Sharon and Guy (not their real names), a couple in their early 40s, were beyond the point of despair. Their eldest, Yonatan, had started middle school and was having serious social problems that only exacerbated his already difficult emotional state. Now he was skipping school frequently, failing to heed authority, hanging out with a bad crowd and putting himself in dangerous situations. Using professional terminology picked up during years of therapy, Sharon says she and her husband noticed that he was having trouble distinguishing between good and bad – that his “boundaries” had become blurred, his sense of belonging was impaired and he was signaling distress. At the worst point of his crisis, Yonatan started cutting himself on the arms. At home he was violent toward his two younger siblings, and cursed his mother.
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The parents had tried various kinds of therapy with their son – animal-assisted therapy, drug therapy, art therapy, holistic medicine and more. “He got lots of help, but he still was going downhill,” says Sharon. “We realized that if we kept on with more of the same, there wouldn’t be any change.”
When Yonatan was arrested at age 14 for breaking into an empty house, and after he stole hundreds of shekels from his parents and used their credit card without permission for purchases on the Internet, Sharon and Guy were completely at their wits’ end. A family friend recommended that they look into the Ayeka method of parental guidance, developed by psychiatrist and psychoanalyst Eitan Lwow.
For lack of other alternatives, the couple started the treatment a year and a half ago.
“For the first time,” says Sharon, “we were really ready to admit that we didn’t know what to do. The whole household was affected by the lack of behavioral boundaries and by the low place that Yonatan was in, and of course our marriage was affected too. I put aside all the other methods I’d learned and dedicated myself to this one.”
Dr. Lwow developed the Ayeka method after years of treating children and adolescents led him to conclude that, rather than treating the children themselves, it would be better to treat the parents and teach them how to cope with their children’s emotional and behavioral issues. The name “Ayeka” is taken from the verse in Genesis (3:9): “The Lord God called out to the man and said to him, ‘Where are you [ayeka]?’”
This is the question Lwow poses to parents – the basis of his whole approach. It may sound like an implied accusation that parents are physically or emotionally absent from their children’s lives, but in Lwow’s conception, the question has practically the opposite meaning. The parent, the psychiatrist explains, must “be there” for himself as an individual and not only for the child. Indeed, the parent must explain his own needs and desires to the child, and not become slavishly devoted to fulfilling the latter’s every wish. Moreover, “being there” may not necessarily mean that the mother or father are physically present, if that exacerbates problems in their relationship with the child.
The ‘lost’ child
In his recently published book, “The Parent as Lighthouse: The Ayeka Method for Optimal Parenting” (in Hebrew), co-authored with clinical psychologist Hila Elkayam, who is also a practitioner of the method, Lwow explains what led him to create a new approach to dealing with the parent-child relationship. He differentiates between what he calls the “paternal” and “maternal” models of parenting (which to some modern ears may both sound outdated). The paternal model, which was dominant in general in the world until about 50 years ago, was characterized by the view that asked what the child contributed to his parents or to society as a whole. This type of parenting, says Lwow, was aimed at raising the child so that as an adult he would be an asset to his family and his people, the idea being that the child exists for the sake of the parent and society. The maternal model, on the other hand, asks what parents can give to the child – how they can best provide for the child’s needs, based on the premise that children are the most important thing and should be the main focus.
Various historical and social forces led to the transition from paternal to maternal parenting, whose drawbacks began to become apparent in recent years, Lwow notes. The main drawback of the latter model is the total abnegation of the parent’s own self and needs, as parents devote themselves completely to their offspring, respond to all their needs and whims, and never voice expectations that could cause their children frustration if they can’t fulfill them. In other words, parents have become overly indulgent and accepting.
“A mistaken version of unconditional love has taken hold among parents, educators and therapists, and it is an important factor underlying the emotional distress and behavioral disorders afflicting children who are raised this way,” Lwow and Elkayam write.
Lwow, 71, who has two daughters in their 30s (one a physician and the other an actress, Naomi Lwow), was born in Jerusalem, raised in Italy and then returned to Israel in 1973 after he received a research fellowship in psychiatry. He says the Yom Kippur War gave him the impetus to remain here. When it broke out, he wanted to volunteer and was assigned to be the doctor accompanying the teams that were sent to inform families that their loved ones had fallen in the war. Lwow’s role was to be there in case someone needed medical treatment.
'Many of the families who come to us have already tried everything, and feel that this is their last resort'
Recalling this period, he is overcome with emotion: “It was very intense. I was basically just an observer, I didn’t have any job to do. Talking about it now, for the first time I’m making the connection between that observation from the side and my decision many years later to treat parents and how they relate to their child – only this time the relationship is with a living child and not a dead child.” Hearing this, his co-author Elkayam says, “My association from that story is about treating parents in a way that can help to prevent tragedy, from a place that contains the possibility of action and not just a helpless stance. Many of the families who come to us have already tried everything, and feel that this is their last resort.”
Elkayam studied clinical child psychology and met Lwow during an internship in the department of child and adolescent psychiatry at Hadassah University Hospital in Jerusalem. Elkayam wrote the book based on his lectures, simultaneously learning about the Ayeka method.
Lwow says that what’s new about his approach is the transition from thinking that a child or adolescent’s problems derive from a pathology, illness or disorder to the understanding that there may be other causes.
“We perceive health as linear and expect development to adhere close to this axis that we call ‘health.’ In clinical thinking, deviations from this axis tend to be labeled as psychopathological or other sorts of problems. When we find the child in this problematic, unhealthy place, our answer is usually that some type of force pushed him there, or that there is something wrong with the child. I suggest that we think of it this way: The child isn’t developing properly simply because he has gotten lost,” says Lwow.
What is gained by this new definition, by saying the child has “gotten lost”?
“As soon as you’re talking in terms of getting lost, the focus of the therapy changes and the question that arises is what signposts and landmarks are available to the child, and how clear are they? The question becomes: Why has he lost his way? And: How clear or unclear is the environment in which he is developing?”
Lwow and Elkayam stress that they do not deny the existence of organic problems, such as attention disorders, learning disorders or emotional pathologies, but say that the manner of dealing with the disorder and the decision to accept responsibility for the attempt to cope with it are of the utmost importance. “In our view, the critical thing is not the diagnosis, but the attitude [of the child and his family] toward the diagnosis,” says Lwow.
Is that enough?
“Our method is very non-deterministic. We don’t talk about cause and effect. Once there’s a certain amount of recognition of the problem, the critical question is what attitude will be taken toward rehabilitation, toward treatment of the trauma. If the child is receiving the appropriate treatment and still hasn’t got back on track, it’s a sign that the child has gotten lost and no one is providing an answer to his need for direction. In such a case, guiding the parents with our method will bring about a change.”
The central metaphor in Lwow’s theory, which defines the parents’ position in the relationship with the child and also lent itself to the book’s title, is the lighthouse. “The lighthouse is there for the ships,” he explains. “It exists for their sake. It has no meaning on its own. But the paradox is that it illuminates itself, and not the waves. It is of benefit to the ships because it is illuminating itself and defining itself – not them.”
'There’s an element of paralysis, of self-denial, of ignorance and confusion. He thinks: What right do I have to tell the child something?'
In the same way, Lwow notes, what motivates him as a therapist is the health and welfare of the child, and the way to guarantee them is by means of clear self-definition by the parents: “The method makes use of the parent’s subjectivity for the sake of the child’s development. In a clear, respectful and non-aggressive manner. The parent does not define the child. That’s the whole formula.”
The objective, banal as it may sound, is for parents to clarify their discomfort or dissatisfaction with the child’s actions, without resorting to judgmental language. Many parents have apparently lost the ability to do this. The new language the method seeks to inculcate – and possibly its most important principle – is called “empowering” language. An example, says Lwow, is a parent who says to his son or daughter: “I feel that something in what’s happening between us isn’t right for me, and I’m not saying that it’s good or bad, just that it makes me uncomfortable.” When such discomfort is explained “in a clear, consistent and systematic way, suddenly a miracle happens and the child feels less lost. When the signpost is clear, what was previously a nebulous situation suddenly assumes direction.”
What if the parent himself doesn’t know what the direction should be?
“That’s where our critical work lies. The modern parent genuinely doesn’t know. Often, he’s not in tune with himself. There’s an element of paralysis, of self-denial, of ignorance and confusion. He thinks: What right do I have to tell the child something?”
That sounds rather utopian. In my experience, it’s not enough for me to tell my daughters, “That bothers me,” to get them to change their behavior.
“If I tell a child that something bothers me, this communication is only meaningful when the child is in a relationship involving consideration toward the parent, and then the request doesn’t bother him either. But if that’s not where he’s at – you can tell him a million times that something bothers you, but you’ll be talking to the wall. That’s being a lighthouse that is flashing a signal at a ship that is beyond its reach.”
Lwow explains that a key step for the parent to take, before addressing a particular problem with his child, is to correctly assess the way the child will relate to his request, with each subject separately and for each situation anew. The parent’s mode of action can then be selected in accordance with the child’s attitude.
To help identify that attitude, the method offers descriptions of relationships that range from partnership between parent and child – or, as Lwow puts it, “a child who wants to get to the same place the parents want to get to” – to a situation where there is a disparity between the parents’ and the child’s desires. When there is such disparity, the child’s response can still vary and can range between identifying with the parent and still wanting to please him; to an attitude of convenience or utility, whereby the child has a vested interest in acting a certain way; or to violent behavior, which ranges from completely ignoring the parent to attempting to force him to bend to the child’s will, even to the point of physical harm to one of the parties.
'As parents, we have a repertoire of responses that are generally suitable for behavior that falls into the partnership area'
“As parents, we have a repertoire of responses that are generally suitable for behavior that falls into the partnership area,” says Lwow. “But when there is a chasm between you and the child, speaking to him as if he were an ally is like broadcasting to him on the wrong frequency, or showing him a signpost in Chinese.”
When there is a gap between the child’s and the parent’s positions, and the child is in a place where he feels he has a vested interest, the method recommends using “respectful worthwhileness” – that is, causing the child to incur some kind of loss due to his behavior. Lwow emphasizes that he is not talking about punishment. “The parent basically says: There is something of me that you, the child, are going to lose. I won’t give you a slap and I won’t yell at you or lock you in your room. But if I’m kept busy dealing with your doing something I don’t want you to do, I won’t be available to do something nice together with you.”
That sounds like mere semantics.
“No, there is a real difference. With punishment, there’s the aspect of reducing the autonomy of the one being punished. ‘Go to your room’ constitutes a revocation of autonomy, as do confiscation of property, a big fine or corporal punishment. Punishment is something imposed upon you, from which you have no possibility of escape. In the kind of losses we’re talking about, there is no such reduction of autonomy per se, but there is an expression of the parent’s autonomy. I decide when I’m preparing a nice meal and when I’m not, when I’m available and when I’m not. Not out of antagonism, but because these are the rules of the game.”
In the early 2000s, Lwow saw that his mode of treatment could be taught as a specific method and he began training therapists in Jerusalem, where he lived and worked before moving to Tel Aviv three years ago. Today there are some 40 Ayeka therapists around the country, all connected in some way to Lwow’s Jerusalem-based Ayeka Center. Recently staff at the center has started training educational psychologists who work with local school principals and educators.
'A child who intimidates those around him is a child who lives in a state of isolation and abandonment'
Many of the cases the therapists deal with have long since passed the stage where the child is willing to alter his behavior out of identification with his parents, respect for their boundaries, or a desire to avoid losing something. On the extreme end of the parent-child relationship are displays of various levels of violence.
“Violence is a way of behaving that uses actions whose aim is to paralyze the other, so that against his own will he will serve the goals of the violent party,” says Lwow, stressing that a child who succeeds in violently imposing his will on his parents can cause great damage, to himself above all. “A child who intimidates those around him is a child who lives in a state of isolation and abandonment.”
Here too, the psychiatrist adds, parents must exercise their freedom to choose. “Only a response that gives expression to the person’s freedom, to not being a hostage to the violent party, will really change the rules of the game,” according to the book.
Lwow delineates three types of violent behavior, with varying degrees of severity: disregard (bitul, in Hebrew), coercion (ones) and destruction (heres). When there is disregard of the parent, Lwow suggests that mothers and fathers exercise their freedom to stop fulfilling their traditional roles vis-a-vis the child until the rules of the game change with respect to behavioral boundaries. In the case of coercion – a situation in which the child tries to cause damage to the parent or himself as a way of imposing his will – Lwow suggests bringing a witness into the home to serve as a safeguarding presence – that is, someone who isn’t part of the family and whose presence could be enough to prevent violent actions.
Another defensive mechanism is to maintain a safe distance. “Violence cannot occur without an object for the violence,” he writes. Parents who come for guidance are thus instructed to try to disengage physically, if possible, from a child as soon as they become a target of violence for him or her, even if it is just verbal violence.
The most severe types of violence – where a parent’s or, more often, a child’s life may be put in danger – include suicide attempts, anorexia, drunk driving and other extreme behavior such as addiction to hard drugs, or joining a cult or a criminal gang. In such cases, Lwow, recommends a series of actions that may also include involving law enforcement. He acknowledges that this may force the parent to deny the child’s freedom. “In responding to an act of violence, there is a different grammar and syntax employed than when it comes to the idea of causing loss,” he explains. “Before trying to tackle any other problem, the first goal is to eliminate the violence.”
Back to the tale of Sharon and her son Yonatan. Following the instructions of an Ayeka therapist, Sharon began changing her parenting approach toward her eldest child. Before the therapy, she was completely enslaved to his needs, she recalls: “I invested in all kinds of therapists whom he didn’t really cooperate with, and my husband wasn’t involved at all and we didn’t function as a team in relation to our son. I was overly protective of him. I protected him from issues with school, I prepared his school bag for him and made sure he wasn’t missing any supplies. Now I see that I didn’t enable him to develop and become independent. At age 14, he had no concept of the connection between actions and their consequences. He hadn’t experienced personal responsibility, motivation or a feeling of having capabilities. To help him develop that, I had to start a painful process of separation from him.”
The therapist taught Sharon to stop being held hostage to her son’s aggressive behavior and to keep her distance whenever a violent situation began: “For example, he would stand there in the kitchen and start talking about drugs, killing, stabbings, suicide, things he knows terrify me. Essentially, it was an invitation to a duel. I had to avoid taking part in it. At first, I had to say something brief to him about how I felt about what he was saying. Like – I’m not willing to listen to this kind of talk. And then, if he didn’t stop, to get up and leave, and not allow him to force me into hearing things that were unacceptable to me. I had to continually make my boundaries and my values clear. I had to identify how I felt in the situation and respond in empowering language that was not accusatory or aggressive, and to speak clearly, concisely and to the point.”
Sharon’s husband, Guy, who had previously traveled a lot as part of his job, helped effect change by making himself a more significant presence at home, and thus disrupting the destructive symbiosis between mother and son. “Seeing his parents united rather than seeing his mother collapsing under the burden alone gave Yonatan more confidence and calmed him down,” says Sharon.
How long did it take until you saw a change?
“A year after the start of the therapy, we were at the toughest moment. There was a total disconnect. He hated with an intensity I couldn’t have imagined. The therapist explained to me that he was angry because I broke a ‘contract.’ The contract was that I was a totally devoted mother who totally negated herself. But I decided that I wasn’t ready to sacrifice my life. At first he was angry, but over the past three months, we’ve built up trust again.”
Now, she says, Yonatan heeds her authority, maintains good communication and their relationship even contains humor and cooperation. “Sometimes he has a tendency to try to bring back the excessive closeness, and I have to remember that I’m the responsible adult and maintain the separateness. From a situation of disregard and of imposition of his will, we’ve progressed to one of reciprocity and consideration. He now has chores to do at home. He understands that he has duties too and he respects me.”
What happens when he does something that goes against the rules of the house?
“[There must be] restraint and a long memory. That means – not to react on the spot. The conversation takes place later, after tempers have cooled. It’s hard work that demands that you conquer anger, stop being invariably right, climb down from the ‘tree’ of perfect motherhood. I had to go through a deep emotional process. It’s not behind me entirely, but this past summer was the happiest of my life. In 15 years of parenthood, I never enjoyed the children as much, and him especially.”