Department of Applied Psychology, University of Portsmouth, England, UK
Received date: February 17, 2016 Accepted date: April 12, 2016 Published date: April 20, 2016
Citation: Thomson W (2016) Loss, a Lame Dog & Beyond! a Family Therapy Case Study. J Psychol Psychother 6:256. doi:10.4172/2161-0487.1000256
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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The referral came via the general practitioner: a girl of ten was suffering from encopresis. I made an appointment to visit the family with some urgency. The family lived on the outskirts of town in a Victorian semi-detached house. When I arrived it was a desperate scene: Joan1 a young woman pregnant trying to cope with a crying child hanging onto her skirt. She was alone with the child and my request for a meeting with all the family present was obviously not going to happen. Joan told me the family consisted of the toddler and three children of school age. The little girl with encopresis Sonya was the eldest of the children now at school. Joan’s partner and the father of the children including the unborn child was away all the week and sometimes much longer working as a shop fitter.
The young woman looked depressed and down trodden she just couldn’t cope.
Joan cried while explaining the position. She had been a student nurse age twenty enjoying her training when she met John age forty five. John was divorced his previous wife had left him in the house with the four children. Joan and John started a relationship, Joan became pregnant and then moved into the home with John and his four children. John then took a job away in another part of the country which meant he was away for increasingly long lengths of time leaving Joan alone to look after his children. The children were insecure they had lost their own mother who now had nothing to do with them. Money was tight and Joan didn’t have enough money to manage. On top of this Sonya began soiling and smearing which involved all the extra work: washing, drying, wiping the mess off the walls and the smell to deal with.
It was not surprising that Joan was depressed. She felt John was taking advantage of her. She told me that she wanted to turn back the clock and continue training for the profession she loved, she knew she had made a huge mistake.
She told me she disliked Sonya because of the soiling, and explained how Sonya would soil her underwear and then hide it in a draw which would then contaminate and soil the clean clothes in the drawer. Sonya would also smear faeces all over the bedroom which meant the house always smelt but it was very difficult to clean. No sooner had Joan cleaned than Sonya would repeat the soiling. Joan couldn’t keep up with the relentless demands of Sonya’s soiling and looking after the children. John the children’s father would only come home briefly and then leave unconcerned about Joan, the children, and the mess he was leaving behind. Joan sobbed explaining that she couldn’t go on. I left her realising that the situation was critical Joan was now the pivot of the family albeit a reluctant one. I could see that she was in fact a very good caring young woman who couldn’t just up sticks and leave the children to the mercy of their father, although that is what she most wanted to do.
My next task was to visit Sonya’s school. I arranged to see the headmaster and find out how Sonya was managing but also how the other two children were reacting. The headmaster was very welcoming and proud of his school. Sonya he told me was a very good pupil but the staff had noticed deterioration recently: she appeared ill and they didn’t know why. They did not report that she was soiling at school which was interesting. They said that she would ‘mother’ her brother and sister and was a influence for good to the other children in the classroom. I didn’t disclose the whole story but explained to the staff that Sonya was a very disturbed little girl asking them for their help and forbearance while I was trying to help the family. They were very understanding and cooperative I left them suggesting I would return in due course. Various social workers had been involved but hadn’t visited recently. If they had they would have most probably put the children into care.
Time was not on my side the problem had not occurred overnight but over a number of months. Clearly it was a family problem. On the one hand I needed to support Joan on the other I needed to help Sonya. I arranged to meet Sonya on her own - she was a frail, slight, nervy child. Fidgeting with her clothes and staring preoccupied out of the window. I started gently trying to engage with her and eventually she turned to look at me and told me about school that day. I felt I had made a good start and together we joined Joan in the living room to have a cup of tea. Joan talked about her nurse training and what she liked about it and Sonya appeared interested.
I could see that they both had loss in common, Joan a loss of freedom and Sonya loss of her mother and stability. I knew Sonya was responsible enough to also have worried about her brother and sisters. When Joan and Sonya were together there was no obvious animosity between them. If I could strengthen their relationship then there might be hope of stopping the soiling, thus reducing the burden Joan was carrying and that maybe that they would help one another. They both had the quality of caring and kindliness.
I decided that I would aim to take them out together away from the home while the youngest toddler was at nursery. It was a very successful but simple outing, just looking at clothes in the shops and ending up with tea and cake. They chatted together throughout and I could see a relationship in the making, they had a lot in common. I repeated the outings regularly leaving them with little tasks they could share such as sewing etc.
But I needed to speak to the father, I sensed he was avoiding me and I hadn’t yet met him. Two months after the first meeting with Joan I met him. He wasn’t impressive. He wasn’t prepared to do anything and didn’t show any responsibility towards his family at all. It was obvious he was using his job away as an excuse to stay away. He tried flattering me – obviously used to conning his way through life. I also met the remainder of the children all suffering in different ways – in this respect the school were amazing: Thinking up different ways of intervening such as awarding gold stars to the children and particularly selecting the children for different school involvements to raise their self esteem. I continued to influence the relationship between Joan and Sonya in various ways. The break through came when Joan rang me was excited to tell me Sonya had won an award - she was so pleased. Joan and Sonya were sharing household jobs, shopping and jokes. Sonya had stopped soiling and smearing.
Joan had the baby which was swiftly followed by the bank foreclosure on the house: the father had not been making payments. The family were rehoused into local authority housing. Social services called a ‘at risk meeting’ and the chief social worker asked why the family had received so little support and why was it all left to me a family therapist ? Social services took over from me providing resources for the family which I did not have access to.
Sometime latter Joan came to see me saying she was pregnant and she wanted advice - she was thinking of a termination? We caught up on the family situation and I was pleased to hear how both Sonya and Joan were getting on well, and that Sonya was doing well at a new school. We parted with Joan needing to decide about the unborn child. Some months later Joan again asked to see me and showed off a new born baby. She told me that the money which was returned to them once the house was sold by the bank was being spent on a wonderful Christmas. Lavish presents were bought for the children including drum kits, for the boys [ in a small terraced house? ] party frocks etc. including a family dog who had been rescued from a dog shelter. The dog had a deformity which would cost £3,000 in vet bills! Various images passed through my mind: How would the very near neighbours react to two sets of drum kits. And why on earth select a deformed dog?
Some years later I was delighted to see Sonya the subject of an editorial! Social services were writing in the local paper about their success stories. She was obviously doing well: the picture showed her looking very attractive living in a nice house. She was married with two children of her own, she had a baby on her knee the other child a toddler was cuddling the baby.