The Feeling of a Therapeutic Milieu

One of the most important ways that therapeutic boarding schools and residential treatment centers help struggling kids is through the therapeutic milieu. The mileau is the atmosphere or environment of the program. It includes the modes and schedules of individual and group therapy, as well as dormitory life and recreational activities. But more than the schedules, activities, and classes, the milieu is the feel of the program, the somewhat intangible culture of it. What are the people there like? What do they care about? How do they care for one another?

It is often difficult to characterize precisely a program's milieu and even more difficult to describe the importance of it. Many times, you have to feel it. That is difficult for parents to do, especially in short visits. Like visiting a foreign country, you often have to live there for awhile to really get a sense of the culture.

While it is difficult to get a handle on a particular program's milieu, you can get a feeling of its importance by watching the movie "Lars and the Real Girl." This 2007 film starring Ryan Gosling provides a moving, funny, and sweet immersion in a therapeutic milieu, even though it is never identified as such. This despite the decidedly off-beat and initially off-putting premise of the film.

The premise is that Lars, a troubled young man, deludes himself into thinking that a life-sized doll purchased on a pornographic web site is a real girl. Yet, Lars isn't interested in sex with the doll, whom he names Bianca. In fact, so chaste are Lars's intentions that he persuades his brother and sister-in-law to put Bianca up in the guest bedroom and look after her. When his brother takes Lars and Bianca to see the local doctor (played by Patricia Clarkson), she recommends that everyone, even Lars's co-workers and neighbors, play along with the delusion. The doctor slowly builds a relationship with Lars, attempting to discover the roots of his delusion.

While the sessions with the doctor look like therapy, the main therapeutic event is the interaction of the townspeople with Lars and Bianca. Despite initial doubts and some derision, the townspeople accept Bianca and Lars's obsession with her. More so than the therapy sessions, these sweet and loving encounters with his friends and neighbors buoy Lars in his troubles and set him on a path toward healing. You can get a sense of the passion that drives the caring for Lars in this scene with his sister-in-law, played by Emily Mortimer. http://www.youtube.com/watch?v=j9OxnHj43uE&feature=fvsr This clip gives you a sense of why the town is willing to help Lars, but only seeing the whole movie can show you how they do it.

The movie is a fable, of course, and the small town is a fabled setting. (Think "It's a Wonderful Life.") But the feeling of being supported and accepted as Lars is provides an approximate sense of what good programs are able to do with milieus--and why they can be so effective.

Allowed to Fail

Today's Wall Street Journal (Dec. 26, 2011) carries yet another article on "Tiger Parenting" from Amy Chua, the celebrated and much criticized author of Battle Hymn of the Tiger Mother. The occasion of the article was her oldest daughter's departing for college and the many questions she's received about tiger parenting from afar. How does she drill and monitor her daughter from miles away?

Mom's short answer: She doesn't. The long answer is more interesting. She begins by drawing a comparison between tiger parenting and helicopter parenting. Tiger parenting, she says, assumes strength, not weakness, in children, an assumption "not that different from the traditional parenting of America's founders and pioneers." Helicopter parenting, by contrast, is characterized by parents "hovering over their kids and protecting them, carrying their sports bags for them and bailing them out." Helicoptering assumes weakness, not strength.

From our perspective as educational consultants to parents, this a crucial distinction. Because many of the students we work with have learning disabilities or emotional and psychological problems, we see many parents who have been struggling with school and home issues for years. Teachers, doctors, day care staff and others have helped parents identify in excruciating detail the weaknesses in their children. Faced with such diagnoses, the parental temptation is to protect and shield them from hurt and failure.

While some support and scaffolding may be necessary, of course, protection as a growth strategy is perilous. Often protection leads to bailing out to stave off failure: Difficult homework is done for the child, sick notes are written to avoid taking tests, curfews are overlooked. Unfortunately, failure is often our best teacher, so when we stand between children and consequences, we deprive our children of a chance to learn. I fear we also send a darker message that we don't think they are strong enough to learn. We tell them they are too fragile to fail.

A parent we worked with once told me when he knew it was time to send his struggling daughter to a therapeutic boarding school. They had tried everything to help her, but finally realized that she "didn't have any skin in the game." By that he meant she didn't really feel responsible for trying to solve her problems. She needed to be allowed to fail, so she could see her role in the solution.

Helping Teenagers Grow Up

It is a banal truth that kids don’t come with operating manuals. But that hasn’t stopped publishers from offering manuals to parents. In this crowded field of printed advice, John McKinnon’s new book To Change a Mind (Lantern Books, 2011) stands out as a useful addition.

Although it is a relatively thin volume (207 pp.), Dr. McKinnon has managed to take a complex subject and reduce it to its essentials. The subtitle to the book—Parenting to Promote Maturity in Teenagers--hints at what makes this book somewhat different from standard parenting manuals. In McKinnon’s estimation, promoting maturity is the parent’s job during the teenage years. As a psychiatrist and co-founder of a therapeutic boarding school in Montana, McKinnon knows well this subject. His previous book, An Unchanged Mind: The Problem of Immaturity in Adolescence, argued that many problems of adolescence, even clinical ones, can be traced immaturity. Drawing on data from his years working with students at Montana Academy, McKinnon proposed that internal and external “obstacles” block some adolescents’ development into adulthood.

While An Unchanged Mind is addressed to psychiatrists and other mental health professionals, To Change a Mind is addressed to parents. To promote maturity in adolescents, McKinnon suggests that parents focus on two principles: recognition and limit-setting. By recognition, McKinnon means that parents need to really see their teenagers for who they are and who they are becoming: their strengths, their weaknesses, their interests, hopes, and dreams. Moreover, he stresses that recognition is an act, not just a thought, emphasizing that teens need to verbally hear and emotionally feel that parents are actively engaged in knowing them. In discussing recognition, McKinnon offers several case studies, describing how a lack of recognition stunts maturation of teenagers. Similarly, McKinnon explains limit-setting as essential to adolescents’ evolving sense of competence and morality as they move into adulthood. As with recognition, he provides case studies and specific examples of how to establish and maintain limits.

The value of this book is the blending of theory and practical application. Because McKinnon has vast experience dealing with troubled adolescents, he has a grounded sense of what can and does go wrong in development of child to adult. However, he also offers very detailed examples—even down to possible scripts and scenarios—to guide parents in applying the principles. While this may sound reductive and simplistic, rather than helpful and accurate, it doesn’t play that way. McKinnon acknowledges that there are many possible ways to recognize and set limits. He also acknowledges the difficulty of doing so for some parents. Given a vast and tangled subject like parenting, McKinnon has marked a useful path through the thickets.

Peter Pan on a Mission

Jason Calder, a therapist at Summit Preparatory School in Kalispell, MT, recently sent me some notes on his reading of Michael Kimmel’s 2009 book, Guyland: The Perilous World where Boys Become Men. I haven’t yet read the book, but Jason’s extensive notes are enormously interesting and suggestive, resonating with my own observations of the perils young men face in maturing. As Jason summarizes the book, Guyland is an exploration of the cultural world where adolescent boys and young men aged 16-26 live in a Peter Pan mindset.

For example, both quoting and summarizing the book, Jason notes the following:

“Every man’s armor is borrowed and ten sizes too big and beneath it he’s naked and insecure and hoping you won’t see.” Caught between being “real boys” and real men, [the Peter Pans of Guyland] have all the entitlement [of mature men] and none of the power. No wonder that, to guys, boyhood is a safe and secure retreat—it’s a regression with a mission. (p. 43)

As educational consultants, we see this up close and often in our office. Parents tell us agonized stories of their boys’ and young men’s development stunted by drugs, video games, truancy, thoughtlessness, and lack of drive. We see in these stories constant examples of the national trends of steadily declining test scores for boys in reading and verbal skills compared to girls. We see parents stunned and often paralyzed by their recognition that their boys aren’t going up. Worse, as Jason’s note suggests, the boys are actively regressing.

What can be done? The answer to that, of course, depends upon the severity of the problem. For some boys their entitled regression is just beginning, and parents can often modify their parenting strategies. For example, parents might reconsider “running interference” for their sons or inconsistently applying consequences. For boys and young men deeper in retreat from manhood, therapeutic wilderness programs and schools (like the one Jason works in) can help point the way to maturity. Kimmel’s book would seem to suggest how far guys have to go—and how widespread is the problem.