When One Consultation May Be Enough

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

The boy's aunt requested a consultation, describing his behavior typical of a psychotic child. "He started it recently and it's getting worse."

The doorbell was drowned out by the screams of the child. When I opened it, I saw a middle-aged woman trying to drag a 6-year-old child onto the doorstep, who desperately resisted. Three people took part in this battle: two women - one in front, the other in the back - tried to move the screaming and obstinate boy from his place. They pulled him, pushed him, persuaded him and begged him. The scene dragged on. The grandmother finally stepped into the hallway with one foot and pulled the screaming body of the child by the hand. The aunt tried to push the child in the back, gently persuading: "You agreed to come."

The monotony of the scream expressed neither despair nor aggression. It's like someone has pressed a button and it beeps. The same mechanicalness was expressed by the masked face frozen in a scream. The mouth screamed on one note, the body rested, repelled.

The grandmother, tired of the struggle, was clearly in despair. Her helpless question "What to do?" let me go into action.

- What? - I asked and, offering to wait, not to force him, entered the office and, taking a bucket of "Lego", returned to them.

I turned to the boy, put a bucket in his hand (he was standing in the same position) and, taking his other hand, said: “Follow me, see all the rooms, don't be afraid, there is nothing to worry about. If you don’t like it, you’ll leave.”

He silently stepped over the threshold, but, stopping at the open door of the office, said:

- I want to go home! - and again a scream.

The women entered the office. He, standing at the door with a bucket, continued monotonously with small pauses:

- I want to go home! - but the pressure of the scream slightly weakened.

Grandmother, taking advantage of the pause, quickly sat down in a chair, the woman in another, at a distance, and I stood in front of the boy, who, having entered and put the bucket at his feet, kept annoying everything: “Let's go … I want to go home,” but not so loudly. I turned to him again:

- You will go home, of course! If you don't want to talk to me, that's your right. But your aunt called me and you know it. They are very worried, they do not know what is happening to you. Since you've come with them, give them the opportunity to tell what happened. And you do something. Here are toys, paper, felt-tip pens. You can listen, you can play …

Standing in front of me, he did not show the slightest sign of interest - an absolutely impenetrable face, an impassive posture. This big child, beyond his years, was as if devoid of emotionality.

“Choose what you want to do,” I repeated, and settled down on the couch opposite my grandmother.

He continued to stand, then began to walk slowly back and forth on tiptoes, then stood behind his grandmother, facing the wall, and froze like that.

- How long has it been? I asked my grandmother.

- Further we go, worse it becomes. Do you think so too?

- How? - I specified.

- Well … - stretched out the grandmother vaguely. There was a pause. The woman in the chair was also silent.

“I don’t think anything yet, because I don’t know anything yet, except what you told me on the phone - that your daughter is not in the city and the behavior of your grandson inspires you with apprehension. But let's start from the beginning, about what happened before your grandson was born, about his parents, about their marriage, pregnancy; about why the grandson is with you, about you.

Listening to my grandmother, I watched the boy. He did not touch any of the toys. He only changed his place in space, only a few times uttered as if for himself "let's go … home …", but non-intrusively, carefully and even slightly detached.

The emotionally rich speech of the grandmother was full of subjective, established assessments and judgments regarding the facts, situations and characters of the group representing two families.

This tired, burdened with cares and responsibility, a pretty middle-aged woman suffered from feelings of guilt ("I understand that I cannot replace his mother!"), Latent aggression ("I told you so" or "I'm afraid when they take him away") …

A brief summary of her story, supplemented by clarifying questions, will allow us to understand the boy's story and the reasons for the changes in his condition, now reminiscent of autism and having psychotic symptoms

The boy's mother (the youngest daughter in the grandmother's family) is bright, capable, sociable, interesting. Very active. Fell in love with the boy's father to the point of unconsciousness ("They are so different. I knew that nothing would work, but do they listen?"). The mother did not interfere with the marriage of her daughter ("I love her too much"), the father also did not interfere so as not to offend the daughter.

The child's father has always been an “ugly duckling” in his family. Silent, never understand what he thinks, what he wants ("I still do not believe that he is able to declare his love, love").

Paternal grandmother is an authoritarian despot. She did not interfere with the marriage of her son ("Why, I got such a girl! She's the sun, full of life and love!").

The father's family practically did not take part in the life of the young and the grandson. The grandfather (father of the father) died early, and the mother-in-law gave all her affection to the youngest son. And the father of the child for her is what is, what is not.

The young couple settled in the family of the wife's parents. Nothing darkened the life of the newlyweds. Pregnancy did not come immediately (after 2 years), but it turned out to be desirable only for the mother of the child. "He (the father of the child) treated it as if it had nothing to do with him."

With the birth of a child, the young seemed to have cooled to each other. "She (daughter) finally began to understand with what egoist she connected her life."

The birth was not difficult, the child was born normal, developed well, but the conditions of care were difficult (the years of the blockade and energy crisis), the young mother fell into a slight depression. And the child's father after a while (the boy barely began to walk) went to live in his mother's house. He showed no interest in the child.

Soon he went abroad for a year, leaving his wife and child without a livelihood. ("You might think he kept it before! So, from time to time I earned something, mostly dreamed and mastered a new specialty.")

A year later, when the boy was three years old, his father returned: although a career abroad was quite successful, life in a foreign land was unacceptable for him. The relationship did not improve, and they decided to finally break up.

A young unemployed mother left her son, who was already 3, 5 years old, with his grandmother and went to work abroad.

("There was no choice. The family broke up: a son with a family in one country, a husband (the boy's grandfather) in another, and a daughter (a boy's mother) in a third. A grandmother must look after her grandson until her daughter is finally settled." my husband cannot go with him, because there are no conditions, the husband lives in a hostel. But here is his (boy's) house, books, toys - and then, he’s with me since childhood … ")

Now the boy is 5 years old. For six months already, the boy's father began to show an unexpected interest in his son.

At first he came himself, and now he takes the boy to his place. He makes enough money from his new profession. The grandmother is worried about two problems - the changed state of the boy ("I became unsociable, does not communicate with anyone, you talk to him, but he does not seem to hear, you saw"). The grandmother explains this by the fact that the boy misses his mother very much. She tries to entertain him, takes all sorts of things and entertainment. But the more the grandmother tries, the more the grandson gets angry (“I'm afraid my daughter won't recognize her son; well, what did I do wrong?”).

“Work with him,” the woman suggested, “maybe something will work out.

Leaving her question open, I turned the conversation to another topic - the anxiety of my grandmother, connected with the visit of the grandson to “that house” (“What if he will be offended there, I’m so afraid”).

My grandmother solved this problem herself, quickly reworking my question:

- Does the boy go to his father with pleasure?

- He wants to go there.

I continued:

- Your anxiety is connected with your responsibility, but if the boy rushes there …

- Yes, - she interrupts me, - I needlessly worry, it means that he and his father are good.

Next comes the most important part of the conversation, the psychotherapeutic effect of which manifested itself almost instantly. This always happens in cases when the word carries the desired right to freedom of choice, the right to be yourself!

I translate the conversation to the topic of the boy's father and show my grandmother that she is clearly intolerant towards her son-in-law.

- Do you not like your son-in-law? I ask her. Instead of answering my question, she says:

- And this one, as luck would have it, is his copy.

I:

- So what? This is bad? Do you want him to be different?

- I dream that he was at least something like my daughter, - says the grandmother.

- Yes, - I agree, - I understand your desire. But perhaps there is something in your son-in-law, the boy's father, something so special that you probably don't notice, maybe you don't understand …

She listens intently, without interrupting me, a semblance of embarrassment on her face. I continue:

- After all, for something very important, a woman like your daughter fell in love with him, as you say, madly. They were so happy that she even wanted to have a child from him, for the birth of which he, perhaps, was not yet ready. But now, when he has matured to fatherhood, for something this very, special, the son is drawn to him. This, as you say, "ugly duckling" may indeed be a "swan" - and he found his place in life, as you say, "he achieved success himself, he has a difficult path in life."

- Yes, he started it all from scratch. He's very smart indeed. The notes of intolerance in the grandmother's voice faded. She is silent in vague anticipation.

- Our children have the right to be themselves, contrary to our good wishes.

Suddenly, I suddenly discovered that the boy was listening very attentively. Standing rooted to the spot in the center of the office, facing me, he tensely, as if through me, drills the wall with his eyes.

“And your grandson,” I continue, quickly shifting my gaze to my grandmother, “can be very happy and loved, no matter who he looks like - his father, mother, grandfather, you, or no one at all. The main thing is to be yourself. And he has been given this right - to be what he is. His dad and mom love him for who he is, because they have him like this. Even if mom is so far away today, she thinks about her son all the time, misses - I already say all this for the boy, catching with a glance that he is heading to the sofa, to my place.

I said all this for the boy, and in order not to embarrass him, I looked only at my grandmother and aunt, but I was sure that he hears everything. I felt close, and soon felt his head on my shoulder. Fearing to scare him away, I continued to speak, feeling some tension in one half of my body, the right side, to which he clung trustingly. Catching the tension in my grandmother's gaze, I realized that I was speaking almost in a whisper, as if afraid to frighten off a dozing child.

I continued to talk about how bored my mother is, how much she works to be able to come or take my son to her. Then she talked about how the son misses and suffers without a mother.

In conclusion, I transferred the topic to my grandmother.

- Is it your fault that it happened? But how wonderful that your daughter has you, such a wonderful mother, whom she trusts her son. Don't worry, - I reassured her, - to be bored, to be sad is hard, but you can cope with it. There is no need to be afraid for him, to entertain and distract. You can talk about this honestly and in an adult way. Do you miss me too?

- And how, - the grandmother sighed bitterly and shed tears.

- Yes, I understand, but you can, but he must not be bored? You are suffering, but he must not suffer? It seems to me that this is human and quite normal - to love, worry, wait for a meeting, suffer. It is much more difficult for a boy when you pretend to pity him, distract him. What to be sorry for? Mom and Dad are healthy, alive, love him, take care of him, and he is also so happy that he is surrounded by loving and caring grandparents, uncles, aunts and friends.

- You are right, - the grandmother agrees, - I must have been very restless, after all, not my child. But he has changed a lot. I am afraid that his mother will not recognize him, and begins to ask me for psychotherapy for the boy.

I do not agree with her proposal and submit my proposal in turn:

- Let's not rush. Leave the boy alone. Do not bother him with entertainment and your worries and pity. Share your doubts with him, ask about his desires, and do not anticipate them: does not want - not until, do not insist - be it food, sleep, clothes or a walk. Take care of yourself and watch him. Call me in a month, a month and a half, then we'll think about what to do, and if necessary, we'll invite dad too.

Grandmother once again tried to insist, talking about the benefits of psychotherapy for the child, but then she accepted my argument that this should first of all be the consent of the child, who did not yet exist, and it was necessary to give him time for this.

The boy sat next to me and no longer leaned against me. At what point it happened, I did not notice. I turned and addressed him, looking straight into his eyes. He did not shy away from this meeting of views.

- You heard everything and you can express your opinion to your grandmother. But decide everything yourself. If you want to come again, tell your grandmother or dad, or your aunt (who during the whole meeting did not say anything except confirmation that he stopped playing with the children and answered his name).

Finally, the grandmother asked:

- Do you think everything is all right?

I answered honestly:

- Not okay, but it happens sometimes with normal children in a difficult situation. And it doesn't have to be a disease.

I admitted that at first I also took it for the threshold of autism, but everything I saw and heard allows me to hope that what is happening is within the limits of the individual norm in a crisis situation.

- Let's wait! Give the boy freedom of choice and watch. I'll be waiting for the call.

Two weeks later, it was not my grandmother who called, but that very aunt. She excitedly talked about the fact that the boy was unrecognizable. Has changed a lot, plays with children, goes to the yard, has become much more independent. All this news was mixed with thanks on behalf of the grandmother, who seems to be about to start her therapy. “It would be nice,” I thought, but said nothing.

To her question: “Now I am even afraid to believe that everything is over; is this the effect of that one consultation? - I answered evasively:

- Perhaps the boy heard the most important thing for himself, and this explains all the positive changes that can be sustainable for both.

My aunt was curious about what the boy heard special, but I kept his secret, saying that this only applies to the boy himself.

This really concerned only him, his right to choose identification with his father, whom his grandmother, and maybe even his mother, did not accept. He received this right, or rather, found it from my words. He believed me, and that was enough for him to give himself the right to be himself, to love his father without feeling guilty for betrayal and fear of rejection. He no longer needs to hide in psychotic symptoms. Forbidden is allowed!

After this call, I did not hear about them, but today, after 4 years, I also have no doubt that everything is in order. For such an intelligent, subtle boy, one single consultation was enough.