What to do when they stop listening

What to do when they stop listening
4 votes

You don’t have to feel this frustrated.

At some point in their development, all kids stop listening. It’s frustrating but normal. There are lots of good advice for getting normal children and teens to listen, or at least follow the rules and directions given by the parent.But it’s different when your child has serious behavioral disorder, and when their behaviors are extreme or outright risky. Your priority may be to prevent destructive behavior and family chaos when they hate you, blame you, or are willing to take extreme risks. Then who cares about the dishes or homework?

First things first, avoid upsetting yourself.

Avoid repeating things over and over, raising your voice, or expressing your frustration. It really matters.  This stresses you as much as it stresses them. Children and teens with disturbances have a hard time tracking, and it may be pointless to expect them to listen. Your child or teen is overwhelmed by brain noise and does not hear even hear you.

But what if they are refusing to listen?  That’s a different issue.  They ARE listening, and they are definitely communicating back to you.  This is resistance and defiance.  (see Managing resistance – tips and advice )

Things to do when they stop listening

Use technology: texting and email.

This mother should be texting her daughter instead

This approach is so simple and so effective that therapists encourage high-conflict parent-teen pairs to communicate exclusively using email and texts, even if the parties are in close proximity, like at home together! Think about this. You are using their chosen medium; you can keep it brief and concise; both you and your child have time to reflect on your response. Your conversation is documented, right there for both of you to track. No one is screaming or repeating themselves.Word of caution
Watch what you write. Don’t use emotionally charged words or tone. Be sure to read texts and emails over and over before sending! “The Journal of Personality and Social Psychology 2006 revealed that studies show e-mail messages are interpreted incorrectly 50% of the time.”

Move somewhere closer or farther, change your body language
Instead of communicating with your voice, use your body. For some children and teens, an arm around their shoulders calms them quickly. Or try standing calmly and quietly. Or put some distance between you and your child’s personal space, even if it means stopping and getting out of the car and taking a short walk. Experiment to see what works for your situation.

Use a third-party
Maybe you are the wrong person to carry the message and settle a tense situation. Don’t be too proud to admit that, for whatever reason, your child will not listen to you no matter how appropriately you modify your approach. So use a substitute or third-party. Is there another person who has a better rapport and can convince your child to complete a chore, do homework, leave little sister alone—a spouse, a grandparent, a teacher or counselor, a therapist? What about a friendly animal, live or stuffed? For young children, you can bring out Kitty and ask her to tell Joey that mommy and daddy only want him to do this one simple chore.

Draw a picture, make a sign

As a young child, I recall my parents hounding me for something, I don’t even remember what.  Then they’d ask, “What do you want me to do, draw a picture?” Well, yes in fact, I understood pictures and they didn’t frighten me as much as my parents yelling at me. Pictures and signs work, put them up where the family can see them (and your troubled child won’t feel singled out).  Maybe a funny comic gets a point across in a non-threatening way.  Some sign ideas: “It’s OK to be Angry, not Mean,” “STOP and THINK,” “Our family values Respect and Kindness,” “This is a smoke-free, drug-free, and a-hole free home.”

Time outs for you
.
Take your own sweet time to calm down and think things through what to say when you’re challenged by your offspring. Consider how you’ll respond to swearing. Put him or her on hold. Don’t return texts or email right away, “I’m busy and I’ll reply in 30 minutes.” Be specific on time, then follow through, or they might learn to blow you off with the same casual phrase, expecting you to forget. 

A Precaution

Watch your tone of voice
From infancy, we are wired to pick up emotions in the voice—it’s literally in our brain.  Your tone is very powerful and can be calming or destructive. Think about asserting strength and caring in your voice without lecturing. Be assertive but forgiving. Be firm and not defensive. Don’t get caught apologizing for upsetting your child or justifying your rules. 90% of parents know the right thing to say, but its common to say it the wrong way.

Is your child bullying you with their behavior?
I’ve observed child verbally bully and abuse their parents. This is not communicating and not negotiable. You have options for standing up to this without making things worse. Temporarily block their email or calls, or ignore and let them go to voicemail. Declare bullying unacceptable. Pull rank and apply a consequence. You cannot let their harassment continue because they will use it on others.
About that mean-spirited voicemail or email.
When you get an ugly message, tell yourself you are hearing from a scared, frightened person, and you’re the one whose feelings they care about the most. See this as a good thing. They are trying to communicate but it’s mangled and inappropriate. You want them to stay in contact and engage with you even if its negative. When a disturbed child stops communicating is when you must worry.  It hurts, but your hurt will pass.  You can handle it.  They will still love you , and some day they will show you.  Be very patient.
If the things they communicate hurt.
It is best that you take your feelings out of the picture and seek other sources of affirmation and support—this can’t come from your child. If they write “I hate you,” maybe they are really saying “you make me mad because you are asking me to do something I can’t handle now.”

Good luck out there,
–Margaret

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Coping with grief when a child attempts (or completes) suicide

Coping with grief when a child attempts (or completes) suicide
4 votes

In the US military, the Purple Heart medal is awarded to a soldier who is wounded in battle, or who later dies of those wounds.

In the years of writing this blog, I have shared practical information on behavior and treatment, and offered encouragement and hope for parents.  But hope and information cannot soften the impact of this horrible statistic:  The mortality rates of teens with mental disorders are 3 to 4 times more deadly than most childhood cancers, and the statistics only measure those deaths by suicide:  Mental illness more deadly than cancer for teens, young adults.

Death by suicide seems especially tragic because it appears to be a choice, and while we tell ourselves that mental illness is the cause, it’s not the same as a car accident being the cause or a tumor being the cause.  Unsuccessful suicide attempts are no less traumatic, like a cancer that keeps returning, because you can’t come to terms with a “maybe.”  A parent is held hostage by the anticipation of loss, a relentless moment-by-moment fear that your child will attempt again in the future until they are successful.  It’s an emotional ride one’s subconscious never ever forgets, and it becomes your PTSD.  You can carry it quietly with you for decades, until a sneak attack, when you find yourself overreacting to a news story, a scene in a movie, or a conversation with a friend.

My PTSD ambushed me recently.  I was attending an evening class when suddenly a person next to me slammed down her cell phone, exclaimed “Oh my God!” and quickly grabbed up her things and dashed out.  I followed to check on her and see if I could help with something.  As she speed-walked to her car, she said her daughter had texted that she swallowed a poison because she was upset, but is now sorry and wants help.  I got back to the classroom in shock, trembling, and completely unable to focus.  It had been many years since I had received a similar message, but it felt like it had just happened again that moment.

You are not alone if you’ve ever secretly felt it would be a relief if your child ended their life, bringing peace to you both.  (And you wouldn’t be a bad parent, either)

But death is more than self-inflicted suicide.  You face a death of hope when child with a serious mental disorder that takes a long slow trajectory through addictions, high risk behaviors, and unstable reactions to life’s many insults.  Families like ours bear witness but can’t intervene, or interventions don’t work.  All we can do is wait and hope and do what we can for our child, day by day, and banish thoughts of a different future.  I consoled myself with the knowledge that my child was getting by, and getting by was enough.

Another type of death caregivers face is the loss of their child’s “self” as they knew it, and their future as they imagined it.  A mentally ill child or teen can morph from a fresh young person in a world that is wide open to them, to a scary being we don’t recognize as our own and cannot understand–a stranger, a changeling, a flame snuffed out too soon.  It should not be this way.  It is unfair.  It is a tragedy.  You start healing the grief when you are able to make the commitment to do the best you can anyway.  YOU HAVE EARNED YOUR PURPLE HEART.

Any serious medical condition can devastate and traumatize a child’s family, but those with mental disorders impose a complicated trauma that’s hardly possible to resolve.  The following stories are actual examples.  Ask yourself:  how does one be a loving responsible parent in these situations?

–  When her daughter attempted suicide, an overwhelmed single mother discovered that her son had been sexually abusing and cutting her for 3 years, right under her nose.  The guilt she felt was quadrupled by the guilt laid on her by others.  She didn’t know how to go forward as a mother from here, after loving but failing both children.

–  A teen girl attempted to hang herself in a very public place, and many found out about it before her parents.  Their first trauma was the call from the emergency room, their second was from the shower of doubt others laid on them:  Where were you?  Why didn’t you help her before it got this far?  What did you do to drive her to this?  And it was unending.  The daughter threw these doubts back at her parents repeatedly.  There were several inappropriate people in the community who wanted to “rescue” the daughter, including a teacher, but undermined the parents’ authority completely, and their ability to get treatment for the girl.

–  One couple devoted themselves to raising a difficult boy they adopted when he was 2.  At 9, after years of problems, he sexually assaulted a playmate, and they found themselves disgusted and repulsed.  The brokenhearted mother said she had long ago accepted that her boy would never be normal, but this was different.  She didn’t want him anymore.  (I’ve heard parents talk half-jokingly about taking their offspring to Nebraska. *)

You are not alone if you’ve ever secretly wanted your child to be taken away to never live with you again. You are not alone if you feel you’re DONE.  (And you would not be a bad parent for thinking this.)

Consciously keep the good things alive.  Display photos of the real child you know or knew, the one without the brain problems.  Keep their writing or artwork or tests scored A+.  Other parents experiencing a loss do this, whether the losses are from death by disease, or death of self due to brain damage from an accident.  Speak often of the good things they were or are, as any proud parent might, keep the memories alive.

Get out of your trance and take yourself back to here and now.  When you notice yourself caught up in a train of thought and obsessing on your fear or paranoia, get back in the room—get back to driving that car or attending that meeting or straightening the house.  Get back to noticing the people you love, get back to making those helpful plans.  Central to the philosophy of dialectical behavioral therapy (DBT) is the concept of “Mindfulness.”

Remember this wisdom: take one day at a time.  You can handle one day, you can keep cool, do what must be done, feel accomplishment, in one day. Don’t think farther ahead.  Since you are the linchpin, the one holding up the world, you probably don’t have the luxury of taking a break, and may have to hold things together until there is time for your own healing.  The one-day-at-a-time approach is imperative.

When you’re leg is broken, you need a crutch.  When you’re heart and mind are broken, use the “crutch” of a medication for depression, anxiety, or sleep.  Do other healing things for yourself, whether exercise or therapy or asking for comfort from friends.  Acknowledge your wounds and admit this is too much handle.  You have earned your scars from bravery, so wear them as the badges of a hero.

A tragic event does not mean a tragic life.  I know a mother whose son completed suicide as a young adult in his 20’s.  She seemed remarkably cheerful and at peace with this.  She spoke lovingly of him often, and her email address comprised his birth date.  She continually did her grief work, was active in a suicide bereavement group, and often offered to visit with families facing such a loss.

— Margaret

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*  In the United States, in 2008, the state of Nebraska enacted a “Safe Haven” law to reduce the tragedy of infant child abuse and neglect.  The law allowed anyone to anonymously leave a child at a hospital with the promise that child would be cared for.  But something unexpected happened.  Parents from around the nation drove hundreds and hundreds of miles to leave their troubled older children instead.  Nebraskans eventually amended the law with strict age limits for infants only.

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The 12 Commandments for Parents of Children with Behavioral Disorders

The 12 Commandments for Parents of Children with Behavioral Disorders
3 votes

  1. Thou art thy child’s best and most consistent advocate.
  2. Thou hast valuable information about your child. Professionals need your input.
  3. Thou shalt put it in writing and keep a copy.
  4. Thou shalt not hesitate to contact a higher authority if you can’t get the help you need.
  5. Thou shalt keep records.
  6. Thou shalt seek out information on your child’s condition.
  7. Thou shalt have permission to be less than perfect.
  8. Thou shalt not become a martyr, thus, thou shalt take a break now and then.
  9. Thou shalt maintain a sense of humor.
  10. Thou shalt always remember to tell people when they are doing a good job.
  11. Thou shalt encourage thy child to make decisions, because one day, he or she will need to do so on their own.
  12. Thou shalt love thy child, even when they don’t seem lovable.

– – – – – – – This is a revised version of “The 12 Commandments…” published by the Pacer Center (Parent Advocacy Coalition for Educational Rights) for children with physical and medical disabilities. www.pacer.org.

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Brace yourself for borderlines

Brace yourself for borderlines
16 votes

Are you ready to bang your head on a wall?  Do you want to abandon your child in the wilderness?  Are you praying for the day they turn 18, when you can change the locks on your doors?  Children with borderline personality disorder (BPD) bring out the worst in everyone around them.

A borderline child or teen is not a “drama junkie” on purpose.  There brain is primed to overreact.

Yes, BPD kids really believe that others are out to get them, and that all their problems are someone else’s fault.  They are appalled that others mistreat them horribly.  They are insulted and defensive when they detect criticism, even when there isn’t any.  They can never be pleased, and it’s always about them.  Most exasperating for you, they turn from monstrous, to sweet and charming, and back to monstrous in an instant.

“Does this explain why I can go from 0 to 60 in two seconds?”
–17-year-old girl when told she was diagnosed with borderline personality disorder

Especially confusing, a borderline teen can be very engaging and affectionate… sometimes at random, and sometimes when they want something.  They will also turn on the charm to embarrass you in front of others (such as in family therapy).  Since they seem so wonderful to other people, you are asked why you get upset at your clearly wonderful child.  People often recommend that you take care of your own issues instead.

Even though their manipulation and upheaval is relentless, strive for compassion.  Trust me, your borderline child will suffer more than you in every important aspect of life.  They make a mess of their relationships because of their anger, instability, substance abuse.  Their clingy behavior is annoying.  They drive away good friends, hate them for leaving, and then suffer from loneliness and depression.  They make a mess of their jobs, often fired or forced to resign, and bounce from one to another… and they don’t understand why it happens to them.

For goodness sakes, why?

When playing a game that requires teamwork, the brain of a normal person shows activity in the bilateral anterior insula.

 

The brain of a borderline person, when playing the teamwork game, showed no activity whatsoever.

A study published in 2008 in Science showed that brain activity in people with borderline personality disorder was abnormal—their brains lack activity in the ‘cooperation’ and ‘trust’ regions, called the bilateral anterior insula.  Borderline personality patients do not have an internal, natural sense of fairness and social norms, and little to no level of trust.

Statistics

One research study reported that borderline personality disorder occurs as often in men and women, and sufferers often also have other mental illnesses or substance abuse problems.  (In my personal observations over many years, teenagers with borderline personality disorder are often diagnosed with bipolar disorder.) Another study reported, “The disorder occurs in all races, is prevalent in females (female-to-male ratios as high as 4:1), and typically presents by late adolescence.”  It is estimated 1.4 percent of adults in the United States have this disorder.

In infants:  the children who were later diagnosed with borderline personality were more sensitive, had excessive separation anxiety and were moodier. They had social delays in preschool and many more interpersonal issues in grade school, such as few friends and more conflicts with peers and authorities.

In teenagers:  they are more promiscuous, aggressive and impulsive, and more likely to use drugs and alcohol. Cutting and suicide are more common.  “…research shows that, by their 20s, people with the disorder are almost five times more likely to be hospitalized for suicidal behavior compared to people with major depression.”

 

Evidence for hope

“Trying to Weather the Storm” (excerpt)
Shari Roan, September 07, 2009, Los Angeles Times

“Borderlines have the thinnest skin, the shortest fuses and take the hardest knocks.  In psychiatrists’ offices, they have long been viewed as among the most challenging patients to treat.

“But almost 20 years after the designation of borderline personality disorder, understanding and hope have surfaced for people with the condition and their families.  Advances have been made in recent years.  Researchers from McLean Hospital in Massachusetts studied 290 hospitalized patients with the condition over a 10 year period:  93 percent of patients achieved a remission of symptoms lasting at least two years, and 86 percent for at least four years. Published in The American Journal of Psychiatry, the research argues that once recovery has been attained, it appears to last.

“Having a relative with BPD can be hell,” says Perry D. Hoffman, president of the National Education Alliance for BPD http://www.borderlinepersonalitydisorder.com.  “But our message to families is to please stay the course with your (child) because it’s crucial to their well-being.”

Treatment

“What Therapy Is Recommended for Borderline Personality Disorder in Adolescents (13-17 years)?”(excerpt)
Mary E. Muscari, PhD, August 9, 2005, http://www.medscape.com/viewarticle/508832

Psychotherapy is the primary treatment of BPD, specifically long-term dialectical behavior therapy (DBT), which helps the person attain and maintain lasting improvement in their personality, interpersonal problems, and overall functioning.  DBT appears to be the most effective.  It focuses on coping skills, so patients learn to better control their emotions and behaviors. This may be complemented with medications that help with mood stability, impulsivity, psychotic-like symptoms, and self-destructive behavior.

There are several appropriate therapies in addition to DBT, and all share common elements:  1. The bond between the patient and therapist is strong.  2. Therapy focuses on the present rather than the past, on changing one’s behavior patterns now regardless of how patients feel about the past or if they see themselves as victims.

On DBT:  I recommend this straightforward self-help lesson to get started learning the concepts and skills:  http://www.dbtselfhelp.com/html/dbt_lessons.html.

When to hospitalize

  • In an emergency – when your child has serious suicidal thoughts or an attempt, and/or is in imminent danger to others.
  • In long-term residential care – when your child has persistent suicidal thoughts, is unable to participate in therapy, has a life-threatening mental disorder (e.g. bipolar), continued risk of violent behavior, and other severe symptoms that interfere with living.

Other treatment a borderline may need:

  • Treatment for substance abuse.
  • Therapy that focuses on violent and antisocial behaviors, which can include emotional abuse or physical abuse, baiting, bullying, and sexualized behaviors.
  • Therapy that focuses on trauma and post traumatic issues when an adolescent loses their sense of reality.
  • Reduce stressors in the young person’s environment.  Most adolescents with BPD are very sensitive to difficult circumstances, for examples: an emotionally stressful atmosphere at home; teasing in school; pressures to succeed or change; consistent rules; being around others who are doing better than them, etc.

What parents and caregivers can do

With a partner or spouse:  Maintain a united front.  Communicate continually to stay on the same page when managing your child and setting limits.  Have each other’s back even if you’re not in full agreement.  Always take disagreements out of earshot of your child.  Any disagreement they hear will be used against you.

Maintain family balance.

Keep your energy in balance so you can maintain your family's foundation.  Too much spent on your child affects everything else your family needs to survive.

Keep your energy in balance so you can maintain your family’s foundation. Too much spent on your child affects everything else your family needs to survive.

 

Keep things relaxed.  If you need to set boundaries and apply pressure, do it only to maintain  appropriate behaviors and reminders for self-calming.  Let other things go.

Use praise proactively.  Borderlines crave attention and praise.  When they deserve it, pour it on thick.  And pour it on thick every single time they demonstrate good behavior and positive intention.  One can’t go too far.  When an argument or fight comes up, search your memory banks for the most recent praiseworthy thing they did or said, and bring it up and again express your gratitude and admiration.  This does two things:  it reinforces the positive;  and it redirects and ends a negative situation.

Become skilled in DBT and help your child stay in the here and now.  Keep up the reminders that enable them to stay in the moment, to take those extra few seconds to think things through before reacting.

  • Did your friend really intend to upset you?  It sounds like they were talking about something else.
  • The delay wasn’t planned just to make you mad, perhaps you were just frustrated by being asked to wait, and it was no one’s fault.
  • The tear in your jacket isn’t a catastrophe.  It is easily fixed and I can show you how.

Prevent dangerous risk taking – Teens with borderline personality are exceptionally impulsive and prone to risky behavior.  Consequently, parents should consider:

  • Tightly limiting cell phone use, email, texting, and access to social networking sites
  • Using technology to track their communications (this is legal), or disabling access during certain time periods
  • Reducing the amount of money and free time available
  • Searching their room (this is also legal)

A couple I know fully informed their borderline teen that all internet activity would be tracked, as well as cell phone calls.  The father also installed cameras in the home, at the front and back doors, in plain sight.  Nevertheless, his son continued with bullying and hurtful behavior towards siblings right in front of those cameras, and he would get caught and pay consequences repeatedly.  His persistence in the face of obvious monitoring became a great source of private amusement for his parents–humor really does provide relief.
–Margaret

Be patient – You are unlikely to receive the child’s respect, love, or thanks in the short-term.  It may take years.  But be reassured that your child will thank you for your firm guidance and limits once he or she matures to adulthood.

Other characteristics of BPD

Signs and symptoms of BPD may include significant fear of real or imagined abandonment; intense and unstable relationships that vacillate between extreme idealization and devaluation; markedly and persistently unstable self-image; significant and potentially self-damaging impulsivity (spending, sex, binge eating, gambling, substance abuse, and reckless driving); repeated suicidal behavior, gestures, or threats; self-mutilation (carving, burning, cutting, branding, picking and pulling at skin and hair, biting, and excessive tattooing and body piercing); persistent feelings of emptiness; inappropriate anger or trouble controlling anger; and temporary, stress-related severe dissociative symptoms or paranoid ideation.

  • Chronic depression: Depression results from ongoing feelings of abandonment.
  • Inability to be alone: Chronic fear of abandonment also leads to these adolescents having little tolerance for being alone. This results in a constant search for companionship, no matter how unsatisfying.
  • Clinging and distancing: Relationships tend to be disruptive due to the adolescents’ alternating clinging and distancing behaviors. When clinging, they may exhibit dependent, helpless, childlike behaviors. They over idealize he person they want to spend all their time with, constantly seeking that person out for reassurance. When they cannot be with their chosen person, they exhibit acting-out behaviors, such as temper tantrums and self-mutilation. Distancing is characterized by anger, hostility, and devaluation, usually arising from discomfort with closeness.
  • Splitting: Splitting arises from the adolescents’ inability to achieve object constancy and is the primary defense mechanism in BPD. They view all people, including themselves, as either all good or all bad.
  • Manipulation: Separation fears are so intense that these adolescents become masters of manipulation. They will do just about anything to achieve relief from their separation anxiety, but their most common ploy is to play one individual against another.
  • Self-destructive behaviors: The behaviors are typically manipulative gestures, but some acts can prove fatal. Suicide attempts are not uncommon yet usually happen in relatively safe scenarios, such as swallowing pills at home while reporting the deed to another person on the telephone.
  • Impulsivity: Poor impulse control can lead to substance abuse, binge eating, reckless driving, sexual promiscuity, excessive spending, or gambling. These behaviors can occur in response to real or perceived abandonment.

 

Drawn from:
Risk taking adolescents: When and how to intervene (excerpt)
David Husted, MD, Nathan Shapira, MD, PhD , 2004
University of Florida College of Medicine, Gainesville

– – – – – – – – – –

How am I doing?  Please rate this article at the top, thanks!

–Margaret

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Filed under bipolar disorder, borderline personality disorder, Bullying, cutting, suicide, teenagers

The blessings and curses of schizophrenia – A father’s view

The blessings and curses of schizophrenia – A father’s view
3 votes

This guest article is by Don Moore.

Some families are presented with the dual dilemmas of dealing with a child that is both gifted and troubled.  Such is the case with my daughter who in spite of her schizophrenia nearly ended up on the popular television show American Idol.

Most fathers would be quite pleased if children came with owner’s manuals.  Mind you, the great majority would not read the manual, but prefer to use their own experiences and logic to determine appropriate actions in parenting.  Owner’s guides would be a fine reference resource to look up how things were to be done after trying their own thoroughly contemplated actions before resorting to some sort of predetermined remedial action.

Particularly in American society, a Man’s perspective is to reason out and come up with solutions to problems they encounter or to follow a set of requirements at their employment to retain their job.  Sure, there are exceptions, especially for those who pursue artistic endeavors, but even these can often be reduced to techniques, learned, practiced and then applied.  (More about men’s approaches to parenting is here:  For men who raise troubled kids) 

Like many other parents and especially fathers, my work revolves around the repair of things and when I first encountered my daughter’s difficulties with life, I followed an approach of analyze, find a solution and apply a remedial fix to my interactions with her.

Much of Western medicine follows this thought process as well; study the problem, recommend a treatment and magically the problem will be gone.  The real problem is that this simplified view does not reflect the nature of the underlying problem with many mental health issues.  An especially difficult disorder to use this approach with is schizophrenia.  Because we define this illness as a set of behaviors and characteristics and each person can have or not have many of the characteristics, the approaches that I followed in dealing with my daughter’s situation were woefully inadequate as well as misguided.

In fact, most of my approach to dealing with my daughter would have been ineffective with just about any teenager, much less one suffering from hearing voices and disjointed thinking.

If the point of reference that you are using to deal with a child with schizophrenia is that the child is somehow concerned with what effect their behavior will have upon you, you are sadly mistaken.  This is precisely what I thought when I would painfully explain why some task had to be done, like load a dishwasher.  If she could not complete the task, it was obviously because she was trying to agitate me and I responded by becoming agitated and angry at either her lack of compliance with my instructions or the poor quality of her efforts.  As the behavioral difficulties became more serious my frustrations escalated accordingly.  The escalations were equally ineffective.

All of the difficulties came to a crisis point when my daughter left to attend a performing arts college in Minneapolis.  There her difficulties took on another level of seriousness and she returned home.  Under the care of a psychiatrist, some progress was made and my wife and I elected to take a class in dialectic behavioral therapy (DBT) for parents.  The class, in conjunction with some wise advice from her psychiatrist finally got me to see that her difficulties were from within her own mind and the best approach was to understand her behavior reflected her struggles to deal with her view of the world and were not based upon a master plan to disappoint or offend me personally.  DBT techniques allow you to understand the effect of delusions on the child’s behavior and instruct you to deal with the feelings that those delusions have on the child’s behavior. There is not an acceptance of the truth of the delusion, but there is an acceptance of how the person feels about the thoughts they have.  Having someone verify their feeling about the delusion (It must be frightening to believe the government is using thought control on everyone) without accepting the truth of the idea helps the person modify their response to the delusional thought.

Once there is an understanding of the thought issues facing the person with schizophrenia, there is hope that the narrative that their brain has created for their existence in the world can be refocused to include new ways of viewing the world and how they are to interact with those around them.  Proposing alternatives to how they see the world is a method of getting them to rethink the ideas that they hold and readjust to a new way of behaving.  It is by no means as simple as an owner’s guide, but progress is possible.

Tracy and Emmy winner Joey Pantolino

In my case, the treatments my daughter received helped considerably at first and she was able to make a journey to American Idol tryouts, meet the famous judges in person and come one audition from actually being on the television show.  You can see her story in the February 2006 SZ Digest magazine http://www.schizophreniadigest.com/e107_plugins/szproducts/images/articles/2006_spring_story1.pdf  or at my website, www.matersofthemind.info .

Another aspect of mental illness that seems to be misunderstood is the wide range of seriousness and variation with symptoms.  My family has been both fortunate and unfortunate.  My daughter has been blessed with a set of skills in singing that brought her national recognition for her efforts with American Idol, but did not ultimately reward her with employable skills or remediate her disease.  There are others with schizophrenia with truly exceptional talents who find jobs and recovery.  There are also those who struggle with more serious symptoms.  Whatever the course of your loved one’s illness, there is some measure of comfort in seeking and finding skills that will help in dealing with the issues that are confronting them.  Not the least of these skills are understanding the emotional turmoil that the person feels in dealing with their view of the world and helping them deal with the issues surrounding that view.

Tracy and Senator Gordon Smith (wrote and passed mental health legislation)

During her American Idol experience, my daughter wrote and recorded a song entitled “I am Not Alone.”   There is no reason that any family or person should be alone in their efforts to deal with their condition.  While it may sometimes feel lonely, seeking out resources and learning about the experiences of other people with similar challenges will help in your efforts to create not an owners’ manual but a guide to help you understand alternatives while you seek a better path to follow.  You may not cure the disease, but you can respond better to the challenges you face in your own journey.

–Don Moore

I offer deep gratitude to both Don and Tracy for sharing their remarkable experiences

Margaret

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Life at home is a war zone

Life at home is a war zone
2 votes

Homes with troubled children are war zones–very different from those with physically-disabled kids.   We can’t make things better for our child with wheelchairs or ramps or other specialized equipment.  We need serious fire power.  This story tells what it’s like to live with our child, seek mental health treatment, and find social and emotional support for ourselves.  It is inspired by, and much quoted from, Emily Perl Kingsley’s “Welcome to Holland,” about having with a son with cerebral palsy.  The original is at the end of this article.

Welcome to the War Zone

I try hard, often unsuccessfully, to describe the experience of raising a child with a brain disorder – to try to help people who have not shared that difficult experience to understand it, to imagine how it would feel.  It’s like this… When you’re going to have a baby, it’s like planning a fabulous vacation trip – to Italy.  You buy a bunch of guide books and make your wonderful plans.  The Coliseum, the Michelangelo David, the gondolas in Venice.  You may learn some handy phrases in Italian.  It’s all very exciting.  After months of eager anticipation, the day finally arrives.  You pack your bags and off you go.

Several hours later, the plane lands.  The stewardess comes in and says, “Welcome to Afghanistan.”  “Afghanistan?!?” you say.  “What do you mean Afghanistan??  I signed up for Italy!  I’m supposed to be in Italy.  All my life I’ve dreamed of going to Italy.”  But there’s been a change in the flight plan.  They’ve landed in Afghanistan and there you must stay.

They’ve taken you to a dangerous unstable place full of fear.  You have no way to leave, so you ask for help, and citizens offer to help but you must pay in cash.  Instead of help, they lead you down one blind alley after another.  You are afraid because you are different, you are a target because you stand out.  After spending most of your cash, you can’t ignore it any more–you are in very serious trouble–completely alone in a strange country, surrounded by people who don’t like you.  You won’t be rescued.  You can only think about hiding and praying and holding yourself together.

After a few years of ‘round-the-clock stress and isolation, you make a couple of connections, and arrange an escape across the border.  There are dangers in the next country, but your connections help.  Your escape seems to take forever, yet you finally make it home!  But everyone you know has been busy coming and going to Italy… and they’re all bragging about what a wonderful time they had there. And for the rest of your life, you will say “Yes, that’s where I was supposed to go. That’s what I had planned.” And the pain of that will never, ever,  go away… because the loss of that dream is a very, very significant loss.  But… if you spend your life mourning the fact that you didn’t get to Italy, you may never feel the fulfillment of using your character-building experience to help others escape Afghanistan.

Margaret

– – – – –

“Welcome to Holland” by Emily Perl Kingsley – http://ourlifeinholland.blogspot.com

“I am often asked to describe the experience of raising a child with a disability – to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It’s like this….When you’re going to have a baby, it’s like planning a fabulous vacation trip – to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It’s all very exciting. After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, “Welcome to Holland.” “Holland?!?” you say. “What do you mean Holland?? I signed up for Italy! I’m supposed to be in Italy. All my life I’ve dreamed of going to Italy.” But there’s been a change in the flight plan. They’ve landed in Holland and there you must stay. The important thing is that they haven’t taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It’s just a different place. So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met. It’s just a different place. It’s slower-paced than Italy, less flashy than Italy. But after you’ve been there for a while and you catch your breath, you look around…. and you begin to notice that Holland has windmills….and Holland has tulips. Holland even has Rembrandts. But everyone you know is busy coming and going from Italy… and they’re all bragging about what a wonderful time they had there. And for the rest of your life, you will say “Yes, that’s where I was supposed to go. That’s what I had planned.” And the pain of that will never, ever, ever, ever go away… because the loss of that dream is a very very significant loss. But… if you spend your life mourning the fact that you didn’t get to Italy, you may never be free to enjoy the very special, the very lovely things … about Holland.”

The Holland story has been used widely by organizations such as NAMI (National Alliance of Mental Illness), as a way to help parents with troubled kids accept their situation when their child is identified as having a brain disorder.  Holland just seems too nice, too peaceful, to relate to our situations.

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Naturopathic and holistic mental health treatment

Naturopathic and holistic mental health treatment
7 votes

This guest article is by a naturopathic physician in Portland, Oregon USA, who specializes in mental health treatment for children and adults.  Following is a summary and link of a podcast about the use of holistic/alternative medicine for the treatment of ADHD.

Addressing Mental Health Issues From a Holistic Perspective
Krista Tricarico, ND.  www.openmindmedicine.com

Holistic treatment

The health of the mind and body are intricately linked. Just as our thoughts strongly influence our physical health, our individual physiology affects our mental and emotional well-being. The foods we eat, our digestive health, the toxins in our environments, our hormones, lifestyles, experiences, beliefs and attitudes all play important roles in our physiology and biochemical make-up. As a philosophy, holistic mental health recognizes this beautiful web of interdependency.

Holistic approaches for adults and children can be used in conjunction with psychiatric medication, but unlike pharmaceuticals, holistic mental health treatments usually have the “side effect” of improved physical health and a richer emotional experience. Rather than suppressing or covering up symptoms with a drug, the goal of treatment is to address underlying causes and work towards integration and balance.

As a naturopathic physician, my goal is to support the wisdom of the body and mind and facilitate an individual’s inherent ability to heal. Naturopathic Doctors (ND’s) are licensed primary care physicians who have attended a four-year, postgraduate-level naturopathic medical school and are clinically trained in the art and science of natural therapies. In addition to conventional diagnosis, laboratory testing and pharmaceutical medications, the scope of naturopathic medicine includes nutrition, counseling, homeopathy, botanical medicine, physical therapies, and mind-body approaches. Naturopathic training does encompass the same basic bio-medical sciences as conventional medical training, but the approach to health and disease differs considerably. It is the philosophy of naturopathy that clearly differentiates this medicine and directs how we approach each patient.

Treatments

This will look different for each person and will be guided by conversation and individual interests as well as physical exam and laboratory analysis when appropriate. I have found the following therapies to be key factors in mental health recovery.

Counseling

Some patients see me primarily for counseling, and people with this focus are welcomed. Others are either interested in a blend of counseling and naturopathic approaches or seek care strictly for holistic medical support. A young person’s treatment needs and interests also change over time, so I meet a patient where they are at this moment. My counseling approach has a strong emphasis on self-awareness and mindfulness. Self-observation coupled with an attitude of curiosity, openness and acceptance allows for conscious insight and more freedom in the responses to the stresses and challenges a young person faces daily. Mindfulness-based therapies are a particularly effective approach for depression, anxiety and addiction issues, and can lead to increased clarity and a sense of contentment.

Nutritional Therapies

The foods we eat have a direct impact on the chemistry of our bodies and brains and, therefore, on our mood, thoughts and behavior. Our brains require the correct balance of amino acids, fats, vitamins, minerals and glucose in order to function properly, and individual needs can vary drastically. I work with all patients, children and adults, to uncover their unique nutritional needs through history-taking, diet analysis and lab testing, and then help individuals address underlying biochemical imbalances through shifts in their diet and nutritional supplements. Food allergies or sensitivities can play a significant role in mental health, as well, and the removal of these foods from the diet can have a profound impact on one’s healing. Orthomolecular psychiatry is a field of medicine that has applied these nutrition-based therapies in the treatment of conditions such as schizophrenia, bipolar disorder, anxiety and depression and has helped shape my naturopathic practice.

For more information about orthomolecular medicine, visit www.orthomolecular.org.
For more information about food allergy testing, visit www.usbiotek.com.

Homeopathy

Homeopathy is a gentle yet powerful system of healing based on the principle of “like cures like.” People have observed since ancient times that a substance that causes an illness or symptom can, in very small doses, cure the same problem by stimulating the body’s intrinsic healing ability. Through an in-depth interview, I strive to understand a child’s unique physical, mental and emotional experiences and, after careful study, select the appropriate remedy. Homeopathy offers a safe and elegant treatment that is a natural complement to counseling and can be used alongside conventional medications and other naturopathic treatments. As a truly holistic and individualized form of medicine, it is particularly well-suited to psychological and psychiatric concerns. Although identifying the effective remedy can sometimes require patience and perseverance, the results of successful homeopathic treatment are profound and long-lasting.

Restoring Digestive Health

Many mental and emotional concerns have their origins in the gut. It is important to identify and treat conditions such as hypochlorhydria (low stomach acid), candida overgrowth, gut dysbiosis (a bacterial imbalance in our digestive tracts), parasites, inflammation, leaky gut (increased permeability of the intestinal wall), and food allergies as they have direct effects on brain function. Imbalances in the gut play a significant role in many neuropsychological conditions. Conversely, our emotions strongly influence our appetite and digestion. The nervous system and the digestive system are intricately linked by a constant exchange of chemical and electrical messages including nutrients and neurotransmitters. Anything that affects one realm is likely to affect the other, and I have found that addressing gastrointestinal health is often foundational in one’s mental health recovery.

Blood Sugar Balancing

The sugar in our blood is called glucose, and this is the primary fuel for our bodies. Being one of the most sensitive and demanding organs, our brains require a constant supply of this glucose to perform its never-ending functions. A healthy body is able to regulate the blood sugar to provide a consistent energy source for the brain; unfortunately, this function is commonly impaired. Hypoglycemia is a condition in which the body can’t sustain constant glucose levels and can be a causative factor in attention and behavior issues, anxiety, panic attacks, rapid-cycling bipolar disorder, insomnia and addiction. Elevated blood sugar over time not only leads to diabetes, heart disease and obesity but also mood and behavior disturbances, decreased mental functioning and dementia. Many psychiatric medications put people at additional risk for blood sugar problems only exacerbating this problem. Balancing your blood sugar is an important component of disease prevention and general health and will also support your mood, energy, metabolism and mental functioning.

Amino Acid Therapy

Supplementation with amino acids can help optimize neurotransmitter levels. Amino acids are the building blocks of proteins that our bodies transform into neurotransmitters such as serotonin, melatonin, GABA, dopamine, epinephrine and norepinephrine. These are the messenger molecules that allow our nerve cells to communicate and have a direct impact on our mood, learning, attention, pain and pleasure perception, sleep, energy, and thought processes. Most psychiatric drugs manipulate our body’s ability to process these neurotransmitters in an attempt to alter the levels of these important chemicals. Instead of, or in conjunction with, antidepressants or anti-anxiety medications, we can give the body the amino acids it needs to make more neurotransmitters and avoid the negative side effects of the drugs. Neurotransmitter testing is available and can help guide the treatments. Targeted amino acid therapy is a powerful tool for addressing a wide variety of mental health concerns and provides a safe and effective alternative to these medications.

For more information on amino acid therapy, visit www.neuroassist.com.

Balancing Hormones

Our hormones are produced and controlled by our endocrine glands and include chemical messengers such as thyroid hormone, cortisol from the adrenals, insulin from the pancreas, and estrogen, progesterone and testosterone from the reproductive organs. As parents of adolescents who are entering puberty know, hormonal change has a profound effect on behavior. Imbalances or disturbances in any of these interconnected systems can alter the way our brain functions. For example, thyroid dysfunction is an often-overlooked, underlying cause of depression, anxiety, poor memory and fatigue, and PMS is a well-recognized cause of mood swings, depression, anxiety and sleep disturbances. Helping the body regain its delicate hormonal balance can have far-reaching effects for the mind.

Detoxification / Heavy Metal Chelation

We are exposed to an extraordinary amount of toxins through our food supply, the air we breath, and even our tap water. Toxic exposures affect the health of our brains. When the body encounters more toxins than it can effectively process, it stores these chemicals in fat cells, and our brains are largely made up of fat. Some people are good detoxifiers. Others with autism, ADHD, Alzheimer’s, Parkinson’s, depression, chronic fatigue, schizophrenia and bipolar disorder are often not. Supporting detoxification and the safe elimination of toxins can be a key component to mental health recovery. I assist patients with appropriate detoxification strategies whether that is a gentle cleanse, a more intensive detox protocol or heavy metal chelation.

Mind / Body Treatments 

Mind/body treatments engage the power of your mind in your own process of healing. I use therapies such as breath work, meditation, memory reintegration, relaxation strategies, and Emotional Freedom Technique (www.emofree.com) to help patients move towards a state of awareness and peace. Reflecting on and connecting with one’s own spirituality can also be an effective stress-management tool. Learning to consciously calm the mind and relax the body has a powerful effect on our neurotransmitters, hormones and immune system, and ultimately our health and sense of well-being.

Dr. Krista, www.openmindmedicine.com


Foods that support brain and mental health

  • Avocado
  • Walnuts, almonds, other nuts and seeds
  • Salmon, tuna, sardines, mackerel, herring, trout
  • Ground flax seed
  • Brightly colored fruits and vegetables – eat the rainbow
  • 70% cacao and higher dark chocolate
  • Green tea (stone ground from whole tea leaves)
  • Berries:  acai, blueberry, cranberry, blackberry

Herbs and other alternatives that support brain and mental health 

  • Fish, cod liver or krill oil (if you could only have one thing, this would be it)
  • L-theanine or kava kava for calming and reducing anxiety
  • Turmeric, curry and other antioxidants
  • B-complex vitamins
  • Magnesium
  • Light therapy, for improved mood and energy

Substances that are bad for brain health

  • Alcohol
  • Artificial food coloring
  • Artificial sweeteners
  • Sugars: cane sugar, soft drinks, corn syrup
  • Hydrogenated/partially hydrogenated fats and trans fats (fried foods). Saturated fats are fine, it’s the hydrogenated and trans fats that are bad.  I actually highly recommend organic coconut oil
  • Nicotine, Marijuana, all other controlled substances

How do you like this article?  Please rate it at the top, thanks.

Integrative Management of ADHD – What the Evidence Suggests
By Richard Balon, MD | January 6, 2011

The use of complementary and alternative medicine treatments by children and adults with ADHD is the rule rather than the exception…more than half of parents who have children with ADHD treat their child’s symptoms with vitamins, dietary changes, and expressive therapies—but only a small minority tell their doctor. And roughly 8 out of 10 patients who use these treatments regard them as their primary therapy.

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On psychiatry and stigma

On psychiatry and stigma
2 votes

When parents complain about psychiatrists, it’s often due to them judging the parent as being the reason for child’s problems; one might call this a bad “bedside manner,” but with huge consequences for the family.  If parents aren’t listened to, or are talked down to, they can’t help, nor live with, their incredibly stressful child.  Yet poor customer service is not unique to psychiatry; the medical field has lots of practitioners who aren’t helpful or people-friendly.  What’s different about psychiatry is that The Rest Of The World often thinks it is sinister and evil.

Our Own Worst Enemies
Nada Logan Stotland, MD, MPH

“Oncology manages to cloak the most primitive possible treatments—poison and burning—with elaborate protocols. Yet the mention of psychiatry conjures ECT, and ECT conjures images of the snake pit.  …We are the only specialty with our own dedicated hate group. We shouldn’t be our own worst enemies.”  May 18, 2010, Blog @ www.psychiatrictimes.com

o        Dr. Stotland, above, mentions ECT  (electroconvulsive therapy), or “shock therapy.”  It reboots the brain and is the only thing that keeps some people alive and eases their suffering.  So how is ECT worse than shocking a stopped heart with a defibillator–two paddles on the chest and BOOM!  Which is more barbaric?

o        In the TV medical dramas, there’s this common scene:  a patient is in a hospital bed surrounded by doctors, and the patient is bleeding, or screaming in pain, or convulsing.  Somehow this is acceptable in prime time.  What if the scene was different.  Instead, an agitated, hallucinating patient is being restrained, and injected with a drug that immediately calms and relaxes them.  My guess is the public would find it sickening and unethical.

o        When a sweet-looking child loses all of his or her hair after being poisoned by chemotherapy, it evokes sympathy and compassion.  But if this same  child’s hair was lost while taking a psychiatric medication, then it would be seen as a barbaric side-effect of forcing drugs on children to send them to zombie-land.  Cancer treatment is forgivable,  treatment for brain diseases is not.

This public attitude must change.   It victimizes the victims who live with mental disorders, and their providers and families.   Mental health treatments are no more barbaric than those of other medical illnesses, but the stigma manifest in blame, prejudice, and ignorance of brain function are cruel–can’t people see we are doing the best we can to get help for sick people?  Let the dialogue be about improving lives instead of finding fault with doctors, sufferers, and families.

mp

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Use IQ sub-scores to guide your child’s future

Use IQ sub-scores to guide your child’s future
8 votes

The IQ of a child or teen does not predict their success or failure in the world, nor their chances for a meaningful life that’s full of well being.  But in very practical terms, your child will need to function as an adult someday, and take care of themselves, which means getting a job and getting a life.  What’s the best job or future path?  What isn’t?  If you know how your child scored on different parts of the battery of IQ tests, you can guide them to a future that rests on their best scores, and this is especially important for young people with behavioral disorders.  Let me explain.

A person’s IQ is the average of the scores from tests for different types of intelligences, and each test can be scored from a range of 0 to ~200.  From the Wechsler IQ Scale, used most widely in schools, there are six intelligence types. (There are many different IQ tests in use today, besides the Wechsler Scale.)

  • Verbal comprehension  Ex:  Measures the ability to write, work crossword puzzles, use words creatively or convincingly, tell interesting stories or funny jokes, debate an issue, explain things clearly, and use a large vocabulary.
  • Perceptual Reasoning  Ex:  Measures the ability to put puzzles together, appreciate of art or photography, use geometry, learn best with charts and pictures, draw, notice details.
  • Working Memory  Ex:  Measures the ability to remember strings of numbers or letters, lists, and subjects just observed or subjects recalled from a much earlier time.
  • Processing Speed   Ex:  Memory recall, speed of problem solving, recognition, and correlation.
  • Reading   Ex:  Measures the ability to read and understand different types of writing, to learn and draw conclusions from reading, reading speed, comprehend the meaning in written material.
  • Math Reasoning  Ex:  Ability to solve mysteries, solve logic and math problems, organize things, figure out how things work, use technology, appreciate and apply science.

Your child’s individual intelligence scores are better indications of your child’s strengths and weaknesses.  You should support interests that take advantage of where their best intelligence is, their high scores, to prepare them for schooling or a job.  On the other hand, if you know where they score low, you can arrange extra support for them before they become adults–or you can guide them away from a future choice (such as a career) where they won’t or can’t thrive.

The philosophy here is to help your troubled child use the best of what they have, and not require them to be well-rounded.  Pressuring them to do well in everything isn’t helpful for two reasons: 1. troubled children commonly have a wider range of low to high scores, and they aren’t or can’t be well-rounded; 2. your effort goes into weaknesses they struggle with, instead of  strengths that need nurturing and celebrating.  For troubled kids especially, self-esteem is critical.

A hypothetical case –  Take two very different children with very different IQ scores, yet both with the same behavioral problems in school.  They act out, pick fights, hit others and damage others’ things.  Sean is a 15-year-old boy with an IQ of 83, diagnosed with ADHD and Fetal Alcohol Effect (FAE); Katy is a 10 year girl with an IQ of 122, diagnosed with PTSD and ODD.  In the graph below, Sean’s scores are in red, and Katy’s are in blue.

 Sean’s score of 83 is misleading because his overall functioning is much lower.  In fact, three of his test scores are below 75, the level designated as developmentally disabled.  His special education teachers are surprised he does so poorly in school because he seems so normal on the surface thanks to his above average verbal skills.  He has lots of friends.  He communicates clearly, he listens to others, and he likes to tell good stories. What should Sean be when he grows up?

Half of Katy’s scores are above gifted, ~130, but her below average verbal ability prevents her from mastering essential social and communication skills.  Because she’s so intelligent, people are surprised that she continues poor behavior even though she is punished for it.  But Katy’s behavior comes from an early trauma.  And with lower verbal skills, she has a harder time communicating her needs, and experiencing the many little interactions that help us mature.  Katy can do anything, but what shouldn’t Katy do when she grows up?

To help people understand the implications of IQ, psychologist Dr. Arthur Jensen created a chart that he believed matched IQ scores to careers:

  • 89-100 would be employable as store clerks
  • 111-120 have the ability to become policemen and teachers
  • 121-125 should have the ability to excel as professors and managers
  • 125 and higher demonstrate skills necessary for eminent professors, executives, editors

“What is an IQ?” http://homeworktips.about.com/od/homeworkhelp/a/IQ.htm

From this chart, Sean’s IQ of 83 is too low for a store clerk, and yet Sean is able to function pleasantly and helpfully around people in structured situations.  He might do fine helping customers in the right kind of store.  He’s also good at tackling one day projects with groups of people.  Maybe landscaping or neighborhood clean-up is is meaningful to him and he thrives.

Katy could easily become the professor or executive in Dr. Jensen’s chart, yet her verbal skills might limit her to careers that don’t require nuanced interactions with people.  She might do best working semi-independently, possibly in technology, science, or engineering.  She might love a summer science camp where her intelligence would get the challenges it needs and shine.

What will your child do when he or she grows up?  You can’t make their decisions, but you can influence their choices.   Introduce them to situations they are predisposed to master.

“No IQ score should be considered an exact measure of intellectual ability…  It does not measure creativity, leadership, initiative, curiosity, commitment, artistic skill, musical talent, social skills, emotional well-being, or physical prowess – all components which can be included in definitions of giftedness.”
National Association of Gifted Children http://www.nagc.org/index 

How am I doing?  Please rate this article at the top, thanks!

— Margaret

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Practical ways to calm yourself, your child, your family

Practical ways to calm yourself, your child, your family
3 votes

You need peace and serenity in your household, and you need to be proactive to attain it, but how?  Therapy works.  So does disciplined meditation and yoga.  Anti-anxiety medications work, use them, but they’re not the best long-term solution.  You need reliable skills for calming yourself, your stormy child, and all other family members.  In psychological jargon, you need to learn “de-escalation” skills.  (see research at the end of this article on the brain benefits of mindfulness Based Stress Reduction)

Calming yourself in the tension-filled moment

Become consciously aware of your tension and ask:  What are my options for coping with my tension right now?  Brainstorm  options ahead of time and create a list because you won’t be able to process in the moment.  For example:  take a very deep breath, then silently count to 10 backwards.  Another idea:  eliminate distractions.  Turn off the cell phone, send others out of the room, pull the car over, turn off music…  You must strategically choose your response to a common situation, which is a key element of CBT (cognitive behavioral therapy), and it works.

Be your own cheerleader.  Silently think, “I can handle this;” “I’m the one in control;” “You Go Girl!;” “I am the calm upon the face of troubled waters…”  Have fun with it.  In psychological jargon, this is called “positive self-talk,” and is a key element of DBT (dialectical behavioral therapy).

Ways to calm your child in the moment

Note:  the techniques are different for each child depending on their disorder and its characteristics.  Experiment to find out what works with your child’s typical patterns at home, in school, with others, or other situations that are typically stressful.

In a steady voice, give them directions or requests to calm down.  You will need to repeat yourself periodically as they struggle with their inner storm.  If you ask them to move to another space or use their own calming, skills, use your body language to initiate the act.  If you ask them take a deep breath, do it yourself.  If it helps them to punch a pillow, punch it yourself and hand it over.

Wait them out.  Give them plenty of time to unwind as long if they are not hurting anything.  There is no rush.  Allow long moments to pass as they struggle with whatever is triggering them.

Have a calm place to go to pull themselves together, a kid cave, or a time-out space, even the car.

Give them extra time to “change channels” and go from one environment to another.  Children and teens often have problems “transitioning.”  Examples: coming home from school; getting out of the car after a long ride; waking up in the morning.  Changes are difficult for troubled kids.

Redirect their focus.  Draw attention to something to distract them in the moment (this is a useful kind of channel-changing).  A young child could be directed to a physical activity (draw, push clay around, throw a Nerf ball against the wall), a teen can be asked to play their favorite music (even if you hate it), shoot baskets, or take the dog for a walk.

Animals heal, but strategically pick the best animals.  If you can have a calm smiling dog, a calm affectionate cat, or a little low-key animal like a hamster, bird, or turtle, you’ve got pet therapists.  Excessively active or barking dogs and aloof kitties probably won’t work.  If you can afford calm livestock like a goat or horse, the ‘largeness’ of their serenity works wonders!

What makes a good “security blanket” for your child?  I’ve completely wrapped anxious children and teens in a blanket or coat, and they became immediately present.  Have a child bury themselves in a favorite piece of furniture, or let them get their video game or iPod.

Once a situation has passed, ask yourself what happened just prior to your child’s episode.  Was there a trigger?  Did they just transition from one kind of place to another?  Do you have options for removing the trigger?

It is very common for a trigger to be so small or elusive that you miss it.  The child or teen’s sibling could have sniffed or rolled their eyes without you noticing.  An object your child or teen reached for (like a remote control) could have just been unintentionally grabbed by someone else.  If you can identify the little frustrations that send them to the stratosphere, and address them immediately, it will proactively ease their mind.  “Your sister is not supposed to tease you and I’ll see that it stops.”  “Your brother was not trying to bother you by taking the remote just now.  It was an accident of timing.”

Calming your home for the long term

Calm your emotional self first and think Zen.  If you can take 5 minutes during a day, even a stressful day, sit quietly and breathe, and consciously work at eliminating all thoughts, ALL THOUGHTS, you would calm down.  Not thinking anything is the hard part of meditation, yet it is the skill that makes it work, and there’s proof.

Maintain bodily calm with the big three: exercise, sleep, and healthy diet.  You’ve heard this a million times already, but there’s good reason and proof.  If you can’t simultaneously maintain all three habits in your family, take one at time and you will still see benefits.

Calm the sensations that exist in your home environment.  Reduce noise, disorder, family emotional upheavals, and the intrusive stimulation of an always-on TV, etc.  Create a place or time period in your home where anyone can go that’s contemplative, where people agree to behave as if they’re in a library, a special place of worship, or a safe zone.

Have you ever wondered how a hospital psychiatric ward is designed to keep patients calm?  I’ve visited a number of wards, and the best ones I saw were in China, where I toured with a delegation of mental health practitioners.

Visual: they had windows and lots of light, plants, and beautiful aquariums with gorgeous fish and lots of bubbles.  Those hypnotic fish are great de-stressors.

Sound: besides the bubbling aquarium, there was often low-energy music.

Physical: soft furniture, a table where people could gather in the comfort and buzz of a group, and nooks where people could remove themselves from the buzz and avoid over stimulation.

Two things to avoid

Do not communicate strong emotions in your voice.  Word choice and sound volume don’t matter as much as strong emotional content, negative or positive. Strong emotions trigger an unstable child or teen, yet are hardest to control when you are excited or under stress!  Practice vocal neutrality.  Which is better: “Will you please let the cat out?” versus “Will you PULLEEEEZ let the cat OUT!!!

Don’t pressure the child to calm down when they’re not ready—it takes time for anyone to unwind.  Wait patiently while a child or teen works through ugly emotions and finishes releasing their stuff.  You may have to take it on the chin, but this will pass.  Let them have their catharsis.  We all need to release our stuff, and we all need others to patiently let us.

In my support group, I’ve observed that very stressed parents, who visit for the first time, need at least one solid hour to vent and cry before they’re calm enough to benefit from another’s supportive words and sympathy.

 

 

 

Be the calm, spread  the calm, live the calm.

 

 

 

Margaret

– – – – – – –

ABSTRACT – Mindfulness practice leads to increases in regional brain gray matter density

Britta K. Hölzelab, James Carmodyc, Mark Vangela, Christina Congletona, Sita M. Yerramsettia, Tim Gardab, Sara W. Lazara 

Psychiatry Research: Neuroimaging,Volume 191, Issue 1, Pages 36-43 (30 January 2011)

Summary in plain English:  Meditation causes structural changes in the brain associated with memory, empathy, and stress, according to new research. Researchers examined MRI scans of participants over a period of 8 weeks. Daily meditation sessions of 30 minutes produced measurable changes in subjects with no previous meditation history. The anxiety and stress region of the brain, the amygdala, produced less gray matter. In a non-meditating control group, these positive changes did not take place.

“Therapeutic interventions that incorporate training in mindfulness meditation have become increasingly popular, but to date little is known about neural mechanisms associated with these interventions. Mindfulness-Based Stress Reduction (MBSR), one of the most widely used mindfulness training programs, has been reported to produce positive effects on psychological well-being and to ameliorate symptoms of a number of disorders. Here, we report a controlled longitudinal study to investigate pre–post changes in brain gray matter concentration attributable to participation in an MBSR program. Anatomical magnetic resonance (MR) images from 16 healthy, meditation-naïve participants were obtained before and after they underwent the 8-week program. Changes in gray matter concentration were investigated using voxel-based morphometry, and compared with a waiting list control group of 17 individuals. Analyses in a priori regions of interest confirmed increases in gray matter concentration within the left hippocampus. Whole brain analyses identified increases in the posterior cingulate cortex, the temporo-parietal junction, and the cerebellum in the MBSR group compared with the controls. The results suggest that participation in MBSR is associated with changes in gray matter concentration in brain regions involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking.

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