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Holding Certainty, and the Uncertainty Beneath It. · Inside The Consulting Room - Understanding the Child Behind the Behaviour

• 0:00
  SPEAKER_00: Hello, and welcome back to episode two in this three-part series on gender identity.
• 0:07
  SPEAKER_00: This is Kim Lee, child and adolescent psychotherapist from the Children's Consultancy.
• 0:13
  SPEAKER_00: In the first episode, one of the things I referred to was the notion of certainty.
• 0:19
  SPEAKER_00: And of course, when I say this, I'm talking about the subjective sense of certainty that the young person experiences.
• 0:28
  SPEAKER_00: This is, as I mentioned, very often a defense mechanism because certainty gives a temporary sense of relief and reassurance.
• 0:39
  SPEAKER_00: It is not, however, a final place that the young person will come to.
• 0:46
  SPEAKER_00: Certainty is almost automatically eroded by the senses that underpin the need for it, namely anxiety and distress and sometimes psychological fragmentation.
• 1:12
  SPEAKER_00: So although we explore the inner world of gender distress as something which may manifest in this emotional protection, we need to look at how that finds expression in the relational space, and by which I mean what happens between the young person and those who care for them.
• 1:34
  SPEAKER_00: Many young people experiencing this distress feel that their essential identity is what is needed in order for them to survive.
• 1:45
  SPEAKER_00: And in some ways, that's not unusual because adolescents go through important developmental processes where their sense of who they are is the most important thing that they have.
• 2:02
  SPEAKER_00: How they dress, how they act, what they do, who they speak like, all paradoxically, in an effort to feel individual.
• 2:12
  SPEAKER_00: They have to be like everyone else.
• 2:14
  SPEAKER_00: But it's true.
• 2:16
  SPEAKER_00: And so for this reason, we could look at gender identity not exclusively, but partly through that lens.
• 2:28
  SPEAKER_00: So it may feel when we ask questions, even with gentle curiosity, that there is something that we are rejecting, or that in some way we are behaving in a manner that they experience as threat or emotional abandonment.
• 2:48
  SPEAKER_00: And parents often say if I ask anything, they say that I'm not supporting them.
• 2:54
  SPEAKER_00: And this isn't unusual because when identity holds psychological stability, any kind of reflection can feel dangerous.
• 3:04
  SPEAKER_00: So the emotional pressure on parents is one where they often feel caught in an impossible position because there is a fear of harming their child or of losing their child emotionally, fear of saying the wrong thing, and fear of doing too little or too much.
• 3:24
  SPEAKER_00: And this inevitably creates an enormous emotional strain.
• 3:29
  SPEAKER_00: So some parents begin to silence themselves, some become reactive, and some withdraw.
• 5:39
  SPEAKER_00: If the therapist questions too quickly, the young person may feel attacked.
• 5:46
  SPEAKER_00: So what's needed?
• 5:47
  SPEAKER_00: Well, a third position, I suppose very similar to the one that I endeavor to take myself, and that's a reflective stance in which the parent doesn't deny experience, doesn't collapse into agreement, and also keeps the curiosity alive.
• 6:12
  SPEAKER_00: It's not easy, but it's essential for development.
• 6:15
  SPEAKER_00: And I would say this is true in all elements of adolescent and the parenting of adolescents and of children, as far as we can manage.
• 6:30
  SPEAKER_00: Now, within the family, gender distress doesn't occur in isolation.
• 6:36
  SPEAKER_00: Families often experience guilt, fear, confusion, and a wish to fix things.
• 6:44
  SPEAKER_00: And sometimes transition becomes emotionally symbolic within the family, and it represents an escape from distress, a solution to conflict, and a way to restore hope.
• 6:59
  SPEAKER_00: But if underlying stress remains unexplored, deeper issues can resurface later.
• 7:05
  SPEAKER_00: So what your child needs from you is to feel seen without being defined, to feel safe without being rushed, and to feel supported without losing the capacity think.
• 7:19
  SPEAKER_00: And this means tolerating uncertainty together.
• 7:24
  SPEAKER_00: In the final episode, we'll step back and look at the wider system, how culture, institutions, and social pressures identify how individuals care and how their influence creates pressures to some extent, but also potentially space for reflection.
• 7:49
  SPEAKER_00: Because sometimes the environment around the child can either support thinking or shut it down.
• 7:57
  SPEAKER_00: What I often find when I'm talking to young people is that there quite often there can be some very dramatic moments, and those dramatic moments tend to have a shocking quality.
• 8:14
  SPEAKER_00: I tend not to take the content of what's being said in a literal way, because if I did, I would be I'd never sleep.
• 8:26
  SPEAKER_00: However, young people will express themselves in a variety of ways which can raise alarm.
• 8:54
  SPEAKER_00: And what can happen in those circumstances is that those groups become a kind of family to them because they feel they belong, they're accepted, these young people all have something in common, and they make their own rules.
• 9:15
  SPEAKER_00: Now, at one level, that has a kind of meaningful value in as much as the individual no longer feels isolated.
• 9:25
  SPEAKER_00: However, what will also happen in some groups is that those rules that I referred to include behaviors which those of us who've been around the block a few times would be concerned about.
• 9:42
  SPEAKER_00: I suppose what I'm saying here is that while separation is normal, typical, if that separation is loaded by other factors, then it is more likely that the separation can turn into distance.
• 9:58
  SPEAKER_00: Whether it seems like it or not, young people need to be within a family that holds them as well as separating.
• 10:10
  SPEAKER_00: You know, once again we come back to these opposites that exist in adolescence.
• 10:17
  SPEAKER_00: So for now, I hope this is another level towards helping.
• 10:27
  SPEAKER_00: I'm not going to offer a personal view about this subject.
• 10:32
  SPEAKER_00: My views are based upon clinical experience.
• 10:38
  SPEAKER_00: That's what I'm here for.
• 10:41
  SPEAKER_00: But I do have one thing, which is that as far as we possibly can as parents, we have to stand by our children and young people as much as possible.
• 10:55
  SPEAKER_00: I hope that helps.