Department of Applied Psychology, University of Portsmouth, England, UK
Received date: January 20, 2016; Accepted date: February 17, 2016; Published date: February 26, 2016
Citation: Thomson W (2016) “ I’ ve Got the answer” - Family Therapy. J Psychol Psychother 6:241. doi:10.4172/2161-0487.1000241
Copyright: © 2016 Thomson W This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Paul1 a boy of eight was referred to the family therapy centre by his general practitioner for encopresis of six months duration. Unbeknown to me a referral had previously been made to a regional children’s unit because of the seriousness of the diagnoses. Where an appointment had been arranged for two month’s time.
I made an appointment to visit the family at home. They lived in a small country village where Paul went to school locally. Paul opened the door and invited me into a small well - kept cottage. He introduced me to his parents who were clearly in fear of my visit. The mother dived in to explain that Paul was soiling himself at home and at school. She showed me the washing on the line outside drying, and led me into the small scullery. Inside were sheets soaking in the sink and clothes were in various buckets. The father looked on nervously smiling benevolently while his wife showed her disgust. – She gave the impression that it wasn’t her problem anymore and looked to me to do something, and here was the inconvertible evidence! Paul hovered in the back ground with his hands in his pockets waiting for my conclusion as if he too was looking for a remedy. We moved into a small living room where Paul’s mother talked about their life and how Paul’s parents and grandparents had all worked locally, never travelling far beyond the village. They were clearly hard working country folk who took pleasure and pride in living simply. Paul’s mother kept referring to the grandparents saying that they were stunned and distraught by the problem. Paul as the only son and grandson appeared to be central to all their lives and his encopresis was obviously a shock which they all shared but could not understand, or tolerate. Paul had slipped from being exalted to being a unprecedented conundrum in the family.
On that first visit I got the impression from Paul that the soiling problem did not appear to have any emotional impact such as guilt, or shame but something which just happened like getting mumps or measles. The mother was the spokes women and reflected predominantly the annoyance of the family. I suspected that the grandparents were a absent force to be reckoned with, goading her into doing something about it. So exasperated was Paul’s mother on that first visit that she issued an ultimatum that “From this day Paul will have to wash his own clothes, and bedding”! She looked at me menacingly as if to say - take that! I felt like a mechanic employed to fix a car that wouldn’t start but that nevertheless it was my fault and it was now my responsibility.
I made another appointment and returned once again to be greeted by Paul. This time he was on his own which I suspected was deliberate – and that his parent’s had decided to absence themselves from what was now my problem.
Paul appeared quite excited saying “I’ve got the answer, come with me”. Interested to hear about the answer I followed him to the scullery and he showed me a bucket and a box labelled Bio-active! He explained to me that all he had to do was to measure out the correct amount of Bio active into a bucket of water, stir it and leave the clothes to soak. Problem solved!
I was interested to learn how he came up with his solution since he only had access to a small village shop. He told me he had read the laundry products for sale in the shop and had paid for it with his pocket money. There was something amusing about Paul’s attitude he was managing the problem in an unemotional detached manner in some ways similar to his mother’s detached and unrealistic standpoint. Naturally most children would find different and more enjoyable ways to spend their pocket money but he was excited to have found what he thought was the solution!
needed to find out more - I was interested to go beyond the soiling. I made an appointment to visit Paul’s school. The headmaster had arranged for Paul’s class teacher to join us in her coffee break. They saw it as a classroom difficulty, managing the soiling within a class of some thirty children was a practical problem. The teacher explained that Paul had to sit at a desk on his own in a small annex adjoining the main classroom, but he was unpopular because of the smell and the mess. For his teacher it was managing the class of children and the mess so that she could teach. A cleaner had been made responsible for cleaning up the mess - she had a stock of underpants provided by Paul’s mother. Unless something changed the management system would remain in place as the school staff felt everything was working well and was under control.
We discussed Paul and his attitude: the teacher’s saw the soiling as a problem that needed practical management. She explained that Paul appeared quite adjusted to it - working alone in the annex and although not popular with the children they tolerated the soiling. He wasn’t bullied in fact his self – reliance attracted children to him on the one hand, but the smell and mess repelled them.
I left feeling the school was a good caring school who had not punished Paul but who had worked out how to deal with what to them was a management solution.
I needed now to work with Paul. I was increasingly of the opinion that Paul was bright probably brighter than average and definitely brighter than his family. Up until now everyone had colluded by dealing with the mess once it had been created which historically was how the family and now the school coped with issues. I saw my job as concentrating on change. What was the mess? I had the strong impression that the family were reliant on Paul for his acumen. Now this reliance was in jeopardy he was in danger of being ostracised both at school and at home but neither he nor the family could stop the soiling. The parents, and I presumed the grandparents, were in awe of him. To some extent he was influencing the school and his home and their reaction and management of the problem: At school he was removed from the class and his contemporaries. At home he was no longer revered beyond his eight years.
I gave considerable thought to the abnormal situation and came to the conclusion that : Soiling was regressive he wasn’t ready to be an adult. If I was right my task was to help him as the child, but reinforce his capacity for growth using the cooperation of those who could best promote that growth. From that day I never mentioned the soiling seeing it for what it was a symptom of an emotionally disturbed misunderstood child.
Using myself in the first instance but then enlisting the help of the school and the education system was the strategy. This strategy was based on the fact that Paul’s difficulty centred around his level of functioning which was much superior to that of his family.
I hadn’t appreciated how socially impoverished the family were, but I learnt that they hardly ever left the village. Paul had never been to the main - town some six miles away. I decided to take him on an outing to a nearby castle. He absorbed everything: the car, the journey, the history, the orange squash and cake. The trip gave me the opportunity to get to understand him without seemingly interrogating him. I wanted to know more about his interests, his thought processes, his dreams and aspirations. When I asked him what he most wanted to do he surprised me by saying he wanted to play a musical instrument, particularly the cello. I revisited the school and discretely aired my view that Paul was a bright boy? But in a dilemma: exalted at home beyond his years. The teacher became interested and shared how he was now progressing in the classroom, suggesting his potential hadn’t been realised before? I kept visiting the home and provided encouragement and support for the parents and indirectly to the grandparents who although I had never met were clearly revered by Paul’s parents.
I contacted the local musical education department and discussed the possibility of Paul loaning a cello and having music lessons at his school. Paul was delighted and volunteered to pay for the cello out of his pocket money. His parents were both dumb founded and frightened by the news. They needed support to provide Paul with the necessary encouragement. It was a huge and frightening progression for them.
Paul began his cello lessons in earnest much to the admiration of everyone. He progressed rapidly practicing at home with his parents in awe of their son. The music stand and cello were on display all the time enabling him to pick it up and practice whenever he wanted to: the key to progressing rapidly. The culmination of this was he was asked by the headmaster to play a solo in the school assembly to which his family were invited. I made sure Paul’s parents appreciated the part they had played in his recovery by not thwarting his ambition and by allowing him the space and time to practice. Paul’s soiling had become a thing of the past.
Paul was a lonely little boy regressing on the one hand and growing intellectually on the other far beyond the functioning of his family. He needed rescuing from an unsustainable situation. The school needed support to see him through the transition from being a nuisance to being a gifted child - they fulfilled this role admirably. The parents needed support to cope with the unprecedented impact this had on them and the extended family. Instead of supressing his talent and trying to restrict him they needed to promote and sustain him, and not to see him as a threat but as their child to be nurtured as part of and a product of their family. A son to be proud of.
He had found the answer but it wasn’t Bio Active.
In the meantime Paul was making progress and he had stopped soiling. I was invited with the parents to attend the consultation which had previously been arranged. During which time I presented the case: The outcome was that he wasn’t admitted and that he continued to progress: emotionally, academically, and musically.