The Field of Stars.

A therapist writes from the frontline.

Something is really bothering me..

Something I'd not been aware of until very recently.

It is this - kids who can’t behave in class risk sectioning…

Let me explain.

Many kids in high school find themselves excluded by cliques, find themselves unable to join in with those groups, then suddenly lose the friendship of that one friend who spoke to them.

The child becomes sad, withdrawn, doesn't want to go to school. And forced to go, or persuaded, or willing to try again, they find it too much. And once back in the classroom they become agitated, angry, frightened...

Parents want an explanation.

Here they are in our waiting room, and they really want a diagnosis - and I’m about to tell them that I never give a diagnosis. Another disappointment. They have contacted the school many times, they have even given the school the names of those involved. All they want is for the bullying and harassment, rape threats, violence physical and verbal, to be stopped.

It doesn't stop.

So the child stops...

Stops being able to cope, stops being able to endure, stops and can't take any more.

Starts cutting.

Stays up all night, can't sleep.

The sense of exile, powerlessness, exclusion and ever present threat from other kids and some teachers doesn’t stop though. And it has made their lives into a living hell. If they haven't yet dissociated into limp, half alive walking dead, is it any surprise to find the child exhibiting anxiety; aggression, and hyperactivity; symptoms of severe distress in response to threat?

And it is called having a melt down.

What I hadn’t been aware of before is, several melt downs leads to A+E. And A+E leads to mental health interventions, and if the child remains non compliant with the mental health team?

Sectioning.

For now I am really curious about the discourse, about how we talk about distress, emotion, rage as outside of normal; how language creates a process of othering, of distancing and of avoiding contact and reacting as if to contagion. The roots of this are I think, buried deep inside cultural notions of fear and disgust.

Why is this a problem?

Anxiety is a brain protocol designed to prepare us for the worst. It is an emergency run through of everything that might happen. It allows us to rehearse. Yet when there is no way to escape threat, when fight and flight are blocked, when the help that is offered is empty words, or more threat is offered such as sectioning then all too often self attack - blaming oneself - suicidal ideation…You know I'm beginning to wonder exactly how much 'ASD' is really what a person does when they are stressed beyond their endurance.

But what caused it?

Many times the behaviour the school finds unacceptable has been triggered by a bereavement. By parents splitting up. By catastrophe. By suffering the loss of security and structure, the loss of love; the shattering of their life. Then they find themselves being told that they have OCD, rather than a raw human need to have order when disorder rules. Many children hear voices after such awful experiences and a GP helpfully (not) calls it psychosis.

The parents and child are now terrified by the implications.

Diagnosis is only words, and words can’t hurt you?

Unfortunately no, there is more to it.

Diagnosis has the power to transmit a belief that something is really wrong; and it creates shame and stigma. Being sent - as opposed to electively choosing to go - to counselling is almost as bad. It can be mortifying to have to ask the teacher in front of everyone to leave the class to go for a therapy session. And the reaction when the child comes back? Others don't want to talk to them. There is an aura of fear, a miasma almost.

Writing about this reminds me of a psychotherapist who told me that he used the picture hanging on his wall as a diagnostic tool. The picture was a reproduction of a famous painting from a time period this therapist was fascinated by. He told me in all seriousness that this was his test for autism. Any client bewildered by the painting, was apparently autistic. I didn't argue with him, his claim was paper thin, but he was convinced of his correctness, and led astray I think, by his own perception of status conferred by his qualifications. He also seemed to believe that if we had received perfect parenting, we would be like Mr Spock (Star Trek) ever rational! I do not believe so, I believe this to have been his personal fantasy, mirroring our culture. For we live in a culture that values glacial disinterest. We are supposed to applaud the man who goes nobly to his death without any fighting or screaming.

Or else in hearing his terror we may feel something a little uncomfortable?

In psychotherapy you could call it regression, as if we become infantile and need rescue…

It’s my contention that this anxiety to fear to panic to attack to rage is what war is made of…so it isn’t an unknown process. Our culture needs to other it, we distance ourselves because we intuit where panic and rage can lead.

Meanwhile the fourteen year old sitting with me in the counselling room, talking about being excluded from the classroom, excluded from school, of how she can’t sleep because of the fear, is calling this anxiety.

As we talk I hear the usual things, of teachers and friendships, of bereavement. And the word anxiety breaks into a hundred fragments of memory.

Slowly together we will construct something more truthful and more practical, made of exceptions and instances, tiny flecks of gold hidden within the story begin to shine like stars…