Sunday, November 01, 2009

Marcus, Take Two

Thank you to everyone who participated- and please, continue to add your thoughts!

If we keep in the front of our minds the idea that symptoms are adaptations, we must wonder what doing the drawings and sharing them with his peers is accomplishing for Marcus. I can think of several possible theories, such as giving him power, expressing his pain, giving him one area in which he is in control and can have an effect on others.

Also, the drawings express a part of Marcus, however disturbing they are. If we just try to ban them, we are giving Marcus a message that we are turning away from his pain, and that we do not want to see, share or accept all of who he is and what he has experienced.

I do not feel that taking drawing supplies away from Marcus will help at all. For one thing, we won’t win on this one. There are many more pencils and pieces of paper in the world than we can ever confiscate. But more importantly, that is a response that tries to eliminate his behavior and not to understand it.

We need to take seriously the effect the drawings have on the other kids, the staff and especially the therapist. This is something we have to discuss as a team and make deliberate plans to give ourselves the stamina to take this on. For example, the therapist may wish to include a male staff at first when she talks with Marcus about the drawings.

Then, as noted by one of the comments, I think we should explore the pictures with Marcus, and not in a judgmental way. What is happening? What are the characters thinking and feeling? What is likely to happen next? The therapist can express her thoughts: "Really? I think the woman might be scared and angry." But all discussion should be from a very centered, calm place- tell me more. Explain how it feels. What does it remind you of?

These discussions should include NO MENTION OF THE NEED TO CHANGE. They are entirely exploratory.

Meanwhile, staff can talk with the other kids about how sometimes when people have had painful lives they draw painful drawings. Encourage the kids not to react, but just bring staff into the conversation if Marcus shows them a picture. Of course, Marcus’ showing them around would decrease if he got less reaction. Then staff would handle it matter-of-factly: you know, Marcus, better to save these for therapy- I’ll give this one to your therapist and you can talk it over with her.

Another area of treatment could be to offer Marcus other opportunities to have power and control, using his drawing. Could he draw some posters for an upcoming agency event (subject to review of course). Can he draw a picture for the unit illustrating some positive message, and can staff get it framed and hang it up? You get the idea.

Marcus has been hurt repeatedly over his life time. He has found a way to both express his pain and get strong reactions from others. His behavior will not change quickly. We must understand that the way that we feel in looking at these pictures is the way that he often feels in his life. And we must support each other in doing the long hard work it will take for Marcus to develop a new, kinder view of life’s possibilities.

Let’s continue this discussion- click on "leave a comment" to share your thoughts.


Anonymous said...

I really appreciated the array of hypotheses you generated regarding the possible function of Marcus' drawings. One you didn't mention explicitly, but only implied, was the possibility that the most important characteristic of his drawings wasn't so much the content but the impact it had on others. As a child who undoubtedly has experienced more than his share of rejection in life (as well as in his current residence), and has likely attempted to make meaning from these events in a way that detracts from his feelings of self-worth, it strikes me as likely that his graphic, off-putting drawings may be his way to keep others at bay (i.e., a 'best defense is a good offense' strategy). His behavior makes me think of other children in residential settings who present themselves in unappealing ways (e.g., disrobing when upset, not bathing for lengths of time, some forms of self-harm, even encopretic behavior) in the service of self-protection. While some of the ways you suggested staff might inquire about his drawings could eventually illucidate a possible interpersonal function, I would think that simply asking Marcus how he thinks others view his pictures could quickly reveal any interpersonal motivation. If it appears its intent is to serve as a strategy of disconnection, then options ranging from further exploring his lack of trust in relationships to teaching basic social skills may be in order.

Pat Wilcox said...

This is a great comment. I am glad you are highlighting the reactions he gets from the peers to whom he shows his drawings. It may be (as you suggest) pushing people away; also their scared and uneasy reaction gives him power and control that he cannot get otherwise. What else would this lead us to consider for interventions?