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Listening to Our Children’s Voices – Harder Than It Sounds

Try to listen to what the child or adolescent is saying

By Leon Hoffman, M.D., and Lawrence D. Blum, M.D.

On May 1-6, 2011, we will observe National Children's Mental Health Awareness Week. And, on May 6, 2011, we will celebrate the birth of Sigmund Freud, the originator of the Talking Cure, or, as we prefer to say, "The Listening Cure." To honor these occasions, we propose paying extra attention to listening to our children, which is more complicated than it sounds.

Psychoanalysis teaches us that listening and understanding have many therapeutic benefits. At the same time, because people, including small children, communicate on many levels at once, understanding everything that someone is communicating is difficult. Here's an example:

An 8 year old little girl came to a therapist (the identifying details are disguised). She was very chatty telling her about her stomach aches and headaches when she was in school but that she did not have them at home. As she was chatting, she set up the doll house, with a mom, dad, and two children: a big girl and a baby brother. The family got up in the morning and they ate breakfast. Then the daddy got into the car and went to work.

In the meantime the mom kept yelling at the daughter to hurry up and get dressed so they would not be late for school. The girl had to get dressed by herself as the mother was taking care of the baby brother. She cried and did not want to do that because her stomach hurt her. The mom yelled out, "don't worry about it, your stomachache will go away." "No it won't," the girl muttered to herself.

The little girl finally got dressed, walked around to the other side of the house, and saw her mother helping the little boy prepare for breakfast. Suddenly, the girl removed herself dramatically from the play scene and said very abruptly: "Let's play something else! She put the house away and took out the game "Connect 4" which she and her therapist played very quietly until the end of the session.

What can we learn about this girl as we listen between the lines to the girl's play, where she essentially described a typical scene from her daily life? What does the girl tell us about her feelings via the play?

First, she follows her mom's rules and gets dressed by herself; however, she expresses her problematic feelings by having a stomach ache. In the play, the big girl gets a stomachache when she must dress herself while her mother cares for the baby brother. It is a safe inference that the stomachache, which bids for maternal care, reflects the girl's wish to receive maternal care as her brother does. She continues her play, but as soon as she sees that her mother is now helping the brother with breakfast, she abruptly stops the play and moves to a very neutral activity - a game with clear rules. This sudden change is non-verbal, but meaningful, and very similar to the interruptions in free association in the psychoanalysis of adults.

Even though the girl was "just" playing - something difficult was touched on when she enacted the scene of mother and brother. When we play with children we often see that sometimes they want to stop playing rather suddenly. In play therapy when that happens, as it happened with this little girl, we frequently have the opportunity to observe that a particularly painful feeling has come too close to consciousness. The feeling has "hit too close to home," as the saying goes. For this girl, it appears that she has a feeling about her mother now preparing to feed her brother that is too hard to tolerate.

Even though she was the one setting up the play scene, as soon as the scene (which like the story of a good writer, just comes out as if it is outside the person's conscious control) of the mother ministering to the brother while the little girl in the play had to watch, the real life feeling of being left out and angry arises. This feeling is intolerable for the little girl and she flees from the play scene to a game with more rules than feelings.

This little girl does not express negative feelings directly to mom or brother. Instead she is quite friendly with him, and both parents had reported that she had no negative reactions to the birth and subsequent presence of her brother. What we see is that this girl keeps her negative feelings to herself but expresses her jealousy of her brother, her anger, and her to wish to be home to receive the same care from her mother as her brother does, by getting sick at school.

Other children in similar circumstances may respond with overt anger and hostility. The challenge for this little girl was to become more tolerant of her angry feelings and not have to suffer the consequences of expressing them indirectly. In the play sessions gradually she began to play out aggressive themes towards boys. In a later session she invented a scene in which two children were walking near the edge of a hill. A little boy who tried to take their toys away went too close to the side of the hill, fell down and broke his head.

After a period of several weekly sessions, the mother reported that the girl felt much better at school and seemed much happier. However, for the first time she fought a tremendous amount with the brother. The mother observed that "she seemed freed up to fight with him." Prior to the sessions with the therapist, she always gave in. She became much more comfortable in school and the new teacher said that she would not have guessed that there had been problems. The therapy enabled the girl to express and tolerate angry and destructive wishes to the brother which were previously forbidden. The parents understood that the misbehavior at home was indicative of progress for this inhibited girl. A very modest amount of psychoanalytic play therapy helped this little girl to return to a freer, less troubled course of development.

Listening to children starts with parents' (and other caregivers') careful attention to babies' cries, learning to discriminate whether their baby is hungry, wet, sleepy, or otherwise distressed. But listening soon becomes more complicated. As children grow, there are more types of distress and types of non-verbal and verbal communication. Little children's stomach aches are not all for the same reason. Some, of course, are from physical ailments, but ones with emotional roots may have many different meanings. And not all children are as straight-forward in their play and talk as was the girl in the vignette above.

Listening also gets hard because of what we don't want to hear: that our children are angry at us (it's even harder when they have good reason), that they have sad, jealous, sexual, or vengeful feelings (depending on what we're uncomfortable with), that they feel ashamed or guilty, or make us feel guilty, or that their distress is very real and not easily relieved. The temptation is to treat things as though they are simple, to pretend we always know what to do, and to listen judgmentally, or not to listen at all.

What we wish to emphasize on this occasion, to parents, educators, and mental health professionals, is to try to listen to what the child or adolescent is saying. The communication may be with direct words, with actions, or in some other disguised manner whose code is difficult to decipher. The communication may make the adult uncomfortable, but listening is worth the effort. Helping a child to understand and accept his or her feelings is a crucial step in the development of emotional intelligence and a key foundation of good future relationships. It promotes children's mental health and honors what we have learned from Freud. It is one of the best gifts we can give a child.

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