Picture the following scenario:
You and your 8-year-old child (or 4-year-old or 12-year-old) are sitting in my office (or the office of the pediatrician or orthodontist), and your child turns to you and announces that he is thirsty. You glance at the clock and see that it is 3:45; the appointment will end at 3:55.
What would you do?
This happens in my office pretty regularly so I have seen a wide range of responses from parents. There are a few common responses that can be illustrated by the following prototypical quotes from parents:
- Parent A: You’ll have to wait until the appointment is over. There’s a water fountain by the elevator.
- Parent B: <pulling a water bottle from his briefcase> Here you go.
- Parent C: <feeling around in her large purse> Darn, I thought I had a water bottle in here. Can you wait?
Any thoughts about which is the best response in this scenario?
Let’s take a look at the incident that inspired this post. Mae is 10 years old and was brought to see me because of interpersonal difficulties with family members and friends. Alone with me at the first appointment, Mom and Dad had described Mae using adjectives such as “demanding” and “spoiled” and with comments like “She always has to get her way” and “Her demands must be met instantly or she melts down.”
I met with Mae alone in the second session for about a half hour. I was impressed with her poise, her ability to express her thoughts and feelings, and her self-awareness. To be honest, after hearing her parents describe her and her behavior, I was surprised to find her so charming and cooperative.
At the end of that session, I brought Mae’s parents into the office to share my impressions and recommendations. The moment they entered my office, Mae announced that she was thirsty. Mom dug through her enormous purse and appeared dismayed when she could not produce a beverage. She apologized to Mae and then, I kid you not, with 10 minutes left in the session, she turned to me and asked if I could get Mae some water. When I pointed out that the session would be over momentarily and there is a water fountain by the elevator as well as a restaurant across the parking lot, Mom stood up and announced that we would have to continue the discussion at the next appointment. Before I could even register what was happening, Mom and Mae had exited my office, and Dad was apologizing profusely to me as he followed them.
I fully expected that I would never see this family again. Clearly, Mom thought I should have interrupted the session to get water for Mae, and the family left without paying for the appointment or scheduling a follow-up. I was surprised a week later when Mae, accompanied by Mom, showed up in my office. I planned to pick up where the last session ended abruptly, but before I could speak, Mom told me that she had not wanted to bring Mae back to me; she thought it was inconsiderate of me to be unwilling to get her thirsty daughter a drink. Her husband had to convince her to give me another chance. When I offered to explain my actions in the previous session, Mae piped up with
I was thirsty; why wouldn’t you get me some water? – Mae, age 10
To which I replied, “Well, Mae, I didn’t get you water because we had very little time left in the session and important topics left to discuss. Plus, we can’t always get our needs met immediately. I thought you could wait for a few minutes. Do you think you could have waited 10 minutes?” Mae assured me that she could have waited, but she just didn’t want to. I asked her what happens when she is thirsty at school, and she told me she waits until snack time or lunch time. I asked her what she does if she gets thirsty while on the soccer field. She told me that she waits until the coach subs her out.
Several weeks later, I met with Mom and Dad alone. The purpose of this session was to introduce them to a parenting approach known as Collaborative Problem Solving (CPS). We were discussing the particular challenges Mae was presenting in the moment when Mom described an incident in which Mae melted down because a promised trip to the mall had to be pushed back a couple of hours. Mom complained that “she can’t wait for anything.” I gently challenged this notion, reminding Mom about Mae’s assurance that she waits at school, she waits at soccer, and that she could have waited in my office. I asked Mom and Dad to consider what they really mean when they say she “can’t” wait. I wondered aloud if they had ever taught Mae the important skill of waiting. I explained that not all children are naturally good at delaying (or awaiting) gratification. Together we explored how the dynamic that had played out in my office had evolved. We began to refer to that moment as The Bottled Water Episode. Here’s what we figured out:
As a young child, Mae was not naturally patient. Delayed gratification was much more difficult for her to tolerate than it was for either of her older siblings. When Mae did not get her needs met immediately, she punished her parents by melting down. These tantrums were so intense and protracted that Mom and Dad did whatever they could to prevent them. The meltdowns were so punishing for her parents that now Mae only had to make a demand in order to get what she wanted.
As this discussion progressed, I could see in Mom’s face that she was beginning to grasp what was happening. When I checked in with her to make sure that everything was making sense, she commented
I see it now; Mae won’t wait or accept no because a long time ago, we stopped expecting her to. – Mae’s Mom
Exactly! And the Bottled Water Episode was the natural outcome of Mom and Dad trying to meet Mae’s needs immediately. Mom was so worried that her daughter would melt down in my office if she didn’t get a drink immediately (unlikely; kids rarely act this way in front of adults outside of their families) that she walked out of the office without even encouraging Mae to wait.
Despite our rocky beginning, Mae’s parents and I now enjoy a nice rapport. I have been using CPS to help this family work in a more collaborative way. We have worked through the Birthday Party Episode (Mae insisting that a younger cousin be excluded from the guest list) and the Science Test Episode (Mae refusing to go to school because she was unprepared for a test on ecosystems), and we very recently successfully averted what could have become the Pierced Ears Episode (Mae demanding that she be allowed to pierce her ears even though her parents have said she must wait until she’s 12 years old). Over the past month, Mae has melted down quite a few times, but Mom and Dad are firm in their resolve to stop yielding to unreasonable demands and to stand firm when they say no to Mae. All indications are that Mae is beginning to understand the importance of developing patience and to manage her distress when her needs are not met immediately.
This family has a lot of work to do, but everyone – even Mae – is clear about what needs to happen. We’ve even had a few chuckles over the Bottled Water Episode. Neither Mae nor her mother has asked me again for water. I’m not sure it is related to our work in therapy, but I’ve noticed that Mom no longer carries an enormous purse.
And, just in case it’s not obvious, Parent A made the best response in the hypothetical situation above.
[Names and potentially identifying information have been changed to protect privacy.]