Sunday, June 9, 2013


Whenever I spend time with my nieces or my stepdaughter, I am awed and intrigued to observe the process of child development in real time, as it unfolds.  As a psychotherapist, I am acutely aware of the wounds that are inflicted when something goes wrong during childhood and disrupts the normal process of development.  While it is true that we do not have to be defined by our pasts, events that happen in childhood influence the development of our very personalities and therefore affect how we perceive ourselves and the world.  If our basic physical, emotional, and psychological needs are not met during this critical time period, we are left with empty spaces that we long to fill but do not know how.

These are the people I see in therapy.  Popular culture pokes fun at psychotherapy for seeming to believe that every adult problem has its origins in a troubled childhood.  I sometimes joke about this myself when I inquire about a patient's childhood experiences.  Still, most stereotypes contain some kernel of truth and this one is no exception.  Children with parents who are controlling and extremely critical sometimes grow into adults who expect too much of themselves, whose self worth is tied to their achievements, and who beat themselves up when they make a mistake.  Children who grow up in chaotic and unstable households sometimes become adults who are obsessed with order, who become extremely upset when things do not go as planned, and who attempt to exert control over everything and everyone around them.  Children who are discouraged from or even punished when they express their thoughts and feelings sometimes become "people pleasers" as adults.  The have learned from their experiences that their needs do not matter.  As a result, they lack assertiveness, have trouble setting limits, and are often taken advantage of (partly because they never say 'no'). 

So I am profoundly impressed when I see evidence of these psychological and emotional needs in children.  About six months after my husband and I got married my stepdaughter came to stay with us for the summer.  One night she got upset about something trivial.  She started crying.  Her tears quickly escalated into sobs and loud wails.  I assumed she was throwing a tantrum and figured she would eventually stop crying if we simply ignored her.  She was still wailing after thirty or forty minutes, at which point my husband insisted on going to comfort her.  It wasn't until later that I realized my mistake; my stepdaughter did not know how to self-soothe!  In other words, she really had no way to calm herself down when she was distressed.  She was still at a stage developmentally where she needed help from an adult.  I'm sure no harm came from the incident but it made me think.  What if this happened often?  What if no one ever came to comfort her or to help her calm down?  That's the kind of thing that happened to my patients in childhood.

I observed an interaction between my eight year old niece and her parents last week that made me smile.  We were all at my parents' house getting ready to go for a walk.  My niece had to go to the bathroom before we left.  In the meantime, the rest of us went outside to wait for her.  "Watch," my sister said to her husband. "When she [my niece] comes out of the bathroom and sees no one in the house she's going to come running out here in a panic."  Sure enough, a few minutes later my niece came running out the door.  "I thought you left me!" she exclaimed.  Of course my sister and brother-in-law have never and would never leave her by herself at her age.  Still, the fear my niece felt was real.  And what happens to those kids who come running outside to find that all the adults have, in fact, left them home by themselves?  What happens to them when they become adults?

These are just some thoughts and observations...

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