Understanding What's Happening in Conflictual Family Interactions

I currently work for a community based psychotherapy service provider that reaches out to families that are undergoing stress.  Our teams go into the homes of struggling families, conduct assessments, and help the family learn new techniques and healthier communication skills.

I was assigned to work with the Hernandez family in the Bronx. Mrs. Hernandez explained that her five year old daughter, Maria, was manifesting uncontrollable behavior, a low frustration tolerance level, and a seeming inability to listen and follow instructions. Maria’s misbehavior was wreaking havoc on their family life, and both mom and dad were at their wit’s end.

One of the first things I do when sitting down with a family is to try to get as detailed a description of their daily routine as possible. When Mr. and Mrs. Hernandez began describing their day, I was stunned.

Mr. Hernandez works at a factory several miles away. Production time at the factory begins at 5am. Daily, the children wake with their father, spent a few minutes together, and then dad goes off to work. Mrs. Hernandez then wakes up and gets the children ready for school. By 7:00 AM, the children are already in day care and do not come home until mom finishes her work at 6:00 PM.  When I arrive at their home at 7 PM, the children have often not yet eaten dinner- certainly not an ideal setting for therapy! At the end of the day, Mr. and Mrs. Hernandez are both so overwhelmed that they simply do not have the emotional strength to effectively interact with Maria and their other children in a positive and nurturing way.

Mr. and Mrs. Hernandez are sincere and caring parents. They want the best for their children, and are dedicated heart and soul to their children’s welfare. They were trying to garner the they need skills to control Maria and their other children’s behavior. My first intervention with the parent’s, therefore, was to reframe their conception of their roles as parents. As parents, our job is not to “control” our children. We need to nurture them. I began teaching Mr. and Mrs. Hernandez how to structure positive and meaningful interactions between Maria and themselves and to try to decipher what Maria was communicating through her erratic behavior. Over time, Mr. and Mrs. Hernandez are learning how to stop viewing Maria’s behavior as a personal challenge to their authority, and they are focusing on channeling Maria’s behavior in a constructive way. Implementing change is always hard, especially when it is requires overlooking one’s own exhaustion at the end of an intensely long and hard work day. Mr. and Mrs. Hernandez are reporting, however, an increased level of forbearance and ability to cope as they begin depersonalizing Maria’s outbursts and they develop skills.  These positive interactions are accumulative. Over time, slow and steady improvement is noticeable and the Hernandez parents as well as Maria are reporting lower anxiety and that they are actually enjoying each other’s company more than they have in a long time.