The adolescent, the young person, the parents and the therapist

An important insight related to these embedded difficulties is that they are essentially family and relationship connected. This requires that the therapist makes this clear from the outset, so that the separate work with the adolescent/young person as well as with their parents is conducted in a transparent manner, understood and accepted by everyone involved. This allows the adolescent and young person to have time separately to air their views, grievances and fears and this is similarly available for the parents. At various times, the therapist may judge when it is appropriate to introduce joint meetings in which these separate ‘understandings’ can be brought together in the service of further expanding the work and any particular areas that need to be specifically addressed.

Helping parents to change the dynamic of the embedded problem

It is critical to involve parents because they will be the key change agents in helping to shift or totally eliminate the embedded problem. The old adage that we cannot change anyone else except ourselves, applies particularly well in this situation. Parents who have been struggling for some time to help their son or daughter will understandably perceive the problem as existing primarily within their child. As such, they will not have paid much attention to how their family dynamics have contributed to the problem and most importantly, how these dynamics continue to ensure that the problem remains cemented into the family structure. Many embedded problems have accompanying rituals with which parents and families comply for the sake of peace, or because of a fear that their son or daughter will become so enraged or fearful if they do not, that this will provoke an even worse situation for them. We may therefore hypothesise particularly with regard to obsessive behaviours that remain unchecked, that parents and often the whole family, are driven into ‘servicing’ the obsessive worry or conviction. This of course, not only shrivels the development of the adolescent and young person, but also shrivels the life of parents and family who fear that they must tread very carefully in any interactions with the young person. Treading carefully on eggshells creates the further problem of an illness discourse around the young person. This may have the function of shielding them from having to take a step back to understand their behaviour or to take any responsibility for it.

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