help4yourfamily

Create the family you want to have

Quick Jobs for Kids

written by, Kate Oliver, MSW, LCSW-C

The chore list

The chore list (Photo credit: demandaj)

Do you ever get tired of the constant routine of getting upset because your child has not done an agreed upon task or said something insulting to or about you, or bothered you while you were on the phone…again? It always seems to end in the child apologizing, you telling them why they shouldn’t do that, threatening with a consequence next time, only to find that they do it again when you are distracted and you just have a redo. Sorrys start to feel hollow when they are said about the same thing one hundred times.

Even though it’s my job to tell you that accepting what we would call a “repair,” (i.e.- I did something damaging to our relationship and now I am trying to fix it by saying ‘I’m sorry’) is best for your relationship with your child, I understand that this can feel more and more difficult to do as a parent when you feel stuck in a rut and like your children get to breeze by with a sorry and no real consequence.

If this sounds like a familiar routine in your house, might I recommend a little trick I like to call “quick jobs.” It’s a list of quick tasks a child can do around the house to help out when they have done something wrong. It’s not a “your grounded forever” kind of thing, it’s not something that has a child doing an extra 20 minutes of chores. These are for the day-to-day grievances, the ones kids say “sorry” for but you have to wonder after a while, “are they?”

Here is a quick list of tasks. You need the list, or this will just be another good idea that you will forget when the time comes (if you are anything like me). You can have fun making them up next time you are trying to straighten the house:

  • Dust the bannister
  • Clean all the door knobs in the house
  • Take the laundry from the washer and put it in the dryer
  • Help finish the dishes
  • Clean off one surface in the house (the dining room table, the end table next to the sofa)
  • Clean out the sink in the bathroom
  • Wipe down the outside of the dishwasher, oven, or pantry

Quick jobs are for when you are irritated and need a little something extra. When you use them you can say, “I realize your sorry but I would really know it if you ________.” If a child decides not to do it, you can point out that perhaps they are not so sorry after all and that is a bigger discussion.

For today let’s just focus on a quick fix that helps set things right again and teaches children how to really “repair” when they have done something they wish they hadn’t.

Related Posts:

March 21, 2013 Posted by | discipline, help for parents, parent support/ self improvement | , , , , , , , | Leave a comment

Staying Strong as a Couple

Sex

Sex (Photo credit: danielito311)

written by, Kate Oliver, MSW, LCSW-C

Whenever it’s time to bring up the topic of sex, I think about that old Salt and Peppa song, Let’s Talk About Sex.

Let’s talk about sex baby,

let’s talk about you and me,

let’s talk about all the good things and the bad things that may be,

let’s talk about sex…

let’s talk about sex!

I guess I’m aging myself here. Anyway, people would be surprised how much I talk about sex with adults even though my main client population consists of families and children. While I spend plenty of time talking to the adolescents and adults I see about sex, more often, I find parents who bring their children to see me are asking me about it as well. Let’s face it, having a highly spirited child, or a child with an attachment issue, depression or any other mental health issues is draining and often the relationship you have with your spouse/partner can fall down a notch on the priority list.

I was inspired to do this post because of Christine Moers, mother of several biological and adopted children who has dedicated her past month of blogging to a month she has named “Sexuary.” I’m a huge fan of Christine and think she has amazing, funny, honest advice for parents.

Before I tell you what Sexuary is, let me say this. Sex is important in a relationship. It is not the most important part, but it is important. As one couples therapist said to me a while back, “Good sex will never fix a bad relationship, but lack of sex or bad sex can ruin an otherwise good relationship.” I completely agree and have seen this in my practice.

Here are some common mistakes I see parents making when it comes to sex:

  1. Not talking about it to each other…ever.
  2. Believing that sex is not important to their spouse without checking to make sure they are correct.
  3. Allowing their spouse to believe sex is not important to them.

There are a bunch more, but this post is not about the problems, it is about finding solutions and bringing couples closer together. Happy parents make happy children and I want your family to be a happy one.

So, for anyone who has questions about having more sex, better sex, any sex, or anywhere in between, I’m going to direct you to Christine’s posts (linked below) so you can read about Sexuary, which is picking the month of your choice to try to have some intimate contact every day. She does an amazing job walking you through the process of bringing this up with your partner, making a plan of action according to where you and your partner are, etc, even if your kids are not helpful, even if you haven’t had sex with your partner for months, or even years, even if you think your partner does not like, or want to have sex…

I would love to hear what you think about her posts:

The Kind of Partner Everyone Needs  (welcometomybrain.net)

Sexuary- What the Heck Are You Thinking? (welcometomybrain.net)

Sexuary- Closer Than When We Started (welcometomybrain.net)

March 7, 2013 Posted by | help for parents, parent support/ self improvement, relationship issues | , , , , , , , , , | Leave a comment

Letting Go of the Parent You Thought You Would Be

Written by, Kate Oliver, MSW, LCSW-C

Funny Family Ecard: You're making it difficult for me to be the parent I always imagined I would be.

It seems to me that many parents I come across in my practice are in a grieving process without being fully aware of it. I would venture a guess that there are many parents outside of my practice who are grieving as well. Grieving, while often associated with death, is really just a word that describes a transition from one reality to another. Transitions have stages that go along with grief like, sadness, denial, blaming, anger, bargaining, and relief. We can grieve relationships with or without death. We can grieve changes, like moving from a home we have loved to a new home- even if we are excited about the move. What I think most parents grieve is the fantasy they had about the parent they thought they would be. We all have those thoughts before we become parents, then, after becoming parents, we have days where we question what the heck we were thinking in the first place.

I remember having my first daughter. I was so excited and felt so much joy that she was coming. I was allowed that pure joy because I did not fully understand at that time, nor could I really without experiencing it, the enormous undertaking I was embarking upon. I remember that almost confused feeling, where my husband and I wondered aloud how it was that we came to the hospital, two of us, and left with a whole extra person. All the nurse needed to check was that we had a car seat properly installed. I’m sure the same is true for adoption and fostering as well. One day there are two of you, or one person on your own and the next day there is a whole extra person who does not know a thing about your expectations (even if you told them) and they are just there…all the time.

I think of those emotions, in contrast to having my second daughter, where I cried in the delivery room before I had her. When my husband asked me why I was crying, I told him I was happy, but I was also scared. I knew then the awesome responsibility we were taking on. We were responsible for a human life…two of them! Even with the knowledge that we had a supportive family and community around us I still felt that feeling, you know, that knowing that “the buck stops here.” I wanted to be a good parent and, even with all my training as a social worker, I knew it was going to be tough to feel successful as a parent.

I know too, that for parents adopting children at an older age, there is an added complexity. When you adopt an older child, you don’t have the advantage that parent of infants have in that, when you figure out you do not know what the heck you are doing, your child does not understand that you are just figuring this stuff out too. Instead, you have a child who is probably a bit hypervigilant, who is looking to see if you do know what you are doing, and who is actively testing you every step of the way (usually without naps). Even if you have already raised biological children, you have now taken on a child with a history you did not control and that was not ideal. They are going to be vigilant in their seeking to see if you know what you are doing, as you realize that really, lots of times you don’t, even if you went to all the trainings about therapeutic parenting.

A few weeks ago, I was laughing with a mom in my office when she told me she thought adopting internationally would be great, her son would be used to other children, having spent the first year of his life in an orphanage with other children.  She would put him into daycare right away, where he would be familiar with other children, then she could keep working, and sometimes she and her husband could sneak away for dates periodically. She told me this after we had just spent the session with me reinforcing the importance of this mom spending time alone with her husband, since she had been a stay at home mom and they had not had a date in the three years since they brought their child home.

We parents all know that the actual day to day realities of raising children are different, perhaps vastly different, than what we expected. Some of it is more amazing than we could have ever imagined. Parenting can be funny, serious, exciting, and tiring! No matter what, it is always different than we thought it would be.

The children I see most often come with an unique set of challenges. They have been traumatized. Their brains work differently than other children’s brains due to neglect or drug use while they were in utero. They have experienced loss. Their hearts have been broken. In a harsher, less gradual way, the parents I see recognize that the children that live with them, sometimes children they have not had an opportunity to fall in love with yet, if they were adopted at an older age, need more than our traditional notions of  parenting have afforded us. Biological parents can find this out as well. We live in a new age of parenting where there really is no dominant model for parents to follow. The media loves to tell you how to raise your child the “best” way until, if you were to try to simultaneously follow all the advice, you would feel schizophrenic trying to figure out whether you are supposed to tell them what to do, let them figure it out themselves, hover, or hang back, stay home or work… the list is endless.

I think a big part of the grieving I see in parents is grieving the loss of knowing what you are supposed to do! As a single, or even in a couple, before those little ones came along, we knew which days were sleeping in days. We ran our own schedules. We thought when the kids came we still would know what to expect in a given day, remember? Remember transitioning from most of the time being your time, to your time feeling like stolen time where you had to weigh whether it was “worth it” to take time for yourself away from your children? I remember before children, going to the movies with my husband and turning around to go home without seeing a movie because we had already seen all the movies that were worth seeing. One day we will get there again…maybe.

Until then, we will go through a series of transitions. We will transition from knowing where our child learned everything, to hearing them have a thought or bring home an understanding from someplace else. We will watch our children prove to us over and over that while we can attempt to control their outside world, we do not have total control over their inside world as they will have their own unique interpretations of the world as they see it. We will realize we can not shield them from pain, nor can we make them forget the pain they have already experienced in the way we fantasized we could. We will see our own understanding of parenting shift as well. The parent we thought we would be makes way for the parent that we are becoming. Often, we find that rather than being the parent we imagined we would be, we must adapt to becoming the parent our unique children need us to be.

What have been some of the transitions you have made as a parent that surprised you?

Related Posts:

Messing Up Children in Just the Right Ways (help4yourfamily.com)

A Quick Primer on Early Primary Relationships (help4yourfamily.com)

To Parents Who Worry Their Children Will Harm Others (help4yourfamily.com)

Quick Self-Care for Parents (help4yourfamily.com)

February 28, 2013 Posted by | child development, help for parents, mental health, parent support/ self improvement | , , , , , , , | Leave a comment

Add a Little Awe to Your Life

Written by, Kate Oliver, MSW, LCSW-C

This week I am writing to you from my vacation because I love you just that much. I am in Hawaii and I have been reminded of something that feels too good not to share. It is this…remember it is important to stand back in awe at the wonders of all life has to offer. I know that feels easy for me to say from Hawaii, but I was actually first reminded of this two times on my day long plane trip to get here (12 hours for those who are wondering).

On the second plane I was on there was an infant that could not have been more than two weeks old with her parents and three doting women, maybe grandma’s and aunts, in her entourage. She was a beautiful little baby and I had a wonderful, nosy neighbor view as I watched her parents rock her, coo with her and love on her. I got to see her sweet little smile and remember other babies I have held, my own, my niece and nephews, my friend’s children, my client’s children and grandchildren. I felt awe at the realization that we go from being such fragile, dependent beings to functioning people who walk and talk and make major decisions on a daily basis.

I know some people don’t like plane rides but I love it. There are so many things you just can’t do on a plane. I can’t fix anyone a sandwich. I can’t take anyone anywhere, get an extra load of laundry in, do a quick clean up, or return phone call or emails. I can have a conversation with anyone who wants to have a conversation with me, my husband, my children, or a random passenger who feels like talking even though I’m too shy to initiate the conversation. I can take a cat nap. I can read a book, watch a movie, if one is offered, or catch up on reading the newspaper. It was actually while catching up on the news that I found my second moment that reminded me of the importance of awe.

Everyone who knows me knows that catching up on reading the newspaper is a pretty quick deal for me. I skim over the bad parts, just enough to be informed, and focus on the good parts. Anyone who reads the news knows that’s a quick read because there is not much good stuff. This past Sunday however, in the Washington Post Sunday Magazine, I got a nice surprise. There is an article which details the love story of Bill Ott and Shelly Belgard, two mentally impaired adults who fell in love and got married. I actually went to high school with Bill. We did not know each other personally but I do remember him going to prom (he might even have been with Shelly). I remember how dear he was with his date, how they both remarked about being nervous to one of the chaperones, and how they both were smiling every time I happened to see them.

The part of the article that reminded me about awe came from a quote from Shelly’s mother, Gail Belgard. In it she talked about how the doctors told her when Shelly was born that she would not live six weeks. Her mother says that Shelly kept “not dying” and actually went on to begin walking and talking. “You know what was nice?” Gail remembers. “People have all these expectations of their children or wishes for their children — to go to Harvard or whatever. For us it was, ‘Shelley learned to tie her shoe! She learned to feed herself! Gee, she’s walking!’ Everything was great. Whatever she was doing was great.” (Washington Post Magazine, Feb 7, 2013)

This made me think of the families I work with. So many children come to me who have suffered incredibly difficult trauma and/or neglect from very early on. It is amazing that they are able to survive with any of their spirit intact. I am in awe of their ability to survive. Much of my work has to do with helping parents to see the enormity of a child trusting in parents again after an essential parent/child trust has been broken. I wish I could give some of the parents who come through my doors a bit of the feeling that Shelly’s mom had but in this case, a sense of wonder when a child is willing to tell you the truth, even after a lie, even though they might get in trouble; or a sense of wonder when a child asks for help, even though they have always relied on their own skewed sense of survival to make it through the day.

As a reward for reading this far, I want to share with you a third moment of awe that I felt, this one from the actual vacation. We went on a whale watch this morning at sunrise. I got to see the sun come up and there was a moment when I realized that on Maui, you don’t have to look for rainbows as much as you see that the world is the rainbow. Whales were all around and my husband was good enough to catch a bit of it so I can share it with you…

The world is a rainbow

The world is a rainbow

A Whale!

A Whale!

The miracle of my eleven-year-old feeling completely happy.

The miracle of my eleven-year-old feeling completely happy.

Mahalo

Related Posts:

When Bill Met Shelly: No Disability Could Keep Them Apart (Washington Post Magazine)

The Importance of Delight (help4yourfamily.com)

Parent Affirmation Monday- being present (help4yourfamily.com)

February 14, 2013 Posted by | parent support/ self improvement | 3 Comments

Upcoming Trainings

Written by, Kate Oliver, MSW, LCSW-C

In my work life, next to being in the office with families, and writing, I love, love, love teaching others how to feel better, love better, and live happier lives. I am always looking for new opportunities to present and share my knowledge with other and I am so excited to share a couple of upcoming opportunities I have been given to do just that.

For quick links to the programs, you can click below, or keep reading for the full descriptions:

March 22, 2013:

Rainbow flag. Symbol of gay pride.

Rainbow flag. Symbol of gay pride. (Photo credit: Wikipedia)

After the Honeymoon: What the Recent Passing of the Civil Marriage Protection Act Really Means for Maryland’s LGBT Families

April 29, 2013:

Micah in Bodegraven  (Parents in law)

Micah in Bodegraven (Parents in law) (Photo credit: Johan Koolwaaij)

A Clinician’s Guide to Attachment and Attachment Related Interventions for Foster and Adopted Children

First, I was invited by the Maryland Chapter of the National Association of Social Workers to conduct a workshop at their statewide conference to look at the impact of Maryland’s new equal marriage legislation on gay and lesbian couples and families. Since many of my readers have probably figured out I am all about connecting people together, I figured rather than doing a workshop all by myself, I would make a panel and include a few amazing people I have gotten to know along the way via my own advocacy for equal marriage rights for all couples. Joining me on the panel are Susan Francis, JD, to talk about the legal changes that come with the new law, and Rachael Stern, MSW, LGSW, who was the media director for the winning Marylanders for Marriage Equality campaign. For anyone interested in attending the Weaving Resiliency and Advocacy conference with the Maryland National Association of Social Workers from March 21st-22nd, (I am presenting on the 22nd) you can follow the link below:

Workshop I
After the Honeymoon: What the Recent Passing of the Civil Marriage Protection Act Really Means for Maryland’s LGBT Families

Presenters: Rachael Stern, MSW, LMSW, LGSW, Kate Oliver, MSW, LCSW-C, and Susan Francis, JD

Synopsis:  While many social workers are celebrating the result of the recent popular vote in Maryland to enact the Civil Marriage Protection Act, what does the law mean in everyday terms for LGBT couples and their children in light of the federal Defense of Marriage Act and other state, federal and international limitations? In this panel discussion including a clinical social worker, an attorney and an advocate who work with the LGBT community, learn a brief history of the work that went into passing the measure, the legal implications of the law (what it does and does not protect for families), issues you may see in a clinical setting, and the next steps for full equality for the LGBT community in terms of marriage and beyond.  Participants will have ample opportunity to participate in a question and answer session following the panel.

Second, I had such a great time presenting for Lisa Ferentz’s Institute for Advanced Psychotherapy Training and Education when I taught a basic course on attachment that the only thing I wished I had for that training was more time! Lisa was gracious enough to offer me just that  and now, instead of a three-hour course, I am offering a six-hour course to teach other clinicians about the importance of attachment and how to address working with children with insecure attachment styles. You can register for this training by clicking the link below:

A Clinician’s Guide to Understanding Attachment and Attachment-Related Interventions for Foster and Adopted Children

We know from research that attachment styles form the foundation for the ways people look at the world and that a healthy attachment style is essential in forming a happy, healthy adult. We know too as clinicians that many of the children and adolescents who come through our doors have not formed a healthy attachment style due to trauma, parental addiction or mental health issues. John Bowlby and Mary Ainsworth laid the foundation of the research which describes healthy versus unhealthy attachment styles, but what is a clinician to do when a child comes to you with a pre-formed, unhealthy attachment style? Therapists such as Dan Hughes and Art Becker-Weidman have more recently built upon the early research to teach clinicians how to address attachment related issues in treatment in a way that understands the root causes of attachment disturbance and treats these issues from the root causes.

In this workshop, Kate Oliver, LCSW-C will train child and family therapists and adoption and foster care workers about the basics of attachment, how to spot attachment related issues in children, and she will provide a framework for working with children and foster or adoptive parents in therapy to repair a disrupted attachment style. Based on her years of experience working with traumatized and attachment disturbed children, Ms. Oliver will provide clinicians with techniques to engage parents and children in re-patterning attachment styles using lecture, videos and role plays.

Related Posts:

PLACE Parenting for Children with Attachment Disturbance (help4yourfamily.com)

Children Are Not Protected by Homophobic Laws (help4yourfamily.com)

February 7, 2013 Posted by | Groups/ trainings, resources/ book reviews | , , , , , , , | Leave a comment

Older Kids with Bathroom Issues: Why Does it Happen? How Can You Help? Part 2

English: Typical Male Restroom in the U.S.

English: Typical Male Restroom in the U.S. (Photo credit: Wikipedia)

Written by, Kate Oliver, MSW, LCSW-C

In last week’s post, we looked at the possible origin for encopresis (soiling after the usual age for toilet training) and enuresis (wetting after the usual toilet training age) in older children with a history of trauma and/or neglect.There is something about an older child wetting or soiling themselves that can send parents into a fury, especially if the incident is perceived to be intentional. This is understandable. We all have buttons, and a big one for many of us involve the transmission of germs whether it’s via spit, mucus, vomit, urine or feces, we don’t want to be around it!

In this week’s post, now that you have a theory from last week about where the issue originates, I want to help you to figure out what to do to help your older child, who will often experience shame as a result of the incident. If you have any questions about implementing any of these strategies, I hope you will ask in the comments section, or discuss it with your child’s therapist.* One of the reasons I am writing this post is because there are very few therapists who specialize in this issue, so if your child’s therapist is not familiar with it, please think about printing out and taking in this article.

As I stated in the first post on older children with bathroom related problems, the first intervention is always to follow the suggestion of your child’s physician as we do not want to fix a broken bone with a band-aid and some medical intervention may be necessary. As sensitive as I know parents are about this issue, children are also very sensitive about it, even if they pretend to be aloof. In fact, I know one of the beliefs parents have that send them into a fury about older children wetting and soiling, is that their child does not even care about the fact that they are doing it when, in reality, often children that have this issue are experts at covering up their feelings so you do not know how humiliated/ angry/ frustrated they are.

Before I give you suggestions, I want to give two important guidelines for all the interventions I use with children. My number one guideline is to follow the PLACE parenting attitude whether your child has attachment disturbance or not. The second is to make sure your child is primed to receive help from you. What I mean by that is, ask your child if they want help. If they say “no,” DO NOT OFFER IT. When you offer children help and they don’t want it, you are only listening to yourself talk and asking to be frustrated. If you offer it, then back off. After you child has refused a couple of times and their refusal has been listened to and honored, their curiosity begins to take over and eventually they ask you what help you have to offer. Then, and only then, are they open to receiving and they will be primed to listen to your advice.

With that said, here is a list of ways I have helped children with enuresis and encopresis:

1. Especially if you recently adopted or started fostering your child, do not panic! You may have a child who is looking for buttons to push to get you upset or make you reject them. If you have an upset reaction, they may see that it gets a rise out of you and will be more likely to continue. Without over-reacting, try to employ natural consequences, i.e. the child has to clean up the mess as appropriate for their developmental age. Remember to use your PLACE attitude, which means that humiliation and embarrassment of your child are not acceptable consequences. In fact, with a child that would purposefully wet or soil themselves, humiliation and embarrassment may actually reinforce the behavior in ways you did not anticipate. To better understand this concept you can read my Caught in the Loop post.

2. My first suggestion for someone with a child with ongoing problems of this nature is therapy. While my sample is quite skewed, I have not seen any children with this issue that did not experience a feeling of fear about the problem, often accompanied by humiliation, even if the behavior is perceived to be intentional by their parents. While moms and dads can be helpful in navigating those feelings, therapists are trained to add an additional and necessary layer of help. Also, as you well know, children are often more motivated to do something someone else suggests over the suggestion of their parents. You know your children do things for their teachers that they would not do for you and bringing the issue to the child’s attention while in therapy often gives a child an extra bit of motivation to work on it. Additionally, if your child has a history of trauma this includes the bathroom in any way, it is important for them to be able to process this history with a trained professional.

3. My most successful intervention in the area of helping older children with encopresis and enuresis is to reintroduce the idea of toilet training. Before you skip this idea because you think your child is too old to re-potty train, let me tell you that I have used this with children in their early teens with success. The reintroduction is delicate and goes like this (and, as I say in many of my posts, the tone is important…think about how Mr. Rogers would say it):

“I wonder if when you were younger and didn’t get what you needed, you might have missed out on some of the signs your body gives you when you need to go to the bathroom.”

It may take a few times of gently suggesting this to your child for them to begin to get curious with you. Suggest you could help them to learn how their body knows it needs to go. Think about this. Your body knows it needs to go when your bladder feels full. I teach kids to playfully ask their bladders out loud in my office, “Bladder, do you have to go to the bathroom?” You would be amazed how many children have quickly realized by asking that question that they do, indeed need to go…right then…and we end up taking a quick restroom break.

You can also point out that sometimes you have been able to tell when your child needs to go and that when kids are young and have parents that take good care of them, the parents often point out when a child is doing the potty dance. For some kids, we come up with a signal that the parent can make, rather than asking out loud in public whether a child needs to go. This works well with a child who has a history of being shamed or traumatized in relation to going to the bathroom,or who was never potty-trained appropriately.

4. An additional technique to use with children who were not properly potty-trained, is to teach each your child about controlling their bowels. One way I do this is to have children picture a balloon full of water. I tell them to picture the balloon turn over so that the opening of the balloon is on the bottom. If you are using your fingers to pinch the balloon, it is like the muscles around your bladder holding the pee or poop in. If you were to let go with your fingers, you would see the water come out of the balloon. For some balloons, you would have to give an extra squeeze from the top to empty it out. Bladders can be like this too. When I work with kids with issues controlling their bowels, I suggest to them that they picture the balloon as their bladder every time they need to go to the bathroom. Muscles hold the urine until you get to the toilet, then they let go and we make sure your bladder is emptied completely. For kids with urinary issues that are feeling brave, I also suggest kegals, where they start urinating, then try to stop the urine one or two times every time they go in order to build up the muscles (consult with a physician to make sure this is a good idea for your child).

Also, and many adults do not know this, there is a right way and a wrong way to empty your bowels. To most easily and completely empty your bladder, teach children to sit, leaning forward with their forearms resting on their thighs. Have a small stool near the toilet so children can put their feet on the stool making it so their knees are higher than their hips. This will help kids that hold onto stool and urine, to most easily and quickly relax and let go when they are going to the bathroom.

5. For kids with bowel issues, especially kids that hold it until it gets painful, I teach a quick exercise to help them control bowel functioning. This is good for relaxation as well. Lie on the floor and counting slowly to five, suck your belly in. Picture your belly button touching your spine. Then, again to a slow count of five, push your belly out until your belly button is actually sticking up. See if you can make the pulling your belly in, equal in time to the pushing of your belly out. Ideally, kids who are learning to control their bowels will do this exercise for 3 minutes a day. The typical response I get from kids when I teach them this exercise and they actually do it in my office is a moment afterward when they start to get excited (like the potty dance) then a request to go to the bathroom. Success!

For children where this does not work, see about helping them find a Pilates class in your area. Many of the Pilates exercises, strengthen the core and pelvic muscles allowing for greater control.

4. I find the toughest kids with bathroom issues are typically the ones who are doing urinating and soiling on purpose, although often the times they do it are few and far between. As I recommended in my previous post on this issue, it is important to figure out the why, but really the intervention for purposeful urinaters and soilers is to make sure they are in therapy with someone who works on teaching them to state their feelings. Often these kids need remedial learning in the expression of feelings, and, while parents can do some of this, a child therapist will have the training to find ways that work for your child to teach them the proper expression of big feelings. Sometimes this means helping them to understand that they will not be harshly punished for the expression of their feelings, and others it will mean having a therapist identify that your child may be experiencing a traumatic reenactment.

I know that this is a sensitive topic for many families and people do not want to be identified by leaving comments, however, if you have questions, or a suggestion that works that I forgot, please let me know. You can feel free to leave a comment or to contact me privately via email: helpforyourfamily@gmail.com

*see disclaimer

January 31, 2013 Posted by | attachment disorder, child development, discipline, mental health | , , , , , , , | 1 Comment

Older Kids with Bathroom Issues: Why does it happen? How Can You Help? Part 1

White Toilet Bowl in Malaysia

White Toilet Bowl in Malaysia (Photo credit: epSos.de)

written by, Kate Oliver, MSW, LCSW-C

No one wants to talk about it. It’s a messy issue, and it stinks…literally. In my practice I see quite a few children who, at a much older age than usual, have bathroom issues, where either they wet themselves at night or during the day. Some even soil themselves. It is often a difficult issue for parents to bring up, and there I times I have seen a child for months before anyone is even willing to mention it, even though it is one of the questions I ask during my initial parent visit for children with attachment related issues. Many of the parents that come to me say it is the most embarrassing of all the issues their child has. It is also the thing that can make parents angry the fastest. After all, if you have a ten-year-old who just wet themselves in your car, it is easy to forget that there might be more going on than lack of self-control. Instead, we tend to focus on the fact that your car smells like urine and a ten-year-old did it!

When a child has a behavior like enuresis (wetting themselves during the night or daytime) or encopresis (soiling themselves), I always look for the root cause. It is important to know where this problem starts because often by knowing where something starts, we can figure out how to fix it in the most loving way possible. In this post I am going to focus on daytime wetting and soiling, as I believe that bed-wetting is an easier issue to find information about and can have a different origin than daytime wetting and soiling which I see most often in children with a history of trauma and neglect.

In my next post we will look at solutions to these problems. Until then, here is a list of questions to help you think about the origin of your child’s issue because when we know the origin, often the solution becomes clear.

1. “Has my child seen a doctor about this issue?” The first place to start with any problems involving the bladder is always with your child’s doctor. Even if your child has not been complaining about a bladder issue. Even if you asked them all the questions that go along with having a bladder infection, still go to get tested. This is important especially if your child has a history of neglect, since they will be more likely to be out of touch with their bodies so they may not be alert to discomfort until it is a major problem. Additionally, even when there is a mental health issue related to a child’s enuresis or encopresis, some children require a medical intervention because, especially for a child that holds on to bowel movements (bm’s), there can be a cycle of holding onto bm’s followed by a painful releasing that can require medical attention in order to stop the pain that reinforces the holding of the bm’s in the first place.

2. “Was my child properly potty-trained?” This may seem like a strange question to ask if you have an eight-year-old, however, if your eight-year-old was being potty trained by an abusive, and or actively drug-using parent, child-care worker, grandparent, etc. during the time when children normally get potty-trained (anywhere from 2-4.5 years old) then they may not have been taught in the ways that they were able to understand. It may be that no one ever walked them through proper wiping procedure after going to the bathroom. It may be that no one ever taught them how to tell if they need to go. Your child may have a developmental lag in this area because they were not able to “master” the developmental milestones that go with being properly potty trained. Additionally, if your child was not properly trained, they may not have developed the muscles that we do not even think about which we use everyday to control our bladder that keep us from our own embarrassing issues.

3. “Does my child have trauma associated with the bathroom?” It may be that your child avoids that bathroom because some bad stuff happened in and/or related to a bathroom at some point, or, they may have experienced trauma related to wetting or soiling themselves. Potty training is reported to be the developmental step during which a child is most likely to experience abuse. If you have a child who has experienced trauma, ask yourself if they may be avoiding the bathroom because it reminds them of something they would rather not think about. Maybe it was a place they hid from someone. Maybe it was a place where they or someone else they loved got hurt. Maybe they were beaten or threatened with harm if they had an accident during potty-training. For children with severe trauma, it may be that they experience a “trigger” wherein they feel terrified, and/or they may be experiencing a traumatic reenactment wherein they are re-experiencing a traumatic situation as their brain’s way of making sense of it and the experience is so intense that they end up peeing on or soiling themselves. An example I have often used comes from when I was a kid myself:

One night I woke up to a small fire in my room. No one was hurt and the house survived but it was scary. The fire truck came and it was pretty clear that things would have been way worse had I not woken up when I did.

Many years later when my children were very small, I remember taking my daughters out to play in the snow. It was a cold day and several people had made fires in their fireplaces. When I went to enter my own home (where we did not have a fire lit), I had a moment when the smell of smoke hit my nose, probably from a nearby chimney. I handed my youngest daughter to my husband and yelled, “Stay out of the house, there’s a fire!” Then I proceeded to run into the house, looking for smoke so I could see where the fire was.

Because I am telling you this story, I’m sure you have figured out by now that there was no fire, however, I can tell you that at the moment I entered my home, I was 100% certain that there was. The smell of smoke was the trigger and I responded accordingly. While it did not involve a wetting or soiling incident (lucky me) I think it does describe how our brains can get tricked for a moment into thinking something is happening again, even when it is not. As I said before, this can sometimes happen with enuresis and encopresis in children of all ages.

4. “Is my child pissed off?” Well, what is the best way to show someone that you are pissed off? Some of the kids that come to see me, intentionally urinate or defecate either on themselves, the furniture, or even mom’s prized photo album. If a child has not been given the tools to express feelings in a reasonable way, they express them in whatever way occurs to them at the time.

Any survivor of abuse or neglect that has not had adequate opportunity or support to process the impact of the trauma often carries an intense level of anger or rage inside. When the anger is not addressed, it comes out in other ways. Even though I have had parents report to me that their child does not act angry when they are urinating on furniture, it is possible that a child with an attachment disorder would seem relatively calm while seething with rage underneath. I liken it to the times when I have gone to the ocean and the lifeguards warned people not to go in the water because the undertow is too strong. The waves look the same to me but there is a pull underwater that you cannot see and that can carry you away from safety. Whether it is because they were not allowed to express feelings for fear of harm, or they gave up on expressing feelings because their feelings were not honored anyway, some children learn that the most effective way to express how they feel is by urinating or defecating intentionally.

5. “Is my child fearful of connection to others?” For children with attachment disorders, it is not uncommon for a child to make themselves seem repellent. I hear a lot about children who refuse to bathe even though they smell terrible, or who have disgusting habits that repulse their parents. If a child is fearful of connection, then feels connection despite that fear, they may do something to make themselves feel more comfortably distant. I see this sometimes when a child comes into my office and we have a moment when the child connects to her mother. Maybe she says something nice about her mom, or they share a hug. For a child where connection is terrifying due to early abuse or neglect, they may subconsciously find a way to reestablish a distance between themselves and their caregivers by wetting or soiling.

Now that we are getting curious about the origins of encopresis and enuresis in older children, in my next post, I will address what we can do about enuretic and encopretic older children.

Related articles:

Older Kids with Bathroom Issues: Why Does it Happen? How Can You Help? Part 2 (help4yourfamily.com)

Caught in the Loop: Why People Repeat the Same Bad Choices Over and Over (help4yourfamily.com)

Parent Affirmation Monday- Curious (help4yourfamily.com)

Chronological Age vs. Developmental Age (help4yourfamily.com)

January 24, 2013 Posted by | attachment disorder, child development, discipline, mental health | , , , , , , , | 4 Comments

Caught in the Loop: Why People Repeat the Same Bad Choices Over and Over

train circle

train circle (Photo credit: bitmapr)

written by, Kate Oliver, LCSW-C

When I met Aaron, he was 10 years old and living with his parents who had adopted him after three failed placements.  Aaron’s parents were at a loss about what to do with him.  They were committed, loving parents who wanted to help him make better decisions; however, after living with them for over a year, Aaron continued to have bizarre behaviors that they did not understand.  In addition to continuing to steal from his parents any time he had the opportunity, his parents had just figured out that he had also been urinating into the vents in his room.  Aaron’s parents were at a loss as to how to help him change this behavior and they were terrified that it would continue to get worse.

Children who have experienced trauma can seem to continually engage in activities that can be baffling to parents.  I have had many a parent come in to my practice and describe a foster or adopted child who seems to seek attention in negative ways and to actually work to recreate the circumstances that were traumatizing to them in the first place.  From rooms that seem to get instantly messy immediately after cleaning them, to repetitive behaviors that pluck even the calmest parent’s nerves, these children can seem intent on turning their parents into a recreation of the child’s biological parent or earliest caregiver.  There is a name for this phenomenon.  It is called “traumatic reenactment.”  The best way to explain traumatic reenactment is to first understand how trauma works, and the ways we store it in the brain.

Think of your brain as a computer.  The files in your computer are stored in different areas.  There is a short term memory file that stores what you had for breakfast today and yesterday.  There is a long term memory file that stores the stories from your childhood.  There is the work file, the running “to do” list file, and many, many more.  Days that go as planned are pretty easy to file away.

But what happens on a day when something traumatic happens?  An easy definition of trauma is anything that impacts you in such a way that it causes you to feel as though your life is in serious danger, with the possibility of death, or that changes who you perceive yourself to be in a negative way.  To show how people typically store traumatic memories, let’s take the example of a car accident.  You do not wake up in the morning thinking this is probably going to be the day you are in a car accident.  If you really believed that, you would probably never get into the car.  But, there you are, driving down the road and someone sideswipes the car you are in.  No one is hurt, but there are a few moments of panic and your car is seriously damaged.  What do you do?  Well, of course, as an adult you make sure everyone in both cars is okay, call 911 to make sure no one is hurt, and then the insurance.  But what is happening with your memory filing system?  How are you filing this memory?  It sure does not go in the breakfast file!

What happens with trauma is that, until we file it, it acts like a virus on our computers.  If you have ever had a virus on your computer, you know what happens.  You go to get on the internet and think you are checking your email, only to find all kinds of unwanted images popping up on your computer.  Then, if and when you are able to get to your email, you may find out you sent a bunch of messages to people that were not even from you!  You never sent that!  This is how trauma works.  Until you file that traumatic memory you just got from the car accident, your brain is going to be working overtime to file it.  You will go to get in the car and up will pop the memory of the accident and maybe another accident you had a while back.  You will start to remember those terrifying moments when you were out of control and you did not know if you were going to live or die.

Healthy adults file traumatic memories as they verbally process the trauma.  Remember how you called the police?  You had to tell them what happened so they knew who to send.  You were processing the memory.  Remember when you had to call the insurance?  Same thing.  Did you sit in your car for a moment and do some sort of self-soothing like deep breathing to calm yourself down?  Maybe you got a hug or reassurance from someone.  Perhaps you reminded yourself that you have been in cars thousands of times and the vast majority of those times nothing bad happened.

If you did any of those things, you were processing and filing your memory.  Another part of filing trauma is finding a way to understand the event.  This includes thinking about whether you could have done something differently, how you got through it, and how you can avoid the same thing happening again.  Therapists call that mastering the situation.

Now, think about the child you have or have had in your home who has experienced trauma but did not have anyone to process it with and did not have anyone to soothe them, nor did they know how to self soothe, after all, who would they have learned soothing from?  The clinical term for the way this “virus” manifests is “traumatic reenactment.”  It goes like this.  A trauma occurs.  It is not filed appropriately because there is either no, or not enough, processing or soothing for the child.  The child tries to gain mastery (understanding) of the trauma by subconsciously putting themselves back into the same situation over and over again in an attempt to understand or “master” it.

Remember Aaron?  When Aaron lived with his birth parents he was repeatedly locked in his room for days at a time when his parents went on drug binges.  When his adoptive parents brought him in to see me he was lying and stealing constantly, then, they had recently discovered that when they sent him to his room for punishment, he had been urinating into the vents of their home.  What became clear was that this child had found a way to experience a traumatic reenactment with his adoptive parents.  He lied and stole, then got sent to his room for punishment.  While in his room, he had the emotional experience of feeling trapped again, just as he was trapped when he was very young.  In his mind, being sent to his room meant he was not allowed to come out even to go to the bathroom.  When he had to go, he did what he had before, went in the vents, so he did not have to be around a wet spot in his room.  His loving parents had responded in every way they could think of to change these behaviors, but it was not until they understood where the behaviors were coming from that they were able to adapt their responses to more accurately fix the underlying problems.

In therapy, Aaron processed the trauma, learned how to soothe himself and to be soothed by his parents.  It really did not take long for the vents to become dry again so his parents could focus on new ways to address other issues related to his early abuse and neglect.  For traumatized children, I strongly recommend counseling, with a therapist that specializes in trauma, as a resource to help them process traumatic memories to improve behaviors and help parents find a way to adapt parenting styles in ways that are most beneficial to the child.

January 15, 2013 Posted by | attachment disorder, child development, discipline, help for parents | , , , , , , , , , , , , , , , , , , | 4 Comments

Chronological Age vs. Developmental Age

written by Kate Oliver, LCSW-C

Having a blog on WordPress is so nice in that I got a nice little report for the end of 2012 letting me know which of my posts has gotten the most attention, etc. By far the most popular post was this one! So, in the spirit of sharing and refreshing for the New Year, I thought I would update and repost this blog, since it was one of my earlier ones and may have been missed by some of the folks who are newer to my blog. I keep my comments open and would love to hear if people are getting what they are looking for from this post even if it has been a while since I originally posted. Enjoy!

Chronological age vs. Developmental Age

When figuring out how to best meet the needs of our children, it is important to understand their developmental age.  For many children this can be the same age as the chronological age, the age we typically think of when we talk about our children, however, if you have a child that, among other possibilities:

  • has a history of trauma or neglect,
  • was adopted at an older age (18 months or more),
  • has a developmental disability,
  • has experienced the death or loss of a primary caregiver,
  • has experienced a major change in family structure,
  • or has a parent with a serious illness or addiction,

you may have a child that has a “stuck” part of their development. If you have a child like this, typically you might notice that there are times when he or she acts much younger than you would expect for their chronological age.  What makes this confusing is that your child may be able to do things that are appropriate for their chronological age.  For example, you may have a child that works at or even above grade level in reading and/or math, but in some emotional areas they may be developmentally younger than their chronological age.

Let’s look at an example everyone can relate to, think for a moment about a time when you have been triggered into a younger developmental age, say, when you go to your parent’s house for the weekend.  Even as an adult, you may find that you act differently toward them or your siblings than you would in your day-to-day life.  You may feel younger, angrier, more docile or more or less confrontational.  What that signifies is that there is a part of you that has not left or resolved some of the struggles from your own childhood.  Most of us have something like this. Our children are no different.

Some important questions about an area where your child seems stuck in a younger developmental age are:

1. Is my child capable of meeting the demands of this developmental stage? Developmental delays, learning issues, issues related to physical abilities and early childhood exposure can all add to a child’s difficulty in meeting a developmental milestone.

2. Has my child ever been properly taught how to meet this developmental milestone? For example, if you have a daughter you adopted from foster care at age 5, she may not ever have been properly potty trained and taught to clean herself appropriately after using the bathroom. It may be that while we expect that to be a skill children learn between ages two and four, your daughter may require instruction now, as she has not received it before.

3. Did something prevent my child from being able to learn this skill at the appropriate time? Perhaps you had a child with medical issues, a traumatic situation or something else. At the time when other children were learning to make friends and play nicely with other children, your child was busy managing an internal or external stressor that demanded all of their attention they would otherwise have been able to focus on meeting a developmental milestone.

4. Does your child have a traumatic trigger that remains unresolved which prevents them from moving through a developmental stage? I see children who have experienced trauma. Many of them have memories associated with trauma that prevent them from focusing on a task. Children (and adults) with unresolved trauma have what we call triggers, which remind them of the traumatic incident. Depending on what happened, a trigger could be a bathroom, a car, candy, really anything that reminds them of the trauma. What this means for parents with children who have experienced trauma is that the simple act of making a snack for your child could result in a child acting much younger until the traumatic triggers have been identified and resolved so that the apple you cut is just an apple again, instead of a reminder of a difficult past.

Why is it important to know where your child might have a developmental lag or stuck place?  Knowing that there are areas where your child is developmentally behind their chronological age allows you to make decisions about how to handle their  behavior appropriately.

What to do about a child acting developmentally younger:

After considering the reasons behind the developmental delay, it is easier to figure out how to address the issue. Sometimes it may just be a matter of time, or finding appropriate school or therapeutic support to allow a child’s brain to develop. For children who are delayed due to an external factor, in addition to school and therapeutic support, consider attempting to change your response to match their emotional/developmental age for the issue you are addressing.  What would you do for a two-year old who needs to brush her teeth?  Would you tell her to go brush her teeth and expect that she was going to easily and happy get right over to the toothbrush and begin throughly cleaning her teeth after applying just the right amount of toothpaste to the toothbrush?  Of course not!  Ideally, you would go with them (even if they are grumbling), you might remind them of why tooth-brushing is so important (if you have a child adopted at an older age, please remember it may be that no one ever taught them the importance), you would make brushing fun by singing a silly song to say how long you need to brush your teeth.

I know many parents reading this might be saying that your 12-year-old, who acts like a 2-year-old at brushing time is not going to stand for you hovering over her while she is brushing her teeth, and you are not going to talk to her like you would talk to a two-year old.  You are right, I am not recommending that you use the tone you would for a two-year old because you might get the death stare or worse, escalate a tense situation.  No, I am saying to use what you would do with a two-year old as a guideline for figuring out something with your child that is developmentally two during tooth-brushing time but is residing in a 12-year-old body.  To me that would look something like, playfully having a contest to see who can get just the right amount of toothpaste on the toothbrush or offering to get your child started by putting the toothpaste on the toothbrush, then saying a silly poem or singing a silly 12-year-old song, or reading a page out of a joke book to your child while they brush their teeth so they can get an idea of how long to brush.  Only read or sing when they are brushing, stop if they stop and start when they start again, and stay playful. Yes, they may look at you like you are crazy, but are they brushing while they are doing it?

Spc. Elizabeth Jarry shows an Iraqi girl prope...

Yes, I can hear protesting parents, now saying that you do not want to put toothpaste on your 12 year old’s toothbrush because they are old enough to do it themselves!  I know they are chronologically old enough, however, we are talking about something that they experience at a developmentally younger age.  And, here’s the good news, if you speak to your child’s developmental age for a while, their needs for that developmental stage get met, and they move on to the next stage of development for that issue.

For more parenting tips that don’t take a ton of time but do improve the happiness level in your home please see my previous posts:

January 5, 2013 Posted by | attachment, child development, discipline, help for parents | , , , , , , , | 8 Comments

A Affirmation for the New Year

written by Kate Oliver, MSW, LCSW-C

In honor of the New Year, I would like to share one of my favorite affirmations. I believe it comes from Louise Hay, but I have been saying for a while now and don’t honestly know the origins. However, I find it particularly fitting for the New Year. It is fairly simple and goes like this.

I am willing to let go of old, painful patterns that keep me feeling unhappy. I welcome new and fulfilling experiences into my life.

I love this affirmation because it rightly implies that you do not need to figure out how to let go of old patterns, as much as you must be willing to let them go. Just the simple act of being sincerely willing to let go of old, painful patterns, can open up a new experience for you and for your family, since your willingness to let go will impact them as well.

It is my hope for you that this year brings your happiest family experiences ever. Thank you so much for traveling with me through the past year, my first year of blogging, and for your support as I entered a new learning experience. I am looking forward to many more years spent together.

candles

candles (Photo credit: rogerglenn)

December 30, 2012 Posted by | affirmations, help for parents | , , , , , , , | 4 Comments

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