T3 - Therapy Basics: Confidentiality

It's come to my attention that I should do posts on some of the basics of therapy. As often as therapy comes into play in our novels (either a character receives/should receive/did receive therapy, has to take a friend to a therapist, etc), maybe some understanding of the mechanics of my profession will help bring a sense of authenticity to what you're writing about.

So my first Thought will be on confidentiality.

What is it?

Confidentiality is a an ethical concept. Legally, I'm required to present the parameters of confidentiality to a client prior to the onset of therapy. They need to know what's not covered before they agree to participate. Most everything (I'll qualify this more later) disclosed between a therapist and client is confidential; that is, I can't just go telling anyone what a client told me in session. It's considered privileged information, but this is actually a legal term I'm not going into on this post.

I can't share anything from our sessions unless I have a client's express written permission (or in the case of multiple clients--like a husband and wife--a signature from all involved parties). Verbal consent can only me used in emergencies, and all therapists would have a form for this express purpose, usually called a waiver.

Who/what does it cover?

Confidentiality is very extensive. If you tell me you have $1000 in outstanding parking tickets, I can't pick up a phone and call the local police station. If you bring in photo albums or journals to share, the information in them is all covered. If you tell me you committed murder (or some other crime), I can't call the cops to come get your murdering self.

Many times therapy is between more than just one person and the therapist. In that case, everyone is covered. For example, a husband needs proof that he attended anger management sessions for his job, but his wife attended some sessions with him and some of what he's requesting came out during one of those sessions. I'd have to get the wife's consent, as well.

Many times, other professionals are consulted on a case. Say, a client needs to have a physical check-up to rule out some medical reason for depression. The results of the exam are given to the therapist, and this is kept confidential.

What's not covered?

It is not a blanket cover indicating that whatever goes on in the session will be kept between the therapist and the client no matter what. Basically, there are three scenarios where confidentiality would not be upheld in (i.e., legally, I'm mandated to report to authorities if the following scenarios crop up in therapy):

1) Client poses a danger to himself. Suicidal clients have to be treated with extreme caution and care. The therapist, acting on behalf of the best interests of the client (in the therapist's expert opinion), would reveal certain information to a crisis response team or a psychiatric hospital or possibly the police in order to ensure a client doesn't harm him or herself. A suicidal evaluation would be done by the therapist to discover if the client has a plan to kill themselves and how strong their motivation is (i.e., how lethal is the plan and how accessible would someone be to help?).

2) Client poses a danger to someone else. Homicidal tendencies can come out in therapy. I'm not necessarily talking about a a scorned woman's comment through her tears, "I'll kill the witch if I see her!" However, even this type statement should be looked into further by a discerning therapist. If the therapist has reason to believe truth to a statement, then he or she would have to further analyze the means, motivation and method the homicidal patient might have to see how big the threat is. Then information is disclosed to authorities accordingly.

3) Client reveals a known or reasonably suspected case of elder/child/dependent adult abuse or neglect. The three groups mentioned in #3 are all protected by special laws. For elders, the abuse could be financial or geographical (isolation, refusing mail or to allow friends over). For all three groups, abuse could be emotional, physical, mental, or sexual.

Even if the client reports hearsay, the therapist has to report. "My neighbor told me his kid's best friend was abused. I guess you can never be too careful." All the therapist needs is a "reasonable suspicion" to disclose information. In the above scenario, I'd have to call the authorities and report what information I could gather (name of the child abused, where it happened, etc).

What about minors?

Disclaimer: everything I'm about to write pertains to California laws concerning minors. It does vary from state-to-state.

A minor is entitled to a confidential relationship even if they aren't the paying party. It behooves the therapist to form a contract with the payer (i.e., parent) at the beginning of treatment to determine what will and will not be disclosed to the payer. Parents are legally entitled to any and all information based on the minor's best interests, but LMFTs are obligated to maintain the minor's confidentiality. (I mean, come on. How many teens are going to open up to a therapist if they knew the therapist was parroting everything back to their parents? Hardly makes for a bonding, therapeutic relationship.)

So the therapist has to balance their ethical duty toward the client (minor) with the legal right of the parent. The best way to do this is for the therapist to first try to talk to the minor first, and urge them to consider sharing pertinent information with their parents. If that doesn't fly, then the therapist can ask permission from the minor to share the information with the parents with or without the minor in the room. If that doesn't fly, then a summary would honor the parents' rights to access the records while protecting the best interest of the client. This way, if a father requested info, you could leave out, for example, the fact that your client said he hated his father when you give a summary.

Well, that sums up confidentiality. Hopefully it wasn't too boring, but this kind of information could be very pertinent at some point to a WIP! :)

If you have any other questions about more specific confidentiality things, lemme know in the comments section and I'll do my best to ferret out an answer for you.

Treatment Tuesday - Doctor/Patient Relationships

We've got a great question on the therapeutic table today, people! The writer, who wishes to remain anonymous, wrote in with a blurb about her book. Molly* sets her sights on hot young psychiatrist Dr. Wade Williams.* She makes about four trips to his office for “evaluation,” even though she’s feigning her symptoms. The author has lots in store for Molly and Wade, but the gist of her dilemma is that Dr. Williams stops his evaluation of Molly and then enters into a relationship with her. She’s afraid the reader might think Dr. Williams is being unethical, but in the final scene (**SPOILER**) he informs Molly that he never took her on as a patient.

* Names have been changed to protect the fictional.

Here’s the real question:

It was brought to my attention it is against the law for a doctor to date a patient for two years or something to that effect, but I took artistic license and played the story out the way I wanted to. Is this a believable plot line (in the realm of romantic comedy fiction)? Or am I staring down the barrel of some serious issues here?

What a packed question! Let’s try to unravel it today.

First off, whoever brought it to your attention that it’s against the law for a doctor to date a patient was absolutely right, mostly, so I’d say you are staring down a very ominous barrel of serious issues. But there is a lot of variation between counseling organizations as to how many years have to lapse before a relationship can be entered in, if ever.

Since Dr. Williams is a psychiatrist, his code of ethics would fall under the American Psychiatric Association (APA), which I knew little about. However, upon a Google search, I came to understand the APA essentially uses the ethical codes of the American Medical Association (AMA). Since a psychiatrist IS a medical doctor, this makes sense. The APA does have an annotated version of the ethical code of the AMA that specifically applies to psychiatrists, yet I couldn’t find anything in this code about sex with a patient (only sex between a faculty member/student and a trainer/supervisee).

So then I reverted back to the AMA’s website. In Opinion 8:14, found here, it reads “At a minimum, a physician’s ethical duties include terminating the physician-patient relationship before initiating a dating, romantic, or sexual relationship with a patient.” It sounds like Dr. Will

iams does this, at any rate. But honestly, this sounds like its more for general practitioners or surgeons or something, not psychiatrist doctors seeing patients in a therapeutic relationship. Let's face it, that's way different from a doctor doing a knee replacement or something.

As a therapist, this “opinion” makes me cringe. I hold to the code of ethics of the American Association of Marriage and Family Therapists (and additionally to the American Association of Christian Counselors). Our code read much more substantially:

1.5 Sexual intimacy with former clients is likely to be harmful and is therefore prohibited for two years following the termination of therapy or last professional contact. In an effort to avoid exploiting the trust and dependency of clients, marriage and family therapists should not engage in sexual intimacy with former clients after the two years following termination or last professional contact. Should therapists engage in sexual intimacy with former clients following two years after termination or last professional contact, the burden shifts to the therapist to demonstrate that there has been no exploitation or injury to the former client or to the client’s immediate family.

See the difference? Of course, what’s really on the table are sexual relationships, which Dr. Williams will not be having with Molly at any rate. But dating relationships still fall under a gray area…because in most of the world, that leads to sexual relationships (in or out of the marital covenant).

The other area your book brings to light is what constitutes a patient. Does an evaluation/assessment count? What if the client wants to meet the therapist to determine if she would mesh well with his treatment modalities?

To answer this question, you’re going to have to really think about these four “evaluation” sessions. I’m not sure what all he’s evaluating that would take that long. It sounds like some of the assessment sessions might be more. Typically, for therapists to get paid by insurance parties, you have to have the assessment done and at least a temporary initial diagnosis to submit to the insurance company. You can continue to “evaluate” if you feel another session might be needed to really nail the diagnosis, but most good therapists/psychologists/psychiatrists already have a very good idea after one hour, I promise.

So what’s really going on in those sessions? How much evaluation does she really need? And what’s taking him so long? I guess what I’m trying to say is that four sessions would likely constitute a therapeutic relationship of some sort. One could assume a session happened every consecutive week and that they were going deeper and deeper into her personal history, problems and reason for coming in the first place. If I were reading your book and read that they’d had four sessions, I would think he was being unethical, then, when he enters into a dating relationship with her. This would put me off so much I might be tempted to close the book, but I’m not the average reader in this area.

You’re doing what you need to do, though, by researching. You want your book to fall into the feasible plot realm for a psychiatrist, and from what I see, you have Dr. Williams dangerously skirting around the line of unethical behavior. Technically, according to the AMA, if he ends the medical relationship, he’s cleared to date her. Morally, though, this might not sit right with a lot of the population of readers. They will resonate with Molly’s sister and best friend, which you’re not going to want!

So now that I’ve possibly ruined your plot premise with my assessment, I’d like to maybe give some alternatives. If possible, decrease the number of sessions they actually have. It will be far more ethical for him to have one session—two, tops—and then not take her on as a patient and date her. I realize your plot twist of him revealing to her he never took her on as a patient is major to the end of the book. Is there anyway for that to come out earlier? Like before they actually go on a date? Then the reader’s mind would be at rest for the remainder of your story. Maybe there would be some other great reveal at the end...like why Dr. Williams isn't with his ex or something.

Another option is for Dr. Williams to perhaps be in a practice where there are more than just one psychiatrist working. Perhaps Molly could be seen by one of Dr. William’s associates and therefore totally bring their romance out of the sticky realm of one of his own patients.

I’m not sure this helps much. I feel like this is the first assessment I’ve done that wasn’t all that positive! Please feel free to email me if you have some other questions, or just leave them in the comment section. Good luck with your writing! Other than the ethical dilemma, it sounds like a superb romantic comedy!

This service is for fictional characters only, so any resemblance to real life examples is entirely coincidental. Any other fictional character assessment questions can be directed to charactertherapist@hotmail.com.

T3 - Alcoholism...Disease or No?

Recently, I was reading over at a post about alcoholism at the Philosophy of KLo. The gist of it was asking whether alcoholism is really a disease or not. Well, I had to jump in on the discussion!

There are definitely people who drink moderately. Let's call them the Mods. Many of them can look at an alcoholic and think, "Have a little control. Be more responsible," or "STEP AWAY FROM THE BEER." Why? Because the Mods are able to drink moderately, having made the decision--conscientiously--not to drink to excess. I'd venture a guess that most of the people in the "Alcoholism is NOT a disease" camp are probably Mods or Complete Abstainers. And you can see their point, right? The camp motto might be, "You control your actions."

And there is something to be said for this idea...especially for beginning alcoholics. Certainly, the initial use of alcohol is voluntary, but once addiction takes hold, those in the camp that alcholism IS a disease (therapists, doctors) believe this initial control is disrupted.

We adhere to the medical model of addiction. There is a biological predisposition some people have that influence them in whatever environment they grow up in. Studies of twins, separated at birth, show them to have higher likelihood for both having an addiction than would be expected if there weren't some genetic component.

The official National Institute on Alcohol Abuse and Alcoholism position is that "alcoholism is a disease. The craving that an alcoholic feels for alcohol can be as strong as the need for food or water. An alcoholic will continue to drink despite serious family, health, or legal problems. Like many other diseases, alcoholism is chronic, meaning that it lasts a person's lifetime; it usually follows a predictable course; and it has symptoms. The risk for developing alcoholism is influenced both by a person's genes and by his or her lifestyle." Go here for a complete, word-by-word breakdown of the NIAAA's definition of alcoholism.

A person who is dependent on alcohol can't process rational cues that Mods might try to tell them about responsibility and control. They don't even process cues from their own bodies, as evidenced by people who drink knowing they are killing themselves with cirrhosis of the liver. Alcoholism is progressive, which is another mark of a disease (think cancer). It gets worse and worse. This level of drinking, despite all the negative consequences, indicates that something is distinctly different in their brain...AND THIS NEVER SHUTS OFF.

People who go to AA meetings will tell you that they are alcoholics. They introduce themselves that way at meetings even when they've been sober for twenty years. The desire is still there to drink! It's a constant struggle they fight every day to win. They will say they are never "cured," but are "recovering." If they relapse, they blame it on their disease, and the fact that relapse is a part of recovery (which it is). But at this point, as a therapist, I tell the client that the disease model is NOT a crutch to further their addiction or an excuse for irresponsibility. (So there is a fine line!)

As a Christian, I recognize the power of Christ in someone's life. I've known people who can literally put down a cigarette or beer after being saved and never pick it up again. This would lend some credence to the "Not a Disease" camp. But studies have been shown that people who reach the stage of "alcoholism" can never go back to being a Mod. So I'm betting even these miraculous "healings" come at the price of never again drinking the tiniest sip, for fear of the disease taking over once again.

I could go on...and I might in a later post...but for now, I'm curious what your thoughts are after reading some of the above stuff. Do you think its a disease or not?

Treatment Tuesday - Blended Families, cont.

This week I’ll be concluding Anna’s assessment on blended families. To read more about her scenario, go here. We had a great discussion in the comments section, so be sure to check that out as well. And like last week, I invite your questions in the comment section again.

So, now for the rest of Anna’s questions about large blended families.

6) Will the fact that they were all cousins before they became stepsiblings change things?

I guess this depends on how much they interacted before. But my professional gut opinion is to say that no…this won’t matter that much. They are still just children who are being combined into one family, regardless of previous relational status. So I’m not sure I’d make this a big deal.

7) And can you tell me about large family logistics in general?

Mike or Carol or both will have to have a job that pays, MONEY will be a huge factor. Sharing rooms, hand-me-down clothes, not able to go out for cheerleading because parents can’t afford the uniforms, lots of mouths to feed….you see where I’m going.

And it’s not like this family will go anywhere in regular vehicles, either. They will have to get a 15-passenger van (and insurance to drive it, which is phenomenally high) just to get them all to school or church. And don’t forget friends, and significant others that will come around as the kids get older. You’ll have to think about bedroom space, as I’m sure many will have to share. Privacy will have to be supreme and upheld if this is the case.

And due to them having so many children, likely they will need to move into a new house. This is actually preferred than having one set of children move into the domain of another, and all of sudden the other family has to share their toys and things. It would be better to move into a new house where neither group has any sort of influence. It’s all new to everyone….an equal playing field, so to speak.

8) Will there be cliques and alliances or just individual jealousies and annoyances?

Oh, yes. Yes, yes, yes. To all of it. The main thing to remember is that each sub-family will be it’s own group, especially initially. They will likely gravitate towards each other, as you can well imagine. There is comfort in the familiar. Siblings who formerly didn’t get along might suddenly form an alliance with each other against the other sibling group. This is simply a case of aligning with the lesser evil.

And as with any family, each of the children will have their own individual differences that will lead to petty jealousies. Maybe Mike allowed his kids to always stay up later than Carol allowed hers. So of course Carol’s kids will be jealous of the bedtime freedoms Mike’s kids have. This is a very simplistic example, but one that would surely cause problems in the blended family and have to be addressed.

The children will most likely be jealous of either the children who are in their same grade, as the competition between them will be fiercest (for highest grades, better at sports, etc) or with children younger than them, as younger children typically take up more parental time. Older kids can be objects of jealousy as they get more privileges, but it probably wouldn’t exceed inter-grade level jealousies.

9) How will the fact that they're all similar in age (fifteen kids over a 10-12 year age range) affect things?

This question was answered some in the last paragraph above. Just as there are some great positive features of having the children all fairly young when the remarriage occurs, there are drawbacks. Children who are further apart in years aren’t as close as those who are near each other in ages. It’s just logistically not as likely. They wouldn’t go to the same school, have the same teachers, have the same friends at church, etc, so there would be a natural gap there.

With the same age group come different inherent difficulties. What about two brothers falling for the same girl in their class? This wouldn’t even be an issue if one brother were two years or even one year older. And what if one child in the same age range as several others happened to have special education needs? How would his like-aged siblings who didn’t have a learning disability treat that child?

10) I want to incorporate some authentic family tension into my story. Any hints you could give me as to what that would look like?

I think I’ve given you lots of ideas of ways tension can creep into this type of family. One type of tension you won’t be able to escape is that between Mike and Carol. Each of them would still be in love with their deceased spouse when they get married (that’s assuming that they were in happy marriages), and there would be the tension of whether to sleep in the same beds and be roommates or lovers and how did they want to present their relationship in front of the children? What are the expectations of each other?

A HUGE area for tension is discipline. Who is going to do it? How will it be done? Both parents need to be on the same page about this, and so often they aren’t. I’ve listened to couples complain that they didn’t want the new spouse disciplining their child. And of course children don’t want to disciplined by anyone other than their own parent, so they wouldn’t take kindly to the new parent trying to tell them what to do or spank them or whatever. (BTW, it is preferred for the biological parents to do most of the disciplining for their own children whenever possible…but when pitted against the new spouse by a conniving child, the new spouse would need to know the “rules” and support the bio parent. I hope this made sense.) ☺

I mentioned this last week, but if Mike and Carol don’t move into a new place (which might be necessary to accommodate all these kids!), then there will for sure be tension as one sub-group of siblings moves into the domain of the other sub-group. Watch out…serious catfights and boxing matches going on. The one group is invading the other group’s nest where they rule the roost.

House rules would need to be gone over at length…with all the children either in attendance or privy to the outcome. Bedtimes might need to be changed. Chores rearranged. The list could go on. But both parents need to have a say, and if possible, listen to the childrens' opinions.

Now, for some positive helps for poor Mike and Carol, who have a long road to haul. If you decide to incorporate them going to a therapist, this is likely some of the things that might come up.

I would always suggest to each parent that they spend time with each of their biological children every day, even if its only a few minutes a day. As traumatized at the adults might be at the loss of their life partner, the children are just as traumatized...but with less cognitive ability to be able to express it. So spending time with them--even though their days are bound to be even crazier once they combine families--will be highly important. Letting the child know they are still a crucial part to their remaining parent's live.

I mentioned last week about having a ritual where the children get to watch home videos or look at picture albums. it would be a good idea for each sub-group to look at the videos and pictures of the other sub-group, to gain an understanding about where each other came from. And there can be some bonding that goes on over the mutual grief each family has experienced. Pictures of the remaining parent with the deceased parent don't need to be covered up or not displayed. the children need to see these pictures prominently displayed (just not like a shrine).

It's a great idea to come up with other family rituals...and if you can have them incorporate a little from both families, even better. Say Mike's children always got to open all their gifts on Christmas Eve and Carol's always waited until Christmas morning. A great family ritual compromise would be to open or two gifts on Christmas Eve and the rest on Christmas...or half-and-half, even. Compromise would be key to trying to re-think family traditions. each family has their own quirks, and now you've got two sets of quirks to deal with. The parents would need to be sensitive about this. There is no wrong or right way to do a holiday or birthday, but children sometimes seem to think so. Creating NEW rituals will circumvent this type of problem.

One more thing. I did a little research online about blended families so I could give some accurate statistics last week. I ran across one of the most comprehensive, easy-to-understand web pages on blended families I'd ever seen, and wanted to share it with you. Click here to go to the site.

Okay...that's all. Finally. Anna...hope this helped. Lots of info, I know! Please drop me any questions in the comments or email me if you want further info.

T3 - Jealousy

How many of us have read novels where jealousy played a huge role in what happened between the MCs? Or maybe jealousy was what spurred the spurned villain on to do evil acts of...well, evilness. It's prominent in books, movies, and real life! A nationwide survey of therapist back in the 90s revealed that 1/3 of couples coming in for therapy had jealousy issues.

Let's do a quick survey of some movies that incorporate jealousy as a major theme.

Atonement
My Best Friend's Wedding
Seven
Single White Female
The Hand that Rocks the Cradle
Fatal Attraction
The Prestige
Indecent Proposal

There are several more (Envy and Jealousy to name a few), but what struck me is how jealousy is overly done in these movies. I mean, most all of the characters in the movies above could have had some serious inpatient work with a psychiatrist, therapist, or both. Glenn Close, Hugh Jackman, Jennifer Jason Lee and Rebecca De Mornay's characters were all completely insane. Seriously.

But jealousy doesn't have to be overblown like in these examples. It can be subtle. For the most part, jealousy is fueled by a combination of two emotions: fear and anger. Fear that you are losing something or someone and anger that something or someone is moving in on something you feel belongs solely to you.

Now, you can be jealous and err on the angry side (Glenn Close in Fatal Attraction) or you can be jealous and err on the fear side (Julia Roberts in My Best Friend's Wedding). I guess another way of putting it is that villains are more likely to lean to the anger side and heroes/heroines are more likely to lean to the fear side. A good test is to figure out which emotion is effecting you (or your characters!) is to pinpoint where in your body you feel different. If your "stomach drops," it's probably fear. If your shoulder or jaw tenses, it's probably anger.

But not all jealous reactions are pathological. Some are very normal reactions to a perceived threat to the relationship. Jealousy can slip into pathological when there really is no perceived threat. For example, if you see a girl moving in on your guy--I mean, she's touching his shoulder, angling her body towards him and giggling like a school girl on laughing gas--then your jealousy comes from the perceived threat you have on your relationship.


However, let's say you don't even have a relationship with a guy anymore. You broke up months ago. He's seeing someone else...and you hate her guts. Well, there's really no perceived threat to your relationship with this guy because there is no relationship. This borders on pathological. Mary Connealy did a great job of this type of pathologically jealous villain in her latest release, Montana Rose.

So most of us are going to write from our experiences...and I'm sincerely hoping most of us don't have pathological jealous experiences in our closets! We'll write a heroine getting suspicious about her love interest being involved with someone else because her past boyfriend cheated on her. We'll write a hero who might tag his love interest to the gym because he wants to make eyes at any guy who might ogle her...you know...stake his claim.

But if you include jealousy as a character flaw, it's important to identify what the jealousy is really about. What does the jealousy indicate as important to the character? How is the character's development furthered by his or her jealousy? What does it say about them? Interview your character with the following questions:

• Why am I jealous over this?
• What, exactly, is making me jealous?
• What am I trying to keep/afraid to lose?
  
• Why do I feel threatened/insecure?
  
• Is the threat real, perceived, or not there at all?

These questions will get you started in understanding your character's motivation.

One last tiny thought. Jealousy is NOT love. Jsut because you feel jealous about someone doesn't not mean you love them. Jealousy is actually the fear and anger of losing love.

Chew on that one a while.

Q4U: What other movies or books out there incorporate jealousy as a theme?

The Duchess and the Dragon Review

Recently, while Books-a-Million was having their 2 for 3 sale on Christian fiction, I picked up some great reads. Some I'm not willing to give up (see post and review here) because the book just struck a chord with this therapist. Others were great reads, but I want to share the fun with others!

So I'm having another giveaway. This time, the book is by Jame Carie, entitled The Duchess and the Dragon. Here's the back cover copy:

Two Worlds, One Destiny

Drake Weston, Duke of Northumberland, is heir to wealth, prestige, and power. But when his rage pushes him to a tragic mistake, he must leave everything behind. Not just his home, but England herself. Cloaked in a false identity, Drake slips aboard a ship bearing indentured servants to America.

Serena Winter lives out her Quaker beliefs tending the sick who arrive on ships in the Philadelphia harbor. But never before has she seen such squalor and misery as she finds on the latest ship from England. Nor has she ever met such a one as the half-conscious man with the penetrating eyes and arrogant demeanor. Though she saves his life, even taking him into her family home, there is little gratitude or humility in this man. And yet Serena is certain that beneath the brash exterior is a heart in search of peace.

Against the rich backdrop of Regency-era England and a young America, two passionate, seeking hearts find in each other the strength to face hard truths – and confront an insidious web of deceit that may destroy all they hold dear.

Donning my therapist cap, I like to give reviews from that perspective. Drake Weston, a duke, has to give up his identity, affluence, wealth and inheritance for that of an indentured servant. This kind of consequence is full blown, touching every aspect of a person's life. Carie writes Drake as a tortured soul, and well she should, considering what he's gone through!

Her main technique is Drake's internal dialogue with himself. Drake hears a "voice," but don't think in a crazy, schizophrenic way. The voice is negative, dark, berating...and Drake believes it. It's words become some sort of inward mantra he has: "You're worthless. No one wanted you and no one ever will. Just look at you. You're nothing."

This spoke true to me because I've counseled people who have thought this exact same thing. And when you believe something like this, you act as if it's true. Everything revolves around this internal schema...and its hard to beat. So I was curious how Carie would write Drake's character arc.

Enter Serena. She's a member of the Quakers - a very simple people with a simple faith and simple trust. She wants what all young girls want: love. And Drake doesn't exactly fit the bill but she'd drawn to him. But to truly love him would mean she'd have to give up everything she holds dear...she'd be excommunicated from her people group. And for what? A man who's not telling her the whole truth? A man who might not even believe the real truth were he told it...because he's got his own inner dragons to contend with?

See why this is an interesting book? You've got to see how it all ends. Carie plays it out beautifully.

Treatment Tuesday - Blended Families

This week’s assessment comes courtesy of Anna. She’s writing a “mega family” series about a blended family. I love Anna’s questions, because they are so pertinent to understanding blended families with his, hers, and their children.

Here’s the scenario (in the spirit of the Brady Bunch): Carol*, the mom, has about five children and is pregnant with twins when there is a huge accident where she looses her husband and one of her sisters. Her bro-in-law, Mike*, grieves the loss of his wife with several young kids of his own. They both want to get remarried sooner than later, but feel the changes of meeting someone willing to jump into a ready-made, full-time parental role are slim. So Mike and Carol eventually marry each other (3-4 months later!), thinking they will better be able to care for their children together than separately. The children are ALL under the age of 10 at the time of the marriage, and likely Mike and Carol will have some little ones of their own.

Anna had several questions about blended families that she posed to me, but before I get to them, I want to give you an idea of how prevalent blended families are today. About 65% of remarriages involve children from previous relationships and form blended families. In 2001 5.4 million children lived with one biological parent and either a stepparent or adoptive parent (Kreider & Fields). One source I looked at said that blended families are now more common than biological families. Another source said approximately half of all Americans are involved in a step relationship.

This is something that is so prevalent in our world today that it’s bound to be in some of your works-in-progress! If YOU have any questions about blended families for your WIP, type them up in the comment section and I’ll see what I can do about answering them.

Without further ado, Anna’s first five questions are:

1) What I can expect from this extra-large family as the kids start to enter their teens and twenties?

For sure, you’ve got an unusual family situation here. The kids will know that. Certainly as they get older, they could have a reaction against how “weird” their family is, or they could rally together…like their own football team against the world sort of thing. A lot will depend on how you depict the parents. If they just get married after 3-4 months, they won’t even be 1/4th of the way through a typical grieving process for a loss spouse (2 years). If you portray them as frantic, desperate people scraping the bottom of the barrel when they reach for each other…this will affect the way they run their home and family.

As the kids get older (after graduation), you’ll have college tuitions and fees to worry about. I would think older children would be encouraged to hold down jobs, but this could even be an undue stressor on the family unless the working children have cars (which cost money!). So I’d spend considerable time figuring out just how much you want to make them struggle. The Bradys seemed to have it all together, what with Mr. Brady being an architect and all.

This house will likely be like Grand Central Station the older the kids get, too. Some might opt to spend as much time away from home as possible, to avoid the crush of all the bodies and all the noise. But girlfriends, boyfriends, and spend-the-night parties…these children are going to want all of that. Imagine if each kid brought home a friend from school just one day out of the week. That’s like 10 additional mouths to feed a snack to and dinner….you see where I’m going. It’s chaos. But the attitude of the parents will have a BIG impact on how the children see it, so we’re back to that again.

2) Will the kids hate each other and resent the stepparent?

These children were already cousins. So chances are they’ve spent considerable time around each other as it is and probably have gotten along up to date when all the family was together (with maybe a squabble or two here or there). But throw grief into the mix. These children will be grieving the loss of one parent, and children respond to grief usually with anger and acting out. A few will get the classic depressed symptoms, but for the most part, younger children just don’t know how to handle all the strong sad emotions, so that’s why they “act out” at school and home. So to be realistic, you’ll need to pick one or two “problem children” who are going to give the parents and maybe even each other a run for their money. This is just real life. To quote the back of my high school Peer Counselors tee shirt, “Life is not a rerun of the Brady Bunch show.”

As for resenting the stepparent…that’s a different beast. These children won’t want a stand-in mother or father to replace the one they loss. The really young ones might slip right into calling the new parent mom or dad, but the older ones (8-10 years) might not be comfortable doing this. Again, it depends on how the parents handle it. I see your question four addresses some of this, so I’ll stop here.

3) Will they bond well because they were young at the time of the marriage?

Most likely, yes. Of course, there are always exceptions. But the younger children are when parents remarry, the better the outcome seems to be. Some of this might have to do with inability to retain memories (how much do you remember when you were 4?) at young ages. But one of the positives in your scenario is that they are young.

4) Will the younger ones remember the parent that they lost, and if not should they be reminded?

The younger ones will need help remembering as time passes. And yes, I think they should be reminded. I’m not one for having some sort of shrine in the house to the deceased parent, though. And I don’t think they should be reminded every day. Initially, like maybe even up to a year or so, younger children will be more likely to remind the adults than need reminding. They’ll remember. But eventually, in their mind’s eye, the deceased parent’s face will start to fade. They will no longer be able to recall the sound of his or her voice. It’s totally fine (maybe even preferred) to replay home videos or go through picture albums to help them remember. In fact, it might should be part of a ritual you have the family start. (More on this next week.) It might even be a good idea to have everyone sit around each others' albums to help the children from the opposite family to understand a bit about their cousins’ past history.

5) Someone who was once the oldest won't be the oldest anymore. Will that be a problem?

Yikes. Having the throne usurped isn’t easy for anyone. Have you ever heard the old adage, “Don’t disrupt the pecking order?” Here, it sounds like it will be unavoidable. I think it will be very important for the parent of the child who is no longer the “oldest” of the family to have a discussion with them, hopefully prior to the remarriage to prevent any foreseen problems. Also the living parent should affirm to their firstborn that his or her worth is in no way tied up to actually being firstborn. We no longer live in Bible times where only the firstborn inherits the majority.

I would advocate not fixating on age at this conversation, but on maturity levels. In some families, there might be a child who is only 12, but has a mental maturity of 15. Or vice-versa. More privileges are usually granted to the older children…but make sure the privileges come when the child is truly mentally mature enough for them. Girls shouldn’t automatically date when they reach a certain age if they aren’t ready for it. (So setting aside a specific birthday for when they can do this can be a fallacy!) But the short answer to your question is yes. Expect this to be a problem for that child. And the first oldest kid from the other marriage will very possibly lord this over the second oldest…because it’s something he or she will have control and power over in a powerless situation for them.

That's it for this week's assessment...but join me next week as I conclude this fascinating look into blended families. And be sure to leave your own blended family questions in the comment section!

T3 - White Lies

So many books are written using the concept of deceit. One of the MCs typically keeps something from the other, or they both do. Of course, by the end of the book, the lie comes out, usually ushering in the black moment when all is almost lost.

Most of these lies are called hard lies. There is no moral ambiguity about whether the lie is right or wrong. These types of lies—and in fiction, they are usually about someone’s identity or an aspect of their identity—are just always wrong. Some examples? A character allows someone to think they are someone else, or that they have a different career than they actually do, or that they have more/less money, or that they are a Christian when they aren’t…those types of falsehoods.

But there is another type of lie that just isn’t so cut and dried. The little white lie. It is said that white lies are said to protect someone else and hard lies are said to protect yourself. Think about the truthfulness of that statement for a second! Also, if a white lie comes out, supposedly the consequences wouldn’t be as bad compared to the consequences of an exposed hard lie.

In a poll done by iVillage.com where participants were asked whether it was ever okay to tell a little white lie, 47% of people said they’d lie if the truth hurts; 23% said they’d lie if there was no harm, no foul with the lie; 19% said no, they’d never lie; and 11% yes, they’d lie to avoid conflict.

So obviously white lies run rampant in the general population. But does that make them right?

Both white lies and hard lies are, in fact, by definition, LIES. A lie is a falsehood, and there is no moral spin on that definition. So no matter what your intention with the white lie, it’s still a lie due to the fact it’s a falsehood. I’m not going to dispute this with anyone, but I welcome your dissenting opinions in the comment section.

I want to focus on white lies for the rest of the post. Here’s a definition compiled from several online sources: an unimportant lie (especially one told to be tactful or polite); an often trivial, diplomatic or well-intentioned untruth.

Usually, people give these white lies about a friend’s new outfit or haircut. Or at the end of a horrendous date, you look over at your flushed companion and say, “I had a nice time.” Or you rave about your husband’s new recipe but scrape it down the sink first chance you get. And to really hit home, what about all those book reviews you give on your blog that aren’t truly how you felt about the book? [Enter music from Psycho here…Jeannie wielding the butcher knife…]

Before you start to collect logs for a Jeannie-roast (and yes, I realize that rhymes with weenie roast—so no smart comments), I want to say that I’m not advocating that you STOP doing the above things. I believe there are times when white lies are appropriate—even preferred. And as I usually try to do, my opinion is based on some verses in the Bible.

Look at Rahab in the Old Testament. She took in the spies Joshua sent to scope out Jericho. The King of Jericho sent Rahab a message telling her to bring out the men, but Rahab lied and said the men had already come and gone. She said she didn’t know which direction they went, and went so far as to tell the king’s men if they went quickly, the could catch up with the spies! James commends Rahab in James 2:25 for her righteousness and execution of good judgment (white lie). She lied to protect the lives of the spies.

Another incident was in Exodus 1 when the King of Egypt told the Hebrew midwives to kill all newborn baby boys. Verse 15 reads, “The midwives, however, feared God and did not do what the king of Egypt had told them to do; they let the boys live.” They lied to Pharaoh to protect the lives of the little boy children.

Gregory Koukl, the founder and president of Stand to Reason, a website devoted to defending the faith and "equipping Christian ambassadors with knowledge, wisdom, and character," said in a radio telecast the following: “I think there are many things that, in isolation, would be wrong, but when a higher moral good is served, they not only become not wrong, they become obligatory” (1995).

If there’s going to be any wiggle room, it’ll be found with the white lies (that we or our characters tell). But where is the line between the morally “right” white lie and the morally “wrong” white lie? Why should this even be important?

I think when you tell a white lie to avoid some discomfort on your part, then that’s bordering on not morally “right.” The above instances of white lies really do pack a punch! I mean, Rahab and the Hebrew midwives were saving lives with their lies. If all you’re saving is someone else giving you a hard time or quibbling with you over your opinion, that’s probably not enough.

One alternative is to just speak the truth in love, and open up the possibility for further communication. You can say something truthful and not be harmful about it, it just takes additional thought and finesse on your part (that we usually don’t want to give). When you give a white lie, the dialogue is closed off…unable to penetrate further because the other person isn’t privy to how you really feel. And what does this say about our trust of the other person? The answer is that is says we don’t trust them.

Application

I guess I just want you and I to think about the reasons behind our (or our characters’) white lies. Is it something chronically overused or is it just the occasional I-don’t-want-to-hurt-my-spouse/friend thing? Is it more about you and your lack of wanting to be confrontational or be seen in a disapproving light or is it more about the person you think you’re protecting from your real opinion?

These are the questions our characters should wrestle with, too. Does one of your MCs glibly spout of white lies…much like Jim Carrey’s character on Liar, Liar? Or does one white lie really rack your heroine with guilt, because she thinks all liars will go to Hell (Rev. 21:8, people…not making that up…but obviously decided not to go there with this post)? And what about lies catching up with them?

Q4U: Have you ever given a white lie and had it come back to bite you BIG time?

Treatment Tuesday - Superteen Love

This week’s assessment comes from Megan. She’s writing a YA about six teenage foster kids who develop superpowers. Way different premise, and challenging due to some of the issues she’s got her two MCs working through.

First we’ve got 17-year-old Lisa.* She was adopted at the age of two after being found abandoned in a car. Her adoptive parents died in a fire when she was 12, putting her in foster care and creating a fear of fire. After years pass in a stable home environment, she feels safe and comfortable. She’s intelligent and overly curious, often to her own detriment, and she’s opening up to friends and a possible new love.

Her love interest is Derrick,* also 17. He was burned by his mother as an infant which put him in foster care. As a young teen, he rebellious and into drinking, sex and playing hookie. His superpower manifested a year ago. It took an elderly couple to help set him straight so he could excel at school and home. Derrick refuses to date or let anyone get close to him because he’s scared he could hurt someone with his superpower if he loses control. But that’s exactly what happens when he lets his guard down with Lisa and almost hurts her, causing him to close himself off and push her away.

* Names have been changed to protect the fictional.

Megan wants to accurately portray the relationship between these two teens. She’s got the desire and attraction they feel and Derrick sending mixed signals of overprotectiveness/closeness/standoffishness. Lisa pushes his buttons, wanting to figure him out and enjoying the mystery of a first love. Both struggle with their powers and both continue a cycle of getting close and then stepping back as they start to open up about their pasts.

Megan wants to know if this is realistic and if I have any recommendations. And you know I do! ☺

First thing that struck me is the role fire plays in your novel. You’ve given both your MCs tremendously traumatic histories, both involving fire. When I read that she’s actually afraid of fire, my head swarmed with possibilities to show this fear, like a high school bonfire, 4th of July fireworks, flames of candles in a restaurant…things like this.

Lisa was 12 when her adoptive parents died (more on that later), so that’s plenty old for her to really have an overwhelming fear. The specific term would be pyrophobia. So you’d have to give her a pretty good reason for showing up at a bonfire, but if you up the stakes—like for a high school girl with a first crush, Derrick would only have to ask her to be there—that shouldn’t be too hard. Also, she might have to wrestle with the burn scar Derrick has. Initially that would probably freak her out. Just something to think about.

I’m not sure what Derrick’s superpower is, but your premise would be so awesome if Derrick had a superpower that involved fire. MAN! That should make an agent or editor take notice! The idea that the heroine and hero should be polar opposites. She’s scared of fire, so he’s a fireman…or to put it in more heroic terms…he’s TorchMan or something like that. Conflict is embedded in a premise like that. And then you’d have a nicely rounded character arc for your heroine to go through…that of dealing with her fear of fire, which love would help her conquer. Every teen girl (and probably adult) reading your book would absolutely sigh at the end of it.

So about Derrick. I’ve worked a lot with foster children, so likely some of what I have to say would hopefully apply not only to him, but also to your other characters. Foster care is something you just about have to have experience with on some level to truly get how the lives of these children differ. Most foster children—on average—are shuffled through at least six different homes before they are 18 and emancipate out of the system. SIX HOMES. Many of them are depressed and overly sad…but this is manifested as anger and tough-man/tough-girl syndrome. Many are forced to get counseling, and it can take years for a therapist to make a dent in this type of anger. I know it took me two years to get to a working place with one 10-year old boy.

I’m not trying to say that an elderly couple couldn’t step in and make a huge difference in his life…but it would take time. So make sure to have some time lapse between when he’s taken in to the time when he’s excelling at school. Otherwise, that might seem contrived and a little too convenient.

Not all foster children are little balls of anger. Some take to it quite well. They are just thankful to have a home and food and to be clean. But the other aspect of Lisa’s situation to consider is the ongoing grief she would have over her parents death. For all practical purposes, her adoptive parents were her real parents…and her grief would be the same as what anyone would experience losing their parents. So start your book off with her in a new home and feeling safe and comfortable, but have her remember and grieve over her parents. This wouldn’t be so prominent with Derrick, since he would have been in foster care since he could remember.

As to teen romance, gosh…most anything would be realistic. I mean, do teens really know what they’re doing anyway? I’m sure there are two steps forward and one step back. One thing for sure to include in teen romance is friends. The proverbial “Feeler-Outer” who sort of paves the way for their friend. The backup friend on the cell phone who will call you at your signal to get you out of a stick situation. Teens have independence issues…and definitely run with the pack mentality. So their romance would be influenced by their friends. Perhaps this would lend a bit more credence to Derrick’s mixed signals (in addition to his fear of losing control and hurting her)?

That’s about all I’ve got. If you’ve got more questions, send me an email and I’ll see what I can do. But I’m intrigued by your premise…and hopefully have given you a few ideas. (It would be totally weird if you made a comment in the comment section that Derrick DID have a superhuman power of throwing fire, or something!) Anyway, thanks for writing in, Megan!

This service is for fictional characters only, so any resemblance to real life examples is entirely coincidental. Any other fictional character assessment questions can be directed to charactertherapist@hotmail.com.