The first thing you notice about five-year-old Jose is his smile – the boy has a quick and playful grin that lights up his whole face. But it wasn’t always this way. When he was just three, Jose witnessed the dramatic arrest of his father, who, unbeknownst to the rest of the family, was selling drugs instead of furniture. One cold November night, while Jose and his mother were curled together reading a book on the couch, law enforcement surrounded their apartment building. In a shocking and horrifying scene, armed officers burst through the door, pushed Jose’s mother to the floor, and tore their furniture apart. Jose hid in a corner, terrified, and watched as the FBI led his father away in handcuffs. In an instant, the life he had always known was over.
Jose’s mother blamed herself for missing the signs and became overwhelmed with guilt and shame. Every day, she sank deeper and deeper into depression. It took every ounce of strength she had just to get out of bed to feed, clothe, and bring her children to daycare.
One day, a few months later, the phone rang. A voice on the other end of the line urgently demanded, “Come and get your child. He is a terror. He kicks, hits, and never stops crying. We cannot take it anymore.” And just like that, Jose was expelled from daycare.
Desperate for help, Jose’s mother reached out to a neighbor who told her about a special school for children with behavioral problems. She called and was able to get Jose enrolled into a school with trained professionals who could support him in the classroom, but it still wasn’t enough. Jose lashed out at the other children, threw toys, bit, and kicked. Nothing seemed to be working. Jose’s mother sank deeper into depression.
The staff recommended that Jose’s mother seek treatment for her depression and that she take her son to outpatient therapy. But it was too much. Jose’s mother did not have the energy or the belief that anyone would understand. Meanwhile, Jose’s behavior continued to intensify. There was talk of expulsion, hospitalization, medication, even future incarceration.
The staff had seen children like this before and they knew that without help, the future was grim. The school contacted Child First, an intensive home-based intervention that had successfully helped many of their hardest to reach families. Child First agreed that the family was in crisis and assigned a bilingual team consisting of a mental health clinician and a care coordinator to help.
Sylvia, the clinician, reached out immediately, but her calls and letters went unanswered. It was obvious that Jose’s mother felt ambivalent about getting help. “I am not sure I want to know what I feel…I do not think I want to show the mess inside of me to anybody.”
Sylvia continued to call weekly, leaving messages asking if there was anything she could do to help. After a month and a half, the team was finally invited to come to the home.
Jose, now at his third school, was still tearing apart the classroom, lashing out at children and staff. When Sylvia first entered the home, an angry little face greeted her and “accidentally” slammed her fingers in the door. She observed Jose kick his mother and bang cabinets. His screaming was constant. As she talked with Jose’s mother, more of the story unfolded: Each week they drove three hours to visit his father in prison. After each visit, Jose would become feverish and he would vomit uncontrollably.
When treatment began, Sylvia helped give voice to the hurt, anger, fear, and sadness that boiled inside Jose – and to the shame, guilt, sadness, and fear inside his mom. She gave Jose a little plastic toy; it was a fat man with a big mouth in his belly. She told Jose that when people have trouble finding words for the feelings they have it sometimes comes out in other ways. Maybe they speak through their bellies. Maybe they have to vomit instead. It became Jose’s favorite toy. He kept it with him at all times.
Every week, through play, words, and songs, feelings were expressed and heard. Things began to change. Jose’s mother’s somber and withdrawn presence became an articulated and authoritative voice, “In this family, we do not hit. Hitting hurts very much. We can have angry feelings because daddy is not here, but we cannot use our feelings to hurt anybody.”
The house became more alive: a picture here, a plant there, delicious food cooking on the stove. Sylvia helped Jose’s mom find a part-time job at a local clothing store and Jose’s compulsive play, where children were eaten by dragons and fathers were dragged away to be killed, gradually stopped. A smart playful little boy, and a loving, energetic mother began to emerge.
One Monday afternoon, Jose’s mother called Sylvia to share some good news. “Jose did an incredible thing,” she said. “Yesterday, we went to see his father. He looked at his daddy, grabbed his face and said: ‘This is not right; you are a bad daddy. You left us alone. I do not like you. I am angry with you.’ Jose’s father hugged him and cried and said, “You are right. I am so sorry. I love you so.” And when Jose and his mother left, for the first time in many months, Jose did not get sick – no vomiting, no fever.
And that week, when Sylvia came to play, Jose smiled and handed her his special, fat little man with the big mouth in his belly. “Here Sylvia, this is for your box of toys. Other kids may use him. I do not need him anymore.
