Contributions from Analytic Work with Children and Adolescents

The Parent-Child Relationship

Amy Eldridge, PhD

The parent-child relationship is like a marriage; it is ripe with possibilities and fraught with difficulties. Working with parents from the perspective of self psychology requires an understanding of the complexities of this relationship. Ideally, parenting is an opportunity for growth, as the parent's self expands in response to the child. I quote Miriam Elson (1984), who wrote so eloquently about parenthood from the perspective of self psychology:

It is not that parents, recognizing the experiences of their own childhood, seek to undo such experiences in their children; such an approach would in effect, intrude the parent's needs. It is that the parents are now empathically in tune with childhood needs. When they are in tune with the child as a center of perception and initiative, parents can exercise the guiding and confirming relationship such needs dictate. In process there is implicit humorous sadness in relinquishing a goal anticipated for one's child, some increase in wisdom in recognizing and supporting the direction of the child's goals, some acceptance tinged with sadness of one's own transience in relinquishing the position of centrality in the child's life. At work here is a simultaneous process in child and parents, a double helix of the formation deepening, and elaborating of narcissism in the child and the further transformation of narcissism in parents.

Erika Schmidt and I (1990) introduced the concept of the parental self, which develops in response to and in interaction with the expectation, birth and growth of children. The ideas are similar in asserting that, in parenthood, the self-state of the parent is deeply affected by the response of the child, and in reverse, the child's development is deeply affected by the response of the parent. The parent child relationship provides each member with needed self object functions.

When a child fails to provide selfobject functions, through anomalies of development, or because of the particulars and/or massiveness of the parents needs, they are at risk for developing the kinds of symptoms that bring parents to seek help. Too often children are depended on to restore a fragile parent's self - especially in the absence of more appropriate selfobject experiences, as when family of origin or marital issues are at play. When these children not only fail as selfobjects but become problems in their own right, parents are so lost in their own distress that they cannot respond reasonably to their children.

How then does a therapist form an alliance with parents in this state? One understands many therapists' wishes to bypass parents and just work with the child. The challenge is enormous, and the answers are not easy. Isolated issues in healthier relationships are obviously easier to respond to. These parents are often relieved to find help and understanding. They then can utilize the therapist's elucidation of the child's issues to enlarge their empathic capacities.

In contrast, when a child's symptoms are embedded in a troubled family, troubled parent and/or troubled marriage, they are just the tip of the iceberg. Parents often hope that the therapist can address the symptoms without addressing the problem. However, addressing the symptom is double edged, as to do so risks evoking intense shame reactions in parents. Parents comes to the therapist hoping for help and defensively resisting it, for it confirms their sense of failure for the therapist to be involved and to help (Hoffman, 1984). Parents' efforts to manage their vulnerability, made worse as they struggle in their role as parent, may lead to the sorts of behaviors that we find to be difficult.

I offer the following suggestions. First, meet with parents on their terms. All too often, I have found that there is good reason why one parent is excluded from the consultation. While excluding does not ultimately help, I have found that honoring the request has more often been helpful than not. Only when the reasons for exclusion are understood, can they be dealt with. And, that takes time. Second, address the parent as a colleague who is consulting you. Respect and sensitivity are paramount. This is like a topical balm for the parents' sense of deficiency. While not deeply restorative, it is an attitude that simply helps. Finally, listen for the breakdown in the parent-child relationship, ie, the selfobject failures between parent and child (Leone, 2001). There are often multiple failures that underlie a parent's request for help. Recognizing that the parent feels both failed and like a failure is the beginning of an alliance.

Within the first sessions, developing some understanding of the parents is essential. One must enter the parents' subjective experience to understand how disturbed they feel by their child's behavior; remembering that the child is likely being experienced in ways skewed by transference. It is important to really appreciate parents' sense that their child has failed them, even when the therapist feels that the parents have failed the child. The feelings of hurt and harm that parents feel in response to the child are very real and must be understood in order for treatment to proceed. I have found that if I respond to the parents' distress initially, I will later be in a position to help them understand their child's distress.

When it is not possible to develop this level of empathy with parents the treatment process is much more precarious. In some cases, parents may be dispassionate and detached in order to avoid the vulnerability of experiencing the child as a selfobject. I have written of child neglect as a symptom of a parent who sacrifices closeness to the child in order to avoid painful emotional states (Eldridge, A & Finnican, M, 1985).

Parents who have been subjected to trauma in their own childhood are likely to approach parenting with a combination of rigidity, vulnerability and poorly organized internal states. In these cases, the therapist has the difficult task of reaching a parent whose subjectivity is filled with painful affects and whose self is extremely fragile. Even exquisite sensitivity on the therapist's part may fail to foster an alliance. Therapists then face the dilemma of trying to give some meaningful relational experience to the child in whatever time allotted or choosing not to see the child and risk possible interruption. I usually choose the former, as sometimes it works and this is then very helpful to the child.

A decision must be made about whom to see. Optimally, this decision is made on an assessment of what configuration will best restore the parent-child relationship: restoration of the parent, the child, the parental alliance, or some combination. Often, this decision is influenced by the parent's state. The parent may insist that you only see the child, or that you never see the child. When parents insist on a particular plan, I have found it best to follow it. The parent-child system is the patient; following the parent's lead is like the process of free association. If allowed, greater understanding will be promoted. To counter often engages the parent's defenses before an alliance can be made. A non-linear dynamic systems perspective suggests that, even if the therapist has conviction about how the therapeutic process should proceed, it will proceed in unpredictable ways.

While difficult, work with parents presents the opportunity to therapists to create dramatic change within the system. When the child is seen and a parental alliance is in place, the therapist is both able to help the child directly and to assist parents in developing empathy for their child. To do so, the therapist must, based on sustained empathic emersion into the parent's experience, interpret the parent's response to the child's behavior. Then, the therapist can help the parent understand that the meaning of the child's behavior is different than the parent attributes to it. With greater understanding and a less fragile self state, the parent is more likely to respond in helpful ways to the child. Over time, and as therapy proceeds, the child is usually more able to respond positively to the parent.

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