Children do not develop behavior problems in a vacuum. So why do we send our children to be fixed by child psychologists?
When kids have behavioral symptoms, it is often a signal that something in the family system needs to change. Unfortunately, when you send a child to therapy, she believes that she is the problem that needs to be fixed. This is highly unproductive and can perpetuate the problem.
Recently I got a call from a mom asking me to see her 5th grader, Aaron, who she described as “out of control.” I asked mom to tell me about Aaron’s misbehavior, and she stated that he has been hitting and kicking her “for no reason.” She also reported that when she tries to set limits, he will scream at her and say, “Stop talking,” or even “Shut up.”
Mom went on to say that Aaron has a one-year-old brother with a severe developmental disability. According to mom, Aaron will pull toys out of his hands or purposely wake him up when he is napping, even after she asks Aaron not to go into his room.
Lastly, she said that when Aaron doesn’t get his way, he often starts rolling around on the floor like a “toddler having a tantrum.” This sounded pretty dire for a 5th grader.
So, imagine my surprise when I met Aaron, and he was super cheerful, articulate, and well-mannered. When I inquired about Aaron’s behavior in school, I learned that he was a terrific student, and his teachers adored him. Something didn’t add up.
After meeting with Aaron for about 20 minutes alone, I got a better sense of the family dynamics and asked Mom to join us. I learned that mom works from home and has a very demanding job with extremely long hours. I asked her if she needed to work as many hours as she did, and she said that there was no way to work less with all her daily meetings and deadlines.
Cut to session number two when I asked to see the whole family. Sitting with mom, dad, Aaron, and Aaron’s 8-year-old sister, I asked each person in the room what the biggest problem was in their family?
Sister immediately answers the question with, “Mom works too much, but we know she has an important job.” Notice I did not hear, “Aaron misbehaves too much.” Dad and Aaron nodded in agreement.
Then I said, “Think about the last few times Aaron had a real meltdown. Who was there while it was happening?” I learned that Aaron rarely misbehaves when he is with his dad or alone with his siblings. All the incidents in the past week occurred when mom was working within earshot of Aaron.
Aaron’s misbehavior was a signal to the family that, yes, something was wrong. But Aaron is NOT the problem in this family. Interestingly, Mom is not the problem either.
Why didn’t Dad step up to the plate to fill the void Mom created by working so much? How come Aaron’s parents did not talk together about addressing their children’s needs for nurturance, attention, and connection? Why did they let Aaron get to this point of being “out of control? When are the parents talking to each other if mom works from 6:00 am to 9:00 pm?
Symptoms develop in children when there is a problem in the family as a whole. When Aaron is acting out, he doesn’t think to himself, “I am going to act out now to get my mom’s attention.” But he feels the disconnection in the family and possibly the distance between his parents and doesn’t know what to do.
In the next family therapy session, I learned that Aaron’s sister was a perfect angel. I wondered, is this amiable behavior a way to connect with mom more? What needs to happen for Aaron to start behaving at home? The answer is obvious. What if mom is not willing to work less? What will that tell you? What message does this send to the kids and her husband?
I often get calls from parents who want me to see their son or daughter in therapy. Maybe their child displays symptoms of anxiety at school, or a five-year-old just started stuttering, or a teacher thinks the student has ADHD. Regardless of the presenting problem, childhood symptoms get resolved much more efficiently and effectively when the whole family comes into therapy.
The reason is simple – when you bring your child to therapy and say, “Meet Dr. Roth; she is going to make your anxiety go away,” the child hears, “There is something wrong with me,” and once in therapy, the child is often unwilling to talk. However, when a parent calls the therapist and says, “Our family would like to come in to see a psychologist to help us figure out why our daughter is worrying so much,” the child hears, “My family wants to help me to feel better.”
Lastly, it is not uncommon for children to develop symptoms to draw attention to a problem or difficult transition in the family that is not being addressed. Maybe Dad just got laid off, or an older sister is leaving for college. When a family is going through a tough transition, the children pick up on the family’s tension. At these junctures, children can develop symptoms to signal that something doesn’t feel right at home.
In family therapy, as opposed to individual therapy, children feel safer talking about what is on their minds, and it is much harder to act as if everything is fine. In the first session, we ask each family member to “define the problem.” This question brings to the surface how family members interact with one another.
When children show their symptoms (e.g., anxiety) in the session, the therapist can observe precisely what triggered the child to become anxious and how each member of the family reacts to the child’s anxiety. The psychologist then uses this information to help the family re-organize to become a more productive family system where problems get addressed openly. The parents become more effective partners in raising their children
