Jack is an unusual young man. We know this. This in and of itself is not a bad thing. He is kinder and much more sensitive toward others than most children his age. He would never mock another child for having overly red cheeks. Not that I ever suffered from that, I’m just saying.
Being different, however, can pose problems for Jack. His precocious knowledge about sexuality can alienate him from other adolescents. His vocabulary matches that of George Plimpton, and his use of words like “vicissitudes” and “sequacious” as opposed to words like ‘yo,’ ‘dude,’ and ‘fo’ shizzle,’ make him appear awkward in the eyes of his peers. He is also made fun of for having a stepmother that attends the same school as him. All of this can sometimes bring his mood down. But his intelligence and instincts tell him that he is a good person who cares about others, and that ultimately seems to help carry him through days when he is feeling blue. When he could use some guidance to give him an additional boost, I come into play.
“Robert, I feel a bit torpid today, and I’m not quite sure what to do about it. You will help me?”
“Of course, Jack. I’ll do my best. Tell me about what you’re experiencing and let’s see what we can do.”
Therapist Rule: When working with children and adolescents, it is important to convey a confidence that, regardless of problem, you can be a help. “Whatever is going on, we can handle it” is the message.
“I know I’m not depressed, just somewhat down. Dysthymic perhaps? Is that the proper term?”
Unsurprisingly that is the exact term.
“I see. A case of the blahs?” Why Jack sounds like the DSM-IV and I’m using words that don’t actually exist is beyond me.
“Exactly. Do you have any specific coping strategies that you can pass along?”
“Well let me ask you a question first. When you feel dysthymic, do you tend be…sedentary?”
“Okay, this is very common. You need to know that a case of the blues and inactivity often go hand-in-hand. They can be best friends.” Like an idiot I cross two fingers to show how connected depression and inactivity can be, just in case the boy genius in front of me doesn’t understand this basic premise.
“So you are saying that I should become more active to help my mood, Robert?”
“Yes, that is exactly right. Additionally, research has shown that people tend to do best when they engage in activities that not only are pleasurable, but also that have a high degree of mastery. You know, things you’re good at.”
“Yes, I am familiar with the term ‘mastery.'”
“Yes. Yes of course you are. You can remember the key terms of ‘mastery’, ‘activity,’ and ‘pleasure’ with the simple acronym ‘MAP.'”
“Indeed,” Jack says. “I think I prefer ‘PAM,’ however. That’s my aunt’s name.”
“Okay, that sounds good to me.”
“Or how about ‘AMP,’ as in I’m ‘amp’ed to beat this dysthymic mood.”
“Any of those are good.” Does his brain ever stop working at the speed of light?
“Or even ‘Plan Many Activities.’ Yes that one is good too! Do you want to write all of these down for your other clients?”
“I think I can remember those,” I say, knowing full well that I will frantically scratch out all of those mneumonics the moment Jack leaves the session.
“Good. I’m glad to hear you haven’t lost your memory yet.”
“Why would I lose my memory?”
“Dementia of the Alzheimer’s Type probably isn’t far off you know.”
So in addition to reading the dictionary, he’s mastered psychiatry terminology.
“I’m glad to hear that you are concerned about my memory, but Alzheimer’s is extremely rare before age 50 and isn’t usually concern before the age of 65.”
“Robert, one day you’ll realize that 30 years is such a short time, given the grand scheme of our universe. I will see you next week.”
Jack can be exhausting at times. And depressing. I think I need a Massive Pint of Ale to help with my own dysthymia now.