A WIN Case Study: Girl in the Closet

When Jelia was a young toddler, she had a great life.  Her cousin and closest playmate, Manuel, lived in her house along with Jelia’s mom Ana, dad Carlos, and her Aunt Pru.  But when Jelia reached 18 months, everything began to change: Manuel was diagnosed with brain cancer.  Over the next two years, she watched as he began to lose his hair, his energy and his joy until he no longer could play with her.  The household became tense and profoundly sad as her aunt cared for her dying son, and her parents tried to care for everyone.

Ana and Carlos reasoned that Jelia was too young to know about Manuel’s prognosis, telling her only that Manuel  ‘had a hurt in his head.’  But as the months passed, and Manuel died at home with his family, Jelia became moody and isolated.  She worried her parents by often locking herself in the closet and crying.  When Manuel was alive, he and Jelia loved to play in the park with other kids; after he was gone, she seemed frightened or angry at everyone.  She bit her nails constantly, and became anxious and aggressive—a different little girl than the one that Ana and Carlos had known before her cousin died.

The family was referred to WIN by their St. Joseph Center case manager who was concerned about Jelia’s abrupt behavior changes and difficulty grieving.  When Dina, a WIN therapist came to Jelia’s home, she noticed tributes to Manuel everywhere.  There were photos of him in every room, drawings he had done on the walls, even little bags of hot Cheetos, his favorite snack, were placed in corners and on altars.  His imprint on Jelia was as unmistakable as it was on anyone who entered the home.   Now three years old, Jelia began to  complain of headaches.  All of her play involved a little boy and girl, one or both of whom would fall off of a bed or a table or a balcony, and hurt their heads.  Frequently, the play would end with Jelia walking alone into the closet.

When Dina first began visiting the family, Carlos and Ana hoped that they could learn ways to help Jelia be less sad and aggressive.  Dina worked weekly with Jelia, Ana, Carlos and Pru—and after a few months, Jelia began to speak instead of push, and ask instead of rage or hide.  She began to express that when she would go into the closet, she was sad—and though she couldn’t say why, she could give voice to her own emotion (and some relief to Ana and Carlos) and that was a big first step.  Next, Dina began working with her on identifying feelings.

During sessions with Jelia and her parents, Dina would help Ana engage her daughter in play.  When Ana saw Jelia begin a falling scenario or move toward the closet, she used to tense in fear and frustration, but as she worked with Dina, she began to understand that this play was part of Jelia’s grieving process, and would help her though them. Throughout treatment, Jelia’s parents were engaged and loving–when Jelia laughed and smiled while playing the games that Dina brought, whether it was Silly Putty or a potty training book, Ana and Carlos happily bought their own copies for her.

After just seven months with WIN, Jelia is better able to navigate her own grieving as well as that of the rest of her family.  She’s beginning to play with other children at parks and parties again—steadily coming out of her dark closet to discover that joy can once again live in her home.