Of Mice and Metaphors: Therapeutic Storytelling with Children

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Jerrold R. Brandell

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    Acknowledgements

    Dedicated in Loving Memory to My Parents, Jules Brandell and Edna Bernice Honoroff

    A Prefatory Note

    Much of the research for the first edition of this book was completed during a semester-long sabbatical I spent at the University of Canterbury as a Visiting Professor in 1999. This newly revised and expanded second edition is a natural outgrowth of my continuing interest in the therapeutic use of stories with children, drawn from 38 years’ experience as a clinician, clinical supervisor, and social work academician. Since the publication of the first edition in 2000, however, the field of dynamic child treatment has changed. Several of the more important changes are noted herein in the development of new theoretical content (e.g., on attachment theory), as well as through the addition of completely new clinical illustrations. Generally speaking, the cases I have selected represent a wide range of presenting problems, each illustrating aspects of therapeutic communication with children per metaphor. They are drawn from a variety of clinical venues (family service, community mental health, outpatient child psychiatry, municipal mental health services, and private practice) in which I have practiced since the mid-1970s. I would certainly be remiss here were I not to acknowledge a significant debt to the scores of young storytellers who over the years have invited me to participate in their very private fantasies and, in the process, have helped me to become a better listener and therapist.

    Many of the chapters that follow are revised and, in some cases, significantly expanded versions of papers I have previously published in the following journals: “Stories and Storytelling in Child Psychotherapy,” Psychotherapy, 21, 154–162 (Spring 1984 [copyright (1984) by Division of Psychotherapy of the American Psychological Association]); “Using Children’s Autogenic Stories in Dynamic Clinical Assessment,” Child and Adolescent Clinical Social Work Journal, 2,181–190 (Fall 1985); “Autogenic Stories and Projective Drawings: Tools for the Clinical Assessment and Treatment of Severely Disturbed and At-Risk Children,” Journal of Independent Social Work, 1, 19–32 (Winter 1987); “Narrative Truth and Historical Truth in Child Psychotherapy,” Psychoanalytic Psychology, 5, 241–257 (Summer 1988); “Treatment of the Bi-Racial Child: Theoretical and Clinical Issues,” Journal of Multicultural Counseling and Development, 16, 113–134 (Winter 1989); “Psychotherapy of a Traumatized Ten Year Old Boy: Theoretical Issues and Clinical Considerations,” Smith College Studies in Social Work, 62, 123–138 (March 1992); and “Using Children’s Autogenic Stories to Assess Therapeutic Progress,” Journal of Child and Adolescent Psychotherapy, 3, 285–292 (October 1986). Chapter seven, “Secrecy and trauma: An adopted child’s psychotherapy,” is derived from a contribution originally published in Understanding Adoption: Clinical Work with Adults, Children and Parents, edited by S. Sherman, K. Hushion, and D. Siskind, and published in 2006 by Jason Aronson/Rowman & Littlefield.

    ACKNOWLEDGMENTS

    SAGE Publishing would like to thank the following reviewers:

    • Walter Buboltz, Louisiana Tech University
    • Charles R. Crews, Texas Tech University
    • LaWanda Edwards, Alabama State University
    • Jonathan Lent, Marshall University
    • Bill McHenry, Texas A&M University, Texarkana
    • Van Vaughn, Missouri Baptist University
    • Gaston Weisz, Adelphi University

    Prologue

    Once upon a time there was a cat who lived in a lost alley, and he was all alone …

    So began one of the first stories presented to me during a therapy hour. Ever since that clinical encounter over 40 years ago, I have been fascinated by the creative ways in which children are able to narrate their lives through imaginative storytelling. These are stories that are intensely personal and often filled with high drama; they are rich with dynamic meaning, important themes and conflicts, and efforts at resolution and adaptation. Like the dreams that are Freud’s “royal road to the unconscious,” the make-believe stories of children offer the listener an unsurpassed opportunity to enter a domain of childhood usually off-limits to grown-ups.

    Actually, children’s stories represent an aspect of intrapsychic life and a mode of expression that for most adults has become rather unfamiliar. I refer to the psychoanalytic notions of primary and secondary process. Although some confusion exists as to how one applies these concepts to particular mental phenomena, they are very much alive and well and uniquely relevant to our work with children. Primary process is, in effect, the lost language of childhood; it is the language of play and imagination, of creativity, and of action and impulse; it is what I shall term the language of mice and metaphors. It is a natural language that is often closely linked to the unconscious realm of mental life and dominated by the pleasure principle.

    As we grow older, we gradually enter a different domain, one where logic, order, and the syntactic and semantic aspects of verbal expression are more highly prized. This is the language of adulthood, of secondary process; in a sense, it represents something of a compromise. In order to function in the adult world, we must give up or at least substantially alter a mode of expression that represents the unselfconscious spontaneity of childhood. This is necessary because we must all somehow communicate with each other in a meaningful way, make sense of what we read in the morning newspaper, know how to make the Bluetooth connection between our smartphone and our car’s media system, and so on.

    But we shouldn’t require children, at least before a certain age, to do this. In fact, within the last generation, some child developmentalists (e.g., Elkind, 1989) have begun to caution parents not to make excessive cognitive and other performance demands of developing children. In our assiduous efforts to prepare children for the challenges they will face as adults, however, we often fail to heed this advice; we tend, in fact, to increase our demands, regulating and directing not only their work but also their play, and arguably, at great peril. Indeed, some writers have made the claim that the noticeable decline in free, unsupervised play in the lives of children and adolescents over the last half-century is associated with a pernicious rise in various forms of psychopathology, including anxiety disorders, depression, narcissism, and even suicide (Gray, 2011). So intent are we in providing them with all the best opportunities that we may forget that our children also require privacy, a less-closely monitored Spielraum within which they can develop their own personal narratives and potentials. We may no longer be able to speak their language, the language of primary process, with fluency; yet, on the other hand, we must be careful not to ask them to leave behind this domain prematurely.

    It has been said that children are natural storytellers. They certainly enjoy listening to stories and (in my own clinical experience, at least) often find pleasure in being able to compose their own. Of course, no single technique used in clinical work with children is fail-safe, or yields the same results for most children, or even yields the same results for the same child at different points in the course of therapy. Storytelling is no exception to this general rule, although when it works, it is unsurpassed as a means for assisting children to narrate their lives. Because we live in an age when public and private agencies and consumers have come to expect instant solutions to problems, it is far more difficult to promote the idea that we must listen carefully to children. As child psychotherapists, we know that meaningful communication in therapy has a life and rhythm of its own, that a child’s narrative evolves or unwinds in its own way and at its own pace. Imaginative stories thus permit us the opportunity not only to immerse ourselves in a child’s fantasy world but also to engage in a therapeutic dialogue as eloquent as it is timeless.

  • Epilogue

    There is, of course, no real magic in stories, even though the storytelling process in and outside of therapy often appears to us to possess magical qualities. Not unlike other techniques and instrumentalities used in psychoanalytic child psychotherapy, reciprocal storytelling taps into a dimension of the child’s psychological life not yet overtaken or subverted by the mandates of adult secondary process thinking and logic. However, precisely because children’s stories characteristically retain a timeless, metaphoric, and primary process-like quality and yet must possess a certain modicum of structure and consensually based meaning, they are especially well suited for the therapeutic playroom.

    In this book, we have examined the value that children’s stories appear to hold as a window to the unconscious, a rather unique vantage point from which we are able to view a child’s inner world and better understand his or her most perplexing problems and most fervent desires. The child’s story, in this sense, is like a secret entrance to the clubhouse from which adults are usually denied access. We soon learn that grown-ups aren’t the only ones with ground rules; indeed, the child’s invitation to play in the clubhouse can be rescinded at any time. If we are able to remain sensitized to the special requirements of communications made per metaphor, the unfolding dialogue can deepen our dynamic understanding and grant us a unique opportunity to assist in the reworking of narrative material in ways that are not only therapeutic but perhaps even transformative.

    Appendix: Informed Consent, Tape Recording, and the Security of Data

    These questions are closely connected to ethical practice concerns, many of which are specifically addressed in the code of professional ethics for each of the major mental health professions. Thus, readers are first advised to familiarize themselves with their discipline’s code of professional ethics, which are listed below:

    Counselors

    “American Counseling Association Code of Ethics”: http://www.counseling.org/docs/ethics/2014-aca-code-of-ethics.pdf?sfvrsn=4

    Clinical Social Workers

    “NASW Code of Ethics”: http://www.socialworkers.org/pubs/code/code.asp

    “American Board of Examiners in Clinical Social Work Code of Ethics”: https://www.abecsw.org/about-code-ethics.html

    Psychologists

    “APA Ethical Principles of Psychologists and Code of Conduct”: http://www.apa.org/ethics/code/index.aspx

    Nurses

    “ANA Code of Ethics for Nurses, with Interpretive Statements”: http://nursingworld.org/DocumentVault/Ethics_1/Code-of-Ethics-for-Nurses.html

    Psychiatrists

    “Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry”: http://www.psychiatry.org/practice/ethics

    INFORMED CONSENT

    In the interest of protecting both client and therapist, it is probably advisable to obtain informed consent/assent from the parent and child prior to audio recording stories or other material from individual psychotherapy sessions. The therapist’s professional code of ethics, as well as the laws of the state in which the therapist practices, are essential to review in this regard.

    The following statement on informed consent, while offered by a clinical psychologist, seems readily generalizable to all who practice child psychotherapy, irrespective of their professional training and affiliation:

    We must ensure that those we treat, assess, study, supervise, etc. are informed of all significant information that might impact their decision to participate, prior to the professional activity is provided. This consent should be given voluntarily and not be given under duress or in response to coercion, the individual should be competent (legally and cognitively/emotionally) to give their consent, we need to actively ensure their understanding of what they are agreeing to, and the consent should be documented. Further, important issues such as limits to confidentiality, reasonably available options and alternatives and the risks and benefits of each, the right to refuse participation and the right to withdraw from participation without penalty, each should be addressed. (Barnett, 2009, p. 1)

    In the case of children, assent from the child, when feasible, should also be obtained.

    CONFIDENTIALITY

    As is generally true for any psychotherapy, it is essential for the therapist take reasonable steps (Barnett, 2009) to ensure that equipment with digital recordings, audiocassettes, and other digitally preserved clinical data be made secure. Many therapists keep such materials in their offices in a locked drawer, or in the case of data that has been digitally transferred to a computer, in a password-protected file. The risks associated with such security measures as well as the limits of confidentiality should also be discussed with parents and/or presented in written form.

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    About the Author

    Jerrold R. Brandell is Distinguished Professor and Coordinator, Doctoral Concentration in Clinical Scholarship, Wayne State University School of Social Work (Detroit), where he has taught since 1992. He has held visiting professorships at the Zürcher Hochschule für Angewandte Wissenschaften (Switzerland), Lund University (Sweden) and the University of Canterbury (New Zealand), and has led workshops and lectured widely on clinical topics in the United States and abroad. A practicing child, adolescent, and adult psychotherapist, and psychoanalyst, he is the author, coauthor, or editor of 12 books, including Countertransference in Psychotherapy With Children and Adolescents (1992), Psychodynamic Social Work (2004), and Essentials of Clinical Social Work (2014). He is the (Founding) Editor of Psychoanalytic Social Work, and also serves on several other editorial boards. Recognized as a distinguished practitioner by the National Academies of Practice in 2001, he maintains a part-time practice in psychoanalysis and psychotherapy in Ann Arbor, Michigan.


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