. . . and it's not their genes either. – Dr. C

Archive for July, 2013

GOTH GIRL – Part IV: A tale from the Lone Arranger

Goth Girl ImageHow Did it End?

Evie went home to her mother about six months after I arrived.  She had stopped “cutting” for more than four months, she was still writing in what we were calling her “journal” by then, and most important to me, she was chemical free.  Evie called me two times in the first month just to say hello and to say that she was doing okay.  She was in school, and she was glad to be home.  She thanked me a few times, and I thanked her for trusting me.  We never spoke again.

About four months later, Pamela called.  She wanted to let me know that Evie was still in school, doing okay.  She said Evie seldom wrote anything in her journal anymore.  She also said she thought Evie may have a boyfriend. Nothing had changed with the relationship with her step-father, although Evie, according to Pamela, was much more steady with this unsteady, one-sided, relationship.  Finally, Pamela told me she was dating.  She met a man at work, they had lunch, and they had dinner.  A third date was planned.  She sounded happy.  I think that’s why she really called, but that’s just me.

This is how it usually ends in my business.  It’s rare to have much contact with children and their families once they leave these kinds of facilities, as it should be.  After all, we are there to help them during an extended life crisis, not to ensure everyone lives a good life.  Our job is to provide them with our security, our trust, our guidance, and to discover and encourage their strengths, as children and families work to move forward in their lives.

~~~~~~~~~~~~~~~~~

Epilogue

          If we want a child to change his direction, we must understand what makes him move.  Rudolf Dreikers, M.D.

 A final few words about Evie.  Why, some have asked, was she “hallucinating?  Why was she cutting on her arms?  What, in a nutshell, is the “cause” of such “madness?”  The short, temperament-based answer?  Those are behaviors that Spheres (Idealists) use to ward of feelings of shame.  A longer answer?  This is what one of Keirsey’s disciples, Dr. Milton Lucius, wrote 30 years ago:

 “ . . . , the reaction to stress will differ according to a person’s temperament.  What may be stressful for the Idealist (Sphere) may be exciting for the Artisan (Star), and perhaps a boring problem for the Guardian (Square) or Rational (Cube).  This is so because stress for each temperament is not merely the pressure to act or decide.  Such pressure is merely pressure.  Stress has particular meaning in temperament theory.   

 “Stress occurs when an individual does not satisfy the basic desire of his or her particular temperament.   This is the essence of a ‘crisis of self-esteem.’  If stress is maintained long enough, or is intense enough, people turn their natural temperamental behavior style to an effort to protect themselves from further stress, and away from further efforts to produce satisfaction for their core need.  Their behavior becomes protective rather than productive.”  (Milton Lucius, Ph.D., 1983).

Whether you like the short or long answer, those of us temperament trained need not dwell on the “why” of behavior.  More important, if the intent is to help, the only question to ask is how do I intervene?  And that, whether parent or professional, above all else, is based on temperament.

These tales are about intervention with children who are troubled, or troublesome, and their families.

Why Star, Square, Sphere, and Cube?

I’ve been asked a few times how I decided on geometric shapes to designate the four temperaments.  It wasn’t easy.  With much consternation at the time – more than 20 years ago – and dozens of workshops since, I’ll be telling that story in my next blog.  Hint:  you’ll be learning a little about Gestalt (form) Theory as well.

Finally, I started writing “Goth Girl” last year.  While reviewing some articles online, I found a video about another girl.  Her name is Emily Longden.  She was hearing voices too.  I wrote a blog about her.  You can learn about the Hearing Voices Network, and you can meet – and see –  this brave young woman, here.

Next:  The Horrible Kid

Horrible Kid 2The next tale is about a nine year old male Star (Artisan) boy who was terrorizing his mother and grandmother.  The family was isolated by choice because he was “horrible” at home, and they didn’t want any neighbors.  The school was demanding that mother “medicate” her child because he was “horrible” in the classroom.  He had no friends.  Social Services was threatening to remove him from home and place him in a facility for other “horrible” kids.

In 1999, I was the Executive Director of one of the first private, non-profit “wrap-around” programs in California.  Our job was to keep him home and out of placement.  See how our team intervened to do that, without therapy, and without those phony chemicals.

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GOTH GIRL – Part III: A tale from the Lone Arranger

Goth Girl Image

Part III:  An act of chivalry

When the three of us were in session – Evie, her mom, and me – I would read aloud the most recent additions to her conversation.  By now, she always wanted to hear what I had to say, and that was good.  She spoke of her many troubles, and Vlad comforted her with sound advice and concern.

I should tell you I already had a few private conversations with Evie’s mom about this.  Pamela told me Evie always had a vivid imagination.  She had “friends” she would talk to when she was a toddler, as many kids do.  Like most kids, she grew out of it by the time she started school.  Pamela never thought it was a problem.  She thought it was normal for some kids. It is, of course, for all kids, with spheres far and away the most adept at using their imaginings to tell stories about their life experiences.

Vlad “arrived” right around the time their marriage was “falling apart,” Pamela told me.  As she entered her teens, Evie was becoming increasingly alone, questioning everything her mother did or should have done.  She was becoming desperate as her father receded from her world.  She was angry, hurt, and isolated.

Once, while I read her story for the three of us, the fair maiden (the girl in the story didn’t have a name other than “maiden”) said to Vlad, “Thank you for your chivalry my friend.”  I smiled.  What could this sad and frightened little 14-year-old Goth girl from Southern California know about chivalry, I said to myself.  So, I asked her.  Before she could answer, Pamela interrupted, beaming, and proudly said, “She knows what it means too!”

“Really?” I said. “What does chivalry mean, Evie?”

“Dr. Cima!”  She was a little angry.  “I know what chivalry means!  It means that when a fair maiden is about to step into a puddle of water, the gentleman is supposed to take off his coat and lay it on the ground so she won’t get her feet wet,” she said grinning, with as much pride as her mother.  It was a good moment for all three of us.  From that time forward, we changed her story of desperation into her search for inspiration.

About That Voice-In-Her-Head

One day, sometime in the second month or so that I knew her, Evie asked me, causally, “Dr. Cima, do you think I’m crazy?”  It was, I think, a question to test my answer more than anything else.  She had her fill of answers by then.

Her doctor told her, and her mother, she had “schizoaffective disorder” and something called “major depressive disorder,” and that she needed a chemical to make her better.  Her therapist told her she was “substituting Vlad for her father,” though she had a “psychiatric disease” too.  Her social worker told her she sent her to this facility for her “mental illness.”  A few counselors, frustrated because she wasn’t improving, told her she was “psychotic.”  The other kids at the facility?  They told her she was a “wing-nut,” and other similar terms, as you can imagine.  All of this convinced Evie this really was a place “for crazy kids.”  I answered her question.

“No Evie,” I said, “I don’t think you’re crazy.”

“Ok, Dr. Cima,” she replied, almost as a challenge, “then where does Vlad come from?”

I shrugged and said “I think it’s just you talking to you.  What do you think Evie?”

“Yeah,” she said with a sly grin, “it’s just me talking to me.”

That seemed to help.  After all, that’s what it is.  We should remember, parents and professionals alike, there really isn’t another person talking, and the voice isn’t coming from the clouds.  It’s her own imagination at work, nothing more.  She’s having a discussion with herself, it seems spontaneous, it seems to be real and, for the most part, she’s was okay with it.  We decided she was having “a wide-awake dream, that’s all.”  That seemed to make sense to her.  We never talked about “why” she was having her wide-awake-dreams, so it made it easier for her to talk to me about them.

After awhile our conversations were about the words she wrote, and the metaphorical meanings they had in her life.  It was a great way for her to explain her inner turmoil, and a great way to encourage her candor.  She was, in the next few months, increasingly candid.

About That Cutting

About one month into our relationship, at a particularly vulnerable and honest moment, I asked Evie if I could see her scars.  She was very ashamed of her scars, in front of me, and she always wore long sleeve shirts to hide them.  Evie took off her jacket and extended her arms.  There were several dozen criss-crossed scratches from her wrist to three fourths of the way up both of her arms, most of them permanent scars.  When I gently held her arm to look, she started to cry.

I’m sorry, Dr. Cima,” she said, her eyes fixed on the floor. 

“Sorry,”  I replied,  “why are you sorry Evie?

“Because it’s a stupid thing to do!” she said, with a bit of anger in her voice.

She said, at different times, she did it because she couldn’t stop herself, and because Vlad said it was a sacrifice she had to make, and because she felt so empty inside, and because her dad wasn’t around, and because it brought her a lot of attention and, sometimes, because she was bored.  Mostly, she said, “I do it when I don’t feel anything.”

Not a small item for Spheres, the loss of feelings.  Feelings provide Spheres their life energy.  Spheres without feelings are like Cubes without a puzzle to solve, or Squares without a job to do, or Stars without a game to play.  In desperate times, in a strange place for “crazy kids,” feeling something is better than feeling nothing.  We talked about her feeling nothing, and decided that feeling nothing was a feeling too.  Even if it felt terrible and empty, it was a feeling.  At least, we decided, she was feeling something.  Evie slowed and then stopped cutting herself six weeks after we met.

About That Chemical Cocktail

I convinced Pamela her daughter didn’t have a “disorder” or a “disease.”  Frankly, and not surprising to me, it didn’t take that much to convince her.  She never saw any improvement in her daughter’s behavior, despite the number of “cocktails” they tried.  She consented because a doctor said her daughter needed “medicine.”

This is a common experience for the many hundreds of parents I’ve worked with in my career.  Parents will say they saw improvement in the first few weeks, then things began to get back to where they were.  Chemicals were increased, or decreased, or changed, or added – it didn’t matter much.  Over time, nothing changed, often their child was worse, and now their child was living in “a place for crazy kids.”

Pamela expressed her right as a parent and asked that her daughter be taken off her “medication.”  The doctor cautioned her against doing so, however, Pamela insisted.  With my support, we began a “titration schedule,” and simply reduced and eliminated both her chemicals in a matter of a few weeks.  Good riddance, and a huge boost to the self-confidence of Evie – and her mom.

NEXT TIME:  How Did it End? 

 

GOTH GIRL – Part II: A tale from the Lone Arranger

Goth Girl Image

Part II:  The Story

Unlike most therapists in society who meet with their clients once a week in an office, in residential settings, the kids live and the staff work at a self-contained campus.  Bedrooms and classrooms and therapist rooms are usually within short walking distance of each other.

That means, if you’re a therapist, it’s not unusual to have lunch with one of the teenagers, or to meet with her teacher, or to take a walk and have a private conversation – in addition to a more formal one-hour session in the office.  In fact, it was my job to make sure therapists didn’t linger in their offices too much.  “If you want to know how your kids are doing,” I would tell them, “go see them where they live.”  So, I spent some time where she lived.

I began to see Evie, formally, once a week.  Our first meeting was cordial.  My job was to develop a trusting relationship, and Evie was rightfully cautious.  As I had lectured my staff ad nauseam over the years, the adult is responsible to earn the child’s trust, not the reverse.  I talked to her about things she liked.  She said she liked to write.  I asked what she wrote about, and if she would share them with me.  “Oh no Dr. Cima,” she said, “I’d be way too embarrassed!”  I told her I understood and maybe she would share with me some day.  We talked about her life a little bit.  She told me she loved her mother very much, though she had many “acting out” episodes when she lived with her mom, especially in the last year or two.

I also learned Evie had sporadic, unpredictable contact with her stepfather.  He married Evie’s mother when she was three, and he was the only father she ever knew.  Her parents divorced a year earlier and were more or less estranged for at least two years before the divorce was final.  Evie’s stepfather had a girlfriend, and her mother was not dating.

 Meet Pamela and Tom

I contacted Evie’s mother after my first talk with her.  I’ll call her Pamela.  Pamela lived by herself in her home about an hour from the facility.  She worked long hours in a responsible position.  I asked her if she was able to meet with me, she said of course, and we met the following Monday.

 Over the next several months, I routinely met with Pamela at the facility.  The two of us would have a conversation, and then we would bring in Evie.  Pamela needed her own private time too.  A good mother, she was confidently independent.  She had a good enough paying job that she could afford to pay her bills and take care of her daughter even if her ex-husband didn’t contribute, which was often. For the temperament trained reader, Pamela is a Protector Guardian.

Sometimes, though, she was overwhelmed with self-recrimination about how all this happened, about what happens next, how the ex-husband’s girlfriend “didn’t help,” that she had no interest in dating, how she is responsible for all of Evie’s troubles, how her ex-husband is responsible for all of Evie’s troubles, and everything else that occurs when couples, with children, divorce.  It’s important to keep in mind divorce is a process, not a date on the calendar, and it inevitably involves unavoidable upset for everyone involved.  Evie was Pamela’s only child, and they were always very close.

Evie’s stepfather – let’s call him Tom – was a blue-collar worker and, from the portrayal Pamela gave me, probably a Promoter Artisan.  I never met him, though we did have one conversation over the phone.  From what Pamela told me, over the past three years, Tom has been less and less involved in Evie’s life, missing gifts for birthdays and Christmas, and often not showing up for scheduled visits.  Still, Evie wanted to see her dad.  (See About Evie’s Father in footnotes [i])

Making Progress

By the third or fourth time I met with Evie alone I asked again, towards the end of our conversation, to read some of her stories.  I could tell she was glad that I remembered to ask a second time.  This time she said “okay,” with an apprehensive smile.  She gave me her well-worn spiral binder and she asked me if I could read it right away.  I told her I would.

I’ve read many stories and many poems from children in foster care over the years.  Anger is a common theme, as is fear, and so is freedom.  Despair is almost always part of them.  For many kids in foster care, futures can be dim.  Evie’s was different.  It really wasn’t a story.

When I first began to read her words, I couldn’t make heads or tails of what she was saying.  Her spelling was okay and her grammar was about the same.  She capitalized the first letter of every sentence, every sentence ended in a period, and each sentence made sense.  There were no questions marks, no exclamation marks, no quotation marks – just periods.  After a while, when I read the sentence Where are you going Vlad, I finally “got it.”

Imagine reading a novel, and the person who wrote it deleted everything in the novel except the dialogue.  There was no introduction, no building of the scene, no sense of when or where this was talking place, or even who was talking.  Instead, the first sentence of the story started in the middle of a conversation between two people, neither of them identified, one sentence after another.  I finally realized Evie wasn’t writing a story for someone to read.  She was writing down the conversation she was having with Vlad, like dictation.

What was the conversation about?  Well, for lack of a better description, it was about a “fair maiden in distress,” who was receiving advice by a loving friend named Vlad.  Vlad was heroic, sometimes dark (he spoke of werewolves and may have been one himself according to Evie).  Vlad loved the maiden in the conversation, Evie once told me, “just as a friend, Dr. Cima.”  Nothing sexual about this relationship, at least in her written and spoken words, and Evie wanted me to know that.

NEXT WEEK:  An act of chivalry

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[1] About Evie’s Father

In my one conversation with Tom, I told him he would have to make appointments to see Evie with me, and that I wouldn’t tell Evie about this until he showed up. In the next six months, Tom called my office on two different occasions to arrange a visit with Evie.  He didn’t show up either time.  I emailed him a few times and I left a few voice messages.  I offered to go to his house to meet with him.  He never responded.  It was a choice he made.  This also meant Evie didn’t hear from him during this time either.  She let me know her feelings about this in her ongoing conversation with Vlad