Adolescent Depression

Sophia was concerned about her son.

Danny, normally an out-going and energetic sixteen-year-old, had been down in the dumps since he and his girlfriend Lucy broke up just over two weeks ago. Since then he stopped seeing his friends and hardly left his room. At meal times he hardly ate anything and was visibly losing weight. His sleep was erratic and he seemed to lack the energy or interest to do anything – even those things he was usually passionate about.

Recently the school called, also expressing concern. It seemed that Dan was getting behind in his school work and had stopped submitting assignments. He was having trouble staying focused in class and the self-imposed isolation Sophia saw at home also seemed to be occurring at school.

Sophia knew that it was time to get help, but other than the family doctor who was booked up for the next two weeks, she had no idea where else to go. Instinctively she knew she had to act immediately.

Sophia herself felt both desperate and helpless – her son was withering in front of her very eyes and it seemed that there was nothing she could do to help him.

Who is Most Affected by Depression?
While depression has been described as being equivalent to the common cold of mental health (almost everyone has been “depressed” at one time or another), clinically significant depression can range in severity from minimal to severe, with adolescence being an especially difficult time in terms of mental health concern.

“According to the 2012 Canadian Community Health Survey – Mental Health, 15 – to 24-year-olds had the highest rates of mood and anxiety disorders of all age groups. About 7% of them were identified as having had depression in the past 12 months, compared with 5% of people aged 25 to 64 and 2% of those aged 65 or older.

Severe depression is associated with suicidal behaviour, which is often conceptualized along a continuum from thoughts to plans to attempts/deaths. As many as one in five teens report suicidal ideation in the past year. Suicide is the second leading cause of death among young Canadians, accounting for almost one quarter of all deaths at ages 15 – 24.

Adolescence and early adulthood are critical periods in the development of mental health. Risk and protective factors may differentially influence this age group, and rates of depression peak during these ages.”

(health reports: Depression and suicidal ideation among Canadians aged 15-24 https://www.statcan.gc.ca/pub/82-003-x/2017001/article/14697-eng.htm)

What Does Depression Look Like?
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), the following are criteria for the diagnosis of depression:
5 or more symptoms present during a 2 week period;

Depressed or irritable mood (outside being frustrated) and/or loss of interest or pleasure, plus any three of the following:
1.  Significant weight loss or decrease in appetite (more than 5 percent of body weight in a month or failure to meet expect4ed weight gains).
2.  Insomnia or hypersomnia
3.  Psychomotor agitation or retardation
4.  Fatigue or lack of energy
5.  Feelings of worthlessness or guilt
6.  Decreased concentration or indecisiveness
7.  Recurrent thoughts of death or suicide
In addition to the above DSM-5 criteria, children and adolescents may also have some of the following symptoms:
–  Persistent sad or irritable mood
–  Frequent vague, non-specific physical complaints
–  Frequent absences from school or poor performance in school
–  Being bored
–  Alcohol or substance abuse
–  Increased irritability, anger or hostility
– Reckless behaviour

(DSM-5 Criteria – as cited by MD Wise – Clinical Care Guidelines for: Major Depression in Children and Adolescents – http://www.mdwise.org/MediaLibraries/MDwise/Files/…/gl-depressioninchildrend.pdf )

What Causes Depression?
A number of factors can cause depression – genetic predisposition, severe life circumstances, substances and certain medical conditions can all affect brain chemistry and thus the moods we experience.

What Should I Do if I Think My Child is Depressed?
Start with your doctor. It is important to rule out any other underlying physical causes or conditions that resemble symptoms of depression – (Bipolar Mood Disorder, Hypothyroidism, Diabetes and Chronic Fatigue Syndrome all share symptoms which can resemble depression).

www.psychologytoday.com/us/blog/the-truisms-wellness/201609/4-conditions-resemble-depression-arent

Once having ruled other possible causes for your child’s depressive symptoms, there are a number of services available to provide support.

Listed below are a list of strategies that have often been found helpful in managing feelings of depression, followed by links to a number of mental health services.

What is important to remember is that depression, while common, can be a serious health concern. If you see that your child is experiencing a number of symptoms listed above, and especially if they express suicidal thoughts or display self-destructive behaviour, it is better to err on the side of caution and have your child see a health care professional immediately.

Exercise – especially cardio, helps to release endorphins, the body’s own built-in feel good drug.
Change your self talk – be mindful of what you tell yourself. Negative self-talk tends to create negative feelings, while positive realistic self-talk tends to diminish negative feelings while promoting optimism
Use positive distraction – changing your focus, especially when very upset, can help to restore a sense of calm which can in turn lead to a more realistic evaluation of one’s current situation. Deciding anything important when upset and caught in the “fight or flight” response is seldom a good idea.
Sleep – getting enough sleep is so important to good mental and emotional health that it is often the starting place for many mental health practitioners. It is amazing to see how often a number of mental health issues improve with simply getting consistent sleep.
Watch your diet – as the saying goes “you are what you eat”. We wouldn’t expect to get optimum performance when putting bad gas into a vehicle. How can we expect to get positive results when our food choices are unhealthy?
Express your feelings –  expressing one’s emotions, whether talking, writing or even creating art, helps to release tension. Not expressing ones’ feelings tends to result in our reacting to those feelings in unhealthy ways (i.e. aggression, withdrawal, or even substance use to numb them).
Keep a mood log – tracking one’s moods and the circumstances in which they occur can help us to recognize and better respond to our triggers. It is hard to change in an effective way what we do not consistently pay attention to. The following is a link to a mood log form and an example of how to complete the mood log – http://www.burdenbearersdv.com/documents/Daily_Mood_with)example.pdf
Take action – do what you would normally enjoy doing, even if you don’t feel like it – often the enjoyment follows the effort, despite what we may think before we start.
Structure your time – planning one’s time and then following through with the plan can create a sense of satisfaction and control when the rest of life may feel out of control.
Get into nature – something about getting out into nature often refreshes our spirit.
Read, meditate, pray – numerous studies have shown the mental, emotional and physical benefits of meditation and prayer.
Listen to Positive Music – music can help to change our mood – for good or bad. “Good stuff in/good stuff out”.
Spend time with a pet – the unconditional love our pets give us can really help to elevate our mood.
Talk to someone “Face-to-Face” – overuse of technology has the tendency to divide and cut us off from each other. Making time to hang out with friends is in many ways therapeutic – we were made to be social.
Practice hope – consciously think about what you are thankful for and what you are looking forward to.. What we focus on becomes most real for us.

Support Services  

Child and Youth Resources – Fraser Health: http://www.fraserhealth.ca/health-info/mental-health…use/…/child-youth-resources/

Depression – Fraser Health: www.fraserhealth.com …. Health Topics A-Z > School Health> Mental Wellness

Short Term, Assessment, Response, Treatment Team – Fraser Health: https://www.fraserhealth.ca/…/short-term-assessment-response-treatment-team/

Rapid Access Clinic – Fraser Health: https://www.fraserheatlh.ca/health-info/mental-health…use/…/rapid-access-clinic

Bounce Back: For adults and youth| CMHA British Columbia: https://www.cmha.bc.ca/programs-services/bounce-back/

Posted in Depression, Family & Parenting, General, Stress & Anxiety

Betrayal

David betrayed his life partner and he was not prepared for his partner’s emotional distress. He wanted to know when it would end. He asked “Why isn’t sorry good enough?” David needed to understand that his partner’s reactions were normal. Her healing was largely dependent on his ability to be empathic, remorseful, honest, apologetic, loving, patient and soothing over a long period of time. And most importantly to stop the behavior that devastated his spouse. 

Normal reactions of the betrayed partner and how to respond:
Disbelief:
They don’t believe this nightmare. This is understandable. They trusted you and don’t want to believe you did what you did.
Shock: They appear numb and dazed. Emotions are frozen and senses dulled.
Reality: “Oh my God. It really happened.” They don’t know where to turn. They may feel shamed by your betrayal. Encourage them to get the help they need for their pain.
Confusion: They’re disoriented, impatient, disorganized and forgetful. Be gentle and helpful.
Physical Symptoms: They may sleep or eat too little – or too much. They may suffer from physical aches and pains, weakness, headaches, nausea, vomiting, weight loss. Take long walks together and ensure a healthy diet.
Crying: Deep emotions well up, released by crying, uncontrollable sobbing and even screaming out loud. Support them by acknowledging they’re upset before verbalizing your remorse for causing their pain.
Self-Control: Too much self-control means they are storing up anger and will release it powerfully. The release of anger is necessary to heal.
Need to Know: They will ask lots of questions to process their trauma, move through it, and move past it. Whatever they ask, answer honestly and apologize with another promise you will never betray them again.
Injustice: Your betrayal is an agony you inflicted upon them. They need to know that you understand how this plagues them.
Inadequacy: Their self esteem is shattered. They may feel belittled, insignificant or unlovable. 
Idealizing: They may live in the past, before the betrayal came along and “messed it up.” Assure them you remember the good times and will work at developing an even better future with them.
Frustration: Their pain returns again and again. They wonder if they will ever recover and feel better. Be there to hold and comfort them. Repeat your apologies.
Bitterness: Resentment and anger toward you and what you have done are to be expected. This is natural. Until they’ve worked through and exhausted their anger, they cannot heal.
Waiting: Their pain is waning, but their zest for life has not returned. They are in limbo, exhausted and uncertain. Life seems flat and uninteresting. Help them by planning activities that bring joy back into their life.
Emotional Conflict: Shirley Glass, PhD states: “The irony of healing from betrayal is that the perpetrator must become the healer. Thus, betrayed partners are vulnerable because the person they need to turn to is the source of their danger.” The conflict for a betrayed spouse is obvious, but Dr. Glass also recognized that…partners who are betrayers sometimes find it hard to stay engaged with their spouses when they know they are the source of such intense pain. The key is to stay engaged nonetheless. Be supportive and remorseful, and above all…keep talking.
Triggers: It is normal for the betrayed partner to be intensely triggered and traumatized by certain dates, places, items or activities. Depression, anger and nightmares are common when triggered. Again, express you are sorry, you acted so selfishly and caused this recurring pain. Never indicate they should “get over it”. Your betrayal will remain a permanent memory for them, which they learn to deal with better as they heal, and you earn back their trust and rebuild your relationship.

If you can apply all of these components: gratitude, love, acknowledging their pain, admitting you caused the pain, an expression of shame and a promise it will never happen again, there is a strong possibility of:

Hope: Life will get better and the good days out balance the bad.
Commitment: Life won’t be the same, but they decide to actively begin building a new life.
Peace: They feel able to accept the betrayal and face the future.
Life Opening Up: Life has value and meaning again.
Forgiveness: While the memory will never leave them, the burden they’ve been carrying from your betrayal is lifted. Given what you have done, the pain it caused them and the anguish they lived through, this is the ultimate gift they can bestow. They give it not only to you, but to themselves. Be grateful for this gift and cherish it always.

Posted in Depression, General, Marriage & Relationships, Personal Growth

How to Talk About Suicide

Suicide is an emotional word. Feelings of confusion, fear, anger, and even disgust are common responses when the topic comes up in conversation, rare as that might be. As a clinical counsellor, I have felt all of these emotions when discussing suicide with clients and will continue to do so. But over years of working with people at some of the lowest points of their lives, I’ve learned not to let those emotions get in the way of compassion.

I ask you today to accept responsibility for how you react to hearing about suicide. I ask you to help foster a hopeful and meaningful conversation about suicide, as opposed to one full of stigma and discrimination. I do this believing wholeheartedly that to do so will change and potentially save lives in the face of arguably the most preventable major cause of death. Both those who experience such suffering, as well as those who are left behind in the wake of a suicide know the sting of stigma and discrimination all too well.

I work with and think about the issue of suicide almost every day. It has drained me and forced me to confront some of the most fundamental beliefs. There have been times when I have asked if I can continue to help people facing such terrible suffering.

Fortunately, that’s rare. I spend considerably more time being inspired by the strength and the courage of the clients I have the privilege to work with. Their stories of hardship are all too common, but the fact that they show up to sessions at all suggests resilience and a strength of character few are ever forced to employ.

The unfortunate and uncomfortable reality is that society shies away from the issue of suicide, when we should be embracing it. Even in the helping professions, it’s not difficult to find stories of therapists “firing” clients following suicide attempts. Our collective fear – of litigation, of loss, of the prospect of our ineffectiveness – dilutes our goal of helping others from a moral obligation to a convenient desire.

Instead of writing off people who are suicidal, we should be welcoming with open arms those who most need our help. A small but meaningful part of this includes being mindful of the language we use regarding suicide, just as we would with any other significant health issue.

Most people who are suicidal do want to live. The problem is that life has become unbearably painful, and when looking for an escape from suffering, suicide appears to be the only option. The solution is to see that alternatives exist and that life can be worth living, and this becomes a foundational component of treatment when a person who is suicidal seeks help.

Stigma thrives in silence. Not talking about suicide only serves to strengthen a discrimination of those experiencing suicidal thoughts and mental illness that is already too prevalent. But talking about suicide in a careless or judgmental way is worse. So how can we start to get it right?

I’ve go three ideas on where to start.

  1. Stop saying “committed suicide.” Suicide attempts are not a death sentence, a permanent label, nor a crime. The word “committed” is judgmental and implies that a crime has occurred. “Died by suicide” is more factual, accurate, and respectful.

    I would also stay away from the commonly heard phrase “failed suicide attempt: (we want to avoid reinforcing the belief that a person is a failure if they survive their attempt).
  2. Consider what is meant by how you use the word “suicidal.” As a label, it can be misleading and damaging, and not just because of the usual weight of stigma and discrimination that comes with it. “Suicidal” implies a trait that can become stuck to a person, much like a diagnosis.

    But this just isn’t the case with suicide. The proof is in the statistics: a 2002 literature review of 90 studies on suicide attempt survivors showed that 7/10 of those who attempt suicide will not attempt again, and 9/10 people who survive an attempt will not go on to die by suicide later.
  3. Speaking of hope, please remember to talk about it, because hope above all other things cannot be taken away from a person, only given up or lost. Hope is powerful and it is contagious, and even the smallest spark of it might be enough for someone to decide that life is meaningful enough to live, even if just for one more day.

    As Viktor Frankl wrote, “he who has a why to live can bear almost any how.”

If you are in crisis, help is available. tell a friend, a health professional, or call 1-800-SUICIDE to speak to a crisis line volunteer. For more information on suicide warning signs and what to do about them, visit the Canadian Association of Suicide Prevention at suicideprevention.ca

Reference:

Owens D, Horrock J, and House A. Fatal and non-fatal repetition of self-harm: systematic review. British Journal of Psychiatry. 2002;181:193-199.

 

 

Posted in Depression, Family & Parenting, General, Grief, Personal Growth, Stress & Anxiety Tagged with: , , ,

The Power of Habit

A book review by Jennifer Foster, MSW

I recently read a book called The Power of Habit, by Charles Duhigg. It is about why we have habits and how they can be changed. I was interested in this book because I have some habits I want to break and I was curious to learn about why they exist in the first place and how to change from having bad habits to good ones.

The author, Charles Duhigg, describes habits as “the choices that all of us deliberately make, at some point, and then stop thinking about but continue doing”. The idea is that at one point we all make decisions that help us get through the day and once we decide we stop thinking about it and proceed with the behaviour automatically. Scientific studies have found that habits happen to prevent us from becoming overwhelmed by all the decisions we would otherwise have to make each day. They are a way for our brain to save effort.

While habits help us conserve mental energy, a key point is that our brains do not always test out and choose habits that would be in our best interest, but rather habits are borne out of urges or cravings. Sometimes we may not recognize or understand an urge and why we respond to it in the way we do, which can make habits difficult to control.

These two points – that we develop habits based on urges and that once we develop a habit we behave without thinking, are important, because it means that if we want to change a habit, we have to be deliberate about it.

Duhigg describes how habits work as a loop that is made up of three things – cue – routine – reward. When we associate cues with certain rewards a subconscious craving emerges that starts the habit loop. Let me tell you about one of my habits – at the end of my work day, I walk down the street to a coffee shop and buy a coffee and a cookie to eat on my way home. The craving that drives this habit is a desire for comfort to end my work day. While I do derive comfort from this habit I also experience guilt because I know it is causing me to gain weight. So this is one of the habits I want to change. Duhigg lays out four steps for changing a habit:

  • Identify the routine (in my case this is walking down the street to a coffee shop)
  • Experiment with rewards (listening to music also brings me comfort)
  • Isolate the cure (in my case this is the end of my work day)
  • Have a plan (I have decided that when my work day ends, I will walk directly to my car and put on music that makes me feel comforted).

One additional point that I want to highlight is that willpower and belief are important in changing habits. Duhigg describes willpower as a skill and muscle. He says that when you learn to force yourself to make a healthy choice, part of what is happening is you are changing how you think. He said the more we use willpower the more our brain is practiced at helping to focus on a goal. He also says habit replacement works pretty well for people until the stresses of life get too high. He says replacement habits only become lasting new behaviours when they are accompanied by an individual’s belief that they can change or belief that they can cope without needing to satisfy a craving in a particular way.

In summary, habits are something we all have and many of them serve a useful purpose but most of us have some that are unhealthy. The good news is that wile change may be neither fast nor easy, by understanding your habit loop and with willpower and belief, almost any habit can be changed.

Posted in General

Up In Flames – part 2

About three and a half years ago I wrote the article: ‘Up In Flames’ that can be found at Psychealth.com. It was written shortly after my apartment burned down and shares my experience navigating through that challenging life event. This article is the follow-up.

It took over three years to rebuild my home. I recall the first few weeks as the most difficult, as I was coming to terms with the scope of the loss. As time went on, I discovered lots of silver linings: I got to experience a new community to live in, I got to live in a place with a superb view, and I got to enhance various relationships/connections that led to many memorable experiences. Not having content insurance posed some challenges but slowly but surely i rebuilt my collection of clothes and unique items, with the help and generosity of my family, friends and colleagues. I often say that my place burning down was the best thing to ever happen to me since it sent my life on a new and fruitful trajectory.

The day before I got the keys to my apartment the anticipation and excitement was stifled: I got word that our family cabin outside of Pemberton had burned down. It was likely an electrical fire; the flames destroyed the house, the surrounding outbuildings on our property, and about an acre of forest next door to our property. I experienced a juxtapostion of feelings; there was gratitude and relief that no one was hurt and the flames didn’t spread to our neighbours’ cabins but the shock and uncertainty was dilapidating as i along with each family member tried to grapple with the situation. We had owned the cabin for just under a year but the connection we had to the place was strong and the sense of loss was significant.

As the days went on, I realized that my experience three years ago helped prepare me for this situation as I began to pivot my mind and explore the positives, shifting my focus to the future. I quickly realized though that my family wasn’t on the same page with me and required more time to process the experience. It once again emphasized how critical it is to talk about challenging situations or write or express the feelings in some creative way. Doing so helps settle the emotions down. It enabled me to be there for them, the way they were there for me three years ago. There was nothing specific or special I said while connecting with my family; I just focused and listened. I provided some feedback, based on my prior experience, when the situation warranted it or when input was invited. As the weeks have passed, the sadness has slowly subsided as I have observed each family member slowly making a shift in their minds towards the future.

A few ideas to assist with challenging moments such as this:

  1. Take the time to process it. Allocate 20 to 30 minutes a day to chat or write. Look at photos; share stories and memories; focus on the way you are feeling.
  2. make self-care a priority. Get out for a walk, have a good meal, spend time with friends, watch a movie, do some mindfulness, etc.
  3. Focus on the next steps. what needs to be done to rebuild or get your life back on track?
  4. Start to explore and highlight the silvers linings. There are always positives! Focus on the moments you are grateful for, no matter how small they may seem.
  5. If the intense thoughts and feelings persist, seek professional support. How someone reacts to a situation is impacted by his/her perception or beliefs which are developed from biology, genetics, temperament and experiential factors.

I look forward to a year or so down the road when my family feels he excitement I feel right now moving back into my apartment. It’s brand new, feels more sturdy, has better sound proofing, and everything has been upgraded to today’s codes and standards. I have realized first hand that challenges can enhance resiliency. As Viktor Frankl suggested, it’s through those challenges we can find meaning and purpose

Posted in Depression, Family & Parenting, General, Grief, Marriage & Relationships, Personal Growth, Stress & Anxiety, Therapy

Five Habits of ‘Anxiety Resilient’ People

Why are so many people struggling with anxiety? This was the question posed to me by a good friend over coffee this week, who was concerned about the levels of anxiety she was seeing in her workplace colleagues.

With all that is happening in the world around us – natural disasters, immigration crises, worldwide political unrest, political shenanigans, housing affordability issues, ethical and moral failures-a more appropriate question might be – Why wouldn’t we be anxious?

According to the Statistics Canada (2012)*, anxiety costs the Canadian government $17.3 billion dollars a year, affecting almost one quarter of the Canadian workforce. Improving accessibility to viable treatment for working Canadians would most definitely be part of the solution. On a personal level. Canadians need to commit to engaging in constructive action to manage anxiety before it becomes debilitating.

Anxiety begins as a normal and adaptive response that can alert us to threat. It is an unpleasant state where we have “a vague sense of apprehension, often accompanied by such autonomic symptoms such as headache, perspiration, palpitations, tightness in the chest, mild stomach discomfort and restlessness”.**It results from anticipation of a future threat, and should be differentiated from fear, which is an emotional & physical response to an imminent threat (either real or perceived). Fear can trigger a full scale “fight or flight” response, but anxiety symptoms are more pervasive, such as muscle tension, hypervigilance, worry and ongoing sleep disturbances, just to name a few. Generalized Anxiety Disorder, Social Anxiety, Panic Disorder, Agoraphobia and specific phobias are a few of the diagnoses given under the “Anxiety Disorders” umbrella when the symptoms become debilitating.

Anxiety symptoms are commonly experienced in normal everyday situations, often if these are outside of an individual’s typical comfort zone. Their initial function is helpful, in that the body and mind are alerted to pay attention to matters at hand. Trouble begins, however, when individuals misperceive what their symptoms mean. thoughts such as “these symptoms are dangers”, and “I won’t be able to function if I become too anxious” elevate and become self-fulfilling prophecies if not curtailed and replaced with truthful cognitions.

Without understanding the function of our symptoms, we may seek to alleviate discomfort by avoiding situations that make us anxious. But in the long term, when the situations are avoided, the greater our anxiety response becomes. Avoidance reinforces anxiety. To overcome it, we must be willing to endure uncomfortable sensations and tell ourselves the truth about them. We must allow ourselves to become comfortable with our discomfort.

What about those people who seem impervious to anxiety? In reality, it’s not that they don’t have anxious symptoms when faced with new or challenging or threatening situations. Rather they may actually use their anxious symptoms as cues to increase their alertness, prepare for the challenges ahead and ultimately “up their game”.

Taking into account learned behaviours and genetic predispositions that may increase one’s proclivity to anxiety, there is much that can be done to step out of the patterns of being anxious. People who are resilient in the face of anxiety tend to:

  1. Recognize their physiological symptoms are just that: Symptoms of increased adrenaline and physiological arousal. they know these will pass.
  2. Maintain awareness of their incorrect misperceptions, challenge them constructively and replace them with more constructive beliefs. They may also limit negative information and media influences, instead looking to sources of information that inspire, encourage and support potential, in themselves and for others.
  3. Offer themselves no excuses. They do not allow their mood of the moment to constrict them. Instead, their motto is similar to that of my 94 – year- old father: “get up, Dress up and Show up!” Despite how they feel, they make commitments and follow through on goals and plans which have been set. Their habits and life choices reflects values of honouring and respecting themselves and others.
  4. Engage in intentional self car. They find ways to take themselves out of stressful life circumstances with activities and people they truly enjoy on a daily and weekly basis.
  5. Not shy away from challenging life circumstances. Rather than procrastinating and letting minor stresses grow into major ones, they deal with problems when still small and manageable . They look for ways to make constructive and meaningful differences in their work, family and community life.

Our normal physiological responses to challenge can limit us, or we can choose to use them to help us take on life’s challenges. The choice is ours.

 

*Global News.ca Anxiety and depression cost the Canadian economy almost 450 billion a year. September 2, 2016.
**Sadock, B.J. & Sadock, V.A. 2007. Synopsis of Psychiatry. (10th Edition). Lippincott Williams & Wilkins, Philadelphia, PA. (p.579)
Posted in General, Personal Growth, Stress & Anxiety, Therapy

My Child Won’t Listen

Parents often complain that their children “do not listen” and that is frequently a concern parents describe when they visit a child psychologist. When I met the parents of six year old Charlotte, they described daily power struggles over routine tasks – getting ready for bed at night – and essentially whenever they asked her to do something. Charlotte’s resistance often escalated into full-blown tantrums that occurred several times a week. This behaviour was disruptive to the whole family and sometimes interfered with family activities. Anticipating conflict whenever they asked Charlotte to do/not do something left her parents feeling tense and largely unable to enjoy their otherwise smart, imaginative and playful daughter.

Learning to comply/cooperate with the expectations of trusted adults (e.g. parents, teachers, coaches) is a critical part of a child’s social – emotional development and is essential to the child’s self image and overall well-being. The child needs to understand that he is cared for by adults whose wisdom and life experience can support him as he grows. Those adults responsible for his well-being also have the right to set boundaries for him and to have expectations of him.

Compliance occurs when a child follows through with an adult’s direction within a reasonable period of time. Defiance, conversely, describes an intentional and often overt resistance to an adult request; for example, when the child says NO and stubbornly refuses to comply. While Non-complicance does not always reflect Defiance, both contribute to frustration and conflict in the relationship between parent and child and furthermore undermine any sense of harmony and wellbeing within the family.

There is good news- Improving Compliance is an achievable goal! These worthy principles can support success in developing better cooperation from your child:

  1. Recognize that learning to cooperate with adult authority is a developmental task. Partner with your child, setting your child up to be successful in achieving this goal.
  2. Ensure that you are in close proximity to your child and have eye contact upon making requests.
  3. Communicate requests that are clear and reasonable for your child – requests that are based upon your child’s age, temperament and skills.
  4. Focus attention on your child’s Compliance = praise his “cooperation”. Help your child see himself as a person who Does cooperate, who Is a “team player”.
  5. Identify the most important requests you have of your child. Avoid “nit picking” and over controlling – allow your child to make independent decisions appropriate to his age and level of development . (This will minimize opportunity for resistance and also allows your child to learn from experience).
  6. Avoid engaging in power struggles with your child. Remember that you are on the same team – your intentions for him are benevolent! You have the right and responsibility for authority and you can respond wisely to your child’s otherwise immature (ie inappropriate) responses. When your child is defiant, understand that as reflecting his immaturity and choose to respond in a calm and authoritative manner – let him know you can handle his poor behaviour (and that you are intent on supporting him developing more appropriate behaviour).
  7. Set Compliance/Cooperation as a Target Goal for you and your child. Keep a record or tally of compliant behaviour and work towards a prize – a privilege, activity together or small gift that can acknowledge both your child’s efforts to Cooperate as well as your effectiveness as a Parent – Child team.

A defiant child can cause chaos not only at home but also at school and elsewhere. The roots of defiance can include the child’s genetic background, his temperament, and developmental history as well as certain parental characteristics. Where defiant behaviour persists, consultation with a child psychologist or counsellor specialized in treating children can be indicated. That specialist would be expected to assess the child, rule out other potential factors, thoroughly conceptualize the reasons for the child’s oppositional behaviour and then work with the family as they support their child’s healthy emotional development.

 

Recommended Reading: Your Defiant Child by Russell A. Barkley and Christine M Benton. Guilford Press, 2013
Posted in Family & Parenting, General, Marriage & Relationships, Personal Growth, Stress & Anxiety Tagged with: , , ,

The Mental Health Boot Camp

Think about it. Your mental health plays a role in EVERY area of your life: relationships, work, physical health, spirituality, even sex. Isn’t it time you made it a priority? The Mental Health Boot Camp is a new and engaging way to accomplish just that.

Created by Joanna Boyd, Dr. Brooke Lewis and Chris Boyd (along with their friend from Los Angeles, Dr. Ryan Howes) the project is the first of its kind and combines the commitment of a traditional ‘boot camp’ with a mental health focus.

The Boot Camp’s comprehensive and varied curriculum is hand-crafted to boost your awareness, self-control, and well-being. Each day you’ll complete 4 or 5 activities that only total the length of one episode of your latest binge program!

The program includes: thought provoking articles, inspirational videos, soothing meditations, and stimulating activities to experience, reflect upon, and integrate into your life. Topics include: psychoeducation on common emotions, cognitive re-framing, character strengths & virtues, Big Five Personality Test, communication, gratitude exercise, acts of compassion, and spending time in nature, and much more! The various strategies utilized in the program have been shown to help decrease feelings of anxiety, sadness and anger.

After signing up, you’ll have 30 days to complete the 25-day program. This is meant to motivate you as the Boot Camp involves a commitment of time and energy to complete. By the time you’re finished, you’ll have an increased awareness of yourself, knowledge of your healthy and unhealthy patterns, and tools to help you live your mental-healthiest life!

This program was designed to boost your well-being and should complement, not replace, existing mental health supports. The program has a cost of $39 USD. To learn more, go to: www.mentalhealthbootcamp.com 

Posted in General, Personal Growth, Therapy Tagged with: , , , , ,

Smartphone Addiction

The headline in the Globe and Mail read, “Your smartphone is making you stupid, antisocial and unhealthy. So why can’t you put it down?” by Eric Andrew-Gee.

As I began to read the article I became alarmed by the research quoted.

Internet companies have spent “billions of dollars” trying o figure out how to hook people into their programs. They have come up with strategies which access the same neural pathways as those affecting gambling and drug usage.

The natural drug that interests the internet industry is a “feel good” one by the of Dopamine. This is a neurotransmitter which is released when the brain “expects a reward or accrues fresh knowledge.” A human vulnerability is being exploited by the internet industry and we are the victims.

Ex-employees of Google, Facebook and Apple have become alarmed by the technology they helped to develop and are now sounding the warning bells we need to hear. One of these past employees was quoted as saying “The short-terms, dopamine-driven feedback loops that we have created are destroying how society works. It is eroding the core foundations of how people behave.”

Professor John Ratey (Harvard Medical School), an expert on attention-deficit disorder, is quoted as saying “We are not developing the attention muscles in our brain nearly as much as we used to.” He went on to say that the symptoms of people with smartphones and those with ADD (Attention Deficit Disorder) are “absolutely the same.”

Research into attention span is sobering. In 2000 the average human attention span was 12 seconds. In 2013 another study found that this time had shrunk to 8 seconds. If the investigation were to be done today, five years later, it is estimated that there would be further decrease. Here is food for thought: the average attention span of a “goldfish” is 8.5 seconds!

Parents need to be particularly cautious with their smartphone usage, as the quality of their relationships with the children is being compromised.

When a mother nurses her baby (or holds a bottle for the little one), there is an opportunity for eye to eye contact with the child; this contributes to the bond between parent and child. It has been determined that, through this interaction, the brain waves of the baby and the mother will synchronize.

Mothers who are distracted with their devices are missing precious moments of bonding with their newborn and only time will tell the impact of this distraction.

Catherine Steiner-Adair, a psychologist, interviewed 1000 children between the ages of 4 and 18. She used the data she collected to write a book entitled “The Big Disconnect” in which she stated that kids said they no longer run to the door to greet their parents because adults are so often on their phones when they arrive home.

Andrew-Gee in his article added “And it gets worse once they’re through the door. One of the smartphone’s terrible mysterious powers from a child’s perspective, is its ability ‘to pull you way instantly, anywhere, anytime.’ (quoting Stiener-Adair).”

“To children, the feeling is often one of endless frustration fatigue and loss.”

Other research findings indicate that “family time” has dropped one third between 2006 and 2011 from 26 hours a month to 18 hours. It was also determined that children are more at risk today due to distracted parents with a 12% increase in injuries for children under five from 2007 and 2010.

Even when families gather, there is no guarantee of healthy interpersonal interactions. A friend recently relayed a situation he observed wile out for dinner with his wife. A mixed generation family arrived and sat at a table nearby. He observed them from time to time and noticed: “They sat around the table and were all engrossed in their phones or tablets for the entire time they were in the eatery.”

I recall dropping into a coffee shop one morning and observing a father with his two kids having a visit together. The kids were quietly drinking their hot chocolate while their father was busy paying attention to his cell phone.

On another occasion, a couple of old friends and I were having lunch in a pub a couple sat down nearby. Once seated there was minimal conversation before the guy pulled out his phone to check messages while his table-mate sat looking bored, more or less twiddling her thumbs.

After a bit, the woman brought out her phone and began to scroll through while the fellow put his away and sat looking bored. He then took his phone back out and they spent the bulk of their time physically present but mentally miles away. An opportunity for some good relationship enhancing interaction was compromised drastically. (And of course I was distracted by what was happening!)

TD Bank is on the right track with a poster it has created for it’s downtown centre in Toronto: “Disconnect to Connect. Put your phone down and be present.”

Posted in Addictions, Family & Parenting, General, Marriage & Relationships, Personal Growth Tagged with: , , , ,

Why do we Lie?

Lying destroys relationships and damages the bonds between human beings.

The Journal of Intercultural Communication Research (2016) states that “we all lie, but not all lies are the same. People lie to achieve a goal: WE LIE IF [we believe] HONESTY WON’T WORK. Essentially the truth comes naturally, but lying takes effort and a sharp, flexible mind. Lying is a part of the development process, like walking and talking. Children learn to lie between the ages two and five, and lie the most when testing their independence.”

While it is a normal developmental process for children to lie, many adults get stuck in the same pattern and do not seem to grow out of a need to lie in order to achieve rewards or avoid perceived punishment.

Below is a list of possible motivations for lying.

TO PROTECT YOURSELF:

Personal Transgressions:                         Cover up a mistake or misdeed.                        22%
Avoidance:                                                 Escape or evade other people.                         14%

TO PROMOTE YOURSELF:

Economic Advantage:                               Gain financial benefits                                        16%
Personal Advantage:                                 Bring benefits beyond money                             15%
Self-Impression:                                        Shape a positive image of ourselves                    8%
Humour:                                                     Make people laugh                                               5%

ALTRUISTIC:                                            Help people                                                            5%

UNKNOWN:                                              Motives are unclear, even to ourselves                 7%

SOCIAL OR POLITE:                               Uphold social roles or avoid rudeness                   2%

MALICIOUS:                                              Hurt other people                                                  4%

PATHOLOGICAL:                                      Ignore or disregard reality                                      2%

The research of David Leys PHD. (Psychology Today) can also help readers gain some insight into the way liars think.

“Believe it or not, their lying makes some sense, when you look at it through their eyes.

  1. The lie does matter…to them. People lie when it just doesn’t matter because they actually do think it matters. While everyone around them thinks it’s an inconsequential issues, the liar believes it is critically important.
  2. Telling the truth feels like giving up control.  Often, people tell lies because they are trying to control a situation and exert influence toward getting the decisions or reactions they want. The truth can be “inconvenient” because it might not conform to what they are trying to achieve.
  3.  They don’t want to disappoint you. It may not feel like it to you, but people who tell lie after lie are often worried about losing the respect of those around them. They want you to like them, be impressed, and value them. And they’re worried that the truth might lead you to reject or shame them.
  4. Lies snowball. If you tell a little lie, but then to cover that lie, you tell another one, then another, and another – each gets bigger and bigger. Finally, we’re arguing about the colour of the sky, because to admit anything creates the potential of the entire house of cards tumbling. If a chronic liar admits to any single lie, they feel like they’re admitting to being a liar, and then you’ll have reason to distrust them.
  5. It’s not a lie to them. When they say something, it’s often because they may genuinely believe, at that moment, that it is the truth. Their memory has been overwhelmed by stress, current events, and their desire to find a way to make this situation work. Sometimes, this can become so severe that the person almost seems to have created a complete alternate world in their head, one that conforms to their moment-by-moment beliefs and needs.
  6. They want it to be true. Finally, the liar might want their lie to be true so badly that their desire and needs overwhelm their instinct to tell the truth. Sometimes, liars hope that they can make something come true by saying it over and over.”

Most people who lie may not be aware that others see through the facade of their lies. This is an entirely different subject to be addressed and begs the question of why the recipient of the lies does not compassionately address their loved one’s lies? It is likely for the same reasons the liar lies. To avoid conflict, deny reality, or having to confront an uncomfortable situation.

Facing the truth of why we lie and becoming dedicated to dismantling this behaviour allows us to stop hiding behind a cloak of desperation and fear. We learn how to become an honest and authentic human being. If you recognize yourself or a loved one who engages in these behaviours, consider getting therapy to stop the devastating cycle that destroys integrity, safety, trust, marriages and relationships.

 

Posted in Depression, General, Marriage & Relationships, Stress & Anxiety, Therapy Tagged with: , , , , , , , , ,