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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.

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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:

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January 5, 2013 Posted by | attachment, child development, discipline, help for parents | , , , , , , , | 10 Comments

PLACE Parenting for Children with Attachment Disturbance

A mother holds up her child.

A mother holds up her child. (Photo credit: Wikipedia)

Written by, Kate Oliver, MSW, LCSW-C

When you have a child with any sort of attachment disturbance, you also have a child that is very good at making you feel like you don’t know what you are doing.  In one training I went to on attachment disturbance, the presenter, Art Becker-Weidman said one of the parents he worked with described it something like this:  ‘It’s like you as the parent are the control station for a radio station, then the kids come up and play with all the buttons until they find one that gets the response they are looking for.  When they find that button that gets them what they want, they just keep flipping the switch over and over again.’  I have used this description with the parents that come through my own practice and find it resonates deeply with them as well.  What to do when you have a child that is constantly pushing your buttons and finding creative ways to make you feel like you don’t have a clue what you are doing?

Daniel Hughes and Art Becker-Weidman are working to popularize a parenting attitude that really can work wonders if parents are able to maintain it when they have an attachment disordered child (or any child for that matter).  It is called the PLACE mentality, it stands for: Playful, Loving, Accepting, Curious, Empathic.  I find that while the words are familiar it can be easy to misinterpret the meanings of those words in this particular context so let’s look at each word to see what we are talking about when it comes to parenting children using the PLACE mentality.

Playful–  The most common misinterpretation of this quality is that parents believe I want them to throw a parade in their child’s honor every time they do something desirable to the parent.  What I mean by playful is just finding an approach that has a less authoritarian tone.  Instead of telling kids where to go to find their glasses, encourage them to play a little game with you where they have to look at your face for them to give you a hint where the glasses are.  When they look into your face and lie, come up with a playful response “That’s a good one.  I’ve always known you were creative.  Tell me another!”  Often being playful can help everyone tone it down a notch.  If you have a child with a history of abuse or neglect, it can also keep them from getting triggered into believing that they are in huge trouble and helps prevent them from going into fight or flight mode so that you have some chance of them hearing some of the words you are saying.  A way to really get playful is to learn from a parent that really gets this stuff.  Christine Moers is a mom raising adopted children with attachment issues.  She posts vlogs on youtube to help other parents (and to keep herself sane).  Her video blog:  http://www.youtube.com/watch?v=HDAALaVG27k&feature=fvwrel is a wonderful example of how to discipline in a playful way.   I would recommend you look at her videos when you need help staying sane.

Loving– When I think of saying things in a loving way to children, what really helps me to stay in that place is remembering my purpose for saying the words in the first place. Yes, ultimately I may be asking my child to do a task because I want it done. But the bigger picture reason for asking children to do a task is to teach them so that they know how to do it, to give them a system for tackling problems, to get them into the routine of caring for themselves and planning how to fit everything into a schedule, or something else like that. In the end, our job as parents is to make it so that our children no longer need us in order to make it through the day. When we remember that we are asking our children to do something because we love them and want them to be happy, healthy adults, we can state requests in a more loving way. By remembering this, I believe the primary change is our tone of voice, which makes a world of difference to children with attachment disturbance.

Accepting– One trap I see so many parents walk into is the argument with their child(ren) about whether their child is having a reasonable feeling or not.  Both the child and parent find this is a way to feel crazy pretty quickly and I would like to present an alternative…acceptance.  Here is how it goes, maybe it sounds familiar:

Child comes down to breakfast dressed in a completely inappropriate outfit for school

Parent (being curious):  Wow, is there something going on at school today?  That’s an interesting outfit.

Child: I knew you wouldn’t let me wear it!  You never let me wear anything I want!  You’re such a witch!  You want me to be the ugliest girl in school!

Parent (accepting):  That made you mad.  I can see how you would be mad if you thought I wanted you to be the ugliest girl in school.

It’s that simple- do not engage in an argument about whether you want her to be the ugliest girl in school!  If that is her belief in that moment, accept that her feeling is appropriate for the interpretation.

Curious– In my office, I often frame this curiosity as being a “feelings detective.”  I tell kids I ask lots of questions because I am a very curious person and sometimes it takes me a while to understand things.  Get curious about your children.  In the above example, rather than arguing about who wants whom to look ugly, you might get curious about it.  “I wonder what made you think I wanted you to look ugly when I asked about your outfit.”  Another way to help with getting kids to understand you are curious (not judgmental) is to say something along the lines of, “I’m curious what got you so mad because I don’t want you to feel that way again. ”  When they tell you what got them mad, again make sure you avoid arguing about whether that is really what happened (accepting) and then …empathize.

Empathy– Empathy looks like this,” If I thought someone felt that way about me/ said that to me/said that about me I can see how you would feel mad/sad/ scared too.”  That’s all empathy is being able to see something from the viewpoint of another person.  Empathy does not involve any discussion about whether someone is right or wrong for feeling the way they are feeling.

So, why does this work?  It works because our children with attachment disturbance find the things we need to do most often, educate, speak with authority, and parenting, to name a few, to be triggers to them of things that remind them of times they were hurt or  neglected.  When kids do not learn the typical role of parents early on, they easily misinterpret the actions of parents.  Using the PLACE mentality is one way of reducing the number of triggers for your child, not to mention that it just makes parenting more fun.  I use it with my own securely attached children as well.  Of course, this is a very quick overview of the PLACE mentality.  It is important that if you feel you are in a position with your child(ren) where you need to utilize the PLACE attitude more and could use support in doing so, that you see a therapist that has an attachment informed practice.

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October 18, 2012 Posted by | attachment, attachment disorder, help for parents, parent support/ self improvement | , , , , , , , , , , , , | 12 Comments

When your inner critic hurts your relationship with your children

Written by Kate Oliver, LCSW-C

We all have an inner critic.  Some of us have several.  You know, that voice in your head that just feels like it is part of you?  It’s the one that tells you that you did it wrong again, you are not working hard enough to fix your child’s problem, and reminds you of all the times you tried and failed to get items knocked off your “to do” list.  If you are not fully familiar with your inner critic, the next time you are upset about something, take a moment to listen to your thought process.  What are the thoughts floating through your head at that moment?  Our inner critic can be harsh…and sneaky.  We don’t even know it’s there, it feels so much a part of us.

I’ve heard our inner critic (or critics) referred to as “the committee.”

Committee

Committee (Photo credit: Editor B)

I love this because it is so true.  Think about the act of going to the grocery store and passing through the cookie aisle.  The committee gets activated!  You hear one part of your committee saying, “Get the cookies you like, you deserve it!”  Another part of your committee chimes in, “Yeah, your butt loves those cookies so much it will hold onto them all the way through summer.”  Then the internal negotiator pipes up, “Maybe there is a new, healthy cookie out that you could try.  Or, if you get the individual packs, you won’t eat the whole thing in two days and you can enjoy your cookies over the next few days, a little at a time.”  Of course then the critic chimes in, “Fat chance…get it?  Fat chance?  Haha.”  And so on.  Even after making a temporary decision to leave the aisle, or put the cookies into the cart, your mind wanders back as you continue through the store, either feeling like you should take the cookies out of the cart, or wondering if you will pass by other cookies and if you will be able to pass them over too.  Is it just me?  I don’t think so, maybe for you it’s not cookies, maybe it’s picking the right birthday card for a friend, or what job to take, the email you are sending to a friend, etc.

When the committee gets involved, we can all empathize with the wish someone stated to me once when he said he wanted to put them on a bus and send them away for the weekend.  Since that is not possible, what is the alternative?  I have one that may surprise you.  Think about loving them.  That’s right, envelop each part of your committee with love and thank it for working so hard on your behalf.  Right now I imagine there are quite a few people reading this who will argue that there is a part of them that is just plain wrong, that it is a part they would like to eliminate completely and that the focus should be on eliminating the “bad” parts.  If you are saying that, here is my question to you…how is that working for you?  I’m guessing that has not been so successful or you would not still be reading this post.   I might suggest that telling them to go away hasn’t been working so well so far.

If you want to try something new, take a moment to reflect on what it is each member of your committee is trying to say to you.  Try to listen to one at a time.  Are they trying to convey important information about your health, safety, or emotional well-being?  Is your committee chiming in about ways to keep yourself or your family safe?  Is it reminding you of something you need to know right now?  I promise you that even the most seemingly destructive parts of you are trying to help you in some way.   When you figure out the message, imagine yourself giving that part of you a hug and thanking it for it’s input, like you would a friend that just told you something that was really hard to say.  Make sure it knows you got the message and that you will take it into consideration.  Often times these parts of us, our committee, can be like any other team meeting where, if people feel like their important message is not being heard they just repeat it over and over again, saying it louder and louder, until people finally take notice.  Your committee may be doing this now.

Remember, listening to your committee does not mean that you will do exactly what they say, but, just like your children, if you take time to really listen to them, and they feel heard, they are more likely to listen when you tell them no, feel good when you agree, and feel less and less like they need to yell to be heard.

If it is confusing when I say to listen to your committee then listen to yourself, since your committee is part of you, that is understandable.  What I mean is, your committee members are all aspects of who you are.  At your core is you.  The you who knows what you really need, the you who is connected to all the love you feel for yourself and others, the you that does not need to judge anyone else, and is the same you that is connected to a higher, spiritual purpose.  Some people call it their higher self.  We all have this, it is the part that tells us we can do this, forgives us our imperfections, and that finds creative ways to solve any issues.  Take a few moments each day to connect with your committee, then to connect with your core, or higher self.  If you worry about fitting this into your daily routine, remember, thinking is free and can be done anywhere.  Even people with young children can take a few minutes a day to sit when the kids are in bed or are eerily quiet in the next room to check in with their inner dialogue.  The process of getting to know yourself and find peace within does not happen in one day, rather, it happens in increments over time.  It takes a lifetime, which is okay, because you have that long to do it.

A word of caution, your committee may try to tell you that doing this is too difficult and to stop or you won’t like what happens next!  Should you hear that warning from your committee, I would urge you to find a therapist to help you navigate the murky waters of your inner workings.  Over time you will find that the process of getting to know yourself can be like finding a long, lost friend that you have been missing desperately for a long time.

Doing this exercise is especially important for parents because, I hate to tell you, our inner dialogue shows to our children whether we like it or not and becomes their inner dialogue.  The best thing we can do for them is to clean up our inner space and be infinitely loving to ourselves so that our children may follow our example.

There are guides for this type of work as well. Self-Therapy: A Step-By-Step Guide to Creating Wholeness and Healing Your Inner Child Using IFS, A New, Cutting-Edge Psychotherapy, 2nd Edition by Jay Earley (Jan 27, 2012) is one such book.  It is available on Amazon and if you click on the Amazon widget link at the top right of this screen you can find out more about it.  Please read my disclaimer page.

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May 9, 2012 Posted by | help for parents, parent support/ self improvement | , , , , , , , , | 6 Comments

Ten Free Ways for Parents to Break Free of a Bad Mood (I’ll bet there are a few you’ve never thought of)

How do they get any work done?

How do they get any work done? (Photo credit: Wikipedia)

Picture yourself, it’s Sunday around 3:00 pm.  You have already watched the children slowly dismantle any progress you made in getting the house into order over the week while they were in school.  They have gone through the playdates, video games, television and 1/2 the board games- as evidenced by the living room floor.  As you think about whether you are up for making dinner and wondering if you even have anything to make, you start to get grumpy.  Okay, you were already grumpy.  Maybe you have already yelled at them a few times and now, in addition to feeling overwhelmed about the mess in your home, you are also feeling bad about the words you have said- not that you are going to stop saying them mind you, because you are stuck in a loop of grumpy, nasty behavior…the same kind you get angry with your kids for having.  Below are a few techniques to help break free from the grumpy nasties and I’m quite sure there are a few you have not tried yet.  Why not print out the full list at the bottom of the post and stick it on your fridge to try out when the grumpies strike again?

1.  Put the kids in the tub or shower or take a bath or shower yourself.  Something about being in the water helps to set the reset button for kids and sometimes adults.  If you are taking a bath or shower, visualize all the angry, grumpy feelings getting washed off of you and watch them go down the drain.

2.  Set up a behavioral chart for yourself (if you get through something without yelling, you get a point and x number of points gets you something like a night out, a new cd you’ve had your eye on, etc.  I cover this one in my post “Ditch Your Behavior Charts!”).

3.  Tap on the inside of your pinky finger and say three times “I forgive myself, I did the best I could do.”  Then, continue tapping and repeat three times “I forgive myself, I’m doing the best I can.”  Don’t ask how it works, it’s an accupressure technique, just try it!  You know a big part of what you are doing has to do with the way you are talking to yourself about what is happening right now.  Think about ways you can forgive yourself- this is one of them.

4.  Imagine you are speaking to someone who loves you, your best friend who always knows what to say, your grandmother, whoever, and pretend they are with you right now guiding you.

5.  Learn EFT.  EFT (Emotional Freedom Technique) is a quick, easy tapping technique that can help in all kinds of different areas of your life.  It addresses anxiety, depression, traumatic memories and much more.  Here is a link to someone teaching EFT.  I would recommend just doing the shortcut he teaches in the first 6 minutes.  It’s all I ever really teach and it seems to be enough.  http://www.youtube.com/watch?v=NPZ-xmj6KTI&feature=related.  If you really want to learn more, check out this site: http://eftuniverse.com/index.php?option=com_content&view=article&id=18&Itemid=21

6.  Do a quick 5 minute spurt of exercise even though it is the last thing you feel like doing right now.  Partly this is just going to break the pattern by doing something different from what you were originally going to do next.  Add to that a quick, natural endorphin rush, and a feeling like you just took care of your body for a moment and it can really do the trick.  A great exercise that we do sometimes in our home that really gets us moving and laughing is playing “Just Dance” on the Wii.  We crack up as we watch each other try to get the moves right.  Just make sure no one gets hit with the remote.  Remind yourself that you don’t have to be at the gym and doing a full workout to get a little benefit from exercise.  See how long it takes you to go up and down the stairs of your home or apartment building 10 times, jog in place, race the kids a few times in the yard.

7.  Cry.  You read that right.  Think of the energy we spend holding back tears when really tears can be quite healing and good.  Even better than crying is crying in a hot shower.  That really gives your body a release.  Your tears actually carry stress hormones, that are otherwise trapped in your body, out of your body.  So, when I say it’s a release, I mean it, you are letting go of stress hormones when you cry.  Also, people worry about crying in front of children.  Unless this is a recurring issue- in which case I think you need to read my post on finding a therapist, crying in front of  your kids a few times a year is okay and actually can teach them about allowing themselves to show feelings and get comfort.

8.  Change locations.  When the kids were little I called them, “I need a witness days.”  I didn’t need a witness for them.  I needed a witness for me.  I needed to go out of the house so that I would be more mindful of how I was acting with my children.  Also, just getting out and going to the park gets you away from some of the compounding factors that may be contributing to your mood.

9.  Accept help.  Remember how you did something wonderful for your friend or neighbor and they were so thankful and told you if you ever needed anything to call?  Call.  Ask for help.  Accept imperfect help from your spouse, partner or friend while you go out to take a walk or clean up so you can feel sane again.  Sure, they may not do things the way you want them to, but are you doing things the way you want to right now?  Right.  Ask for and accept the help.

10. Picture yourself tomorrow, thinking back on today.  What do you want to say you did today when you were feeling this way?  Do you want to say, “yesterday I was in a foul mood and I couldn’t pull myself out of it?”  or do you want to say, “Yesterday I was in a foul mood, then I remembered this list of things to do to get me out of it.  I looked on there and found something and I’m pretty proud of myself because I gathered the children and pulled myself together and we all went for a walk.  The rest of the day went pretty good.”  Once you have pictured what you want to say.  Break it down into three smaller steps, what you need to do to get to feeling that way.

Good luck!  Let me know what works for you, or, even better, add to the list…

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May 3, 2012 Posted by | help for parents | , , , , | 10 Comments

getting insurance to finance specialized therapy

No matter how you feel about the whole health insurance debate in the United States, I think most of us can agree that dealing with insurance companies can be confusing and frustrating.  It can almost seem like the insurance companies have their own special language and code words.  If you have a child in need of specialized therapy, or you are in need of therapy yourself, going through your insurance can seem really daunting and to add to the difficulty,  many specialists no longer deal with insurance.  My hope is that this post will help you navigate the way US insurance companies work so that you can get services paid for (even if they are out-of-network).

Do not let your insurance’s first response, where they say they are not funding an out of network provider, or they say they will but will only pay 20%, throw you off.  You still have options, they just aren’t going to tell you what they are.  Let’s start with a quick primer on insurance “lingo” you need to know:

in-network providers– are providers covered by your insurance company.  If you are going to an in-network provider your insurance company has an agreement with your provider so that they are likely to pay most of the bill except for your regular co-pay.

out-of-network providers– are providers your insurance company does not have an agreement with.  If you are calling your insurance company and they say the provider you are calling about is out-of-network, you will want to ask if you have out-of-network benefits on your plan.  If they say no- do not panic- you have options!

usual customary rate (UCR)- is the rate your insurance customarily agrees to pay for a given service.  When your insurance says they will pay 70% of the UCR that means they will pay 70% of what they normally agree to for that service- which is often different from what the specialist charges.  If your insurance says they cover a percentage of the UCR, ask them what the UCR is for the service you are getting.  If they say $80 and they cover 70% of the UCR, that means they will reimburse you or the therapist $56 and you would be responsible for the remainder of the UCR if you are seeing an in-network provider, or the remainder of the provider’s fee for out of network providers.

Now that you know these terms. give your insurance a call and see what they have to say about the provider you want to see.  Remember to also ask if you have a deductible and how much of your deductible has been covered.  Other insurances have a rate that changes, for example, they pay 20% for sessions 1-5, 40% for session 6-30 and 70% for sessions 31 and above.  Don’t worry, I’ll summarize at the end so you can get all the questions together.

So, what do you do if your insurance company tells you your chosen specialist is not covered? 

Gather the information that makes your provider special.  Do they have special skills and training to help your child that other providers do not have?  My clients that call would tell their insurance I have specialized training in trauma, attachment and adoption- if they are bringing their children for one or all of those reasons- pick only the issues that pertain to you and your child.  Ask your insurance if they have anyone in-network that provides that same level of expertise.  Your insurance is required to find someone with comparable skills within a reasonable distance of your home who has the specialized skills you require.  If they do not, they are required to offer to pay their UCR to your specialist.  If you have a willing specialist, with just a short conversation with your insurance, they can negotiate a rate for services.  I have done this several times now.

To summarize, the questions for your insurance are:

1.  Is (name of the provider) in-network for my plan?

2.  Do I need authorization?- asking the question starts the process if you need it.

3.  If my provider is out-of-network, do you have an in-network provider with the same skills and availability within reasonable distance from my house?

4.  If you do not have anyone in-network, could you offer the provider a single case agreement?

5.  What is my deductible?

6.  What is the reimbursement for this service?

7.  If they mention UCR, what is the UCR?

Remember, if they say they have an in-network provider with the same skills as your specialist, make sure to follow up and call that specialist to make sure they are taking clients because if they are not, you can call the insurance back to report and they need to find someone else or offer a single case agreement.

In case you understand better with a flow chart, I have included one of those below as well.  If you have further questions or would like clarification, please ask in a comment.  This stuff is confusing and someone else probably has the same question!

insurance questions flow chart

April 27, 2012 Posted by | health insurance, thinking about therapy? | , , , , , , , , | 1 Comment

Is Chimpanzee good for your child to see if they are adopted or have lost a parent?

See description on File:Chimpanzee mom and bab...

See description on File:Chimpanzee mom and baby.jpg. I cropped it slightly to remove the original black frame. (Photo credit: Wikipedia)

Written by Kate Oliver, LCSW-C

Just from watching the commercials, we can easily see that  the new Disney movie, Chimpanzee, is going to be all about adoption.  While it is predictable that the movie will have warm fuzzy messages about adoption overall, if you have an adopted child, or any child who has lost a parent through divorce, abandonment, death, etc. it is a good idea to take a moment to consider whether this is a good movie for your child.  Of course we know all children are different and only you can decide what is right for your child so please do not use my post as a replacement for your own judgment since obviously you know your child way better than I do.  Also, spoiler alert, you will know all about the movie by the time I’m done with the post.  My hope is to attempt to address the adoption related issues in the movie so you can make the best decision for you and your family and to be ready for any conversations or feelings it might bring up for your child (and you).

First, let me say, the movie was pretty entertaining for the children seven and up in our group, the youngest (5) got bored half way through and I saw several younger children leave during the movie.  The parents were thoroughly entertained and there were quite a few “aww’s” and chuckles throughout.

The movie starts in an idealic world where little monkeys are taken care of by mommies (no mention of daddies).  Little Oscar and his mom, Esha, are the focus.  Children who were not taken care of by their first mommies or whose first mommies have left them in some way may have some feelings about the portrayal of moms in this part as the idea of mommies taking care of babies is presented as the only way things can go.  I can see how a child who feels bad about having a mommy who did not take care of them might be triggered if they carry residual feelings of guilt or believe it was their fault their birth mother did not take care of them.  Additionally, the mention of dads is not just downplayed, it is completely non-existant in this part of the movie.

Soon, the idealic world of the chimps is threatened by another group of chimpanzees who want to take over their territory.  Esha keeps Oscar safe during a particularly scary time when this group attacks and the movie continues to highlight Oscar’s reliance on his mother and her role in keeping him safe, fed and protected.  Sadly, the other group of monkeys attacks a second time and it is during this attack that Esha and Oscar are separated and Esha disappears forever with the assumption being that only death could keep her away.  It continues to be quite heartbreaking as we see Oscar get harshly rejected by several other female chimpanzees who already have children (triggering for children who have been in multiple foster care placements).  During this time, Oscar tries, and fails, to find his mother.  Obviously, no one is able to explain to him where she is and he is left to fend for himself.  Oscar is sad and lonely and experiences difficulty finding food and caretaking.  Do I need to point out the many opportunities for adopted children and/or children who have a parent that is not in their lives will have to identify strongly with this section of the movie?

After suffering for an intense ten minutes or more during the movie, Oscar begins to follow the alpha male, Freddy.  He begins gently befriending Freddy (there is a good conversation to be had about shadowing adults and learning from thier modeling behaviors here).  Freddy, who it was earlier emphasized in the movie, had no interest in the younger chimps, slowly also begins turning toward Oscar and teaching him to get food.  Over time, their friendship grows and, in a particularly heartwarming scene, Freddy grooms Oscar and lets him ride on his back.

During this portion of the movie, there is no mention of moms and, knowing that I see children with attachment disorder in my practice who work pretty hard to come between their parents and who often punish the mom and complian to the dad (because moms are scary for them since they represent the original abandoning mom), I can see this particular part of the movie reinforcing that behavior a bit.  Additonally, I can see how children who have struggled to bond with an adoptive parent would be triggered to wonder what it is about them that caused them to be first rejected or abandoned by other parents if that is their emotional experience.  Those children who struggled to bond with an adoptive parent may also wonder why it is so easy for Oscar (no internal loyalty struggle here, also no negative behaviors from Oscar) to bond with Freddy and just what must be wrong with them that they have difficulty bonding.

While Freddy and Oscar are bonding, however, trouble lurks nearby, the narrator, Tim Allen, says that while Freddy and Oscar have been building their relationship, Freddy has neglected to protect his area and the other chimpazee group is closing in for another attack.  Freddy senses this and begins to do some team building again.  Oscar feels ignored by his new dad and we see him again feeling lonely because he does not understand why Freddy is turning away from him to take care of other chimps.  This made me think about moms or dads taking care of new babies or other siblings and the triggers that has for many of my adopted children, not to mention kids in step-parent families.

I can see this movie being especially nice for single and/or adoptive dads as it reinforces that dads always protect their children even if they didn’t always know how to parent at first.  I can also see it being an issue for moms and other primary, nurturing caregivers (including dads) who, like I said before, have a child that uses them as a representation of all abandoning people in their lives, and for children who did not have a mother that took good enough care of them before entering an adoptive family.  I would also recommend it for children who are able to articulate their feelings about adoption, parental loss, etc. over children who are still unable, or unwilling to discuss those issues.  Ultimately, it is up to parents to decide what is right for their children.  Either way, in the end, the movie has a happy ending where Freddy and Oscar get to be together and Freddy focuses on Oscar again.

I see multiple opportunities for parents to bring up good conversations for kids about: whether Esha’s disapperance was Oscar’s fault; how Oscar must have felt when the other mom’s rejected him; how Oscar befriended Freddy and whether they loved each other right away; how dads and other parents protect children even though sometimes it is hard to see how (like when they go to work or pay attention to other kids); and why Oscar had an easier time of bonding with Freddy (because his first mom was good at teaching him how to love other chimps).

Have you taken your child to see this movie?  What did you think?  Did I miss anything?  I would love to hear how the experience was for your child.

April 23, 2012 Posted by | attachment, resources/ book reviews | , , , , , , , , , | 2 Comments

Laugh and your family laughs with you

One of the funniest kids I've met while travel...

Written by, Kate Oliver, LCSW-C

After a couple of days of heavy posts, it’s time to lighten the mood.  I’ll post about good programs tomorrow like I said I would, but for now, let’s talk about bringing a little light and levity to our everyday life with our children.  Sometimes, all you can do is laugh…or cry.  I would encourage you to laugh.  Sure, I could tell you about all the research that tells you that laughter is, indeed, the best medicine for many situations, but you can easily look that up, or you can just trust me on this one.  Laugh more.  Build humor into your family system.  Make sure that your children understand your humor (even if they do not like it).  Most importantly, teach your children to laugh at themselves by laughing at yourself.  My younger daughter does an impression of my husband when he is telling her to clean up that is hilarious.  We all laugh, then we clean up.

This morning, when I grumbled at my older daughter to rinse her mouth after brushing her teeth (who doesn’t rinse after you went to the trouble of brushing!?) because I’m tired of paying an extra car payments worth of money every time we go to the dentist, I went up to the bathroom after she went to school and found a post-it note she put up in the bathroom to remind herself to rinse:

In case you can’t read that, it said “RINSE OR DIE!”

Parenting does not have to be a series of serious teaching lessons all put together.  It can be easy to forget this. You can teach, love, learn and grow with fun and laughter.  Have a child that asks obvious questions all the time?  Find a code word, like “marshmallows” that tells them they are asking a question they already know the answer to and use it whenever they ask nonsense questions.

Kid:  “What’s for dinner (while they are staring at you cooking a hamburger)”

Parent: “Marshmallows.”

Kid: “When are we going to get there?” (on a trip they have been on 100 times).

Parent: “When we pass the sign with the marshmallows on it.”

Kid: “Do I have to do my homework?”

Parent: “Just do it until you get to the part about the marshmallows.”

Marshmallow Nightmares!!

Marshmallow Nightmares!! (Photo credit: katerha)

It might drive them crazy, but it keeps you a little more sane while you focus on a fun way to fit more marshmallows into your life.

Laugh together over silly jokes or silly things they say.  Make sure you are laughing with not at.  No one like to feel like people are laughing at them but laughing together as a family brings your family closer and reminds us why we brought these “no-rent paying, mess making little people,”  as my husband likes to say, into your home in the first place.

How do you laugh with your family?  Please fell free to share a funny story that makes you smile 🙂

April 19, 2012 Posted by | help for parents, Parenting | , , , , , | 16 Comments

The Perils of Perfectionism in Parenting

Photo taken by me as an example of a stay at h...

Photo taken by me as an example of a stay at home dad and kids. (Photo credit: Wikipedia)

Written by, Kate Oliver, MSW, LCSW-C

Quite a few recent books have alluded to just how fed up parents are with people expecting them to be the perfect parent.  Scary Mommy, by Jill Smokler, was just released this week and details confessions of real parents who feel all the feelings that go along with parenting that we often do not talk about such as, anger, isolation, depression, fear, and embarrassment.  In this age where so much of what we do is recorded and we see so many recorded images of parents on reality television, it also seems like everyone is judging everyone else’s performance all the time.  When we do this, we can wind up in a seemingly endless cycle of judging others and ourselves constantly without any relief in sight.   In fact, there are several studies that have come out in the past few years stating that parents are significantly less happy than non-parents.  I believe part of this is our unrealistic, perfectionistic tendencies during which the thought patterns can begin to get quite vicious.

My profession has not been much help in making parents feel much better either, I’m sorry to say.  Not only do most of our books focus on what you can do for your children, rather than how to help you feel better so that you can be a better parent, we are constantly telling you how to improve communication with your child, have educationally enriching activities, spend quality time with your children and encouraging you to take constant care of their emotional needs.  While all that stuff is nice and worthwhile in many ways, I think too much of it also takes away the important quality of being genuine with our children, you know, like the genuine feelings expressed in the popular picture book for adults “Go the F@$k to Sleep,” by Adam Mansbach.  If you don’t know that book, take a moment to look it up on youtube and you can listen to Lawrence Fishburne read it to you- when your kids are not in the room.  Really, isn’t that how most of us feel when our children are coming down six and seven times to say goodnight and asking to be tucked in even though we already tucked them in?

Here is what I think many parents are wanting and it is something we hear all the time about everything but being perfect parents… everything in moderation!  Yes, even lovey, touchy stuff.  It’s actually good for the kids to understand that their parents feel- gasp!- genuine emotions.  If you are fakey, fakey all the time and pretend things are nice, they know it’s BS anyway and later they call you on it- I’ve seen it too many times to have any doubt about this.  And you know, many times when our kids call us on stuff they are right.  Has your child ever said anything to you like my daughter when she said, “Mom, that’s what you say when you’re not really listening?”  She was right.  I had no idea what she just said.  That’s the daughter my husband and I joke that someone must have told her in the end she will get paid per spoken word because she sure does act like it.  You bet I zone out the chatter sometimes and maybe even miss important things.  As one of my favorite professors in my Master’s program said, one of the great thing about people is that if you miss something important they said the first time around, they are pretty certain to repeat it.  I know this is true for my daughter too.  Now, don’t get me wrong, remember- everything in moderation, so it is also important to take time to turn on our listening ears for our children every day, but I also want to be realistic that it feels quite impossible to be in the moment and listening to one child while the other is asking you to make them a peanut butter sandwich.

Another reason genuine = good with our children is that they, like us, are humans too!  They are often not perfect and they need a good example of how to recover from imperfection.  I give my kids lots of opportunities to witness imperfection without even trying that hard.  I’m a real natural 🙂  I burn things, forget stuff, and plan poorly sometimes.  Most parents do.  It’s the ones that admit it and give children an example of how to recover via apology, forgiveness of self and others, humor, etc. that have happy, not entitled (another by-product of over-perfect parenting), healthy children with a good sense of who they are and who their parents are.

Dare to be perfectly imperfect!  Your kids will thank you for it.

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April 12, 2012 Posted by | discipline, help for parents, resources/ book reviews | , , , , , , , , | 2 Comments

Parental Reframes When Things Don’t Look So Good

through the frame

through the frame (Photo credit: Wikipedia)

written by Kate Oliver, MSW, LCSW-C

Alright, so you did something you are not so proud of.  Let’s be clear, we’re not talking about major screw ups- like anything that meets criteria for abuse or neglect- we’re talking the overly harsh words or failure to understand the depths of need of our child if they have been trying to tell us about a problem.  You know, the things we routinely beat ourselves up for as parents.  First of all, I want to say (I may have said this before and I will probably say it again because it is such a wonderful statistic) that being “good enough” to support a securely attached child means we meet their needs a mere 30-40% of the time.  This is not meant to give permission not to meet your child’s needs, but serves more to allow us to forgive ourselves when we miss something or respond differently than we would have liked and to see some of the positives in otherwise difficult situations such as divorce, death of a loved one, illness, trouble at school or with friends.  Parental reframes work in all kinds of situations.

What do I mean by parental reframe?  Well, you know how you can take the same picture and put it in different frames to make it look different?  Depending on the frame a picture is in, you may notice more of one thing or another.  Life can be the same way.  A large part of parenting, as I see it, is to help children (and ourselves) find the most appropriate, helpful frame to put our issues in.  Notice, I did not say it was to shield children from all difficult situations.  First of all, that is impossible and we would only be setting ourselves up for failure.  Secondly, you would not want to do that since childhood is precisely the time we need to learn to handle difficulties while we have our parents to protect and guide us.  We are there to help children frame the pain they will inevitably have- not to keep them from any pain.  So, what is a parental reframe?  It is taking a step back to look at the frame we have put around a situation, then asking ourselves if there may be another frame that we might like to use instead.  There really are so few absolutes in life and really our reality can be framed in many different ways.

Take a look at the picture below.

Do you see the baby?  If you are like me, it will take a minute for you to find it but once you do, you will see the baby was there all along.  The toes are in the branches on the right, the head is made where the trees come together on the left.  Once you see it, you can’t un-see it, even though it was there all along.  That’s how a reframe is.  We get stuck on a story: divorce ruins children for example, or maybe even a worry more universal to parents like the feeling that our child never helps around the house.  These times are precisely the times when we need a reframe.

How in the world are you supposed to reframe issues, especially beliefs or worries about your child that feel deeply entrenched?  Let’s start the easy way first.  When you have a few minutes, stop and take a few breaths while you pause to see if you can think about this issue in another way.  It can be easier to do this if you ask yourself what your most loving friend might say about this issue to you.  Ask yourself if it is possible that there may be alternative possibilities from what you have come up with so far.  If you think it would be helpful, take a moment to brainstorm other possibilities for the belief you are clinging to.  After all, this is only a belief and there are very few absolute truths out there.  Let’s take our example of kids that don’t help around the house.  Is it possible they try to help in some ways, just not the ways you wish they would?  Is it possible they need more instruction to help?  Is it possible you are asking (or demanding) for help in ways that are not effective for your children?  Do they have something going on that prevents them from focusing on helping you like their age, ability level, extra-curricular activities, schoolwork, etc?

Next, take a moment to consider what you would like to believe about your child.  Create an affirmation about what you would like to believe.  My child is helpful around the house in many ways.  Think of ways this affirmation is true.  Say the affirmation many times over the next few days.  Point out when you child does helpful things and begin stating ways they can help you as if you expect them to do those things.  Be surprised when they haven’t picked up their items off the dining room table!

Just changing our attitude about a situation can help our children to change theirs.  I have seen this work too many times to think otherwise.  I have many clients with attachment disorders.  Many times when they first come to see me their parents lament about how they are constantly in trouble.  Their parents, who usually adopted them at an older age, often adopted them with the desire to show them how wonderful life can be!  These parents want their children to have new and exciting life opportunities and they come in so frustrated that their children continue to get into trouble that requires the parents to keep them home more over and over.  We reframe the statement of “my child is constantly getting into trouble and can’t ever make good decisions” to “my child gets easily overwhelmed by new experiences and transitions.”  When we re-frame the child’s acting out behaviors from “bad” to “overwhelmed” the feeling as a parent changes significantly as well from a hopeless stance, to protective.  While the child may still not be allowed out to do much, the intent and feelings behind the parents decisions feel more loving and come across that way to the children.

I know this may all sound a bit Pollyannaish to people. Additionally, I do not want to say that a reframe on cleaning is the same as a reframe on divorce.  However, there are helpful aspects to all experiences in life.  If the technique of thinking it through is not working for you, please take a moment to read my previous blog “How to know if you or your child need a counselor” (link below).  Reframes are a lot of what we therapists help people to do.

Having trouble with a reframe?  Let me invite you to post the belief you need reframed, or a belief you have reframed and tell me how it worked.  While I can not diagnose or treat via a blog, I would love to have feedback on this topic (or any others).

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April 10, 2012 Posted by | help for parents | , , , , , , , , , , , | 6 Comments

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