So often, children come into our office for treatment of symptoms, and we later discover that parents are struggling with issues of their own. This might seem obvious–especially since COVID, what parent doesn’t have some level of stress, overwhelm, or some trauma from the past few years?! I have had so many parents express their fears to me: what if I’ve somehow created these problems in my child? What if this is my fault somehow? And, I’ve experienced others who probably had this same fear, yet are guarded or even defensive about the possibility that their mental health or behavior could potentially be contributing to their child’s symptoms. The defensiveness makes so much sense considering that parents deeply love their kids (even when we can’t stand them!) and the thought of being the source of their pain can feel shameful and unbearable.
I work hard with parents to shift this narrative. The majority of the time (with exceptions of abuse and neglect), parents aren’t the cause of problems, and even if their behavior has directly caused some problems, I like to start with the assumption of good intentions. I believe that parents are doing their best with the skills they’ve got, and so if they are reacting negatively or creating distress for a child, they are probably feeling very stuck. As parents, we all want to see our kids feel their best, so the instinct to bring them in for therapy is a good one; and yet, it is incredibly hard to find a child specialist with openings these days, and symptoms and behaviors get worse during the wait. Not to mention, it might feel blaming, shaming, or stigmatizing for kids to come to treatment, especially if they feel like their parents are part of the problem; some kids resist even coming in for an intake. And, if kids do access treatment successfully, but parents are contributing to some of the symptoms, then therapy for just the child will be helpful but not sufficient.
Parent work offers a pathway to healing for the whole family system. When parents come to therapy they can learn strategies for responding to their kids’ needs, like how to set boundaries consistently and kindly in order to promote feelings of mastery and connection rather than feelings of shame or distrust (common with kids’ lying, sneakiness, defiance). Or strategies to respond when a child is anxious, in a way that soothes and regulates the child but doesn’t accommodate or reinforce the anxiety (common with separation anxiety, social anxiety, and avoidant behaviors like school refusal). Or strategies for communicating to foster more closeness and understanding, rather than surface-level conversations while feeling like there’s an “elephant in the room” (common with teens, and also when there’s a trauma history for parents). These are nuanced, not easily learned, and not always intuitive strategies (that’s why we spend years getting our training!), but they’re evidence-based and effective and usually more aligned with our values than our knee-jerk reactions when our child is suffering. It is really natural to get frustrated, to panic, to jump into “fixing” mode, or to feel helpless when our kids are suffering, acting out, or failing in school. It is hard to change these reactions, but we feel better and more capable when we do, and so do our kids.
Developmentally, children won’t have the awareness or the communication skills most times to tell us their needs underlying their behaviors. Your 4 or 8 year old won’t say “I need help feeling more secure before I leave you, my nervous system is going into overdrive because I thought about something scary,” they’ll just come to us with a stomach ache and want to stay home from school. Your 15 year old won’t say “I feel overwhelmed and sad, I could really use some validation,” they’ll snap at you and push you away because their coping capacity is overwhelmed. These behavioral mis-cues could lead to misunderstandings about somatic symptoms, or attention-seeking behaviors, or “acting out.” As therapists, we can provide treatment that helps a child identify and communicate feelings, and then appropriately cue parents for support. But it’s even better if we can involve the parents to help facilitate this process at home.
It’s much more helpful to learn about our reactions as parents and why we have them, to explore the function and underlying needs of our child’s behaviors, and then learn how we can use strategies informed by neuroscience, and relational and behavioral therapies, in order to promote healing for us AND our kids. Sometimes, our reactions and behaviors are not just patterns relating to our kids, but are signals of our own unresolved struggles – like negative self-beliefs, chronic stress, anxiety, mood dysregulation, trauma histories, or grief (sometimes grief specifically about parenting realities or aspects of our kids). This doesn’t make it the parents’ fault; this makes it the parents’ opportunity to be the change in the family system. The parents are THE pathway to their own and their child’s healing. Not just symptom management, but actually healing the underlying problem, resolving patterns and preventing future symptoms, and building skills and resiliency for new challenges that arise.