The Ambivalence of Recovery (When Progress Feels Strange)

Ambivalence describes two conflicting feelings that exist at the same time. When a child is getting better, it looks like this: The child’s symptoms subside, their mood improves, and yet they don’t feel pure relief. Many parents feel a subtle tension, sometimes sadness, or the sensation of losing their footing.

The reason often lies in everyday life. For weeks, everything revolved around doctor’s appointments, monitoring the child’s mood, or counting meals. When this structure disappears, a void remains. The child also experiences this change. They regain responsibilities they had been allowed to relinquish for a long time and must learn to navigate them anew.

This unease usually has multiple causes. They often occur together:

• Fear of a relapse. Every good week feels fragile. A bad day immediately triggers the worry that everything will start all over again. For more on this, see “Relapse (Parents’ Perspective).”
• Changing roles. During the crisis, it was clear who was providing care and who was receiving it. As the child recovers, this dynamic shifts. Siblings, partners, and parents must find their new roles.
• Letting Go of the “Illness Identity.” Over time, some children have come to define themselves strongly through their illness. Without it, the question arises: Who else are they? The same applies to parents whose days were dominated by caregiving.
• New expectations. As soon as things start looking up, everyone hopes for more: the school, relatives, and often the child themselves. This pressure can strain the newly found stability.

Research on motivation for change is familiar with this pattern. The transtheoretical model developed by James Prochaska and Carlo DiClemente describes recovery in stages, from the initial intention to maintaining the progress made. The maintenance phase is considered particularly delicate because the new habits are still fragile and old patterns can resurface. In this model, setbacks are part of the normal process and are viewed as opportunities for learning.

Motivational interviewing, as developed by William Miller and Stephen Rollnick, views ambivalence as a natural part of any change. Conflicting feelings indicate that a person is in the midst of the process. Experts also point out that therapy can sometimes be stressful and that a child’s growing strength can lead to conflicts within the family. Such friction often accompanies genuine progress.

Progress is easier to cope with when it’s acknowledged. Here are a few strategies that can help in everyday life:

• Allow yourself to feel both sides of the coin. Joy and worry can coexist. Suppressing tension usually only makes it worse.
• Celebrate small steps. A shared dinner without an argument is a success. Recognizing moments like these strengthens confidence in the recovery process.
• Gradually return responsibility. The child takes on tasks again, at their own pace. This fosters their sense of self-efficacy.
• Be mindful of your own exhaustion. After prolonged stress, parents’ bodies need rest, too. Signs of persistent exhaustion should be taken seriously.

Open communication within the family also helps. When everyone understands that mixed feelings are part of the process, there’s less pressure to feel relieved right away.

Some issues can be resolved within the family, while others require outside support. Coaching, such as that offered at Rückenwind, can provide parents with support during this phase, help structure conversations, and guide them to focus on their own strengths. Janike is a social worker and parent coach who is training to become a child and adolescent psychotherapist; she provides support without making diagnoses.

As soon as the fear of a relapse begins to dominate daily life, the child’s mood deteriorates significantly again, or signs of a crisis emerge, the situation should be assessed by a professional. Diagnosis and treatment are provided exclusively by a child and adolescent psychiatry (KJP) clinic or a medical or psychotherapeutic specialist.