Omission, Commission, and a New Mission

            I recently got together with a friend who has a 6-year-old daughter the same age as mine. As we watched the little girls play I commented on how nice little Sara’s* American girl doll was. My friend smiled wryly, “It’s a gift from my mother. Trust me, I’d never buy such an expensive doll. You see, when my mother was little her parents couldn’t afford any dolls so she now makes it a point to make sure each granddaughter gets a beautiful doll. Honestly, my daughter would be just as happy with a cheap doll but buying these fancy dolls makes my mother happy.”

As therapists we hear a lot about the traumas people have been through; the abuse, the molestation, the bullying, the domestic violence, the list goes on. Much research has been devoted to developing effective trauma treatments and understanding the impact of what happens when someone has been that badly hurt.

There’s another category of pain that’s less spoken about but equally important. While trauma refers to the harmful things that were done to someone, neglect refers to the things that weren’t done. And for many people, this list goes on and on: the birthdays that were not acknowledged, the suppers that weren’t made, the school performances that weren’t attended, the homework assignments that weren’t signed, the haircuts that weren’t given, the braces that were never had, the “how was your day”s that were never asked….

In the Internal Family Systems model of treatment, part of the healing is for the client to go back to parts of them that have been hurt or neglected in any way and to give them or say to them, what no one has ever given to them. For example, to sing happy birthday to a sad 7 year old who waited for the cake that never came, or like my friend’s mother, to buy a doll for the little girl who never got one. To play football with the ten year old part who went to each game alone because dad was too busy.  To sit with a lonely 15 year old adolescent part and to hear all about high school politics and who is friends with who and who wore what to the party and which knapsack is in style and all the other things that matter to that part but were never shared because nobody cared to listen.  

            Research on the effect of neglect has shown that children who have been neglected often imbibe the message, “if I’m not important enough to take care of then I must not be worth anything.” In fact, in his work treating traumatized people over the last 50 years, Dr. Bessel van der Kolk has done extensive research and cites that not being seen or responded to can be psychologically even more damaging than abuse. This can perhaps be illustrated most dramatically in studying the phenomenon that at times children who have been abused will seek out the abuser for the sake of being noticed, so strong is the human need to be seen.

            In his book, “The body keeps the score,” Dr. Van der Kolk discusses his work at a treatment center for children who had been abused and neglected. One of the staff members there used to go in to the waiting room to try to engage the children waiting by throwing a big beach ball at them in the waiting room. At first they would ignore him, after a while they would grudgingly nudge the ball back with their feet, until eventually they were throwing it back. Dr van der Kolk describes the therapeutic impact of that seemingly simple interaction. Playing catch  helps a kid understand that they are someone who someone responds to. “If I throw a ball and someone catches it then I guess my actions do matter and just maybe, I matter.”

How great is our power. As parents, therapists, teachers, spouses, friends- to say the things that need to be said, that perhaps have never been said. To give the message to those who we impact on a daily basis: I see you, you matter. Let us make that our mission.

Tzipora Shub, LCSW works as a supervisor at the JBFCS adolescent clinic in Flatbush and in private practice.