Not the Jerry Springer Show working with families in chronic crisis Dr Sebastian Kraemer Consultant

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Not the Jerry Springer Showworking with families
in chronic crisisDr Sebastian
KraemerConsultant Child and Adolescent
PsychiatristWhittington HospitalLondon N19
5NFkraemer_at_doctors.org.uk
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Families with serious problems have - in addition
to social deprivation - experience of abuse,
verbal, physical and sometimes sexual, going back
several generations.A Jerry Springer show is
always going along in the background of many
disadvantaged families, and in the foreground of
some.
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love is a reason to be hurtfather local
london man, 40, beaten in childhood by his own
near-eastern Mediterranean father. Severely
disabled brother born when he was 2 and died the
following year.Remembers his mother stabbing
his father with a fork, after which he left home
for the last time.Father says he has no emotion
since killing his dog 20 years ago when he lived
on the street. Now martial arts expert, security
guard and proud father of 14 year old boy and ten
year old girl.
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The boy was referred to me because he had
threatened self harmhe was already a paediatric
patient with many psychosomatic problems my
paediatric colleague, who referred him, was
present at first two family consultations. are
you a wacky doctor?
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mother, local london, 32. Youngest of six. Her
mother died when she was six weeks old. brought
up by father and step mother. Sexually abused
by two stepbrothers from 8 -11 years, which
neither step mother nor father protected her
from.All I can remember from my childhood is
fear.
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10 sessions over 18 months boy hates school,
but even more worried if father threatens to go
down there.. I attempt to get parents to work
together
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power and charisma of boy, bright and
parentified eg offers to fill in a form for his
dad. Always sits close to dad, who cuffs his
head affectionately (but quite hard) from time to
time.
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brief diversion on parentification
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Why is he looking at me like that?
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infant mammals are programmed to seek looking
after human adults do this both by thought -
keeping the baby in mind - and action if
caregiver cannot do this very well, the programme
goes into reverse, with growing child being
careful to note how parent is feeling
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this leaves little space for his own
development its a full time job anxious,
or even disorganised, attachment the child
takes the place of his or her grandmother if
the parent relies on the infant or child for
support in this way the child cannot thrive
parents need adults to support them
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the children are outspoken and brave (cheeky,
too)sister to mother I wouldnt let a man
talk to me like that. Id smack is face in!
..to father if you are afraid your son will
be like you, then you should change
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this in response to constant barrage of
offensive antiwoman talk mainly from father (son
tries but does not convince) though she does
not seem an intimidating or even powerful person
mother thinks son is rude to her because he is
afraid of her.. son and daughter had a better
deal than their parents, who were intimidated and
silenced as children
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father buys mother an eternity ring but will not
say he loves her. Insults continue - shell never
get a job or go on a coursebut he is very
fragile behind the mask. He stares at me, but it
is not threatening. Says he can feel nothing
and will never changehe has a passion for
oriental music and martial arts discipline
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crisis following death of close family friends
in car crash. couple in despair. Son shouts at
father, daughter bursts into tears. I send son
and daughter out of the room.father feels
nothing and says wife does nothing around the
house. we all feel hopeless
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family do not attend. I phoneson has left home
to live with his girlfriend they both feel
relieved, and guilty because of that
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son has returnedbeen in fight with teacher at
school. I advise parents to visit togetherI say
to boy that he is now strong enough to kill me
(and by implication his father), so what will he
do with his power?father silent when I ask if
he has ever killed anyone or been in prison, but
advises son to just bite your lip
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how each one deals with loss father urges son
to tell me of his girlfriends pregnancy and
abortion, and how he wept over it like a man
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Can we talk honestly about real families and our
reactions to them?Think about your own family
life? Is everyone always polite and thoughtful?
We have to learn how to dredge up our own
generosity, humour and wisdom when working with
families where these qualities are in short
supply
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what adjectives or phrases describe your
relationship with your mother, your father, as
far back as you can remember?when you were
upset as a child, what did you do, and what would
happen? did you ever feel rejected as a child?
What did you do do you think your parents
realized they were rejecting you?Adult
Attachment Interview Main Goldwyn 1994
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Thats all very well for him but what about our
work?
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work discussion and peer supportnot prescribed
in national directives, but does it all have to
take place over coffee or on mobile phones?
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anxious/disorganised attachment this leaves
little space for infants own development its a
full time job child takes the place of his or
her grandmother if the parent relies on the
infant or child for support in this way the child
cannot thrive parents need adults to support
them