Saturday, May 22, 2010
I had a conversation with a colleague of mine this week, a psychiatrist who has been providing treatment to children for at least 35+ years. I was telling him about the difference of opinion I was having with some of my staff, regarding children who "act disrespectful" in sessions. I tend to believe that children should be able to come into therapy and feel free to say or do whatever they please during their 50-minute session. I have co-workers who do not allow tantrums or sass and are appalled that I allow that. It gets very frustrating sometimes. This doctor laughed at me and said, "We were debating that 30 years ago!"
So apparently this has been a source of conflict among psychotherapists for some time now. I don't think I can argue the other side with real conviction, but from what I understand, these therapists feel you are reinforcing negative behavior by allowing tantrums in session. For example, a child comes into therapy and begins to yell and curse about her Mom making her share a room with her little sister. There are some therapists who would say, "I know you're mad about this, but I don't allow that kind of language in here. It's not appropriate for a 12 year-old to curse like that. If you want to stay here, you need to calm down and stop yelling, so we can talk about this." One of my co-workers has explained to me that she is establishing "good boundaries" with this client and "I don't allow people to yell and curse like that at me, and this child is no different than anyone else." I can actually see the logic in this argument. It is perhaps teaching the child to get control of herself and emphasizing the importance of showing respect with adults. In this scenario, I would also say the therapist was calmly setting parameters for the therapy sessions.
Faced with a similar scenario, I tend to encourage the child's expression of this anger and may even repeat her words to show that I do not judge her anger. For example, after the child has made some loud "inappropriate" comments about Mom, I repeat it back to her with similar conviction, "You think that bitch is just favoring your brother again and you are very mad about it!" Often this diffuses children right away, because they're shocked to hear their therapist cursing. After several instances of this, however, the child becomes settled in knowing that their anger and tirades are not going to be shut down or judged, and they will express themselves freely. After several sessions of this, I've seen children gain a comfort in knowing that their anger is heard and respected in this room by this therapist, and the need to yell and curse about things tends to diminish. I think it's important to note that there has to be some realistic limits to what a child can do in treatment. These limitations should not feel restrictive and are there to keep the child safe and to protect property from being damaged.
I take this stance because I want children to bring all their ugly stuff into therapy. I want them to say the vile things for which other therapists might reprimand them. It's my opinion that giving a child this kind of freedom, allows them the space to bring everything that is inside to the outside. There we can look at it all without judgment, and children tend to sort it out for themselves. The fear of many therapists is that aggressive behavior acted out in therapy may transfer to the home or school environment. I will say that I have not had this happen. It seems that working freely through the anger in sessions actually decreases the need and desire to do it elsewhere. Often when children have been allowed to cut up drawing pictures of siblings or beat up dolls of Daddy, they have come back to me later and reported improved relationships with these people. Anyway, that's the debate!
I feel really passionate about allowing this sort of freedom of expression, because I see it work so well. I work with a 9 year-old girl who shares deeply painful memories of bullying and abandonment by Mom only after her puppet doll "beats me up" for about the first 10 minutes of therapy. I've seen another 10 year-old boy gain insight on his own about jealousy toward his sister, only after I allowed him to dump an entire bin of toys on my floor, toss them around for 40 minutes saying, "THIS is my anger!" With this child, all I had to do was stand by to ensure safety and validate as much as I could, "this is your anger! It's a lot! It's big and very messy!"
I have to say that, as a therapist, you must be really comfortable with your own anger to allow such expressions from other people. I've clipped some shrubs to pieces "working out my mads" and scrubbed some tubs to a sparkling shine while crying it out. I have to believe this has allowed me firsthand experience of physically kneading through emotions, letting them run through my body and my words until they are spent. Perhaps if a kind therapist had allowed and encouraged this from me years ago, I wouldn't have struggled with it as an adult. Nonetheless, my landscaping looks great these days! So, the debate "rages" on, so to speak, and I will continue to encourage my little people clients to come on in and let it on out.
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Friday, May 14, 2010
I had a really neat thought today. Have you ever noticed that the 12 steps and the 23 Psalm actually go hand in hand? They move through the same succession. Check this out:
1. We admitted we were powerless over (insert addiction), that our lives had become unmanageable.
2. Came to believe that a power greater than ourselves could restore us to sanity.
3. Turned our will and our lives over to the care of God as we understood him.
Admitting powerlessness, developing faith in a higher power, and putting your life in God's hands: The Lord is my shepherd; I shall not want. He maketh me to lie down in green pastures: he leadeth me beside the still waters. He restoreth my soul: he leadeth me in the paths of righteousness for his name's sake. Psalm 23:1-3
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and another human being the exact nature of our wrongs.
6. Became entirely ready to have him remove these defects of character.
7. Humbly asked him to remove our shortcomings.
Getting real about your own "stuff," and letting God begin to clean you out: "Yea, though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me; thy rod and thy staff they comfort me." Psalm 23:4
8. Made a list of all persons we had harmed and became ready to make amends to them all.
9. Made direct amends to such people, wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God, praying only for knowledge of his will for us and the power to carry that out.
Making it right with those you've hurt, being set free from the past, relying on the power of God and the steps to continue the healing: "Thou preparest a table before me in the presence of mine enemies: thou anointest my head with oil; my cup runneth over." Psalm 23:5
12. Having had a spiritual awakening as a result of these steps, we tried to carry this message to others and to practice these principles in all areas of our lives.
"Surely goodness and mercy shall follow me all the days of my life: and I will dwell in the house of the Lord for ever." Psalm 23:6
Isn't God so clever?
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Wednesday, May 12, 2010
Hello blogger friends! It's good to come back to this blank page and "blah" a little bit. Like most of us at some point in our lives, I have been spending a significant amount of time these last few months actively pursuing a personal dream. This is a career dream that I have held for as long as I can remember, even back to my childhood. In these last few months, it has been almost surreal watching what has been only a picture in my imagination become a reality in my life. It has been scary and exciting, both joyous and nerve-wracking. Just in this last month, however, the building of my dream has come to a screeching halt.
I have hit what seems to be an insurpassable roadblock. There is no way through this one. I've come upon other roadblocks on this course, and, with some some time and determination, have been able to make it through. This one, however, remains firm. I am slowly coming into the realization that this just is not going to happen for me. My dream is dying and this is tough-- really, really tough.
Yesterday, in my car driving home, I turned off my radio and just began to pray. I don't remember exactly what I said, but it was something like this, "God, you know my heart, and you know that I am saying these words from a place of true sincerity and not an attempt to force anything from you. If it's your perfect will for me, I am asking and trust that you will remove this roadblock. I will do my part and wait patiently for you to swoop down with your powerful hands and make this happen for me! You are well able to remove this obstacle right now in the name of Jesus. You can do this and I know you love me and want me happy!" I paused while a giant "but" bubbled up into my prayer. "But if you do not remove this roadblock, I will accept that. I will go where you want me to go and be the woman you want me to be, wherever you want me to be that." I began to feel gratitude build in my chest, "after all you have done for me, I can give this dream to you, God. It's really not much for you to ask, after all. If you want me to give this up to you, and that's your plan for me, I will do it. I love you and just want you to be pleased with me. I'm not perfect, although I try to be daily to no avail (God knows I'm a perfectionist despite His grace :-) ). Really, at the end of the day, and at the end of this life, my dreams are such a small thing. All that really matters to me is that you can say you're pleased with me. If this is all you ask of me, I'll do it for you, Lord."
In the course of that prayer something clicked in me. This career dream I have is but one pie slice in the pie of my life. It is not the entire pie. God has done amazing, truly amazing and miraculous things in many of the other pie slices. I'm so grateful for that. Yes, I'd love to have every pie slice just the way I want it, and maybe God will do that. I'm sure He'd love to really show out in my life and He's done it many times before, BUT if He doesn't... who am I to complain, really?
Suddenly, I remembered Abraham and how he was asked to sacrifice his son Isaac. This was the son he for whom he had prayed and believed for nearly a hundred years! This was the one thing he had always wanted from God more than anything else, a son, and he finally got it. Now God was asking Abraham to sacrifice him. It was always so inexplicable to me how Abraham was able to take his highly prized son out to be sacrificed, without question, without hesitation! What?! I always read that story and thought, "Wow, what amazing faith! Abraham must have know that God would not really do this to him and that a true sacrifice would be provided in the end." Ultimately, that is what happened. Just as Isaac was laid upon the sacrificial fire, a lamb appears from the bushes as the sacrifice. Today, for the first time ever, I see this story in a completely different light. After years and years of waiting on God, trusting in God, watching God work, trial and error, trial and error, a believer learns very acutely what it feels like to be apart from God. I have struck out on my own way many times only to crash and burn. It's no fun.
For me, and maybe even for Abraham, I believe, it's not faith alone but also reaching a place of resignation with God. I don't mean a hopeless, angry kind of resignation. I'm talking about a resignation that, when asked to give up to God a seemingly essential part of SELF, says, "I thought I needed this, but really, if you want it, it's better if you just take it. I'll give you whatever you need just to stay with you, even this. In fact, in the grander scheme of things, this is a very small thing to give you. My entire life is right here on the sacrificial fire. Just take it all... including THIS," whatever THIS might be in your life.
I apologize if I may sound a little preachy today or overly "religious" for some. Although I have my particular spiritual views, I don't ever intend to try to force those on other people. I want to allow everyone the space to make and find their own spiritual path. Please know that the sharing of my particular struggle is just that... my own personal struggle, and not intended to be a sermon on the mount. One of my earliest intentions for this blog was a selfish one-- a place to rant and philosophize as self-indulgently as is personally necessary! We all need the space to do that and sometimes knowing that our words are being heard is very validating. Thanks for validating me today. :-)
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