Saturday, April 25, 2015

You are working with Michelle, age 32, who is a single mother to Jaime, age 12. Jaime's father, Dennis, has been incarcerated since he was 5 years old, and he has had very limited contact with his father since his incarceration by choice. Dennis verbally and emotionally abused Michelle and was known in his neighborhood for his gang involvement. Fearing retaliation from other gang members and Dennis's family, Michelle moved out of state and has started over with the support of her family. Recently, Jaime has been engaging in aggressive behavior and giving Michelle a hard time at home. While you are conducting the intake, Michelle tells you that Jaime had gone to therapy when he was younger and was discharged after a few months because he seemed to have adapted to the transition and was not impacted by his father's behaviors. Michelle does not understand why Jaime is behaving this way and assumes that he hates her and is struggling because he does not have a male role model in his life. She also reiterates that Jaime never observed his father being aggressive and denies that there was any physical abuse in the home. Michelle is having a hard time understanding how Jaime may also be a victim of Dennis's abuse, gang involvement, and/or incarceration. How do you explain to Michelle the impact of Dennis's behaviors on Jaime? How do you clarify that Jaime was also a victim despite the fact that he was never physically injured or at risk?

Several key possibilities present themselves immediately that would have an impact on how one would analyze this case.
First, a caseworker should probably not reflexively accept Michelle's statement that Jaime "never observed his father being aggressive and denies there was any physical abuse in the home." We've already been told that Dennis emotionally and verbally abused Michelle. These forms of abuse are significant enough that even if no physical violence actually occurred, there would be a lasting impact on both Michelle and Jaime. It could also be that Michelle is in denial about the extent of what took place, or that she did not personally witness the boy being abused (or has suppressed her memory of it). Dennis was not incarcerated until Jaime was five years old. Even if Jaime says he does not remember scenes of domestic violence or abuse, it's difficult to believe that at least on an unconscious level, a child would not be affected by a repressed memory of such behavior.
It is possible that both Michelle and Jaime are presenting with PTSD (Post-traumatic Stress Disorder). The child also could be unconsciously blaming his mother for the overall situation of not having a father present in the home. This is especially likely if it really is true that Jaime himself never was exposed to abuse. Often children will build up an idealized picture of an absent parent and take out their anger on the parent who is present and is taking care of them, since no one else is available upon whom they can vent their frustrations. Additionally, Jaime is probably under tremendous stress at school because the other kids will ask him where his father is, and he then has to admit his father is in prison—or lie about it if he is too ashamed to admit the truth.
Michelle needs to be told that although she is not at fault and has done the best she could for her child, the family dynamic—one in which there was abuse, separation, and a parent in prison—has been a dysfunctional one, and therefore, her son was victimized by it. In addition, there has recently been research indicating that elevated stress-hormone levels can be passed from mother to child in utero. If, as is likely, Michelle was under stress during her pregnancy because of the abusive situation at home, Jaime may have had elevated levels of this hormone (cortisol) from birth. This fact can do much to alleviate a sense of guilt Michelle would have about "making the wrong decisions" during Jaime's childhood. It needs, again, to be emphasized that Jaime's troubled and aggressive behavior is not "her fault," but that they are both victims of the overall situation.

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