Monthly Archives: April 2014

The Episode of the Raincoat on the Playground: An Effort to Make Transitions Easier for a 2-yo

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“Ben” was born after a difficult pregnancy and had “the worst colic (their experienced pediatrician) ever saw”, crying for 10-15 hours per day until he was 4 months old. Because of gastric reflux, he was put on numerous medications and a gluten free diet. Ben is also over reactive to sensory stimuli stressed by sounds and sunlight, and particularly by touch – , making bathing, diaper changing, and wearing clothes aversive! His parents describe him as always preferring to be in motion. He has seen many specialists and has received OT and speech therapy.

At age 2, he entered preschool. Ben’s classroom has a calm but playful atmosphere, a predictable routine, a small number of children, and three skilled teachers. In this environment, Ben began to make strides in his development. Although his teachers delighted in his sense of humor and in the rapid progress he was making, his parents continued to struggle with meltdowns at home. They described him as a 24/7 occupation. They were worried about having a second child. How could they manage another when they were so busy with Ben?

In particular, Ben’s parents noted his difficulty making transitions. Although he loves school, he often refuses to go downstairs in the morning in order to get ready. He may have a tantrum about getting into the car to go to school. In addition, not surprisingly, he makes a fuss about going to bed at night.

One day, I encountered Ben on the playground. He was crying softly and burying his head in his teacher’s chest. There was a light rain that morning, and raindrops were making dark spots on Ben’s shirt and sweat pants, and even glistening on his hair and forehead. His teacher was holding a raincoat in her hand and attempting to persuade Ben to put it on. She explained to me that Ben did not like to get wet, but he didn’t want to put on the raincoat. She asked Ben why he didn’t want to wear it, and he just shook his head and continued to cry, explaining only, “I sad.” Acknowledging that maybe Ben himself did not know what was making him so sad, his teacher and I continued to imagine why he was crying. Maybe he did not want to wear a different raincoat, since his own raincoat had been left at home and this raincoat was from the lost and found. Maybe he didn’t like the feeling of a coat on his body anyway. Also, he didn’t like to get wet! Maybe he was crying because of all of these things.

Eager to draw from the teacher’s experience, I asked her what she had tried and what she was going to do. She explained that they had a rule that children must wear raincoats if they wanted to play in the rain, and that otherwise they had to go inside. Ben cheerfully said he wanted to go in. His teacher said that he could go in, but she also knew he wanted to play with his friends, and he couldn’t play with his friends if he went inside. Ben looked confused and unhappy. The teacher consulted her watch. She told me that there were only a few minutes left of their outside time, and that she was inclined to let him stay outside and change into dry clothes after all the children returned to the classroom. This was the “choose your battles” approach. I asked her what she would do if the circumstances were different. She said that if it were pouring rain, she would insist on his putting on his coat if he chose to stay outside in the rain and refused to go in, even if she had to physically help him put it on. Often parents and teachers are reluctant to take the concrete initiative to help a child put on his coat. However, I have found that sometimes doing so has a good result; once the initiative has been taken, a momentum is established that makes it easier for the child to collaborate. Of course, one wishes to support the child in taking his own initiative, so encouraging him to do so is the way to begin. Only if that fails would I take the lead. It is always important to have many strategies available.

What was most impressive about the whole situation is that when I called Ben’s mother afterwards to follow up, she told me that Ben had explained the whole experience to her after he came home from school. He told her about not wanting to put on the raincoat, that it wasn’t his raincoat, that he was getting wet and that made him sad, but that he had wanted to play with his friends. I reflected on the remarkable learning experience this had been for Ben. In Ben’s presence, his teacher and I had discussed slowly and thoughtfully the meaning we made of Ben’s dilemma and some possible solutions. We noted that Ben didn’t like any of the solutions we suggested. We came up with others. He didn’t like these either. There was a way in which Ben’s rejection of our suggestions enhanced the learning experience by drawing out the reflective process, by allowing him to consider more and more possibilities, by helping him see that there was a bigger territory in between all or nothing than he had realized, even if he could not bring himself to choose one of those options. Finally, in telling the story to his mother, he engaged in the active process of creating new meaning of his own of his experience. In remembering, in choosing the words to fit the memory images, in making himself known to his trusted and beloved parent, he took a small step into a mind of his own.

I believe that through a repetition of small growth experiences like this Ben will learn how to make transitions more smoothly, because he will be making them in an expanded repertoire of choices.

Photos by Ginger Gregory

 

The author and the Photographer

 

 

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This is the author of the book we used for our workshop at Kasganj Nursing School, Your Baby is Speaking to You, Kevin Nugent, with my colleague, Ginger Gregory, who is also the photographer for all my postings from India. The two were participants at the Infant Parent Mental Health program in Napa.

Nugent K (2011). Your Baby is Speaking to You, Houghton Mifflin.

 

The Witch and the Forest Goddess Part II

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Then I asked Rahul to tell me the story of his original picture, the house with rainbow colors. This is the story he told me. A woman wanted to go to the hills. She wanted to go to a special hill, a hill with a temple. The conductor said that she didn’t have enough rupees to go, but she finally got to the temple anyway. After reaching the temple, she descended the hill again and found the house, which she claimed as her own. Some boys came by, and they asked her if she had a place for them to stay. She told them they could stay with her. Again, she wanted to go to the temple, but this time she had no money at all. She had the idea to approach people on the way, asking for donations. She was rewarded with a bag full of money. She reached the top of the mountain and then returned to her house. At the house there was a spike, and a bird tried to sit on it and was pierced and died.  The boys shared the bird – one ate the head, which was said to make the eater into a king, and the other ate the body, which was said to make the eater into a rich man. The prophecy came true, but then the boys went into the forest and were captured by a witch. The witch gave them poison, and they vomited the two pieces of the bird, both of which she ate, conferring the position of the kingship and the wealth onto the witch. Now poor and without status, the boys went further into the woods and found the forest goddess, who heard their story and took pity on them. She gave them a magic ring, which allowed them to retrieve their royalty and wealth from the witch, who was duly punished.

This wonderful story had to be finished before its natural conclusion because, despite the charm of the storyteller, it had continued for longer than the patience of the adults in the room. I thought the story told Rahul’s fantasy of being reunited with his idealized mother, represented by the first generous woman and again by the forest goddess. The abandoning bad mother, I thought, was represented by the witch. Although Rahul has not seen his mother for years, I am guessing that he holds a fantasied image of her as an ideal mother in his mind to protect him from the pain of the awareness of the loss. If he had to believe that he was truly abandoned, he might also wonder what he had done that was so bad (stealing a biscuit, losing a ball, etc.) to deserve to be left behind, and a sense of himself as that bad could be crushing. In fact, to believe that you were bad enough for your mother to leave you, you might believe you deserved to eat dirt.

Rahul responded to this intervention with an enhanced sense of himself. He sought us out with his eyes and seemed to be longing for more attention. However, perhaps most important was that we offered the caregivers a new glimpse of a child’s inner world and the way these insights could be used to understand a child’s behavior. As the stories suggest, our view into a child’s inner world is only one of many possible meanings, but increasing one’s repertoire of ways of understanding human behavior is likely to expand the caregiver’s capacity for empathy and consequently to enrich the caregiving environment of a child. In addition, as the photos in the Part I posting indicate, we helped Rahul feel connected with the father figure of the children’s home and in that special connection gave him a chance to identify with the Professor’s power and kindness.

After our experience with Rahul, we brought colored pencils and paper to the other boys.

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Winnicott DW (1958). Collected Papers: Through Paediatrics to Psychoanalysis, London: Tavistock Press

The Witch and the Forest Goddess Part I

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This posting is an example of a brief (about one hour) psychoanalytic intervention at a children’s home. It illustrates the universality of the human capacity to use symbols to express the individual’s inner thoughts and feelings. It also emphasizes the importance of culture in the style and content of this expression. In particular, this is the story of a child at a children’s home in India. It is a sad story but hopeful. At its core is the cultural practice of story telling as a way of communicating values, and in this case, a sense of one’s self. Because of the length of the posting, I will present it in two parts – Part I and Part II.

An 8-yo boy came to home when he was 5-yo because his impoverished single mother was unable to feed him. I will call him “Rahul”, not his real name. Not long ago, a caregiver at the home noticed that Rahul was eating dirt and sand. When asked why he did so, he said he did not know. The head of the home, the Professor, took him to a local psychiatrist who prescribed Prozac, and Rahul stopped eating dirt. Besides this symptomatic behavior, the caregivers did not consider R a problem. He is bright and does well in school. The Professor volunteered to translate for me.
I invited Rahul to draw. A small, dark boy with huge brown eyes, he sat seriously on the floor between me and the Professor. Carefully, he sketched out a jagged mountain range, a house at its foot, and a river beside the house. It looked like a school drawing, an observation that was confirmed later by noting similar drawings other children drew. Then he colored in all the shapes in stripes of rainbow colors.

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Shantu drawing

To approach an understanding of his inner world, I decided to use Winnicott’s technique of squiggle game (Winnicott, 1958). In this game, the clinician draws a squiggle on a piece of paper and asks the child to “turn it into” something. Then the clinician asks the child to draw a squiggle that the clinician turns into something. In my adaptation of the game, I ask the child to tell a story of the pictures that the squiggles are made into.

Interestingly, Rahul responded quickly and well, but when asked to tell a story about the figures we made of the squiggles, he chose folk stories heard in school to illustrate the pictures. Nonetheless, the folk stories are remarkable for their meaning. My first squiggle drawing was an elaboration of his minimal diagonal straight line. I made a tree with one branch pointing downward as if it might be bent or broken, and I put leaves on the tree. Rahul told a story of a deer that came along and saw an ant drowning in the water below the tree. The deer put a leaf from the tree into the water and saved the ant. He had chosen a story about a rescue.

Another squiggle of mine was a loose coil made by looping the pencil Rahul made this into a girl wearing a scarf. Again he told a folk tale. However, the most interesting part of the story was in the improvised continuation of the folk tale.

In Rahul’s spontaneous narrative, the girl went home, and her parents were not there. She was hungry, so she bought a biscuit. That night her parents still did not come back. Finally her parents returned and asked her where she got the money to buy the biscuit. She said that the money was in the showcase of the store. Her parents called her a thief, but she proclaimed she was not a thief. – “Only a mother can cook; a small child cannot cook food, and she was hungry so she bought a biscuit.” I imagined that the story expressed Rahul’s early experience of severe neglect and perhaps abuse in that the parents accused the child of a sin. On the other hand, it may be that the child also thought of himself as a sinner, a bad child, as a way of making sense of his neglectful parents’ behavior and as a way of explaining his efforts to satisfy his needs.

As important as the content of the stories, is the visual image of the relationship developing between the Professor and the child during the consultation. The remarkable attunement between the two figures in the photos illustrates the sensitive bond – like a carrier wave – that supported the meaning the child made of the experience.

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