Emergence Techniques Used: Visual Dialogue, Direct Emergence
Personal Skills Age (estimated age at the time of the original injury): 8
Key(s): hearing the words, "sit still!"
Alice was young when she first came to my office. About four, I think. What brought her to my office that day? Her mother, who had been seeing me for some months, had no sitter.
Even now, I can picture how still Alice sat, her mom across from me, and she, happily coloring in the chair nearest my bookcase. Because she was so young, her mother and I had been concerned as to how well Alice would tolerate the session. Rightly so. It was, after all, therapy.
In hindsight, Alice did quite well. And so did we. Until her ride home, that is. On the way home, Alice told her mother she never wanted to come back.
Not surprising. She was, after all, only four. It simply had been too stressful for her, perhaps because she had seen her mom cry briefly. Whatever the case, though, two weeks later, Alice came again.
Why? Again, her mom had no sitter. Fortunately though, by the end of this session, Alice seems to have reversed her opinion of therapy, so much so, in fact, that a few years later, at the ripe old age of seven, she asked her mother one day if she could have a session of her own with me. She said she needed to "see Steve" because she was so angry at her friend she wanted to hurt her.
Even today, I see this request as one of the more genuine diploma's I have ever earned, and Alice is still the youngest person ever to ask to have a session with me. I guess that also makes her one of the bravest as well.
Now her "can't sit still" story.
Alice's story begins with the day her mother asked me to help her. As her mother asked, I immediately read the pain in her eyes. And realized she was probably suffering as badly as her daughter. After all, she loved her daughter but was repeatedly unable to connect to her after having been very, very close to her.
In a very real sense then, Alice's mother was grieving a painful loss. At t the same time, she was hoping for a miracle.
What I also saw was pain she felt from repeatedly failing to do what she saw as her duty as a mother. In essence, she had repeatedly failed to help her daughter to "sit still," both at home and at school. In fact, part of what had prompted Alice's mother to ask me for help that day was that Alice's school had called. In this call, she was asked to consider putting her daughter on medication, that Alice had not only become unable to keep up with her schoolwork but also had become a distraction to the other kids in her class.
Can you also imagine how guilty and alone Alice's mother felt, and singled out as well? After all, any parent watching their child suffer like this would feel much of the same pain the child felt. Being that Alice's mother and Alice were closer than the average mother and child only added to this pain, and to be honest, she literally seemed desperate.
Of course, I'm sure Alice felt all this and more. She was also being singled out; the kid who was distracting the class. And can you imagine how alone this little girl felt, especially in school? Any young child who is seen as significantly different from others suffers deeply from the pain of this aloneness, even if this pain doesn't show.
I, of course, immediately agreed to do my best to help Alice, adding quickly that I had little experience with such difficulties and so, could guarantee little other than my sincere involvement.
Alice's mother asked if I would try anyway.
I, of course, said yes.
As they arrived that day, I was immediately struck by how different both Alice and her mother were from the two people I knew them to be. Incredibly so. They both seemed really nervous, this despite the fact that the three of us had enjoyed a warm, safe relationship for years.
To be honest, even I felt nervous. And I grew even more nervous still as I continued to be unable to comfort them. After all, failing to comfort people is not what I am used to. Thus, within minutes, I, too, was nervously struggling. Probably very similarly to how Alice's mother had been struggling.
At this point, I did what I always do in these tough situations; I began to search inside myself to see what I was feeling. I do this knowing that in most cases, my insides, what I am experiencing, will reflect the feelings of whomever is seated across from me, what they are experiencing. Thus, what I'm feeling is usually a lot like what the other person is feeling.
This similarity was true here as well. Thus, as I self examined, I realized, I, too, felt nervous and anxious and confused and worried. Very much so. In fact, to some degree, I even felt unable to get my own thoughts and feelings to "sit still." More important, though, I realized how alone I felt. I felt very, very, very alone. Not my usual state. And the more I felt these things, the more I realized that what I was feeling was but a small window into what they both had been feeling.
At this point, my heart went out to them even more. I then pushed myself past these feelings and began, as best I could, with a visual dialogue.
The "Visual Dialogue"
Having never intimately dialogued with anyone with ADHD before, let alone an eight year old with ADHD, I had little sense of where to begin. I knew theoretically where to begin though; with what Alice could not picture during a time when she couldn't sit still. Still, how was I going to find such a time? Where should I even begin?
I said a prayer. Then, trusting the process, I began with the obvious. I asked Alice to tell me what it was like to be her, beginning with her sense of what it was like to be unable to sit still.
Do you know how odd it is to try to have a conversation with someone who can not sit still? I was just not used to this. As I continued, then, I began to have even more sympathy for those who must care for these kids. After all, they, too, must suffer from great personal aloneness, perhaps as much as the children themselves. Perhaps, at times, even more.
It's funny how concretely an eight year old reports. Very directly and honestly. Within minutes, then, Alice was describing a recent scene in which she had seriously cut her finger. She had been down in the basement opening a a can of cat food.
At first, she said, she tried to "fix it herself." Then, when she couldn't, she then went upstairs and showed her mom. Finally, after Alice's mother also failed to be able to stop Alice's bleeding, she told Alice she would probably need stitches and so, the two of them quickly drove to the doctor's office.
At this point, Alice really started getting squirrelly. Twisting and turning and barely able to continue telling me her story. Even so, she did her best, and soon, we had what I was sure was the wounding scene. And even if this scene was not the original wounding scene, From Alice's reactions, I knew we had at least a "representative" wounding scene, a scene with which we could create a healing scene using direct emergence.
The "Direct Emergence"
At this point, I began setting the stage. I did this by asking Alice to describe in more detail what the doctor's office had looked like, especially what it looked like from where she had been sitting.
Next, I asked Alice's mother if she would sit in the chair to Alice's left and hold her daughter's hand. Here, I felt pangs of guilt as I witnessed this scared, skinny little eight year old squeeze her mother's hand tightly and continue to squeeze it.
Ugh. Some sessions are just much harder than others.
This one was really hard.
Next, I asked Alice if she would show me where to stand, that I wanted to be standing in the same position her doctor had stood.
She positioned me to her right and somewhat bending over her with my right hand reaching out toward her arm.
I then asked Alice to position her arm the way she remembered it being positioned.
She then rested her arm on the arm of her chair, turned up and palm open.
Does the irony of what I was doing here hit you yet? Here, I was asking Alice to be on a stage wherein she had to sit still in order to heal. Yet this was the very thing she had come to me to help her to heal; her inability to sit still. In fact, despite her best efforts to sit still, Alice still had a heck of a hard time trying to stay in that seat let alone stay still in the seat. She was obviously doing everything in her power to not just get up and leave.
Soon we had set the stage, though, so much so that Alice's fear began to increase visibly. Here, I began to have even more concern for Alice and for whether she would be able to tolerate the healing process. After all, she was only eight. How much could I ask her to bear?
Looking to her mother helped me though. Her mother, having worked with me for years and having witnessed many miracles, seemed a bit more confident than I. Certainly her openness to what was unfolding in the room was a significant factor in her daughter's even trying to go through this process. This, then reassured me as well.
Once more, then, I pushed my worries aside and began with the process of "playing the bad guy"; meaning, pretending to be Alice's doctor about to stick her with a needle.
Here again, is yet more irony; you have to get stuck with a needle; the anesthesia; in order to not feel a needle; the stitches. And from what I was seeing, I knew Alice had been wounded by seeing the anesthesia needle. What made me think this? Alice stopped being able to picture the scene right in the moment in which her doctor had leaned forward to give this needle to her.
Think about what I'm saying. Alice didn't get injured from getting stitches. She got injured from seeing the anesthesia needle coming toward her. Equally important, too, is that fact that she had been injured before the needle even touched her arm. The hurt had happened in her head, from what had she experienced from picturing what the needle would feel like.
This "getting wounded" before the actual physical pain is very common. In fact, I would say I have seen this occur as much as injuries from feeling actual pain. Odd. Still, we already know how powerful the mind can be. This is simply yet one more example, albeit, a very significant one.
Using a paper clip, I unfolded it until Alice was responding to it the same as if it was a hypodermic needle. I then began to slowly go through a series of repeated attempts to move the paper clip toward Alice's arm while at the same time, getting her to continue to connect to my eyes.
This was the hardest part, and to be honest, I several times found myself wishing I had not agreed to do this. It was simply too hard. Still, I continued to do what I knew had to be done, all the time watching Alice and her level of shock.
This, then, was what ultimately guided me; Alice and her level of shock. Gradually, then, through repeatedly redoing the wounding script, Alice began to noticeably reclaim her ability to stay present. More important, she began to reclaim her ability to visually witness the scene.
Finally, I knew to stop. More honestly, I had witnessed all I could take of this brave little girl's suffering. I had hit my limit. And I told Alice and her mother this.
Alice, on the other hand, seemed pretty open to continuing. Interestingly enough, though, although I noted this openness, I missed the deeper significance of it.
In hind sight, the significance was obvious. As are many things in hindsight. Whatever the case, though, at this point I told Alice and her mother I had done all I could that day; that it was simply too hard for me to witness Alice suffer any more.
Alice's mother and I returned to our seats.
The End of the Session
At this point, Alice's mother and I began to process what we had seen. She, of course, still worried about her daughter, wanted to know what else we needed to do, what was left.
Almost reflexively, then, I told her she needed to watch for any changes in Alice, that while I was sure we had helped Alice to heal some of her difficulty, that I had no way of knowing how much healing we would actually see.
Some of you may now realize that I was, in this instant, having a moment of little faith. God, I thought, what was I thinking, agreeing to try to help such a young child with such a serious condition. Adults are one thing. But little kids.
Quickly, this thought passed, though, and I remembered my intent. I also began to remember how often I have seen my sessions end with what others would call miracles.
How odd, then, the perfect timing of what came next.
Almost simultaneously, Alice's mother and I stopped our conversation and turned completely toward Alice. Why? We both realized that Alice was sitting perfectly still. Then, as the both of us stared in disbelief, our concerns eased a bit as we realized the truth; that our efforts had made a difference. How much of a difference and how permanent was yet to be seen. But the difference we were seeing was startling. At least in that moment.
Cautiously, we both hoped out loud to each other that this change would some how be permanent. Then, as we closed, I assured Alice and her mother that should they need my help, they could count on me to be there again.
Several years have passed since that session with Alice, and in these years, the improvement Alice's mother and I saw in Alice that day has remained a constant.
Am I saying Alice displays no evidence she was ever injured?
No. Not exactly. And to be honest, this is often not the case. Perfect healing is not normal in our world.
What is important though is how different Alice became. She and her mother again became able to deeply connect, and today, they are closer than ever.
So how much of Alice's injury is yet unhealed? Hard to say. She is still a rather energetic and enthusiastic kid, to say the least.
Even so, if you asked me to say how much of this energy is her injury and how is much simply her natural enthusiasm for life, I'd have to say, probably most of what you'd see is just who she is, simply a wonderful, healthy and beautiful part of her nature.
What is most important for you to hear and remember though is what happened to Alice's ability to connect. Has this improvement stayed?
Yes. Absolutely. Along with her restored ability to stay focused when need be. And sometimes, her ability to sit still is even better than normal.
As for medications, to date, Alice has taken none. She hasn't needed them.
And for this, we are all grateful.