Sharing secrets from therapy: When a parent comes for a first interview, what is that I am looking for? Three probing questions reveal parental attitudes that psychologists believe to influence problems.

I receive a phone call from a parent. S/he is nervous, apprehensive. A parent who phones about a problem with a child normally feels a little embarrassed, maybe an anticipation of being shamed: How come their child has this problem and all other children in the group seems to be fine? I understand this, so that in my response I hope to be generous and kind.

 

If at all possible, the first interview is with both parents. A parent who is “too busy”, who “can’t take off time from work”, whose “work schedule is too hectic”, I speculate to either being blocked by the other parent or one who is trying to avoid a potential uncomfortable confrontation- something along those lines. So I use some tactics to get that parent in. Not because I want to prove something, but if a child has sufficient contact with both parents, I need to see both to get an impression of the child’s familial world. Where someone other than a parent is looking after a child, I mostly do a home visit as well.

But back to the first interview. What am I looking for?

 

Three questions revealed:

One of the first questions that I ask goes something like this,

I do not know your child? Can you describe your child to me?

Here is a sample of some answers from real life. Spot the difference:

  1. a) Puzzled: “Oh, she’s a child, she is just like a child you know.”
  2. b) Big sigh: “ He doesn’t listen. No matter what you do. He is never still, not even when he sleeps. We think he has ADHD. And he is aggressive, even with his little sister. We are scared that one day he is going to hurt her. Doing his homework is one big battle.”.
  3. c) Face lightens up (a sense of relief to be able to talk): “You know, the school asked us to see a Psychologist. She bullies other children. This is such a worry to us, because she can also be very kind. She loves to help with the chickens at home. At times she can be so sweet, and then at other times she throws a huge tantrum and there is nothing that we can do to calm her down. She is smart, she knows the names of all her cousins and uncles and aunts, even those she do not see often. But when they do come to visit, I think she is jealous, because she does not want to share her toys. Sometimes she hits the other children.”

Parents who can provide a nuanced description of their child, with both positive and negative examples, and who have some idea of why certain behaviours happen (“I think she is jealous’), already have the first step in place: Seeing your child as a nuanced person and not as a stereotype, is a first step in the right direction. It is one of the aims of therapy.

Allow me to defend the other parents:

The more stress you have in everyday life, the more difficult it is to “see” your child. When we are stressed, we cannot see- not our children, or the wood from the trees.

Parents quite logically think that they come to see you because their child has a problem, so they provide a list of problems. Yet, an attuned parent, will want to defend their child against a totally negative view by others, so invariably will add some positives.

I have worked with many grandmothers who look after aids orphans, sometimes as many as 14. It is enough of a challenge to keep these children clean and fed, they must see each child as an individual as well? Yet, working with them has been my greatest joy and a source of deep satisfaction. Because given just a little support, they do, they do!

Question two: When you lie awake at night, and you worry about your child, how do you understand your child’s problem?

What am I looking for? More or less the same scenario applies as in question one.

A parent who can make a connection between their own behaviours and a child’s behaviours is on a substantial way along the path towards a solution. This relates not only to parental behaviours, but also to outside influences as well. Multiple moves, divorce, bereavement, parental mental health issues, school environment, cultural context; all of these have a strong impact on our children.

Fluidity in thinking and logical connections. If you shout and beat or belittle your child, then aggression in a child is a logical response (If someone shouts at you and belittles you, how would you react? How come we think children are a different species from ourselves?).

What I would prefer not to hear:

“”It is the influence of bad friends”

“They deliberately pick on her at school”

“S/he is such a sensitive child ”

“ I am afraid it is in his genes” (preferably from the opposite parent, especially in divorce)

Why not? Could this not be true?

Maybe, to an extent. But placing all influence outside of the child’s control/ contribution, is a way of shirking responsibility and/or ‘growing’ victimhood. This attitude, once fostered in a child, becomes an adult habit, whence it will increasingly frustrate and irritate you as well as undermine the child’s progress and relationships.

Social media and the Internet play an increasing role here, as exasperated parents trawl for answers.

Caveat

I am not trying to blame parents. Believe me, at my age I understand that we are all flawed, that we all make mistakes, that with hindsight, all of us as (myself certainly included), would have done specific things quite differently.

One of my benchmarks of a successful outcome, is a deeper and more nuanced understanding of the systemic nature of a child’s problem. That a child does not exist in a vacuum, but responds to a multitude of stimuli – both internal and external. A child is not a stand-alone act.*

Often, deep down, one parent knows this, but for a multitude of reasons, does not feel free to own it.

* How do I know this? If a child can respond differently inside the room with me than outside (e.g. sit still, not interrupt, can focus on a task), then the problem is not only internal to the child, but in the child’s reaction to an outside world. Children in therapy play out an amazing inter-connectedness of all things as well as a depth of feeling that to this day leaves me in awe.

Question three: Can you describe what have you tried thus far, what has worked and what was unsuccessful?

By the time that a child ends up with a psychologist, the problem is usually advanced, and many solutions would have been tried. Also, by this time, a typical pattern of behaviours around the problem would have been established. Parents and teachers would have tried multiple interventions. This is a way for me to understand how they have made sense of it all, as well as what they have tried thus far. One of my favourite maxims is: The problem is not the problem, the solution to the problem is the problem.

This question seeks to understand the relationship between parents and a child, as well as the “solutions” and the sequential logic applied. I can also trace the influence of the Internet and topical solutions (e.g. empty chair). It is my experience that inconsistencies (one day you shout at a behaviour, the next day you try to reason, the following day you are to tired so you just ignore it), a hostile attitude, and an over-emphasis on the problem are some of the more prominent markers of poor solutions. These types of “solutions” often lead to additional problems like defiance or despair.

It matters, of course, that I know what has been tried and what has failed;  I do not want to prescribe what has already been proven not to work.

Mostly this question has to do with helping me get to a deeper understanding of the relationship around a problem, as I want to lift the despair that has built up. Optimally, a good solution should empower both a child and it’s parents, it should enhance the relationship between them, must build more autonomy and competency in a child. Without experiences of autonomy and competence , and without hope for improved family relationships, both parents and children are bound to fail, no matter how smart and topical the solution.

 

 

 

 

 

 

 

 

Author: elzanfrank

I am a psychologist searching for more natural and enlivening ways to help. After thirty years in the profession, it is time to move on, time to search for new ground, time to venture out.

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