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Why behavioural approaches do not work for all children

One of the most frequently asked questions put to me in clinic, is why some children do not respond to traditional reward/punishment based behavioural strategies. The answer is simple – because, contrary to popular opinion, these strategies do not work for all children in all situations.

This is because the ability to make a mental link between a behaviour and a punishment, and to then be to be subsequently less motivated to use that behaviour again, actually involves quite sophisticated cognitive processes. It also requires specific parts of the brain to be functioning well. Difficulties with this may apply to children with learning disabilities or neurological conditions. It may also apply to children who are anxious, fearful or traumatised. This is because anxious or fearful children are often operating from a very primitive part of their brain that physically impedes their ability to access more developed parts of their brains. This in turn makes it harder for them to make cause and effect links, to generalise, to suppress their impulses, to make rational decisions, to maintain empathy for others and, in some cases, even to trust in the motivations of others. Punishing these children without supporting them to understand what is happening for them, therefore, is actually more likely to increase their fearful behaviours and further undermine their trust in those around them. For some children, it can also exacerbate feelings of shame.

A second concern with an overly heavy reliance on behaviourist principles when applied to children, is the theoretical and research origins upon which these principles are based. Behaviourism was largely developed in the 1950s and 1960s in laboratories with small mammals such as dogs, cats and rats – animals with significantly less developed brains than our own. Whilst these experiments can teach us a lot about how to shape behaviour in its purist sense therefore (i.e. classical and operant conditioning), they offer nothing in terms of how we build children’s self-esteem, build their intrinsic motivation, or even how to protect their attachment relationships. For instance, classically conditioning young babies to sleep by ignoring their attachment-seeking behaviours, can have detrimental effects on a child’s subsequent relational security and internal regulation skills. Similarly, a heavy reliance on operantly conditioning ‘good behaviour’ in young children with external motivators (e.g. star charts) has been shown to undermine a child’s natural desire to problem solve, be creative and to keep building on their successes when these external motivators are later removed.

Whilst some behavioural principles within a parenting repertoire can undoubtedly be helpful, therefore, when used to excess, and particularly when used in the absence of a broader context of sensitive, loving and developmentally appropriate care, they can quickly become damaging. This is because human children have brains that require so much more from the parent-carer relationship than simple behavioural conditioning.

Part of my role as a Clinical Psychologist, therefore, is to help parents, carers and professionals, to find new and more effective ways of supporting children to reach their full potential.

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

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Covid-19 – talking with children in uncertain times

How do we contain our children’s anxiety in such uncertain times, when we too feel anxious and unsure ourselves?

When children are nervous we may notice them continually searching for reassurance – the usual advice would be to acknowledge this but keep reassurances to a minimum, modelling to them that fundamentally the adults in their life believe that the world is a safe place.

However, here we are – smack bang – in the middle of unprecedented times where it may be difficult for us, ‘the grown ups’, to keep level heads ourselves around our families health and economic future.

Our most important job is to manage our own anxiety whilst engaging with our children honestly and openly about the developing situation. Their worlds of home and school have been thrown into orbit; they had to say a hastened, brutal goodbye to friends and teachers not knowing when they would see them again.  The novelty of not being is school has now probably faded a little – time at home with parents is usually pleasurable but sometimes not.  Relationships can be put under extraordinary pressure when we are in lockdown with an unclear future.

Whilst we need to talk to children openly and find out their understanding of the pandemic, our responses should contain reassurances aplenty but we must to be careful not to give absolute guarantees.

It is within human nature to endeavour to provide an environment for our children in which they feel safe. Maybe we can begin to appreciate how these trying times can be viewed as an opportunity for us to model kindness, resilience and compassion.  We can hope that our children will remember these formative times as a period in which they learnt important life lessons along with resilience for their futures.

 

Sharon Spindler is an experienced Systemic Family Therapist with twelve years experience within the NHS and private practice.  Sharon is available at the Brighton & Hove Practice.

 

Further reading by Sharon Spindler –

Family Therapy for Beginners

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Tips for talking to young children about their behaviour

When talking to young children, most people know that ‘open’ as opposed to ‘closed’ questions are helpful. That is, questions that cannot easily be answered with a simple “yes” or “no” answer and invite the child to give more information. These questions typically start with “who..?”, “where…?”, “what…?” and “how…?”. What many people don’t realise, however, is that the most frequently used open-question starter – “why…?”, can be hugely counterproductive to conversations with young children.

This is because young children can easily experience the word “why” as threatening. A “why” question implies that the child should have (and the adult expects them to have) a level of insight about their behaviour that they genuinely might not have at this stage. For some children it can cause them to close down by becoming silent or simply saying “I don’t know”, which can feel infuriating to parents. Other children may feel the pressure to just give an answer – any answer – which might not even make sense (e.g. “I did it because my tummy was hurting”). This is because they just feel the pressure to say SOMETHING, which can also feel upsetting to parents. (Incidentally, when a child says that their tummy is hurting, that actually can be a sign of anxiety).

Much better, is to side-step the “why” question altogether with young children (e.g. “what made you do that?” or “when you did that, what did you think might happen?”) These kinds of questions keep the dialogue flowing and importantly, help the child to start to understand for themselves what their thoughts, feelings and motivations were when they used a particular behaviour.

This is an important foundation step towards impulse control and emotional regulation.

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

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Educational Psychotherapy: (1) supporting social-emotional development and learning

Educational Psychotherapy was developed by Irene Caspari in the 1970s, an Educational Psychologist working at the Tavistock Clinic in London.  She was interested in understanding learning difficulties from a psychoanalytic and attachment perspective. In order to address both learning needs and emotional difficulties together, she pioneered a method of blending structured (educational) tasks and free expression within a 50-minute weekly therapy session.  Treatment usually lasts 1-2 years but some work continues for longer or is adapted for shorter periods or extended assessments. Trainees are typically experienced teachers or learning support staff and undergo their own therapy during training. Many continue to work in schools and adapt their learning to therapeutic teaching and attachment-aware, trauma-informed practice.  

What follows is an anonymised, disguised case study which illustrates how Educational Psychotherapy can begin to support social-emotional development and learning.

11-year-old Sammy was referred for therapy by his key worker on account of difficulties he was having with relationships, expressing and understanding emotions and understanding the world. An earlier Educational Psychology assessment had suggested that high levels of anxiety were impacting on Sammy’s capacity to make full use of learning.  Therapy took place over 18 months.  

Sammy soon engaged with a variety of word, number and drawing games and activities, offered within the context of a supportive relationship.  Tasks which combined cognition, physical activity and relational connection proved an effective way to build trust, stimulate thought and enliven Sammy’s felt experience in the room.  Shared story writing and the free use of paint and clay facilitated expression and imagination. Conversation also had a significant place, at the point of checking in, within and around activities and, over time, for sustained periods.

Over the first 6 months of therapy, progress became evident in the following foundational areas:

Sense of self and reciprocal interaction
Sammy came to enjoy the process of co-creation with craft activities and solving problems together, including making up physical word and number games and negotiating the rules between us.  He became more comfortable with what he didn’t know  and embraced the opportunity to find things out, explore new skills and introduce me to new areas of learning.  Sammy also started to talk more about himself and grew comfortable with the routine of checking in at the start of a session, when he would share a happy achievement or discovery or an experience of frustration, disappointment or confusion.

Tasks and learning

Persevering at a challenging task requires the use of Executive Function skills, such as being able to monitor and evaluate where the difficulty lies, use problem solving skills to work out and plan the next steps, use working memory, inhibit distracting thoughts and so on.  Young people like Sammy, who have difficulties in these areas, require considerable “scaffolding” to help them develop and practice skills and tools for thinking. To begin with, Sammy found it hard to take instruction or support from me but as trust grew he became a little more comfortable with not knowing and clearly more curious.  My sense was that a space for thinking opened up in his mind which enabled him not to panic but to consider what was required next in order to proceed. 

Thinking about and talking about feelings

The development of a language for feelings was a significant area of development.  In early sessions, Sammy would habitually say that everything was “fine” or “normal”, almost seeming oblivious to the relevance of emotional experience or reflection.  After a time, Sammy disclosed that he had been getting into rages at home and taking out his feelings on objects which had sometimes become broken.  He acknowledged that this was confusing, upsetting and problematic for him and that he wanted help with it.  Activities like squeezing paint directly onto paper or working with clay enabled Sammy to express himself viscerally and then reflect on how he connected with the images created.  We also thought about activities Sammy could do at home to self-regulate.  

In time, thinking about feelings became an area that Sammy would actively seek.  He talked about experiencing fear and how this had caused him to adopt particular behaviours as an avoidance mechanism.  It seemed that the naming of these fears was enough to create some distance and enable Sammy to make a choice about how he wanted to act.  Sammy also talked about sadness and acknowledged that he had grown used to keeping his feelings to himself.  He started to voluntarily make links between his expressive material in artwork and his own thoughts and feelings inside.  

 

In part, these conversations involved psycho-education, helping Sammy to understand more about how feelings work, that it is normal to experience a wide range of feelings and that it can help to be self-aware and to share some of what we feel with trusted others.  At times, we were able to do this through playing board games or through role-play with miniatures.  Sammy showed that he could recognise the difference between actions held in mind and actions lived and that he could think hypothetically about possible future consequences of taking a particular course of action.  

This phase of the work paved the way for more profound developments which were to follow.  Sammy was now ready to take more risks. (Read more about this in Educational Psychotherapy (2) – article will be published shortly).

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch with us. Online therapy is available.

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Parenting Styles

Since the early 1960s, psychologists have been interested in the relationship between parenting and the emotional, social and behavioural development of children. 

Of particular significance to this field of study, is the early work of psychologist Diana Baumrind and colleagues, who conducted the first longitudinal study of more than 100 preschoolers through to their adolescence, specifically examining the impact of their parents approaches towards them on their subsequent development (Baumrind & Black, 1967). This study, which used a combination of naturalist observations and parental interviews, identified four ‘dimensions’ of parenting – (a) disciplinary strategies, (b) warmth and nurturance, (c) communication and (d) expectations of maturity and control. More than this, however, this influential study identified three ‘parenting styles’ which have since stood up to considerable empirical scrutiny. 

The first of the parenting styles identified by Baumrind is now more commonly referred to ‘authoritarian parenting’. This an approach to parenting which is generically low in warmth but high in control. Parents who fall into this category, typically hold very high expectations for their children’s behaviour and develop strict, non-negotiable rules for which they must live by. They are described as “obedience and status-orientated and expect their orders to be obeyed without explanation” (Baumrind, 1991). Failure to abide by their rules, or to meet their behavioural expectations, is typically met with punishment rather than with empathy or understanding. This type of parenting is often seen in adults who they themselves were raised by parents with a similar style of parenting [see my earlier blog on ‘family scripts’] and who therefore hold an authoritarian working model or ‘blueprint’ of what it is to be a parent. This style can also sometimes be seen in anxious parents, who respond to a fear of losing control of their children by exerting total control. The implications for their children, however, is that they are often left feeling angry, confused or upset internally, but have no capacity to process or make sense of these emotional experiences as they develop. Their children are also often limited in their opportunities for free play and exploration of the world, which is equally important for healthy emotional and social development. 

The second parenting style identified by Baumrind is that of ‘permissive parenting’. This style can be broken down into two further parenting styles – ‘permissive-indulgent’ and ‘permissive-indifferent’. A ‘permissive-indulgent’ parent is broadly defined as a parent who is very high in warmth, but very low in control. In direct contrast to their authoritarian counterparts therefore, permissive-indulgent parents make very few demands on their children, rarely discipline them and typically seek to avoid confrontation. They are described as “generally nurturing and often take on the status of a friend more than that of a parent” (Baumrind, 1991). The implications for their children, however, is that whilst their internal worlds are largely attended to (although negative emotions can still be feared), they lack the developmentally appropriate structure, boundaries and expectations that they need in order to develop into healthy, socially-adept adults. ‘Permissive-indifferent’ parents on the other hand, present as very low in control AND in warmth. These parents offer neither structure and boundaries nor warmth and affection for their children. They are what we typically consider to be emotionally neglectful parents, who in extreme cases, may actively reject their children, leading to inevitable attachment difficulties as their child develops.  

The third parenting style initially identified by Baumrind’s study is known as an ‘authoritative’ parenting style. This style bridges the gap between authoritarian and permissive parenting styles and is known in research circles as the ‘gold standard’ for child development. This is because parents who are able to approach caring for their children with this style of parenting are able to establish developmentally appropriate rules and boundaries, but can at the same time, remain responsive to and curious about their children’s internal worlds. This means that they can be open to trying to understand a child’s internal world (e.g. their thoughts, feelings, motivations, perceptions, beliefs, etc.) even if they do not accept their behaviour. Indeed, when their children fail to meet their expectations, an authoritative parent is more likely to respond with forgiveness, nurture and find structured opportunities for new learning, rather than with punishment. Similarly, they can remain democratically open to questions and challenges from their children about their rules. They are defined as being able to “monitor and impart clear standards for their children’s conduct. They are assertive, but not intrusive and restrictive. Their disciplinary methods are supportive, rather than punitive. They want their children to be assertive as well as socially responsible, and self-regulated as well as cooperative” (Baumrind, 1991). The benefits for children raised with this type of parenting style is clearly evidenced in their later performance on a broad range of emotional, social and behavioural indices. These include social responsibility, the ability to cooperate with peers and adults, independence, assertiveness, problem solving and high self-esteem. Support for this ‘middle ground’ approach to parenting is also offered by recent research which has identified that children with a history of severe developmental trauma and attachment disruption, respond most effectively to an ‘authoritative ++’ approach to nurture whilst in care – a specific type of parenting approach which is very high in both control AND warmth and nurture – also known as the ‘two handed’ approach to parenting (Hughes, Golding & Hudson, 2019). 

As alluded to earlier, the type of parent we become will be influenced in part by our own experiences of being parented. Whilst we can adapt this to a degree, however, when we are under stress, it is likely that we will move closer towards our ‘blueprint’ of what a parent is. For this reason, it is extremely important that as parents, we take the time to notice for ourselves when we are starting to a more extreme type of parenting style (authoritarian or permissive) as an indicator or ‘red flag’ that we need to take some time out to recharge in order to be the parents that we want to be, and which our children need us to be. If you are co-parenting, it can also be helpful to think about where you and your partner each naturally fall on the continuum between high warmth and high control as parents, and to spend some time thinking about the strengths and weaknesses of these respective similarities or differences in your parenting styles, as well as the impact that the combination of your parenting styles has on your child. When challenges or parenting styles feel unhelpful or entrenched, however, it can be worth seeking professional help. 

References – 

Baumrind, D. (1991). The influence of parenting style on adolescent competence and substance use. Journal of Early Adolescence, 11(1), 56­95. 

Baumrind, D., & Black, A.E. (1967). Socialization practices associated with dimensions of competence in preschool boys and girls. Child Development, 38, 291­327.

Hughes, D., Golding, K. & Hudson, J. (2019). Healing Relational Trauma with Attachment-Focused Interventions: Dyadic developmental psychotherapy with children and families. Norton

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

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Leaving the Family

Long-term Psychotherapy is all about leaving the family – not literally – but in the psychological sense.

This is a much more complex process than it sounds. Why? Because it takes years of back and forth, and it is a journey which although slow, in my view essential for psychological health.

If you were lucky enough to have had a secure attachment relationship to your main carers – meaning an upbringing with parents who were secure in enough themselves to support your natural development throughout life – even if you experienced challenges or significant losses, you will feel enough security (real security, not an inflated one) in yourself to navigate life’s challenges.

For the rest of us, probably the majority – we will probably need to come to terms with the reality and aftermath of growing up in dysfunctional families, with parents or carers who were at best unskilled, and at worst abusive.

Leaving the family in the psychological sense can result in leaving in the physical sense too – such as choosing to have limited or no contact with an abusive or toxic family member.

This can be a difficult and painful decision to reach because of feelings of guilt, and expectations/ ideas of what a family should look like. For example, in some cultures it is taboo to cut contact with close family members (especially parents). Also, the person who is choosing to not have contact is usually accused of being difficult, making up stories, etc. Putting the blame on one family member (usually a child) is also a way of denying systemic dysfunction within the family.

Status Quo

Being in Psychotherapy can be risky because of what can get uncovered. Ideas about family which were not true, love which wasn’t there, destructive behaviour which was condoned or kept secret, etc. It is often painful to come to terms with reality. However, it is much more painful to live in denial.

Things which are denied or suppressed, remain unaddressed. What remains unaddressed affects us anyway because we can’t make links between our experience (past and present), feelings and behaviour. This is confusing and can cause a lot of unnecessary suffering.

As children we may have tried hard to keep our family together, because we depended on them for survival. And whilst some families are held together by love, compassion and humanity, other family relationships are held together by denial of serious dysfunction and/ or secrecy around abuse. This is not to say that love isn’t possible in dysfunctional families. There are degrees of how much harm dysfunction in families will cause.

Short Cuts

The reality is that there aren’t any short cuts for this type of work. Many people come into psychotherapy having tried to bypass their pain through short-term fixes, and shallow pursuits. Maybe after a string of failed relationships or a life that feels empty. Unaddressed, long-standing issues can also manifest as chronic depression or anxiety.

Of course, there needs to be a certain readiness and willingness for this type of work to take place. Maybe a certain level of maturity even (not usually related to age).

Aims and goals

The destination is unknown because it depends on each unique individual’s circumstances and hoped for outcomes.

The aim could be to finally become an adult in an emotional and psychological sense. This means to take more ownership of one’s feelings, thoughts and decisions. To be more present in one’s body. To have more fulfilling relationships and a more meaningful life.

Who wouldn’t want this?

Sam Jahara is UKCP Registered, CTA, PTSTA and is one of the Brighton & Hove Psychotherapy Co-founders.  She is an experienced Transactional Analysis Psychotherapist. Her special interests include culture, identity, belonging, sustainability and environmental issues. Sam is available at our Lewes and Brighton & Hove Practices.

 

Further reading by Sam Jahara –

Psychotherapy can change your life – but you may not want it to

On rushing towards answers

How do Psychotherapists work with anxiety? Trio of Blogs – Part 3

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Post Natal Depression in Mothers & Fathers

In this blog, we explore postnatal depression and summarise a classic paper by Lawrence Blum, an American psychiatric and psychotherapist. It was originally written in relation to postnatal depression in mothers, but also explores the conflicts that appear when becoming a parent and applies to fathers, same-sex couples and couples where caring for the child is more equally shared.

How Postnatal Depression Can Affect Fathers as Well as Mothers

Although understandably, we focus on new mothers in the postnatal period, dads and other co-parents also need support.

Dads have a lot to take on board when a new baby arrives due to the huge life change. Money problems, sleep deprivation, new responsibilities and new relationship dynamics can leave dad feeling overwhelmed, emotional, and even depressed. On top of this, it’s easy for dads to feel guilt for not being able to take on the responsibility of breastfeeding as their partner is still recovering from labour and birth.

It’s important to seek help if you’re a father feeling the negative effects of new parenthood, or if you’re a mother who has noticed a negative change in your partner. Talking therapies can be a great help in overcoming depression.

The Difference Between ‘Baby Blues’ And Postnatal Depression

In the paper, Blum explains the difference between ‘baby blues’ which is a hormone-induced depression, and postnatal depression which more closely relates to depression. Many factors contribute to postnatal depression, including:

  • Lack of external support
  • Stressful life events
  • Difficulty conceiving
  • Previous mental health issues
  • Low self-esteem
  • Anxiety

To help with postnatal depression, supportive counselling, CBT, and psychodynamic psychotherapy were the most effective in controlling the issue.

What Is Psychodynamic Therapy?

Psychodynamic therapy had the biggest impact on depression. This type of therapy focuses on the psychological roots of emotional suffering. This approach combines many different types of analytic therapies and works on the idea that each person’s unconscious thoughts and perceptions are developed through their childhood.

When working with a psychodynamic therapist, a mother will be encouraged to talk about relationships with their parents and other people to uncover the unconscious reasoning behind their depression.

There are different psychodynamics of depression which we will outline below. There are three principal emotional conflicts, these are:

Dependency Conflicts

When you become a new parent, you are completely depended upon by your new child or children. This is extremely tiring, emotional and in some ways, draining. Support at this stage of becoming a new parent or carer is extremely beneficial, however, if there is a lack of support, parents may feel a sense of denial of their own needs which can result in depression.

Anger Conflicts

Anger is a normal part of depression, and it can make parents feel guilty for feeling this emotion. Anger can be felt towards the baby as a projection of past hurts or for how their lives have changed in terms of money, sleep, jobs, social life and sex life.

The dangers of feeling anger as a parent are that when these feelings are denied and controlled, the feelings can build up and eventually be released which threatens the relationship with the baby or, more commonly, the partner.

Parenthood conflicts

Becoming a parent and caring for a baby can bring unresolved and unprocessed feelings about a parent’s own experiences of being cared for to the surface. Negative childhood experiences can positively affect how you raise your own child as you want more deeply to give your child what you didn’t receive, however, on the other hand, it can also stir up old wounds which can heighten the risk of depression.

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

 

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Curiosity: how can children’s behaviour help us understand what they need from us?

“Watch your plants and see what they’re telling you” (Ollie Walker, Hosta grower, Gardeners’ World, BBC2, 14.6.19).

Ollie Walker has fallen in love with the diversity of Hostas and delights in watching them grow.  This is some dedicated watching: the nursery he works at stock over 800 varieties.  Noticing small changes in thousands of plants, he knows exactly which nutrients are needed for the healthiest growth.

Many babies are fortunate enough to be watched with arguably much greater devotion than this.  For starters, the care-giver: cared-for ratio is much better – 1:1 attention at least.  The sense of wonder surrounding a new-born breeds connectedness which begins relationship. It gives the baby an experience of felt safety, of being held psychologically as well as physically. This is just as well.  We now know that early attachment relationships are a foundation for all forms of later development.  As Winnicott said, “there is no such thing as a baby.” [i]  Infants cannot exist independent of someone to look after them.

An attuned care-giver is open to a baby’s non-verbal communication -her cry, gaze, gesture, smell, touch or muscle tone – and finds meaning there. “Good enough” parents provide consistent, appropriate care and interaction enough of the time. Inevitable mis-attunements are further food for curiosity, opportunities for adjustment and repair which strengthen attachment and resilience. Toddlers and children of all ages, continue to require the mind of a benignly curious adult to scaffold development.  Behaviour is a window to a child’s inner world of thoughts, feelings and body states.

All children, at one time or other, behave in ways which cannot be dealt with easily or quickly and might be perplexing, concerning, maddening or all three.  Those children growing up in environments where their needs are not sufficiently met or where they are unsafe will be more likely to do this.  We may find that even our best intentions and the most tried and tested behaviour management strategies are not effective.  This is often because they have not evolved from a relational understanding of the child’s needs and what is being communicated through the behaviour.

Staying curious can be hard if there is pressure from friends or family to quickly stamp out unwanted behaviour. Or we may be driven by a need to make something better and hurry to provide instruction, fix a problem or eradicate pain without first considering what the matter might be.  These can also be the behaviours which trigger our own vulnerabilities.

In addition to highlighting aspects of our own internal make-up, intense emotional experiences inside of us can be an effective clue as to what children themselves are feeling.  This is central to Wilfred Bion’s development of Melanie Klein’s theory of Projective Identification.[ii]  Bion proposed that not only can unwanted feelings be projected into another person, who then feels those feelings, but that this process serves the purpose of communication.  For example, a looked after child who sabotages her own birthday meal after a lovely family day out may cause a foster carer to feel rejected and resentful.  This could be thought about as the child (unconsciously) letting her carer know about both early experiences of rejection and how hard it is to believe in her own capacity or deservedness to sustain states of joy in the present.

For children with experience of trauma, challenging behaviour and Projective Identification may be the only means they have of telling the emotional story of what has happened to them.  It can seem counter-intuitive, but we need to welcome this and, alongside setting appropriate boundaries, seek to find meaning in it.

Symbolism in the child’s play and other activity can be very revealing about a child’s inner world and language itself can be thought about beyond its literal meaning.  For example, a child who repeatedly says she is hungry, when we know she has recently eaten, may be letting us know she is hungry for connection, as opposed to food.

It is the wondering process here which is as or more important than the resulting care itself.  Through close observation and knowledge of the child and attention to his/her own emotional response to what is happening, a care-giver takes in the communication of discomfort, frustration, distress, fear and so on, reflects on it, digests it, and feeds it back in a more manageable form, often through words, as well as through tone/ gaze/ affect/ posture/ actions.  Correspondingly, the child feels accepted, held and understood and receives a message that his/her care-giver is able and willing to be alongside and help manage emotional pain.

This is what Bion called “containment”, the parent as “container” the child as “contained” – in my view, one of the greatest gifts we can give to the younger generation. Through repeated experiences of this kind, children develop their own capacity to think about and process feelings.

In addition to patience, true curiosity requires flexible thinking, open to the myriad nuances of human behaviour.  The same actions can have different meanings for different children or even for the same child, such as a troubled 7 year-old boy who would regularly take himself into the corner during a PE lesson and sit with his head in his lap.  Over time, staff learned that he would do this both when he was hyper-aroused (worked up) and needed space away from others to calm down and when he was hypo-aroused (switched off) and in need of company and livening up.

In psychotherapy with children (and in therapeutic parenting work) we are often dealing with issues which have felt too difficult to think about and make sense of.  The therapist’s task is to engage, observe, listen to, accept, be curious about and sit alongside a child, gently helping to make thinkable the unthinkable.  This takes time.  Emotional defences are there for a reason and require sensitive handling.

Holding steadfast to curiosity is one of our soundest investments with children.  If we can start to wonder about a child’s behaviour, we stand a much greater chance of coming up with an effective way to meet his/ her needs.  As Gerda Hanko (Educational Psychotherapist) and others have said: “Don’t just do something, stand there!”

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch with us by telephone or email. Online therapy is available.

 

Resources – 

[i] Winnicott, D.W. (1960). The Theory of the Parent-Infant Relationship. Int. J. Psycho-Anal., 41:585-595.

[ii] Bion, W.R. (1962b). Learning from Experience. London: Heinemann

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“Ghosts in the Nursery” – The Power of Family Scripts

 

 

As much as we might fight it, our own experiences of being parented, create within us blueprints or ‘internal working models’ of what it is to be a parent. These models only become fully activated when we become parents ourselves, and often take us by surprise. For instance, we may find ourselves ‘turning into’ our parents in ways we hadn’t intended. Similarly, memories from our past can be unexpectedly invoked in us when our own children reach the same age. 

Selma Fraiberg (1987) emotively referred to this phenomenon as “ghosts in the nursery”. Her hypothesis is that without conscious effort to alter entrenched family patterns, family life can essentially become a ‘rehearsal’ for the next generation, which then can repeat technically in perpetuity. More commonly, we refer to this phenomenon as the enactment of ‘family scripts’. John Byng-Hall (1985) proposed three ways in which these family scripts may manifest – 

  1. REPLICATIVE SCRIPTS: 

These scripts are a direct replication, or repeat, of the parenting that we received ourselves. They can include replication of positive scripts (e.g. family rituals, ways of nurturing children, ways of enforcing boundaries, certain sayings, etc.). They can also include replicating negative (unresolved) scripts, which may be consciously replicated (e.g. “smacking never did me any harm”) or unconsciously replicated (e.g. needing to hide one’s sad or angry feelings from a parent can make it harder for these children to later recognise or respond to these feelings in their own children).

  1. CORRECTIVE SCRIPTS:

These family scripts are a conscious decision to offer our children a different experience of being parented to what we received ourselves. The danger for this type of script, however, is that because they are driven from an emotional response to our past, there is a risk that we will go too far the other way (e.g. feeling hard done by as an older child, so favouring our own eldest child). It’s not uncommon to encounter a parent who states ‘I want my child to feel loved because I wasn’t’, but because they have not worked through their trauma, they nonetheless end up repeating the script by, for example, smothering their child emotionally.

  1. IMPROVISED SCRIPTS: 

These family scripts relate to the ability to flexibly and creatively amalgamate what we most value from our own experiences of being parented, with what we now value and learn from new relationships, education, culture, etc. We generally consider that the most resilient and healthy families adopt this form of script and they are generally composed as a result of significant psychological work in cases where the parent experienced neglect or abuse as a child.

Difficulties can arise when damaging or unhealthy replicative family scripts cannot be consciously thought about by parents – which is another definition for trauma. In extreme cases, these can negatively impact upon a parent’s relationship with their child and therefore, their child’s subsequent emotional well-being. For the most part in ordinary parenting, however, activation of family scripts is normal, inevitable, and actually helps children to become embedded within the familial and social context to which they belong. Indeed, almost all the parents that I meet in my work (myself included), offer a fascinating mix of all three of the above scripts to their children.

References:

Byng-Hall, J. (1985). The family script: A useful bridge between theory and practice. Journal of Family Therapy, 7, 301-305

Fraiberg, S., Adelson, E. & Shapiro, V. (1980). Ghosts in the nursery: A psychoanalytic approach to the problem of impaired infant-mother relationships. Journal of the American Academy of Child Psychiatry, 14, 3.

 

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Family Therapy for Beginners

Professor Richard Layard, one time ‘Happiness Tsar’, wrote, ‘in every study, family relationships, (and our close private life) are more important than any other single factor in affecting our happiness’.

It’s hard to grow and feel safe and content in the world if our family stories are causing us distress and discomfort. This is especially true for children, and young people when their family is their world. When they are struggling with emotional and behavioural problems or maybe unexplained physical ailments a ‘systemic’ approach can be revealing.

Systemic therapy is relational, that means looking at the spaces in between people and their relationships with others, as opposed to looking inside individuals. Systemic therapists are interested in the ‘systems’ that people belong to, such as our families, school, work places, peers and friendships. Exploring the context of tension, distress and unhappiness can help us illuminate the possible causes.

For example we may find stories of divorce and separation, estrangement, sibling rivalry, family illness and disability, bullying, academic struggles, financial problems, loss and bereavement, or drug and alcohol use Family therapy is about having conversations that can be difficult, exposing, controversial, and upsetting.

But also about reconnecting, understanding, sharing and being surprised. Feeling heard, understood, loved and believed. Explaining your side of a story, hearing family stories that help you understand current struggles and appreciating other people’s point of view. Feeling proud and united, relieved and supported and wondering together how you can move on.

Any therapy involves taking a risk; family therapy provides an invitation to be brave and accept that families may be worried, sad or confused about someone they love. Or maybe family relationships are feeling tense and strained, or they are missing someone who played an important role in your lives.

Established, repaired and revisited relationships give families a rich resource for healing.  Family Therapy sessions usually last 90 minutes, and as many family members who are available are welcome.  Work would begin by exploring why it had been decided now was the time for family talking and noting individual and family goals to help focus the work. Some family members may be initially reluctant to attend, its important for them to be aware that just be attending they are showing their support. They do not have to contribute verbally if they do not want to – this could be agreed at the beginning of the session. By just turning up they are able to listen to other expressing their views and will usually join in when they feel comfortable and safe within the process.

A genogram or family tree is usually constructed looking at the current family structure and remembering older generations. This provides a map of the family and a cultural context for the current problems. It generates stories, sometimes forgotten, about how positive and negative patterns and traits may have been inherited by the family in the room. This can be a revealing and emotional, with younger people hearing about relations that may have died before they were born and older ones remembering stories that help build to a clearer understanding of the family’s identity. A time-line constructing a chronology of family births and deaths and other family events is also useful. Again, this begins reveals its own narrative, which can help a family begin to plot the life story of a problem.

Family Therapy is always driven by the goals of the family and continual feedback allows the therapist to ensure that the family are having the conversations they want and need to have. Sometimes it may feel useful for family members to meet individually, in couples or sibling groups as part of the therapy.

It is not necessary to meet weekly; sometimes families find one or two sessions are enough to feel they are able to move forward. In my experience family therapy can be a powerful process with the family leaving more connected with and appreciative of each other.

Sharon Spindler is an experienced Systemic Family Therapist with twelve years experience within the NHS and private practice.  Sharon is available at the Brighton & Hove Practice.

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Acceptance: What does it have to do with managing children’s difficult behaviour?

The Paradoxical Theory of Change[i]  states that we can only change aspects of ourselves when we first become what we are.  Likewise, in order to support children’s development, we also need first to see them for who they really are and accept where they are at.

This can be a difficult thing to do.  To begin with, we need to be present with children for long enough and with sufficient attunement to really get to know who they are and how they are doing.  This is perhaps one of the greatest challenges for many parents today, with the pressures of work and the distractions of technology.  I once passed a young boy walking with his Mum who was on her phone.  “Mum, you’re not listening” said the boy, tugging at her sleeve. “I am listening” she said, not looking up.  “But you’re not hearing me” the boy replied.

Quantity of time together is important, but quality of contact is what matters most.  Setting aside a block of time for a planned activity at home or a trip out will usually be very well received.  In addition, briefer periods are valuable windows of opportunity for everyday re-connection through child-directed play, shared tasks and focused listening.

Really being present with a child can be challenging for other reasons.  When we look and listen we can be alerted to traits and behaviours  which we may find irritating or displeasing.  This can leave us feeling that we have failed as practitioners or parents and, at desperate times, that perhaps we made a monumental error ever choosing to take on a role of responsibility with children.  We may feel disempowered, at a loss as to how to help and so we look the other way as the task seems too big. Challenging child behaviours may also reflect vulnerabilities in our own character that we would rather not acknowledge.

For children who have experienced complex developmental trauma (repeated adverse experiences over time), there can be an additional avoidance, in society at large and even in adults providing care and support.  These insecurely attached children usually develop their own defensive patterns of behaviour.  These can be aimed at either deflecting adult attention by presenting as pseudo-independent or drawing adults in to collude with their own negative self-view through becoming critical, rejecting or punitive towards them.  Adults and systems taking up these scripts struggle to see beyond the child’s surface behaviours and may unconsciously be finding a way not to witness and sit with the child’s emotional pain, the enormous elephant of loss in the room.  This protects individuals and services from the powerless anguish of imagining the horror and injustice of what life might have been like for a child during periods of abuse or neglect.

Once present and engaged with children, our next task is acceptance. In Dan Hughes’ P.A.C.E. approach to parenting[ii], the ‘A’ – Acceptance, is the fore-runner to Curiosity.  This is not about condoning or encouraging negative behaviours.  It is about being real and seeing the whole child for who he or she is.  By accepting what is happening for a child, we are joining him/her and building a bridge, making it possible to develop understanding and then convey empathy.

This kind of acceptance is about taking an integrated view of human beings, steering clear of both idealisation and demonising.  We accept that all of us have different parts which includes parts that we might think of as positive and negative.  We go on existing, despite our apparent contradictions.  Vulnerable children often need help with this as they split the world into either good or bad and fear that we will reject them if their less favourable parts are visible or made conscious. We can model integration for children by talking about different parts of ourselves – our cake-loving part, our grumpy part, our forgiving part.[iii]

True acceptance is not about putting up with behaviour and it is more welcoming than tolerance, more than bearing and giving permission to another’s way of being.  It is about setting judgement aside as much as we are able, and privileging connection and relationship.  It says “I am going to be with you no matter what you do and I am going to stay open and engaged to you, whatever you try to do to push me away”.

Acceptance is therefore unconditional.  Even in their darkest, wildest and most hurtful moments we accept children and stay open and engaged.  Without this, connection is lost and curiosity, understanding and empathy become marooned. This can feel like a radical, even reckless, position to take, but it is essential for building emotional resilience and enabling relational repair, both in the home and the therapy room.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch with us by telephone or email. Online therapy is available.

 

Resources – 

[i] Beisser, Arnold (1970) The Paradoxical Theory of Change  https://www.gestalt.org/arnie.htm

[ii] Golding, Kim (2017)  Everyday Parenting with Security and Love.  Jessica Kingsley.

[iii] Bomber, Louise (2007)  Inside I’m Hurting.  Worth Publishing.

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When praise becomes harmful to children

Contrary to its intention, praise does not always make a child feel good.

Whilst we might typically think of praise as a gift, it is technically an evaluative judgement on the other person (e.g. “you’re a good girl” or “you’re a brilliant artist”), which for some children can be experienced as threatening or even dysregulating (Stephen Porges Polyvagal Theory).

This risk is particularly pronounced in children whose earliest relationships have not enabled them to trust in the safety of relationships and/or have caused them to develop negative core beliefs about themselves as inherently bad or unlovable. For these children, being told that they are “good” or “fantastic” at something, is so far removed from their own sense of themselves that they cannot make use of it. More likely, they will be put on high alert for when the other person will no longer see them as “good” and will see their true self. It also creates inevitable comparison – and therefore, competition, with other children. For very traumatised children, therefore, ‘global praise’ (or generalised, non-specific praise), can actually act to undermine their trust in the safety of their relationship with the person giving it to them (Hughes, Golding & Hudson, 2019).

Whilst not all children have experienced developmental trauma, however, it is still true that global praise is not helpful to children. This is because it contains too little information about what the giver is enjoying about the child, or what they are doing well, for them to make use of it. Indeed, a natural tendency (for any of us!) when offered global praise, is to immediately deny it (e.g. “I don’t always have gorgeous hair! You didn’t see me yesterday!”), to assume that the giver is lying or does not know what they are talking about (“As if I always sound intelligent!”), to focus on our weaknesses (e.g. “Clever! You should see me doing my times tables!”), to make us anxious (e.g. “I’ll never be able to hit the ball again now you’ve said I’m a good shot!”) or to assume that we are being manipulated (e.g. “What’s she after?”; Faber & Mazlish, 2001).

A healthier alternative to global praise is ‘descriptive praise’. That is, the act of actively looking for specific things that you appreciate, value or enjoy about your child (e.g. “You two have just sat there colouring for 20 minutes with no squabbling”, or “You picked up all your toys, thank you!”) In offering descriptive praise, parents and professionals should attend as much, if not more so, to the effort that a child is making as their achievements (e.g. “I can see you are putting so much hard work into revising your spellings”). They should also ‘own’ their opinions (e.g. “I really like what you’ve drawn there. I like the stripes on your zebra. I think that’s a great drawing!” rather than “you’re a brilliant artist!”).

Unlike global praise, descriptive praise helps to build children’s self-esteem. This is because it supports children to start to recognise the positives in themselves. This happens because having someone else point out specific things that they like or value about them, in a way that they actually can hear and accept it, enables children to give themselves the praise they deserve (e.g. “Yeah, I did draw that chimney well”). Descriptive praise can also be a wonderful way of building enjoyment, joy, trust and security in attachment relationships, for instance, building in a period of descriptive praise for the child before they go to sleep each night. Further, descriptive praise can help to build a child’s resilience, as parents can support their child to start to recognise all their strengths in the face of adversity (e.g. “I know you’re sad that you didn’t make the football team, but I was so impressed with how you went and congratulated the other players. I thought that was really kind”).

For descriptive praise to be effective, however, it should always be within the context of GENUINE heartfelt appreciation and gratitude for the child or their behaviour, as our non-verbal communication is always stronger than our verbal.

References:

Faber, A. & Mazlish, E. (2001). How to talk so kids will listen and listen so kids will talk. Piccadilly Press

Hughes, D., Golding, K. & Hudson, J. (2019). Healing Relational Trauma with Attachment-Focused Interventions: Dyadic developmental psychotherapy with children and families. W. W. Norton & Company.

Porges, S. (2019). Home of Dr. Stephen Porges. www.stephenporges.com; Accessed: 2019.06.07

 

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What is ‘Blocked Care’ as it applies to parenting?

The phenomenon of parental ‘blocked care’ is a term coined by Clinical Psychologists Dan Hughes and Jonathon Baylin and Psychiatrist Dan Siegal. It represents a central feature of the Dyadic Developmental Psychotherapy (DDP) approach to treating children and young people with a history of developmental trauma and attachment disruption.

Neuroscience research into the areas of attachment, trauma and neurobiological development, are teaching us that children’s brains are shaped on a neurological level by their earliest caregiving experiences. 

We now even know that an infant’s brain is primed, even in utero, to adapt to the type of care that it anticipates receiving from its primary caregivers in order to maximise its chances of survival. In other words, even in utero, infants are relational.

The Five Care Systems in parents

What is perhaps less known however, is that parents’ brains are also neurologically influenced by their experience of caring for their child – that the relationship is symbiotic. When things are going well, we now understand that five main areas or ‘care systems’ in the parental brain are optimally functioning. These are:

  1. The Approach System: The system that enables us to fall in love with our children, to crave to be with them and to become completely absorbed in them. This system is associated with the release of oxytocin (colloquially known as the ‘love hormone’).
  2. The Reward System: The system that enables mutual delight and attunement when a parent interacts with their child. This system is associated with the release of dopamine (the ‘addictive hormone’).
  3. The Child Reading System: The system that enables parents to positively interpret our child’s behaviours and motivations and to remain interested in their unique qualities.
  4. The Meaning-Making System: The system that enables parents to think positively and meaningfully about their relationship with their child.
  5. The Executive System: The system that enables us to physically care for our children.

For some parent-child dyads however, things do not go so well and one or more of these care systems do not operate optimally. For example, some parents may face unmanageable levels of stress whilst caring for their infants, which may be exacerbated by their own poorly developed care and emotional-regulation systems. 

Others may be offering reparative foster parenting to children who, owing to previous experiences of abusive or neglectful parenting, now fear, mistrust and reject the care they are being offered, which can be extremely painful for their new carers to bear.

The real risk when things go wrong however, is that parents may enter (chronic or acute) periods of ‘blocked care’. When this happens, the first four systems listed above start to shut down. The parent no longer experiences joy or fulfilment of being with their child. They do not get the rushes of oxytocin and dopamine that other parents get, and they do not seek to be with their child.

These parents also become much more likely to interpret their child’s behaviours and motivations from a negative perspective (e.g. “he is manipulating me” or “she is a spiteful child”) as well as their own relationship with the child (e.g. “I am a rubbish parent”).

In psysiological terms a stressed out parent is operating in ‘survival mode’. They are no longer able to remain open and engaged to the child’s emotional and developmental needs and are simply coping. The feedback system between child-parent-child has effectively shut down, or become ‘blocked’.

Without external support, the final care system – the executive system –  may also start to shut down. This is the point when we start to see abusive or neglectful parenting emerge where parents are physically unable to care for their child or children.

The growing evidence-base for blocked care highlights the crucial need for psycho-education, as well as early and non-judgmental support to parents and carers who are most vulnerable to it.

 References:

Hughes, D. & Baylin, J. (2012). Brain-Based Parenting: The Neuroscience of caregiving for healthy attachment. Norton

Hughes, D. & Baylin, J. (2016). The Neurobiology of Attachment-Focused Therapy: Enhancing Connection & Trust in the Treatment of Children & Adolescents. Norton

Siegal, D. & Hartzell, M. (2003). Parenting from the Inside Out. Tarcher/Penguin

 

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The role of ‘attunement’ in relationships with babies and young children

Babies are not born with the neurological capacity to understand distress, or even to differentiate between discomfort and mortal danger. To ensure their survival therefore, babies are biologically programmed to communicate all forms of distress to their primary caregivers through very primitive means (e.g. crying, screaming and reaching out).

Under ideal circumstances, these ‘signals’ from the baby will elicit a sensitive (‘attuned’) response from their caregiver, whereby their caregiver will utilise their more developed brain in order to empathise with the infant’s distress, to soothe them and overtime, to give them words to better understand and communicate their distress. Repetition of this pattern over time, coupled with a deepening joy of the relationship, is not only the foundation for a secure attachment relationship, but the building blocks for other important skills such as developing empathy and emotional regulation.

When working well, attunement enables a child to feel truly understood, accepted and ‘felt’ by their caregiver. Inevitably however, “getting it right” all the time is not possible and sometimes signals will be missed or responded to incorrectly (‘mis-attunement’) – also known as a ‘relationship rupture’. Ruptures are normal and actually present opportunities for a child-carer relationship if the carer is able to repair the relationship appropriately. Indeed, it is estimated that for a secure attachment to develop, carers need to attune correctly around one third of the time (Hoghughi & Speight, 1998), which is reassuring!

Over the years, researchers have examined the importance of attunement on an infant’s mental health. This includes Ed Tronick’s (2007), ‘still face experiment’, which illustrates the distressing disintegration of a young child, whose parent temporarily stops responding to their cues (Youtube link). It also includes the work of Lynne Murray, who demonstrated that even warm responses to infants are not regulating unless they are exactly timed with their cues. This is important as for some parent-infant dyads, ruptures can be severe and chronically prevent the carer from being able to sensitively attune to their infant – ‘toxic mis-attunement’. This might occur when factors specific to the child get in the way of them being able to communicate their needs effectively (e.g. speech and language difficulties or neurodevelopmental difficulties), or when factors specific to the parent stop them being able to receive and process the child’s distress signals appropriately (e.g. mental health difficulties or substance misuse problems). There may also be external stressors impacting on the relationship (e.g. domestic violence or poverty). In these cases, it is imperative that mental health and social support services are proactively mobilised to offer early support to both the child and the carer.

Hoghughi, M. & Speight, A. (1998). Good enough parenting for all children – A strategy for a healthier society. Archives of Disease in Childhood, 78, 4, 293-296.

Murray, L. & Trevarthen, C. (1985). Emotional regulations of interactions between two-month-olds and their mothers. In T. M. Field & N. A. Fox (Eds.),Social perception in infants (pp. 177-197). Norwood,NJ: Ablex.

 

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What is Sibling Rivalry? – Part 2

Over two blogs I have focussed on one area of sibling relationships, namely rivalry. In part 1, I looked at some aspects of sibling rivalry as they can surface in childhood. In part 2, I will suggest how these might impact on ongoing struggles in adult life, before suggesting ways in which problematic issues with rivalry can be helped.

Sibling Rivalry in Adulthood

Feelings of competition and rivalry are perfectly normal and to be expected in adulthood. However, when childhood rivalry has been particularly problematic and unresolved, this can shape and lead to intense struggles later in life. Below are some thoughts about sibling rivalry and adulthood.

An obvious impact is in relationships to competition. Difficulties might particularly arise at work, socially, in educational settings, or any other situation where competitive feelings are heightened. This might lead to over competitiveness at the expense of other experiences – for example friendship, fun, comradeship etc. The rivalrous person may be driven towards success, however, often these feelings just seem to cause paralysis, procrastination, and low-self-esteem, as the individual constantly measures themselves against others.

As siblings are the earliest relationships they become a kind of template for later relationships. If feelings have never really got beyond negative experiences of aggression and dislike, this can make it hard to establish positive, caring and cooperative adult relationships.

Siblings who hold onto intensely rivalrous feelings, may be unable to establish a good adult relationship with each other. They therefore lose out on what these uniquely close alliances can potentially offer.

Sometimes sibling rivalry that’s not overt in childhood later manifests in adulthood. This can often be triggered through a change in the family dynamic. The most common is the serious illness or death of one or both parents. In these circumstances, feelings of rivalry can intensify or, if latent, can suddenly manifest. This is particularly common if there are issues around sharing responsibility or care for the parent, or around inheritance.

Fair shares and mutual concerns

Dennis Brown, a group analyst, wrote a paper entitled ‘Fair shares and mutual concern: The role of sibling relationships’ (1998). He explored how these rivalrous battles with siblings belong to an early stage in the individual’s development and that in healthy childhood psychological growth there is a shift to a more cooperative position towards siblings and therefore later relationships.

Our relationships with our siblings are usually the earliest experiences of grappling with love and hate for our peers. It’s important that aggression, jealousy and rivalry can be countered by experiences of love, companionship, and affection. Achieving this in childhood helps this balance of positive and negative feelings in later relationships.

The potential for change

But if this change hasn’t taken place in childhood can anything be done in adulthood? Below are some suggestions of how to work towards resolving the more crippling preoccupations with ‘fair shares’ towards a greater feeling of ‘mutual concern’ for and with others.

One way forward is to try and develop an adult relationship with your adult sibling. Sometimes family members get stuck in a narrative belonging to the past. We carry the child templates of our siblings inside us without perhaps getting to know the adult version. This is particularly compounded if relationships don’t develop outside of the family environment, for example when siblings only ever see each other in the presence of the rest of the family, particularly parents.

During or after times when you find yourself preoccupied with doing better than others, or having painful feelings of inadequacy or exclusion, it can help to reflect on links between this experience and what you may have felt as a child in your family. This can help you step away and separate from those past dynamics, reminding you that this is no longer the actual situation you find yourself in.

I mentioned earlier that sibling rivalry can worsen or manifest after a major family dynamic change such as brought on by the illness or death of a parent. Sometimes the opposite shift can happen. For example, the loss of one or both parents, or other family events, can suddenly bring problems of historic rivalry between some siblings to a natural end.

The Role of Group Psychotherapy

Group psychotherapy is particularly helpful in working through the difficulties arising from unresolved sibling rivalry.

Being in a therapy group stirs feelings of rivalry for everyone in it. In this way, it tackles rivalry in a way that individual therapy (where you have all the attention to yourself) can’t. Bringing these feelings alive and to the foreground means they can be worked with head on in the safety of a therapeutic environment.

In a therapy group, members find that each other remind them of their siblings, some more obviously than others. This offers an opportunity for working through difficulties that they may have had growing up with actual siblings. Members can then develop the kind of affection and closeness with rivals that might not have felt possible growing up or since.

Group members often find that the group feels a bit like an alternative family. This gives the opportunity for everyone – including ‘only’ children – to have different kinds of ‘sibling’ experiences than those they grew up with.

Conclusion

Preoccupation with ‘fair shares’ is symptomatic of a world where we feel pitched against each other and encouraged to see ourselves as alone. These feelings can be particularly heightened if the conflicts of our earliest peer relationships have not been resolved. Psychotherapy and counselling give the opportunity to explore and understand these deep rooted and painful experiences and how they may continue to have impact. Psychotherapy groups emphasise our connectivity as human beings. This challenges the notion that we are on our own, offering a direct release from the paralysing grip of rivalrous conflicts, towards greater co-operation, affection, and ‘mutual concern’ in our relationships.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

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