WE ALL KNOW THE PROVERB “little pitchers have big ears,” which means, of course, that children hear and understand much more of adult conversations than we realize. Children—even young children—are especially prone to eavesdropping on conversations between parents on important matters such as a parent’s health or his job. This is precisely what happened with Alex, an adorable five-year-old boy with curly blond hair and blue eyes.
“I’m worried about Daddy because he doesn’t have an occupation,” Alex said to me. What in the world does he mean by that? I wondered. Alex and I were sitting on the pale blue carpet in my office playing a game of Don’t Break the Ice. Occupation, I mused. What an unusual word for a five-year-old. I asked Alex what he meant, and he replied, “Daddy doesn’t go to work anymore because he doesn’t have an occupation.” Then he added in a small voice, “We don’t have any money to buy new toys or go on trips.”
Now I understood. Alex was worried because his father was out of work. I would have to pursue that topic with his parents. I wondered how Alex’s mother and father were handling his unemployment. Perhaps they had been talking or arguing about his father not having an occupation, and Alex had overheard them. Or maybe he had heard the word at school. Someone might have asked him what his father’s occupation was.
In my practice, children are my scouts and my co-therapists. They lead me across unfamiliar terrain right to the heart of their family’s problems, which is an all-too-familiar landscape to them. I had just asked Alex my usual question, “Are you more worried about your mommy or your daddy?” and he had told me. Then I had reassured him that now I was going to be his family’s helper, and the worrying would be up to me. I told him that I would meet with his parents alone. “Is that okay with you?” I asked him. Alex nodded his head.
I don’t know if it’s the kind way in which I ask the question, or whether children simply feel relieved when I say that I am going to help their parents, but I have found that most children respond positively. If a child is at all hesitant to tell me who he is more worried about, I rephrase the question. I say, a little playfully, “Just pretend that you are worried about one of your parents. Which one would it be?” or “If you were worried about one parent, would it be Mommy or Daddy?” Moving into the realm of make-believe usually prompts even the shyest child to answer. I have never had a child refuse to answer because he is worried about getting into trouble. Children seem to instinctively trust that I am asking only so I can help their family.
We finished our game. Alex won.
When Alex’s parents, Jackie and Logan Harrison, had brought him to therapy that morning, the first thing I noticed was the large cast on Logan’s right arm. I didn’t make much of it until after my conversation with Alex, which took place later in the session.
“Alex has always been a little hyper,” Logan said when I asked the couple what had brought them to therapy. “But now it’s gotten to the point where we get a call from his kindergarten teacher every day about him kicking or biting other children. He never did that before. His teacher says that he doesn’t follow directions in class and won’t sit still. He keeps jumping out of his chair and roaming around the room. And he doesn’t listen when the teacher talks to him. He runs ahead when the class is going to the playground. Once he almost ran into the street.”
“We had a meeting with his teacher last week,” Jackie added. “She thinks he might have ADHD. So we took him to the pediatrician, and he said that Alex was ‘just behaving like a typical boy.’ But when we told him that Alex was about to be kicked out of kindergarten, he recommended we see you. He thought family therapy might really be helpful.”
“Alex did seem to have more tantrums after the baby was born,” Jackie said. She went on to explain. “We have another son, Andy. He’s six months old.”
This isn’t unusual, I thought. Many children react to the birth of a sibling with some sort of acting out because they feel displaced or dethroned. Some regression is predictable. Sometimes the older child even wants to drink from a bottle or has “accidents” and needs to wear a diaper at night. Did Alex’s parents give him enough special attention after the baby came home? I wondered.
As though she were reading my thoughts, Jackie said, “My parents came to stay with us for a month to help us right after Andy was born, so Logan and I spent lots of extra time with Alex while they babysat. We took him to special places, like the circus and the beach. He never had tantrums while we were out with him.”
“And now is Alex misbehaving at home also, or is it just at school?” I asked.
“He doesn’t want to do anything we ask him to do at home, and he doesn’t calm down easily. Putting him to bed takes a long time,” Logan said.
While her husband was talking, Jackie looked overwhelmed and about to cry.
In their early thirties, Jackie and Logan were an attractive couple, but they seemed preoccupied and tense. When I asked Logan about the cast, he told me he had broken his arm when he fell on the tennis court four weeks ago. The arm was almost healed enough for the cast to come off. “And I can’t wait,” he said.
“It’s been a really hard time for him,” Jackie said with concern in her voice. “And for us.” The tears were flowing now. “Logan is usually so active. And he misses his work terribly.”
Meanwhile, Alex was playing quietly with a set of trains, making me wonder what was going on to cause so much “hyperactivity.” I asked Jackie and Logan about their family. “We have just the two boys, Alex and Andy,” said Jackie, smiling now. “Andy is with the babysitter this morning, but she’s only part-time.” Her voice trailed off.
“Alex adores his baby brother,” Logan assured me.
Jackie nodded in agreement and then added, “But of course we wonder if he might sometimes feel jealous.”
“We tried to make Alex feel especially loved after Andy was born, but Jackie needed more time to take care of Andy,” said Logan. He added, almost apologetically, “Our kindergarten only goes till one in the afternoon, so we put Alex in an after-school program three days a week. He was doing fine there, until recently.”
Then, Logan told me, he broke his arm and had to go on disability leave. He was a tennis coach and couldn’t do his job with his arm in a cast. Logan was concerned that his time off from work put a financial strain on the family. His disability checks helped, but they didn’t cover everything. He also used to earn quite a bit of extra income from taking on private students after work, and of course that income was gone now. And they both agreed that Jackie shouldn’t go back to work yet because the baby needed her. She was now on maternity leave with half-pay.
At this point I had asked if the parents would step out to the waiting room so I could speak with Alex privately. That’s when the boy told me what was on his mind—that his father didn’t have an “occupation.” Inviting his parents back into my office, with Alex playing quietly on the floor, I asked them when the teacher had started sending home notes about Alex’s behavior. They said it was about six weeks ago.
“So it started around the time that Logan broke his arm?” I asked. They thought about this, and then Logan replied with surprise in his voice that yes, it was right around that time.
“Do you think my accident had something to do with Alex’s misbehavior?” he asked incredulously.
“Possibly,” I answered. I suggested that Logan and Jackie come back the next day to talk with me. I wanted to speak with them alone and give them some strategies to help Alex. Then I looked at Alex and said with a smile, “Remember, I’m the helper now.” We exchanged high fives.
In the session with Alex’s parents, I shared with them what Alex had told me: he was worried about his father’s not having an “occupation.” Logan and Jackie laughed at the word, but they were surprised, even shocked, that their son was so aware of his father’s health issues and his work situation. They weren’t sure where Alex had heard that word. “Maybe at school,” I suggested. Then Jackie remembered that she and Logan had been arguing, and she had said something like “It’s all because of your occupation that you broke your arm.”
“Could Alex have overheard you?” I asked.
“Sure,” said Logan. “He was in the room.” But Logan could scarcely believe that his injury was troubling his son so much and causing him to behave badly. He just did not see the connection. “Is that usual for a child his age?” he asked me.
I explained to Logan that it is typical for a child to notice these things and have worrisome fantasies about what they mean. Did he believe that his father would never go back to work because he no longer had a job? Did he think the cast would stay on forever or his mother would always be sad? Young children have a tenuous grasp on the future, and fears like this are not uncommon. We couldn’t know exactly what was on Alex’s mind, but we needed to get him to stop worrying. It was that simple. To accomplish this, I asked Logan to reassure Alex every day that he still had a job and would be going back to work very soon. I even suggested that Logan take Alex to the tennis club where he coached, so Alex could see for himself what his father’s “occupation” was like.
“Have you ever taken him to work with you?” I asked Logan.
“No,” he said. “But there is no reason why I couldn’t take him there and show him around. That’s a good idea.”
I asked both parents to reassure Alex that his father’s arm was healing and he would soon be back to his normal routine. It was the most important strategy for this family. I also asked them not to discuss financial matters in front of Alex, and to say upbeat things about their lives when Alex was around. Even when a parent is unemployed, he can still tell a child some positive things such as, “I went hiking today with an old friend and it was fun.” They agreed to focus on the positive around Alex.
Then, as I typically recommend with very active kids, I suggested that they enroll Alex in a sport like soccer or T-ball, so he would be tired out by bedtime. Another strategy was for his parents to make a star chart to reward his good behavior. For every day that Alex got ready for school on time and went to bed without fussing, he would get a gold star. If he had a good day at school and his teacher did not call his parents or send a note home, he would get an additional star. At the end of the week, eight out of a possible ten gold stars would earn him a trip to the ice-cream shop with one of his parents. The Harrisons were very health conscious and rarely ate ice cream or other sweets. So this would be a special treat. Also, it would give Alex time alone with one parent without his baby brother. Jackie and Logan liked the idea of a star chart and agreed to try it for two weeks.
At the next session two weeks later, they told me happily that Alex had had “a great two weeks!” They were using the star chart and rewarding Alex with trips to his favorite ice-cream store. Logan reassured Alex every day about his health and his job. He told him that his arm was healing very quickly and he would soon be back at work. He had taken Alex to the tennis club twice and introduced him to the other coaches and some of his students. Alex’s behavior at school had improved. At a parent-teacher conference, the teacher was surprised he wasn’t on meds for his “ADHD.” She was amazed at so much improvement in such a short time.
Because there was a dramatic change in Alex’s behavior, I could tell that the parents were following my recommendations consistently. Seeing this kind of rapid improvement is not unusual in family therapy. Once Alex told me which parent he was worried about, I could immediately start to make changes in the family dynamics. If Alex had gone to a play therapist, he might have eventually expressed in play his fears that his father was injured and might never go back to work. This would certainly have made Alex feel better at the time, but his behavior probably would not have improved until his father’s arm had actually healed and Alex saw with his own eyes that Logan indeed had an “occupation.”
Jackie and Logan said they wanted to follow up in a month. At that meeting, they said there had been no more incidents at school, and bedtime was much less difficult. Alex had started playing T-ball and came home exhausted after practices and games. He now fell asleep at night with few problems. Logan’s arm had finished healing and he was finally back at work.
Stories are a way we make sense of our experience. Where the story starts and what is included in it depend on the goals of the storyteller. When Alex’s parents told me he might have ADHD, my goal was to find an alternative story to this medical diagnosis. I asked myself, “What was this little boy worried about and when did his worrying begin? What else could be part of the story of his misbehavior?” And, as it happened, Alex’s school problems coincided in time with his father’s injury. Alex had been an active child before that, but his behavior had not been a problem at school. Creating this story—that Alex was upset about his father’s injury—allowed me to remove the worry from his shoulders. I also considered his new brother as a possible cause of Alex’s problems. But the timing wasn’t right. Yes, Alex had tantrums around the time his brother was born, but, significantly, he was not misbehaving at school. Alex telling me that he was worried about his father not having an “occupation” was the clue.
Family therapy is not just a method of psychotherapy. It is a new way of looking at human behavior, of narrating the flow of events in people’s lives. Rather than look for a biological “inner” cause of a child’s misbehavior, we try to find another possible sequence of events, another narrative or story. Pioneer family psychiatrist Salvador Minuchin reflected in a recent interview that he learned more about being a good therapist from watching movies than from observing therapy. Minuchin tells us that the best training he ever had as a therapist was learning to create stories when he was thirteen years old. He lived in a small town in rural Argentina, right across the street from a movie house. The usher was a friend of his and would allow him to sneak into the theater at 6:00 p.m. But Minuchin’s father had a strict rule that dinner was at 7:00 p.m. So after watching the movie for an hour, Minuchin would have to leave the theater and create an ending in his head. This experience “was my first training in being a psychotherapist,” he says. As the narrative therapists also tell us, plays and stories teach us new possibilities. They serve as alternatives to our dominant social narratives and help us make sense of our experience in new ways.
Creating stories as a family therapist requires a shift in perspective that is not always easy to make. It took me five years of supervision and study to learn to frame sequences of human interaction like a strategic family therapist. Of course, unlike Minuchin, I didn’t have to make up movie endings; when I went to the movies on Saturday afternoons, I watched them all the way through. As a family therapist, I have to identify significant events that occur at the same time that a child’s problem begins—like a death, an illness, a new baby, or, in Alex’s case, his father’s broken arm. In sessions with children and their parents, I learned to notice that just when parents begin to argue, their child begins to act out. The child might whine. Perhaps he will run over and jump into his mother’s lap. He might throw a toy on the floor, causing his parents to admonish him and apologize to me. I learned to see that a child will do just about anything to make his parents stop arguing and shift the focus of attention to himself. To grasp what is really going on with a child, I had to understand the whole sequence of family interactions of which his behavior was a part.
My teacher and mentor, Jay Haley, was fond of comparing strategic family therapy to Zen. He told the story of a university professor who visited a Zen master to learn about his spiritual practice. The master served tea. He poured his visitor’s cup full, and then kept on pouring. The professor watched the overflow and exclaimed that his cup was full. The master replied: “Like this cup, you are full of your own opinions. How can I show you Zen unless you first empty your cup?” In the same way, I had to give up many of my own ways of viewing therapy clients. I had to give up thinking about individuals and began to think in terms of two or more family members.
A training video that I watched at Jay’s Family Therapy Institute in Washington provided a dramatic lesson in perceiving sequences from a family therapy perspective. The video was about a young man in his twenties who used heroin. Right there in the family therapy session, whenever his parents raised their voices or talked about separating, the young man threatened to start using heroin again. I literally learned to “see” the sequences as connected. The son kept interrupting their arguments by drawing attention to his terrible problem. The task for the family therapist was, of course, to help the young man’s parents become happier together so that they would stop threatening to separate. Then their son would not need to use heroin. If the therapist simply focused on the young man’s heroin use out of context, there would be no improvement.
The best way of conceptualizing his heroin use, I learned, was to see that he was sacrificing himself by having a terrible problem so that his parents would stay together to help him. His parents’ lives thus had a focus and a purpose; they had to help their problem son. This is not the only story one could make up about a young man’s drug problem, but in this case it turned out to be a powerful instrument of change. The parents stayed together. The son stopped using heroin.
Young children have many ways of protecting their parents, and school failure is one of the big ones. If a child acts out at school or doesn’t focus on his class work, his parents must put aside their own problems in order to help their child. They will have to spend time together talking about their son or daughter’s problem. They will have to attend parent-teacher conferences, keep counseling appointments, and make extra visits to the pediatrician. They will need to work as a team to help their child instead of dwelling on their marital problems and thinking about getting a divorce. By deflecting the parents’ attention, the child’s problem protects the parents from facing their own issues.
In my experience, a child of loving parents will do almost anything to distract her parents’ attention away from their own problems. Unfortunately, misbehavior is what most readily does the job. After all, reasons the child, my tantrum is a surefire way of getting my parents to focus on me; it has always worked before. As children get older, they may develop more serious problems, such as drug or alcohol use or truancy, to protect their parents and bring them to therapy.
As a rule, the more loving and caring the parents, the more their child will try to protect the parents from their own problems. For years my colleagues and I have pondered whether these attempts are conscious and deliberate or unconscious. What I learned in my early training was that younger children protect their parents unconsciously, but after age fourteen or so, the kids’ efforts to help are conscious. However, in recent years I have begun to have my doubts about this. Because young children are so responsive when I say to them “Thank-you for being the helper” or “I am going to help your parents now,” I have begun to think that even in a young child the intention to protect a parent is conscious.
But whether intentional or unintentional, a child’s attempt to help a parent can have terrible consequences. As we have seen, in today’s overmedicalized society, a child may develop a problem that will be framed as a psychiatric diagnosis such as ADHD or bipolar disorder. And that diagnosis can lead to real trouble. The child’s attempted solution to the parents’ problem becomes the very problem presented in therapy.
When I think that a child is having a symptom or developing problem behavior in order to help or protect a parent, my strategy is to communicate to the child that I understand what he is doing and from now on I will take over his role as the family helper. This is what I did with Alex, as well as with Joey, the little boys whom we met earlier. My goal is to see the child as little as possible in therapy—so that the child does not feel like there is something wrong with him—and work instead with the parents. Once I have reassured a child that it’s my job to help his parents, there is usually no reason for the child to come to therapy sessions.
Transitions or abrupt changes in family life can trigger problems. Alex was reacting to a family transition in which the smooth narrative of his father going to work every day came to a stop. This was worrisome to Alex. His mother telling him “Daddy’s cast will come off in six weeks” didn’t have a clear meaning for him.
A more common reason for a child to have ADHD-like symptoms is hearing his parents argue, especially about disciplining him. Although the disagreements may not be serious, a child might secretly worry that they are a sign that his parents might separate. Even if the fantasy is unfounded, the specter of divorce has become a profound fear for children. These days 50 percent of marriages end in separation or divorce, and every child has friends whose parents are divorced.
Teachers’ notes or phone calls are often the first sign that a child is having trouble. Sometimes the parents are not surprised; they’ve been disturbed by their son’s or daughter’s behavior at home. But occasionally a teacher’s concern comes as a bolt out of the blue. That was the case with seven-year-old Jarrod. His second-grade teacher, Mrs. Coleman, was particularly worried because Jarrod was completely out of control in the classroom. She had been sending notes home since the beginning of the term. “Jarrod can’t keep his hands to himself during recess,” she reported. And worse: “He kicks or bites other students and even spit at one little girl.” The teacher was especially worried because the other children were afraid of Jarrod and were starting to avoid him. And she told Jarrod’s mother she’d had several complaints from other parents.
At a meeting with Mrs. Coleman, Jarrod, and his mother, Roberta, Jarrod claimed that the other boys always attacked him first and he only defended himself. But the teacher quietly insisted that Jarrod was the one who initiated the aggressive behavior. Also, she told Roberta, Jarrod was not completing his work in class and sometimes didn’t even take the assignments home with him. Roberta seemed to be unaware that Jarrod wasn’t turning in his worksheets, and she was distressed to learn about his kicking and biting. “Jarrod doesn’t act that way at all at home,” she said. Mrs. Coleman seemed unconvinced, but she was eager to help the boy. She suggested that Roberta try sitting with Jarrod and encouraging him while he did his homework. And, she added, if he did misbehave at home, Roberta might do well to try “time-outs.” She also suggested that Roberta limit the amount of television that Jarrod watched at home, and to be particularly careful that he not watch television shows or play computer games with violence in them.
Roberta tried what Mrs. Coleman suggested, but the teacher reported that Jarrod was still misbehaving at school. A friend at work to whom Roberta confided about Jarrod suggested that Roberta consult me about family therapy. Roberta wasn’t quite sure what this entailed, but her friend spoke so highly of how I’d helped her teenage daughter that she called me immediately.
Roberta and Jarrod came to therapy on a rainy evening in late February. Roberta, an elegant, slim woman who practiced law in a neighboring town, had come directly from work and looked tired. Jarrod was a sturdy boy, tall for his age, with a brown crew cut. He was neatly dressed in jeans and white tennis shoes with flashing red lights on the heels. He looked decidedly unhappy, the corners of his mouth slanting down. When I greeted Roberta and her son in the waiting room, Jarrod didn’t want to come into my office; he hung back even when I told him there were lots of toys he might like to play with. But when Roberta leaned over and whispered something to him, he finally followed her into the office.
The first thing Jarrod wanted to know when he sat down next to his mother was if I was “a doctor who didn’t give shots.” I laughed and replied, “You’re right, I am a doctor who doesn’t give shots. No shots in my office; see for yourself.” I gestured at the toy shelves.
“That’s what my mom just told me,” said Jarrod as he sat down on the floor to play with Lego blocks.
On the phone, Roberta had told me that she had been divorced from Jarrod’s father, Tom, for two years. Her ex-husband had been emotionally abusive to her, and once he had been physically abusive as well, shoving her so hard that she fell onto a glass coffee table and shattered it. This incident prompted Roberta to move to her parents’ house. She and Jarrod, who was five at the time, stayed with her parents for six months until she found a house of her own and saved up enough to pay the rent herself. Tom had custody every other weekend. Things went pretty smoothly with the co-parenting, Roberta said, but there was not much communication between her and her ex-husband.
Roberta told me about her meeting with Jarrod’s teacher and Jarrod’s misbehavior at school. Observing Jarrod out of the corner of my eye, I could scarcely believe that he could be the kind of bully his teacher described. He was careful with the toys, scrupulously putting the blocks away when he was finished playing with them. He had a very gentle presence for a seven-year-old boy. I was puzzled as to why this child who seemed so sweet and genial in my office turned into an aggressive bully at school. I asked Roberta if she would mind reading a magazine in the waiting room while I spent a few minutes talking with Jarrod alone.
When Roberta left, I sat down on the carpet next to Jarrod and asked him my invariant question: Was he more worried about his mother or his father. Jarrod averted his eyes, but he answered right away, “I’m worried more about my daddy. He cries when he drops me off at Mommy’s house because he’s sad that he doesn’t have more time with me.”
“Daddy cries?”
“Yes. He’s really sad.”
“And what about you?” I asked. “Do you want to spend more time with Daddy?”
Jarrod nodded vigorously. Then he said quietly, “But Mommy won’t let me.”
“Why is that?” I asked.
“Because Daddy once grabbed my arm and hurt me.”
“Why did he do that?”
Jarrod hesitated and then replied very softly without looking at me, “Because he didn’t know what he was doing. He was angry.”
I asked Jarrod when that had happened, and he said it was a long time ago. His father had never done that again, and he had apologized to Jarrod many times over for hurting him.
I asked Jarrod about school. He liked his teacher even though he knew she got angry at him sometimes. Despite his acting out in the classroom, Jarrod did have one friend at school, Jordan. He told me that he liked to go to Jordan’s house because he had a trampoline and they had fun playing on it. I was happy to hear that Jarrod had at least one friend he got along with, a hopeful sign that he wasn’t always aggressive with other children.
At the end of the session, I asked Roberta to come alone to the next appointment. I wanted to find out more about Jarrod’s father and his feelings about the custody arrangement. As a family therapist, I know that divorce can be hard on children, but if the parents are respectful toward each other and agree about custody, the damage to the child can be minimized.
In my session alone with Roberta, she repeated what her son had already told me: that during an argument, her ex-husband, Tom, had grabbed Jarrod’s arm in frustration. What Jarrod didn’t know was that the couple was in marriage counseling at the time, and when they told the marriage counselor about this incident, she reported it to Children’s Services. As a consequence, Tom was allowed to have only supervised visitation for the first six months after the separation.
Once the six months were over, Tom and Roberta settled in to their arrangement for Tom to have custody of Jarrod every other weekend. Roberta said she thought Tom had learned his lesson. He had apologized to his son and to her.
“Would Tom be willing to come to therapy to help solve Jarrod’s behavior problems?” I asked. Since Jarrod had told me that he was worried about his father, I thought that his misbehavior was in some way protective of Tom. I had to figure out what Tom would need in order to be happier and see how I could bring that about.
“I think so,” Roberta answered. “We don’t have much communication, but I know he loves Jarrod.”
Roberta had anticipated my request. She had given Tom my phone number, although she wasn’t surprised that he hadn’t called. “I don’t think Tom believes in therapy,” she said. “But if you would call him and tell him it would be good for Jarrod, that might help,” she added.
I was a little hesitant since she had told me that Tom didn’t believe in therapy, and calling him seemed like barging into a lion’s den. But I knew that I had to get Tom to therapy in order to help Jarrod. I have called resistant fathers before because it is essential that noncustodial parents be involved if a child is having problems. Very often the custodial parent, usually the mother, doesn’t want the father to be involved in the therapy. But my job description includes persuading reluctant mothers and calling antagonistic fathers.
I gathered up my courage and made the phone call to Tom. We left phone messages back and forth, but when I finally talked with him, he surprised me. He was very willing to come to therapy if it would help Jarrod.
The four of us met the following week. Tom was tall and stocky and had a gentleness about him similar to his son’s. When he saw his father, Jarrod’s expression changed instantly from despondency to joy. With a shout, he ran over to Tom and jumped into his lap. Tom bent over and kissed Jarrod on the top of his head; he sat for the rest of the session with his arm around Jarrod’s shoulders.
Tom was defensive with me at first, presumably because he thought I would judge him harshly. But when I was friendly and respectful toward him, he slowly opened up about his resentment at seeing his son only every other weekend. He really wanted to have Jarrod for two weeks or more in the summer so they could go fishing with Tom’s father, who had a cabin at a nearby mountain lake. And Tom also wanted to see Jarrod during the week so he could help him with his homework and be more a part of his life.
While Tom spoke, Roberta looked wary and tense, keeping her arms crossed defensively in front of her chest. Until now, she had refused to change the custody arrangements. She didn’t seem comfortable sitting here in the room with Tom. Because of the single incident of Tom’s grabbing his son’s arm, the judge had awarded sole legal and physical custody to Roberta, with very limited visitation for Tom. Typically, in the absence of any unusual circumstances like abuse, child custody in California is evenly divided between the mother and the father.
I asked Roberta and Tom to come back for a session alone so we could discuss these issues without Jarrod’s being present.
The couple came in later that week. They were barely seated in my office when Tom exploded. “You’re just using Jarrod as a pawn to get back at me,” he spat out. “You’ve never forgiven me for pushing you around.”
Roberta was quiet and didn’t interrupt, although I could see that Tom’s words were difficult for her to hear.
“Maybe that’s so,” she said finally. “But there’s no excuse for it, and there’s no excuse for your hurting Jarrod. You shouldn’t have grabbed his arm.”
Tom was quick to speak up. “You know that was an accident. I never meant to hurt him. And I apologized right away. Jarrod forgave me right away, but you just can’t get over your grudge. And you know that it’s hurting Jarrod not to see me more often.”
Roberta was quiet. I knew that she loved her son and had been through a lot of worry with his behavior problems. Although Jarrod’s teacher hadn’t mentioned a diagnosis of oppositional defiant disorder directly, Roberta knew that it was on her mind. Jarrod’s pediatrician had already suggested this diagnosis as a possibility.
After talking to me and seeing the affection between Jarrod and his father, Roberta was finally beginning to realize that, for her son’s sake, she needed to compromise with Tom about visitation. She also wanted Tom to be more involved with Jarrod’s teacher and the school counselor about his behavior problems. She needed Tom’s support in dealing with the school.
“Give the teacher my e-mail address and phone number, and tell her to keep me in the loop about Jarrod. I’ll go to parent-teacher conferences or whatever it takes,” said Tom.
Roberta turned to me. “Are you sure this is what’s causing the problem? Are you certain there’s nothing wrong with Jarrod? Do you think he might have oppositional defiant disorder or something like that?”
“The proof is in the pudding,” I said. “Let’s see if you and Tom having a more cordial relationship will have a positive impact on Jarrod’s behavior.” Based on my experience, I was sure that it would. I also knew that Roberta and Tom would have to see actual changes in Jarrod’s behavior to believe that their son’s real problem was their hostile relationship.
Toward the end of the session, Roberta tentatively agreed to let Tom take Jarrod on a camping trip along with Tom’s father, whom she had always liked, for a week over the summer. She also agreed for Tom to have Jarrod for a week during the Easter school vacation.
So far nothing had changed with Jarrod at school. His teacher was still writing notes or e-mails home every day. But I hoped that the thawing of the parents’ tensions would start to have some positive effects.
Jay Haley used to say that children’s violence is always a result of conflict and tension between the child’s parents. This is true whether parents are living together or divorced or separated. In a second session with Roberta and Tom alone, I convinced them of how important it was to resolve their disagreements privately and not air them in front of Jarrod. I explained that their fights made Jarrod feel terrible.
Tom told me that now he and Roberta were talking on the phone and trying to be more civil toward each other for Jarrod’s sake. They were trying hard to be good parents, and there was not as much tension between them. Tom, looking at the floor sheepishly, admitted in a low voice that he had felt spiteful after the divorce. He admitted that he did try to turn Jarrod against his mother, complaining bitterly to Jarrod about his limited custody and allowing Jarrod to see him crying. Now he could see that what he had done was not in his son’s best interests.
“I was being childish,” Tom said candidly.
At the beginning of the fourth session, this time with Jarrod and his father, Jarrod greeted me with a big grin and excitedly told me that he had gotten gold stars from Mrs. Coleman every day that week, and got to choose a toy on Friday from the teacher’s big toy basket.
“I didn’t know that Mrs. Coleman gave stars,” I said.
“Yes, she does. She gives everyone gold stars if they don’t get into trouble. Then on Friday if you have five stars you get to pick a toy. And I didn’t get into trouble once.” Jarrod was clearly pleased with himself.
Tom proudly announced that there had been no notes or e-mails from Jarrod’s teacher for nearly two weeks. There had not been a single incident of hitting, biting, or spitting at school. He was now picking up Jarrod from school on Wednesdays, and helping him with his homework before dinner. Jarrod was finishing his class assignments and turning them in on time.
Because Jarrod’s behavior had improved so dramatically, his parents were undoubtedly using the strategies I had given them. They were no longer arguing in front of Jarrod. They were careful not to say bad things about the other parent. I asked for a telephone update in a month. At the update, both Tom and Roberta reported that Jarrod was no longer having problems at school.
Children often act out the feelings of a parent that the parent is not able to express directly. Family therapists say that the parents are communicating indirectly through the child because direct communication between the spouses has broken down. In Jarrod’s case, his hostile behavior at school could be seen as his acting out his father’s unexpressed anger at his ex-wife. The way I saw it was that Jarrod was protecting his father and also acting out his father’s hostile feelings by bullying other children.
The family therapist’s goal is to restore healthy, more direct communication between the parents so that their child no longer needs to be a vehicle for their exchanges. Jarrod’s problems brought his parents together in therapy, where they learned to speak more amicably to each other and negotiate their needs. This process began when each of them took a respectful, nondefensive stance toward the other parent, with each of them admitting they had been wrong.
When Roberta agreed to give Tom more visitation rights, he became less angry and more cooperative. This increased visitation was actually a relief for Roberta since it gave her more time for herself. She admitted that she had fought Tom on the custody issue out of anger and spite because he had been abusive to her. With a new arrangement that made Tom much happier, Jarrod was free to improve his behavior because he did not need to protect his father anymore.
Tom and Roberta successfully made the transition from having a difficult divorce, in which they were both trying to recruit their son into siding with them, to a more civilized divorce that would not burden their son with having to take sides. As therapy researchers Marla Isaacs, Braulio Montalvo, and David Abelsohn point out in their book The Difficult Divorce, couples do not have to be friends after a divorce; they need only to contain their hostility so that the children are not burdened by their ongoing anger. After divorcing, parents need to negotiate a new relationship, with their highest priority being the best interests of their children. These authors also point out the importance of both parents participating in therapy. Even though they were no longer husband and wife, Tom and Roberta were able to form a peaceful working relationship with each other for the sake of their son.
An important consideration is that a young child does not understand what divorce really means. Children often have fantasies and even dreams that their parents will get back together again. The family therapist can help a child by asking the parents to gently remind him that they will never be together as husband and wife, but they will always cooperate as parents and do what is best for him.
Both Alex and Jarrod might easily have been labeled with ADHD or a conduct disorder such as ODD. Alex’s pediatrician chose to frame his behavior as acting “like a typical boy.” And Jarrod’s parents were eager to avoid medication and therefore willing to try a different approach to solving their child’s problems.
Parents sometimes ask me what I think about giving a child a stimulant medication such as Ritalin. These parents have usually been through a lot—screaming fights at home, discouraging meetings with teachers, strains on their own relationship—and they are desperate for help. What I propose is that we try very hard to help the child with family therapy without medication. If we don’t see significant improvement after four or five sessions of family therapy, then the parents are of course welcome to pursue other avenues of treatment. I have found that if parents respond well to my interventions—such as being careful not to argue or disagree with each other in front of their child and to shelter their child from problems in their own lives—they will be well on their way to avoiding medication.
I never refuse to see a child who is already taking medication if the parents want to try family therapy. But often parents bring a child to me when medication is no longer helping and their doctor fears that increasing the dosage might produce harmful side effects. This was the situation with Laura, whom we met in Chapter 2. Laura was already taking medications for ADHD, anxiety, and depression when I first met her. I suggested that her mother try family therapy to supplement the medication for a couple of months, at the end of which time we would reevaluate.
With Laura, the outcome was positive and she was able to do well without medication. But like any other therapist, I am not successful with every case. No matter how hard I try, not every family therapy story has a happy ending. I recall a nine-year-old boy named Justin who was distracted and disruptive in his classroom, and aggressive with other students. He also wet the bed at night. Justin’s parents had been through a difficult divorce. The father had custody of Justin and the mother had custody of Justin’s twin sister, Julia.
The parents refused to come to therapy together to discuss how to help Justin, and they refused to talk to each other, even to arrange visitations. Justin hadn’t seen his sister or his mother for over a year. Although both parents trusted me, I was not successful in getting them to put aside their angry feelings and negotiate a cooperative co-parenting relationship. I even met with both sets of grandparents and tried to get them to mediate between the parents. But nothing worked. Justin was eventually diagnosed with ODD and ADHD and was put on Adderall—which did help calm him down and focus better at school. I often wonder if he ever saw his mother or his twin sister again.