What to Do When Your Child Is Struggling

by Judy Yanof , M.D.*

April 25, 2013

 

Seeing that their child is unhappy or struggling often leaves parents feeling not only distressed, but also helpless. As parents, we often do not know how to help our children, because children generally are not very good at telling us what is bothering them. They often do not know why they are unhappy, and they may not have the words to articulate their experience. Instead they “show” their parents that something is wrong through their behavior – behavior that often leads to a negative response from their parents, rather than the more specific kind of attention they need.

Children often use the same pathway to express very different kinds of trouble. This also makes their call for help more complicated and, therefore, more difficult for their parents to read. Let’s say that a middle school child’s grades begin to slip. Is this a sign that he is experiencing some learning difficulty that has begun to show itself, now that more is expected from him at school? Is it that she is upset because she isn’t developing as quickly as her friends? Is he being excluded or bullied? Is she becoming depressed, or is a family problem weighing more heavily on her than on her siblings? Or is it simply that early adolescence is a fraught period developmentally for all youngsters? Will the passage of time heal things, or is this something that needs to be taken more seriously?

Parents often do not know, but watching their child falter makes them feel anxious, ashamed, alone, and unsure of what to do. Sometimes, simply not knowing what to do to help your child is good enough reason to seek assistance.

 

Seeking Help

 

When children are having trouble, seeking professional consultation is often a good choice for parents, because they no longer have to be alone with their questions, uncertainty, and feelings of helplessness. Yet, professional consultation is often a difficult choice. It is important to know that no parent feels completely comfortable about beginning this process. Besides having to overcome one’s feelings of discomfort at the idea of asking someone else for help, there are so many consultation options out there that it is often unclear where a parent should turn. This is also a problem for teachers, pediatricians, and other professionals who want to direct a parent to someone who can help a child who is struggling.

In today’s world there are an overwhelming number of specialized approaches to helping children and families with their difficulties. While many of these approaches to treatment are useful in some cases, the existence of so many different approaches can make choosing the best one a confusing and bewildering experience even for well-informed parents. For instance, there is talk therapy, play therapy, cognitive-behavioral therapy, medication, neuropsychological evaluation, educational remediation, parent training, and family therapy, to mention just a few forms of intervention. Some clinics specialize in specific symptoms.

 

First Step: A Child Analyst

 

My advice to parents (as well as teachers and other professionals) is that their first step should be to seek consultation with someone who can think with them about what form of help would be best suited to the individual needs of their particular child. This is why I recommend a child analyst. Child analysts think comprehensively, taking into account the complexity of factors – biological, developmental, psychological, and environmental – that contribute to a child’s strengths and difficulties.

Although psychoanalysts are often thought of as doing a specialized kind of treatment, child analysts are also uniquely equipped to help when a parent is trying to determine if treatment is in order at all, or when a parent is trying to learn what kind of treatment will have the best chance of success. This is because child analysts are specially qualified to understand the child or adolescent as a whole person and to help parents think about what form of help would be the best fit for their particular child. Child analysts are also well positioned in the mental health community and able to assist parents in connecting with the professionals most qualified to provide the chosen treatment.

 

Who Is a Child Analyst?

 

Child analysts are mental health professionals with an advanced degree in a mental health field (psychiatry, psychology, or social work) and extensive additional training in understanding child development and how a child’s or adolescent’s mind works. By virtue of their training, child analysts are particularly sensitive to the multiple factors (including biological, genetic, neurological, familial, and social) that influence personality development. Child analysts are mindful of the importance of developing an integrated understanding of the complex interaction of all these factors in determining a child’s unique developmental trajectory. This understanding can then be used in developing an individualized treatment plan specifically tailored to the child’s particular needs.

 

What Is Child Psychoanalysis?

 

Child psychoanalysis is a specialized approach to working with children, adolescents, and their families. Psychoanalysis is an intensive talk or play therapy.

Psychoanalytic treatment tries to help the child understand feelings and manage them more effectively, recognize and change maladaptive coping strategies, and reexamine negative feelings about himself and others. Such treatment stabilizes psychological functioning by increasing freedom of expression through words and play, rather than through impulsive behaviors. It helps the child to develop flexibility and a realistic assessment of the realities that she faces in her life. The goal of treatment is not simply to overcome immediate troubles or a specific symptom, but to help each child reach his full potential in all areas of life and build a deep, long-lasting strength and resilience.

 

Much of the therapeutic work of analysis is accomplished by building a strong, trusting relationship with the analyst, who becomes a partner with the child and the family in understanding the child’s struggles and capabilities.

Analysts are sensitive to the critical importance of the parent-child relationship to the developing child. A crucial aspect of analytic treatment is to help parents understand their child in more depth so that they can respond to the child in ways that facilitate and support the child’s development. Therefore, child analysts aim to work and collaborate with parents in all phases of treatment. In addition to helping the child return to the path of normal, healthy development, psychoanalysis aims to strengthen the relationship between the child and parents and restore it to a more loving and mutually gratifying one.

It is useful to think about psychoanalysis when a child or adolescent has struggled during many developmental phases, when development is being interfered with, when there has been a history of some kind of trauma, when more than one diagnosis is involved, and when other treatments have failed. It is also true that young children do exceptionally well in psychoanalytic treatment when it is indicated.

 

*Portions of this blog entry have been taken from the American Psychoanalytic Association’s Brochure on Child Analysis.