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Mental Notes
Musings on creativity, psychology and living better

How to Keep Your Kid Out of Therapy

Thursday, June 26 9:05 AM

Many children referred to therapy are functioning pretty well, but are having some emotional hiccups. Maybe they have some self-esteem problems or occasional outbursts. Possibly they have become oppositional or are withdrawing into their own worlds. All of these symptoms are of concern, but many of them are not pathological or intractable. It is reasonable that parents might refer their child to therapy for any of the reasons stated above. But, it is these very children who inform my anecdotal list of ways to keep your child out of therapy.  I am not speaking of children who have suffered trauma, been abused, have biologically-based disorders like ADHD or autism, or other diagnosable mental disorders. I am referring to kids who are currently operating outside the norm of respectable or appropriate behavior, but are, for the most part, functional.  In mental health terms, that means that they sleep, wake, eat, go to school, have some friends, engage in physical activities, love their screen time, but are showing signs of mental un-health.

It might seem like bad business for a therapist to tell you how to keep your kids out of her office. But it is my job to help parents understand their children better, so I am happy to share my insights here so that parents can try this at home, before they call me or my colleagues.  

As a therapist (and a person), I have an over-active empathetic system. Like Star Trek’s Spock, I do a sort of mind meld with children as they telepath ideas through art, drama, and play.  I become the translator. I communicate the thoughts and feeling experiences of a child directly to his parents in a way that the child sometimes feels he cannot. When I play or make art with a child I am not supposed to be replacing the parent, but it sometimes feels like that’s what I am doing. This is the parent I find myself replacing far too often: The attentive, attuned, validating, loving, unconditional, supportive, playful parent.   P.S. I always tell the truth.

So, buried in that last paragraph are the things your child communicates to me about what he needs to feel okay.  (Once again with the caveat that abuse or biological concerns have been ruled out).

1. Always tell the truth. Seriously, I cannot emphasize this enough. Do not lie to your children. Do not lie to other people in front of your children. If you say you are going to do something. Do it. If you might not be able to attend the soccer game, do not say that you will. The disappointment of your not showing up is much greater than some honesty at the front end. If you don’t want to go to a party, don’t pretend that your family came down with the flu. Your child will forever question your honesty and integrity when it comes to things that matter most to him, for example, if you love him, or even if you like him. Many parents think children “will not understand” adult situations, like divorce, anger, death, or illness. Indeed they may not understand the complexity, but we mustn’t underestimate our children. Half-truths or softer explanations do not help our children. They need clear, straight explanations or their brilliant, active, fantastical imaginations will conjure a much more serious and devastating truth to explain why mommy and daddy are getting divorced. And I will tell you exactly what their imaginations will come up with: “I did something wrong.”  Really. That’s the default setting for a child’s imagination when his world is falling apart. It’s his fault. That’s because a child feels that the world revolves around him (they do, right?), which means, in turn, that when it falls apart it must be something he did.

2. Play with your child on his or her terms - at least three times a week! This advice is not just for parents of small children. In fact, it may be even more important for parents of tweens and adolescents. Let your child pick the activity, set the rules, choose the movie, whatever it is. And you show up with your best game face, your most inquisitive curious self, and rally to show some interest. I know you can do it. Remember back to your dating days, when you first start talking to someone and you hang on their every word?  When you convincingly feign interest in the minutiae of their hobbies? We all have this skill, the one that ensures that our species will procreate because we can make the other person feel so good about him or herself that one thing will lead to another. Reading your tween’s Tumblr or playing RescueBots with your five year old, may not be your personal interests, but they are your child’s. And your showing interest in him will make him feel good about himself. The gratification and validation your child will experience will make him feel 100% worthwhile. There is nothing better than feeling valued. That may very well be the definition of love.

3. When you say “no”, mean “no”. Don’t equivocate. This is a topic for another blog, but for now I’ll refer you back to Item #1. They are closely related.

Finally, let me loosely back up my assertions with some research. In our practice we use an adapted version of a therapy called Parent-Child Interaction Therapy (PCIT). This is an empirically-supported therapy protocol to help parents reduce extremely oppositional behavior in their children. We have found that the primary construct of this approach—that we must first  improve the parent-child relationship before we can begin managing problem behavior—supports everything I wrote about above. If you want more information about this therapeutic intervention visit: pcit.org.  If you're a parent and you find these "simple" suggestions to be more difficult than they sound or that these small steps are not improving your child's mental wellness, then find a therapist who will help you and your child.  Or come to our creative arts therapy studio for a free consultation. We love to talk about this stuff.