The Symbolic Meaning Of A Child’s Symptoms: What’s in the Shadows?

DK: The birth of the baby represents a quantum jump in intimacy and the complexity of living. There is a deep mutuality in the relationship between a parent and an infant. A baby is a salve for the mother’s deepest wounds, for example, her sense of loneliness and meaninglessness. But as the baby grows, and the need for mother declines, the pain returns, and the small garden of paradise becomes the world-as-before.

When the mother’s “I” is not secure, it puts pressure on the baby, who by simply “being” provides a feeling of being healed, a sense of wholeness and adequacy, a decrease in pain. When the imagesmother is anxious, the baby’s upset demands she care for him, and when she is caring for him, her pain is better. This dynamic is present in virtually all mother-child connections and manifests itself in myriad ways. It is not inherently pathological, it just is. It becomes pathologic when it can’t be outgrown. If the mother has been wounded in the past or present in a historically notable or symbolic way, it may contribute to pathology in the child.

This does not signify a moral problem. It is not about being good or bad. However, it may look like a moral problem, because of the confusion created by parental guilt and disappointment in self or spouse. It becomes a psychological problem when the baby grows and the mother’s anxiety goes up, she unconsciously demands the baby remain a baby. It is not an intentional problem, it is a problem that is the result of emotional hunger, pain and a search for more health.

The situation is more likely to develop when the father is not emotionally engaged with his spouse or with the baby. When the father is an emotional presence in the family, when he loves the mother, if the baby is cared for and loved by the father, the mother is not so desperate for the baby to remain a baby. However, in our way of thinking, the child experiences the father’s lack of involvement and the mother’s resultant dependency as a corruption of the family function, and loses faith in the family’s ability to help him grow up. This type of relationship pattern results in what I characterize as “defiance” (which can take the form of depression, ADHD, anorexia or somatization)” as a way to preserve the “I.” The child grows up and the child’s growing threatens the mother’s emotional security.

Case Illustration

Brian is twelve, a spectacular basketball player and a popular seventh grader. He is the middle of three children and is viewed as having attention deficit disorder because of minor acts of defiance at home and school combined with anxiety symptoms. The pediatrician prescribed Ritalin, but it made his anxiety worse and interfered with his sleep. After the medication was stopped, the sleep problem persisted. He became afraid of being anxious. A psychiatrist suggested Paxil, but the family refused, fearing it, too, might make him worse. At that point the pediatrician referred Brian and his family to me for therapy.

Unknown-2Father, a hard-headed successful general surgeon made the phone call. I insisted on the whole family attending, but doctor/father, was against “counseling” for unclear reasons. He said the family could come but he wouldn’t. I told him I wouldn’t start without him. He was too important. My fantasy was that like many successful men he feared therapy because it would expose him to uncertainty and behind that his unacknowledged hunger for intimacy.When the situation intensified, father called back and grudgingly agreed to come in. At the first session, I interviewed them about the family in the present and the symbolic past. On the surface they were a healthy, attractive and satisfied family. Brian was clearly the family star except for his tendency toward “mouthiness” and his anxiety, an incongruous blend.

In the first interview, the following crucial dynamics came to light. When Brian was born, His mother’s brother was ill with leukemia. When Brian was four months old, Mother went to live with her mother to help her care for her brother. Her brother died when Brian was ten months old. Mother had breast-fed Brian during this period. She admitted baby Brian “saved her life,” held her together emotionally, while she was caring for her dying brother. Breast-feeding calmed her and restored order to her world, which was disorganized by her isolation and the haunting presence of death. During that period Father was in the early years of practice and because of his own emotional underside was unable to offer solace. He seemed to have little capacity for emotional warmth. This is likely related to why he was reluctant to bring the family.

During the first interview, Mother relived the pain of the past with her brother and son, yet she was radiant and relieved as she spoke of it. My impression was that reliving those sad, but sweetly intimate moments was deeply comforting to her.

At this point in the family life she was a newly certified teacher who was just beginning to work after 17 years of mothering. She was anxious about leaving the home to re-enter the outside world. Her anxiety reactivated the old relationship program between herself and Brian. Father was a nice person, but emotionally impaired, he could not appreciate her distress and tended to dismiss her. His non-subjective nature added to the wife’s anxiety and thus to Brian’s. Father was a non-subjective physical presence, but he was too realistic.

This is a description of a normal family. I am giving a sense of covert distress in a normal family and its contribution to a young man’s symptoms of distress. Hopefully, you can see how the images-6baby was a healing presence in the mother’s life. Then later, his attention deficit disorder can be characterized as attentiveness to the family’s emotional field which made it difficult to pay attention to more mundane matters like social studies. Likewise, when mother was disturbed, the family anxiety would go up, Brian’s anxiety would increase. Her caring for him, made her feel better and thus he felt better. In the meantime, father’s ambivalence about himself, his self-loathing, masked by professional competence was reactivated.

This illustration gives a picture of the underlying dynamics of defiance. In this case, defiance was manifested in Brian’s “mouthiness”. The vignette illustrates how Brian was programmed by his infant experience to respond to his mother’s emotional pain. His symptoms restore the mother and restore the bond between them. The therapeutic process is helpful by identifying the relational pattern and giving the process value. Father did become a patient, he learned how to use his relationship to me to question himself. He even became curious about himself and about the realm of human experience. He discovered a previously unknown part of himself. Father commented that he was amused by these changes in himself. Brian’s symptoms faded out.


A Detached Boyfriend: Seeing Beneath The Mask

FAB: One of the helpful ideas  I’ve gotten from my conversations with David Keith involve new ways of  thinking  about the male emotional landscape. As we know, men have been typically acculturated not to show much emotional pain or need. My discussions with David have reminded me not to be fooled by the “strong guys”, that men are as hungry for love as women. They just wear it differently

Here’s an example of a couple that I see frequently in my office, only more so. It has something to say about how people are not necessarily as they appear:

It was hard to guage the state of Nora and Charles’ relationship when they first sat down on the couch. ( An initial glimpse into a couple’s energy often says a lot about where things are at). I hadn’t seen them for several months due to traveling and other scheduling issues. They had been to see me five or six  times, with gradual improvement. “Improvement” in this case means less fighting, and that Charles was no longer threatening to leave the relationship.

images-3At this session, Charles acknowledged that things are “better”. Asked what he meant, he said, “Less nagging, less fighting.”. Nora agreed, said she felt happier, they were enjoying each other more, but still worried that this lack of fighting signaled a fragile peace, rather than meaningful change.

Charles, an Australian-born film editor  and Nora, owner of a graphic design company, first came to see me when they were on the verge of separation. They’d lived together for 7 years, never married, and had a 3-year old son, Benjamin. The initial, superficial impression was that these two people were polar opposites; he–uptight, unavailable, with clenched jaw, she–emotional, open, vulnerable.

At our initial session, Charles said he’d “give therapy a chance”, but he “couldn’t take the nagging” and seemed to be headed for the door. Nora, a sweet-faced strawberry blonde, looked really weepy and upset, while Charles sat stone-faced on the couch next to her. Charles was one of the most understated characters I’ve seen in my office; a handsome, expressionless face, monotone voice, and his body seemed weighted with exhaustion. His wife appeared to have much more life in her; even her pain was more alive.

images-6In our sessions I ended up working like an archaeologist,  unearthing the emotions which Charles had long denied, both to himself and to Nora. Slowly, one layer of rubble at a time, Charles began emerging, slightly more vulnerable, slightly more revealing. It required some heavy lifting on my part. I knew how Nora felt.

Charles , whose parents divorced when he was an infant, had been kicked into an early adulthood at age thirteen, when , in the midst of his mother’s re-marriage, he was sent to a European boarding school As he said, he “never returned home” except for brief periods. He maintained a cool, cordial relationship with both parents, nothing cozy or messy–-mostly polite and distant-ish.

Nora, by contrast, had more overt upheaval in her family, including a parental divorce when she was 12, and a sister with apparent bi-polar disorder. The family pressures had calmed down over the years and now Nora, the oldest, enjoyed a warm relationship with both parents–her Mom especially–and felt emotionally protective toward her sister and brother .

Unknown-2Over the course of several visits, Charles and Nora’s relationship seemed easier, lighter. However, I could clearly understand Nora’s “nagging”, since this guy’s stony silence made me want to light a fire under him. But I also understood how bad it must have felt for Charles  to be under the gun all the time. Indeed, Nora, though a lively and intuitive woman, DID seem to be overly tuned-in to Charles’ deficits. For example, Charles came alive when talked about how much he loved his daily ritual of making breakfast for their son. Nora, however, felt that this ritual could be improved upon, and she had suggestions to go with it.

At this last session, the couple did seem to be in a better place. Charles was slightly looser, less uptight, and Nora looked and sounded lighter and brighter. Though she said she indeed felt “happier”, Nora harbored  a worry that if she raised something “unpleasant” Charles would  bolt. She became convinced that “he would be just fine” without her.

This was the theme of every session–to lift the mask of disengagement from Charles face so that Nora could  really, truly, see her partner. I asked Nora if she was serious in believing that Charles, this pseudo- Iron Man, didn’t need her? I told her (and him) that I was quite sure Charles’ hunger for love was as deep as hers– he just had more practice hiding it. I knew that he had been “practicing” since he left at home at 13. He hadn’t asked for much since that time.

Charles didn’t deny it. He turned to Nora, and with as much feeling as I’d seen from him, said, “Of course I don’t want to break up this relationship. Of course I would hate to see it end!” That’s probably as much an expression of need that she’s ever gotten from him. But it was heartfelt, and she recognized that. The tension seemed to go out of her body.

Unknown-2As we finished the session, I realize that the process of “unmasking” Charles has been critical to this couple’s increased sense of well-being. I always assumed, despite evidence to the contrary, that this relationship was more emotionally equal than it looked.

In fact, that’s a concept which I often include, overtly or covertly, with couples. In general, our unconscious emotional antennae is reliable, in that we partner with people with the same degree of emotional need. Family therapy theorist Murray Bowen, called  it the same level of “differentiation of self”. Others important family therapists  like Carl Whitaker or Sal Minuchin described  it differently, but all imply that  we, for the most part, marry our emotional equal.

This is an important understanding in working with and understanding couples,  including ourselves. It may help us to  begin to look at the picture a bit differently. If the wife seems “needy”, you can assume that the cool-seeming husband is just as hungry for love, on the inside. No matter how it looks!

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A Wife Worries: “We’ve Got A Lousy Sex Life”

AB: Over the years, I’ve seen many couples whose presenting complaint revolves around sex. Usually it’s because the sex is too infrequent, too lackluster, or at the male parter has some kind of sexual dysfunction. (I’ve only seen one case where the complaint was too much sex!) As usual, unless there’s a biological problem, the sexual relationship is embedded in the larger emotional/psychological dance of the couple.

Here’s a snapshot of a couple where the wife worried about their lousy, uninspired sex life:

Unknown-1Sarah and Alan initially came to see me because of Sarah’s distress  over their extremely lukewarm sex life. Sarah described feeling “turned off” to Alan, and when he did attempt any kind of sexual overture, she described his efforts as “half-hearted”, without any enthusiasm or “oomph”. She felt both frustrated and bored.

A little background: Sarah and Alan have been married about 15 years, with 3 kids. They met while visiting mutual friends in Europe. Alan is from Moscow, and his mom and sister still live there. Sarah’s parents were born in Russia, but they moved here many years ago, and Sarah and her two brothers were born here. Alan speaks good English, with an elegant-sounding Russian accent. He’s a handsome, intellectual kind of guy with a tender quality. He works at a prominent, progressive graphic design firm, where he says he gets to indulge his artistic inclinations. Sarah looks like an ex-hippie; natural looking, without make-up, she doesn’t appear to care about clothes or “girly” things. She works part-time in investment banking, what she describes as a real “boys club”.

I could see the relationship inhibition as soon as I met them. As usual, sexual inhibition–-premature ejaculation, and its relatives–is symbolic of a broader inhibition. Typically, especially in an ongoing relationship, the “inhibition” doesn’t belong to one person, but rather, can be found embedded in the couple’s duet. And, clearly, Alan was scared of his wife. Not the kind of “scared” that’s visible to the naked eye. He spoke with authority, but in a controlled manner, cautious and correct in his responses to Sarah, seeming careful not to upset her or challenge her perceptions.

images-6And, though Sarah came across as bold and opinionated, she also had great humor and conveyed an openness and willingness to look at EVERYTHING–-herself included. Though her tendency to be “in charge” was very much in evidence in the way she talked to and about Alan, she also seemed willing to relinquish control; her life did not depend on it. She was not brittle. I saw an opening.

As we met over several months, I approached their unsatisfying duet in a couple of ways. As we talked, I wanted to enlarge their narrow view of their dysfunction as merely sexual. First,  I invited Alan into some conversational play.  I wanted to get him out of his box, and the one of the best ways I know how to do that is through play. I talked to him about his artistic vision, we talked about jazz, I admired his quirky and creative responses to my questions. If fact, as I suspected, this guy had a much wider range than his overly correct version of himself.

I kept my eye on Sarah as Alan and I played. During those sessions, Sarah commented repeatedly how she “enjoyed” this guy she saw in my office. She said she wanted to take this guy home with her, not the other, dryer version. Sarah’s open enjoyment of this new, looser, husband gave him confidence to take a few more risks with her. Over the months, Alan’s expanded, more playful self began to slowly work it’s way into the relationship. They had sex slightly more often, with, according to Sarah, slightly more enjoyement. Not perfect, but better.

images-3We also addressed what emerged as Sarah’s overly vigilant, controlling approach to sex. She had fantasies about how other people must be having “wild” sex, but was afraid to apply these fantasies to herself and her husband. With Alan, she was often worried about their sexual dance, anticipated “failure” and somehow needed to diminish the power of their sexuality as a couple. She seemed both eager to be “wild” and afraid of it.

A little exploration into Sarah’s background proved helpful:  Her father, a well-known painter, was apparently a demanding, tempestuous kind of guy. Sarah’s mother catered to him, and both Sarah and her brothers were convinced that Sarah’s mom should not be such a “doormat” for her husband. When Sarah tried to bring this to her mom’s attention, the mother claimed she loved “doing things” for her husband, and felt happy in this relationship.

Sarah’s parents had (and apparently still have) a passionate relationship, but it felt psychologically dangerous for Sarah in some ways. Apparently her parents occasionally had noisy sex within the earshot of Sarah and her brothers, horrifying them and leaving Sarah feeling “disgusted” and “dirty”. Sarah felt too “embarrassed” to bring these incidents to her mother’s attention.

Though Alan knew this history, somehow I think it felt different hearing it in my office. Sarah clearly came into this marriage with a toxic association to “wild” sex. Passion became associated with being out of control, not in a good way, but where someone gets hurt. Alan had clearly picked up on this early in their marriage, and this helped shape his cautious approach to his wife sexually. Clearly, Sarah needed to be rid of this past burden, and she needed her husband’s help. As she said at the end of one session, “It’s not easy being me.” Meaning, always “in control”.

Alan’s second-guessing himself with his wife reinforced her control in the relationship. This interfered with their freedom as a couple. Alan’s status as an immigrant–-not being “from here”, not always being sure of the cultural rules–-operated covertly but powerfully in keeping Sarah on duty. I discovered that Alan would run his emails by Sarah before he sent them out. Since his English was excellent, I took this to be an artifact of their caution/control duet. I laughed when I discovered his use of Sarah as his email editor. I intended this as a therapeutic laugh, like…”Are you kidding? With your excellent English and articulate speaking style?” I knew that if  Alan was going to help free his wife from her sexual fears, he needed to stop constantly asking for her approval.

After about six months, Sarah commented on how their relationship felt “much better”–sexually and otherwise. During this time, I had also seen them with the kids several times, to get a sense Unknown-2of how they operated as a family. This appeared to help the couple as well. As the therapy was winding down, Sarah reflected on what had been helpful: She said  “it really helped when you said it has nothing to do with chemistry”. When I initially saw them, Sarah was convinced that the problem was “lack of chemistry” between her and Alan. I politely rejected this explanation, and offered an alternative way of looking at their cautious sexual relationship.

Chemistry, of course, is a purely subjective response. From my perspective, my  “it’s not chemistry” approach is a way to introduce a dynamic approach to a couples’ problem.  “Chemistry” is immutable. Not feeling loved, or anger at being criticized, you can change. Always, with couples and families, I try to convert a static idea about a problem, i.e., She  “has depression”, into a problem that’s more alive…”(To husband) Your calm indifference feels like abandonment to her.”

My intention with this couple was to loosen their frigidity with each other, to give them more freedom to play. They came to me emotionally polarized, under the symbolic heading of “sexual dysfunction.” Sarah  had labeled Alan as sexually boring/inept, which I viewed as being an artifact of their relationship, rather than qualities possessed by Alan.  Alan, in fact, had much more to offer, but his overprotectiveness prevented him from using what he had with his wife.  As Alan grew bolder and less approval-seeking, this helped Sarah to trust him. She learned to lean on him, sexually and otherwise. This was a different kind of sexual liberation–a whole-person freedom that could, with any luck, develop and grow over the course of a lifetime.



Defiance in Families: Rebellion in the Name of Health

DK:  (What follows is an excerpt from Chapter One of Defiance in the Family: Finding Hope in Therapy , a book I wrote in 2001 with Gary and Linda Connell).

We are bombarded daily by examples of defiant children and adolescents out of control. This problem of “defiance” extends  to  all social classes, in every school and neighborhood, and it is often characterized in the media as  reaching epidemic proportions. Many of society’s responses to defiance only stimulate more defiance. For example, the impulse to punish, to exclude, to enact zero tolerance policies may be an error that adds to the problem. My co-authors and I  work with the idea that family therapy is a way to detoxify, to undermine the alienation that results from defiance. However, this is not a simple solution. It is a solution that takes more energy than punishment does. It takes more time and more investment than medicalizing problems, but we believe the change that comes from therapeutic work with families is more enduring.

Defiant adolescents and oppositional children are being demonized. How do we deal with demons? We provide structure and discipline so that they will stop being demons and become images-3more angelic. When structure and discipline works and angels emerge it is very pleasing. But we need not worry about the angels. We intend to worry about what to do when discipline only makes the demons more defiant. Our culture, looking backwards to some fantasied era follows simple principles. If they don’t behave, we extrude them, diagnose them, medicate them. We kick them out; of the school, the family, the inpatient unit, and look around for a human wastebasket where we can toss them, until they learn to behave.

The prevailing thinking is that those demons need “counseling.” “Send her to the counselor! Let’s get to the bottom of this!” The counselor says, “This kid doesn’t want to be here, so how can I help him?” Now what? We are for simple solutions when they work, but what about when they don’t work? It is possible that many of our solutions become part of the problem. “Spare the rod and spoil the child.” Don’t forget; use the rod and embitter the child; use the rod and wound the child.

We have many ways of distressing our intimates, especially children and spouses. One way is by making them responsible for carrying our hopes for the future. The other, more dangerous way is by identifying in them what we fear most in ourselves, then acting as though it has nothing to do with us.

We look at defiance as a byproduct of family interactions, and simultaneously a byproduct of the family’s interaction with the culture. The family serves several contradictory purposes. It teaches imagesits members, especially children, to adapt to the culture, it shields its members from the culture, and it teaches its members when not to adapt to the culture. But more important than demonizing the demon’s family, and throwing the whole thing in the human-sized wastebasket outside the walls, we work on ways to help families repair the problems that lead to defiance.

When the parent, the school and the counselor say, “He chooses to do these defiant things. He has to start making the right choices, or we are going to kick him out.” We respectfully disagree. The so-called “choices” are part of a pattern that includes irritated-to-outraged adults. The therapeutic process looks at the hidden or culturally invisible parts of the pattern.

What is “defiance”?

The dictionary is a helpful guide to understanding language, the organ system that enables interaction. Language is an organ system. “Defiance” is “bold resistance to an opposing force or authority; a deliberately provocative behavior or attitude.” But if we go further to the etymology of “defiance” we find it implies a renunciation of faith in, alliance or amity with. It represents a declaration of hostility against some entity. Defiance is a result of a collapse of fealty. “Fealty” is the duty and loyalty owed by a vassal or tenant to his feudal lord, or of a dependent person on their caretaker. “Fealty” refers to faith, loyalty and fidelity; it is synonymous with allegiance.

What we find fascinating, even though slightly tangential is that “defiance” comes from the same etymological root as “faith” and “fealty”.  If we look for “defiance” in the etymological dictionary, we are referred to “defy” (Partridge, 1966). Quoting loosely we find: to renounce a sworn faith, hence to remove one’s confidence from, to provoke or defy. Then, surprisingly, we are referred to “fidelity” and “fait”: faith, faithful, fidelity, and fealty, federal, federate, federation…….. fiancé, fiancée, confidant, confident, confidential. These are all words that have to do with trust and unity.

Then the ground shifts slightly to diffident, diffidence, which implies hesitance or a lack of self-confidence. Then, finally, we arrive at “defy, defiant, defiance”. And continuing leads to extremes; infidel, infidelity, perfidious, perfidy, having the implication of being disloyal and without faith. What is important here, in the linguistics of experience is that, faith and defiance are linked. Defiance emerges when faith is compromised. But we must emphasize that this collapse and reconstruction of faith and fealty is an inevitable component of family living. We believe that where there is caring, all pathology is sharing or repairing. But if the origins of the defiant behavior (collapse of fealty) are not considered and the process continues, it becomes treacherous and perfidious, the defiant one is morphed into the extruded infidel.

Unknown-1The family is a metaphorical forest of personal growth. That is to say, the complexity of any family is immeasurable and poetic. In order to know what is going on in a family it is necessary to enter a family, and the interior is much like a forest, the forest can be beautiful, treacherous or changeful. Likewise, the family is the arena for loss of faith and bold resistance, the collapse of fealty we call “defiance.” Defiance is disruptive and destructive, it urges a suppressing response. We view defiance as a call for repair, and while harshness is sometimes required, the salve of caring is always necessary. What is important in the linguistics of experience is that faith and defiance are linked. Defiance emerges when faith is compromised. We underscore that this collapse and reconstruction of fealty is an inevitable component of family living. If the origins of defiant behavior, collapse of fealty, are not considered and the process continues, it becomes treacherous and perfidious. The defiant one is morphed into the extruded infidel.

Defiance is a dance, but it is not one person dancing alone. Defiance is part of a multiple-person system of behavior. At extremes, the defiant one ends up in a parallel universe that has very different values from those held by the adults. When we talk about the need for the child to make the right choices, it is important to consider the fact that he is making choices based on experiential coordinates we don’t comprehend. Children do live in a parallel universe. When we try to enter it by recalling our own growing up, we still don’t approximate what our children are experiencing.

The more ways we have of looking at a complex problem like defiance, the better able we are to understand how to engage it. It is crucial to recognize that defiance does not just appear. Rather it represents a response to a disruption of faith, a collapse of fealty somewhere in the family system. There is a deterioration of the trust between child and parents that implicitly guarantees an environment of self-realization for all members. From an existential point of view, it refers to a situation where the “I” is not respected. Defiance is part of a correcting system; it is activated in order to provide correction but is easily distorted or over-amplified when there is poor response. The poor response may be overly repressive at one extreme, or non-existent on the other.

images-3There is a capacity for defiance in all of us, a fight or flight reaction, an instinctual response. When an individual’s or system’s integrity or dignity is threatened, when the threat is persistent or overwhelming, defiance protects the threatened boundaries. The threat may be real or perceived and may come from any authority figure such as a parent or teacher. For younger children the family usually experiences concern or discomfort with the child’s behavior and seeks help or advice.

In adolescence this behavior requires attention, not only because of family conflict, but as a result of complaints from other systems like the school. The outside systems pressure the family to seek help by threatening sanctions against the child or family, such as expulsion from school. When outside systems push referral, families may enter therapy angry and resistant. The therapeutic endeavor is to understand what purpose the defiance serves by getting beneath the underlying dynamics;  the fear of extrusion, the loss of faith. It is useful to keep in mind, however, that defiance begins as a self-protective function, a way to restore dignity or integrity.

The Case of the Invisible Mom

AB: I first saw Amelie and Bob when they came to see me at the advice of their family doc. They had been fighting a lot lately, and they worried about the toll on themselves and their two daughters. Bob made the initial phone call, saying Amelie was “reluctant” to come in, but could probably be persuaded.

Unknown-1Amelie, a Swiss-born fashion designer,  and Bob, a poet and “house-husband” had been married about ten years. When I first saw them, Bob–a wispy, rather effete  guy, complained mostly about how Amelie “picks” on him. He described how when she arrives home she finds fault with his housekeeping, pointing to “smudges on the wall”, which he found “minuscule.” He made it sound like he quivered in anticipation of her rebuke.

As I observed this couple, I saw a duet that looked different than the one Bob described. While he saw himself as the victim of his wife’s domestic tyranny, Amelie looked to me like a depressed and defeated woman. When  she tried to answer his charges that she “berated”him,  she came across like a woman without much power in the relationship. With her prominent French accent, she acknowledged that she “over-reacted”to the messiness of the house. But she said with a sigh, “I feel like the house is the only thing I have.”

She went on to describe how Bob is so busy with their two daughters when she gets home that she doesn’t want to “interrupt” his schedule with them. The only bread-winner, she works a demanding schedule at her design firm,  often arriving home at seven or eight p.m. As she Unknown-2haltingly talked about what family life is like for her, it sounded to me like she didn’t have a place in this family, that somehow she had become marginalized over time. I made a comment to this effect, and she nodded. I think she felt relieved that someone understood her pain. Bob looked on as I talked to Amelie. This wasn’t the conversation he expected, but he seemed interested. I asked for the kids to come in for the next session.

Family Session: The parents walked in with two adorable-looking little girls, aged five and seven. These girls looked European in their neat dresses, and, in fact, they went to a Swiss school and spoke French with their mother at home. Bob spoke with them in English, though he had a decent understanding of spoken French.

I asked these little girls about their family, and  they acknowledged that they worried about their parents’ frequent arguments. I noticed how, in  the session,  Bob freely criticized his wife in front of the kids, though Amelie did not respond. Both daughters climbed on their Dad, clearly enjoying an intimacy with him, which he obviously encouraged. He was a “magnet” Dad.

As we talked and I observed their dynamics,  it became clear that Amelie did not know how to enter this cozy trio. And it looked like there was no room for her. At one point the oldest daughter, Claire, had to go to the bathroom. When Mom offered to take her, Claire refused, saying she wanted Dad to take her. Mom backed off and Dad moved to take her. This family was used to the kids openly rejecting Mom and opting for Dad. No one questioned it.

When they returned I commented on this strange thing, that Mom’s qualifications as loving parent had become suspect. Dad proceeded to criticize Mom as “too picky” or “not involved enough”, but I stopped him. I said it looked like both these little girls needed some body warmth with Mom. I then asked Mom to spend a few moments with her little daughters, one at a time, in the session. (I wanted to stretch these rather rigid family patterns to see how the family would respond.)  As we watched, Mom gathered Lola to her, and put her on her lap. They quietly began speaking in French, each absorbed in the other. Dad busied himself with Claire while watching Mom; this kind of intimacy between Mom and child stood in stark contrast to their usual patterns.

images-3Mom and Lola blossomed like flowers. Mom’s body softened, and they looked like they could have remained locked together for hours. Soon Claire clamored to be let in; the coziness looked inviting, and Mom took her on her lap. It got too crowded, so Lola got down from the chair and went to the corner and began drawing.

The session was drawing to a close, and I commented on Mom’s beauty as she cuddled with her kids. Mom responded quietly, almost apologetically, “That felt good. I don’t get to do that too often.” Dad, to his credit, did not use this as a chance to attack Mom. Instead, he seemed like he enjoyed what happened. This was not the family he came in with, but this different version seemed to satisfy him.

Follow-Up: Amelie and Bob returned for a follow-up visit before they left for Switzerland with their kids to visit the grandparents.

The previous session initiated some new movement in the family. Amelie commented that Bob had begun leaving her with the girls in the morning, so she was able to get them dressed and off for school. Amelia said she “loved” this time with them, and said she “wanted more”. For his part, Bob said it was “easy” for him to stay out of the way, and he had used the time to do some of his own writing.

Unknown-1I congratulated Bob on his “mini-retirement”, and he chuckled, saying “no problem.” Clearly the patterns of this couple and family had begun to shift, in small but important ways. As I saw  it , Amelie’s fussiness about the house represented the only way she felt she had a voice in this family. Her irritation masked a depression at feeling marginalized as a mother, and Bob’s prize-winning, non-stop parenting has contributed to her feelings of second-class citizenry.

Until then,  Amelie only knew how to become visible through her anger and upset. She only knew how to complain about “the smudge on the wall”, not about the pain of feeling unwanted. She did not know how to talk to her husband about what it felt like to be an outsider in her own family. And he, like all of us when we’re in it, did not know how to recognize her anger as pain.But now, her distress at feeling unloved had begun to acquire a voice. And Bob appeared  to be listening.

Postscript: I got a followup phone call from Bob when the family returned in the fall. According to him, he and his wife  were fighting much less, and Amelie continued to be enjoying her greater involvement with her children. He let me know all was well and that they would return to see me if needed.

Unexpected Therapy from David Keith

AB: Something unexpected happened to me when I read David Keith’s “Unconventional Therapy Perspective”. (7/23).  I wrote David  a note when I finished reading his  Unknown-1post and, though I hadn’t intended to,  began recounting a rather unsettling experience I’d had the day before with a professional colleague. In this episode, I ended up feeling “scolded” by this colleague for my rather expansive and free teaching style–for, perhaps, not conforming perfectly to the institutional patterns.

Something about David’s post made me tune into my discomfort about this exchange.  I have much more experience that the colleague in question, and our students are generally quite appreciative of my rather unorthodox perspective.  And my aim is always to operate in a therapeutic way, to offer my students and their patients an opportunity for healing. This may have been stimulated any David’s reference to “abstract intent.”

I’ve never put much weight on the importance of “playing the game”  within institutions. I respect my colleagues, enjoy cordial and sometimes deep relationships, and believe that I enjoy their respect as well. But I’ve never invested much energy in cultivating any voice other than my own.  That’s the only voice I have, and I’ve never been good at trying to adopt any other. Something about David’s post made me re-engage with myself. It reminded me that I take responsibility for my own living patterns, including as a therapist and teacher. I felt a renewed freedom; perhaps it was David’s affirmation about the importance of our creative, authentic, expressiveness.  My colleague’s “disapproval” receded into the background of my consciousness. Thanks you, Dr. Keith, for the therapy.


Faking Happiness Can Lead To The Blues

Unknown-1Tara Parker-Pope’s NY Times Well Blog talks about how faking happiness can  bad for our health. This reminds me of an article I read many years ago by Paul Watzlawick and John Weakland from the Palo Alto research group. Some of their pioneering work involved applying the field of cybernetics, or “feedback loops” to the understanding of relationship patterns. In an article from their landmark book,”An Interactional View”, Dr. John Weakland noted that “The way to turn a child’s sadness into a depression is to tell him to go into his room and don’t come out until he has a smile of on his face”.

On some level we have adopted this posture as a culture. In our frenzy of anti-depressant use, we forgot how valuable our moods are. We forgot that it’s our depressions that tell us when our life is off-course. We forgot that our depressions function as a GPS when navigating life’s mysterious and sometimes hazardous terrain.

The author in this post, Anahad O’Connor,  notes,

“Trying to suppress negative thoughts, it turns out, may have made those thoughts even more persistent.”

This, of course, is one of the genius aspects of a good meditation practice.   Buddhist monk Thich Nhat Hahn (known as “Thay”) talks about taking care of our painful emotions–anger, depression– “like a mother takes care of her crying baby.” She doesn’t fight with the baby, she holds the baby. She comforts  the baby. Thay suggest we take care of our baby with tenderness:  “Come here my little anger/depression:   I will take good care of you.” No faking here. Just love. Self love.