Human Growth and Development
Concepts of Human Growth and Development
Jade complains that Zak won’t show her ‘his real self’, as if he is holding back on purpose, but it’s quite possible that he doesn’t have much sense of having a real self. As in a number of these case studies, Winnicott’s concept of mirroring is relevant here (HGD: 44). Zak to us seems like someone who may have had difficulty developing a sense of what Winnicott would call his true self, because Lily may simply have never been robust enough to respond to, and mirror his needs. Another way of looking at this would of course be in terms of the internalised working model of attachment theory (HGD: 67ff). It seems to us possible that, when he is asked to talk about or write down what he wants or needs, he might find it difficult to answer, not just because he finds it hard to make demands on people, but because he genuinely doesn’t know what he wants or needs, other than the things that make him feel relatively safe or comfortable in the short run, and it might be that quite a long and patient process would be needed to get him to really ‘engage’ in the way that Jade would like him to. (If we wanted to look at this in behaviourist terms (see Chapter 5, HGD: 103), we could say that Zak’s characteristic way of avoiding anything other than superficial contact is a behaviour that has been reinforced negatively: it allows him to avoid anxiety.)
Ideas about adolescent identity formation are obviously also relevant here. Zak would seem to be a fairly extreme case of a young person in a state of identity diffusion (HGD: 154). He is not preparing himself for adult life. He is not even thinking about it. He’s simply distracting himself as best he can from the whole problem.
The systemic idea of a feedback loop (HGD: 224) is relevant to this case, not just in relation to Zak’s small two-person family, but in relation to the way he relates to others. As is often the case with people who are socially withdrawn, his behaviour makes others feel that it’s too much trouble to engage with him (again, you could see this also in terms of negative reinforcement), and this in turn reinforces in him the idea that others have little to offer and that he is better off remaining detached.
The unconscious process of countertransference (HGD: 38) is always important to consider when professionals express strong positive or negative feelings about service users. In these situations, something about the client’s situation is stirring up something inside the professional, and it’s always worth asking how much of the emotion that the professionals feel is a reflection of the client’s feelings, and how much of it is related more to the professional’s own history or circumstances. We’ve already mentioned this in relation to Jade’s feeling of uselessness. As someone who turns his back on the world, Zak probably feels pretty useless himself and professionals will pick up on that. But if they are secretly afraid that they are useless themselves, they may pick up on it more, and in a way that makes them feel uncomfortable and resentful, rather than sympathetic. And, as mentioned above, Zak may even at some level need to make people feel useless, as a defence against feeling his anger at the failure of anyone to care for him in a reliable way. He may be transferring his unexpressed feelings about previous poor care onto current carers, in other words. (Please note, we are not suggesting he does this deliberately or that he is even aware that this is what he is doing. Defences are unconscious. [HGD: 34ff])
Still on countertransference, you may remember that in Case Study I, the Veloso family, the mother also had psychiatric problems which meant she wasn’t always available as a parent. Deanna was a strong defender of the mother in that case study, and we suggested there might be links between her feelings and her own experiences, (a) (Case L: Deanna Whiteworth and Zoe Scott) of having to cope as a child with a mother who had a drink problem, and (b) of being the co-parent of a child with her partner Zoe who also has a drink problem. In the present case, it’s noticeable that, while she is sympathetic to Lily, that strong need to defend her doesn’t seem to be happening here. For whatever reason, this situation doesn’t seem to trigger the same defensive response as the Veloso case. Perhaps the gentle and passive Lily and Zak just don’t remind her in the same way of her own circumstances? The ways in which cases influence us emotionally are subtle, largely unconscious and not necessarily predictable.