felt Drake’s mutism was worth further investigation simply because it did seem unusually extensive; nonetheless, experience told me that in all likelihood the problem was minor. I suspected Lucia was not admitting the degree to which she spoke Italian to Drake and that his mutism was influenced by his not being wholly comfortable in English. My hunch was that everything would come right quite easily with a bit of very gentle intervention in a supportive environment, but that was the key: “supportive environment.” Sympathetic adults, a relaxed atmosphere, and time for Drake to master two languages were crucial, if there were to be no long-lasting problems. Unfortunately, I went away from the meeting dissatisfied that Drake would receive that. Instead, I was left with the concern that Lucia and the grandfather were locked in some kind of battle of wills or in a series of accusations and denials over the use of Italian in the home and this was causing a poisonous environment, which Drake was reflecting with his mutism.
Anyway, that’s what I considered. However, having lots of time to think as I made the long drive back to the city, a couple of spare not-fitting-in thoughts refused to fall silent. One was Drake himself. He was an extroverted, charismatic little boy who gave such a clear impression of wanting to communicate. This was not at all the typical profile of an elective mute. Nor was it typical of children who had bilingual problems. In my experience with young bilingual children, the extroverted, confident ones would happily bull ahead with whatever mixture of the two languages they had available and not worry whether they were right or not. I had encountered more than a few who were electively mute due to bilingualism, but in all the cases these were very shy, private children by nature who feared humiliation when making mistakes. Moreover, of what I could remember, they had all come from homes where no English was spoken at all, so their problems came from having no chance to practice English outside the public arena of the classroom.
The other odd thing was Lucia’s comment that Drake had never spoken to his father. This did not fit at all with bilingualism, and I had never encountered a bilingual child who did not speak to everyone at home. Moreover, not speaking to immediate family members in the privacy of the home is an unusual pattern, even when elective mutism stems purely from emotional issues. In my own research it had been closely associated with serious child abuse and severe family dysfunction. Again, Drake’s open, gregarious manner did not give the impression of such a traumatized child. However, I knew not to presume.
Into my next session with Cassandra I took with me one of my favorite therapeutic props, a box of dolls. These were called Sasha dolls. They were about sixteen inches high with beige nonethnic-colored skin; smooth, stylized limbs; and wistful, enigmatic expressions that were neither clearly happy nor sad. That alone set them apart in an era when virtually all other dolls had vacantly delirious grins that would better suit a stoned hippie.
I now had eight of these dolls, three of which were baby dolls, and the other five – two boys and three girls – had the proportions of a child in middle childhood. Through the years I had made or acquired a large wardrobe of clothes, plus many other small accoutrements, so I now used an apple box to accommodate it all. Wanting to give the apple box a little more longevity, to say nothing of a little more style, I had covered it in bright green wrapping paper with tiny cartoon rabbits all over it that I’d found in a store one Easter.
Cassandra noticed the box straightaway when she came into the therapy room. She looked at it, looked back at me with an interested, curious expression on her face, and then approached the box.
“It looks like a present, doesn’t it, with all that wrapping paper,” I said. “It’s not really, though. So it doesn’t need to be unwrapped. If you put your hands on the bottom, you can lift the top off because the paper is wrapped separately around the top of the box and the bottom.”
Carefully, Cassandra eased the lid off the apple box. “Look!” she cried. “Look at all these dollies! And look at all the clothes!”
“Yes. And we’re going to use those things in our work together.” I sat down at the table.
“This is the kind of work I like!” she replied and reached in to take out a red-haired doll wearing a long blue patterned dress.
“There are a couple of things, however, I want to talk about first,” I said, “before we get down to work. When you were in here yesterday, I asked you if you knew why you had come to the unit and you didn’t seem quite sure. So I want to make certain that’s clear to you.”
Cassandra appeared to be paying little attention to me. She was enthusiastically rooting through the box, looking at various clothes, trying them up against the red-haired doll.
“Sometimes when kids come to the unit, they think they must have done something wrong and leaving their families to come to the hospital is a punishment for that. It’s important to understand that isn’t true. You didn’t come here because you’ve done anything wrong – ”
“Yes, I have,” she interjected in a casual, almost cheeky voice. She didn’t look up at me.
“You think you’ve come here because you have done something wrong?”
“I put a frog in the blender! Whirr!” She reached out with one finger to press an imaginary switch. “Just like I’m going to do with this dolly right now. Here’s a blender,” she said, pointing to a bare space on the table. She held the doll upside down by its feet and lowered it into the imaginary blender. “Whirr! It’s chopping it all up. Look at the blood. It’s gone all bloody. Whirr!”
She looked up cheerfully. “And now I’m going to take the lid off. The blender’s running and I take the lid off. WHIRRRRR! The blood spatters all over you! You’re all bloody now. Ha-ha-ha-ha-ha!”
O-kaaaay. I sat back. I was definitely getting a better sense of what Earlene Baker had meant by Cassandra’s “creepy” behaviors.
“I’m taking the lid off again. It’s still running. Whirr! Blood and guts going all over. All over you. Splash! Splash!” Cassandra threw the doll into the air and made wild gestures with her hands to indicate splashing.
I remained silent. I didn’t want to get drawn into questioning Cassandra on her imaginary blender. I suspected it was simply a replay of the old joke: “What is red and green and goes two hundred miles per hour? A frog in a blender.” As with our conversation the day before, there was a vaguely manipulative feel to what she was saying, a sense that she was trying to shock me or engage me in a way she could control. Even if it were a true event and she had really put a frog in a blender, I wanted time to suss why she had chosen to insert this topic into the conversation here. So, instead of responding to her comments, I reached into the box and took out a doll, too. It was a blond boy doll dressed in hiking shorts and a T-shirt. I walked him along the side of the table.
“I haven’t got a doll,” Cassandra announced, even though she was still holding on to the red-haired doll. “Mine’s all chopped up. Here, put yours in the blender.”
“You know what this boy’s wondering?” I asked and walked the doll closer to her.
“Unh-uh. And I don’t care.”
“He’s wondering, why does that girl want to play that game?”
“What game?”
“This boy says, ‘Why do you want to pretend something that’s not true?’”
“Because
