Psychoanalytic Therapy for Children:
A Resource for Parents, Teachers, and Healthcare Professionals
– Do you want to strengthen your relationship with your child but don’t know how?
– Interested in learning new ways to communicate effectively with your child?
– Curious about the meaning behind your child’s behaviors?
What makes parenting so hard?
Parenting is the hardest job we do. Imagine being asked to drive a car without any instructions or a map. That sounds tough, right? That’s exactly what parenting is like.
Children don’t come with instructions or a guiding map on how to raise them!
Each child is unique and it can be hard to figure out what is most helpful for your particular child. Each kid has their own special way of seeing, understanding, and reacting to things. It’s hard for adults to understand how kids think. Kids see and feel things differently
because their brains are still growing. They make connections we might not see. They have thoughts or may behave in ways that don’t make sense to us. There’s no way to just magically know what’s going on in their minds and understand what they are thinking or feeling.
It might look like other parents have it all figured out, but that’s not true. We’re all trying our best to navigate this parenting journey. It’s complicated for everyone to raise their own child and it’s not always clear what will help lead to success. It can feel lonely and even embarrassing when it seems like other parents have it easy.
But remember, parenting is hard, and we’re all in this together!
It’s normal to feel many emotions while trying to parent our kids. It can be frustrating when things don’t go as planned even while we are trying so hard. Sometimes, we even get angry with ourselves and our children. While there are times we feel angry and frustrated there are also times we feel happy and loving. Even if we thought we were prepared before-hand, we really can’t be. Babies and children are constantly changing and growing so fast that we are still trying to figure out what has happened not long ago even while they are entering a new phase.
Their needs for us are in constant flux.
Psychoanalytically oriented therapists understand all this. We help parents and children work together to create a map for the challenging journey of raising happy kids. The psychoanalytic approach is not about “fixing” anything broken, but about understanding. We create a safe space for you to share your complicated feelings and build a map for this journey. This helps you and your child work together to
understand each other’s needs, find and practice new ways to handle challenges, and strengthen your bonds on the road ahead.
Parenting is tough, but with the right support, we can make the journey a bit easier for all.
Why are my kids acting this way?
Does it have meaning?
Parents often have questions about their child’s behaviors. Is this part of normal development or not? Should I be worried?
Here are some examples of things parents wonder about when their kids are at different ages. An analytically oriented psychotherapist can help you understand more about what is going on with your child or adolescent and if help is needed.
Early childhood/pre-school:
- Toilet mastery (potty training).
- Clingy, angry, or babyish behaviors after a new baby.
- Hitting instead of using words.
- Issues around confidence and self-esteem.
- Trouble asserting themselves with other kids.
- Sudden irrational fears and worries.
School age:
- Holds back or is a know-it-all.
- Has trouble making friends or makes
bad choices of friends.
- Perfectionism and frustration.
- Challenges parents and school requirements – bossy or defiant.
- Puzzling new habits, routines, and rituals.
- Preoccupation with screen activities to the exclusion of hobbies or time with friends and family.
Tweens:
- Acts like an adolescent but can’t handle responsibility and thinks they can.
- Lacks self-care.
- Overly mature or its opposite, immature and entitled.
Teenagers:
- Anxieties and confusion about sex and gender.
- Self-consciousness about their bodies.
- Eating habits.
- Social inhibitions.
- Conflicts around screen time limits and social media.
- Angry outbursts.
- Why is my once happy child so moody?
- How can I set limits or should I?
Therapist as Collaborator
Psychoanalytically oriented therapy with children and adolescents helps children get back on track. An equally important goal is to foster a closer, more satisfying relationship between parents and their children. Making this happen involves the development of a unique collaborative working relationship between parents and therapist.
Parents bring their family values, cultures, experiences, and expectations to the consulting room, and the therapist brings extensive therapeutic experience, skill and knowledge of child development. With this informed knowledge, the therapist can help parents navigate the relationships within the family. Parents and the psychoanalytically oriented therapist become a team and develop a strong partnership. This partnership helps parents to understand and make more sense of their child’s behavior, needs, attitudes, and personality.
Some therapists describe parents as the eyes and ears to the child’s world, one that provides an important glimpse into the everyday life of the child. As trust builds between therapist and parents, parents often become more comfortable sharing not just events but difficult feelings that they encounter while parenting. Because the therapist has gotten to understand the child or adolescent through the trust and intimacy that has developed in the child’s sessions, the therapist can provide deeper understandings, guidance and support for parents for the benefit of the child’s development. The therapist really becomes a bridge between the family and the child or adolescent patient, while they rebuild their strong relationship.
How Does Psychoanalytic Oriented Therapy Work?
Research shows that our kid’s behaviors result from complex thoughts and feelings they might not even realize they have. Often kids don’t know exactly why they act a certain way. A psychoanalytically oriented therapist uses play and talking to help kids learn what is going on in their minds and how their minds work. Once children learn to reflect on, understand and verbally express their feelings, they become able
to have honest communication with themselves, their therapists, and their parents. They can then choose how to respond in better ways.
Psychoanalytic oriented therapy comes in two related but distinct forms: psychoanalytic therapy and analysis.
They both work similarly and are based on the same research. The difference is about how often the therapy sessions take place.
When the sessions are once or twice a week it is usually called psychoanalytic therapy. When the therapy sessions are more frequent it’s called analysis. Why would someone go to therapy more than once a week? Because each day has a lot happening and a lot of big and small reactions to what’s happening. It’s challenging to summarize and understand it all in one session a week.
The more often our child meets with their therapist the more effectively they can try to understand the feelings causing specific thoughts and behaviors. Once a week can be helpful. Two-three times a week is even more helpful.
Psychoanalytic therapy and psychoanalysis both begin with a thorough assessment of your child’s unique strengths, vulnerabilities and needs. This often includes several initial meetings with parents, two or three meetings with the child, and then a return to the parents in order to discuss the therapist’s recommendations. We begin by meeting with parents in order to understand fully any emotional or behavioral issues at home, to review the child’s developmental history, and to learn about the way in which family members interact and respond to each other. Child therapists may ask about parents’ own upbringing in order to understand intergenerational pressures and patterns. Next, the therapist will meet with the child to get a sense of how she interacts and what’s on her mind. They may talk or play during these sessions, depending on the age of the child and on her comfort level with direct conversation. Psychoanalytic child therapists are trained to evaluate any additional, important issues that might affect the child’s development – such as learning challenges, eating problems, depressed mood – and will make appropriate recommendations if other assessments or consultations are also needed.
After hearing about the family and getting to know the child, the therapist meets again with the parents to discuss a treatment plan. They work together to figure out how many times a week the child should be seen, and how often the therapist will meet with the parents. The therapist will explain that, although parent-therapist meetings and collaboration are crucial to the child’s forward progression, some parts of the child’s therapy will be confidential, meaning that the therapist does not repeat all things that the child says or report on all of the child’s reactions; even very young children sometimes need a safe, private space to confide thoughts and feelings that they may worry about sharing with the people they love.
Why Choose Psychoanalytically Oriented Child Therapy?
Investing In Children’s Social, Emotional and Intellectual Development.
Starting your child or adolescent in psychoanalytic psychotherapy represents a significant commitment of family resources; scheduling sessions within a busy week of work, school, and activities, arranging parent meetings to speak with the therapist about life at home, and managing the associated costs require a serious expenditure of time and effort. Additionally, in contrast to behaviorally oriented treatments that only address symptoms, psychoanalytic therapies can be lengthier or more frequent, because the goals are to improve all aspects of your child’s development, mental health and relationships.
Psychoanalytic therapies offer unique benefits that make the investment worthwhile. The advantages include:
Parents come away with a fuller understanding of their kid’s strengths and weaknesses, family and friends become closer and get along better, children feel more positively about themselves; they show more cooperative behavior at home and at school; and therapy creates a strong base for future development.
Indeed, we find that parents often seek out psychoanalytic psychotherapy after they have tried other, briefer and more behaviorally-focused types of treatment because they still feel that their children are not thriving and not reaching their emotional, social and intellectual potential.
Specific benefits include:
- Psychoanalytic therapists seek to reduce immediate stressors (behavioral problems, relational conflicts, anxiety reactions, etc.) but also aim to help parents understand their child in a deeper way, including the root causes and underlying meanings of problematic behavioral patterns, and the impact of more hidden feelings, fears and wishes.
- Psychoanalytic treatment promotes inner strength and resourcefulness that will help your child navigate future developmental challenges and reach their potential. Such resourcefulness includes: increased tolerance for frustration and other uncomfortable emotions; more stable self-esteem despite momentary
disappointments and inevitable setbacks; improved capacity to express feelings via verbal communication rather than through impulsive actions; more consistent behavioral self-control and emotional self-regulation; and enhanced self-awareness and concern toward others. These various capacities make for happier relationships at home and with friends, and lead to greater cooperation
and collaboration at school.
- Psychoanalytic child clinicians are trained to take the time needed to build a solid, trusting relationship with your child by interacting with them at the age level they are at. They follow the youngster’s lead and facilitate open, comfortable communication. For very young children, that means using the natural medium of play as well as conversation. Even for older kids and teens, direct talk about personal problems is not always comfortable until a positive connection is developed. This is one reason why psychodynamic treatment takes time and patience: trust cannot be rushed.
- Your child’s important relationships are a top priority: improving parental, family, school-based and friendship connections and communication are a main goal of psychoanalytic treatments.
Psychoanalytic child clinicians are among the most highly trained mental health professionals; often, they have already attained advanced degrees in a particular field (psychology, medicine, social work, education) and then do additional training in psychoanalytic methods. They offer a uniquely high level of expertise in the social, emotional and intellectual development of children and adolescents.
Some Examples of Common Behaviors and Meanings in Detail
Early Childhood: Is Potty Training Still a Challenge?
Toileting success is all about control, and emotional and physical readiness. If your child says NO, it’s their first expression of being a separate person, with a mind of their own. They are not trying to make your life miserable. At that time in development that “NO” is more pressing than wanting to please you, the parent. Sometimes parents are very tentative about approaching toilet mastery, or they may expect too much too soon. Kids pick this up and it can become a theater for playing out who’s really in charge. Parents can get frustrated and jump from one method to another, until it becomes a chaotic situation. That can confuse everyone. What is needed is a sense of patient leadership, confident expectation of success, and a partnership.
So, why do children go along with our expectation that they learn to use the toilet?
They need our help to get to the point of feeling “I want to do this”, which reflects a wish to be more grown up and big and enjoy a sense of mastery. “I can do that!!” is a wonderfully satisfying feeling that motivates further effort.
A psychoanalytically oriented child therapist or analyst knows how small children’s minds work and can guide parents through these developmental steps.
How to Help My Young Child Welcome the New Baby.
Imagine your child as the focus of your family, and suddenly there is someone else who needs a lot of attention. A new baby! The new baby’s presence is bound to stir up a lot of different feelings and behaviors in your child: Curiosity, tenderness, jealousy, worry, insecurity, longing to be a baby again. There can be toileting accidents, clinging, and general extra neediness.
As a parent, you need the language to help your young child understand what they are feeling and why. You can help your child make these feelings acceptable by naming the emotions, encouraging your child to put their feelings of rivalry and insecurity into words, and not into all kinds of behaviors. That is the way children can feel heard and understood! So important!
Sometimes parents are uncomfortable raising these issues, or it’s hard to recognize that these behaviors might be related to the baby. The feelings may be unacceptable to parents for many reasons. They may be uncomfortable with their own feelings of jealousy, guilt, or insecurity and in those situations, outside help may be needed.
School age: What Does My 6-10 Year Old Need From Me?
Parents are often unaware of the explosion of new capacities that develop between the ages of 6 and 10. As they go out into the wider world of school, children are less focused on pleasing their parents and more focused on developing their own ideas, identifying with other grown-ups and learning how to behave with kids their own age.
Their social life is important to them, but they are continuing to learn how to manage friendships and rivalries. In order for them to succeed they still need help from grown-ups in negotiating and managing conflicts and disappointments. They are beginning to be able to imagine how someone else feels which sets the stage for all successful relationships in life.
We can observe their drive for independence, as well as their sometimes exaggerated view of their knowledge and capacities. They can be explosive when they feel their wishes and ideas are not accepted. Important achievements for children at this age are to learn to tolerate frustration, learn to work together with others and begin to take pleasure in a finished product, not just in play, This time in life should establish pleasure in work, which will determine future success as an adult in the world.
Your 6-10-year-old still needs help from you in many areas; time management, bodily care and routines, social skills, empathy for others, managing conflicts, as well as recognizing and validating their feelings. Sometimes parents are too influenced by their child’s insistence that they do not need your help or “you are not the boss of me.” Without your ongoing help and support, children can fall behind on the skills needed to progress and succeed.
Parents often feel more confident about their role with a younger child (0-5), since it’s more clear how much a younger child needs. The 6-10-year-old’s life is full of stops and starts and detours and individual differences. Their character and personality are in the process of formation. This is a newly emerging young person that you see. Keeping up with these rapid changes is a real challenge. There is no one formula for knowing what to do. Parents often feel out of sync or confused. It may take reaching out to a professional to help you sort out and answer questions about what exactly is going on with your 6-10-year-old child.
Adolescence: Dealing with 12-19 Year Olds.
Adolescence encompasses a complex stage of development beginning with puberty (which can be anywhere from 10 to 14) and continuing until at least the end of high school or a year or two beyond. Puberty changes the body, the body image, your sense of who you are… It is a biological process with many psychological consequences. One of the most potentially difficult aspects of puberty for most kids is that they have no control over what is happening. Stimulated by hormones, this process affects sexuality and your child can now see themselves more as a sexual being. This change can bring forth self-consciousness, insecurity, anxiety about parts of the body, comparisons with the peer group and more.
Your early teen may become moodier, have social group worries, and complicated feelings about their body changes. They may and should exhibit a drive for separateness and may become challenging and competitive with you, which can be part of healthy autonomy. They may want to isolate themselves from the family and you may wonder how much of that is healthy. How do you draw the line between
their questioning your ideas and surliness? Where did my co-operative kid go? You may feel rejected or angry. Parents are also affected by their children’s growth into a new stage! The challenge is to respect the young teen’s growth while maintaining a sturdy relationship at the new level.
These are all contributing factors in a move toward interest and investment in peers. Friends are becoming their strongest social allies. Kids also will find people in the outside world to idealize and admire, like cultural heroes, and want to be part of that group. Your child may be confronted with urges and situations they may not know how to handle. Parents need to recognize and offer help when they see their children reaching out for help and support, even though these signals are often disguised. Teenagers may feel no adult would understand them; that it would be a loss of face to seek help, or that they will get in trouble. Parents sometimes need to struggle to suspend judgment to make space for a teen to share a trouble. Parents need to tread carefully and respectfully when they sense their child is in distress.
Professional help for parents and children to negotiate the early teen years may prepare everyone for the expanding opportunities and risks that come in the later part of this stage. Later adolescence can be a turbulent time, and kids need guidelines to help them use good judgment. Parents are challenged to walk a fine line between being overcontrolling and being alert and available to offer help with planning and organizing. You play an important role in regulating your teenager’s life. This is difficult because teens don’t like it when you try to regulate them and often fight against it. It’s important to clarify for yourself what to stand firm about and not be intimidated by their anger and resistance to being parented.
What if your child does not respect your authority and frequent conflicts with you occupy too much space? It’s important to listen to your own distress signals – your child’s adolescence shouldn’t be miserable for them or you! If talking the situation through with your teenager doesn’t work or is rejected, that’s when professional advice from a psychoanalytically oriented therapist or analyst can help you get things back on track.
A project of the APSA Child and Adolescent Psychoanalytic Department