When Mom or Dad consult me about their child, I request that the parents come in too. In later hours, I'll even bring in the entire family which is always an illuminating experience. The child who "needs" help is the designated patient. If that kid gets squared away, the family tells itself, everything will be great. It's that kid who has the problems, not us. No, it's the family system that is sick and the difficulty is typically between Mom and Dad. The kid malfunctioning actually keeps Mom and Dad together. Mom and Dad can gripe about the kid instead of looking to their own marital problems. They even use the kid to attack one another. For example the parents may undermine each other's discipline of the child. If the child is treated alone, he/she will get yanked out of treatment once there is improvement. In some cases, another child in the family takes over the role of designated patient.
Recently I began treating a family whose thirteen year old daughter talked about killing herself. I'd seen the mother one time five or six years ago and her history was unbelievably sad. It didn't surprise me that her daughter was having problems. The girl described a life of being a social misfit, the butt of every one's jokes and years of being excluded by other kids. Now I'm asking myself why this is so. The kid seems immature and perhaps would do better hanging with kids a year younger than herself. I find out later that she has done exactly this successfully. So the social skills are there. She is very thinned skinned. She is the only girl with four far older brothers. Mom pervasive anxiety has engulfed this girl and this is a good deal of the problem. Dad wants the girl to grow up. Mom is afraid of he daughter's growing up and leaving her.
The marriage is horrible. There are lots of screaming matches. I thanked the girl for doing an excellent job of getting Mom and Dad some help. She had to pull the suicide trump card to do it but it worked. The kid grinned as she sat safely between Mom and Dad.
2 comments:
I am reading a piece of fiction that Anne gave me for my birthday a couple of years ago, and it's all about an incredibly dysfunctional family, but the author uses it as sort of a metaphor for the incredibly bizarre political dystopia it's set in. Addiction features prominently. I occasionally wonder if there are any disorders and/or goofy things that happen to you that can be exacerbated by the time and place that you live in, sort of like the post 9-11 anxiety that gets tossed around. And by extension, I wonder to what degree national disasters can be blamed for voting disasters ;)
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