help4yourfamily

Create the family you want to have

Happy Parent Tip #1

English: Houston, TX., 9/8/2005 -- Elementary ...

English: Houston, TX., 9/8/2005 — Elementary school students wave good bye to their parents as they leave the Reliant center for their first day of school in Texas. They are sheltered at the Reliant center and were evacuated from Louisianna. FEMA photo/Andrea Booher (Photo credit: Wikipedia)

written by, Kate Oliver, MSW, LCSW-C

One super amazing thing about my job is that I get to see and learn so much from the parents that I work with. Even before my own children reach a particular age or stage, I have acquired knowledge about the issues that come with a particular time in a child’s life. Over the years I have amassed a wonderful body of learning which has helped me enormously in my own practice as well as with my own children. I feel blessed to have found the job that I have and from time to time, I would like to share some of the tips and understandings that I have come to which have created happier moments for me as a parent and for the parents I have worked with.

Tip number 1 is:

Give your child room to take ownership of their own responsibilities and accomplishments.

Here is a situation I am sure many of us can relate to:

It is time for school. You steel yourself for the daily battle of shoes, coats, and getting to the bus on time. Won’t your children ever learn how to tell time? Don’t they understand that the bus waits for no child and that you have to get to work on time? Within the first month of school you find yourself in the daily cycle of first gently reminding your children of the next step in the morning routine, then, getting firmer with your voice and using your best “I’m serious” tone to get them closer to the door, until you finally get tired of the games the children are playing and either start yelling or start resentfully doing activities they are more than capable of doing had they just managed their time in the ways you suggested.

This is an example of you caring more about your child getting to school than they do. And, really, if you are going to do something and take pride in it, you have to care. As adults we can see this when we go to a store with poor customer service. It is clear that the employees do not take ownership or pride in the running of the store most likely because they have not taken on the understanding that the quality of customer services reflects on them as well as the owners.

Of course it is important to remember your child’s age and developmental stage. For the example of going to school on time a kindergartener, will need much more help than a freshman in high school to get out the door. Also, if asked to in a respectful way, I am all for parents helping children in the morning just as you would want them to help you if you were running late as long as it is not a daily expectation.To illustrate ways you can help your child become more self-motivated rather than allowing you to carry all of the responsibility, you could say any of the following statements that you think would work for your child in a loving way that may cause your child to pause, think and re-prioritize. In the following suggestions I am focusing on elementary school, but they can work well for middle and high school as well although you can expect some verbal push-back.

  • I’m not going to work harder to get you to school than you do anymore. You know what time you need to leave. It is up to you to get to the bus on time.
  • I wonder what else you have to do to get ready for school? (they know the routine already, they have just been allowing you to do all the thinking for them thus far).
  • If we are late, I hope I’m not asked to write a note to excuse you because I won’t be able to do that without telling them why. (You can feel free to fill in the blanks here: Suzie didn’t feel like getting out of bed, taking her shower, etc.) If your child is late after you say this you cannot write an excuse note and you must allow for an unexcused tardy. Otherwise they will know you care more about it than they do.
  • I have had several parents who absolutely needed to get kids on the bus on time for work reasons in the morning who told the school that they were going to send their child in pajamas if they refused to get ready in the morning. These parents would pack an outfit for the child to put on at school. (hint: do not pack your child’s favorite clothes)
  • If you end up driving a child to school, you can have them pay you back for your time later by saying, “I had to use my time to fix your mistake this morning. You owe me the ten minutes it took me to take you to school. Now I need you to….”
  • Don’t forget that when a child has gotten themselves out the door on time, you want to point it out and ask them if they are happy with themselves. Reinforce the good feeling your child has about being on time and point out that there was no yelling, arguing or fussing.

While I know that everything can not be turned so that you help your child find their own initiative for making good decisions (I find it difficult to get children to understand that it benefits them to go to bed on time, for example), there are many times that I see parents, and I include myself in this group, taking on the emotional work for children. Many responsibility issues that cause conflict in families can be eased into in this way, grades, chores, clean rooms, curfews. Sometimes in the process of making our child’s life easier by doing things for them, we can forget that we may also be depriving them of important lessons about taking responsibility for themselves, and learning to manage success and learning opportunities with dignity and a forgiving heart. By stepping back and remembering why we care in the first place, we can realign our own priorities as parents. Ultimately, we want our children to do the things we ask because we love them and we want to learn responsibility etc. so they can have a happier adult life. The best way to do this is to help children see the ways in which taking responsibility is helpful to them, rather than telling them it is important.

What is something you could use help getting your child to take more responsibility for?

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February 28, 2014 Posted by | child development, children, counseling, family, help for parents, kids, mental health, parent support/ self improvement, Parenting, psychology | , , , , , , , | 1 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

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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.

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

A Few Thoughts on Seasonal Affective Disorder

written by, Kate Oliver, MSW, LCSW-C

seasonal affective disorder

seasonal affective disorder (Photo credit: Evil Erin)

This is the time of year when, like many clinicians, I see a spike in the number of people calling for first time appointments. One of the reasons for this is Seasonal Affective Disorder (SAD). SAD can impact both adults and children.

At it’s core, SAD is a kind of depression that occurs at a certain time of year. If you have ever heard people talk about the “winter blues,” they are typically referring to SAD. Two issues I see which keep people from seeking treatment for SAD is that they worry about being put on medication, and that they have normalized feeling blue at this time of year. If this is you, please allow me to educate you about some of your easy, quick, medication-free options that you might want to try.

1. In the United States, there is an epidemic of people who have lower than optimal Vitamin D levels. Vitamin D is that essential nutrient we get from the sun that, among other benefits, helps us to regulate our moods. As people spend more time indoors, and get better about using sunblock and covering their skin in the sun, we also end up getting less Vitamin D in our system which impacts our mood. We are more prone to this in the winter months. Your Vitamin D level is a quick and easy thing to test. If you have a regular doctor, you can contact them and ask them to test you for your Vitamin D levels. If you do not have a doctor, there are in-home kits you can order off the internet.

2. Talk to your physician about a sun lamp. These are special lamps that produce light which mimics the sun and, for people impacted by a change in the seasons, they also help to even out your moods. You can even purchase them inexpensively online.

English: A 30 kHz bright light therapy lamp (I...

English: A 30 kHz bright light therapy lamp (Innosol Rondo) used to treat seasonal affective disorder. Provides 10,000 lux at a distance of 25 cm. Suomi: 30 kilohertsin kirkasvalolamppu (Innosol Rondo) kaamosmasennuksen hoitoon. Kirkkaus 25 senttimetrin päässä 10 000 luksia. (Photo credit: Wikipedia)

3. Take fish oil. Iceland, a nation where people experience shorter days and longer periods of darkness has one of the lowest levels of depression anywhere, why? The eat fish like it’s candy around there! Okay, maybe not like candy, but they do eat a lot of fish and fish oil specifically has been linked to reducing depression. Obviously, you want to check with your doctor before starting this, especially if you have any seafood allergies or if you have any blood related issues especially as fish oil can change the clotting of your blood.

4. Try therapy. You might not have SAD. Just because you experience depression around this time of year it does not necessarily mean you have SAD. I see many people who, around the anniversary of a specific trauma, experience some symptoms consistent with depression. If you have a loved one that passed away this time of year, you might be missing them more. Even if they didn’t pass away this time of year, if you have specific memories linked to this time of year (this happens a lot around holidays), you might be sad thinking about them. Death is not the only trigger, perhaps you experienced the loss of a job, a relationship, or something else around this time of year. If you have not resolved those losses to the point of acceptance, you may just be getting triggered to remember that particular feeling and your brain is giving you a chance to resolve the issue now. I find that seeing a good therapist is essential in this process and that some people who have told me they have SAD have actually, via therapy, addressed and resolved old issues that pop up around this time of year making it so that they did not experience SAD the following year.

For more about Seasonal Affective Disorder from the experts, please check out the link below from Everyday Health.

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November 8, 2012 Posted by | counseling, mental health | , , , , , , , | 10 Comments

Parent Affirmation Monday- 10/29/2012- Love

English: In the End ...

English: In the End … (Photo credit: Wikipedia)

Written by, Kate Oliver, MSW, LCSW-C

This week we are focusing on the second of the parenting characteristics detailed in the PLACE attitude, loving. While it may seem simple to say we must always strive to parent with love, as parents we know that can be hard at times. I find the matter to be simplified if I focus on the true intent behind my interactions with my children, without being side-tracked by the other details.

Take chores as an example, yes, I do want my children to help with the dishes but what is behind that desire? Sometimes the desire we are most connected to when we ask is the desire not to do the dishes ourselves, but we also know that there are times we ask our children to do a chore that we could easily do in less time, with less effort for the child, and less effort for us. So why bother to ask children to do chores at all? Of course we do it because we want them to grow up to be contributing members of society and to any relationship with others. Why do we care about that? Because we love them and want our children to be happy and proud of themselves as they grow into adults. Boiled down to its most essential qualities, our direction toward our children comes, for most parents, from a place of love because we care about them and their happiness.

There are ways to phrase requests or instructions that help our children to know that we are coming from a place of love. One of these ways I detailed in my post, End the Hassle! Tell Kids What They Deserve, in which I describe how to tell kids they deserve a clean room, safety, a healthy body, less stress about school (i.e.- do your homework), etc. Some other statements that put love first with your children:

I love you too much to argue with you about this.

I love you more than I care about what you accidentally broke/spilled/ruined.

I don’t want you to feel any worse than you are going to feel about talking to me this way, let’s both cool off in a separate room…

I love you.

You are special to me.

I was thinking about you today.

I think you get the picture. This weeks affirmation is:

I am loving and loveable and I honor my love for my children by showing them with my words and actions.

Remember, the more you say the affirmation, the truer it becomes for you. If you find yourself slipping, remind yourself that is how you used to talk to your kids before you figured out this way of talking. Forgive yourself, because you probably learned how to talk to yourself and your children the other way from your parents, who learned it from their parents, and so on. Congratulate yourself on trying something new. Good luck!

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October 29, 2012 Posted by | affirmations, help for parents, parent support/ self improvement, Parenting | , , , , , , , | 3 Comments

Suicide Prevention: Determining if Someone is Suicidal

Written by, Kate Oliver, MSW, LCSW-C

Man thinking on a train journey.

Man thinking on a train journey. (Photo credit: Wikipedia)

Over the years, I have talked to many, many parents, partners, and spouses about what to do if you think someone you love might be suicidal. There are really two parts to figuring out about suicide, 1. determining whether someone is indeed suicidal, and 2. if the person is suicidal, figuring out the level of risk and making sure they are safe. I am going to tackle one section a week so stay tuned for next weeks post. I want to state at the beginning of this post that, of course, my advice here is general and should not be substituted for individualized mental health advice. If you absolutely know someone is suicidal, please take them to the nearest emergency room or contact your local mental health hotline. And, if you are reading this post because you have someone you are concerned about, even if they are not suicidal, please do your best to encourage and support them in seeking therapy as soon as possible. There are mental health services available to many in the United States even if you are under-insured or are not able to afford counseling.

Determining whether someone is suicidal

There are times when you absolutely know someone is suicidal, either you found a note, they told you they were, you find them in the process of attempting, etc. But other times it can be more difficult. Sometimes parents tell me they think their adolescent is saying they want to die in order to get attention. If this is happening, please stop for a moment to think how desperate you have to feel about getting attention in order to say this. I want to make sure that you know that, even with young children, any indication that someone is suicidal needs to be taken seriously. Even if you think they are trying to get attention, don’t you think it would be a good idea to give them some if things have gotten this extreme? I’ve actually come to know of quite a few people via the work that I do who have tried to “get attention” by attempting suicide in the hopes that someone would notice them. I wonder how many suicides are just that, someone thinking they are doing something to get attention but they actually end up dying. Pay attention! Here is what I recommend to all parents who tell me that their child is saying they are going to kill themselves for attention. Tell them you need to take any statement like that seriously and ask if they are serious. If they say that they are, take them to the hospital. Here’s the thing, I know you might say to yourself, “I don’t want to waste the time of the hospital personnel” or, “This kid is trying to waste my time.” Take them to the hospital. Tell them you love them and that you have to take this threat seriously. Sit with them for the hours it takes to be seen. If they are not suicidal, they will be so bored and so over it that by the time you have finished with it, they will never want to have to do that again. You will have nipped a nasty reaction in the bud. The alternative when you take them to the hospital is finding out that they were, in fact, serious and you took them right where they needed to be anyway.

Here’s the thing about the hospital. They are busy. They don’t want to take your child, your friend, spouse, etc. unless they think they need to. Just like they are not looking to keep people for any extra time after surgery, they are not looking to take in people who do not actually need to be there, so please do not worry, the person you take will not be admitted unless they need to be, in which case, you did the right thing.

Warning signs

Other times, you may have someone who you care about who you fear may be suicidal and not telling. Maybe they have had a series of unfortunate circumstances or are having a mental health issue, like a depressive episode. Here are some warning signs that a person is more likely to consider suicide as an option:

  • They have had recent loss such as a death in the family, ending of a significant relationship or loss of a job.
  • They have a history of depression. Depression is characterized in adolescents differently than it is in adults. Adults tend to have a loss of interest in their usual activities, difficulty attending to tasks, a sense of hopelessness. In children and adolescents, depression more often manifests as irritability and anger.
  • They have friends or family members who have committed suicide.
  • They have mentioned, even just in passing, that they should just kill themselves, or that they wish they could die. Sometimes they may talk about everyone being better off without them.
  • They suddenly begin giving away important items you would not expect them to give away and seem to be suddenly peaceful after a period of difficulty.
  • They begin to isolate themselves from friends and family members.
  • They have increased alcohol or drug use and/or impulsive or reckless behaviors.
  • They have previously attempted suicide in the past.

If you notice any of these symptoms, please take these next steps to ensure that your loved one is safe. Better safe than sorry, as they say. It is especially true in this case.

Stay tuned, next week I will write about what to do to support someone if you fear they are suicidal. In the meantime, here are a few resources.

National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

American Foundation for Suicide Prevention

How to Know When You or Your Child Need a Therapist (help4yourfamily.com)

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October 4, 2012 Posted by | keeping children safe, Suicide | , , , , , , , | 9 Comments

The Art of Breathing

Written by, Kate Oliver, MSW, LCSW-C

Meditating on Airport Mesa Vortex - Sedona

Meditating on Airport Mesa Vortex – Sedona (Photo credit: Al_HikesAZ)

Based on a question I had from my parent affirmation about breathing last week, and because I teach people the mechanics of breathing several times a week, I decided to take a moment to really break this breathing thing down for everyone. Breathing is the first step in getting connected to our bodies and what our body is telling us.  Before you think that you already know how to breathe, take a moment to ask yourself whether there were any times in the last week where you noticed you had been hungry and meaning to eat for several hours but did not get around to it. Or, alternately, did you find yourself mindlessly eating away at your child’s leftovers as you were doing the dishes? Maybe you realized you needed to go to the bathroom and just did not give yourself the time to take a quick break. If you did any of those, that indicates is that you, like most everyone else, have learned the art of neglecting your body. You or your child may have especially mastered this art if either of you has a history of abuse or neglect.  In order to survive ongoing childhood trauma, people tend to cope by overriding their body’s system for communicating in order to survive the abuse. Anyone with a history of neglect, never learned to listen to their body in the first place. After all, babies learn to continue voicing discomfort because when they do someone responds with caring and, typically, an explanation. It usually sounds like, “Awww, what’s the matter? Are you hungry? Is your diaper wet?” Even before we understand this, we get the message that what we feel matters and that listening to our bodies is important. The attachment disturbed children I see have unlearned this lesson to the point that most of them have an issue with bed or daytime wetting, or soiling. They have learned to take on the neglect that was dealt to them in early childhood. The first step to getting reconnected to your body is paying attention to your breath.

Even if you do not have a history of trauma or neglect, I would argue that the vast majority of us have seen the art of listening to our bodies become devalued over the course of our lives. We are encouraged to “push through” pain, to “get over” discomfort, and to wait or delay gratification. These values all have their place. I’m certain Olympic athletes, world leaders, and good parents are required to do all of these things to one degree or another. Still, taking time to check in with the body that supports your ability to selectively push through, delay gratification, etc. is only fair, and in that spirit, I would like to teach you the art of breathing, which you may have forgotten since infancy.

In a recent training I went to with Pat Ogden, a well-known expert in somatic (body) psychotherapy, she said that our bodies predict what our brains think is going to happen next. Think about that for a moment. What does a child standing like this think is going to happen next?

Sad child

Sad child (Photo credit: Lejon2008)

How about these children?

Children near Pawana Dam

Children near Pawana Dam (Photo credit: santosh.wadghule)

Our breath predicts what we think is going to happen next as well.  In fact, it gives our body a message about preparing for the next step.  To get connected to your breathing, take a moment, without trying to change anything, to pay attention to your breathing. Which part of your body moves when you breathe? Is it your chest? Your shoulders? Your tummy? Your ribs? Most of the traumatized children I see are breathing from their shoulders. Whether or not you were breathing from your shoulders, take a moment to try it. How does it feel? When I say breathing from your shoulders, I mean that when you take the breath in, your shoulders rise. Some might also say it is breathing into your chest. You feel your chest expand, and your shoulders rise. Try that for a moment and see what emotions come up.

Now try this. When you breathe in, think about breathing all the way to your belly. In fact, put one or both hands on your belly. When you breathe in, think of filling your belly with air, like a balloon. When you breathe out, think of letting the air out of the balloon. This may feel awkward and take a moment if you are not used to it. Breathe in, fill the balloon. Breathe out, let the air out of the balloon. You may also feel your ribs expand a bit when you breathe this way. How do you feel now?

Why does the way you breathe matter? Just as the way you hold your body predicts the future, so does the way you breathe. When people breathe from their shoulders, it sends a signal to your body much closer to a fight/flight or freeze reaction. Think of how you would take in a breath just before a car hits your car, or how you breathe when you just went for a strenuous run. You breathe to your chest or shoulders. Your body is working hard to protect you at those times. Now think of how you breathe just before you are going to drift off to sleep. Or, if you have one handy, watch a relaxed baby. You will notice the breaths are belly/ rib cage breaths as opposed to shoulder/chest breaths. This signals to your body that you are calm, and that there is nothing to fear.

English: A sleeping male baby with his arm ext...

English: A sleeping male baby with his arm extended (Photo credit: Wikipedia)

The first step to training your body into understanding that it is not under siege is paying attention to your breath. I teach my clients to do it. I encourage you to do it. I encourage you to teach your children to do it if you see they are struggling. I find simply noticing that a child needs to try a new way of breathing can help to ease anxiety. I introduce it by saying something like, “Can we try something?”or “I’m curious about something. Can we do an experiment?” Then I ask them to play around with their breathing, the same way I asked you to. It often changes the feelings in the room from tense to more relaxed. If the mood goes back to tense, I simply notice it out loud, “Wow, look, as soon as we started talking about that your breathing went back to the old way. What happened?” It gives me the opportunity to help a child or adult explore the feelings that go with the breathing and to teach a way to disconnect from the old intensity of the emotion that goes along with whatever they are remembering or anticipating.

Have you tried this exercise? How has it worked for you?

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August 15, 2012 Posted by | help for parents, parent support/ self improvement | , , , , , , , | 9 Comments

Parent Affirmation Monday- Healthy Eating 7/23/2012

Written by, Kate Oliver, MSW, LCSW-C

Fresh vegetables are important components of a...

Fresh vegetables are important components of a healthy diet. (Photo credit: Wikipedia)

It’s the middle of the summer.  Schedules are out of whack and ever-changing.  We have vacations and might be spending more meals on the go or out at restaurants.  Summer can be brutal to a healthy diet, especially if we take the old approach of telling ourselves what not to eat, instead of focusing on what to eat.  It might not seem like a big difference, but focusing on what to eat over what not to eat can make a big difference.  Think of it as looking for abundance rather than deprivation.  Which sounds better to you?  Try this affirmation for the week to see about getting your health back on track or keeping it healthy.

I nourish myself by joyfully eating healthy foods and sharing them with my family.

What does this have to do with parenting?  Two major things happen as a result of joyfully eating healthy foods.  The first is, of course, setting a good example for your children.  Then, when you talk to them about the importance of healthy eating, they are more likely to listen.  I have picture up in my office that says:

Children often fail to do as we say but seldom fail to do as we do.

It is so true.  Second, eating healthy foods is an important, and often overlooked part of regulating emotions.  Have you ever noticed that you were in a foul mood because you were hungry or ate junk all day?  Later this week, I will be posting about what to do when your child is acting just plain nasty and take a closer look at some of the ways food can play into foul moods.

One sticking point I know some parents will have with this affirmation is the feeling they have about children who refuse to try healthy food.  I have one of these in my home.  I am not asking you to pretend this is not a struggle.  I am asking you to reframe this issue.  Rather than focusing on what your child is not doing, I would encourage you to model what you are doing, eating healthy, feeling good, looking at healthy foods with excitement and savoring the way they taste.  By doing this, you greatly increase the chances of your child following suit.  If you do not feel excited about the healthy foods you are eating, perhaps you are eating the wrong healthy foods for you.  While I am not a dietician, I do try to be aware to these things and I can tell you a simple rule I have learned: if it has been processed and comes in a package, it is not as healthy as something that was picked and sent right to your grocery store, roadside stand, or, best of all, came from your vegetable garden.  One resource I have come to trust is the website Everyday Health.  If you are looking for more information about making healthy food choices, I would suggest you check them out or go to your family physician for resources or referrals.

What healthy foods do you enjoy with your children?  Please share any ways that you have been creative in finding healthy food choices for you and your family.

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July 23, 2012 Posted by | affirmations | , , , , , , , | 19 Comments

Preparing Children for Major Transitions

Summer Camp 2010

Summer Camp 2010 (Photo credit: Olds College)

Written by, Kate Oliver, MSW, LCSW-C

It’s summer.  Anyone with a child in school recently has, or is about to experience a major transition from having the school routine schedule to a summer schedule.  Perhaps your children have camps, vacations, different childcare arrangements, or long stretches of time at home, or, if you are like my family, a combination of all of those depending upon the week.  Even though summer can be a time of excitement and activities that children love, remember, even something exciting can be stressful.  To illustrate this, think about the last time you went on vacation.  Did you experience any stress before you went away?  Did you worry you were going to forget to pack something?  Did you have to work to make sure you stayed in budget or planned accordingly for activities vs. rest?

Even though your child does not necessarily have the same stressors you do, they have others.  Their stressors may include concerns like whether any other kids they meet on the trip or at camp might like them, whether this is going to be a fun place to go or not, whether the rules will be the same or different for them than what they are used to, whether they will have the food they like to eat on the trip, and what to expect next.

The adopted children I see can often have additional concerns such as whether someone from their birth family might spot them (I have heard this even from children adopted at birth), whether people in public will spot their family and ask why they look different or whether their family will be accepted.  They may worry if they are going to see relatives that they feel treat them differently from children born biologically into the family, or that their adoptive family is planning on leaving them in the new location.  Many of the children I see have the additional worry about embarrassing themselves by wetting the bed or their pants during the day if that has been a problem for them.

So, how can we prepare children for all of these transitions?  Here are a few tips to get you started.  The first few are for everyone, then I have a few special tips just for people with children with attachment issues.  Remember, every child is different.  That is why I am giving you several suggestions.  I encourage you to use those that feel right for you and your child.

1.  Prepare your child by telling them in a matter of fact way about what to expect.  For example: “Remember, you are going to camp tomorrow, I don’t know if you will know any of the kids there but I do know Ms. Suzie from last year will be there again.  I’m going to pack you an apple and some cereal in your lunch instead of a peanut butter sandwich because the camp does not allow peanuts in your lunch.”  Or, “We are going to Grandma’s.  Remember, we went there last year and you slept in the same room with your cousin Joey.  Sometimes you got to go to bed later and one night Aunt Cindy is going to watch you while Mom and Dad go out.  If two adults tell you two different things to do, I want you to come ask me if you are confused.  If I’m not there, I will always let you know who is in charge.”  You may need to break this information up into several conversations if you have a child that has difficulty taking in too much information at once.  I also like to ask children what they heard me say so I can hear them say it back and confirm that they heard what I think I said so I know if they got it.

2.  Always let children know who is in charge if you are not with them.  Meet the camp counselor, introduce your child to them and point out that that person is in charge.  “She’s in charge of this camp and I expect you to listen to her.”  Or, “We are going out and you are staying with Nana and Pop, I expect you to listen to both of them.”

A side note about tone here: I am not suggesting any kind of accusatory tone.  I always recommend a matter of fact, friendly tone that takes into account that our children are little humans with feelings.  I could see the above statement being said in an accusatory way and I hope you will refrain from that as much as possible.  If you have a child that has attention or attachment issues making it possible that they were not hearing you, or that they will pretend they did not hear you later, you can have them repeat it back.  Make it a game: You: Who’s in charge?  Child: Ms. Jenny’s in charge.

3.  Talk to your child about any transitions before they happen a few times so you can figure out if your child has questions that are causing anxiety so that you can get answers for them.  It is difficult to predict the ways in which children will formulate stories to fill in the gaps in their understanding.

When I was around 13 and my youngest sister was five, my family moved to a house about five miles away from the home we were living in.  I remember one night at dinner, we were talking about the move and someone asked my sister if she was excited to be moving.  She hesitated and got a little teary, then blurted out, “Yes!  But, I’m going to miss you guys!”  Remember, even if your child has made this transition before, it may only be their second or third time doing it.

A year in the eyes of a child is infinitely longer than a year in the eyes of an adult.  For a 33-year-old, a year is 1/33rd of their lives, for a four-year old, a year is 1/4 of their lives.  That’s a big difference.  A lot happens in the year of a child, and going somewhere, like a camp or vacation, where they have not gone for a year still qualifies as a major transition in their eyes.

4.  While you are making sure that you are talking about the upcoming transition some, I want to caution you to refrain from talking about it too much.

Recently my family and I went for a vacation weekend to a child friendly hotel/amusement park.  While we were there, my husband and I walked through the lobby where there was a show going on.  The show had animatronic characters singing a song.  I can only assume the song was called “There’s Nothing to Be Afraid Of.”  I assume that was the title of the song because the characters sang that line at least twenty times in the short time we were walking through the lobby.  I turned to my husband and remarked that while I was not scared before, I was thinking I might need to be scared now!  After all, why are they so adamant about telling me that there is nothing to be afraid of unless there is, in fact, something that might be kind of scary?

My point is, I have seen many parents who are worried about their child’s response to something new, prepare their child by talking about it endlessly.  A child who might not otherwise have been so worried, can then become fearful and put more energy and focus more anxiety on this thing Mom and Dad seem to be so worried about…it must be big.  Discussions about a transition need not be endless, just check-in, answer questions gently and matter-of-factly, and refrain from shaming or embarrassing children for asking what you think is a silly question.

I have two additional tip for parents with attachment disturbed children:

1.  Attachment disordered children still need safety and predictability, however, be mindful that they can often find ways to mess up vacations for themselves and put extra strain on the family by acting out when they are anxious.  Often a child worries they will mess up a vacation until they torture themselves internally about it so much that they go ahead and get in trouble just to get it over with.  Depending on your child, you may want to keep some things about a vacation private until just before they happen and to keep your plans flexible.  For example, say you have decided to go to a water park for one day during the vacation.  If possible, give yourself a window of days and times to go.  That way if your child is having a rough day you can just go the next day so they do not feel you are taking it away because they ruined things.  Then, on the day you do go, you can tell your child that morning or even on the way there and field questions as they come.  Children with attachment issues can get overly anxious and have temper tantrums as their anxiety builds and giving them a few surprises can actually save them from this anxiety in the long run.  Reserve this for things you are all doing together, do not surprise your child by telling them you are leaving them with someone else, even someone else they like.

2.  Be mindful that as you tell a child your expectations, you are not also handing them “the keys to the kingdom” as one of my colleagues likes to say.  What she means by this is that attachment disordered children are interested in what makes you the most upset so that they may use that against you whenever they are feeling anxious, insecure or fearful.  Be careful that when you are telling them your expectations as detailed in the suggestions mentioned earlier that you are not also highlighting the things that will annoy you the most if they do them.  “We are going to grandma’s and she is making cookies.  You may have two.  I expect you to use your manners.  If there is something you would like to have, please let me know so I can tell you if it is okay,” is very different from, “We are going to Grandma’s house.  No stealing, no lying.”  The first example encourages children to meet expectations, the second informs the children of the ways they can disappoint themselves yet again.

For all children, stating what you do want is always preferable to stating what you don’t want.  If I told you not to look at the title of this post, what is the first thing you think about doing?  Reading the title of course!  However, if I said to you that I hope you keep reading this post to the end, where is your attention?  Children are the same way.  High energy children, and attachment disturbed children are like this more than others and if you say, “Don’t steal,” their little minds say over and over, “Don’t steal.  Don’t steal.  Don’t steal.” until they have thought it so hard they find a chocolate bar in their pocket that they really may not have meant to have there.  If you give a child another thought such as, “Ask me if you want something,” and they say this over and over in their heads, even if it does not always work out, it plants a better seed in a child’s mind.  The more seeds like that you plant, the more likely they are to take root.

What are some transitions your children are going through?  Are there other ways you help your child with major transitions?

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June 21, 2012 Posted by | attachment disorder, child development, help for parents, Parenting | , , , , , , , | Leave a comment

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