The Unkindest Cut of All

She sat in the outer group room waiting for the other kids to arrive, waving her arm, trying to get my attention. The green sports band on her left wrist caught my eye.  Dressed in a black sweatshirt, jeans and skateboard sneakers, her brown hair cut into a bob, she looked tired and dishevelled. Had she been crying? Her wire-rimmed glasses could not hide the redness around her pale blue eyes, and yet there was urgency to her gestures.

“Did you talk to my mom?” she asked.

Her mother had called earlier to let me know that Katy had cut herself last night. Mom didn’t understand and started to cry on the phone wondering if she should hospitalise her daughter. I told mom that I would check in with Katy, and get back to her.

“Yes, your mom called.”  I sat next to her and pointed to the sports band. “Would you like to do a piece of work about ‘this’ today?”

“OK.”

In 2005 I began facilitating Family Constellation groups as part of the IOP (Intensive Out- Patient Programme) at a local mental health clinic.  The IOP was a group focused, 3-4 day a week, 3 hours a day programme for teens aged 12-18. IOP was either a step away from being hospitalised, or a step down from it. Like Katy, many of the kids struggled with self-injurious behaviours, depression, anxiety, eating disorders, drug abuse and other traumas. Often motivated by love, these intense symptoms presented a radical and sometimes desperate attempt to  ‘fix’ one’s family, leave it, or become un-entangled.

When assessed for the IOP, Katy was a 15-year-old middle school student trapped in the centre of her parents’ recent unpleasant divorce. She loved music and poetry, mostly poetry, and would spend hours writing. Words brought some relief, but they weren’t enough so Katy began to cut. No-one knew. She managed to keep it hidden from her parents and teachers until the battles between her and her mom and dad reached a peak. Currently, she was living with her mom and younger brother. However, if things became difficult with mom, she would move in with her father and vice versa. These clashes over Katy’s comings and goings wore her down as she struggled to remain loyal to both parents and to herself.

When the others arrived, we gathered in the group room. Many of the teens had been in and out of therapy. They had experienced groups where their behaviours were challenged. This way of working, though valuable at times, can create resistance.  Because Family Constellations was new to them, and not what they were expecting, resistance was put on hold. Besides the ‘psychiatric issues’ mentioned, there were normal adolescents’ concerns: sex, self-image, body image and fitting in with peers. Wrapped in these struggles, the kids, intense and very present, brought a high level of energy to the work. But for Katy, the ground kept shifting as she fought to find her place.

After a round and a guided meditation, I told the group that Katy had an issue and that she would like to go first. She had been part of the group for a couple of weeks and most of the kids knew that she was a cutter.  Some were cutters themselves, some had tried it, or knew others who cut regularly.

“Katy?” I invited her to sit next to me. “What happened?”
“My father,” she replied.
“What about your father?”
“He embarrasses me. I find that I cut myself whenever he acts stupid or like an idiot.”
“What happened?”

“I spent yesterday afternoon and evening with my dad.  I guess he was supposed to do something for a friend and didn’t do it. I heard him talking on the phone to his friend making all sorts of excuses, lying. It made me sick. I went back to my mom’s, but I couldn’t stop thinking about my dad’s conversation.  I felt so uncomfortable and embarrassed.  Later, I cut myself, pretty bad.”  She held up her left wrist and pointed to the green armband. “My mom found out.”

“You felt better afterwards?”

“A little,” she said.

I notice that many in the group were nodding their heads.
 
“You guys are familiar with this? I asked.

“My mom is always annoying me. She acts so dumb sometimes that I can’t stand it,” offered Sara, 16.

“So you cut?

“No, I lock myself in my room, listen to my iPod, and ignore her. But I know how Katy feels. It turns your stomach!”

What was going on here? Kids cut because of the pressures they are under or sometimes because of a post-traumatic stress.  Barent Walsh, Ph.D. (2004), says cutting:

“Reduces tension and restores a sense of psychological equilibrium.  It provides a sense of control and empowerment.”

Yet, Katy was cutting because her father embarrassed her.  Sara had a similar experience with her mother, but didn’t cut. What was this embarrassment they felt? What role did cutting play in Katy’s family? Was she relieving some anxiety, trying to restore the family equilibrium or honouring her father in some way? Cutting oneself because of someone else’s behaviour was different. Had Katy become her father’s ‘whipping boy’? 

 According to Wikipedia (2007):

“A whipping boy in feudal times was a boy of the same age but lower rank raised with a prince or nobleman as a playmate, who was whipped in his place when the young nobleman -- too high in standing to be beaten by anyone below his father, who was often unavailable - misbehaved or slacked in his studies, as a psychological 'indirect punishment’.”

Was Katy indirectly punishing herself for her father’s transgressions or was she acting out her mother’s disappointment with the father? Perhaps this was this something older?

“What would you like to get out of this? What would be a good result for you?” I inquired.

Tears welled up in her eyes. “I don’t want to cut anymore.”

“OK, well, let’s take a look, and see what emerges.”

I asked her to set up her family: to pick a representative for her father, mother, her brother, and herself.  The group had already participated in a few constellations and they knew the procedure. I didn’t ask Katy any more about her family or about any significant fates. Through experience, I’ve discovered that adolescents are not the best of historians. Their energy tends to be focused in the present, mostly around mom, dad and siblings and friends. I stay with what they are feeling and experiencing in the moment, and allow the field/constellation to show me and the client what is needed.

Katy looked around the room, took a deep breath, and began. I asked her to identify each one and then put them in position.  She placed them all side by side at the edge of the circle facing out:  brother, father, herself, and mom. 

Besides being out of order, I wondered about this configuration.  What were they looking at? Had someone died? Did someone want to die or leave? Was there an event they were all connected to?

I approached each representative, starting with the mother to ask about their reactions.

“How is the mother?” No response. I asked again, and again no response. Then, the mom turned to me abruptly and said, “Oh, are you talking to me? Excuse me I wasn’t sure who you were talking to.”

Before the mom could respond to my inquiry, the client said, “That’s my mom, a total air head. She never responds right away when I talk to her.”

“And the father, how are you?”

“I feel OK, a little odd, yet OK.”

“And the brother, how are you?”

“This is weird, I feel like I want to move.”

I sat back down next to Katy. “Does this mean anything to you, how they are standing?”

“No. Except my family is all kind of like this, a little spacy.” 

“Any idea of what or who they might be looking at?”

“No.”

I kept looking at the constellation. Katy had placed her representative in between her parents. This is what she had been describing, and acting out for more than a year: She was out of place and the family was out of order.

I told Katy that I was going to try a little experiment to see if it made a difference.  I moved the representatives for the father, mother, Katy and her brother to the centre of the room and placed them side by side in the right order.

“Is this better or worse?”

“Better,” they said in unison.

From her chair, Katy said that it felt better.

Next, I had Katy’s representative stand facing her parents with the brother off to the side.  I asked the parent’s to face on another.  As soon as they turned they began to smile at each other. I looked at Katy. She was smiling too through her tears.

Katy’s representative responded immediately.

“This is making me a little nervous.”

“Of course, Can you hold it here?”

“Yes.”

At that moment I noticed that Katy’s mother had tears in her eyes and the brother was crying softly. Moments ago these were tough ‘in your face’ kids and now they were being moved in a very deep and profound way. It was as if their souls suddenly slammed into their bodies and cracked open their hearts.

I asked her parents to say to each other, “Even though we are not together, I honour you as the mother/father of my children.”

Katy’s representative began to cry.

“Are you OK?”

“Yes. I feel like saying something.”

“Hold it for a moment. Can you do that?”

To the parents: “How is that?”

“Better,” they said and let out a big sigh as did the rest of the room. I asked the parents to face Katy’s representative, who was trembling at this point.

Katy’s representative. (Maria) was a tough, no-nonsense, streetwise, angry 15-year-old. And yet here she was shaking with words bubbling to the surface. I touched her elbow.

“What is it you wanted to say?” Without knowing, she led the way to the next step.
She looked at her father and said, “Dad, I can’t take this shit anymore. I don’t like it, I hurt. I’m always hurting. I don’t want to do this anymore. You need to take care of me! I’m  tired of taking care of you!”

Dead silence. My arms were covered in goose bumps and I was close to my own edge. The power coming out of this tight little circle was amazing. I glanced at Katy. She was crying quietly and nodding in agreement. I touched her representative on the elbow and asked if she was OK. She said she was and let out a big sigh of relief.

“I’m not sure what just happened, but I really needed to say that.”

“I know. Now say to your dad: ‘Dad, I don’t really know what this is all about, but I don’t want to cut any more. So I’m leaving the embarrassment and shame with you’.”

She said it, took a deep breath and said that she felt better. I noticed that the father was standing more erect and solid. I asked him to tell his daughter that whatever this is, it’s his responsibility and he would take care of it. Then I had both parents say to their daughter and son that the divorce is their business. It has nothing to do with them.

“You honour us by living your own lives,” they said. More sighs of relief.

I invited Katy to take her place and to repeat the last sentences her representative had said. She moved into place.  Her representative stepped behind her.

“Stand here for a moment and allow yourself to feel this.” I suggested.  She began to wave her left arm in front of my face pointing to the sports band. She was trying to speak, but couldn’t get the words out. Gently, I moved her arm down and asked her to wait and to look at her father and repeat the last words of her representative. She took a deep breath and spoke the sentences. Her parents repeated their sentences. Katy smiled. Everyone let out a big sigh.

“I think this is a good place to stop. Is that OK with you Katy?” She nodded. I thanked everyone and Katy thanked the representatives. Back in our chairs, Katy told me what she had wanted to say when she was waving her arm while standing in front of her parents.

“My wrist was throbbing, and the cuts hurt. But now, nothing; they don’t hurt anymore.”

I invited her and the group to hold on to what they had witnessed and experienced; to revisit the images that had been created when they had questions or felt unsure about things.  It was time to end.

That was February 2005. Katy remained in the programme for six more weeks. She stopped cutting.  Her graduation from IOP was a happy, tear-filled, joyous event. She returned in late Spring to speak at a celebration honouring the Child & Adolescent Programme. She told me that she had not cut since her constellation. It was then I learned that her dad had an older brother whom he adored who had been killed in Vietnam. Perhaps this is who the family had been looking at as they stared beyond the group. Perhaps Katy was representing him somehow and her cutting was honouring the manner in which he had died. I’ll never know. It was the last time I saw Katy.

In December 2005, I left the agency to pursue a private practice. In March 2006 I ran into Maria. She had been Katy’s representative in the constellation. I asked what she was up to. She told me that she was a sophomore in High School and that she was doing OK. She wanted to know if I remembered Katy.

“Of course I remember Katy,” I said.

Maria told me that they were in school together. Katy was doing great and they had become best friends. I wasn’t surprised. I asked Maria to tell Katy I that said hi and to wish her well.

“You know Mr. Bill that was some weird stuff, that constellation thing you did back then.”

I smiled. “Weird,” I’d heard this before.

“Maria, by ‘weird’ do you mean ucanny, unusual, extraordinary, unexpected and deeply moving?” She nodded in agreement.