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Activists' Community

Forum Counselor: Michal Herbsman

This forum is designed to be a platform for questions, comments and deliberations by the professionals who use NVR and NA in their work. Please feel free to share your thoughts about various issues concerning NVR & NA and make contact with each other. There is no need to be registered in the NVR activists' list in order to participate in the forum.


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Total messages: 127
An obese child with 5 "governmental "euro fo...
Idan Amiel
12:09 03.04.2011
Dear friends and colleagues to the NVR&NA spirit

When Iris and I planed the training schedule we were not able to spare some time for one of the most important things - case studies from the participants… It is important because those cases are the exact bridge that should be between theory and practice. One of our tasks and intentions in creating this forum was to use it as a kind of a reparation act for that. After that said, I would like to use Evelines' third question (see 4 conversations below) as an example for a new authority treatment plan.
The question concerned a governmental decision that - "every child has the right on an allowance (5 euro every week) and they can do with this money what they want. You can't use it to punish and you can't withhold it". And this is where the problems come in: an obese child has to follow a diet but we can't prevent him from buying sweets with this.
First if we look at the problem from a perspective that this poor boy is also addicted to sweets a plan that will prevent him the money and by that remove the "buying sweets option" is a possible and reasonable treatment plan. But as mentioned, sometimes governmental rules concerning childrens' rights seems to prevent this option. We are less able to use reward-punish plans and sometimes some good CBT treatment plans are weakened by that…
A different treatment plan will look at the individual and try to strengthen his inner abilities or in other words bolster his self-image. Of course this is also a possibility but then again - after 3 month the government will probably demand to release him from the ward. To our frustration building self-esteem with therapeutic plans takes usually more time than any government is willing to spend on a child. In many cases also our ability to use good psychodynamic treatment plans is seriously limited by that…

Can the New Authority concept suggest a different road for treatment? I believe in that … Now, let us try to look at the problem from a New Authority perspective. If you recall our slogan – from individualism and loneliness towards community and support, we can take a different road to help in this problem. Is it possible that at the beginning of each week (usually there are morning group meetings with the kids) there will be a discussion with all the children on how they spent the 5 euro at the weekend? Here we start to think in terms of community and the children are part of the wards' community. As you will read later on we can even recruit them as supporters for a treatment plan. We believe that children always need an adult around but sometimes they can heal each other and can do a good job as the wards' professionals. In our culture it's of course unprofessional to think that non-professionals can do a good professional job. (Sorry for that, but well, by now you know me already, I can't control myself sometimes, self-control is not my best part when I start to talk or write… :-)
But back on track now – let's look at that boy not from an individual perspective (self-image…) but as part of a community. As a child who's secret and most intensive wish is to belong – to be part of a community. Now suppose the child will say in the group that he bought sweets with the money, how will others react?
Here comes the first risk in "going public" and recruiting supporters with the Childs' problem - If someone from the group laughs at him, can we initiate support for him? Well, I'm sure we can – this is our duty as (new) authority figures in a residential setting. Indeed group dynamics tent sometimes to escalate quickly but here our experience and profession as therapist is useful (Sometimes a professional intervention is certainly needed :-)
What if the child devaluate us? - says something like "they forbid me to buy sweets – I "won" they can't forbid me so I bought it". Here again in terms of a new authority figure the reaction is simple – "we forbid it because we care for you but we know we can't control you." I think that here you can see the concept of recruiting supporters at its best. The same statement could be said in four eyes between the therapist and the child but the children in the ward sitting there in the group are like an amplifier for that statement! I'm also sure that within the children group you will find those who will not only understand the message but will also be able to help in stopping the power struggle of control between the authority figures (us) and the child. More than that, I can assume that in some cases the child will use the power struggle of "forbidding-buying sweets" to continue his behavior. For example if we don't talk with the group and keep it only in the therapeutic sessions he can tell a friend secretly he bought candies but I'm sure he will pick the one who will back him up in the struggle to "freedom" (and of course more risk for him…). Going public and using the childrens' group as supporters can prevent that.
But here comes a different dilemma – what if the child will not tell he buys candies in the group? Can we here again think in NA terms? Can we as NA figures initiate resistance? I think it's a possibility. For example – first to talk in individual therapy with him why he lied and later checks if he is willing to tell it to others.
More than that – another possibility is to make an Announcement about that in the group and ask the group for support. This is exactly what we mean when we say that the NA figure should be able to initiate resistance & support. After an announcement is made there is also a possibility that other kids will support him by calling him in the weekend to ask what he bought. Is it a possibility? Aren't we breaking here some privacy rules? Those questions are as I was trying to explain part of our cultural problem. I'm sure that most of us can agree that sometimes even "crazy" children can help each other when they are out of the ward on weekends, by calling each other. As mentioned before this can create sometimes an escalating process but just like Haim said in his lecture – when you solve one problem sometimes you create another. I would add that my believe is that when you change your problems it's a good sign, when you face the same problem again and again, well you have a problem. Putting it in terms of one of the participants who preferred to write an email instead of using the forum – " It’s pleasant to feel a reassuring mix between idealism en realism: NA en NVR are attitudes and have techniques but they don’t pretend they can ‘solve’ all problems. It’s more a way of life to deal with problems than to solve problems". So, I truly hope that the NA treatment option I suggested here can be useful for you as an example. I feel also an urge to say that one of the difficulties in trying to act in new authority ways is our cultural inclination to think in terms of individualism and professionalism instead of believing more in the power of community to heal. OOOpppss here I start again, this is the right time to stop – I'm also practicing self control with this example :-)

Yours always,
Idan

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Freedom of language in this forum
YaelR
11:54 03.04.2011
Dear participants,

Since we got some thank you e-mails about this forum and some participants wrote that writing in English makes it difficult to respond, we have a suggestion: We invite you to write in this forum in any language you wish- German, Flemish, Dutch, and even French :-).
We think that this way you will be able to write better to each other in the forum, and we promise that we will answer it. Don't worry, it doesn't mean that our team will answer in Hebrew! We have Google Translate to overcome the language barrier...
We believe that this can enable us to profit more from our forum.

Yours,
Yael

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flexibility and creativity
Patsi
22:37 03.01.2011
Hi everybody,

I can only subscribe and stress all positive comments that were made on the training. I somewhat got a kind of NVR-boost, it got under my skin and it keeps itching. Still there's a little inner voice which keeps asking: how come that nothing was mentioned about reconciliation gestures in a basic course? I'm sure an answer will follow.

I would also appreciate some advice on a family which puzzles me. Biological parents and 2 boys of 15 and 8. A lot of violence, mostly between the mother and the oldest son. An announcement was made earlier, the agression of the father reduced. Mother still is very agressive, she keeps being provoked by the oldest boy. At this moment I'm thinking of coaching them more thoroughly in not being provoked. Only, in our setting of home guidance, a social worker goes to the family once, sometimes twice a week. Every social worker has a supervisor who occasionaly sees the family. So we don't have telephone supporters. But I think it might help if the supervisor acts as a telephone supporter. Could it work or am I missing something important here?

Thanks a lot for this forum, in my opinion it will be very precious!
Warm regards,
Patsi

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Aggression prevention vs. Sit-In
Idan Amiel
00:57 03.02.2011
Dear Patsi,
We really wished that we will be able to touch you all with the new authority concept so thanks alot for your charming and touching respond! :-)
As to your question – No you didn't miss something!! and Yes a telephone from the supervisor can be a great help in this case!!!...
Indeed the reconciliation gestures were not in the training and it's a pity but our intention in the short time we had was to put a lot of energy on the less intuitive parts of NVR – meaning Resistance. Our assumption was that the complementary "soft and caring" parts are more intuitive for therapists. I will also use my answer to your case to illustrate that.

Lots of questions need to be answered before we could be more certain on setting a detailed NVR plan. For example What was written in the announcement and how did the child reacted? what helped the father to reduce escalation? What does he thinks about the mothers' escalation? Can he help her in an active way or as happen in many cases he blames the mother for not being able to control herself as he does? What are the provocations that lead to the mothers' aggressiveness? Is there a possibility to recruit also family support in that case? Etc.
I mentioned these questions to demonstrate an NVR way of thinking on a case but I will try to give also some guidelines according to the information you gave here.
First I'm not sure that the target should be the mothers' aggressiveness I think that the focus should be on what kind of behavior she and her husband should resist and then set a sit-in with them. I would do this even when I know that the mother is still aggressive and will not wait until she "calms".
The chances she will be able to control herself will be higher if she feels supported in her resistance to the child provocations! I would use the supervisor support phone after the Sit-In to encourage her. That will enable the supervisor later on to be a supporter for the mother in cases she feels her aggression grows. For example she can SMS to the supervisor in cases that happens or better to call the father. But the second most important thing here is to understand that we will lower the mothers' aggression only if we will make her feel stronger (via a sit-in or supporters…) and not by focusing more on lowering her aggression.
This is the second most important thing because the first one was not mentioned – Please, please check with the parents if the younger boy is afraid or suffers from the older! If this is the case the whole picture changes. Don't forget that as Irit mentioned violence between siblings is the most common family violence and when a 15 yo is aggressive toward his mother I would check very carefully the siblings' relationship!...
Hope that helped a little,
Idan

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thanks!
Patsi
10:35 03.02.2011
Hi Idan,

your answer helps a lot, I even feel stronger in not giving up on this family!

I hope the parents are free tomorrow evening or Friday and then I'll do a sit-in with them. Great idea. And of course, we'll check on the younger one, I must admit I forgot this very important issue and hope this is a learner's mistake.

I'll keep you posted on the evolution.
Best regards,
Patsi

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progress
Patsi
20:13 03.04.2011
Hi Idan,

we (me and my collegue) paid a visit to this family yesterday and I questioned them on your suggested questions. In fact, the father really couldn't think of anything what helped him in reducing his agression. But as I see it, he neglects the boy, he doesn't even dare to say hello to him when he comes home from work in order not to lead to agression. Also, the mother claims keeping very low profile. When she tries to go out in order to prevent her of getting agressive, he attacks her fysically on which she responds with agression. In fact, the boy terrorises the family, his younger brother included, of course.
I stated that we would help her more in coping with her own behaviour in order to stop agression from her behalf. As we know that one visit a week didn't help much, we agreed that as from today, she would first call her husband when she feels that she's getting into trouble, when the boy wouldn't stop, she tries to get out with the younger boy (who they never ever leave alone with the older one!). When it still doesn't help she can call me (supervisor in this case) and we'll try together getting control of her own behaviour. She claims that it is difficult for her to call for help, but I was clear: this is not a question, it's a demand because we, just as much as you do, want it to go better in this family and we believe you can do this.
The mother agreed to be more open to help from her husband as well because this also was an issue. He has the possibility of calling me as well.
A sit-in was explained to them earlier but they never did it. Now they are willing to do it, with the help of our social worker. With the next conflict they will agree on the date and as the parents do the sit-in, our social worker will stay on the first floor with the younger boy.
Most of all, they are finally willing to accept support. By next week, we will get a list of persons who they see as possible supporters and they accepted to set up a supporters meeting. This is great news to me.
I was wondering how come that these parents now seem much more motivated and willing to try what I suggested. I think that it is because since the basic training I got 'infected' with the teams belief and enthousiasm which made me much more convinced about the power of NVR/NA that the parents felt this. Of course, this is hypothetic but I'm really curious on what's to come.
Just for info: we taped the conversation on camera hoping it's usable for further internal training.

Best regards,
Patsi

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more to do :-)
Idan Amiel
15:28 03.09.2011
Hi Patsi!
Sorry about my late respond for your important message I only hope that what I'll add here will also help. I will start with my idea on why the parents are more cooperating now. I believe (although you can never be sure…) that they feel that the focus of your therapy changed from "how should the mother stop her aggression" to "how should we stop the childs' violence" and this is important for the parents. Please try to continue that line as I'll explain now. It is indeed not easy to know that the mother also hit her child but the most urgent focus now must change as I mentioned in my previous respond. The focus should be on stopping him from beating his small brother! I will also ask Irit to help you in preparing a more detailed program but as for now try to set a supporters meeting ASAP with the message – "we are not willing that you will beat your brother". I will strongly recommend that although you know that the mother also beats her own son but just ignore it for now in the supporters meeting. I almost can promise that when she'll feel supported it will not happen again. Now setting a message as to stop a child from beating his younger brother is a message that many supporters will agree to go along with and this can be an important turning point in your treatment. As for the brother who is beaten the supporters should contact him and tell him they will help him so he can call them if needed. But as I mentioned Irit is the expert so she will write more about it

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sibling
irit
12:43 03.11.2011
hello. Idan recrute me to answer your Q. about vailont against youger brother.
the most important thing is letting the young boy know that his parent see his suffer and give him the recognition of being buling by his brother. the parent and the supporter of the family become the young boy supporter- after every fight with his brother or after being builing by his brother the parents and the supporter talk with the young boy and write him letters that they heard about what hapened and they will do every thing with in their power to help stop his brother violent toward him. the child can contact the supporter when being heart by his brother and ask their support- come to hekp him or run to them (supporter how live close). the has yo have their telephone number to do so. another thing is not to leave the 2 children by them self with no adoult supervision. give the young boy a separate and safe place to go to when his brother start being violance, a kwy to luck him self in a separate room and a telephone that will be in the room to call help.
give the boy a notebook that he can wrote what his brother is doing to hin and the parents and the supporter read it every day/week and reasponde to the young child that they support his batel against his brother violance. the buling child get letters and telephone from supporter about stop being buling . more ideas are in the notebook from the convantion in the chapter :violance against sibling". good luck
Irit

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thanks
Patsi
13:21 03.11.2011
Thanks for your reply Irit!
I can assure you that the two boys are not left alone without adult supervison. The idea of a notebook is nice and worth introducing. Also the advice to give hem the possibility to lock himself up. It might be possible to recruit the younger one's teacher as a supporter. I'll check up on that. Anyway, the supporters meeting is set on Monday the 21st. I'm looking forward to it. In the meantime I'll read your article.

Best regards,
Patsi

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writing a letter to a child
Annelies Huybrechts
18:00 02.26.2011
Hi everybody,

Of course, I also enjoyed the training a lot!

Yesterday but one I already wrote two letters to children who were involved in a serious fight. I picked up inspiration in the lecture about he supporters network.

When incidents happen in the group and other team members pass by, we don't interfere with it and keep out of it, unless it is really needed of course or when the caretakers give us a sign to help.

Now I decided to write two letters to the children and asked the caretakers to hand them over when the children cooled down. Also asked to send them their reactions.

One child got the letter later on in the evening and already announced that she would tear it into pieces. she read the letter though, and of course teared it. I was told that she did it in another way than she usually does; she did it very quitly, after reading the message. The message seemed not to have made her upset. It was more of doing what she told, staying loyal to her words.

The other child read it and kept it.

So, next time that they will come for psychotherapy, it could be a topic.

In actual sense, I myself felt confortable with it. Cause the not interfering attitude, seems sometimes to confuse young children: "Why is one taking it so serious and the other one just passes by, as if nothing is happening....?".

It was also very supporting towards the team members. So, thanks for the lecture once again, it really seems to be a combination of two important things: the boundary and the support.

lots of greetings,
Annelies

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support network
ishay
23:08 02.26.2011
hello everyone,
I was more than pleased reading annelies's experience about making a support network and showing the children that we as adults are taking responsibility and working as a community whenever they cant work their conflicts in a non violent ways. Children are not used and will resist at first to any "interference form outside" but as I learned from the participants in the trading " the public is the enemy of the symptom" . From my experience the effect of working as community is so strong because its includes any adult or child who share our concern not accepting acts that threat and hurt our basic right for security. Building a support network isn’t an east task but as Woody Allen says "success is 90% persistence"
Best regards to everyone
ishay

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The power of support
irit schorr sapir
20:53 02.28.2011
Dear Annelies,
I am happy to hear you already started to use the tools you learn in the NVR conference. good for you!
As you can see, different children react in different ways to the NVR just like different therapists. The reactions you descibed are tipical to letters of supporter. the important thing is that you wrote them and that the child got the message that there is a support network and what happened in the group donot stay in the group when its involves violent!
I am interest to hear about the teem members feelings when they learn about your support?
Yours, Irit Schorr Sapir

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Consilidating the network and what with the ...
Eveline
11:42 02.25.2011
Dear training staff,
Dear training-colleagues,

First of all, I want to say that I enjoyed the training very much! Meeting and talking to people from different backgrounds made the experience even more prominent.
We work in a residential setting so I particularly liked the lecture about vigilant care. I think this is something essential but also very difficult for our educators. How do you make contact with a child, knowing that there are 9 or 10 other childeren and adolescents waiting for you, that you have to make sure that everybody has his meal in time, his homework corrected, the laundry done... It's living in a big family but with no biological (and thus another position) connection. Playing with the distance between you and the child: when becomes something danger instead of experimenting and what if you think different from the parents? How can you keep a professional "distance" but also show the care without becoming his friend? I already had great respect for their job and this only grew!

Second: The part about consilidating the support network left me with some questions: I see the importence but do you have any experience working with parents who have mental disabilities? The parents we work with often have problems with mentalization. Some of the parents from children in our institution, stayed in a residential setting when they were young. They now live mostly separated from any of the family (no contact because they don't know any familymembers), have only contact with social workers and live in a neighbourhood where they don't want to speak with neighbours because they have even more problems (so they think they will be involved in the problems of the neighbour when they even can't handle their own).

Third: my last question involves the "universal rights of the child". I think (amoung other principles) that the NA gives back the right to give bounderies to the child, as long as they are based on principles of care, duty and not because you want to controle the child. Please correct me if I misunderstood this. Our institution gets it refunds from the government. In one of the last declarations they stress upon the fact that the rights (within an institution of care) of the child are central (which is very nobel ofcourse). But they don't speak of limits, bounderies. I got the feeling that this ties the hands of caretakers
Their translation of one of the rights: for example "every child has the right on an allowence (5 euro every week) and they can do with this money what they want. You can't use it to punish and you can't withhold it". And this is where the problems come in: an obese child has to follow a diet but we can't provent it from bying sweets with his allowence. Do you have any suggestions how we can deal with these situations? Any experience in residential settings?

Kind regards,
Eveline

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a fractional answer
Idan Amiel
09:00 02.26.2011
Dear Eveline

Great to know that you enjoyed the training, indeed I also got the feeling that one of the most powerful results of the training was the possibility to meet professionals from different countries working in different settings while trying to implement the New Authority concept to their work. I truly think it was an extensive training – we wanted to share with you broad aspects of the possibilities the New Authority concept have to offer in different settings, while also introducing the basic ideas. We hope that this forum as well as the website will enable us to sharer more, learn more and also to create a potential for broadening the possibilities of applying this concept.

As to your questions – I agree that the vigilant care concept is not easy to accomplish or act upon it but it is important to understand that the 3 levels enable you also to adjust the right "distance" in different situations and in that way it helps in preserving "energy". In residential setting for example the levels can be adjusted to Childs' behavior for example if s/he is well you can provide only the basic needs (that also includes of course love & understanding in "small talk" from time to time), if s/he starts to show signs of unrest in her/his behavior than you move to a different level of vigilant care – you come more close to the child. The distance now is shorter – we, as authority figures (a parent, a caregiver, a nurse in a ward etc.) watch the child more closely and the care activity may also include acts of resistance to the Childs' behavior. But the most important thing to understand is that usually when a child "misbehaves" we tend to try and exhibit more control over her/him, acting as a new authority figure means that our state of mind should be – "We have to watch more closely initiate care or resistance if needed, but we can't control the child.

The concept of consolidating a support network is much easily understood than vigilant care but as you mentioned not always possible to activate. In the circumstances you described when the parents have no family or social contacts it will not be possible to use it. From my perspective in the training we didn't have enough time to work more on this important concept. More than that, our team wanted to make a role-play on the supporter's' meeting and ways to overcome dilemmas concerning who should we recruit, but the training timetable prevented that. But the critical issue in consolidating a support network is to constantly try and seek for adult support for the child. If parents are not there, is there another family member, or a neighbor or a teacher etc. who in some way we can be in contact with him/her. Consolidating a support network means that part of our work should be to recruit as many people as possible in order to create a net that in one way or another will later on be there for the child. As was explained in the training we are not looking for the "right" people who will be there, we as professionals usually tend to look for "supportive" figures in terms of therapy but support can also come from people who are not our cup of tea in terms of relationships. As Haim mentioned in his example at his lecture we will be willing even to recruit the Mafia if needed :-)…

As for the third question. You raise an interesting dilema concerning childrens' rights but right now I have to rush for my kids... ;-) so I'll try to answer later. Meanwhile maybe others also have more inputs on that…

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Hello Eveline
Elfi
09:09 02.26.2011
Hello Eveline,
Hello everybody,

great to have this forum! I also enjoyed the training very much and I'm looking forward to reading and hearing more from all of you.
Working in a residential setting, I recognise very well the difficulties that you describe.
Being an educator is a profession that asks a lot of ongoing commitment to caring for children, who are sometimes not that open to messages from adults. The messages that the children send are influenced by how they perceive the world and therefore difficult to interpret.
I have struggled also with the concept of presence (in stead of control) in our child psychiatric ward. The only thing I was able to do is by being present myself (as head of the unit and therefore responsible for the wellbeing of the children and staff) during one meal a week. Having diner together with the educators and children is a great opportunity to do what I am commited to, that is getting to know the children and to feel the atmosphere. My actions are limited to being my curious self and telling little things (not to personal of course) about myself that children recognise. So for the educators themselves in your setting, could it be possible that they start to focus on being present in a vigilant care way during some small moments. If they see that this leads to chaos, is it a possibility that more people from your setting would eat together with them?
Your second question is also very relevant. I would like to think about it some more.
The third problem is of course the result of the current society way of thinking and organising things. In our setting we experience also many boundaries that make working a challenging thing. In our setting I try to focus my attention to what we can work with (making it much easier for the team members to work) and showing acceptance for what we can't change. In the example you describe, is it a possibility that this obese child has low selfesteem, that influences it's eating behaviour? If this is so, is it a possibility to accept the boundaries that are there and focus on giving positive feedback to the child (because we believe in him and we want to say this).
On the level of governement I also dream of informing them about our mission and invite them to support! This will of course be a slow process that will need a lot of preparation and mutual support in making it a coherent request coming from different settings, but with one focus (the well being of the children). Maybe it is possible?
So thank you for this forum as an opportunity to support each other.

Kind regards,
Elfi

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To protect without control- is it possible?
irit schorr sapir
21:57 02.28.2011
Dear Eveline,
You raised a very interesting and importance dillema- how to protect the child without taking his basic rights? to me it is a question i am asking my self in every day
At evrt therapy meeting with a child or with a parent and even with my own children- where is the boundary of letting the child learn by him self and when to say what we think and further more, to decide for him.
there is no easy answers.
I think that the boundary is at risk behaviors- in yours example, i am sure your goverment will agree to take his allowance if he use it to buy drags. to this obese boy candy is like drugs- it is dangerace for his health. in that case i think you can give him his allowance but keep it in a place that he canot rich without your help . for example, put the moeny in a safe (little gip box safe) that only you have the key. in that way you give him the moeny but he cannot use it without your control of what he is buying because he will need your permission (and perhaps your escort to use the moeny) .
this is what we are doing in NVR treatment-putting the boundary to every spesefic child with in his own caracter and behavior- for one it is drugs , for anthor it is binging eating or wandering at nights with bad company or not going to school. If your goal is not to control but to interrupt dangerous behaviors the quastion of boundaries become a little bit less difficult
Your, Irit schorr sapir

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