Mike

Mike was brought into treatment by his mother who described him as defiant, unresponsive, constantly cutting school, uncooperative with all family rules, and smoking marijuana daily. Our sessions quickly took on a very different course from that of most adolescents in his situation. I said very little, yet his behavior began to change substantially in only 15 sessions. 

His mother was in fact angry at me for not reading him the riot act. For example, he had agreed to call her when he wanted to stay out late, but he persistently "forgot" and just stayed out. As result, she would become understandably incensed, causing greater friction in the house; Mike would then lose privileges and in general have a more miserable life at home. A simple "Ma, I’m at my friend Jim’s; I’ll be home an hour late if that’s OK" would have allowed him to stay out and would have avoided all the hassle. 

Why didn’t I simply tell him this? Two reasons stand out among the many: First, I didn’t have to. Mike was more than smart enough to know already. Second, it wouldn’t have worked. In all the talks he’d had with guidance counselors, school principals, relatives, and his parents about his behavior problems before he came to me, this had been pointed out to him more than once. What magic would be accomplished by my repeating it? When someone is acting so counterproductively -- when they fail to see the painfully obvious -- unless they are simply dumb, the explanation for their behavior must lie outside the obvious realm of real life situations and logical choices. The conclusion must be that Mike was acting out unconscious feelings.

But Mike and I didn’t discuss those feelings much more than we did his symptoms. Still, Mike began to calm down and think clearly. His own natural and formidable intelligence came into play, and he found his own way back from being lost and stuck. He came in one day and reported some big changes. One feature of his personality that had troubled many, including the school psychologist who tested him, was an apparent fantasy that he would always be able to "handle it", that things would always work out, despite the mounting evidence to the contrary -- his ever deteriorating academic performance and interpersonal relationships. Suddenly Mike told me he saw that attitude as "big talk; I just say it to convince myself". We were then able to discuss his true and quite opposite feeling of impending chaos and total failure. At the same time, he started to see how counterproductive some of his behavior was. He started complying with the few rules and limits his family imposed on him and he stopped cutting school and smoking marijuana, much as he still wanted to. He even told me how these behaviors were part of avoiding the great discomfort of his true feelings about himself and his life; he would cut school and avoid contact with his family in large part because dealing with school and family reminded him of how scared, inadequate, and out of control he felt. 

Mike and I never talked about his past, nor did we analyze his behavior. I did not administer advice or in any other way try to talk him out of his behavior. I did not work with the family on their handling of discipline and rule-breaking. I did not try to get him to see the irrationality of his behavior, nor to generate alternative behaviors, nor did I teach him "coping skills". I did not even try in any direct way to get him in touch with his feelings (even the phrase wreaks). In fact, I might be hard pressed to describe exactly what I did do. But you cannot argue with data, and the data are that after over 5 years of deteriorating behavior, a few months of psychotherapy and this boy was turning his life around and feeling much better. And he is not a unique case. 

So what did I do? I provided a relationship, a space in which Mike could experience, remember, feel, and process. Sounds rather fuzzy, I know, but it worked. It was, for example, in the context of our relationship, within its safe, reflective, and yet light atmosphere, that Mike finally began to question his original position that he "just forgets" to call his mother. He remembered that in the moment he actually does think of calling, but then immediately says to himself, "Nah, it’ll be easier not to". This little piece of internal dialog was always edited out of awareness. Now, however, he remembered it, reported it out loud to me, and in the process saw how silly and counterproductive it was. He recognized in it his habit of retreating into bravado when he feels uncomfortable.

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