When Your Child Doesn’t Participate in Therapy {EP 86}

Robyn: When I think about my own experience, as a therapist, and as a therapist, with the kids with the biggest, most baffling behaviors, right? I was often seeing kids who had been through multiple other therapists before they landed in my office. And I then had the good fortune to be partnering with them and their families, that kids show up to therapy and all- a variety of ways they behave in a wide variety ways in the therapy office, that sure, it would be really easy for us as adults to label as not participating in therapy. So I did a quick little brainstorm. And I just came up with like some of the top behaviors that I would see really regularly in therapy that adults or even other therapists, like my therapist colleagues, could label as, quote, unquote, not participating in therapy. So one, of course, is just kids who don't talk. Whether they're kids or teens, they come to the therapy office, and they don't talk. They just sort of sit there. Or they're talking, but they're talking about a lot of unrelated topics. So they're not talking about what the identified problem is, or the identified symptoms are, that's why they've come to therapy is talking about all sorts of other stuff that feels, to the grownups as irrelevant. Or they're only playing. Or they're playing in a way that isn't obviously therapeutic, or obviously related to the behavior or the symptoms that brought them to the therapy world. Or they're playing but not doing any verbal reflection on it. Like there isn't explicit meaning being made out of the play, or they aren't talking about coping skills, or ways to kind of change their behavior, right? It's just, quote unquote, just play. Or the other thing that grownups will talk about, and sometimes I can find myself in this category as well. That there isn't any obvious changes happening in or outside the therapy room, and then the adults can label that as due to not participating in the therapy. And maybe even, you know, I've- I've seen adult- go as far as saying, the child doesn't want to change or want to get better.

Robyn: So, I'm gonna try to tackle all these things in a short, little podcast episode for you today. The first thing that I want to say, like let's kick off this episode by saying, I really, really firmly believe that it is, never the child's job to behave in a way that an adult would label as participating or not in therapy. It is only the child's job to be exactly the way that their nervous system is asking them to be in that exact moment. It is never their job to behave in a specific way that I, as the therapist or as the parent would say, is them participating or not. It is the therapist's job, however, to stay continuously focused on the truth that safety is what is the treatment. Felt safety the offering of, the cocreation have safety inside the therapeutic experience. That's the treatment, and that's the therapist's job. Okay? What I know with certainty is that your child's nervous system is a longing, it's desperate to rest into safety and connection. And I'll also say that everything we're gonna say applies to all therapy clients regardless of their age. But we're going to talk about your kids today. Your child's nervous system is a longing to rest into safety, and connection. And I know this, because this is how the nervous system works. The nervous system preferences, safety and connection. It is looking for safety and connection. It wants to move towards safety and connection. If safety and connection is available, the nervous system is enticed to move toward it. Now, it is also true that for probably most of you listening, and certainly for the vast majority of the clients I've worked with, because I've always specialized in working with kids and adults who have experiences and histories of significant complex relational developmental trauma. That, in addition to the nervous system, always longing to rest into safety and connection. There is also other parts that have been developed, protective parts, that are working really hard to prevent rusting into safety and connection, because there's been too many experiences where safety and connection wasn't actually safe. So I'm absolutely validating that you probably have a child that isn't really acting like they want to rest into safety in connection with themselves, with their therapist, or with you. You're not imagining that that's really happening. But it's also true that coexisting at the same time is a part of the nervous system that is looking for and longing to rest into safety and connection. 

Robyn: Moving towards safety and connection, like having the safety, having the space, being with somebody who isn't requiring a certain behavior, or a showing up in a certain way inside the therapy room. That's what the therapy is. Talking about or playing out themes that are clearly related to the reason that that child is in therapy is such a very, very small component of what the therapy actually is. So let me say that, again, we think that going to therapy is about talking about processing, or at least playing out what the problem is. You know, directly addressing what we, on the outside looking in, think the problem or you know, is that's related to the symptoms. And so oftentimes, we will, you know, be okay with what we would call like relationship building therapy. But it still is being talked about in this context of it's what we do to get to what their real therapy is, quote unquote, real therapy, right? That actually isn't what therapy is at all; therapy is not about exclusively talking about or playing out the themes or the symptoms, or what's brought that person to therapy. Therapy is about learning to trust safety. Therapy is about learning to trust relationship. Therapy is about learning to trust that there is nothing wrong with you. And it could take literally years of therapy for a therapist and a client to co-create together enough felt safety that that client can risk and tolerate bringing to mind and focusing on the struggles like the overt struggles that have brought them to therapy. The behaviors that are being troublesome in their life, right? Or their past traumas that are underneath some of those behaviors. It could literally take years for enough felt safety to be developed that a client is directly paying attention to those specific things. And lots and lots of therapy is still happening. The therapy that happens and all those micro moments leading up to a client directly addressing or talking about or playing out those, you know, their problems or their traumas is still therapy. And it's crucial, it's necessary, it has to happen. The end goal isn't talking about the troubling thing, the end goal is resting into connection, and safety. Now it's true that for many people, eventually doing some sort of like targeted work related to the specific trauma, or even just the symptoms or the behaviors that have brought them into therapy. It's true that for a lot of people that does become a part of the therapy and a useful and important part of therapy. It's actually also true that it never does. I have worked with so many folks, kids and adults, where wild change has- has made- has been made, even though we never directly target the thing directly. 

Robyn: I've also seen the opposite be true, right? That like clients talk or play out their behaviors or their traumas for years, with no real evidence that it's helping them. Because there is no real evidence that it is. Like simply talking about something isn't what makes, you know, the possibility of change. There's a lot more that goes into shifting and changing in the nervous system. And talking about and- or playing out symptoms or traumas directly is no more indicative that any, you know, change is going to happen, than not talking about or not playing out, you know, the symptoms or the behaviors or the traumas. Therapy happens in the moment that the therapist first lays eyes on their client in the waiting room, and the client sees how genuinely happy the therapist is to see them. Therapy is the bravery of a client who walks through the door week, after week, after week, after week. Therapy is experiencing new rhythms and relationship by playing balloon volleyball for months, which I've done. Therapy is learning to tolerate the closeness of relationship while playing Uno for a year, which I've also done. Therapy is about having a deep relationship with someone who has no agenda, no expectation that I show up in a certain way, or change. 

Robyn: Therapy happens in those teeny, tiny little micro moments of being with micro moments that accumulate and build up over time at exactly the right pace for your child, or for whoever the client is. And how do you know that it's exactly the right pace? It's exactly the right pace because your child has said it. 

Robyn: So if you have a kid who's refusing to talk about traumatic or hard content, and refusal looks like all sorts of things, right? Like they literally are refusing, saying like, No, I'm not gonna talk about that. Or they're, you know, just finding a million other things to talk about. Or they're talking about nothing, or all sorts of things, or they're talking about things that are just so fascinating. We all get distracted about, you know, what we're really quote unquote supposed to be talking about. So refusing looks like a lot of different kinds of behaviors. But what we're going to do is reframe that. We're going to reframe, refusing, we're going to reframe not participating, and look at it as the child knowing themselves so well, that they know that they don't yet have the safety in their nervous system, in this relationship that they're co-creating with this therapist who's probably a stranger. You just don't have that safety yet to tolerate bringing any- bringing memories to mind. Bringing the trauma to mind, like putting a foot into their traumas, putting a foot into their current behavioral challenges or their current symptoms. It's so wise, it's the child having so much knowing of themselves that like I just don't yet have the safety, to tolerate being with this really hard content, while also being regulated enough, that being with a really hard content could actually matter. Like it could actually change. If we force talking about something in a way that causes dysregulation that either overt like out of control dysregulation or kind of like a dissociated dysregulation. Generally sure the child can talk about it, but they're not really feeling it. There's no change happening, like the neurobiological mechanisms that are needed, in order for true change to happen inside the nervous system, inside the memory networks requires a sense of safety, a sense of regulation. Tolerate, you know enough safety and enough regulation to tolerate the lack of safety and lack of dysregulation that comes with talking about or playing out the hard stuff. Okay?

Robyn: The only person that's in charge of the pace of finding and creating the safety in their nervous system is your child, is the client. And it is our job, the grownup’s job, to believe that this pace is happening at the absolute perfect pace. It's the therapists job then to make sure that they're approaching each of their sessions with this child from a space of non judgmental a agenda less presence. Let’s say that, again, non judgmental agenda less presence. That's a quote from my mentor, Bonnie Badenoch that is the therapist job to show up with a non judgmental agenda less presence. It’s the therapists job to make sure that they show up to the sessions with their whole brain and their whole body. Offering the opportunity to co-create with their client, no matter how small, a we space. I is not the therapists job to ensure that the client participates in a certain way, acts a certain way, or even changes. Now without question, I have known families who have had therapists who didn't know the signs to look for and didn't know how they should respond to a child whose behavior is clearly saying, there isn't enough felt safety yet here for me to participate in the way that everybody thinks I should participate in therapy. And so what can happen is very, very well meaning therapists who just haven't had the opportunity to be mentored or trained by folks who can help them support them can either force something, which absolutely does not create safety. Let's go back to some of the behaviors I talked about at the beginning of the episode. Not talking in therapy, talking about unrelated topics only playing, or playing in a way that isn't obviously therapeutic, or when there's no obvious changes really happening in- or outside the therapy room. And let's just look at those a little bit more closely and consider what might actually be happening. And it isn't that they're not participating. 

Robyn: If the child is showing up, they're participating. And I really can even make a case for the child who's like refusing to even get in a car and go to therapy, that in a way that child participating, as well. But that's probably another episode for another day. So for this moment, let's just say if the child is showing up, they're entering into the therapeutic space, walking through the door of the waiting room, they are participating. They do not- there's no requirement that they participate in a way that I or anyone else thinks is how they should participate. We have to trust. We have to trust that their nervous system is moving and shifting and moving towards safety and moving towards connection at exactly the pace that it can, without question. It can be excruciating to watch how slow that pace is. And to watch the intensity and the severity of the symptoms continue because of how slow the pace is. Excruciating. People's lives are really, really difficult because of their behaviors or because of their symptoms. And on the outside looking in it can feel it because it just excruciating. Like oh my gosh, I could help you. i If we you know, it's so easy for me, especially as a therapist to say something like or to think something like oh my gosh, if you- if you could just show up and participate in therapy in this specific way, your symptoms would alleviate and you'd feel so much better and your life would be better because we're we're very well meaning, right? Like we want the symptoms to get better. We want the behaviors to change. We want the trauma to integrate, right? But in my most regulated self, I can remind myself that I'm not in charge of anybody else's path towards healing or towards integration. I'm not in charge of their timeline. And I'm not in charge of deciding when their symptoms seem bigger than the risk of, you know, quote unquote, participating in therapy in a certain way. Right? Like, I'm just not in charge of those things. 

Robyn: So what's it mean for a child who's not talking in therapy? And let me tell you what I've had many, many children. I've had many adults, but adults tend to not tolerate as well, a lot of silence. And so this doesn't happen quite as much as adults. But I've been many, many children who come in and just like, they don't kind of do anything, they don't talk, they don't really play. They just sort of sit there. And it's like, yep, yeah. What about that is not participating? Like, why do we call that not participating? Right? The participation is that they're there. The experience that's needed, maybe. I have no idea I'm just musing here. I mean, I could only begin to guess specific people, right? But perhaps the- the needed experience is I can show up in this way, and you will be willing to accept me for exactly how I show up. I don't have to perform for you or be anything for you in any kind of specific way. And it's okay. Maybe that's what is needed. Right? How wise then, for that child to come in and not talk. Right? Because there is an expectation in the therapy world, that there's talking involved. So if a child really, really needs to experience, I'm okay exactly as I am. I don't need to change to make you more comfortable. Then not talking therapy is brilliant. 

Robyn: What about the child or the client who talks a lot, but it's always unrelated and unrelated as in air quotes, right? Because what's- what's that mean? Because the content- the content, the what people are saying, kids or adults, is actually really shockingly, largely irrelevant. What is really happening in therapy is very little the words that are being spoken. Right? So the talking about things that are unrelated, is still the opportunity to have a relationship- have a relationship where my interests are shared by someone else. Have a relationship in which the other person is allowing me to lead the relationship, it could be simply about practicing, serve and return. It could be simply about practicing it being safe to be in relationship. And if I talk about these other topics, I'm titrating easier topics. I'm titrating the safety of connection right?

Robyn: Similar for kids who are kind of quote unquote, only playing or playing in a way that isn't obviously therapeutic. So yeah, that sometimes looks like playing a board game over and over and over again. Oh, making slime. Making slime was- I haven't seen a client- I haven't seen a child in the office in a couple of years now as I don't know if slime is still all the rage, but oh man, did I go through a time period of making unbelievable amounts of slime in the therapy room and even me in my my brain, I can be like, Oh my gosh, is this therapy? Like, what are we doing here? And remembering that my job is to trust the client. It isn't the clients job to trust me. My job is to trust the client, that their body is getting exactly the experience that it needs in exactly that moment. So I could muse for- forever about what a year of playing you know, means a year of making slime means. I'm being extreme here, but not as well. Alright, um, you know, a year of playing catch, a year of playing cars. Like we could muse forever about like, what's the therapeutic theme or the content that's underneath all of it? There's billions of options. My job is to trust that it's exactly what that person needs, and then to stay exceptionally present and engaged in the live. One of the risks as a therapist when it feels like the client isn't participating, or they're avoiding, or they're, you know, not going to the hard stuff or whatever it is that we call it. One of the risks is that I, as a therapist, get really lost in my head. I get worried about what I'm doing wrong, I'm getting worried about what the client’s supposed to do for this to be successful therapy. Well, another risk is that I get bored. There's all sorts of risks. But ultimately, the theme of those risks is that I, as a therapist, get disconnected and disengaged, okay? So when it feels like the child's not participating, or they're playing in a way that's obviously not therapeutic. Again, I put that in air quotes, obviously not therapeutic, or not obviously therapeutic. That's what I meant to say. My job as a therapist is to make sure that I continue to show up in an extremely present, extremely embodied extremely relational way, because that is what the therapy is. 

Robyn: And then one last thing I want to chat about here before we wrap up this episode. And this might be an episode that has helped you, as the parent, feel a little bit more regulated about your child and how they're showing up for the therapy hour. This might help those of you who are professionals feel a little bit more regulated about that. And you all might want to share it with each other, like maybe you want to share it with your child's therapist. Maybe want to share this episode with your child's therapist, or maybe you want to share this episode with the parents of the child that you're working with. I hope that this episode is helpful for all of y'all. 

Robyn: So the last thing I want to talk about is when we're not seeing anything change. And I want to just remind you, that there is so much change that's happening, that we can't see always. It isn't possible for the brain not to change inside a resonant, attuned, relational experience, it is literally not possible for it to not change. Change on the inside, doesn't mean we're going to see change on the outside. And we can't measure it, and we can't place a higher value on change that we can see on the outside. I have seen clients come to therapy for a very long time before we see change. Sometimes a lot of inner change has to happen before we would ever see outer change. And that doesn't mean that change isn't happening. 

Robyn: Without question, there are circumstances in which it is reasonable to consider. If it's a good idea for this particular therapeutic experience to continue. Not all therapy should be continued, kind of ad infinitum. Simply because, here I am saying that if your child's going to therapy, they're participating in therapy, okay? So don't take it to mean that there are definitely some things that we could think about and consider that would say, you know, what, it's- it's maybe appropriate, take a break from therapy. Or maybe it's appropriate to find a different therapist. Right? That's a whole 'nother episode. We'll talk about that. We'll tackle that a different day. But I just want to be clear, I'm not necessarily insinuating that. What I am asking you to do is if the thought is coming into your mind, like my child's not participating in therapy, whether that be your child client or your actual child that you're taking to therapy. Ask yourself, like, what are you really asking what does that mean? What does my idea of participating mean? Am I asked- does that mean I want this child to act or behave in a certain way that I would call participating? Right, those are- that's what I want to ask you. Want to0 you want to encourage you to ask yourself about, and I want you to feel good, trusting in the fact that safety is the treatment. That in a therapeutic experience where the therapist is- is offering the potential for the co-creation of safety and connection that your child's nervous system can't help but notice it, can't help but move toward it. Now how fast they move toward it, I have no idea. And do they take the teeniest tiniest little step towards it and then their protector that says “no, connection is dangerous” swoops in. Of course, of course, that's happening. But that's still therapy, right? When the child is rejecting or refusing connection, and the therapist keeps showing up, the therapist keeps offering it with no expectation that the client do anything. That's the therapy. 

Robyn: So I want you to take a breath, I want you to feel okay. That your child's way of showing up at therapy and their pace of how they're able to change in therapy is very likely, exactly the pace that their nervous system can- can move at. And that's all that it can be y'all. We're not in charge of it moving faster, we can feel tremendous grief. That is not moving faster, because the repercussions of that are substantial. We have to trust the child in their pacing. 

Robyn: All right, I'd love to hear what you think about this. And what- what additional questions you have so that I can make more episodes for you that are answering the questions that you have about- really about anything. But, in this moment, I'm talking specifically about like, how do you know that this therapeutic experience is what your child needs and is in their best interest without placing upon it our ideas about what it means to quote unquote, participate in therapy. So I hope this episode was helpful. I hope it was thought provoking, I hope it was helpful to you rather, your parents, or professional, I'd love to hear how it was helpful. You can find me on Facebook, you can find me on Instagram. I usually have two posts a week about podcasts. And so find those posts, and we can chat about the episode there. And I can hear from you kind of like what next like what is this episode leave you asking so that I can address those questions and future episodes. Thank you, thank you, thank you for for showing up, for pressing play. For loving a child with a vulnerable nervous system with big baffling behaviors continuing to want to show up for them, for continuing to show up for yourself. So that we can support these kids and maybe there's even moments where you realize you're that kid. And so when you press play, you're showing up for this child in your life but you're also showing up for you. If you haven't recently, head over to my website because I've got lots of cool stuff for you there I've got my What Behavior Really Is masterclass. I've got my Brilliance of Attachment ebook. Oh! The What Behavior Really Is masterclass also has an ebook. All of that's free. I've got The Club which is my community for parents of kids with big, baffling behaviors. I've got my year long immersion program Being With for professionals who want to do this kind of work, the work that I do with families, they want to do that with families, too. So go to my website. Check it all out, see what's available to you now, see what's on a waiting list. Lots of freebies. I'll see you back here next week on the podcast. Have an awesome week.