AB: This past week I began thinking about a case from my office from several years back. It made a strong impression on me at the time, and I thought it might be useful to share with our readers. 

Here’s the scoop: I got a call from  Sarah, who said their family doctor suggested that she and her husband bring their  child in to  see me. She said her husband was worried that their 3-year old son showed signs of “bi-polar disorder” and wanted a professional opinion.  This was a puzzling request,  given the young age of the child. My curiosity was peaked.

The Consultation Snapshot: Sarah and Jared, a hip-looking mid-thirties couple entered my office with a spiffy-looking three year old, Michael. The father, Jared, a very  buttoned-up British guy,  met his California-born wife at a wine-tasting event five years earlier. Jared worked in the high-powered finance sector, and Sarah worked as a part-time consultant for an event-planning group. Little Michael was their only child.

images-6The father, Jared, was worried about his son’s temper tantrums,  and thought this might be a sign of “early bi-polar disorder”.  Sarah didn’t share her husband’s  concern, but she didn’t openly challenge his viewpoint.  Very soon into the interview the family dynamics revealed themselves in full-blown color. Early in the interview, Jared asked his son to “shake hands” with me, and was very insistent that his son clearly express “please” and “thank you” in the process. This formal requirement for a toddler made me feel  like I had been transported back to Victorian times. Of course, I treated this child as if he were three, not thirty-three. I’m not sure the father approved.

The  poor kid. It soon became clear that his development had been inadvertently hijacked by the father, who wanted his son as a little adult version of his perfectly controlled self. And this was a really sweet kid, who looked a bit sad at not being allowed to be three. He was trying his best, though. As Dad talked, it became clear that he felt “mortified” when his son had a temper tantrum in public. I think it felt to him like his own (inner, unacknowledged) craziness was on display for the world to see. The father felt exposed by his toddler’s irrationality.

UnknownFor her part, Sarah offered a more relaxed, healthy perspective on her son’s “childish” behavior.  Sarah seemed less afraid of her son’s outbursts  and worried that he had too many “demands” on his little shoulders. But part of the problem for this family,  as I saw it, was that Sarah’s voice didn’t carry the same authority in the family as Jared’s. She expressed herself rather tentatively, and seemed to lack confidence with her husband.

The session lasted about an hour; I openly supported Sarah, telling Jared that he “deserved credit for marrying such an intuitive woman”.  It looked to me like Sarah was not used to feeling tall in her husband’s eyes. Jared accepted the “compliment” without irony. And I enjoyed teasing Jared, gently and respectfully.  I made comments like, “It looks like part of you would love to be a wild three-year old,” or, “There’s a lot of freedom in being able to go crazy”. To his credit, he allowed me to say these things and appeared to be taking it in.

Toward the end of the session, when the husband briefly revisited the  “bi-polar” question, I responded casually, “All three year olds are bipolar”.  Jared smiled. I think they got what they came for, or at least the father’s anxiety appeared visibly reduced. But some underlying tensions remained  that may show up at a later date.

Unknown-1Since this was a single consultation, I didn’t get a chance to explore the parents’ family backgrounds in any detail. I’m pretty sure if I did, the concern over “self-control” would have shown up as a theme in Jared’s family. My guess is that if I investigated further, there may have been someone, or several important people who went crazy, or drank, or were unpredictable/untrustworthy  in ways that created pain for the family. Jared’s worry over “losing control” reflects  what psychiatrist Murray Bowen  called the Family Projection Process. This important concept in family life has to do with the way parents–all of us–project our own unconscious anxieties/wounds/hopes  onto our kids. We all do this to a certain extent.  It only becomes  problematic  when these projections become pervasive and are outside our awareness.

But, hopefully, with the help of our partner, friends, family or a skillful therapist–people who care about us, and who can see things we don’t see–we’re able to interrupt these unconscious projections. I think that happened to a certain extent in this family consultation.



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