March 14, 2011 ~ Day 95 Unexpected Dilemma

Thanks to the warm and loving suggestion of a dear friend, I had looked into play therapy for our eldest son and discovered a wonderful therapist in our city. Today I went to meet with her for the first time. We had planned for my husband to come as well, but as it turned out he needed to be at some crucial work-related events and was unable to attend.

The therapist suggested that I meet with her anyway to get a feel for her practice and fill out all relevant paperwork. Since I'd already arranged babysitting, I was happy to oblige.

Her office was beautiful and inviting, located only about fifteen minutes from our home. Thankfully I did not know that our car clock had been re-set to the actual time, and so drove all of the way there blissfully unaware that I was running late. Only when I'd parked the car and the radio announcer said, "It's 4:30" did I realize that I was actually just walking through her front door at the exact moment our session was set to begin. I'm grateful that I didn't know about my tardiness all along, because it saved me fourteen and a half minutes of stress.

The therapist herself was everything I had expected her to be from her website. Beautiful in an earthy way, not too much older than my husband and I, extremely intelligent and highly educated in her craft. I chose her out of all the therapists because (a) she gave me concrete and necessary advice up front; (b) she seemed to genuinely care about the long-term welfare of our son, and (c) she really looked like someone I would be 'friends' with.

As our appointment progressed she launched right into an explanation of attachment theory and the idea based on my description of the problems we have faced that our son might not have formed a secure attachment to me during his first year of life, based on the fact that I was working 80 hours a week and rarely home. She said that insecurely attached children often suffer from issues of self-esteem and inappropriate acting out, especially when they are competing with a sibling who might be viewed as "securely" attached.

This would certainly be the case with our sons, as I have been a stay-at-home mother for my second son's entire life and he feels incredibly safe with me and attached to me. My daughter too would be a securely attached child, but our eldest would be less so, given the way in which he was reared by a team of nanny/daddy/grandparents/mommy for his first 18 months.

He may actually have formed a more secure attachment to our (then) Mexican nanny who spoke no English... and in learning Spanish before English, he may also have developed a sense of frustration in his own abilities to communicate with me - his mother. I described for her the delay in his language, which had been recommended for assessment at one time. "He might not have been quite understanding you," the therapist advised, "And you were not quite understanding him. This could have placed further stress on his ability to securely attach to you."

We both agreed that this scenario largely explains why my son is so much closer to his father and so much more loving with him - my husband worked from home a great deal of the time during my son's first year and also brought him to the office. So my son had the chance to form a much stronger secure attachment to his dad.

However, when my husband returned to work full time (and even more than full time), it may have been devastating to the little guy emotionally because first his nanny was gone and then the parent to whom he had formed the strong bond was also gone... leaving him alone with the parent to whom he was insecurely attached and who he did not trust as much (me).

I worked hard during the six months between when I left my job and when his brother was born to focus all of my attention upon him and lavish him with the mothering that he had lacked from me for 18 months; which may explain why he grew even more jealous of his little brother when he realized that this new 'creature' that looked just like him was going to take away my time and full attention, which he had only just recently begun to enjoy.

I suppose had he been securely attached to me at that time, he might not have grown so jealous. However, when you add the insecure attachment to the adjustment of having a new baby, it may have overloaded his emotional circuits.

Anyway, it is all making a lot of sense now and I feel like this therapist has given me in just under one hour of actual conversation not only a totally logical framework for why our eldest is so intense and emotional with his brother, but also a lot of concrete strategies to begin helping him work his way back to balance within our family.

All well and good, right?

Here is the surprising, unexpected dilemma.

When we went on to discuss paperwork and privacy laws, the play therapist said: "In the interest of full disclosure I think it is important that I tell you that I believe we live in the same community and that our children attend the same school."

Um, what?

"Are you serious?" I asked.

She named my son's school and said, "Is that where he goes to school?"

"Yes. Wow, I can't believe it! See, my intuition was right-on when I told you that you looked like a person I would be friends with. I can't believe you are one of my neighbors!"

"I have a child there in the first grade," she said. "My child had your son's teacher last year."

"So, does this mean that we can't be friends?" I joked.

"Yes, that is exactly what it means. It would violate the code of ethics for my profession if we developed a friendship. I am just telling you this because you may see me around school and you need to know that it is illegal for me to acknowledge or say hello to you if you have not said hello to me first."

"Oh, well of course I will wave and say hello!"

"If I am going to treat your son and/or your family there needs to be a professional distance maintained between us. If ever you choose to terminate therapy, then after a certain appropriate period of time we could then be friends."

"Oh! Wow."

This gave me a lot to think about. In fact, I thought about it all along our drive home and well into the night, when I discussed it with my husband who had returned home from his appointments. He and I agreed that it is truly an unusual situation. Our new community is so small, we are bound to run into the therapist (with or without her family) at random places like the grocery store, the coffee shop, the park, school events, my son's dance studio, on sports teams, etc.

Later I also began to think about the potential effect of this proximity on our son, especially should he ever go in to see her in person and develop a relationship with her as his therapist. "What if he meets her child (boy or girl, I don't know) at school on the playground or at lunch and they happen to become friends? What if they play little league together? What happens if they want to have playdates with each other and we are obliged to maintain a professional distance? How does that work?"

Worse, I wondered how it would affect my son in school if he felt that other students might "know" about his inner turmoil. Would he avoid her children? Would he feel deeply uncomfortable around them? Even though my husband and I know that she would never confide in her family about our family's private life, our son might not understand the code of ethics that she follows - and he might develop anxiety that he was being privately discussed or even teased by his schoolmates.

So there you have it. An unexpected dilemma! We've found an incredible therapist that I truly believe can help us, but she also happens to be a neighbor who - for all I know - could live just down the street. I'm not really sure that I want that kind of messy integration of personal and professional, so I too am feeling a bit unsettled.

If she was able to become a friend of mine I would of course share all of the details and events of our personal life without reservation, and be quite open to her advice as a mother and a professional because I like and respect her a lot. However in that scenario, we would be equals - friends learning about each other at the same time.

It feels very unbalanced to think that a neighbor and fellow parent at our school would be privy to so much detail about our private life yet we would know almost nothing about hers. I envision very awkward PTA meetings where we have to co-chair activities but can't really talk personally or openly.

My husband and I are going to think this through further, and I have also posed our dilemma to her directly. As much as I would like to work with her, if our kids are going to be in school together for the next 11 years it might make more sense to terminate therapy asap and then take her out for coffee in a year. She is a lovely person. Life can be so ironic.

March 1, 2011 ~ Day 82 Helping Hands

I guess it is no secret that I was feeling pretty raw when I wrote last night's blog about the protracted torture of my younger son by his elder brother, because today I have been blessed by an outpouring of love and sympathetic understanding from a handful of cherished friends who are also mothers.

Thank you so much.

I don't typically write follow-up or companion pieces but since this is the issue that has been at the forefront of my heart and actions today, I thought I would describe a conversation I engaged in with a play therapist over the telephone about everything going on in our home. She gave me some really concrete advice, which I immediately took to heart and embraced.

After giving her a nutshell version of the past three years with my sons, she gave me four main pieces of wisdom:

First, she told me to reframe the way I look at the situation with my eldest son. "Rather than thinking "What is *wrong* with you?" when he does something terrible to his brother," she said, "Remind yourself that he had a rough entry into the world (with the 60 hour labor) and frame it for yourself that he is doing the absolute best he can and really hanging in there despite a relatively tough beginning. Give him the benefit of the doubt and think of him with compassion."

She then told me that my expectations about my son and my fears about his actions will all come across in my tone and the way I react to him, and that it is important not to create a self-fulfilling prophecy where I treat him as though he is going to turn out as a violent or disturbed adult and then he unconsciously meets my unspoken expectation.

Second, she told me that it is actually a really good sign that he acts out at home with me rather than in the classroom, at the homes of friends or with his grandparents, etc. "As a therapist, this is actually the scenario that we would most hope for," she described. "As hard as his behavior is on you, the fact that he is letting it all out at home tells me that he feels safe and unconditionally loved in your home and family unit so he can 'let it all hang out' there, without fear that you will stop loving him."

Then she advised me that there should be some middle ground - a way in which he can act out his aggressions without inflicting them upon an actual human being (i.e. his brother). "Do you have a back yard?" she asked, "Do you have a tree? If so, when he feels like hitting his brother he can grab a pillow or a foam swim noodle and hit the tree with it instead. He is only five years old so asking him to completely extinguish his instinctual behavior is unrealistic. Instead, consider asking him to modify his behavior. If he really wants to kick or punch something, have him kick or punch his bed."

All of this excellent advice brought to mind something his first preschool teacher shared with me three years ago when he was just two years old and actively biting his baby brother. "If he wants to bite," she'd said, "Give him a wet rag - maybe even a frozen wet rag so it will feel good on his gums - and let him bite that. It will satisfy the urge and give him a place to get rid of his anger safely, without hurting the baby."

I had completely forgotten about that until now.

The last piece of advice the play therapist gave to me was perhaps the most profound. I had asked her whether she accepted our health insurance, which she does not. We discussed out of network fees, deductibles and other bureaucratic details... but before we ended our conversation she asked me to think about one thing.

"Given your financial situation," she said, "I can see why you may want to consider finding an in-network play therapist. However, before making your decision please consider this. You may wish to pay privately to consult with a therapist rather than going through insurance companies, because once a mental health diagnosis is given and recorded on his insurance record, it will stay there forever. Do you really want this sibling rivalry issue dogging him for the rest of his life?"

What a kind woman to share this information with me! I had reached for the telephone to call her based on the recommendation of a dear friend (thank you, K!!!) coupled with my own gut instinct. I obviously had not taken the time to think through what potentially using our insurance coverage to enroll our son in a few sessions of play therapy would mean for his long-term future.

I adore my son and I am not ready to make *any* choice that will even possibly affect the rest of his life~his ability to receive insurance coverage~his school and work records. Land sakes, he is only five years old! Everyone in life deserves second chances, and I feel like at his age he deserves fiftieth and one hundredth chances. He has so much potential and is such an incredible human being in so many ways. I am not ready to slap a label on him (e.g. "Adjustment Disorder!") and I am not eager for anyone else to do so either. He is HIMSELF. He is amazing. He is difficult. He is artistic and sensitive. He is my complex, much loved son.

My husband and I talked all of this over tonight during what was supposed to be a romantic dinner date (note to self - do NOT discuss children on romantic dinner dates!!!) and agreed that it will be worth the money for us to pay privately and go together a few times to meet with this play therapist to learn how we can parent our son more effectively and be a strong team for each other in the process.

We're not sure if our son himself will ever actually make it to a therapist's office, but we did agree that we both need help in learning how to respond to our child's words, moods and actions. It's nice to be on the same page about this.

At the end of the day, the friction between my sons may well turn out to be something I have unwittingly instigated or perpetuated. Who knows, there may be some big changes that I need to make in my parenting style! Whatever happens, I am 100% up for it and open to learning. "Please, be honest with me about my own parenting behaviors and ways of thinking," I encouraged her. "I love my son with all my heart and if there is something that I can alter in myself or my own behavior or parenting style that will help to nurture him and make him a happy (and reasonably kind) sibling, I will do whatever it takes."

So that is where we are at, as of now. I am feeling so much more optimistic and proactive. I can nearly see a path forward and a potential light at the end of the tunnel of carnage, where yesterday evening I saw none at all.

Perhaps my eldest son could sense my relief, for he is a sensitive and intuitive kid. When I picked him up from school this afternoon he confided, "Mommy, I think I'm going to earn one of those 'family tickets' for acting good tonight and I do not think I will hit my brother at all because we both love our grandma and we are going to have a lot of fun with her tonight while you are on your date with Daddy."

I'm so happy to wrap up this blog by reporting that for the first time in weeks, both boys DID indeed earn their special family tickets tonight (for treating each other gently with no fighting... even when we were stuck on the freeway in traffic and they were both exhausted!) which puts them each one step closer to earning the special toy of their choice... and puts me one small step closer to creating an atmosphere of genuine peace and contentment in our family life.

It may not be much... but it's a start!