Latest / Inside The Consulting Room - Understanding the Child Behind the Behaviour / Inside the consulting room. Episode 4.The Invisible Child

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Inside the consulting room. Episode 4.The Invisible Child · Inside The Consulting Room - Understanding the Child Behind the Behaviour

• 0:00
  SPEAKER_00: Hello and welcome back.
• 0:01
  SPEAKER_00: This is Kim Lee from the Children's Consultancy.
• 0:05
  SPEAKER_00: And this is episode four in the series Inside the Consulting Room.
• 0:12
  SPEAKER_00: You'll know by now that every case that I talk about, although anonymized, describes a kind of arc of experience in which the presenting concerns around the child, which put to me by way of referral, are followed by my impressions of how the child presents in that first assessment appointment, the sense that I initially make of that, and the both the clinical sense, but also the individual sense.
• 0:50
  SPEAKER_00: And I want to say at this point, that's because I don't regard children as disordered.
• 0:56
  SPEAKER_00: I regard children as having difficulties, but first they are children, second they have difficulties.
• 1:06
  SPEAKER_00: When so she came to see me, she sat quietly on the sofa.
• 1:11
  SPEAKER_00: Her hands were carefully folded in her lap, and she'd been in the room for several minutes, but she'd answered every question politely.
• 1:21
  SPEAKER_00: She'd smiled when it seemed appropriate.
• 1:24
  SPEAKER_00: She hadn't caused any difficulty at all, either inside the room and apparently outside as well.
• 1:31
  SPEAKER_00: But what felt strange was it was as if she wasn't there.
• 1:37
  SPEAKER_00: It was although she's physically here, but the sense of who she was simply wasn't present at all.
• 1:49
  SPEAKER_00: In families and schools, attention is very often drawn towards the children who disrupt.
• 1:56
  SPEAKER_00: They shout, refuse, can't be contained, and generally very visibly demonstrate that there is something wrong.
• 2:08
  SPEAKER_00: But there's another kind of child, the one who adapts quietly, who cause no difficulty, who require very little, and who, for that reason, can pass through childhood almost unseen.
• 2:25
  SPEAKER_00: And this episode is about a child who had learned very early on in life how to be unintrusive and how to disappear.
• 2:35
  SPEAKER_00: Sophie was ten when she was referred for therapy.
• 2:39
  SPEAKER_00: Teacher described her as an absolute pleasure to teach.
• 2:43
  SPEAKER_00: She completed all her work, she helped tidy the classroom.
• 2:47
  SPEAKER_00: She was kind to other children, she helped the teachers, and she never argued.
• 2:53
  SPEAKER_00: But over time, a concern began to emerge.
• 2:57
  SPEAKER_00: So when asked simple questions about herself, like what did she enjoy and what did she like to do and how did she feel about the things she did?
• 3:09
  SPEAKER_00: Sophie often gave the same answer.
• 3:12
  SPEAKER_00: Things like, oh I don't know, or I don't mind really, or it doesn't matter.
• 3:20
  SPEAKER_00: And at home her parents described something similar.
• 3:23
  SPEAKER_00: Sophie really asked for anything.
• 3:25
  SPEAKER_00: She didn't complain.
• 3:27
  SPEAKER_00: If plans changed, she just accepted it without protest.
• 3:31
  SPEAKER_00: If something upset her, she didn't express it, but instead she just became quieter and sometimes more withdrawn.
• 3:40
  SPEAKER_00: Almost as if she'd learned to remove herself from emotional attention altogether.
• 3:49
  SPEAKER_00: Sometimes people will say, Oh, what a compliant child.
• 3:53
  SPEAKER_00: She's wonderful.
• 3:56
  SPEAKER_00: Almost like, you know, she makes no demands at all.
• 3:58
  SPEAKER_00: She's so easy, she's so placid.
• 4:02
  SPEAKER_00: I think where is the real child gone?
• 4:07
  SPEAKER_00: Sophie's presentation suggests that a pattern of internalized emotional neglect developing within a family system where attention was directed elsewhere.
• 4:18
  SPEAKER_00: Her older brother required significant behavioral management.
• 4:22
  SPEAKER_00: Her younger sister had ongoing medical needs, and family life was organized around urgency, appointments, crisis management.
• 4:32
  SPEAKER_00: And emotional energy within the family system was pulled to the most immediate demands.
• 4:39
  SPEAKER_00: In such environments, quieter children often make a kind of unconscious adaptation.
• 4:46
  SPEAKER_00: They reduce their emotional presence, not because they lack feeling, but because expressing those feelings feels unnecessary or even disruptive.
• 4:59
  SPEAKER_00: And over time this can develop into a form of inhibition within the attachment.
• 5:06
  SPEAKER_00: So the child learns my needs are less important, my feelings shouldn't take up space, and gradually they become psychologically less visible.
• 5:17
  SPEAKER_00: The true self, as Winnicott described it, gives way to its counterpart, the false self.
• 5:26
  SPEAKER_00: The false self is an adaptation.
• 5:31
  SPEAKER_00: Inside the consulting room in the early sessions, Sophie presented as remarkably contained.
• 5:38
  SPEAKER_00: She sat neatly, answered questions politely, but her responses were minimal, measured.
• 5:46
  SPEAKER_00: And if I asked what would you like to do today, she would often reply, I don't mind, or whatever you want.
• 5:54
  SPEAKER_00: This could look like cooperation, but over time something became very clear.
• 6:01
  SPEAKER_00: Sophie was unable to express preference, so she avoided it.
• 6:07
  SPEAKER_00: One afternoon I decided to introduce her to different things.
• 6:14
  SPEAKER_00: So I placed several activities on a nearby table, drawing activities, a small game, some coloured blocks, and I said, Would you like to start one of these?
• 6:30
  SPEAKER_00: And she hesitated and said, You choose.
• 6:37
  SPEAKER_00: And so I said, Well, I wonder if sometimes it's just quite hard for you to know what you want or to say it.
• 6:44
  SPEAKER_00: And she gave a small nod, but that was all.
• 6:49
  SPEAKER_00: Across several sessions, similar moments occurred, and if Sophie made a drawing, she would quickly offer it to me.
• 6:56
  SPEAKER_00: You can keep it, she would say.
• 6:59
  SPEAKER_00: If she completed a task, she would ask, is that okay?
• 7:04
  SPEAKER_00: And there was a consistent orientation towards me.
• 7:07
  SPEAKER_00: She was seeking approval, she was deferring choice, kind of minimizing her own position.
• 7:16
  SPEAKER_00: And so I decided to respond differently.
• 7:20
  SPEAKER_00: Instead of evaluating or directing, I shifted the focus back to her and said, Well, what do you think about it?
• 7:28
  SPEAKER_00: Which part do you like?
• 7:30
  SPEAKER_00: And at first these questions seemed unfamiliar, and Sophie often paused for a long time before answering or not answering.
• 7:41
  SPEAKER_00: Essentially I was saying, let's let's have Sophie have a voice.
• 7:50
  SPEAKER_00: Several weeks into therapy, Sophie drew a picture of her family, and her parents stood in the centre, her brother stood beside them, and her younger sister was drawn slightly closer to her mother.
• 8:03
  SPEAKER_00: And the therapist therapeutic approach is one where we look we look at what children offer, and so I said, Can you tell me about who's in this picture?
• 8:15
  SPEAKER_00: And Sophie named each person, and then I asked, Where are you?
• 8:20
  SPEAKER_00: And Sophie pointed to a small figure in the corner of the page.
• 8:25
  SPEAKER_00: The outline was faint, and it was drawn so lightly that it was almost invisible.
• 8:31
  SPEAKER_00: And I leaned forward slightly and said, That's you.
• 8:35
  SPEAKER_00: And she nodded, and there was a quiet pause.
• 8:39
  SPEAKER_00: And I said, You're quite far away in the picture, and I I couldn't see that you were there.
• 8:45
  SPEAKER_00: Can anybody else see you?
• 8:48
  SPEAKER_00: And she just shrugged slightly and said, Well, they're they're all busy.
• 8:54
  SPEAKER_00: Said without complaint or distress, but the meaning was very clear.
• 8:59
  SPEAKER_00: I didn't move quickly to interpret or reassure because I felt that would close down more that was there and needed to be said.
• 9:10
  SPEAKER_00: So I said, It sounds like there are a lot of things happening for everyone else, because they seem to need a lot.
• 9:19
  SPEAKER_00: And then I said, Maybe can feel like there's just not much space for you sometimes.
• 9:24
  SPEAKER_00: And there's this little person in the corner of the page.
• 9:30
  SPEAKER_00: She looked down and then very quietly said, It's easier if I just stay out of the way.
• 9:36
  SPEAKER_00: This was the first time Sophie had put into words her internal position.
• 9:43
  SPEAKER_00: And from this point, the work began to shift because I started to create small manageable opportunities for Sophie to exist more fully in the room, not through pressure but through invitation.
• 9:58
  SPEAKER_00: So I might say, today I'm gonna let you decide what we do first.
• 10:03
  SPEAKER_00: And this was hard for her and she hesitated.
• 10:06
  SPEAKER_00: But bit by bit she began to choose, can we draw a picture again?
• 10:12
  SPEAKER_00: And I want to do the puzzle today.
• 10:16
  SPEAKER_00: Now these things may seem very small, but psychologically they represented something significant.
• 10:22
  SPEAKER_00: Sophie was beginning to occupy the space.
• 10:28
  SPEAKER_00: Then there was what I call the moment of change session when one afternoon she arrived looking really unsettled, and I noticed this and said, You seem a bit different today, you okay?
• 10:42
  SPEAKER_00: And she hesitated, but then she said, Something happened at school.
• 10:47
  SPEAKER_00: I said, Can you can you tell me?
• 10:49
  SPEAKER_00: And she said, A girl pushed me.
• 10:52
  SPEAKER_00: And I said, So what did you do?
• 10:56
  SPEAKER_00: And Sophie looked down and said, Nothing.
• 11:00
  SPEAKER_00: And then she said, I wanted to tell the teacher, but I didn't.
• 11:05
  SPEAKER_00: And so I said, What do you think it was that stopped you?
• 11:10
  SPEAKER_00: And she said, I didn't want to make a fuss.
• 11:14
  SPEAKER_00: And I said, Well, it sounds like you've learned that it's better to be quiet than to say something about how you feel or what's happened.
• 11:28
  SPEAKER_00: And yet you're telling me you're making a fuss of a kind, you're you're letting me know.
• 11:36
  SPEAKER_00: That's good.
• 11:38
  SPEAKER_00: And she looked up and said something that I f I I really felt was uh quite remarkable, and it was it's okay for me to say it.
• 11:52
  SPEAKER_00: And she it was as if she was playing with the concept, not playing, it's the wrong word, but sort of acclimatizing to the concept.
• 12:02
  SPEAKER_00: And I simply said, yes, it is.
• 12:04
  SPEAKER_00: You can say whatever you want.
• 12:07
  SPEAKER_00: Now I'd like to be able to say that the magic was done, and that was another case finished, but that's not how it works.
• 12:18
  SPEAKER_00: Over the following week, she began to make small changes and she expressed preferences more clearly.
• 12:25
  SPEAKER_00: She didn't disagree with me, but I understand that she she disagreed with her parents when they had gone out for the day, and she said afterwards, I didn't like it.
• 12:38
  SPEAKER_00: And she told me that something else had happened, and she said, I didn't like that game.
• 12:44
  SPEAKER_00: And I said, Well, that's important to know.
• 12:47
  SPEAKER_00: And I smiled at her and she smiled back.
• 12:52
  SPEAKER_00: Just a small moment, but deeply significant.
• 12:57
  SPEAKER_00: I think helping children to become visible and accepting what they show is a very powerful thing to do, and I'm reminded of the author Tovei, who wrote the Mumin series, and she wrote a remarkable story about Nini, the invisible child, and how when children have adapted to environments where they can't be seen, they can't exist, then the task of enabling that is a delicate one because they already have reached a point where they feel like they don't deserve to exist.
• 13:46
  SPEAKER_00: But inside the consulting room, the child who's learned to disappear begins to discover something new that they don't need to stay in the corner of the picture, and that their place wasn't always meant to be somewhere out of sight.
• 14:08
  SPEAKER_00: In fact, her place was always meant to be in the center of her own life.
• 14:15
  SPEAKER_00: Thank you for listening.