Study: Therapy Session
Parents often know when it's time to see a professional
with their child - a psychotherapist who will do something to make things
different: help build communications in the family, change painful and
leading nowhere behavior patterns of the child, calm down raw emotions
and redirect power struggles. But how does it happen? Is there any logic
to the process or is it a pure intuition and personality of the counselor?
Sud, Psy.D., the BGCenter new therapist specializing in attachment disorders
and treatment of childhood sexual abuse trauma answers the question
of a parent and thus gives you an insight into the logic she would follow
in investigating the real roots of the child's issues.
Parent: My daughter tends to be a dictator. When
she is controlling a game I sometimes do not follow her just because
I don't want her to get used to being followed. However, I think that
I might be setting a bad example. Should I follow so that she learns
to follow? When I get mad at her, she scolds me or other people the
same way. She imagines a lot that she is talking to people and she is
scolding them. When talking to her, she seldom looks in the eye at the
person talking to her and you can tell that she is hearing but at the
same time thinking about something else. I sometimes move her head to
face me. And say "look at Mommy", but she would stare at me
with a look that I know she is thinking of something else.
Dr. Sud: First of all, I would
need more information such as: the age of the child, is she adopted,
from where, how long the family has had her, are there other children
in the family, was the child in a placement facility prior to coming
to live with the family, if so, for how long, starting at what age?
If she is adopted I would want to know the quality of care she received
in the first two years of her development (if such information is available)
and, once again, if available, information regarding the psychological
profiles of her birth parents.
Based on the little information provided, I think there
are a number of behavioral interventions that could be utilized. I also
think the mother would benefit from being better informed, so she feels
more in control and can better understand what may be going on with
her daughter. Ultimately, the parent should be able to provide nurturance
and limit setting without blaming herself.
It's good to keep in mind that this girl may have an attachment
disorder, for which she would need to be evaluated (hence again, the
need for more information). A proper diagnosis needs to be made regarding
the type of attachment disorder she may have. This information could
then be used to plan treatment which is more specific for this particular
The following statements made by the mother: "she
imagines a lot that she is talking to people and she is scolding them,"
"you can tell that she is hearing but at the same time thinking
about something else," and that "she would stare at me with
a look that I know she is thinking of something else," makes me
question if the girl is reliving some kind of traumatic event/events.
She may be acting out ways in which she herself was treated, as well
as utilizing dissociation as a defense.
Lastly, it's possible that this child began to feel threatened
by the closeness of the family, in particular with the mother. This
often happens with attachment disordered children. The more they develop
relationships, the bigger the chance of loss. Adopted children are all
too familiar with loss, that's mostly what they've known in their lives.
So children begin to act out after an initial "honeymoon period."
They test and see if this adult will also "fail them and send them
away, or leave them."
On a positive note, this girl appears to want to stay
connected to her mother or there would be little, or no conflict at
all. However, it's important to keep in mind that the child may be so
controlling because having control is what keeps her alive. So to ask
her to just "give this up" can be experienced by her as literally