Character Clinic: Scott Byron Aylward

Today I've got Katherine's murder mystery character on my couch. Scott is a very effective detective. He's married to a surgical nurse, and at home, he's messy, disorganized, and unfocused. A girl in his hometown is murdered, and Scott often feels compulsion to seek justice for victims. Lately, he's been a mess. He's starting to drink and forget to eat, running compulsively, and spending his own time hunting down leads on the home-town girl's murder. His wife recently left him, getting tired of waiting for him to "grow up."

Katherine wants to know: Scott is in therapy, but doesn't see that he needs to learn to be happy with or without his wife. Nor does he see that winning his wife back is an unrealistic goal. What would you as a therapist tell him to do? What exercises would you suggest for him to follow to gain focus?

Oooh! I true therapy question. I must say that if you ask twelve therapists, you'd get twelve different answers, but I'm honored you chose me. :)

Many times clients come in with unrealistic goals. It's not for me to tell them that the goal isn't feasible, but for them to come to that realization on their own. I might start out with a discussion about what things in their life they have control over, and what things they don't. I break out a chart like the one below to give structure to this activity.

 

I then have the client list all the things that they would like to see change. As the person lists everything (and usually it is a litany), I plug each item into the right box.

So Scott wants to his wife to come back. This would fall in Box 4, since it isn't something he can do himself (she has to come back) and it isn't a change that happens internally for her. It's a physical, external change of location/marital status. If he said he wanted to "grow up" and take more responsibility in his life in order to get his wife back, this would fall in Box 1, because it happens internally, and only he can make this change.

What clients usually see is that the only thing they have 100% control over is Box 1. In fact, control slips further and further away as you go to Boxes 2, 3, & 4. I usually will play devil's advocate and ask questions that help the client arrive at this conclusion.

Therapy is about internal change affecting external change. At least it is to me. There are lots of things you can do to get immediate external relief, but unless you change internally, the external change doesn't usually stick. It's a lot of work, so I hope to help clients not worry about what other people are doing, and focus on themselves. Perhaps this exercise will help Scott do that.

I'm open to answering additional questions about this method if you have any. I think it could make a compelling scene with him in therapy coming to this conclusion.

Treatment Tuesday - Fictional Therapy Session How-To

Recently, Nicole O'Dell, a published YA author and creative mind behind Scenarios for Girls and interactive fiction where the reader chooses the ending, wrote in for my opinion about an excerpt from her current WIP. Essence of Lilly, which releases in Spring 2011, features a scene with a therapist and a family.

As a result, I had the thought to do a little how-to post on writing a fictional therapy session in your manuscripts. So here are a few tips to consider when a therapy session makes it way into novel.

1) Consider how the therapist will approach clients in session. I never approach people in the same way. For younger children, I'll go for Miss Jeannie instead of Mrs. Campbell. For teens and adults, I usually go with just Jeannie. I want to build rapport the fastest way possible with whoever I'm seeing. Children are so used to calling their friends of parents Miss Janice or whatever that they are comfortable using this terminology. They also understand when I ask them to call Miss Jeannie instead of Mrs. Campbell that I want to be friendly. They call their teachers at school Mrs. Wilson and Ms. Buckley. So right away, they put me on a different intellectual level...like a family friend or church member.

2) Consider what role the therapist will play in the story. If the therapist is just going to be minor secondary role, then it's not important to go into credentials or framework of therapy (how the therapist conducts therapy). If the therapist will have a recurring role, then it's more important to give them more of an introduction. Readers will want to get the idea that this therapist is someone who either knows what they're talking about or not. How do you do this? See #3.

3) Give the reader a glimpse into the therapist's office. This is an easy way to paint the therapist as an ally or enemy, intellectual or wacko. Have the characters notice the degrees on the wall, or the nice furnishings to suggest business is going well for this therapist. Vice versa if you want to set the therapist up to be incompetent. Picture frames on the desk, crayon masterpieces on the wall, papers piled high or not a one in sight...each description gives the reader just a little bit more about the therapist as well as gives you a chance to share the main character's internal thoughts.

4) Don't write too much of the actual therapy session unless it really moves the plot forward. It's way too easy to start the session with introductions and mindless chitter-chatter. I sometimes don't start actual therapeutic stuff for 10 minutes. that doesn't make the initial 10 minutes void of worth, but it's setting up the bond between the client and me. It's crucial to having a good session. A reader won't necessarily be interested in this portion, though. Get to the meat of the session and don't give the reader any new backstory while the clients "fill in" the therapist on why they are seeking help. Just skip that portion...readers will get it.

5) Identify who the client(s) will be. A therapist can see an individual or a family or any combination of family members. But if therapy will play a large role in the book, then it's important not to mix clients with therapists. In Nicole's book, the father was seeing a counselor who recommended for the family to get counseling. This is an appropriate referral, because once you've started to see a person individually, they are the client, not the family. It would be too difficult to include the entire family when your loyalties already lie with one member. When an entire family comes in for counseling, that counselor can see one child or both parents for individual or marital counseling and that's okay. The idea with those sessions, though, is to always bring it back to the family. This might seem a trivial distinction, but to anyone in the field, this is a really big deal. You want to look like you've done your homework.

6) Things to do while in session:

• Notice body language. Eye rolls, staring off into space, head down, arms crossed...these are great visuals that therapists definitely notice (well, good therapists) :)
  
• Use silence. Nowhere is it written that every second of every session has to be filled with talking. Silence is actually very powerful, so don't be afraid of using it. You can have a great tension-filled moment with silence, describing the uncomfortable shuffling and hand fluttering that can happen.
• Think of family therapy as group therapy. It's appropriate for the therapist to bounce from one to the other and ask, "What are your thoughts on what X just said?" A therapist will be interested in the individuals in the family have to say and think about the other individuals in the family.
• Throw questions back at clients. You really don't realize how often clients ask therapists questions. They come seeking some sort of magic response to fix their problems. But instead of answering, therapists frequently throw the question back at the client. Little tool of the trade...I say, "What do you think?" quite frequently.
  
• Never give advice. A therapist wants the client to arrive at their own solutions. Plus, if a therapist did give advice and the client took it and had negative side-effects from it, the client would blame the therapist and it could effect the rapport between them.

Hopefully this gives you a starting off place to write in authentic therapy sessions. Feel free to add in the comment section any other specific questions you might for your WIPs.

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 (at) hotmail (dot) com.

Q4U: Have you written in therapy sessions in your manuscripts? Did you include any of the above suggestions?

Treatment Tuesday - Childhood Trauma

Today’s assessment comes from Cathy over at Word Vessel. She’s writing a contemporary romance that includes a 6-7 year-old boy who witnesses his father's injury from a horse kick to the head. The father dies a month later from the injury. The boy’s disobedience caused the accident. Her story is going to start 6-8 months after this accident.

Cathy wants to know: What are some possible behaviors that he would take on as a result of this? What steps would a counselor take to help him through the trauma? How long would the process take?

I love questions like this, Cathy, mainly because there are some general predictors of human behavior, but nothing is set in stone. This boy witnessed a horrific sight. Not only that, but he had a personal connection to. A young child is going to feel tremendous guilt, but because of his developmental level, he won’t be able to convey this any other way except by anger.

It’s important to remember that children have the capacity to feel the same things adults do, but they lack the ability to communicate those emotions. Very typically, children will begin to “act out,” as this is the only way they have of expressing themselves. Unfortunately, adults all too often misread the acting out and think the child is doing bad things just to be annoying and that they can control it better. Maybe they can, but just as an adult might utter a curse quickly after enduring pain or blow up at a spouse for belittling them in public, children have reactions, too. But they might not be able to immediately express what they felt. It may take months or even years.

So my first suggestion to you is to consider some way in which this child could act out…and school is the primary place this would happen. Children spend more time at school than anywhere else, so this makes sense. Some typical behaviors you might give him would be hitting, kicking, biting, spiting, choking (most of which would occur on the playground or in the cafeteria when the day’s activities aren’t as structured…these behaviors are less likely in the classroom); defiance, disobedience, inattention, self-isolation, daydreaming, not getting work done on time or at all (all of which could happen at any time). Many of these could also happen at home or with other authority figures at church, baseball practice, what-have-you.

You mentioned a fear of horses as a possibility. Definitely. As an adult, if I had witnessed an accident like that, I’d be scared to be around horses for a while. So a specific phobia (or crippling fear) of horses is more than feasible for a child. What would be interesting is to have the child go see a therapist who specializes using therapeutic animals in their practice. (You find these type therapists out in the country on ranches, mainly, which sounds like it would fit your book.) I don’t know much about this personally, but I found an interesting article here and here about Pet Therapy. Just a suggestion to consider.

The other things you mentioned (sucking his thumb, bed-wetting, not letting his mother out of his sight) are all possibilities. Those behaviors would be considered “regressive” in a child his age. But sometimes children regress to former behaviors because they find comfort in them. You can see my post here about enuresis, also known as bedwetting.

Now to a bit about the process. Every therapist goes about this a bit differently, so I can only tell you how I would approach this young boy. The most important thing would be for the child to feel safe and comfortable around me. This is during the rapport-building stage, which could take months all by itself. But a good therapist can achieve a relatively good rapport within 3-4 sessions. During this time, I do non-threatening activities, like free play (where they can play with whatever’s in the room and I join them), art, games (many of mine are therapeutic, which reveal things about the child unbeknownst to them) or outside sporty stuff (if the space allows).

Once the child is comfortable with me, then I start to do more directive play where I choose activities that are more pointed toward what the child is dealing with. I’ll give you two examples that you are free to use in your novel.

With a child having gone through trauma like this, I like to use a book called Brave Bart, which is called bibliotherapy (using books with therapeutic messages). You can find info and an excerpt about this book here. This book is great because it’s generic and applicable to ANY kind of trauma. The questions at the end of the book are designed for the child to project what happened to them on to the cat Bart, giving the therapist an idea of how to better help the child.

Another popular activity with children I use is a mini-trash can I bought. With the help of one young client, we named it Mr. Trashy, but you can insert your own name. Mr. Trashy “eats” pictures of things that make the child sad, angry, scared, etc. It’s an age-appropriate variation of what’s called ritual. The child gets their emotion out on the paper, but the trash can “eats” it so they child doesn’t have to deal with it. There’s also the ritual of worry dolls (read about them here) where the child whispers their worries (or what causes nightmares, etc) to the dolls and put them under their pillow, which relieves their minds and enables them to go to sleep. Adults do this type ritual at Christian camps everywhere when they write down their sins and nail them to the cross or throw them in a bonfire.

The idea is that by talking and processing through what happened, the child’s behavior improves. And this works. It just does. The child feels heard and understood, and as a result, no longer has the compulsion to act out (which really is just a cry for help). I’ve spent anywhere from 6-8 weeks with a child up to 2 years. Time frame depends on a lot of things (like willingness of the parents to allow the child to come, insurance, etc).

So hopefully this has given you quite a lot to go on for your WIP. I enjoyed sharing some of my therapist tools with everyone. Feel free to leave additional questions in the comments.

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.