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My thoughts on Lena Dunham

questionning-sliderI’ve been asked about my thoughts on Lena Dunham and the passages in her book that detail her sexual behavior with her sister. At first I declined to post them here because I felt like there have already been so many people talking about it that I really had nothing to add to the discussion. But then I realized that as a therapist and with the understanding that you might be wondering if I’m the right therapist for you or your child, I ought to weigh in for no other reason that my clients — current or potential — have the right to know where I stand on such a contentious and difficult issue. So here are my thoughts.

First, I haven’t read the book and I have no plans to; I’ve only read the quotes and passages (that link will allow you to read them, too) that have appeared on other sites. Because of this, I can’t really discuss the context in which those quotes and passages appear, which is one reason I can only speak in generalities. Also I don’t know Lena Dunham or her sister, Grace (obviously) and I don’t know the family in which they grew up and I don’t know the way their relationship was or is now. I only have these passages, which are in Lena’s words and further words in a memoir, which means they have been shaped for a general thesis. This means that I can’t really trust their reliability. Therefore any commentary I am making about Lena Dunham and her sister aren’t really about them; my commentary is more about our general discussion of child bodily exploration, sexual play and the potential & possibility for sexual abuse between siblings.

Child sex play is a normal, developmentally appropriate part of growing up. Some children keep to a mild “show me yours and I’ll show you mine” and some may do more graphic sexual play. What makes it play and not abuse is the absence of a power differential and coercion and this can be very hard to ferret out. A six year age difference — Lena is six years older than her sister — is always concerning. Always. Whether or not it is sexual abuse or a serious boundary issue depends a whole lot on exactly what happened, how and when. Is it a one time thing? A pattern of enmeshment? Is it straight forward bodily exploration or is the more powerful sibling using the younger sibling for his or her sexual satisfaction or to act out an unhealthy power dynamic? What is certain is that a relationship that Lena describes (while acknowledging that the reality of that particular relationship may be much different) deserves more attention from parents.

This leads me to a discussion of culture. Family cultures differ and so family boundaries differ. There are families where privacy and general touching (hugs and cuddling) are more or less important, which is another thing that needs to be considered as we talk about boundaries and the violation of boundaries. While there are values that we as a broader community can agree on, there are others that are murky. When I read the quoted passages I feel I’m also missing this important context. I do not know what (if anything) her parents did about their relationship. I don’t know if Lena was reprimanded for the intensity of any of her actions towards her sister (the bribes with candy and quarters). I don’t know if Grace protested or if she was silent (not that her silence equals consent but I don’t know how much her parents were aware of their dynamic). In my office I sometimes see some parents describe a closeness that I, as a therapist, find concerning but I can’t know at first glance. It’s easy to jump to conclusions and misunderstand what’s actually happening. It takes continued discussion, questions, and observation to get a better sense of what’s going on. So when I feel my antennae go up I remind myself to go slowly and listen hard.

I also want to honor Grace’s right to label and define her own experience. Grace has said she does not see herself as a victim; I believe her and want to give space for her assertion. I also want to give her space to think differently at some point if she chooses to. Many of us think about our family of origin in one way and then we grow to think about it in another way later on. This is our right and important part of growth and empowerment. Whatever I may think of how I might feel if I were Grace, I am not her and in this important conversation about violation, I do not want to participate in a violation of her right to speak her truth.

In other words, this is a discussion that we need to be having but I think it’s extremely important that we do not expect her to uphold our own take or Lena’s take on their relationship or the scenes Lena describes.

These are things I do know.

Kids make mistakes. Some of those mistakes will certainly be violating the boundaries of siblings, cousins, friends and pets. In some cases those boundary violations may be bodily (kids who hit, hug too hard, hold down a cat who wants to get up) and sometimes those bodily boundary violations may be sexual. It is normal and developmentally expected that a child’s self-centeredness would lead to boundary violations. Remember that normal does not mean OK; I am not excusing or shrugging off the seriousness of boundary violations.

I am also not saying that normal means that no one gets hurt. One child’s normal behavior can harm another child. I mean, it’s normal for toddlers to bite but that does not mean it’s ok and it does not mean that the child doing the biting does not hurt the child who is bitten. Normal does not mean we ignore things.

If the type of activity Lena describes truly was typical of her behavior then her parents should have been intervening. (They may have been; we don’t know because we only have Lena’s side of the story.)

If one child is treating another child as a toy or as an object, that’s concerning and needs interrupting whether or not that treatment includes sex play. If a parent only jumps because the play turns sexual, that’s a problem because I would argue that there is likely a pattern of coercive play that needs parental attention and intervention. To a child, dressing up a reluctant pet and coercing a sibling into allowing genital exploration may come from the same misunderstanding of the division between self and others.

It’s our job as parents to protect our children from each other and also from themselves. Many of carry a great deal of guilt for the way we treated our siblings when we were kids but we needed adult help to figure things out. We can own our responsibility but also acknowledge that our childhood selves did the best they could with what they were taught; many of us were not taught how to treat each other.

Sometimes parents have trouble intervening because they don’t know what good boundaries between siblings looks like since we were not protected from ourselves or from a violating sibling. We see a certain amount of roughhousing and conflict as perfectly normal and it’s true — some of that is normal. But we should pay special attention when:

  • One child is always the victim;
  • One child is much older or stronger or otherwise more powerful;
  • If we detect real hostility in the interactions;
  • If the hostility is pervasive (if they never really get along).

In the case of sexual boundary play, I would also check in to ask where the children got the idea. Sex play is common in kids, absolutely, but a check in can help us know if something is happening to the child who is acting out (did they learn this from another child? from sexual abuse at the hands of an adult? unsupervised time watching HBO?). I would ask parents not to react as if sex play is always concerning but I would ask them to remember that sometimes it is.

Interventions do not have to be shaming. Parents can and should interrupt inappropriate behavior in a way that promotes empathy, compassion and an understanding of where a child leaves off and the other person begins. This starts when we protect that child’s boundaries. That means no forced hugs, no forced kisses, no forced sitting on Santa’s lap. There are lots of times where we have no choice (diapers changes of wriggly toddlers!) so when we can protect our child’s right to say no, we need to do that.

Finally parents need to be aware of their own understanding of boundaries and violation. Many parents who are struggling with their children’s sibling relationships are acting out their own experiences growing up. When I talk to parents in my office I’m always interested to know where they are in their own family configurations because this can illuminate my understanding of dynamics they are repeating (or trying not to repeat) in their own homes.

It also helps me understand why some parents are reluctant or afraid to make changes. To say, “This should not be happening to my youngest” may mean saying, “This should not have happened to me” or “This is not something I should have done to my sibling.” These are painful things to confront and I see some of that happening in the discussion around Lena and her sister.

We all come to our reading loaded down with our own baggage and it’s pretty hard not to bring that to a discussion about someone else’s very biased, perhaps somewhat fictional, and certainly manipulative (in the way that all writing — even this — is meant to sway the reader) story.

I don’t know what happened between Lena and Grace, not really. I cannot speak to it. I can only speak to the general things I know to be true and hope that I can help the individuals and families who come to me for care, informed by what I know about kids, about siblings, about families and about the truly hard work we all do growing up.

Teens and Confidentiality in Counseling

Teens and Confidentiality in CounselingParental involvement is a key ingredient in kid client success in therapy. What this looks like will depend on your child and his/her treatment plan, your practical ability to be involved (are you a noncustodial parent? Is your child receiving services at school?) and the therapist. But at the very least, you and your child’s therapist should be communicating regularly.

Depending on the child, the parents and the treatment goals, I include parents in the following ways:

  • Parents attend sessions with their child (this is common with young children and with children who are struggling with attachment);
  • Parents come in for the first or last few minutes of session;
  • Meeting with parents separately before or after the child’s session;
  • Scheduling separate sessions with parents when needed and appropriate;
  • Arranging for phone calls to check in.

I like kid feedback for how parents should be involved, particularly with teenagers who are navigating the developmentally appropriate need to separate along with the necessary support from parents. Sometimes this means helping the teen figure out how they want to talk to parents about something and then inviting parents to session to help mediate a discussion.

I go over confidentiality with parents and teens in session with the understanding that we will all respect the teen’s privacy in the counseling relationship but that the adults will keep her safety paramount in decision-making around what to share. When kids are struggling in a gray area, I always encourage them to invite parents to the discussion but I won’t go over their heads and tell secrets unless I’m concerned for their safety.

Here’s the Ohio ACLU publication about minors and their rights. The part about counseling (this is a PDF file) starts at page 40: Your Health and the Law: A Guide for Teens.

From the file:

A minor who is at least 14 years old can request outpatient care without notifying a parent as long as the treatment does not include medication. However, such care is limited to six sessions or 30 days, whichever comes first. After that, the care must stop or the parents must be informed and must consent in order for treatment to continue. During the first six sessions or 30 days, the parents will not be informed of the treatment unless the teen consents or the care provider feels the minor is likely to harm someone. Still, before the parents can be informed, the care provider must first tell the teen that the parents will be notified.

I have not had a teen call and ask for counseling on her own but I have had other loving adults (relatives or family friends) call me to find out if they can bring the teen to counseling without parental consent. I always explain how the law works and explain that except in cases where parental involvement would be dangerous to the child, it’s really best to have parents be a part of counseling.

There are guidelines around counseling teens and maintaining confidentiality. As a counselor practicing in Ohio, my ethical guidelines come from Ohio’s Counselor, Social Worker, and Marriage and Family Therapist board and my professional organization, the American Counseling Association. Both these entities recognize that teen confidentiality is a gray area. The ACA and their sister organizations for social workers and other therapists regularly publish articles and papers on the topic.
Here’s a handful for you to check out:

As you can see, there are not definitive answers because these topics are complex and so very individual. How I might, for example, handle it if a client tells me s/he is sexually active will depend on many things including but not limited to:

  • Why the teen is in counseling in the first place;
  • With whom they are being sexually active (is it consensual? Is it legal?);
  • How old the teen is (there’s a big difference between a 13 year old and a 17 year old);
  • The family’s values around sexual activity;
  • The circumstances surrounding the sexual activity (are there pressing concerns about safety?).

My first priority is always first and foremost safety but I recognize my ideas about safety may be different than the families. For example, say I learn that a 17-year old after careful consideration and planning decides to access birth control and have sex with her long-term partner. Perhaps she comes from a strict, conservative family whose religious beliefs condemn premarital sex. I am unlikely to break confidentiality under those circumstances.

I say this to encourage parents to talk to their teen’s counselor to make sure that they understand each other. If you want a counselor who would break confidentiality then I’m not the right person to work with your teen. It’s best we all know this ahead of time.

That said, I do not ever encourage teens to lie and I do not side with them against parents.

Finally, when confronted with a sticky situation I seek supervision, meaning I go to my peers and my mentors to get feedback when I’m not sure. While maintaining confidentiality about the individual and the family, I ask for help and document these efforts accordingly. It’s dangerous for any therapist to operate in a vacuum and I am fortunate to have great counselors available to me to answer questions and help me examine ethical practice as it applies to the complicated reality that is counseling kids and teens.

Needing context

kids-insideThere’s a lot I don’t know and knowing what I don’t know is a big piece of being a good counselor. One of the most important things I do know is that I can’t make sense of anything without context.

Because I work with kids and parents, people sometimes assume I must have hard and fast rules about what makes for good parenting but hard and fast rules only work on paper. In real life, we make decisions in the context of our histories and our current experiences. We are making big, well thought out decisions and we are making quick, on-the-fly decisions. Those decisions never happen in a vacuum so when people say, “Is this a problem? Is that a problem?” I have to say, “I don’t know. Tell me more.”

Before I meet with a child for the first time, I meet with her parents. We talk about what’s going on and we talk about what the parents have tried already. We talk about what works and what doesn’t work. Parents are sometimes apologetic or defensive when they share one parenting choice or another because parents (unfortunately) are used to being judged. But I don’t judge parents. My job is to understand them and understand their goals and to understand their children so that I can help them live out those goals and to support their children.

Let’s take spanking for a very heated, very emotional example. I know great parents who spank and I know terrible parents who don’t. I can’t really tell anything about a parent or about their child or about their struggle when I hear, “I spank my kids.” It’s just a single choice in a sea of choices so when I hear a parent say, “I spank my kids” I want to know more about that. Why? Is it a knee-jerk reaction? A considered decision? Under what circumstances? What is the child’s reaction? What is the parent’s reaction?

This is how I approach all of those hot button issues: co-sleeping or crying it out, homeschooling or not, time outs or non-coercive parenting. I want to know what these decisions mean in the context of that family. How did those decisions happen? How do those decisions support or undermine the family’s goals? Do the parents feel their choices are working for their children? For themselves? Is it time to consider new options?

When I make recommendations, I make them in front of a background of what the research says, what I know from personal experience and from talking to lots (and lots) of families and — most importantly — I do with respect for the child and family in front of me. I may push parents to reconsider some of their previous choices but I will do it with respect for the values that drive those choices.

Dual Relationships in Therapy

networking-insideThere’s this thing in counseling relationships where you can’t have two roles with a client.

For example, I can’t be your therapist and your friend. Or I can’t have you as a client and use your house sitting services. Or I can’t be your child’s therapist and your therapist. The reason for this is that when we have dual relationships with clients, we run the risk of creating conflicts of interest. The therapist/friend one is obvious, right? And the client/house sitter thing doesn’t work because what happens if I’m supporting you to become more assertive and then you come to me for a raise that I don’t want to give?

The roles in the therapy relationship — being your child’s therapist and not being yours — are more complicated. It’s one thing to support you to be the best parent you can be and to help you confront any issues that come up in that context but it’s another thing to, say, address your issues of trauma and do sand play with your kid. This is because when you are being someone’s therapist you are also being their advocate. If I were seeing you as an individual and your child as an individual, what happens when my advocacy for your child runs up against my advocacy for you? Whose needs take precedence? Let’s say a parent discloses that she’s thinking of moving to Boca Rotan and wants to use me as a sounding board to talk about her career options but I’m already seeing her child who has severe separation anxiety. Can I honestly help her assess her choices if my first concern is that her child’s life not be too disrupted? No, far better for her to talk to me about the impact those decisions might have on her child and to find another therapist to help her figure out the bigger picture.

This is why sometimes I’ll encourage my clients to seek the support of another therapist. This is why I can see an individual and include her partner in sessions but I cannot go from being her therapist to being their therapist. In the first case (including the partner in her individual therapy), my advocacy is always with her. In the second case (going from her therapist to their therapist), the established relationship I have with the client would set me up to have some pretty heavy bias when it comes to understanding her partner’s experience.

It’s confusing for people, I know, but the structure is there to protect the client first and foremost.

What I’ve learned in a decade of parenting

morningbeach-insideThis post originally appeared on my old this woman’s work personal blog. I’m adding it to the site because I saw some people clicking an old link to it on a parenting forum and getting the 404 message that it was missing. I’ve now been parenting for more than one and a half decades and my toddler is now a tween, my tween is now a teen. Basically the message I have is the same: It’s OK. You’re doing OK. Go easy on yourself.

Since my kids are so far apart in age (seven years) I find myself with a whole new cohort of parenting peers. Instead of moving on to parenting a school-ager while having a preschooler like most spaced-sibling families, I’ve got a school-ager and a toddler. Unless my friends have more than two kids (kinda rare), I’m hanging with a new set of people at baby gym class, etc.

In my daughter’s rec center classes, most of the parents have kids that are younger than my oldest (not all but most) and for many of them, the toddler tumbling around is their oldest and so they are fairly new parents. Listening to them really brings it all back to me — the worry, the fretting, the rigidity, the belief that there’s one way to get it right. I remember. But in ten years of parenting and watching my friends parent their kids, I realize that all the things that used to get us worked up just aren’t as important as we thought they were. I hear them discussing the things we discussed with the same earnest conviction and it makes me … tired. I don’t want to live those debates again and I also no longer care whether or not people I like are doing things the way that I think they ought to be done. (In other words, when a woman leans across the child in her lap to speak urgently about the dangers of television I neither feel defensive nor passionate in agreement. I simply don’t care about anyone else’s television choices and I don’t care what they think about mine.)

I also have found (horrors!) that I am very much one of those women who tries not to say, “Wait and see” when someone is telling me that their child will never play computer games/eat fast food/own a Barbie. I try not to be but I can’t help it. (Never say never should be the theme song to parenthood.) I can’t help but raise an eyebrow when a passionate new parent swears s/he will never send their child to school or let them eat refined sugar. Or when they lecture another parent (as I was so happy to lecture) about the proper way to get a child to sleep through the night or learn to pick up his toys.

I hate to say it, but parenting the baby/toddler/preschooler? It’s easy. Well, easier. Why? Because their domain is so totally in your control. Yes, it’s exhausting and physically tedious and certainly a huge challenge but they get bigger and not only do they become more themselves (and less amenable) but also the rest of the world intervenes and suddenly you’re not dealing just with your inlaws, who totally don’t get this whole no refined sugar thing you’ve got going on, but with the birthday parties of friends or the Bratz fad that’s infiltrating the neighborhood. (Note from Dawn of the future. Bratz have fallen by the wayside. It’s all about Monster High these days.) I mean, when they’re preschoolers, you can keep them ignorant or else you can just come down hard and fast. Preschoolers mostly listen because what do they know? But bigger kids? They’ve got opinions and sometimes their opinions are absolutely at odds with yours.

Then there’s this other thing — people with a good kid think they’ve got the key to good parenting. I know this because I thought it myself. My oldest is a pretty good listening kid, a kid who wants to please his parents and who craves structure and I thought that was our superior parenting but the truth is, it’s him. He had and has his challenges — not sleeping through the night for the first 3.5 years, an inability to process change well or easily, a tendency to the dramatics — but he’s a pretty easy kid. We’ve parented our youngest exactly the same (mostly) and she’s a fireball of loophole seeking and arguments (but also slept through the night much earlier — go figure). We never had to childproof with him because one stern shake of the head and he’d immediately back off from whatever it was that held potential danger but our youngest has gone out of her way to find the most deadly things in our house and try ’em on for size. A “no” to her is simply a sign to wait until her parent’s back is turned and then try harder.

I love new parents. I love their shell-shocked pride and out-sized concern. I love their myopic devotion. I so remember how important every decision felt. Me and my friends, we were such intense devotees of motherhood. Oh the debates about flaxseed oil! About kindergarten curriculum! About toothbrushing and fluoride and non-punitive discipline! Oh the discussions about the right way to give compliments and the proper way to put a child to bed! And as it turns out? The choices are less important than the values that drive them. When they’re ten, no one can know that you used sun-bleached organic diapers or disposable. You can’t even tell the breastfed babies from the ones who got bottles. The homebirthed babies who ate nothing but organic for their first years are standing by the soda machine jingling their change. The daughters of feminists are putting on lipgloss; the baby boys who nursed their trucks are wrestling on the gym mat. It’s not that our choices have no impact, it’s just that the impact isn’t always what we expect.

I say this not to be discouraging but to be reassuring. It’s OK to let go of some rigidity — your good kids will be good kids even if you “slip” and let them eat jarred baby food instead of painstakingly steaming that organic potato before you run it through the food grinder. It’s the big picture stuff that matters, not so much the tiny decisions that we fret about. I’m just not all that convinced that baby signs or Ferberizing or infant toilet training are going to matter all that much by the time our kids hit their twenties. It’s more about why we do those things.

So I guess I’d say that in ten years of parenting I’ve learned that you do the things you need to do to get through the day with love and hopefully some laughter, you trust your kids (and yourself), and you let yourself have fun along the way.

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