrettably, this matches the experience of many LAC/ChiC who are not prepared for what is about to happen to them. Colloquial language describes sick people as ‘taken’ into hospital. Are children in care sick in some way they don’t yet know about? Will they get better? Will they die? For many children, the emotional pain of not-knowing feels like a physical illness; while the loss and uncertainty is as dismal as death.

Many children imagine they must have done something dreadful if they are taken into care and language can perpetuate this belief. Children are ‘removed’ from home, while other things that are removed include tumours, cysts and warts; bad things that cause harm and which, once removed, leave us feeling relieved. ‘My parents are better off without me’ is an all-too-common refrain, which can be interpreted as ‘now the bad me is gone, the good parent will be better/happier’.

As is often the case, the children I work with describe their experiences more eloquently than I can; using language with a lack of self-consciousness that absolutely defines their experience. One child likened himself to a five-pound-note, explaining to me that, like money, he had been passed around between numerous owners and was usually kept in a dark place. As well as describing his experience of multiple carers, I think this metaphor also expresses his sense of self as an owned/passive object with little value. Like many children in care, he didn’t perceive himself as care-able-about and he couldn’t comprehend what was being done to him or why.

Children encouraged to explore their experiences in their own language communicate in a profound way that gives us a real sense of what it feels like to be them. We must listen and we must ensure that their language is assimilated into the way we communicate about children who are looked after in the public care system.

First published in BACP Children & Young People September 2013

O “jornalismo” sobre os videojogos

In the interest of fairness, and with the adage; 'no publicity is bad publicity' is mind, I am publishing a (shaky) translation of a scathing report citing 'Where Lunatics Prosper' which I wrote in 2011 and was published by BACP. It has caused quite a stir in Portugal...

Preconceito e ignorância - Prejudice and ignorance.

This week generated great discussion in Portuguese about network a "report" of the national channel, TVI, about the E3 video game trade show [1]. Dissatisfaction with the way in which the culture of games was treated in this part "journalistic" even led to the creation of a petition calling for a formal apology from the television chain [2]. I saw the "report" and surprised me more by the misrepresentation of the basic principles of journalism, than the lack of knowledge of, the simple: "what?", "Who?", "When?", "Where?", "how?" and "Why?". The piece was intended to address the fair games, in which they were announced the two big international consoles. The last time this happened on a E3, was seven years ago, which gives good account of the importance of the event. But the piece ended up talking about alleged emotional problems caused by the games. That is, the "journalist" did not address the matter at hand, I wanted to before issuing an opinion on the subject, background. So I have to use quotation marks when I refer to the piece as "report" or "journalism".

This is not a problem only of TVI, is not even a problem only. There are weeks shared on the network article, "where lunatics prosper" [3] of Jeanine Connor that left me far more disturbed than this piece. The article goes way further than what has been done here, although focusing on the same topic. Moreover, it is not a mere loose text, or a report that is a low audiences anytime. The text was written by a psychotherapist, and published in the journal Therapy Today, published by the British Association of counselling and psychotherapy. A magazine dedicated to disseminate advice and resources for use by professionals in the field of therapy practice. That is, it is assumed that before being published, was read by pairs, filtered by editors, and seen as reliable enough to become the main article, and complete cover theme, in the number this month.

And so what tells us the British Association of counselling and psychotherapy, according to the words of Jeanine Connor? The article starts by presenting the case of a child of 11 years that has a terrible behavior in school, slams us colleagues, evil teachers, has bad notes and has been suspended several times. After tells us that this child was born of an unwanted pregnancy, pretty new parents, who have been living together for a social House. The father beat the mother, drank alcohol and took drugs. After a few years the boozy father almost killed the whole family firing the car under a truck, and was arrested. The mother herself, joins a friend, who had in the meantime violated. The friend who also beat in the pregnant mother-of a second child. This friend fled, and mother arranged a third, which also beats, and you made a third son. The 11-year-old child doesn't like the mother, and tells him that wants to die. Spends most of his time locked in the room playing video games ("GTA" and "CoD")."

Now the analysis and interpretation of the case conducted by the psychotherapist. The child lives in a real and virtual world laden with violence. The child has no parental affection and is educated by the screen. The screen serves as a mirror for your outsourcing, merging real and fantasy. In the absence of a parent, the formation of identity of teenage boys is entangled with the characters of the games. These teens are educated by games with aggressive characters, provocative images of women that do "oral sex simulations". The text ends saying that the continuation of these trends in media, will lead the boys in the future to feel more attracted by rape, paedophilia and domestic abuse, and that "this dreaded future will then be the true place where lunatics prosper." To support this text, was created an image for the cover of the magazine, in which one sees a scene of domestic violence to be controlled by a gamepad.

Just read, or want to believe. It is true that putting images of Anders Breivik in a story on the E3 is an unusual distortion level, but you want to solve the problems of violent homes and disrupted with the withdrawal of videogames and violence of the screens, should give to laugh if it weren't published with this seriousness. I know that it is much more difficult, if not impossible, to a psychotherapist change the social reality that surrounds the child. Give it a new home, new parents, a second life. But then streamline and synthesize all the problems that plague the life of this child in games, and to propose as a solution to what has been reported, the simplistic ban of these artifacts, is an affront.

But what hurt me most when reading the text, was the moment when the therapist asks the child alone, about the games more liked to play, and surprised says, that was the first time during the entire evaluation, in which the child was lively and awake. Then again, a child who lives in a home to physical, sexual violence and daily stress, in which everything is uncertain and nothing is safe, the only thing that guarantees some cognitive and emotional stability are exactly the video games. The video games are to some extent the ones who understand, that give you positive feedback by the actions and achievements which, when around them all just the face as a hindrance.

This goes beyond ignorance and prejudice. This is a symptom of liberalism that took the pulse of society, or what remains of it. Are accurate to blame, and these cannot be us, nor the rulings that stimulate highly individualistic societies. Because no matter the promotion of social policies with ability to maintain a cohesive society, healthy and educated. In the middle of all this, the journalism rather than investigate, limited to debit the current speech.Bottom of Form

Reflecting on... What I do

I am often asked what I do when I ‘do’ psychotherapy. Depending on who’s asking; a student, parent, potential client or service provider, my response varies. I don’t have any stock answers, in my experience, they don’t really wash. And anyway, non-psychotherapeutic people have watched ‘The Sopranos’ and ‘In Treatment’ and think they know what therapy is about. So what is therapy about? 

In theoretical terms, psychotherapy is about helping patients to think about, reflect upon and come to terms with what’s going on, or has gone on, in their lives. So far, so comprehensible. It gets complicated when I add that much of these ‘goings on’ are beyond conscious awareness. At this point the questioner does one of three things: 1. Glazes over, none-the-wiser, 2. Assumes I’m talking about Freud and all that [I quote] ‘wanting-to-shag-your-mother stuff’, or 3. Remains interested enough to want to know more; then repeats ‘but what do you actually do?’

If I’m feeling playful, which I often am, I might wonder what it is they think I do. Answering a question with a question is the stuff of therapy, right? This may sound glib, but there’s truth in it too, because wondering back, when a patient asks a question encourages joint exploration and demonstrates that I, the therapist, don’t have all the answers (and even if I did, I wouldn’t deliver them readily).

Patients frequently use metaphor to describe what therapists do. I hear about the ‘wounds’ that brought them into therapy, which has been described as ‘picking at’ or ‘uncovering’ something difficult. It sounds painful, and of course psychotherapy often is, as the defense mechanisms/plasters/scabs are gradually removed to reveal the unconscious trauma/wound beneath the surface. Only then can healing begin, and this can take a long time. As one patient who wasn’t ready to end treatment told me, ‘if I leave now, it will just scab over again but the badness will fester away inside me’.

So when people ask me what I do when I do psychotherapy, they are usually asking what I can do for them/their child, and that depends on what they are ready, willing and able to do for themselves. If the time is right for them to start treatment, I will respect the defences that have served them well-enough for long-enough and be alongside them as they start to slowly remove the plaster and reveal the wounds beneath. We will examine those wounds together and try to make sense of them, and finally, with patience and compassion, we will embark on the healing process together. Because that is what I do. 

Published in BACP Children & Young People June 2013