Getting Unhooked

Connecting with Traumatized Kids who Push Your Buttons

Martha Straus

Screen Shot 2014-09-15 at 2.42.41 PMJenna is waiting for me, perched on the edge of her seat outside my office. The moment I open my door, she springs out of the chair. Though it’s just a few feet to my sofa, she can’t wait to cross the threshold before she bursts into a tirade. Today, she works herself into a high-pitched lather about the mean woman at the DMV who wouldn’t accept her documentation to get a learner’s permit. As with many of the tougher adolescents I treat, Jenna’s defiance and woundedness go hand in hand. I sit back, nodding and clucking supportively. Until she gets the story out in full, there’s no bigger role for me.

My work is still hard, though. I have to be as fully present and attentive as I can, letting go of my anxiety about her, a tendency toward judgment, and some informed skepticism about her version of events. If I respond too soon, or too fully, or ask a question that suggests, even in the slightest way, that I’m not all in, she’s furious with me. ”Just listen to me and don’t interrupt,” she demands.

Most weeks start this way: someone—a so-called friend, an employer, her boyfriend, a parent—has done something to thwart her, and she’s undone by it, preoccupied with unbearable injustice. About the DMV bureaucrat who suddenly needed additional forms of ID, Jenna fumes, “I’ll curb-stomp that woman if I see her in town and leave her bleeding.” By now, I know it’s just bravado; that’s how bad she feels.

Sometimes I get tangled up in a convoluted story and completely miss Jenna’s intended point. Then I’m the one letting her down. Although I don’t screw up on purpose, these small but significant and recurring ruptures are essential to our work. Despite my aversion to conflict in my personal life, I take in her searing glare head on, knowing my work is strongest when I’m fully engaged with her disappointment in me—when I feel wretched, too.

The metaphor I keep in mind at these times comes from driving on icy Vermont roads at night. When my car starts to slide, I know I have to turn into the skid, even when it’s scary to do so. With Jenna, when I get it wrong, we practice on our own slippery hill. I apologize for being confused; I might beg her to slow down to accommodate my aging brain. I commiserate about how hard it can be explaining yourself to people, and thank her for trying again. I feel her mounting irritation, my anxious defensiveness, and I think, Aha! Here’s the hook. Here’s the unbearable way it is for her in relationships. How do I unhook or at least go down trying?

Although patience isn’t her long suit, Jenna is beginning to know, in her heart, that I’ll do what I can to fix things between us. My job is to feel calm with her. It’s not a matter of just teaching her isolated coping skills. If she can be mad at me, she can also come to feel, in real time, what it’s like to let go of smaller injustices. Practicing that with her loving but befuddled therapist is as safe as it gets. And her nascent acts of forgiveness are thrilling to me; they mean we can get back onto the road with more traction, together.

By the end of the hour, even when we begin with her raging and sobbing, Jenna usually leaves more cheerfully. She’s much less reactive than when she entered, and, best of all, we’re more in sync. When I’m able to be present in this way, my cooler, more regulated brain lowers the emotional temperature of her hot head. Over the year or so that we’ve been meeting regularly, she’s allowing me to comfort her more and more, using me more effectively for soothing. This is the wonder of what I call Time In.

Essential to the reflective practice of Time In is an intentional relationship with an adult who really shows up—self-aware, engaged, and compassionate. For me, and for most people I know, these vital qualities are not automatic: they have to be developed and practiced. To play our part, we must first foster our own capacity to self-regulate before we can demand it of a terrified or furious teen. Thus, we need to be aware of our own attachment styles and of theirs. We may sometimes have difficulty believing we can be important to a defiant teen, but this uncertainty often reflects our own history of insecure love and desire for self-protection. Attachment is a two-way street: it’s not just about them.

Our default use of Time Out and all the cognitive emphasis on teaching self-soothing and problem-solving skills miss the point with these most vulnerable kids, for whom Time Out often doesn’t work: the problem persists, the behavior resumes, the teen gets more agitated and resentful. Down the road, if they have the capacity to be comforted and know what comforting feels like, they can learn to self-soothe. But first these kids have to learn to rely on others to feel better. For a child to develop, parents need to lend the infant---and then the child, the adolescent, and the emerging adult---their adult regulatory system. But most complexly traumatized teens have missed out on this opportunity when they were little, and so a major goal of therapy is to backfill this absolutely essential experience. For these kids, it’s a gigantic leap to allow someone to provide comfort to them. They don’t trust others to be reliable, nor do they believe they merit such care. Their behavior puts to the test the most important question: will you be there for me when I need you? When we send them away as punishment, or chide them for being irrational, or get upset because we can’t tolerate what they’re doing, our answer to that question is no.

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Topic: Attachment Theory | Children/Adolescents | Aging | Anxiety/Depression | Trauma

Tags: add | emotion | kids | parents | psychotherapy | psychotherapy networker magazine | TED | teens | therapist | traumatized

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4 Comments

Wednesday, December 24, 2014 8:42:44 AM | posted by eleanors
So I'm wondering if the therapist is giving unconditional positive regard by being there, which provides the client with another chance to learn attachment security? Since brains are plastic, can we learn to be secure, even much later and when highly traumatised? Yes, I believe we can.

Saturday, November 15, 2014 8:25:25 AM | posted by Pippa
Reading this as a therapist but realising that it applies to me as someone who has never gone through that teenage rage stage...far too well brought up and needing to please and gain approval...have been in my own therapy for ages but feeling stuck and frustrated but perhaps now realising why that might be. Recognise myself as the teenager going
Through sessions very much as described but not really understanding why. This has helped a lot , thanks

Friday, September 26, 2014 5:18:01 PM | posted by Sari Roth-Roemer
Beautiful description of the therapeutic process, not just with kids, but also with the adults those kids grow up to be. Thank you.

Friday, September 26, 2014 3:31:02 PM | posted by Richard Kagan
Thanks to Dr. Straus for her excellent post on ‘Connecting with Traumatized Kids who Push Your Buttons.’ I really appreciated her use of ‘Time In with Caring Adult ‘who shows up’ and discussion of the challenges of doing this kind of treatment and the risk of focusing on skill development without developing relationships. I’m going to use this in my next workshops on attachment and co-regulation.