Myths about Behavior
Often Repeated in Therapy

Jacob Azerrad, Ph.D.

“Billy was in therapy for years,” a parent will tell me, “and I never knew what was going on.”

At the beginning of psychotherapy, the therapist often makes a point of stressing that the therapy will take a long time. The problem behaviors have frequently been there for years, therefore it will take year to understand and change them.

It may also take years, the parents are told, because the child’s “emotional disturbance” is so serious. It’s essential to set up the expectation that therapy will take a long time because changes take place slowly and the weekly visits by parents and child go on for a number of years. Without this expectation established at the outset of treatment, the parents at the end of the first year of therapy, seeing little or no progress, might seek help elsewhere.

When the parents ask what is going on behind the door of the therapist’s office, they are often told little. Games are used, so they are told, because the child is often reluctant to talk about his or her problems. It is the rare child, in truth, who is verbal enough and willing to discuss things which are “bothering” him with a therapist.

To get behind the child's resistance to talk (which is more likely the lack of awareness that there’s a problem to be uncovered), the therapist claims to be learning about the child’s problems in more subtle ways – games, drawings, play activities.

They’re not games at all, in fact, the parents are told, but methods which enable the trained therapist to look within the inner recesses of the child’s mind and help the child achieve “insight” into his “problem.”

Little Effect

I’ve suggested that discussions of feelings and talk about problems don’t appear to have much effect on helping a child learn positive, valuable behaviors when they take place between the child and the people who really have a significant role in his or her life – the parents. If the person involved in such discussions is a therapist whom the child knows only from weekly visits, there’s not even the bond of love between them which has such a powerful effect on giving a direction to behavior.

A basic tenet of both child and adult psychotherapy is that the person in treatment wants, at least on an “unconscious” level, to maintain the status quo. He resists change.

When I studied psychoanalytic theory a number of years ago, an analyst giving some of the lectures spent considerable time telling us about his patients who had “failed.” It wasn’t the analyst who had failed. As he viewed it, the patients had a “need to hold onto their illness, their symptoms.” This resistance to treatment was more powerful than any treatment methods the analyst had at his disposal, and therefore the patients “failed.”

The games and other activities the child therapist uses are means to circumvent the resistance to change: in fact, anything the child does or says in treatment is grist for the mill. It has “meaning” that can be related to the child as a person and is somehow related to his “emotional disturbance” or emotional problem.

Pictures are analyzed for hidden meanings, games are viewed with this same eye to uncover secrets of the child’s personality. Projective tests of questionable worth are supposed to suggest what is going on in the child’s mind (the most famous of these tests, the Rorshach, was recently described in an article in the Annual Review of Psychology as one which will be looked upon in future generations as “a blot on the history of psychology”).

Too Much Talk

All the myths about dealing with children’s problems and behavior at home are repeated in psychotherapy with children.

“Let’s talk about it . . .”

“Tell me what’s troubling you . . .”

Instead of going over and over the bad feelings and the bad behaviors, it is much more sensible and productive to dwell on the good, however expected the behavior, however often it occurs.

This philosophy of raising children, of helping them solve behavioral difficulties, treats children as the unique individuals they are, responding to the values of their parents and their environment instead of the “demons” over which we have no control.

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