The crankybolt strikes

I thought I was a bit snippy before, but then I got some really insightful comments to my post on people “outwitting” their therapists and now I would like to bite something (not my commenters!), as people contributed a lot of great ideas about how clients get set up in adversarial relationships with their therapists.

I have this dangerous habit of naivete that’s hard to break, which is: I forget about bad therapy and people who use therapy badly.  I like to relegate it to this separate place in my head and separate it from my vocation.  We may have come pretty far, but psychotherapy’s roots still go back to deeply toxic structures of institutionalization and social control.

I think a really common thread to the stories I get treated to was that the person was brought into therapy as a child, often for being “weird” or “odd”.  And a lot of child therapists, bless their hearts (she says through gritted teeth) actually do take it as their mission to take “odd” children and turn them into normal, happy, healthy children.  And sadly, a lot of dominant discourses say that normalcy is the path to health and happiness.  “If you stopped monologuing about Pokemon, then you could make friends and have a good social life!”

And, well, these conversations usually take place while at least one of us is in costume.  We’re geeks.  We’re odd children who grew into odd adults.  We monologue at each other.  “Normal” is the shoe that doesn’t fit.

Also, I did some work in my last practicum as a child therapist, and what really got to me was that all the parents assumed at first that taking your kid to therapy was like dropping your car off for an oil change.  You go and someone takes the kid away, and then brings them back 45 minutes later a little bit more fixed!  “Here’s your counsellor, Timmy.  She’s here to make you less of a freak.  I’ll be reading a magazine in the waiting room.”

The nice way to talk to the parents I worked with was, “I’m a stranger who sees your child once a week.  I’m good for what I’m worth, but I am nowhere near as important as you are.  You’re with him every day; you’re one of the foundations of his world.  If I do work with him, unless it’s being supported by things that change at home, it won’t be nearly as effective.”

(That was also the practicum that got me a case of, “Your child’s doing amazingly well considering the circumstances, but holy hell YOU need some psychiatric services STAT.  Let me write up a list of symptoms to take to your GP, and show you how to dial 211.  Also: HOW many social workers, law enforcement officers, and doctors signed off on your case without noticing this?  Jesus, Mary, and Joseph.”)

I love knowing that people like Social Jerk are slogging it out in the trenches of Child Welfare work, because when I think too much about the way our society practically enshrines a parent’s sense of proprietary ownership over their child I kind of want to swell up into a giant beast of rage and start lighting things on fire.

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2 thoughts on “The crankybolt strikes

  1. My adolescent son had a disastrous therapist who thought introversion was sick; not only did she disapprove of Internet friends and interactions, she was appalled that we didn’t socialize in person, either. The therapeutic relationship finally ended when my son told us she had doubted his chronic illness; he was shaking in the car when we went to close off the relationship, because he so feared the confrontation. He would rather have continued seeing this deeply judgemental and toxic (for us) woman than have the meeting where we told her she’d done damage to him.

    She spent the ensuing meeting assuring us that she would never have said such a thing and that she was a very good therapist. Not a moment spent on how our son might have felt on believing that she’d said it. She did, however, find time to tell us that our son needed to be institutionalized to get away from our toxic family environment.

    Bad child therapists are extremely damaging, because they (A) encourage children to doubt themselves (B) discourage the child from believing that therapy can ever be worthwhile.

  2. It’s funny you post this now. I actually had to redirect my attending the other day when we had a little boy come in wearing nail polish–she’s from an Eastern European country and kind of weird and old-school when it comes to masculinity, so she zoomed in on this blue nail polish and how maybe he was using it to provoke the kids at school into making fun of him.

    I interrupted to ask him who had given him the nail polish.

    It was his older sister’s cute friend, and he shyly admitted he has a crush on her.

    I’m betting he was still wearing it because it reminded him of that one time this cute girl actually spent some time with him, rather than making fun of him for having untreated ADHD and possibly bipolar.

    I told him a true story about my wedding, where my brother was my Maid of Honor (and also my husband’s Best Man. And the Ring Bearer. And the Flower Girl. And the Run Interference Between My Newly Divorced Parents guy. And the Politely Turn Down Unreasonable Requests from the Groom’s Mother guy. He won at all of those roles, no joke), and got his toenails painted to match mine, and wore it for months despite people giving him crap about it because it made him happy to remember my wedding.

    This kid smiled like I’d just told him he was accepted into Hogwarts.

    After the kid left my attending admitted she had looked at the nailpolish wrongly and thanked me for stepping in, which is cool of her to say and I hope she’s doing some introspection, but I’d never seen her let her own biases get away from her like that, before. I don’t know if it was some misplaced attempt to try to get him to interact with other kids in a more positive way (it seems like this kid legit does provoke other kids, on occasion), but it was definitely weird and could’ve been a really, really bad moment.

    I don’t know where I’m going with this comment, other than I think a lot of psychiatrists, particularly those who don’t have a ton of children in their practice (and it’s hard to find one who does, at least in our area, and it’s even harder to find a pediatrician who is comfortable with treating psychiatric issues in kids), don’t realize/can’t think about how weird and one-sided the power dynamic they have with the kids and their families is, and wouldn’t know how to deal with it other than by going “NOPE. CAN’T DO THIS. CAN’T WATCH EVERY WORD I SAY EVEN MORE CAREFULLY THAN I DO WITH MY ADULT PATIENTS. NOPE, NOPE, THIS IS A PRACTICE FULL OF NOPE” and not treating kids at all. These clinicians are already overworked and burning out–they didn’t have a lot left to give two assisted living facilities ago. Giving them ONE MORE THING might just break them, so they can’t think about the ONE MORE THING or it won’t happen.

    Which is also not good for the kids, but in a totally different way. I mean, this kid legit needs medication, because he is legit having symptoms of bipolar disorder at the age of nine. But it’s not going to help him if his psychiatrist is jumping on him because he’s wearing nail polish this cute girl gave him that one time which makes him happy, you know?

    It’s hard to practice as a psychiatrist at all, and it is particularly hard to practice with kids. It is particularly hard to BE a kid. I really wish there was a way to make that particular therapeutic relationship simpler and easier for both parties to navigate, but I can’t think of one.

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