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Hidden meanings of actions and reactions of children in therapy: the psychotherapy series

THE INNER, EMOTIONAL WORLD OF THE CHILD WITH CHD

AUSTIN E. WILMOT, M.S.W., L.C.S.W.



In this brief article, I wish to outline 20 common ways that children act and react within the relationship with a child therapist. We might also describe this as 20 common patterns exhibited by children in the course of a child therapy—patterns that tell of an unspoken story taking place under the surface that becomes, in part, the work of the therapist and child to understand together. My hope is that this article provides parents a perspective on the kinds of twists and turns that might be in store during a child’s therapy and questions that a therapist might have in mind about these turns of events. While not an exhaustive analysis, the questions and ideas shared give a taste for how a search for meaning in a child’s behavior unfolds.


Initially, in any therapy, the therapist looks to see how the child takes to a new relationship with the stranger their parents have been talking to. Do we hit the ground running or does the child react in another fashion? A well-trained therapist helps the parents understand a child’s reactions to therapy and tailor their responses to these initial anxieties, if present, for the child. The parent work side of a child’s therapy is the meeting ground where insights about what is emerging in the individual child sessions can be shared to enhance understanding about the child, helping parents to gain a sense of where their child is at in the process and what that means about their child and their own ways of being with and responding (or not) to their child’s feelings and actions. For parents, their own involvement in their child’s therapy (in separate parent sessions) is an exercise in learning to reflect on and more deeply understand the meaningfulness of their child’s (and their own) ways of being and responding to one another.


Therapy is a process that opens up an entirely new space and relationship for a child. Over time, a child’s feelings, fantasies, patterns, conflicts and personality make their way into the therapy room and come alive within the therapy relationship. It is there that the work of making witness to and understanding a child’s inner life can take place with therapeutic aim. A child’s play and the ways they act and react become open to the therapist’s involvement and interpretation as the therapist endeavors to help the child to find the words for talking through the twists and turns of the child’s activity that evolves over time in a meaningful way. Below, each particular child action pattern is paired with the related questions that might be swirling in the mind of the therapist. It is intentional that the reverie of the therapist is shared as questions as it represents the curiosity and open position of the therapist as regards the child’s unfolding behavior. While we cannot assert certainty that X behavior means Y without knowing the child over time, the intention is to exercise those “thinking muscles” for hidden meanings. As you read, it might be helpful to first read the child action pattern and think for yourself about what might be going on inside the child, and then read the right side of the chart to see if you had the same or different questions in your own mind.








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