Before there is any possibility of working together on anything, a platform for autonomous motivation and cooperation has to be established. The question is how to accomplish that, when all of society (home, school, law) in their eyes has already failed them? In general they feel, in spite of their young age, already so damaged and disappointed, that they can be highly mistrusting any authority figure. And many of them carry some kind of psychopathological disorder, such as ADD, ADHD, ASS, PDD-nos or borderline, diagnosed by the many authority figures they have already been presented to. Most of them enter the practice room with their eyes completely shut down on the outside world. With a dark look, heavy energy and sometimes even with a hostile attitude. Expecting nothing but the worst. And who can blame them?
I remember vividly the first time a young man like that walked into my practice room. One look at him and I could feel my whole inside cramp and fear came up, contracting the space in my stomach and chest next to my armpits. A big rubber ball sunk into my stomach area, and immediately doubt set in. I felt myself small, frightened and incompetent.
Of course the conversation didn’t go too well at all. It left me puzzled about what had happened there. Speaking with colleagues I heard they knew this feeling all to well. It was the reason why they preferred not to work with this ‘difficult’ age group.
Sitting down with this I couldn’t feel any gratification in such a decision. I remembered very clearly how awfully lonely my own adolescence had been, and how I craved for somebody to notice and help me through it. So I decided to look at my own responses instead, and work with them. Inquiry, although I had no idea what that was at that time, was the answer. Curiously inquiring into, and allowing myself to be in the experience, instead of wanting to fix or avoid the awkward feelings on the spot, I went into the same situation over and over again. Seeing more and more teens and adolescents every week. By allowing the feelings to be there, to observe them, I gave myself the opportunity to see what it had to say to me. And my, did it talk! In fact it never stopped talking to me, and it became my ally in working with this at first glance challenging age group.
Over the years they became the main part of my clientele, and I have never had any regrets. In fact, it was the best thing that could ever had happened to me in my professional life. Since I discovered how wonderfully honest and beautiful they are. How unwilling to compromise to their inner truth and their beliefs they are. They are perfect mirrors, which helps me to be truthful, transparent and not compromising too. With every session I learn and heal as much, if not more, as they do.
Being at an age that their ego is starting to take on a more permanent shape, and peer and parental pressure makes them sometimes appear rigid and stubborn in their ideas, their true essence is still very close at hand, and visible like a diamond in the rough. Helping them to see it, get access to it and invite it to come out in the open, is to me the most gratifying job there is.
As already said, first some work has to be done to establish a platform for cooperation. It is in this stage where some tend to strand in the communication. Usually because they approach the client and his or her issue from their own perspective, easily finding themselves get entangled within their own projections or goals. With teens and adolescents from there it quickly all becomes nothing more than pushing against a closed door. While in fact it is quite easy to just walk around a bit and see if there’s somewhere a window slightly opened.
To be able to do that requires a letting go of all your own set ideas, expert knowledge, personal and professional judgments and hidden goals. It requires for the therapist to fully embrace the world-view of the adolescent, and work with an open mind and heart from an equal level. Which in truth is very easy, since it’s a relief to be able to let go of so much heavy luggage.
Carrying nothing, being in the not-knowing, maybe in the beginning feels somewhat uncomfortable. But gradually this space becomes more and more friendly, as trust kicks in that somewhere along the line, somehow, the answers will unfold between you and the other.
For this being able to happen a few things are required on the side of the young clients too. Whatever it is they will be working on with you, they have to really own it. It has to be their goal, their dream, and their own chosen path. And to be able to embrace it as their own, they have to be able to see the advantages, the benefits. The answer to “What’s in it for me?” is really important to them. How else can they motivate themselves to do anything? There have to be benefits, or if not immediately visible, at least the loss of disadvantages, of burdens or problems.
Feeling ownership, and seeing it’s value is crucial. But they also have to have trust, some kind of confidence, that they are able to achieve it. In the beginning that trust or self confidence usually is low or even fully absent. It has to be slowly built, reconstructed by small achievable steps forward, steps that still have to be taken, as well as steps that are already made, but were left unnoticed or seen as insignificant. The rough diamond is covered with a thin layer of sooth, making it invisible to the eye. Luckily sooth is easily removable by a gentle rub with a soft cloth.
So choosing their own goal, seeing it’s value, having the confidence they can achieve it, and consciously experiencing progress, are vital parts of a successful journey. And last but not least it is also exceptionally important to constructively prepare and deal with setbacks, since setbacks are a normal part of learning, of every day life. I’ve found that these five factors are essential when it comes to autonomous motivation for teens and adolescents to get their lives on track, and to walk their own chosen paths and flower.
Jesse (20) is a very gifted young man. He is highly intelligent and creative. He has a natural talent for leadership and is usually well behaved. He has been adopted at age three, and was left right after birth in an orphanage in Haïti. During his first years there he suffered from severe hunger and lack of adult attention. When he finally was adopted he was super friendly, always laughing and very playful. His adoptive parents loved him dearly and the first 11 years of his life, everything seemed to turn for the better. Getting good grades at school, having lots of friends, and a stabile home, made him an ideal child.
Problems started to arise when he turned 12 and went to high school. He didn’t work, let his grades slip, played hooky with some shady friends, and started using soft drugs.
Now 20, he still hasn’t managed to overcome his drug habit and suffers from periods of mild psychoses. Making commitments and keeping them is hard for him. Especially when these commitments are for his benefit. It seems he always finds unconscious ways to sabotage his own life. Since four months he comes to my practice. His social worker wants him to get clean, finish some kind of school education and get a job. This is how our first meeting went:
Jesse enters the room with a baseball cap pulled deep over his eyes, so I cannot see them. He does shake the hand I offer, and then falls down on a chair, sitting mainly on his back, with his legs opened widely. I have to hide a smile on this typical monkey behavior. He shows he has balls, literally in this case.
We sit for a few seconds silently opposite each other. He starts to get nervous and snaps at me in an unfriendly voice: “Is this going to take long?”
I look at him and ask: “What else do you have to do? We can make sure you can make it there on time if needed. No problem”
J.: Hmm, well, let’s get on with it then.”
Me. “Great. I like it when people want to get to work and make the best of the time we have. What other characteristics do you have that make you eager to start?”
Now somewhat surprised looking at me from underneath his cap.
J.: “Well, I just don’t think this is going to work.”
Me: “So you are critical. That is indeed a great characteristic. It helps you to make wise choices. Can you think of even more?”
J.: Now taking of his cap and looking me straight in the eyes while sitting upright. “What is this? Are you pulling my leg?”
Me: By no means. Why would I?”
J.: “Nobody asks questions like that.”
Me: “What do you mean by ‘questions like that’?”
J.: “Questions about what I am good at. Nobody has ever been asking me that. Everybody only wants to talk about my problems. Telling me what I shouldn’t do.”
Me: “What would you rather talk about?”
There is a long silence. Jesse sits back in the chair, turning his baseball cap in his hands. Then when the silence begins to feel a bit awkward he starts to speak slowly.
J.: “I do like to talk if people are really interested. I do talk. Mainly with my friends and my mom.”
Me: “Wonderful, what do you talk about with your friends or your mom?”
J.: “Anything. With my mom I can talk about anything. Even about my experiences with drugs. And with my friends ... it depends on with which ones. With some I talk about music, and with others I talk ... well, about stuff. You know. The world as it is.”
Me: “Wow! That’s a broad variety of topics. Does that mean you have wide interests?”
J.: “Yes, I believe I do.”
Me: “What would you say if we would take time to get into these things you are interested in while we meet?”
J.: “It would certainly make it more worthwhile. That’s for sure. But didn’t I get this referral to you to get clean?”
Me: “How do you feel about that?”
(Big silence followed by a big sigh.)
J.: “I would like to get rid of the habit. It’s just that I have tried so many times. And I don’t think I can do it. It always fails. I always fail.”
Me: “Jesse, how would like to spend the time we have in these meetings exploring if what you just said is really true or not?”
J.: “Do you doubt it to be true then? Do you think I can do it? ... (Long pause)... Of course you are going to say yes now. That’s what you are supposed to say, I guess.”
Me: “What would need to happen for you to be able to quit using drugs and stay clean? How would that be?”
J.: (silence)... “I would have to loose this feeling of worthlessness inside.”
Me: “Wow. I am impressed that you know why you are using drugs. Not many people can tell so clearly, you know. What makes you so clear about it?
J.: “I have thought about it a lot. Also I talk with my mom about it.”
Me: “What else makes you see so clear?”
J.: “I’ve always been like that. As a kid I would drive my mom crazy sometimes with all my questioning. I’ am always hungry for answers, so I think a lot. That’s just who I am.”
Me: “That’s really great Jesse. That is your ticket out of all this, your genuine curiosity, no matter what. That is really fantastic. Now tell me more about this feeling of worthlessness inside.”
J.: (Silence. ... After some time he starts crying.)
Me: “Just take your time. We’re not in a hurry. There is plenty of time to explore this. Just tell me what you sense in your body right now.”
J.: “It’s a big, gigantic deep hole of emptiness, like a black hole in space. It sucks all the life out of me. It makes me shrink and vanish.”
Me. “Jesse, would you like to know more about what it is, and how you can make it stop sucking the life out of you?”
J.: “More then anything in the world.”
Me: “Even when it will at some points be scary, and you still have to come here and not quit working on it?”
J.: “Yes, I want to. I will come.”
Me: “What makes you want this, while you already have walked out on several other therapies? I want to know why you think this time you will do it?”
J.: “Nobody else has talked about these things before. This is what I really want to talk about. Now it’s getting interesting.”
Me: “Even when it will be hard work?”
J.: “Yes. I’m sure.”
Me: “How can we prepare for those moments it will be hard or even scary? What can you do to still keep on track on such moments? Think of support from friends or family, any strategies that might help you, whatever you can think of. Then when you come here next time, that will be the first thing we will talk about.”
J.: “Why?”
Me: “Jesse, in every process there will be hard times. You probably have already discovered that over and over. It doesn’t mean you have failed. It’s just normal when you are learning things, exploring new territory, that there will be bumps in the road. In my opinion it’s best to prepare for those bumps, so they will not make you stumble and fall. What do you think? Does this make any sense to you?”
J.: “Yeah, I guess. (Sigh...) Shit happens. That’s a fact.”
Me: “Yes, that is a fact. And preparing for it means we can keep our shoes clean.”
J.: “Haha, that’s a good one. I like that one. Clean shoes. Maybe that should be my tag. Walk with clean shoes.
Me: “Yes, we are now both embarking on a new journey. Project ‘clean shoes’. See you next time Jesse. I’m looking forward to it.
Jesse is now four months on the road with his ‘clean shoes’. He still has a long way to go. So far he hasn’t missed an appointment, and has managed to stay clean for several periods of time varying from 1 week to 16 days. On the days he is still using, he uses less then half of what he used before the therapy started, and he hasn’t had any psychotic episodes since. He starts working in a printing shop next week for two afternoons. It’s a promising start.
The story of Jesse’s first appointment shows to me clearly how little one can prepare for a meeting like that. If I would have, would I have been able to see what was presented in that moment? Would I have been able to see the many gems that popped up in the conversation? They are already there, always, even if they come disguised as resistance in the beginning.
To meet with an open mind and an open heart... It takes some courage to be in that space of not-knowing, unable to hide behind my expert status, I admit to that. It can feel shaky at times. But, with what rewards? To meet a young man, seeing him opening up and sharing such beauty, such clarity, and intelligence. It leaves me in awe and deeply grateful again and again.
