Father absence and its influence on child and adolescent development: a case report

Abstracts

A ausência paterna durante o desenvolvimento da criança e do adolescente é um tema complexo, com grandes possibilidades para estudo. É feita uma revisão da literatura a respeito do tema. Discute-se a influência da ausência paterna no desenvolvimento emocional, cognitivo e comportamental da criança e do adolescente. A participação da mãe nessas situações, do ambiente familiar como um todo e dos fatores sociais e econômicos como mediadores das conseqüências da ausência do pai na vida da criança são levados em consideração. Os autores apresentam o resumo de um caso clínico em que a ausência do pai é um ponto importante da vida do paciente. Ao longo do atendimento psicoterápico, foram surgindo as percepções e emoções do paciente associadas à ausência do pai.

Ausência paterna; criança; adolescente; psicoterapia

CASE REPORT

Father absence and its influence on child and adolescent development: a case report

La ausencia del padre y su repercusión en el desarrollo del niño y del adolescente: un estudio de caso

Mariana Eizirik^I; David Simon Bergmann^II

^IGeneral Practitioner, Resident, Psychiatric Service, Hospital de Clínicas de Porto Alegre (HCPA), Brazil

^IIPsychiatrist (Childhood and Adolescence), Childhood and Adolescent Psychiatric Service, Hospital de Clínicas de Porto Alegre (HCPA), Brazil

^{Correspondence}

ABSTRACT

Father absence during child and adolescent development is a complex theme, with several study possibilities. The authors of the present study review the literature on the theme. The influence of father absence on emotional, cognitive and behavioral development is discussed. In these situations, other participation, family environment and social and economic factors are taken into account. The authors present a clinical case in which father absence was an important aspect in the patient's life. Psychotherapy allowed for the patient's emotions and perceptions associated with father absence to appear.

Keywords: Father absence, child, adolescent, psychotherapy.

RESUMEN

La ausencia del padre durante el desarrollo del niño y del adolescente es un tema complejo, con muchas posibilidades de estudio. Los autores revisan la literatura sobre el tema, y discuten la influencia de la ausencia del padre en el desarrollo emocional, cognitivo y comportamental. Se toman en cuenta la participación de la madre en estas situaciones, el ambiente familiar en su totalidad y los factores sociales y económicos como mediadores de las consecuencias de la ausencia del padre en la vida del niño. Los autores presentan el resumen de un caso clínico, en el que la ausencia del padre fue un importante hecho en la vida del paciente. A lo largo de la psicoterapia, aparecieron progresivamente las emociones y percepciones del paciente asociadas a la ausencia del padre.

Palabras clave: Ausencia del padre, niño, adolescente, psicoterapia.

INTRODUCTION

The influence of father absence during a child's development is a rich and complex theme. An examination of the impact of such absence, in conjunction with the various different individual features of each case, on the psychological, intellectual and behavioral development of children and adolescents is indispensable.

This theme awakens special interest nowadays because of the modification of the modern family structure, in which an increasing absence of fathers is observed. The main developmental theories are based on the conventional family model and it is possible that the new family configurations have repercussions for interpersonal and intrapsychic relations, making this theme relevant.

Following a literature review, a summary will be presented of a clinical case in which this issue and its consequences permeate the patient's life and, consequently, his psychotherapeutic treatment.

THEORETICAL REVIEW

According to data from Fishman,¹ only 16.3% of fifty-six million North-American families are of the conventional, nuclear type. Furthermore, the number of children living within a family with only one genitor was estimated to be between 20 and 50% of all families, and among these single-genitor families most are probably headed by separated or divorced women. The author considers the large number of families headed by a single mother to be a significant reorganization of the North-American family system.

Montgomery² provides the following data: in the population originating from lower social and economic status, the number of children who do not live with their biological fathers exceeds 40%; 55 to 60% of the children born in the nineties have spent the major part of their lives separated from their biological fathers; in 1960 the number of children living with just their mothers was 5 million, reaching 8 million by 1998, and more than 50% of these children have never met their biological fathers; 26% of the absent fathers live in states other than their children's. It has also been reported that children whose biological fathers are absent are twice as likely to have to repeat a school year and that children who present violent behavior at school are 11 times more likely not to be living with their biological fathers than are the children whose behavior is not violent. These children, primarily boys, present increased difficulties in final exams and lower grades in reading activities.

Data collected by the Brazilian Institute of Geography and Statistics (IBGE)³ in 1999 showed that 74% of the families in Brazil are headed by men and 26% by women. In the Southern region, 77.6% of the families are headed by men and 22.4% by women.

A study by Shinn⁴ reviewed the effects of father absence on children's cognitive development and concluded that whenever a father was absent or used to interact scarcely with his children, an increased association with poor performance in cognitive tests would occur. Anxiety and financial difficulties could contribute to these effects.

Svanum et al.⁵ also looked into the association between father absence and cognitive development in children aged 6 to 11 years. The results led them to the conclusion that the use of father absence as an indexing variable to represent subjacent family and psychosocial processes is inconsistent and poorly related to cognitive development in children. They also point out that differences attributed to father absence may be the result, to a great extent, of families' social and economic status.

Freud⁶ said, in his article Leonardo Da Vinci and a Memory of His Childhood, that "for the majority of human beings, both today and in primitive times, the need to base themselves on an authority of whatever type is so imperative that their world collapses if this authority is threatened."

Rohde et al.⁷ concluded that the paternal function is fundamental to the development of babies. According to the authors, such function is a dynamic one since the father represents an emotional support for the mother to interact with her baby and, during the first few years, should also function as a divisive factor in the mother-baby symbiotic relationship.

Muza⁸ adds that "the father appears to be the third indispensable ingredient for the child to work out the loss of its initial relationship with the mother", and "the child needs the father in order to detach itself from the mother and, at the same time, it also needs a father and a mother to satisfy, by identification, its bisexuality." Muza continues by stating that, "the father comes to represent a principle of reality and order within the family, and the child feels that it is no longer the only one to share the mother's attention."

According to Ferrari,⁹ "it is the presence of both parents that allows a child to experience the identification and differentiation processes in a more natural manner", and when one is missing the role of the other becomes overloaded and generates an imbalance, which may prejudice the personality of the child. Furthermore, in many cases there is a "maternal overpresence that nullifies the son or daughter's personality." Commenting on the Oedipus complex in boys, he says that "for boys, father absence means that there is nothing interposed between him and his mother, the object of his desire, which is his alone. However, this so-loved mother also begins to impose limits and war breaks out as a result." Besides, Ferrari ponders that starting school may help in the sense that new objects might appear for boys to compete and identify with, but he believes that such types of later compensations are not always able to balance an internalized situation.

In addition to the crucial role a father plays in father-mother-child triangulation, as previously seen, Muza⁸ cites another point at which the paternal role is crucial to children's development: the start of adolescence, "when genital maturation obliges the child to define its role in procreation."

The impact of father absence during adolescence is investigated in a work by Jones et al.¹⁰ The authors compared psychological separation and separation-individuation from parents in two groups: 25 adolescent boys who lived with both biological parents and 25 adolescent boys who lived with just their biological mothers. Results showed that the boys did not differ across the groups regarding separation-individuation measurements, and that the quality of the mother-son relationship mediated many of the separation-individuation manifestations evaluated. These results emphasize the importance of the quality of the child's relationship with its mother and with its father as a mediator of many dimensions of the separation-individuation process.

According to Muza,⁸ children who do not interact with their fathers end up having problems related to their sexual identity, difficulties recognizing limits and learning the rules of social interaction. Muza states that, "this shows the difficulty in internalizing a symbolic father capable of representing the moral instance of an individual." Such failure can manifest in a number of different ways, including an increased tendency to engage in delinquency.

Mason et al.¹¹ studied the behavioral problems associated with the effect of peers and the moderating role of father absence and the mother-child relationship. Peer behavior and father absence have been associated with increased levels of behavioral disorders in adolescents. Research has shown that father absence usually has a negative impact on children and adolescents, and that these would face an increased risk for developing behavioral problems. The study examined the impact of peers, father absence, and the mother-child relationship on 112 African-American adolescents with behavioral problems. A moderating model was used to test the hypothesis that father absence (or its equivalent) would exacerbate the negative impact of peers with behavioral disorders, while a positive mother-child relationship would be a protective factor against this risk and father absence. The moderating model suggested that father absence or its equivalent increased the negative impact of peers with behavioral problems, while a positive mother-adolescent relationship attenuated this risk. A strong mother-adolescent relationship has also shown to protect adolescents in families without fathers from the risk of behavioral disorders associated with involvement with peers presenting such problems.

Paschall et al.¹² studied the effects of father absence, paternal care, and association with delinquent peers on African-American adolescents presenting delinquent behavior. They showed that the findings of studies on the theme are mixed and inconclusive, and that there is great concern over father absence in African-American families in terms of the negative effect this could have on the development of these boys. In this study, father absence was not associated with a delinquent behavior of their sons, nor was it a moderator of the association of delinquent peers with delinquent behavior of their children. However, a negative effect of social and economic factors on delinquent behavior was more frequent in families where the father was absent.

Pfiffner et al.¹³ studied the association between father absence and familial antisocial characteristics. Results show that families where the father lives at home presented less antisocial symptoms on the part of the mother, father and child than families with an absent father. Antisocial traits were higher when the father was not located to participate in the study. They concluded that antisocial behavior, by any member of the family, was more likely to happen if the father was absent or non-participatory.

An interesting study by Jensen et al.¹⁴ showed that father absence under routine conditions and in relatively healthy families might not exert any significant independent effects. Such effects would be more closely associated with maternal psychopathology and environmental stress factors. Two hundred and thirteen daughters of servicemen who had been absent for the year prior to the study were investigated. Children whose fathers had been absent for one month or longer showed a more significant level of self-reported anxiety and depression. However, such result proved no longer significant once environmental stress factors and maternal psychopathology were controlled.

Such findings draw attention to an important datum: the influence of maternal behavior in situations of father absence and the way in which the mother reacts to this absence. It could be said that the effects of father absence on the child are mediated by the interaction of the mother with her child and by her emotional resources. The same can be said of the role played by environmental factors and the family unit as a whole surrounding the child.

Ferrari⁹ has contributed extensively to the study of this subject and claims that, "there is an innate need for affiliation within human beings and this is no different for the children of single mothers." He says that they "have a need to know why their father left and to hear this from his lips and not through the mother's interpretation."

Ferrari deals with the issue of substitute fathers, by commenting that they too may leave, leaving the child with a renewed sensation of abandonment. This situation becomes is further complicated if the mother is used to maintaining quick and unstable relationships. Additionally, there is the child's ambivalence to accepting a substitute for their biological father. Another significant aspect is the end of a mother's relationship, a moment when children may feel once more to blame, increasing their sense of being made an orphan.⁹

The same author⁹ comments that the search for a father may make a child feel it is betraying its mother, and he thinks that certain critical moments over a child's life (e.g., marriage or parenthood) make the subject's desire to meet the absent genitor stronger, as "a need to wrap up their its life history." He states that "even if children do not say a word, the void is there and it disturbs them."

This void, according to Ferrari,⁹ is caused by children's notion that they are not loved by their absent genitor, with the consequence that they strongly devalue themselves. In addition to this self-devaluation, there are feelings of guilt, "for being a bad child, for having caused the separation, for having been born." Children think they are bad because they have been abandoned. The author believes that this "can generate different reactions, ranging from sadness and melancholy to aggression and violence." He then goes on stating that "those that are timid and fearful of the outside world turn completely to themselves, while the extroverts and those that are fearful of their inner history seek revenge by resorting to antisocial behavior."

As Ferrari says,⁹ schools have to play the part of cutting the umbilical cord, at a moment when the child comes into closer contact with the real world. As previously mentioned by the same author, it is not known if it would be too late for that. Furthermore, some situations show that starting school would not be sufficient to produce the necessary separation. According to the author, "academic failure and learning and interaction difficulties are, in most cases, based on family conditions." He states that the opposite can also occur: in the hope of pleasing its mother, and being fearful of abandonment by its mother, a child may become a model student. This "fear of abandonment by the mother may not last the whole of the child's school career." The author says that "this total identification with the mother can saturate as puberty or adolescence arrive and, when the moment the enchantment is broken, problems begin."

In brief, the literature consulted provides evidence of a changing contemporary family structure, of the negative effects of father absence, and of the repercussion this absence has for both behavioral aspects and emotional experiences related to the Oedipus complex, producing a variety of expressions of conflict, defense mechanisms, and feelings of guilt in fatherless children.

A clinical example could more clearly illustrate a number of these aspects.

CLINICAL CASE

João is a 16-year-old adolescent. He was referred for psychotherapy for having problems at school. He was held back a year in the sixth grade and twice in the eighth grade. The patient says he does not like studying, and that this is the reason why he cannot manage good academic results. Diagnoses of attention deficit disorder and hyperactivity were ruled out, since the patient has no difficulty paying attention to details or focusing on activities, and he does not match other criteria for this disorder. He does lack stimulus and interest in studying, particularly when at home.

João was brought up by his mother, his maternal grandmother, and a maternal uncle. He has never met his father. He knows that his father has other children and says he has never had any interest in meeting him. He mentions that his mother had suggested introducing them, but he would not want that to happen. He is currently living with his mother and grandmother who has a chronic degenerative disease. She was diagnosed two years ago and is highly symptomatic. The patient has become responsible for much of his grandmother's care, takes care of her money for her and looks after her physical integrity when they are at home together. This situation has caused him much suffering, and he describes it as if he was losing someone important again, which makes him feel more and more alone.

His mother and grandmother have a difficult relationship. They fight constantly and the patient feels "in the middle" of them, playing the role that used to be his uncle's. He knows this is a strain on him and he has been feeling tired, with a great desire to stay away from home or lock himself in his room to avoid hearing their fights.

João's mother has always worked long hours and was kept away from the daily domestic life of the household. He tells of being raised basically by his grandmother and his uncle, who passed away when he was 6. He does not comment much on this fact, and if such issue is brought up during a session, João does not feel at ease, probably because of the suffering it still causes him. When such issue is approached, it is generally minimized by the patient, who will say, "it's been a long time" and "that's got nothing to do with my present day problems."

His relationship with his mother is difficult. He often complains that she worries and controls him too much, and that she is only interested in his schoolwork. He notices that she compares him with some relatives who are more successful in this area, and he feels that he lets her down, by not meeting her expectations. He constantly repeats that he does not like studying, that he is "a bum" and has no great future ambitions. He intends to finish high-school because "I know I need to", but doesn't want to go to university.

He has a group of friends that have grown up with him and with whom he goes out at night, to parties. He has no girlfriend. He feels embarrassed talking about dating in our sessions. At such moments he compares the relationship with the therapist with that with his mother, since both women keep on "asking him about everything."

He denies using drugs. He drinks alcohol only at parties, usually a little, just to "loosen up and enjoy myself better." He used to get involved in fights easily, without questioning his own part in starting them. After a number of sessions in which this issue was brought up, he realized that he used to provoke such fights and that he could not help getting involved in them. He concluded that fighting and hurting himself, as he had been doing lately, could be the ways he knew would call his mother's the attention, since he thought she would only paid attention to him and be concerned when he was in trouble. He has not fought after realizing this, by trying to pay attention to his own behavior and by avoiding further confrontations.

At the start of treatment, there were long and frequent periods of silence. João seemed uncomfortable, not knowing what he should say or do with the silence, which made him uneasy. Nevertheless, he rarely missed an appointment, and he showed an effort to come to the sessions on time. As time passed the therapeutic bond began to form, and he allowed his suffering and loneliness to become more clearly apparent.

Loneliness appears as an extremely important issue in his life. He was a fatherless boy throughout his development, and the investment he made in his uncle as a substitute father figure resulted in an increased feeling of emptiness when he lost him too.

João resisted the issue concerning his father for a long time. When it did come up, he would give short answers, minimize the importance of such issue in his life, and he would avoid showing any kind of emotion. He repeated innumerable times that his mother had been like a father to him, that she had given him everything she possibly could, and that he had never needed a father; that a father for him was not missed at all.

The patient began to talk more during our sessions as his confidence in the treatment grew and as he realized its benefits. At one such moment he managed to express some of his feelings in relation to his father absence, an issue he had not approached for months during treatment:

P- My Grandma is not well, I miss her.

T- It's hard because you're losing her and watching it too, isn't it?.

P- Yeah. I was lonely already, and without her I'll be even more lonely. Completely alone. There's my mom, of course. It'll be just the two of us from now on. When my uncle died, it was "tough", and now my Grandma. But I'm quite a "grown-up kid" now.

T- You are a "grown-up kid" for what?

P- Not to be moaning nor complaining. It won't help, I'm a "grown-up kid" who can manage life.

T- And you do manage, but even grown-ups suffer, get sad.

P- I never had a family. I'm jealous of my friends who do.

T- A family with a dad and a mom?

P- I never had a dad. But my mom always managed, she gave me everything. I never needed a dad. She says she always wanted a son, OK, it was her choice.

T- And if you miss having a dad? I think this makes you suffer.

P- Yes, it does. My mom asked me once if I wanted to meet him and I said no. Why? He never gave me anything, never came looking for me.

T- I think this is an important issue for you, one that is hard for you to mention.

P- I don't think it is that important really. I don't need a dad anymore. I wouldn't want him for a dad (...) I get mad, because he never came to see me, for Christ's sake, not even to find out who I am, how I look like. I think I'd punch him if I met him. (...) I've already dreamt about him. I dreamt that he came looking for me and I called him names, asked him why he had done this to me.

At the following session the patient said he didn't remember what he'd said at the previous session. When the therapist asked him if he really didn't remember he said our subject matter had been his father.

P- Ah, we were talking about my dad, about him not coming to see me, that stuff. If he came looking for me today, I'd even talk to him.

T- In the dream you told me about, he came looking for you and you fought with him.

P- Did I dream about that? I don't even remember it. Well, anyway, today I'd even talk to him. But he never showed up anyway.

T- And you, have you ever thought of looking for him?

P- No. I'm not going for that. (silence.) I don't tell these things to my mom, nor to anyone..

T- But you're telling me.

P- Yeah, I know. I've never talked much about myself or about my stuff.

Being able to talk about an issue that had long been repressed was a relief for this patient. One of the reasons for that was that he realized he had the right to suffer for this lack and to express it, and be accepted. This fact brought an increased freedom to his treatment, while creating space for the analysis of other conflicts with greater ease and increasing the therapeutic bond.

FINAL CONSIDERATIONS

Based on the clinical case described and the bibliographic review carried out, it can be stated that this issue is rich in possibilities for study and reflection.

It is evident that father absence has the potential to generate conflicts within a child's psychological development. The influence of father absence on cognitive development and on behavioral disorders, based on the data cited, remains an open question, with data suggestive of father absence having a negative influence on such matters, and other data indicating that there is no influence.

In the clinical case described here, the patient's poor performance at school is a formative feature of his life, both past and present. He has been held back three years at school and continues to have problems in this area. One hypothesis formed was that by doing badly at school João found a way to call his mother's attention, since he thinks she is only concerned with him on this level. In other words, if he did well at school he would be on the pathway to being "left out", as his mother would no longer have any reason to think of him. In relation to the issue of behavioral disorders, we do not believe that these constitute a problem in the case of this particular patient. His frequent involvement in fights also occurs seemingly in response to a need to be cared for, by attempting to awaken maternal worries. Furthermore, this pattern was significantly reduced once the patient understood its function.

The absence of João's father was a theme he used to repress. His relationship with the therapist, and possibly the therapeutic alliance established allowed him to bring such a painful theme to light and particularly his hatred of his father: "I think I'd punch him if I met him. (...) I called him names, asked him why he had done this to me."

There is, perhaps, something ambiguous in both utterances, possibly conveying ambivalence. "Punch him", "called him names", "asked him why" may suggest aggressive expressions but, at the same time, a desire for contact, for emotional contact.

The expression of these ambivalent feelings over the course of psychotherapy is an element which can allow for a better elaboration of this mourning, which is being relived through the loss of the grandmother (and previously of the uncle).

One factor which is essential to take into account when considering cases of father absence in terms of a child's development is the mother's role. The presence of maternal psychopathology should be considered as should her emotional resources and the type of relationship established between mother and child. Greater or lesser predisposition towards the conflicts associated with the missing father may result from the mother-child relationship, i.e., the relationship would act as a mediator of the repercussions of this absence on the emotional life of the child. We should consider the participation of the familial, social, and economic environments, which will also have an influence on a child's development and on how it deals with the absence of its father.

In the clinical case under discussion, we have noticed that João's mother, even with all her possible emotional shortcomings and time constraints, by counting on the help of her mother and the patient's uncle, could manage to perform well in her role as a caregiver and educator. This is evident from the patient's adaptable personality traits and his ethical values. He demonstrates he is interested in improving himself, by creating a good therapeutic bond, in addition to showing respect for others and concern for his family. This is probably the result of an environment with an adequate level of affection and continence, despite the father absence. This was possibly one of the reasons for João's low self-esteem, which can be observed in situations when he defined himself as incapable of achieving his goals, of acquiring material wealth or social status, to "be someone in life".

More studies are necessary in order to increase our knowledge and, consequently, to increase our possibilities to understand and help patients.

REFERENCES

3. Instituto Brasileiro de Geografia e Estatística (IBGE). Disponível em www.ibge.gov.br. Acessado 1º ago 2004.

Received on August 11, 2004.

Revised on September 21, 2004.

Approved on October 6, 2004.

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Publication Dates

• Publication in this collection
  14 Sept 2005
• Date of issue
  Dec 2004

History

• Accepted
  06 Oct 2004
• Received
  11 Aug 2004
• Reviewed
  21 Sept 2004