“I don’t know what to do.” Andy’s mom is beside herself. Three-and-a-half-year old Andy bites and sucks the sleeves and collar of his shirts until they are soaking wet and ragged. She says she has tried everything: talking, scolding, ignoring, making him take his shirt off. Nothing works. If he is shirtless, he chews on his hand instead. She’s come for a consultation because she’s worried. He sometimes chews on his hand until it is red.
When a child shows such an unusual behavior, evaluation, not new discipline, is what is needed. Children’s behavior always makes a kind of sense. It’s our job to figure out what Andy is trying to tell us. Once we have a better understanding of what is going on, we may be able to help him out.
Many adults underestimate little kids. Sometimes kids absolutely do know what’s bothering them. They’re just not sure what the big people will do when they’re told. As soon as they know they won’t be scolded, many kids are quite forthcoming in their own kid way. Simply asking is always a good place to start.
Andy is an engaging little guy. He’s willing to chat. I notice that he sometimes bites his sleeve. Does he know why? He doesn’t. He says he doesn’t think he can help it; he wishes his mom didn’t get so upset; he doesn’t want to do it. It just happens.
I believe him. He has already shown me that he’s an exceptionally verbal and insightful three year old. I ask him if anything might be bothering him. He gets quiet and thoughtful. I ask him if maybe he can show me if he can’t tell me. This makes him curious. So we go over to my sand table to play.
A sand table is essentially a sandbox on short legs. There are lots of figures, toys, and objects available for a kid to play with in the sand. With some gentle questioning, most children get involved in playing their problem for the therapist. Once engaged in play, many children forget about the therapist entirely. They make a world for us to see.
Andy first chooses some cars and a bulldozer to try out the sand table. He glances at me for approval. “You can do what you want,” I tell him. “Vroom.” The bulldozer makes a road. “Vroom” go the cars in the new road. “The cars are going fast,” I say. “Vroom.” Cars start at opposite ends and crash. “Those cars made a great big crash,” I add. It’s important that I only note what Andy is doing and not judge it. Andy is doing what most kids do. He’s checking out if I meant it when I told him he could play anything he wants or if I’m going to get upset.
Reassured, he chooses a number of rubber boy and girl figures, a superhero action figure, and a box. Soon he is setting up a scene. The box, turned upside down, becomes a building. He places groups of children around it. One boy figure is apart from everyone else. Soon the superhero comes by. “Whish!” The superhero takes the boy flying on his back. Andy makes them swoop around the room and even under the table. He smiles and laughs, intently involved in his imaginary game with his superhero friend.
As he runs out of steam, I ask him what happens next. He makes the action figure fly off, leaving the boy figure in the sand. “That boy is by himself,” I say. Andy looks sad. Andy looks a little upset. Andy’s wrist goes to his mouth. I sit quietly. Andy looks at me, bewildered, sucking on his shirt cuff all the while. Then he bulldozes his scene.
Often a family therapist is as much detective as counselor. We look for clues and try to put the pieces together. Andy has given me a very strong hint about what may be troubling him. It’s my job to piece together the larger picture.