Create the family you want to have

What is attachment disorder?

Mother and Child watching each other

Mother and Child watching each other (Photo credit: Wikipedia)

One of the areas I specialize in is working with children with attachment disorders.  If that term is new to you, please allow me to explain.  Attachment is the relationship a child forms with their early caregivers that shapes how we form connections to other people throughout our lives.  We are all born relying completely upon adults to meet our needs.  I am no animal expert, however, I believe humans are one of the few species that cannot feed ourselves soon after birth.  For basic nourishment and caretaking, we rely heavily upon adult caretakers for a relatively long period of time.

As infants, while we are relying on our caretakers, we are also building the neurotransmitter systems in our brains.  When babies look into the eyes of their parents, literally thousands of neurons per second get activated and the building of this neuron wiring sets up the building block of our attachment system or structure.  When you think of it this way, it is simple: if baby gets her needs met “enough,” she develops what we would call a secure attachment, if baby does not get her needs met “enough” she develops what we would call an “insecure” attachment.  By the way, “enough” has been studied and it means that we meet our babies/ children’s needs 30% of the time (or preferably more).  That does not mean that 7 out of 10 times are gimme’s!  Think about when a baby is crying.  You try to figure out what is wrong…diaper?  No.  Hungry?  No.  Rocking and singing?  Bingo!  You just got it wrong twice and right the third time.  The trick to this is to keep trying to label and meet a child’s needs and to help them learn to label and name their needs to make it easier for you as they grow.  But I digress…

Securely attached children tend to think more along the lines of:

  • The world is a safe place.
  • I am loving and loveable.
  • I get my needs met.
  • Adults are reliable.
  • If I have a problem, I can usually fix it or get someone to help me.
  • My choices make a difference.

Children with insecure attachments tend to think more along the lines of:

  • I need to get my own needs met.
  • I am bad.
  • When I trust people I usually get hurt.
  • My choices don’t make any difference.
  • I need to fix my own problems.
  • People are not trustworthy.

In the classification of insecurely attached children there are two categories.  I see these categories as insecurely attached with a structure (anxious or avoidant) and insecurely attached without structure (disorganized) .  Why the distinction?  Because if you have a child who tends toward anxious/avoidant, you are more likely to be able to predict behaviors and their response to different challenges.  However, with a disorganized structure, because the child has no system for tackling issues in place at all, it is incredibly difficult to predict what the child will do in a given situation.

To find out more about attachment disorder please visit the website I participate with  There you will find a wealth of information on this topic.

Stay tuned for future posts on attachment as well!

March 31, 2012 Posted by | attachment disorder | , , , , , , , , , | 10 Comments

Finding the right counselor/therapist for you and your family decided that you want to find a therapist for you or your child.  How in the world are you supposed to know how to do that?  What an intimidating thing to do, and, like any other doctor you see, who you pick can have a strong influence on your outcomes.  While your first instinct might be to go through your insurance to find a provider, this is actually not the path I would suggest for the majority of people (even if money is an issue).

My first suggestion is that you identify the reason you are seeking a therapist.  Is it for marital issues?  Are you looking for a social skills group for your child who has a diagnosis of ADHD?  Have you had a history of trauma and are you seeking to heal from it?  If you know anyone who has had similar experiences and you are close enough to them to ask, check with them if they have found a good mental health provider.  Even if you do not want to see their provider because that might feel weird, if their person is good, you can call them and ask for referrals. Similarly, do not be afraid to ask a mental health provider that you know personally about referrals as long as you trust their opinion.  While someone you know personally can not see you for ethical reasons, they may know of a referral for your specific issue.  If you do not have a resource like this, look up local groups in your area that specialize in the issue for which you are seeking treatment. They may have some providers they commonly refer to.   School counselors also typically have referral resources.  If you are attending a college or university, you may also be able to see a therapist on campus.

On a side note, if you are not clear on the specifics of who you are looking for, think of mental health professionals being like other health providers.  There are specialists and general practitioners.  If you are unsure, go to a general practitioner.  If you work for a large company, there may be an Employee Assistance Program (EAP) provider who will see you for a few sessions and steer you in the right direction (with the understanding that then your work has a record you saw someone), or there are many good, general mental health practitioners out there that you can find using your personal network.  If you find a good one and they identify that you need a specialist, they may refer you out for more specialized treatment.

Now that you have identified possibilities, it’s time to make some calls.  I would encourage you not to be put off by someone if you can not find them on-line, you may find that in my profession, there are not as many technologically savvy people out there so there are tons of wonderful professionals who may not have a website- or even email!  Call the professional directly.  Try to speak with them on the phone to get an idea of availability and whether they specialize in the area for which you are seeking help.  Ask about what insurance they take, if any.  Those lists you find on line from your insurance company can be hopelessly out of date so always ask.

Pay attention to how you feel when you are speaking to the provider on the phone.  Do you feel they listened to you?  Do they have availability to see you at times that work for you?  If you are uncertain, do not be afraid to say that.

Now is the time to check with your insurance.  If the provider you want is in-network for your insurance, great- skip this paragraph!  If not, call your insurance and see what your out-of-network benefits are.  For instructions on how to do this, you can look under the insurance button on my practice website:  Do not give up if you do not have out-of-network benefits and your selected provider does not take your insurance.  Call your insurance, ask them to find someone in-network who works with the specialty you are looking for.  If they can not locate someone in-network with the specialty you need and who has openings to see you- they must offer you an option to reimburse the person of your choice.  There is a law that says insurance companies cannot deny you coverage simply because they do not have an in-network provider that provides that specialty.

If all else fails, ask your chosen provider if they are willing to give you a sliding scale for payment up front- you would be surprised how many providers are willing to negotiate.  Finding someone that you work well with and trust, while it may cost more up front, you will also probably get better quicker so you do the math- say you go to see someone 10 times for $75/ week sliding scale vs. seeing someone who takes your insurance with a $40 copay but since they don’t specialize, let’s estimate it takes twice as many sessions- 20 for you to feel better.  That’s a total of $750 for the first treatment and $800 for the second (plus the extra time in your life you spent in treatment).  When you look at it that way, it’s a no-brain-er.  And, don’t forget, if you have a health spending account through your work, mental health care is covered and reimburseable.

Next it’s time to go ahead and meet with the person you feel comfortable with on the phone and remember- you are a consumer!  As a consumer, you have the right to decide where and from whom you are going to get treatment.  If you go in and see someone and they just are not it- try someone else.  Not all therapists are a good fit for every person.  However, if you find you have gone to meet five different people in search of the right person, you might want to think about whether your expectations are realistic and give the one you found the most helpful another try.

I will be the last person to tell you that all therapists are good, or even the same.  Look for my future post on different kinds of therapists to learn about just how different we can be.  No matter who you see, what is found consistantly in studies about mental health is that it is the relationship between the therapist and the client that is more important than the choice of intervention when we look at whether therapy has been successful.  You have a right to getting what you want from treatment.

Look for future blogs to address red flags when looking for a therapist and when it might be time to move on.  Since I specialize in attachment disorders, I will also be posting about finding an attachment focused therapist.

March 30, 2012 Posted by | thinking about therapy? | , , , , , , , , , | 7 Comments

How to answer tough questions from your kids

The sex talk!  Did you ever try drugs?  How old were you when you first….?

We all dread these questions as parents but we all get them.  So, what to do?  Let me give you the quick 4 step system that I use to help navigate those sticky questions with my children and that I teach to the parents of my clients.

1.  Think through what you would want to say to your child about any things you did that you are not proud of.  Think past denial, denial- your kids know you aren’t perfect and when you lie to them you look bad and they trust you less.

2. Think about the developmental age of your child (this may be different from their chronological age).

3.  Make sure you know what the question is!  How many times have parents had a child ask where babies come from, then launched into a whole developmentally appropriate conversation about where babies come from, only to have their toddler then say they just were wondering if you got babies from the hospital or whether the stork brings them?

4.  Once you have determined the questions, answer only the question your child asked.  See my second step for part of why you want to do this, but another reason why is that with sticky questions, your child may not want to really know all of the answers.  They may ask if you ever tried drugs but they are not ready for a whole conversation about who, what, where, when and why…A simple- I did try them in college but I don’t do them anymore and hope you don’t either- will suffice, unless they ask for more and you are ready to give them more.

As you can see, I am an advocate for honesty.  Children are like little bs detectors.  Their little antennae go up when you lie (just like yours do when they lie to you).  I advocate matter-of-fact honesty with kids.  They will appreciate you for it and will listen more to the part of what you say when you say- I did that, I tried that and I’m so glad I don’t do it anymore.  Or, I never did that, I never tried that and I’m so glad I didn’t.  Be sure to watch your tone- you don’t want to glorify the behaviors or demonize them either.  In many cases your child may be gearing up to tell you something they or a friend have done, or witnessed and by telling a child all the evils, you shut down the next, most important conversation- what if I…?  You know the conversation where you tell them about how to stay safe, and how even if you were disappointed in their choices you would still love them.

Please stay tuned for more parenting tips.  To find out more about me, or my practice please visit my practice website:

March 29, 2012 Posted by | help for parents | , , , , , , , , | 2 Comments

Does my child need medication?

This is probably one of the most frequently asked questions that I get the first time I meet a parent who is planning to bring in their child for therapy.  I am a Social Worker and have a private psychotherapy practice which means I am not licensed to prescribe medication, however, many children I see have taken or are taking medication and I do refer out to psychiatrists, who do prescribe medication, if I believe a child is in need.

The short answer that I give to parents who ask this question is to do what I would do with my own children if I felt they needed medication: try everything else first!  This is just my opinion and it is not shared by everyone in my profession, however, while there was a decade or so that many parents were turning to pills to solve the problems for their children, this is not true today.  I do not mean in any way to offend any parent who has a child on medication, nor do I intend to say that all medications are bad.  I just think it is important to try everything else first.  Now, obviously, if your child is psychotic, they need medication.  More often, I have parents who bring in children who have experienced trauma and are feeling anxious or depressed.  There are many therapeutic techniques that can help with these issues outside of medication.  Before starting medication, I have a few recommendations:

  1. Get a full physical with a doctor that is familiar with depression and anxiety.  Even mania can be attributed to physical ailments such as a thyroid issue, as are depression and anxiety.  Depression is closely linked to vitamin D deficiency and research also supports the use of fish oil to increase Omega-3.  In fact, in a recent talk training I went to, physician Andrew Weil taught us that fish oil and vitamin D, combined with regular, moderate exercise are more effective than medication for depression.  Now don’t go out and do these things because I said so please consult your or your child’s doctor before changing anything.
  2. Start exercising.  In research with a control group who changed nothing, one group that used only medication and another group that introduced moderate exercise 3x’s/week for 20 minutes or more the group that exercised had the best results in treating mood disorders.  For kids I especially love exercise that gets them focused on controlling their bodies, dance, martial arts, qui gong, and yoga are all wonderful.
  3. Look at the food you and your child eat.  I have seen more and more children developing food sensitivities.  The main culprits seem to be food dyes, sugar (you knew that), caffeine, and gluten.  I used to see a kid where you could tell if he got into the pretzels just by looking at him when he walked in the door because his sensitivity to wheat caused him all kinds of trouble.  This is the easiest (and the hardest) one to do because all you have to do (feel free to laugh here if your child is a picky eater like mine) is eliminate each category of food for about a week to see if you see a behavioral change.
  4. Learn to meditate.  Meditation is good for just about everyone.  Even kids can meditate.  Just start small and work your way up to 10-20 minutes at least 3 x’s/ week.
  5. Check out other alternatives.  Acupuncture and reiki- even with children- have both been helpful to my clients.  Don’t ask me what it does I just know it works for many people.
  6. Let’s not forget talk therapy, art therapy, and play therapy are all helpful.
  7. Learn EFT (Emotional Freedom Technique).  I use this tapping technique with most children and adults I work with at some point.  It is easy to learn and you can find out how by contacting a therapist who knows it.  They should be able to teach you in one or two sessions.

Like I said before, medication is not all bad.  I have seen quite a few children who have been helped by it, however, more and more, I and others in my field are looking to try alternatives first and with good reason.  Dr. Weil also pointed out more recent research that points to our bodies adjusting to medication in ways we did not expect.  For example, the study he cited found that people who took SSRI’s to increase serotonin production to treat depression also had the effect that once a patient stopped taking the SSRI, their brain had adjusted to making less serotonin as it became adjusted to allowing the medication to stimulate production.  He also used the example that acid reflux medication, when given to a group of young adults who did not have issues with acid reflux, actually ended up causing acid reflux issues in a significant number of participants after they stopped taking the medication.  Why?  Because their bodies adjusted to producing more acid to counteract the medicine to try to reach “normal” for their body.  My point is, there is still a lot we don’t know about medication, especially for children and that the long-term studies on psychotropic meds for kids just isn’t there yet.  Before putting our children on these medications, please, let’s consider less extreme alternatives.

March 28, 2012 Posted by | help for parents, thinking about therapy? | , , , , , , , , | 3 Comments

How to know when you or your child need a therapist

“I’ve thought about coming in for a long time but it just didn’t seem that bad.”  How many times have I heard these words?  They are usually soon followed by the wish that the individual or family I am seeing had come in sooner.  Many people delay going to therapy because things just don’t seem bad enough.  I would encourage families to start thinking of therapists not only as people you go to as a last resort, but also as a kind of preventative help, kind of like going to your primary care physician when you have a cold.  How often have you delayed taking yourself or your child to your physician only to find out that had you gone sooner you would have been better off- that cold was actually strep, or that cough was really asthma?  Many people delay for understandable reasons, we are all busy, but by going when the problem starts, you can often (just like in medicine) reduce the amount of time it takes to recover from whatever the issue is.  Take depression for example, a person who is in the early stages of depression takes way less time in therapy to get better than a person who has been depressed for years.

Many people worry that once you start therapy, you end up going for years.  While this is true for some people, there are many people who go only a few times and find relief.  In fact, I have had an increasing number of parents calling my practice who just want to come in for a check in and guidance in helping their child adjust to a major change such as a move, or the death or illness of a relative.  Sometimes I never actually see the child, but the parents want someone to help them tailor their response to a distressing issue for their child since, especially if you have more than one child you know every child is different and has different needs.  Once you establish a relationship with a therapist, even if it is short-term, then you can continue to refer back to that person if any issues come up in the future.

Some signs that a person needs to be seen for therapy can be subtle but if they come in groups, you would want to have yourself or your child seen.  They include:

  • a sudden change in mood or behavior that does not seem to be going away.
  • lower grades than usual on a report card.
  • comments about feeling different from other people and not fitting in.
  • excessive worrying or depression.
  • an increase in challenging behaviors and/or bad moods.
  • increasingly disrespectful attitude or tone with parents.
  • sudden interest in death and dying.

If you see two or more indicators from the above list, I would recommend you contact a therapist.

Some indicators in and of themselves that indicate therapy is warranted include:

  • a statement from someone (including young children) that they want to die.
  • any previously untreated significant childhood sexual or physical abuse or neglect.
  • anyone in a family where the parents are separated or divorcing.
  • anyone who is self-harming (self-inflicted cuts, bruises, burns, etc.).
  • anyone who intentionally starves themselves or makes themselves vomit.
  • anyone who has become increasingly agitated and starts to make less and less sense (this could indicate a manic episode and needs to be treated)
  • anyone in an abusive relationship (if you do not know if your relationship is abusive, I would recommend therapy).

When in doubt, just call a therapist in your area.  We all know it is part of our job to speak to people who are just not sure if therapy is right for them or their child.  I have had plenty of people who have called where I have told them they did not need to bring their child in (like the parents who called to ask if a young child playing doctor with another young child needed to be in therapy).  Other times, people have called who have been on the fence and I end up saying if X, Y and Z happen, call back but lets see if some of this self corrects.  For example, sadness over the passing of a grandparent is normal, however if the sadness interferes with daily activities after a few weeks then I would want to see that child.

If you are thinking your next step is to find a therapist, please stay tuned for future posts about finding the right therapist for you and your child and on therapy myths- debunked!

For more information on my practice, please feel free to look at my practice website:

March 28, 2012 Posted by | help for parents, thinking about therapy? | , , , , , , , , | 13 Comments

What to expect from this blog

Are you a parent that feels guilty a lot over things you said or did with your children?  Do you feel guilty over things you didn’t say or do with your children?  Join the club.  We have all been there.  My hope is to make this blog about helping you to find resources to overcome the guilt and shame many parents come to find is a perpetual part of parenting.

My name is Kate Oliver.  I’m writing this blog not only as a parent of two myself, but also as a therapist.  I have been an LCSW-C (licensed Social Worker- Clinical) in Maryland for the past 12 years.  And have worked as a child and adult therapist with a specialization in attachment and trauma.  I am currently in private practice.  Some of the things I plan to write about are: feeling “good enough” as a parent, figuring out how to find a system of parenting that works for you, helping your children with every day issues, helping your traumatized child, caring for your attachment disordered child, parental self care, and teaching your child to love him or herself. I welcome topics people want to hear about.  I also plan on sharing good books and letting you know helpful books I like and the population I think those books would be helpful to.

I find that parents in my practice tend to come to me with similar issues all in a cluster.  For example, in one week, I had several parents find out that their children were using technology in a sneaky way.  I can only imagine that this is an issue for many parents out there.  After all, we are all connected so if your little Suzie is using her alarm to wake her up so she can talk to her boyfriend you didn’t know she had at 3am, somewhere, Bobby’s parents are finding out he was talking to Suzie and he figured out how to do that from Johnny because he was doing it with his boyfriend and so on and so on. When that happens, I will be writing to let you know about the trend and how to handle it.  I will not be writing any information about my clients that would identify them to you only about issues I see in my office, nor will I be able to diagnose or treat anyone online.  This blog is for psycho-educational purposes only. Oh yes, by the way, this blog will be inclusive of all families and all children, if you are trying to make it as a family and help your children to have a happy life, and you would like to be happier along the way as well, please stay tuned!

March 26, 2012 Posted by | Parenting | , , , , , , , | 1 Comment


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