I have been talking about psychotherapy but I realize that I haven’t really said how we effect the changes that we want to make. To that end I want to share some illustrations of ways in which I have seen people make positive alterations in their lives through psychotherapy. I will present examples which are composites of several patients and situations in which the details are changed to protect confidentiality.
I’ll start with Ethan. Ethan is the youngest of three siblings with two older sisters. His parents brought him to therapy because he was failing in school. I might add that that is the most common reason that teenagers come into treatment. A student is “not living up to his potential” and the parents and sometimes the teachers are baffled. Ethan was in 9th grade and his grades had dropped precipitously since 8th grade at a middle school where he was getting A’s and B’s.
I talked briefly with the parents about the family situation. Had anything changed recently—a death of grandparents, the birth of another sibling, a move to a new city, health issues in parents or children? The parents could not identify any major changes of that kind. The parents were married and both were living in the home. Both worked outside and had made reasonable childcare arrangements for the young teenage children. Finances were not a pressing issue.
As I began talking to Ethan—by himself now—it became clear that he was stuck—stuck in an earlier phase of his life. His room was a disaster area (as are many teenagers’ rooms.) It was a conglomerate of clean and dirty clothes, some which fit and some which were too small; childhood toys and stuffed animals; lost piles of books; homework and the like. His parents had promised him a new bedroom set if he cleaned it up but to no avail. Ethan had withdrawn into a shell—hiding out in his room, playing computer games and ignoring former childhood friends.
He had the habit of doodling, that is, scribbling and drawing all over his papers, including homework and class notes. The scribbling made his papers unreadable and understandably annoyed his teachers no end. We began to talk about the scribbling. Why did he do it? Could he stop himself? While it was in part motivated by his anxiety it was also a positive outlet. He was creative and artistic in a number of ways. We arrived at a compromise: he could continue doodling but he would minimize the extent of it so that teachers could read his homework papers. He also said that he had taught himself to listen while doodling so that he heard his teachers when they were talking and giving homework assignments.
As we talked it became clear that Ethan had many creative outlets. He joined an improvisation group at school and began doing stand-up comedy. He shared some of his routines and I found him to be quite funny. Amazingly enough he also began clearing out his room. He stored or disposed of childhood toys. He was excited to set up a desk and study area and decorate his room in the way that he wanted. At the same time his grades were improving as he organized his school work, completed assignments and remembered to turn them in.
Ethan was a relatively healthy adolescent who was stuck in an earlier developmental phase. In this instance the therapy allowed him to assess his situation in a non-judgmental atmosphere. He could then explore new and more mature outlets without the well-intentioned but ill-timed censure of his parents. He almost literally “found” himself again to be the creative, funny and thoughtful young person that he was. Given the stable and relatively positive home situation Ethan was able to move forward in a relatively short space of time.
I wish it were always that successful. Next week I’ll talk about another adolescent whose presenting problems were similar but whose underlying issues were far more serious.
Ellen Toronto is a clinical psychologist in private practice in Spring, Texas and has been practicing since 1980. In 2017, she was elected a Fellow in Psychoanalysis by the American Psychological Association. In 2016, Dr. Toronto's practice was recognized as one of the top Ann Arbor Psychology practices. She received her Ph.D. in Psychology from the University of Michigan. Dr. Toronto is married to Robert Toronto, Ph.D., and together they have four sons and eleven grandchildren.