An unfortunate complication of medication for children, is that it is often so effective that it takes away all motivation to work in therapy. I don’t want to keep children on medicine indefinitely. I’d much prefer they participate in therapy and learn how to manage their symptoms. I can then taper off their medication. With this goal in mind, I try to leave kids with enough symptoms to motivate them for therapy, but not make them inordinately uncomfortable.
“I don’t want to do therapy!” they scream at their parents and me. “I don’t have time for it!”
Having two completely overscheduled children at home, I can sympathize. If I had to add therapy once a week to my kids’ already bursting schedules, they might as well forget homework that night. I try to comfort them as best I can. “Look, Marylou, it won’t last forever. If you go to therapy now, you might not have to take medicine one day. Won’t that be cool?”
Marylou usually looks at me with disdain, and continues screaming. Kids don’t mind taking pills. It’s an easy fix compared to schlepping to therapy, and then practicing extinguishing techniques every night. Their parents and I can force them to go, but we can’t force them to participate. We certainly can’t force them to practice therapeutic exercises. I find the whole scenario quite frustrating.
I had a nine year old OCD patient, who attempted to weasel out of therapy by criticizing every therapist his parents and I chose for him, and refusing to participate.
“He used puppets!” George would exclaim, in a tone of voice that implied some dreadful sin had been committed.
“What’s wrong with puppets?” I’d ask.
“Puppets are for babies!” he’d explain.
“I like puppets,” I’d say. George’s face would light up. “You’re a baby!”, he’d laugh, knowing he had me dead to rights.
George hated every therapist. Their techniques were stupid. Drawing pictures was for idiots. (At least I wasn’t dumb enough to say, “I like drawing pictures.”) Modeling clay was for dumbbells. His parents and I gave up, and I raised his Prozac. I imagine George in college now, studying to be a film critic. One day I’ll open The New York Times movie review section and read, “Her acting was babyish, dumb, and a bit idiotic.”