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MIND MATTERS: Ask Dr. Ross
By: Ross Andelman, MD
We shrinks – psychiatrists, therapists, counselors – are in the change business: we try to help individuals change the way they feel, the way they think, and the way they behave. We want to help people feel happier and more confident; to think more logically and with greater insight; and to act less impulsively, and with better judgment. Before I say more about change and therapy, I want to look at change from a different angle.
Consider change in a non-therapeutic sense, in the sense of things changing around us. When you get right down to it, nobody really like change! Change is scary; it makes us anxious. We find security in knowing what to expect when we wake up or when we sit down for dinner; we like a stable reality, even a reality that is not optimum! Consider the anxiety we have all experienced moving to a new home or to a new city, advancing from middle school or high school, or changing jobs! Will there be unanticipated problems with plumbing or the roof? Will the new neighborhood be safe? Will I get lost in a sea of more students? Will I be able to keep up with harder schoolwork? None of us is completely impervious to the trepidation of the new. So, it should not be surprising that children in the foster system have a hard time with change.
For youth in foster care, there are factors that can make change even harder.
First, many foster youth have had more than their fair share of change and very little experience of a secure, dependable reality; some of them have no internalized sense of stability or security to fall back on, or to take with them from one reality to the next. When change is an ever-present part of one’s reality, there is no safe haven and the world feels like one big scary place. So, when they arrive in a new environment, their expectations might negatively color what they find in the new place. And if you are on the receiving end of a child without an internal sense of security, your best efforts at welcoming that child may go unnoticed or even spurned.
Secondly, unexpected change can be frightening. The scariest thing is the unknown. The example above – new home, school progression, and job advancement – are changes most of us can usually anticipate, and when we have some expectation of change, we can better prepare for it psychologically and experience less apprehension and fear. It is often not possible to fully prepare a foster child for a big change, so even if they have an inner capacity to accommodate change, this is undone by the element of surprise.
When we lack sufficient internal security or when we are taken by surprise, we might react poorly to change. We might defend against change by asserting rigidity – I only eat Jiffy peanut butter on white bread – or we might go to the other extreme and embrace chaos – I will throw everything I own all over the room and kick the walls. Judgment is jettisoned. In the most extreme cases, anxiety gives way to despair or anger.
Back to therapy: I lied a bit. Although we therapists are in the change business, I would like to suggest that we are really in the partnership-in-change business. I think that the most important part of our job is to be empathetic with our clients as they traverse inevitable or even catastrophic life changes, kind of like holding their hands as we cross a busy street, teaching them to look both ways while assuring them that we have already done so! An, of course, I am still lying a bit: this is not a job just for a therapist. This is the job of the parent or foster parent: It is up to us to shepherd the kids in our care as they face changes, small and large and to be sensitive to the vulnerabilities borne of experiences over which they have had little control. They cannot help but bring these vulnerabilities with them into any and all new situations, and it is up to us to show a degree of tolerance for their struggles and to praise their achievements. By taking on the role of partner-in-change we promote the development of an internal sense of security and help our children anticipate new experiences without fear and become more resilient in the face of the unexpected.
Now it is your turn! I want your questions and concerns to drive this column. Fax or email your questions to: Mind Matters – Ask Dr. Ross c/o Rachel Goldman Sklar, email: goldmr@ehsd.cccounty.us; fax: (925) 313-1758.
From Contra Costa County Foster Families Newsletter, May/June 2006