Emotions in Child Psychotherapy: An Integrative Framework

208 Pages·2009·2.45 MB·English

by  Kenneth Barish

“In this practical, concise, and sophisticated new book, Barish provides
an integrative approach to child psychotherapy based upon a wonderful
synthesis of the latest developments in emotion theory and research, infant
developmental research, psychoanalytic theory, and cognitive approaches.
By emphasizing the fundamental role played by emotion regulation in
both healthy functioning and the therapeutic process, he provides a coher-
ent theoretical framework that illuminates the way in which a range of
diff erent therapeutic interventions operate. Conceptualizing play therapy
as a vehicle for facilitating emotion regulation and the renegotiation of self-
other relationships, Barish provides a theoretically stimulating and clini-
cally rich guide that will be appreciated by clinicians of all orientations.”
—Jeremy D. Safran, Ph.D., Professor and Director of Clinical Psychology,
New School for Social Research, and author of Negotiating the Th erapeutic
Alliance: A Relational Treatment Guide
“Dr. Barish has written an eloquent book for the use of emotions as a
central component in psychotherapy with young children and with their
families. His main premise, that children develop the capacity to recover
or ‘bounce back’ from frustrations and disappointments in c hildhood,
is clearly explained through his presentations of case material. Th e
beginning of the book off ers a clear theoretical foundation for his work,
emphasizing the variety of emotions humans experience. Each emotion is
carefully discussed, with examples from his practice demonstrating how
he handled a particular negative emotion of a troubled child, and then
how he used the emotion as a stepping stone to open the way for healing.
Th e practical suggestions for parents and for teachers at the end of the
book add to the richness of his discourse.”
—Dorothy Singer, Senior Research Associate, Yale Child Study Center, and
co-editor of Play = Learning: How Play Motivates and Enhances Children’s
Cognitive and Social-Emotional Growth
“Th is is a most impressive, comprehensive, and authoritative contribution
towards understanding both the development of emotions in children
as well as the child’s lived experience of emotions as ‘signals to ourselves
and to others.’ Dr. Barish’s perspective focuses considerable attention on
reparative experiences, which he argues become determinative elements
in identity formation and character structure. Accordingly, he stresses
the crucial but underappreciated therapeutic value of empathic listening
and its role in helping children develop the capacity for age- appropriate
aff ect-regulation. Th is is a must-read book for both experienced and
beginning child psychotherapists.”
—Kirkland C. Vaughans, Ph.D., Editor, Journal of Infant, Child, and
Adolescent Psychotherapy
“Th is book is a gem: practical, wise, and scholarly. Dr. Barish integrates the
best of a psychodynamically informed perspective with recent research-
based fi ndings from the neurosciences, attachment research, and cognitive-
behaviorally as well as systemically informed perspectives. I wish I could
have read this book when I was beginning my clinical work.”
—Jonathan Cohen, Ph.D., President, Center for Social and Emotional
Education, and co-author of Making Your School Safe: Strategies to
Protect Children and Promote Learning
“An insightful, integrative, and clinically sensitive book that will help
students and p rofessionals of all major theoretical orientations appreciate
the value of emotions and emotion theory in the practice of child psy-
chotherapy. Barish presents a rich theoretical and conceptual framework
in which to understand and treat diverse childhood disorders. Th is book
comes at a particularly important time, when empirical support for vari-
ous treatments is growing dramatically, and when the fi eld is looking for
developmentally sensitive interventions that not only incorporate emotion
theory but also possess evidence that they actually work. Th e approach
espoused in this book, although not fully tested at this time, will surely
help set the stage for thoughtful review and appraisal of such interven-
tions. It is a must-read for all serious students of child psychotherapy.”
—Th omas H. Ollendick, Ph.D., University Distinguished Professor and
Director, Child Study Center, Virginia Polytechnic Institute and State
University
“Dr. Barish has done the impossible: he's written a practical, engross-
ing, meticulously documented and researched, authoritative, brief, and
innovative book on psychotherapy with children. All clinicians who work
with children will love this book, and they will rejoice in how much they
learn in so few pages! A triumph!”
—Edward Hallowell, M.D., author of Th e Childhood Roots of Adult
Happiness, Crazy Busy, Delivered from Distraction, and other books
Emotions in Child
Psychotherapy
An Integrative Framework
KENNETH BARISH, P .D.
H
1
2009
1
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Copyright © 2009, by Oxford University Press, Inc.
Published by Oxford University Press, Inc.
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Oxford is a registered trademark of Oxford University Press.
All rights reserved. No part of this publication may be reproduced,
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without the prior permission of Oxford University Press.
Library of Congress Cataloging-in-Publication Data
Barish, Kenneth.
Emotions in child psychotherapy : an integrative framework / Kenneth Barish.
p. cm.
Includes bibliographical references.
ISBN 978-0-19-536686-0
1. Child psychotherapy. 2. Emotions. I. Title.
RJ504.B33 2009
618.92′8914—dc22 2008041071
9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
Th is book is dedicated to the memory of my parents—Bernard
and Min Barish—whose warmth and generosity survives
as an inspiration in the lives of their children
and grandchildren. And, with love and gratitude,
to Harriet, Rachel, and Dan—what it’s all about.
This page intentionally left blank
Contents
Acknowledgments xi
Introduction: Why Emotion? 3
An Integrative Framework 3
A Language of Emotion 4
Plan of the Book 4
Part I Normal and Pathological Development in Childhood
1 Emotions and Emotional Development 11
Emotions: Basic Tenets 11
Emotion, Need, and Self 15
Interest 16
Shame and Pride 18
Anxiety 21
Anger 22
Sadness 24
Notes 26
2 Optimal and Pathological Development in Childhood:
A General Th eory 29
Optimal Development: Resilience and Positive Expectations 29
How Does Emotional Resilience Develop? 32
Attachment and Interactive Repair 32
Affi rmation 34
Lessons from Longitudinal Research 35
Notes 39
3 Th eories of Pathological Development: A Brief Review 41
Psychoanalytic Theory: The Classical Model 41
Psychoanalytic Theory: Developmental and Interpersonal Models 43
Cognitive and Behavioral Models 44
Emotion Regulation: An Emerging Consensus 45
Notes 48
vii
viii CONTENTS
4 Psychopathology in Childhood: Malignant
and Reparative Processes 49
A Reparative Perspective 49
Demoralization 51
Defi ance 53
Vicious Cycles 54
The Role of Confl ict 55
Notes 56
Part II Th e Th erapeutic Process
5 Th e Th erapeutic Process: An Overview 61
Review: The Basic Model 61
Engagement 61
Understanding 62
Emotional Understanding: The Role of Empathy 64
Understanding and Action: The Child’s Defenses 65
Parent Guidance 66
Diagnosis and Assessment: Essential Diagnostic Questions 67
Notes 71
6 Th erapeutic Engagement 72
Positive Affects: Theory and Research 73
Interest and Positive Affect Sharing 74
Floor Time 75
Being Heard 80
Sharings 82
Notes 84
7 Empathy 86
The Nature of Empathy 86
How Is Empathy Expressed in Clinical Work with Children? 90
The Therapeutic Function of Empathy 91
Diffi culties and Limitations 92
Notes 96
8 Th e Problem of Resistance 98
Overview 99
Children’s Resistances: Typical Forms 100
What Can We Do? 102
Is Anything Happening? 103
Notes 104
9 Child Psychotherapy as a Socializing
Process I: Moral Development 107
Socialization: General Principles 108
Socialization: Theory and Research 110
Contents ix
Parental Pride and the Development of Ideals 111
Emotion and Moral Development 112
Emotion Coaching 113
The Inherent Socializing Function of Play 115
Notes 118
10 Child Psychotherapy as a Socializing Process II: Winning
and Losing 122
“Mommy, I Cheated, I Won” 123
Losing and Demoralization 124
A Therapeutic Opportunity 125
Expanding the Conversation 126
Variations on a Theme 127
What Can Parents Do? 128
Notes 131
Part III Parent Guidance
11 Parent Guidance I: Promoting Emotional Health
and Resilience 137
Goals of Parent Guidance 137
A Therapeutic Plan for Families 138
Positive Affect Sharing 140
Criticism 142
Repair 144
Proactive Problem-solving 146
Again, Sharings 147
A First and Final Principle: Staying Positive 148
Notes 152
12 Parent Guidance II: Helping Parents with Common
Problems of Daily Living 156
Rules and Limits 156
Tantrums 160
Homework 162
Sleep 164
The 15-Minute Rule 165
Television and Electronic Games 166
At School: A Book of Positives 167
Notes 167
Epilogue 170
References 173
Index 187