Mankind is the only animal that spends 18 years at home and 40 years getting over it.
I talk about childhood, anger at parents, and stress and social pressure from school all the time in therapy; but I don’t work with children or teenagers. Early on in my career as a psychotherapist I wanted to think that there was nothing that I couldn’t do. I wanted to be all things to all people. Slowly you, if you are self aware, discover what you are good at and begin to find the clients that you are better able to help. I stopped working with kids one Saturday while my family was on vacation at the beach. I had spent the entire evening on the phone with a fourteen year old patient whose mother had kicked him out of the house in twenty degree weather. He called to ask me if I could come pick him up so that he wouldn’t freeze.
It is not uncommon for me to spend weekends on the phone with patients in crisis. Not all therapists take crisis calls, but I think that it is an important part of healing patients. When a therapist is doing psycho-dynamic work they are temporarily acting as the patient’s parent in order to reparent the patient in a healthier way. Psycho-dynamic therapists do this in order to replace the critical or abusive voice that we internalize voice from our parents with a more adaptable and caring one.
Part of this reparenting process is teaching a patient that it is beneficial to reach out and ask for help. Many patients with abusive or neglectful caregivers have learned that they will not receive help or that they do not deserve it. While many therapists are adamant that therapy takes place only within the therapy room, I don’t find this to be the case. I believe that if we are going to repair a patient’s ability to ask for help we need to show them by example that asking for help is beneficial.
I stopped working with children in therapy because; while I can tell adults with abuse in their home to “Get the hell out of your environment or let’s talk about why you don’t think you can” ; I can’t say that to a child. In fact I found myself that Saturday not knowing what to say. I can report the experience to DHR, in fact by law I have to, but this seldom changes the child’s reality. That Saturday, while I waited on the phone for my patient to be picked up by police, I made the decision to stop working with children and adolescents forever.
Later I was talking to a colleague who exclusively works with children about my admiration for his ability to do that work. “I just can’t do anything, and I can’t stand that” I told him about working with teenagers. “I don’t know how you work with adults,” he told me with a wry smile. “I feel like I can’t do anything, it is already too late” he continued. “I am doing something with teenagers, I am being present in crisis and letting them know they deserve love” he finished.
Our feeling that there was nothing to be done was mutual but we were looking at the problem from two different sides of time. I felt like it was hopeless to work with children because I couldn’t stop the abuse or neglect caused by their parents. My colleague thought it was hopeless to talk to adults who had needed someone to love them long ago that would never be there. I was drawn to psychotherapy because it allowed me to stop people from hurting. My friend was drawn to psychotherapy because it gave him the ability to make people who were hurting feel less alone. For me it was enough to allow patients to forgive themselves and heal from a childhood that I couldn’t change from their past. For my friend it was enough to be present with another person who was in pain he couldn’t change at that moment.